I turned into the hospital parking lot, placed my car into park, and looked up at the time. 5:44 a.m. I’d spent the previous night researching COVID-19 symptoms and treatment options, preparing to field questions from my patients, family, and friends. Attempting to understand this disease process, which seemed to present a new wrinkle every few days, felt like trying to spot a chameleon. While the number of COVID cases in my East Texas hospital was only a fraction of what providers in other areas of the country – like New York or San Francisco – faced. While I should have been quickening towards the ambulance bay, my mind was weighed by anxiety. “Can I do this? How many of my patients will be asymptomatic carriers? Will I encounter any false-negative tests? Will I make family sick? What if I end up on a vent? I haven’t completed my will yet!”
A sharp chord of trumpets blasted from my stereo, derailing my train of thought. A 1996 version of Jay-Z exclaimed, “Can I Live?!” The irony of a rising wave of doubt, to the soundtrack of the album Reasonable Doubt, was not lost on me. Irritated, I quickly switched the stereo off and stared into the distance as I tried to quiet the worry and refocus on my responsibilities for the day. The combination of a complex and rapidly evolving disease, public paralyzed by mixed official messaging, and the interdependent solutions required to move forward weighed heavily on my mind. 5:55 a.m. As I forced my body towards the hospital entrance, I contemplated physicians’ role in treating patients and communicating knowledge to the public to allay the fears of patients, their families, and our loved ones. But who heals the healer?
Reflecting on this storm of emotions just a few months later conjured up memories of one of the greatest counselors I have ever had the privilege of knowing—the late Dr. Sam Hooper. During my residency, Dr. Hooper was the universal counselor of residents, faculty, and administration alike. He was a trained clinical psychologist who spearheaded our residency’s integrated primary care-behavioral health clinic—one of the few in the country. One year ago, Dr. Sam Hooper passed away just months after receiving a terminal diagnosis. His professional accomplishments were myriad, but let me tell you about Sam Hooper the man.
Dr. Hooper was a force of positivity. He always had a kind word, or reflection of wisdom to share, even in the briefest of interactions. Indeed, it was rare to see Dr. Hooper in any state other than smiling and cheerful. Even his bad days were indiscernible. He somehow found the resolve to show his colleagues his best every day, giving all who requested precious minutes—sometimes hours—of his undivided attention. He was always deliberate, never in a rush. He treated everyone with respect and recognized each contribution, no matter how low you were on the totem pole. Nearly everyone had a Hooper-story. Personally, he helped me work through the emotions of one of the traumatic deaths of one of my friends from medical school. He helped attending physicians process a colleague’s suicide. While this may seem an Atlas-like burden, he had a great talent—cultivated through decades of deliberate practice—of guiding us through a briar patch of emotions so that at a conversation’s conclusion, we devised solutions to our own problems. He gave us the invaluable gift of agency in what felt like hopeless situations.
Reflecting on Dr. Hooper’s passing brought to mind a quote from the Marvel movie Dr. Strange: “Death is what gives life meaning—to know your days are numbered; your time is short.” Mortality acts as a guiding light, providing perspective on days that threaten to devolve into a never-ending stream of to-dos. Am I acting each day with intention? What energy am I projecting into the world? Do I leave those with whom I interact feeling better or worse about their day? If my end were near, how would I approach each day differently? Am I prioritizing those who I say matter most with my actions and time? Powerful questions, inspired by a powerful man.
Before COVID-19, one of the hottest topics in the news and medical literature was physician burnout, which contributed to high rates of job dissatisfaction and physician suicides. Adding a global pandemic, for many, has exacerbated the call to do more with less that drove much of the burnout in the first place. This cascade of events has led to crises of confidence on individual, institutional, and societal levels, resulting in well-documented increases in anxiety, PTSD, and, tragically, suicide.
Hooper-like qualities—altruism, being present, and empathy—can guide us as we navigate these uncertain times. Indeed, they are some of the psychological first aid and emotional support elements espoused by the American Psychiatric Association.
Check on your colleagues, particularly those in hotspot areas. Take the time to really listen. You may not have the solution, but studies show that simply verbalizing problems and identifying negative emotions can decrease physical and emotional distress. Communicating feelings also reduces amygdala activation, decreasing the maladaptive fight-or-flight response and may strengthen our immune systems by reducing the effect of chronic stress response.
Becoming more Hooper-like is not just beneficial to others. Take the time to refill your cup. Prioritizing self-enriching activities, even for five minutes, increases one’s sense of autonomy and maintains self-efficacy. Further, the literature suggests that supporting behaviors to promote autonomy (e.g., controlling your own schedule) is one of the few systemic interventions organizations can implement to decrease physician burnout.
Prioritize checking your emotional vitals daily. Commiserate with colleagues. Encourage your communities to wear masks, employ hand hygiene, maintain physical distance, and trust the process. Collectively, we will overcome.
Olubadewa A. Fatunde is a cardiology fellow.
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