Berks County Medical Society Medical Record Winter 2021 - 6

Editor's Comments

What to do When
Life Hands You a
Dumpster Fire
by Lucy J. Cairns, MD, Editor

T

he year 2020 has aptly been described as a dumpster fire.
Adding fuel to the flames have been:

*	The worst western wildfire season in modern history and
other disasters related in part to the continuing climate crisis
*	Widespread civic unrest in response to police killings of Black
citizens and to ingrained social injustices that have long affected
Black and other minority groups
*	A dreadfully divisive national election whose outcome
prompted a brazen and prolonged attack on our election system
by the losing presidential candidate and his many allies
*	The successful penetration of software systems in the Pentagon,
many vital national government agencies, state and local
governments, and private industry--suspected to have originated
with a Russian intelligence agency
*	The COVID-19 pandemic and its resulting economic
devastation
*	... not to mention all the disasters that have occurred outside
US boundaries!

Physicians and other healthcare workers responsible for treating
COVID-19 patients have endured a particularly grueling year, made
significantly worse than it had to be by failures of leadership at the
national level.1 So-called 'frontline' physicians across the nation have
been forced to work without access to adequate supplies of PPE
and other vital equipment at times, while confronting a deadly new
pathogen for which there were no known treatment protocols at
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first. Rapid surges in patient numbers and the absence of colleagues
(either ill or quarantining after COVID exposure) resulted in
longer work hours, extra shifts, and in some cases the need to 'draft'
physicians not used to caring for life-threatening respiratory illness.
The exhaustion is exacerbated by the intensity of care needed by
many hospitalized COVID-19 patients, encompassing very close
monitoring for the sudden deterioration that can occur and physical
tasks such as proning.
Added to the stress of personal exposure to this contagion and
the fear of bringing it home to loved ones has been the emotional
toll of being a daily, intimate witness to the sometimes excruciating
suffering of patients with severe COVID-19. The physical suffering
of patients is aggravated by the natural anxiety of being ill with
this virus, being short of breath and sometimes in pain, and by the
necessity of being denied the comfort provided by having loved
ones at the bedside. Compounding the distress of some physicians,
nurses, and other healthcare workers who spend their days and
nights in this environment is the knowledge that a significant
number of COVID-19 infections and deaths could be avoided if
acceptance of basic public health measures such as mask wearing
were more widely practiced by the public. It is no wonder that
doctors, nurses, and others who help care for the sickest of these
patients have accumulated a heavy burden of emotional suffering as
individuals and are struggling to cope.
What can physicians and other healthcare workers do to
tamp down their stress level and respond to this 'dumpster fire' of
circumstances in a positive, constructive fashion? Guidance can be

Dying in a Leadership Vacuum, by the Editorial Board, N Engl J Med 2020; 383:1479-1480
DOI: 10.1056/NEJMe2029812
http://www.berkscms.org
Berks County Medical Society Medical Record Winter 2021

Table of Contents for the Digital Edition of Berks County Medical Society Medical Record Winter 2021
