So many of us keep looking around and thinking, what now? Meaning now that “it’s” over, what is next. Are we supposed to go back to that life from before? Is that what is happening? Isn’t that what we are seeing on social media and in the lay press. The return to normalcy. The “freedom” to get our lives back. The right to our liberties and pursuit of happiness. But what about those of us who are still in it. Despite the promise of vaccinations and the decrease in numbers, we are still very much on a long and brutal plateau. Those of us in my ICU have seen the same number of critically ill COVID patients on ECMO since last summer. We still fight this monster of a disease every day. The fighting goes on while the rest of the country moves on. We live in two different worlds at the same time. It’s akin to being deployed while simultaneously at home. As I have explained to my husband before, who is a combat veteran, we are fighting a war at work while being expected to come home at the end of the day and be a mother, a father, a spouse, a friend, a child, a care-taker. We are expected to fight an invisible and forgotten war while still maintaining a shred of sanity for the sake of those we love. We are expected to move seamlessly from one role to the next, and throughout it all, we still carry the burden of the scars from the past year. While not having anywhere to put those burdens down because no one really cares. They are focused on “what now.” So what do we do? How do we cope and continue? What do we do now? We get angry. We lash out. We numb the pain with actions and words that we may or may not live to regret. We keep going, but it is starting to feel strained. We watch the country move on while we tube, line, bronch, and intervene on the same COVID complications over and over again. We have lost ourselves in this disease. And many of us have lost our families or our careers in the process. Were there cracks in those relationships before COVID? Maybe, but in the end, COVID will be the culprit that we all blame for what is about to transpire in medicine over the next decade. Without the war against COVID, we likely would have ended up at the same place and in the same space, but years to decades down the road. COVID acted as the great accelerant on the careers and lives of many of us. We have been forced to learn how to be a doctor faster, filling a year of practice with 10 years of experience. The byproducts of medicine are coming at us faster than we can manage. Burn out, moral injury, fatigue, illness, addiction, divorce, suicide. And with it, a generation of physicians may never return to the bedside. The “what now” question really needs to be replaced with the phrase “what can be done.” We may not be able to patch up or erase all of the self-inflicted wounds from our desperate attempt at self-preservation, but we can do one thing. And that is to lean on each other. Together, with understanding and deep empathy for the pain of another, we can come back to the bedside. Safely. We are battle buddies now. We have gone to war together. And let’s be honest, we all already knew that the career we chose would wear us down and expose us in the most intimate and unflattering ways, but the accelerant of COVID has forced us to acknowledge our scars and approach each other with understanding and grace. With each other, we can continue to take care of ourselves, each other, and our patients. We don’t have to leave medicine to heal. But we will need to leave behind the idea that we “are fine” and acknowledge that we are broken. And that being broken is ok. Because together we can piece together the best that we have left and make something new and beautiful. Something that is resilient and kind. Something that embraces and accepts us for who we have become over the past year. Something that is far greater than anything we were or had before. Now is the time for us. Source
