COVID and mental health awareness in health care


I wake up in a cold sweat. It’s 4 a.m.

“Are you awake?”

The text goes to one of my colleagues and best friends. I call him brother. He responds as calmly and kindly as he always does.

“Sure, what’s wrong?”

I don’t know where to begin. I feel stuck in a nightmare surrounded by drips filled with jet fuel, antibiotics, and sedatives.  I see the face of my most recent COVID-19 patient, fighting for his life when only hours ago, he was laughing and making jokes.

“I just don’t know if I’m doing the right thing for these COVID patients, I am trying but it’s not going well. What am I going to tell his family?”

I proceed to profess how afraid I feel, plagued by sleepless nights and anxiety, praying for him and checking his chart even in the moments I’m away from the hospital.  My friend quietly reassures me, assuring that I am doing all that I can in a time of unprecedented obstacles and unknowns, and I drift back into a comforted and much needed hour of sleep.  The sky is painted with rosy hues of red and orange as the sun rises across a mountainous silhouette, and my first COVID-19 patient slips into eternity, and I sit paralyzed and perplexed at the juxtaposition of such a glorious sunrise in such a dreadful moment.

As the sun set, I reflected on why the death of this patient had impacted me so profoundly.  After all, I have been in this place before. Holding mothers as their children lay dying, crying on the floor, praying on the phone. Gut-wrenching collapses and screams that pierce like sirens at the loss of a loved one. I have seen race, religion, and politics all wither away in the face of death, the great equalizer, as we simultaneously hope for yet another breath.  However, somehow this one felt different.  Maybe it’s the fact that there is so much attention brought to this issue, the fact that the whole world seems to be watching.  Although the emotion seemed much more rudimentary and raw than a mere fear of public opinion, and then my thoughtful trance was interrupted by a commercial in a distant television, reminding us that May is mental health awareness month.  Oh.

Mental health awareness. Health awareness. Awareness. I dissect these words meticulously in my mind as I reflect on the recent tragic loss of Dr. Lorna M. Breen, an exceptional ER physician in New York who was on the front lines of the COVID-19 pandemic and died by suicide. Today, in a pandemic, I am not just worried about my patients, I am also worried for my fellow health care providers.  We are all fighting the unknown, the unforeseeable.  As I read the article, I felt a deep sorrow, because this song is also a familiar one.  You see, in my short time of being a physician, I have known three fellow physicians who have taken their own lives.  I finally realized the depths of the trench of mourning I was sitting in. I myself have known darkness so thick and suffocating after the recent murder of my grandmother, Sadie Roberts-Joseph.  I, too, have tread such tumultuous waters that a path forward seemed impossible to navigate.

Physician suicide is not a rare occurrence, and unfortunately, the perfectionist filled health care field remains relatively unforgiving of any misstep, fatigue, or mental instability. So, what is there to gain from the fear and loss that we experience during this pandemic? Perhaps it is a single beam of light illuminating the darkness that many are facing now and were facing before, a patience, a kindness, an empathy that we may have lost but now can be inspired to regain.  Mental health awareness means that many who struggle in silence no longer have to.  That we are, in fact, all in need of support and community. That it is OK not to be OK. That is the power we can gain from this wreckage, a power we can carry into the future.

Leah Machen is an internal medicine physician.

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