At its core, medicine is about a relationship between patients and health care workers. This bond between the sick and those who care for them transcends conventional boundaries and restrictions. Health care workers often witness the most profoundly intimate moments of complete strangers’ lives. We see patients in their most raw and vulnerable states. Patients, in turn, allow us into their lives and put their health and welfare in our hands. Like any good relationship, this one is based on mutual trust.
Over the past year, the COVID-19 pandemic has strained this relationship to its breaking point. Health care workers are utterly depleted physically, mentally, and psychologically. But at the root of our exhaustion is a sense that the trust that sustains our connection to our patients has been broken. When the pandemic first hit almost a year ago, there was an appreciation of partnership between those who worked in health care and the general public. Health care professionals continued to show up and care for the sick, despite the risk of contracting and transmitting a potentially fatal virus. In return, everyone else endeavored to do their part by quarantining, slowing transmission, and keeping hospitals from becoming overwhelmed. Health care workers were called heroes. Video tributes to frontline workers populated the internet. People donated supplies and sewed homemade masks to ensure that we had adequate personal protective equipment at work. It was a difficult time for everyone, but this difficulty was mitigated by the sense that this was a shared struggle and that we would all help one another.
But this sense of community would not last. Society could not tolerate prolonged isolation and restrictions. People began to chafe at admonitions to wear masks and avoid social contact, despite growing evidence that these were the most effective measures to decrease disease transmission. Misinformation proliferated rapidly. Instead of tributes to health care workers, the internet was now populated with conspiracy theories regarding the virus’s origin, distribution, and severity. Soon, what should have been a public health crisis became a political one. Elected leaders openly challenged the recommendations of scientists and health experts. The President of the United States publicly accused doctors and hospitals of misreporting COVID-19 fatalities for financial gain. After several months, there was a prevailing sense that Americans were simply tired of doing this.
But the virus did not get tired. As patience with social distancing waned, COVID-19 continued to surge all around the country. Hospitals in both major urban areas and remote rural locations were overwhelmed as they struggled to care for sick COVID-19 patients on top of all the other medical maladies that keep our system close to capacity at baseline. Being constantly exposed to infectious patients, health care workers were unsurprisingly much more likely to fall ill from COVID-19 themselves. Many hospitals and practices experienced staff shortages, forcing other employees to work more in the place of their ill colleagues.
The personal toll that this year has taken on those of us who provide care is difficult to quantify. Out of fear of transmitting a deadly disease to their loved ones, many who work in health care have spent long periods of time physically isolated from their friends and family. Despite the efforts and sacrifices that these professionals have made for their patients, COVID-19 continues to spread at an unrelenting pace. The job that we once loved for its human contact has now become a demoralizing slog of attempting to provide patient care from behind plastic gowns and face masks. The public who called us heroes now seems steeped in misinformation, distrust, and conspiracy theories. In the news and on social media, we face a barrage of disrespect, attacks, and even threats of violence from those who believe us to be complicit in a nefarious plot to use this disease to undermine individual liberties. During this past holiday season, exhausted health care workers, many of whom have not seen their own families in almost a year, watched as millions of Americans traveled to and from COVID-19 hotspots to have unmasked gatherings with their family members in unventilated, indoor spaces.
It is difficult to say where we will go from here. Even when COVID-19 has finally abated, there will remain a lingering sense of mutual distrust between those who work in medicine and the public at large. Ultimately, this job is probably not worth doing without the profound human connection that has become so frayed in the past year. I fear that many seasoned practitioners will burn out and leave medicine altogether. There will always be a demand for medical care and thus a role for those willing to provide that care, but there is something special that has been lost in this connection during the past year. As with any damaged relationship, it will take time to repair.
Brendan James Flanagan is an emergency physician.
Image credit: Shutterstock.com
