Living At The Top Of Our Humanity: A Patient’s Plea

I often hear professionals talking about “working at the top of their license” – contributing their highest skills according to their training. To overcome this pandemic, now more than ever, every single one of us will need to work and live at the top of our humanity. Patients, families, nurses, doctors, front desk staff, administrators, lab techs, health plan executives – everyone – must find even small ways to create the kind of human connection and community that keep us going, and especially clinicians on the frontlines.

It’s going to be tempting to engage in blame and shame about all that is wrong with the system as it buckles under the weight of the COVID-19 pandemic. But this could shatter the human spirit that has kept the health care system afloat until now. Pre-COVID-19, we were already in trouble: patients struggling to navigate its complexities and cost, a shortage of primary care professionals, many suffering from burnout, and some so miserable they are jumping from buildings. As a patient, I’m worried about what coronavirus will do to our system. I know clinicians are too.

How do we live at the top of our humanity? There are some insights that might help us. In a free, foundation-funded program called the 3rd Conversation, over the past two years, we facilitated in-person gatherings of clinicians and patients in 10 communities, and we learned a lot about the humans of health care. We paired frontline health professionals with patients to share personal stories and explore ways they collectively needed the system to change in order to make it more human-centered. We didn’t just focus on patient stories, either. Clinicians got vulnerable and told their stories too.

What we heard:

• Clinicians described a kind of moral injury — how the design of today’s system sometimes forces them to behave in ways that are counter to their deeper calling to heal people. Like rushing patients through appointments without answering all their questions in order to meet productivity goals on which many salaries are based.
• Patients said they felt lost, frustrated, and powerless, but also said they were grateful for their relationships with their providers and cared deeply about clinicians as people.
• Administrators told us they felt ground down, trying to lead amidst massive amounts of pressure and unpredictability, feeling a sense of isolation and yet also a deep yearning to connect more meaningfully to patients, colleagues and to a larger sense of purpose.

Some key takeaways emerged that might help us bolster the system in this unprecedented time:

1. Human connection is a balm; it’s an antidote to the isolation we feel on any given day in the pre-coronavirus health care system. It helps patients navigate the complexities of care. It helps providers survive just one more day, or week, or month on the job and remember why they chose this profession in the first place. It makes a trying experience better for everyone.

2. Each one of us holds an important kind of power.

• Patients have the power to make clinicians’ days better through simple acts of human connection and empathy, even while appropriately distanced.
• Clinicians have the power to connect at a deeper emotive level, showing vulnerability with patients and with peers, which creates deep and authentic connections that help them through their days in immeasurable ways.
• System administrators have a different kind of power to be sure, but the opportunity to feel seen and supported in their own humanity helps these leaders maintain the personal reserves required to stay on the job day after day.

3, We have more in common than we know, even when we play different roles in the health care system. Empathy reminds us all of our common humanity. We are in this together. And it feels better just to know that.

Bottom line: There is joy and relief in authentic human connection, and this is highly at risk in the coronavirus world as less physical connection, and more social distancing become the norm (appropriately). As patients and providers take all the necessary physical and social precautions, my hope is that we also take extraordinary measures to leverage the relationships between us as a source of sustenance.

When the pandemic subsides, we will need a new national conversation about many things – including how we engineer the humanity back into our system, once and for all. A way of focusing on the “who and the why” of health care first, and then rebuilding the “what and the how” around the humans that should have always been at the center of our system. But for now …

To our health care professionals, clinicians and staff: thank you. Thank you for choosing one of the most challenging and rewarding professions, for being there when we need you the most. There are so many moments ahead of us that we’ve never encountered or planned for. We are here for you. Tell us what you need, and let us care for you, too.

Christine Bechtel is a patient advocate and president and chief strategist, X4 Health, a purpose-driven organization on a mission to make health care better for humans.

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