I am not sure what just hit me. By all rights, I should be flying high right now. COVID numbers have steadily decreased over the last few months. The extra ICU has remained close. I am well vaccinated. The vaccine efficacy data so far has shown an excellent response. Most of my elderly patients have at least received their first vaccine. My in-laws and my mother have now received both their shots. I took a few days that had been slated to work in the ICU to go see my mother and had a nice visit. To top it off, I was recently honored to receive the Joe Ansty Award for clinical excellence for 2020 at my hospital, Missouri Baptist. Knowing that my peers at the hospital saw and recognized the efforts of me and my supporting team this last year was very emotional for me. Yes, on all fronts, I should be in the very best of spirits.
The reality is that I have been more physically, mentally
and emotionally exhausted than at any other time of my career these last two
weeks. Work at the office was busier
than normal. I had twice usual the
number of patients in the hospital to take care of. It seemed that I was having end of life
discussions every single day. Most of
these patients I have known for more than 20 years. It was disheartening to navigate through the
stormy seas of COVID to then tell a patient that they were dying of cancer, a
stroke or of heart disease. At the
office, it seemed that I was being pulled from all directions. On leaving a
patient room there were times when my secretary had the ER on the phone, my
assistant had a question and my nurse practitioner needed help with a patient
she was seeing. From the second I
entered the hospital in the morning, I felt that I had to be totally engaged
and “on my game.” It wouldn’t let up
till late in the evening. Even then, the
hospital would call, sometimes all through the night.
“How,” I asked myself, “could I go go go all year long only
to struggle now that life was getting back to normal?” In my moments of reflection, I recognize some
of the reasons for this. First, when the
adrenaline is running high and the stress levels are increased, I tend to function
pretty well. It is when I let down my
guard that I am prone to a letdown. I don’t think I realized how tired my body
truly was from the year long stress.
Secondly, I am truly just busier than normal at work. Some of that was a back log of issues that
were building from having to cancel clinic days to work in the hospital. Some of it is from patients who have been
keeping issues on the back burner and they are now feeling comfortable coming
to the doctor to be evaluated. My
patient panel is getting older. My many 70-year olds are now 90. As much as we as doctors try to prevent
disease, all of us are mortal.
I frankly have hesitated to share what I have been feeling.
After my blog on COVID Fatigue, one of my former patients, a retired
psychiatrist, reached out concerned that I was headed for a mental
breakdown. I have decided to go ahead
and post this, suspecting that I am certainly not alone in having stress this
last year. Taking the time to describe
my feelings is a step towards healing. The last two days at work have been
decidedly better: busy, but normal busy.
It has been such a blessing to come home to a supportive wife who has
always been there for me. My faith has certainly
been sustaining. I am buoyed by prayers in my behalf. Focusing on my blessings
helps. Making time to exercise is my
therapy time. It is therapeutic both mentally and physically. Lastly, as much
as it wears me down, I truly do love my job.
What a privilege it is to be a partner in a patient’s life journey. The truth
is that you and I can allow external forces to determine our demeanor or we can
look past the darkness and allow the light of God to prevail in our lives. All
of us have been beaten down this last year.
Let’s focus on what will keep us on the path to brighter days.
