At one point, many of us will ask the questions, “Am I going to die? Am I safe? Who can I count on? It could be as you face your mortality or find yourself in a dangerous situation. Or, as it has been for many frontline health care professionals while facing a job-related risk like contracting COVID-19. Medical professionals are not the only ones who have experienced high levels of fear, anxiety, anger, and depression stemming from the global COVID-19 pandemic. We all did, and those emotions were only made worse by the isolation, uncertainty, and disruption to our lives caused by the pandemic. There was the constant risk of becoming infected with COVID-19 and pressures stemming from remote working and learning, as well as childcare and eldercare challenges. For many, harsh economic challenges arose from having lost their jobs.
The fears and anxieties associated with my role as a pediatric neurosurgeon are those related to my patients’ lives I have put at risk during the past 20 years. I have had many sleepless nights not thinking about the hundreds of children that had great outcomes, but the 1-2 each year for whom I may have made an honest mistake, or their disease just won. In my 20-year practice, I can count over 40 children that I still blame myself for their untoward outcomes. I am constantly beating myself up over these children, which causes me both mental and physical pain.
In the late 1980s when I was a medical student and then in the 1990s as a resident, the human immunodeficiency virus / acquired immunodeficiency syndrome (HIV/AIDS) was at an epidemic stage. Like other medical professionals, I feared contracting HIV/AIDS without knowing how it was diagnosed, managed, or prevented. Back then, there were limited antiretroviral therapies. As a resident, I was working extraordinarily long hours as the federally mandated ACGME 80-hour workweek duty standards were not yet in place. I was routinely exposed to percutaneous needle injuries and blood exposures. I underwent HIV testing numerous times, which always was accompanied by anxiety, waiting for follow-up 6-month testing, and taking a toll on my mental and physical health.
The last decade presented an opportunity for me to learn something from the commercial fishing industry about life circumstances where we experience fear and anxiety. In 2009, I was privileged to work on the F/V Miss Colleen, a commercial salmon fishing gillnet boat in Bristol Bay, Alaska. Then, in the fall of 2019 and winter of 2021, I was fortunate to be a deckhand on the F/V Saga, a commercial crab fishing boat in the Bering Sea profiled on the Discovery show Deadliest Catch. Both experiences had a profound effect on me and taught me how to switch from a “my life is at risk” mentality to one focused on preventing mistakes from happening through teamwork and effective communication. It occurred to me that there is no room for error in both the health care and commercial fishing industries. Both giving a patient the wrong medication or going overboard in rough seas can lead to death.
Commercial fishing is recognized as one of the world’s most dangerous occupations. According to the National Institute for Occupational Safety and Health, there were 117 deaths per 100,000 fishing workers from 2000-2015, 29 times higher than the average U.S. workers (i.e., four deaths/100,000). On the popular television show, Deadliest Catch, many gained an awareness of the Bering Sea crab fishing industry. I learned firsthand as a commercial fishing worker just how physically and mentally agonizing the work was. But I also learned that feeling of being safe equals freedom. And I became acutely aware of how important teamwork, communication, and connecting at the heart are in those circumstances and that to be effective, you need to develop compassionate, supportive relationships with your teammates. Everyone must have each other’s back to keep each other safe. One mistake could result in the death of the entire crew. To ensure safety while completing the tasks at hand, each team member must understand the strengths and weaknesses of the others.
Often, I wonder what makes a great commercial fishing boat captain, physician, or leader. Many successful leaders desire to succeed, yet they also possess humility and respect for and trust in others. They lead by example and not just words, even when facing high-risk and even life-and-death situations.
Fishing on the dangerous, unrelenting Bering Sea makes you understand your mortality and just how precious life is. You appreciate the value of fostering teamwork and communication as you are constantly faced with death. In life, developing loving relationships, being there and showing up for others, and connecting at the heart with each team member are critical to combatting fear and anxiety that accompany the goal of keeping everyone safe while still catching your crab quota.
These are unprecedented and challenging times as we continue to grapple with the pandemic and its aftermath. I am continually in awe of the collective selfless response of those serving on the front lines – not just our health care workers and first responders but also utility workers, truckers, grocers, and other heroes. We have made tremendous progress due to their contributions, while our mental and physical fortitude has been tested and will continue to be tested, along with our ability to endure the new normal and remaining uncertainty of what will happen next year and thereafter. But, if we think like commercial fishing workers, like teammates entrusted with each other’s lives and well-being, and remain like bamboo, flexible and resilient, we will endure. We need to listen, learn, and heal with each other to achieve a healthier, peaceful, and purposeful life with optimum performance in mind, body, and spirit.
Anthony Avellino is a pediatric neurosurgeon and the author of Finding Purpose: A Neurosurgeon’s Journey of Hope and Healing.