Dr. Back knows what health care providers first and foremost. They need to “power down, renew, reboot.” But can they?
Dickens believes they can. “The medical profession is resilient. But there probably will be some mental issues. This is where we’re walking into a completely foreign land and we don’t know. We don’t know how we’re going to reopen. We don’t know what that’s going to look like. There’s just so much we don’t know. And as a species we really don’t like that.
It’s not uncommon to get out of sorts and we take it out in a number ways.
And yet we can also share our fear, our sadness. I’ll be walking down the street and burst into tears for no apparent reason. But there is a reason. So it doesn’t feel good at the time. I get quite scared that I’m not going to stop crying. I’m never going to get out of this. What am I going to do?
But if you share with me that you are thinking this too, then it becomes normal processing. We shouldn’t push it down because this is normal. And to me, that’s the important part. We’re not denying it. We are all sharing because we’re in this together.”
I asked her, “What are some other methods that can help health care providers cope mentally?”
How does one become grounded?
Dickens answer reminded me of Dr. Back’s comments. “It’s relatively simple. Let’s wait a minute. Let’s slow it down. Let’s slow this down and really look at it. Let’s really feel what this is like right now in the current moment.”
A surgeon Dickens worked with was in trouble because ‘he didn’t say hello that often and he wasn’t that friendly.’
She remembered when he turned to her and said, ‘Hey, this is how it is. I go to bed. If it’s your father that needs to have the operation in the morning, I say to myself, okay, well I’m going to do this, this and this, and if that doesn’t work, I’m going to go to plan B and I’m going to do this, this and this. And if that doesn’t work, plan C and D and so forth. I go to bed and I wake up, I brush my teeth. I think the same thing again, plan A, B, C, D. I kiss my family goodbye, get in the car and I go through the plans all over again. And then on the way I think all right, what about E? That’s when I walk through the door and everybody wants to say ‘hi,’ I’m still running through A, B, C, D and now E because I have to go into surgery and save this man’s life. And that where my mind is.’
“At first he didn’t understand why people were upset with him,” clarified Dickens. That’s when working with a therapist like me is critical because we’re not attached to the hospital. Not in administration. Not an EAP program. It’s all confidential. Health care providers are not going to go home and tell their spouses because that just adds to the load. And by the way, it’s not important right now. Right? At least that’s what they think.
Dickens explained to me that one step a surgeon can do to mitigate this appearance of lack of caring is to let the patient and family know you won’t be talking. Tell them in advance that when you walk in, you’re going to be in your surgery mode.
“We can all respect that. I like to think that there is some level where we can find our commonalities, find that human part of us. In reality, we are all just the same. We need to be connected, we need to be heard, we need to be understood.”
Dickens reminded me “We’re always trusting them. Who are they going to trust, who are they going to turn to? So the more that we, the therapists, can pay attention, I think the more efficient, accurate, cohesive and collaborative health care will become.”
But that begs the next issue. The American Journal of Psychology noted some concerns being raised that people in general are going to their therapists or finding therapists to talk about the state we’re in, whether it’s grief or fear or both. And what concerns me when I read this is, who’s going to help the therapist? And what do you do to help you to do self-care?
“I have a little routine, says Dickens, because us humans like routines, right? I meditate, I journal and I read every morning. But I also have consultant groups with whom I share my concerns.
As a therapist I may not fully understand how you feel. But tell me more. Tell me about your grief or your pain or your fear. I then realize, I have the same thing. But maybe that’s the beauty of it. When I’m helping someone else and we do it together, I understand the big message. We really are in this together.”
“Do you have any last words? No pun intended,” I asked Dickens with a chuckle.
“Oh, that’s a very good question, she replies. I love the quiet that the world has created. Yes, it’s lovely and I’m wondering, how do we get back on track. Of course, we’re going to all try to do our best, but let’s not lose that thread of reconnection. Can we continue the slow-down of life? Can we just stay with the truth of it.”
Let’s all “Power down, Renew, and Reboot” because we all know better now.
Dr. Anthony Back is a co-author of Mastering Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope along with Drs. Robert Arnold and James Tulsky .