We must give others the dignity of their own path.” – Judith Orloff, MD As the Delta variant surges, few words can underscore what we as a physician community are grappling with. We struggle to make sense of humanity around us. As physicians, we trust and believe science. We understand the data. For us, the answer seems simple and obvious: just get vaccinated! Yet, we are dealing with a population unwilling to believe what we are saying, or even to listen. As a result, our health care system is on the brink of buckling under the weight of yet a fourth wave of COVID-19 patients. As fellow physicians, I know you have tried, in vain, to convince your patients. You have tried to reason with them. You have tried without success to show them the overwhelming evidence that getting vaccinated is not only safe, but essential if they want the best chance of surviving COVID-19. You have tried to help your patients understand that we all must be vaccinated if we are to curtail the spread of disease and come out of this pandemic alive and intact as a society. But in many cases, no amount of reasoning, data, patience, listening, or empathy seems to make a difference. Even when we take the time to slow down, really listen, and ask our patients, “What is it that you are most fearful of?”, when we offer the compassion that we vowed to give our patients as we entered this profession, we fail to produce change or understanding. I have witnessed countless colleagues and fellow physicians struggle with the anger, emotional exhaustion, and deep frustration over these questions: Why won’t people just get vaccinated? Why are they choosing to possibly die or infect someone else who can’t be vaccinated—perhaps children who could die from COVID—rather than just get the vaccine? Don’t people see that our health care system and workers are about to break, because people continue to refuse to be vaccinated? Why? We may never fully understand why, because the origin of this fear and mistrust is so deeply emotional, and irrational—and so innately human. As physicians, we are experts in the safest and best courses of prevention and treatment of illness, not only for our patients, but for our communities. So, it feels like such a defeat when patient after patient, and parent after parent, refuses to be vaccinated, no matter how much compassion, empathy, and love we offer as their trusted physicians, family members, or friends. If we are not able to reassure our patients, what can we as physicians do instead? And how can we possibly go on, continuing to care for patients who refuse available medical intervention not only for themselves, but for the sake of the safety of others? How can we reconcile this for ourselves? I see colleagues taking on this issue as their own personal mission, their burden to bear. And failing. They are worn out, weary, exhausted, and done. They feel ready to give up on humanity, and on our profession. To my colleagues: I hear you. I feel this deep anger and frustration. I feel the disbelief. I am here to witness, reflect, and consider what we might do not only for others in this world, but for ourselves as physicians. What has given me peace is the knowledge that I cannot possibly save or help everyone. That we cannot possibly save or help everyone, no matter how much we want to and are deeply motivated and driven to. Perhaps understanding this is how I can keep going, taking care of end-stage pediatric oncology patients. As Dr. Orloff says, “We must give others the dignity of their own path.” This is a reminder not only of giving others the grace to choose and to live their own lives, but a reminder that we must also give ourselves the same grace. We must give ourselves the grace to do what we need for ourselves and to live our own path as physicians. Allowing grace also means that we cannot save everyone. Not everything is our burden to bear. Not everything is our responsibility. Not everything is our job to do. How could we survive in this profession if it were? We must take care of ourselves and our own internal experience before we can take care of or help anyone else. This is the most basic and necessary of boundaries. We must hold this boundary, so that we can continue to do the work we felt called to do from the very beginning: to heal those who are willing to let us heal them. We cannot save everyone around us. But we can lead by example. And we can save ourselves. Source
