As our health care system teeters yet again on the brink of collapse, the big questions on so many of our minds are: What does our future hold for us as physicians? What is our path forward?
As physicians, we currently live and work in a constant state of crisis. We’ve seen record numbers of patients, experienced personnel shortages, and instituted crisis staffing and standards of care. We’ve cared for patients under conditions that we’ve never experienced in our privileged and wealthy nation.
And the questions continue to arise. When will these conditions end? Can health care continue as we know it? And how long can we physicians bear the daily strain—we who vow to do no harm, and to care for others, but who now can barely care for ourselves?
I see this situation every day in my work as medical director of provider wellness for my health care system. The personal stories shared by colleagues have shaken me to the core, and their words are a punch to the gut. Our ICU physicians have withstood months of shouting from angry family members, who blame them for the death of unvaccinated loved ones with COVID. Our ED docs stare bleary-eyed, numb from the continuous onslaught of incoming patients, who often spill into the waiting room and even outside. Through the hospital speakers come the daily announcements of Code Blues in the parking lot: emergency calls for patients who can’t make it into the ED, because there is no space left.
At times, I’m reminded of the months I spent shortly after the end of the Liberian civil war, as a med-peds resident. With only fifty physicians and meager resources, we cared for a population of more than 3 million people. Over the course of a month, I saw dozens of children in the pediatric ward die of illnesses that would have presented no challenge for a developed country and health care system. That harrowing experience remains etched in my memory and heart nearly fifteen years later, with eerie echoes of our current pandemic.
Last year, I wrote about the need for physicians to have boundaries, and about giving ourselves and our colleagues grace. More than ever, these are not mere suggestions; the actions I propose have become essential to our survival. Trained for decades to sacrifice our own well-being and personal needs in the service of our patients, we must now set a limit to our stoicism and to our giving. If we are not well, then we can’t care for our patients or for anyone else.
Far from signaling weakness, asking for and receiving help is not only a sign of strength, but a sign of courageous leadership. And so, I ask you to put on your own oxygen mask, and then to reach out and help your colleagues put on theirs, too. As physicians, the trauma we’ve experienced through our decades-long education and training, through our competitive medical culture, and through years of silence and self-sacrifice have created a common bond and an unspoken understanding. We must give ourselves the love and compassion that I know is deep within each of us, and we must help each other to do the same. Our greatest power comes from standing in support of each other, together. And it is the only way forward.
Tammie Chang is a pediatric hematology-oncology physician and co-founder, Pink Coat, MD. She can be reached on Instagram @tammiechangmd and at her self-titled site, Tammie Chang, MD.
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