Carry on, my weary one: Persevering in the aftermath [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

“Frontline workers may have temporarily experienced a heightened sense of personal success and gratification, but I doubt many of us are still able to feel satisfied at this point, after all the repeated moral injuries and losing so many patients. COVID-19 assuredly changed me. The virus changed my residency experience. It changed the hospital, and it changed the entire world. As Prime Minister Boris Johnson recently stated, ‘We simply cannot revert instantly … to life as it was before COVID.’ We must try our best to carry on, cautiously, into the new unknown era of vaccines and virulence. For me, that means wearing a mask in public long after restrictions are gone.”

Elizabeth Sarah Haberl is a resident physician.

She shares her story and discusses her KevinMD article, “Carry on, my weary one: Persevering in the aftermath.”

Did you enjoy today’s episode?

Please click here to leave a review for The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out!

Do you know someone who might enjoy this episode? Share this episode to anyone who wants to hear health care stories filled with information, insight, and inspiration.

Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Elizabeth Haberl. She’s a resident physician, and she wrote the KevinMD article “Carry on, my weary one: Persevering in the aftermath.” Elizabeth, welcome to the show.

Elizabeth Sarah Haberl: Thank you for having me.

Kevin Pho: We’ll get into the article in a little bit, but first off, can you share your story and journey to where you are today?

Elizabeth Sarah Haberl: Sure. I was born in College Station, Texas, and I ended up staying there for my undergraduate training. I initially thought I wanted to be a veterinarian, but I realized I enjoyed playing with kittens more than actually treating them, and I found myself headed towards human medicine. I was lucky enough to pre-match into McGovern Medical School, and it was a great experience. I met a lot of wonderful people along the way. I couldn’t have done it without my friends’ and family’s support.

When I entered medical school, I may have entered with a little bit of a closed mind. I thought that I was destined for surgery or emergency medicine and wasn’t as open-minded towards the other specialties. But I was lucky enough to match into a general surgery residency, and I completed three years of that, and I’m currently on a year of research and reapplying to diagnostic radiology, and I guess we’ll see how that works out.

Kevin Pho: All right, so tell me about that potential transition from surgery to diagnostic radiology.

Elizabeth Sarah Haberl: Well, it’s been interesting. I was very thankful that they allowed me to take a year of research, and it’s been a massive change of pace from surgery residency. I was grateful to have time to sort of reflect on the last year, which has been a whirlwind for everyone, and have time to write again, because I enjoy creative writing.

I think the main thing that’s common between a lot of surgeons and radiologists is the love of anatomy, and I’ve always loved the visual aspects of that. Surgery is certainly grueling, and it’s tough to be a female in surgery, and I think that I’ll just be a better fit in diagnostic radiology. I look forward to seeing the anatomy in a different way, and it’s certainly helpful to have been in surgery and seen it in a different way.

Kevin Pho: So as we reflect, as you said, on your surgery training over the last few years, especially during the pandemic over the last 18 months or so, tell me, what are some of the challenges that you faced?

Elizabeth Sarah Haberl: It’s been just unbelievable. Looking back, with the first surge, no one really knew what to expect. Cases were shut down, and we thought we shut down too early, and then the hospital lost millions of dollars. So for me personally, we ended up not having as many cases, and I found myself not really missing the OR as much as maybe a surgery resident should, so that was one eye-opener for me.

And just the burnout between all residents and nurses and RTs was so obvious, especially the second surge that came in January of this year. And then to add on top of that, we had this unprecedented winter storm in Texas that knocked out power, and people were risking their lives driving to the hospital on ice, and it was tough.

I have a lot of friends that are nurses, and they have really had to be full of resilience and grit to keep coming to work, and I’m thankful for all the people that have truly been on the front lines. As I mentioned in the article, as a surgery resident, we have some exposures in the trauma bay and the operating room, but not nearly as many as folks in the ICU.

Kevin Pho: Now, you mentioned that the burnout among your health care colleagues was so obvious, especially during the storm and during the pandemic. So if you could paint us a picture, what kind of symptoms did you notice that made you realize that your colleagues were so burnt out?

Elizabeth Sarah Haberl: Most of the time, it was from conversations with my nursing friends, that they honestly were considering transferring hospitals, or sometimes to the point of leaving medicine altogether. I saw a lot of Facebook posts throughout the pandemic of all my nursing friends really hit hard. There was a point where we thought we wouldn’t have enough PPE, and we were saving every N95, and I think it just wears on a human after a while.

People would show up to work really kind of emotionally exhausted and tired, and not as much empathy with the patients and families, because a lot of families would just get angry at us because they couldn’t come in. They couldn’t visit. And it’s tough to continue to be patient with those families and communicate with them via phone calls every day, and that’s all you can do during the pandemic, although now they’ve allowed more visitors, so it’s getting a little better.

Kevin Pho: And from your observation and to your knowledge, anything that the hospital or administration did to help alleviate some of those symptoms of burnout that you observed among your health care colleagues?

Elizabeth Sarah Haberl: Yeah, they’ve tried. It’s certainly tough on a large scale to provide resources for everyone, but they created this little oasis with snacks and waters and different things to allow people to rest. There have been a lot of rooms with the massage chairs, and I think it’s encouraged for people to take a five-minute break if they need it, if they’re reaching that point. I think there are sometimes that you feel like you truly cannot, but they have tried, and they certainly encourage mental health and reaching out for help if you need it, and they have some counseling resources.

But I think the biggest thing is dismantling the stigma around mental health as a provider or a nurse or RT, and not being seen as weak if you do need to reach out for help and get counseling or therapy.

