We are all traumatized by the unfathomable devastation caused by the coronavirus. What can we expect as a result of this national and worldwide trauma?
The trauma approach uses posttraumatic stress disorder (PTSD), as a frame to understand trauma. PTSD is a normal reaction to abnormal situations, which can be ongoing, according to the American Psychological Association. It is normal, not abnormal or pathological, to feel emotions, even extreme ones, from abnormal events. This can include distress, anxiety, depression, feeling alone, loss of ability to feel, inability to enjoy life, pessimism about the future. It can include lack of ability to concentrate, trouble being productive at work, trouble sleeping, flashbacks, memory loss, avoidance of circumstances, and people associated with the trauma, or trouble with relationships. Physical symptoms of increased arousal (heart rate, breathing, blood pressure, etc.) are often present. PTSD can occur immediately after the trauma or after a long delay, even years.
Sometimes trauma survivors don’t know what to do with all of these emotions, which may be quite strong and can spill over into behavior. Survivors often have impulses to “act out” and behave in out of control ways (explosive temper, substance abuse, violence, avoiding certain places, people, or experiences, startling easily, etc.). Survivors sometimes “take it out” on others around them with yelling, abuse, or hated. Sometimes they are just angry all the time. We are currently already seeing spikes in partner and child abuse. People must control themselves for their own well being as well as others.
Most doctors have at least some familiarity with these basic aspects of trauma. But typically, it is trauma that is happening to the patients. Currently, trauma is also happening to doctors directly. They live here too, and something terrible has happened. And it is worse for those on the front line.
Our doctors have stepped up incredibly. I understand this is what they were trained to do and what is expected of them. Other health care professionals have also answered the call to duty. Although I focus on our doctors in this essay, all of these professionals are placing their lives on the line for the rest of us. Some of them are sick, and some of them have died.
My article, “No one cares about the doctors,” is a compilation of statements made by interviewees for my book. One of them said, “We are used as pawns in the system. No one cares about the doctors.” I concluded that “If this isn’t what we want, we need to rethink how we treat our doctors and start caring about them again.” Not only have we not rethought anything, but we have called them into extraordinarily demanding, dangerous service, with inadequate backup, such as protective gear and personnel. And they have risen to the occasion. But they have also noted the unreasonableness of this situation.
There are so many noteworthy articles on this site written by doctors. They talk about their own fear. Working in chaos. Being afraid to die. Grieving so many concurrent deaths. Struggling to balance home and work. Terrible pressure and stress. Fear of getting fired if they speak up about the lack of PPE and the untenable working conditions. And in one essay, Dr. Candace Good says, “The lucky doctors who find mental health care will live with a new fear—that their treatment will interfere with their ability to practice. Credentialing applications, state medical boards, and malpractice carriers often ask antiquated and illegal questions.” And the shockingly accurate essay, “How dare you America?“, asks that very question. Who cares about our doctors?
Something is terribly wrong with this picture.
So what are we, the American people, going to do about this travesty when we come out on the other side of this nightmare? What are we going to do when all of the parades, group cheers, shows of solidarity, and signs are done? When all of the fundraisers for supplies are closed? Are we going to continue to treat our doctors with such disrespect? Although we are all familiar with the saying, “Those who do not study history are doomed to repeat it,” we repeat history all time. Psychiatrist Judith Herman’s tells us about our desire to “forget” about trauma. Trauma survivors want to forget, observers want to forget, and society as a whole wants to forget. It is too painful to remember. So, are we going to learn anything from this pandemic? And will we remember, or forget, the selfless sacrifices of our doctors? Or will we just go back to our previous ways of behaving towards them? Will we continue to vilify them and blame them for things that are not their fault? Will the doctor shortage continue to worsen because fewer and fewer people want to sacrifice so much for so little in return? Will we continue to regard them as the enemy?
In my essay, I said that Margaret Mead was right: “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” We — me and you — are that small group. We have to create a change in how our doctors are viewed and treated. We need to reach out to the public and call them to action, as partners in making this change. This is a tall order, given how exhausted and traumatized our doctors will be on the other side of this nightmare. But, I just don’t see another way around it. The public needs to care about our doctors so that they can care for us. This needs to be part of the national conversation about health care. Our lives depend on it.
Peggy A. Rothbaum is a psychologist and can be reached at her self-titled site, Dr. Peggy Rothbaum. She is the author of I Have Been Talking with Your Doctor: Fifty doctors talk about the healthcare crisis and the doctor-patient relationship.
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