COVID Letdown

 

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.