Kevin Pho: All right, let’s talk more about the KevinMD article that you wrote. It’s titled “Carry on, my weary one: Persevering in the aftermath.” Now, for those who didn’t get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?

Elizabeth Sarah Haberl: Sure. So I kept going back to the image of seeing two dead bodies at the same time in the COVID unit. It was rather shocking and powerful to walk by and see, first of all, all of the bodies that were barely alive, and then two bodies at the same time. I’ve seen plenty of people pass and pronounced a few deaths starting as a PGY-2, but I’ve never seen two people at the same time. And there was no separation between the patients. It was just all one unit without rooms or curtains, and so we could see all of them at the same time. I was walking around with the thoracic surgeon.

It just was really one of those images that’s burned into your brain, and I kept thinking about that and sort of decided to expand on that, and recalled seeing the nurses and just looking at their eyes and how weary they looked, with their wrinkled masks, and every day showing up 12 hours, not being able to take their masks off, and just went from there.

Then I decided to focus on sort of what we went through in central Texas with the ice storm as well and turn it into a public awareness of the mental health of providers and health care workers, and found some great articles on that. And then I was lucky enough to have my sister paint a pastel image of me during the pandemic, and thought that adding that would make it more powerful.

Kevin Pho: So for those who read your article, what would you say is the main message that you want to convey? Certainly among clinicians, we are certainly aware of the burnout in our profession, but for those who may not be involved with medicine, it’s a little bit of a hidden characteristic of the burnout, the stress, and everything that health care professionals are going through. So talk to those who may not be involved in health care. What’s the main message that you want to convey?

Elizabeth Sarah Haberl: The main message I’d like to convey is truly to be kind to everyone you interact with. You have no idea what they’re going through that day or that entire year, and you can always control how you react in a situation. Obviously we can’t control anything in the universe right now, it seems like, with oil spills and pandemics and everything going on, but you can always control how you treat others.

And I think that goes for physicians, how they treat nurses, and how patients treat providers that are only able to give them a phone call and only allowed to have one person enter the hospital. You can always be patient and kind and try to have empathy for the person in front of you, even when you’re tired and it’s tough.

Kevin Pho: Are you seeing an increasing frequency of hostility between health care workers and potentially patients and their families?

Elizabeth Sarah Haberl: We definitely saw some hostility from family members towards residents and the people making the phone calls. “Why didn’t you call earlier?” or, “Why did I not get a phone call yesterday?” And it’s hard to explain to them everything that’s going on with the other patients in the ICU or everything else.

I don’t think I’ve seen too much necessarily between health care workers, but I think that when everyone is exhausted, it’s just easier to react in ways that you wouldn’t normally. And I hope that people continue to take care of themselves and take days off when they need to, if they’re feeling burned out, rather than coming in and just having poor interactions with everyone they work with.

Kevin Pho: So physicians and medical students, we’re conditioned to tough it out, right, and not recognize symptoms where we need a day for behavioral health, or recognize symptoms of burnout. Now, how do you fight against that perception, where physicians are conditioned, and especially stereotypically in surgery residency, to kind of fight through every single obstacle?

Elizabeth Sarah Haberl: Yeah, I think the best way to start is talking about it and encouraging it and normalizing it, and just talking to even people at your same level, getting close with them, being vulnerable, and saying, “Hey, I went to see this counselor lady, and it’s not a big deal. You’re not weak. I just needed someone to talk to.” And then the more you normalize it and encourage it, which also requires having leadership that encourages it and gives you time to do that, I think that it will become less of a stigma.

It’s tough, because there’s not always a ton of resources. We’re lucky at Scott and White to have a counselor that’s free for physicians and confidential, almost any time, and you can just go talk if you need to. But I don’t know if all hospitals have that, which is unfortunate. But I hope that residents and everyone that has gone through this unbelievable trauma of the pandemic and the ice storm now realize that mental health is really important for everyone, for nurses, RTs, janitorial staff. It’s been a hell of a year.

Kevin Pho: We’re talking to Elizabeth Haberl. She is a resident physician, and she wrote the KevinMD article “Carry on, my weary one: Persevering in the aftermath.” Elizabeth, you mentioned as part of your story that you were a surgery resident and you’re going to switch in the next year or so to diagnostic radiology. Now, for those other physicians who also may be thinking of switching specialties, what kind of advice do you have for them?

Elizabeth Sarah Haberl: Sure. It’s a big decision. Certainly take time to think about it. Weigh the pros and cons. Talk with your friends and your family, people that knew you best, maybe before you even started that specialty training, or whatever level you’re at right now. And if you’re truly unhappy and you feel that you don’t fit and this isn’t your calling, then I think it’s OK to just risk everything.

It is very scary, I must say, to sort of uproot your life and go away from the path that you were on. But I think that if you can see yourself in that other specialty and see your future better there, then it’s probably worth it.

Kevin Pho: And my final question, what’s your take-home message that you want to leave with the KevinMD audience?

Elizabeth Sarah Haberl: Respect is so important for all providers and all levels of training in medicine. If you respect your co-residents and you respect your nurses and your respiratory therapists, it becomes a team, and that’s so much better for the patient. But also respecting yourself and taking the time you need to rest and reflect and do whatever you’re passionate about. For me, it’s writing and artwork, but it’s different for everyone. So respect others, respect yourself. Carry on, my weary ones.

Kevin Pho: Elizabeth, thank you so much for sharing your time and insight, and thanks again for being on the show.

Elizabeth Sarah Haberl: Thank you so much.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes