VICDOC Winter 2022 - Magazine - Page 35
C
OVID-19 created the
perfect mechanism to
allow for the shared
understanding of the experience
of those of us working on the
healthcare frontlines. As a
collective, we and our nursing
comrades were held up as heroes,
risking our own safety to heal
the sick and care for the dying.
We wore not capes, but fatigued
(and often forced) smiles hidden
behind layers of PPE. We were
the foot soldiers in a war against
an invisible foe.
But this was not my view of
the fight. For me, as someone
with a chronic mental health
condition, the last 2 years have
been more about the sidelines
than the frontlines. On more
than one occasion, I raised my
hands in surrender, departing the
battlefield to tend to my weary
self, unable to tolerate the distress
that my mind and body were
faced with. I broke down, I was
spent. More than once, I could
not go on.
I have struggled with an
overwhelming sense of shame
at times when reflecting on my
own experience of COVID-19.
For this registrar, much of the
peak of the pandemic was spent
on the bench, forcibly removed
from the team by a mind and
body unable to keep pace. I felt I’d
let the team down whilst others
had been better able to cope. The
imposter syndrome haunted me
like a shadow I couldn’t escape.
Sitting on the sidelines, watching
colleagues soar where I could not
even stand, felt very lonely indeed.
My experience is one shared
silently by the several colleagues
I met whilst admitted to the
psychiatric ward. We formed a
bond, a quiet understanding of
one another. Code words
described our experiences:
exhaustion, burnout, depression.
But what united us — the
common theme — was a matter of
there just being nothing left. We
were the silent minority unable to
fight in a war we never wanted.
But was COVID really to
blame? It is no revelation to note
that medical culture is an ever
demanding one, even without a
pandemic. We are conditioned,
from the very earliest of our
experiences in medical school
that we must strive to do more.
And as we progress, we are
commanded to do even more
with ever-dwindling time and
resources. Internship arrives and
with it comes new rules and roles,
a gruelling after-hours roster
and the stark reality that we now
live and breathe the game of life
and death. Our residency is a
whirlwind of on-call beeps met
with stolen sleeps as our new
nocturnally tolerant selves strive
not to stuff up until the team
arrives the next morning.
But none does it hit so hard as
our registrars… Completed your
rounds? And your paperwork?
Joined that committee? Published
that article? Started that second
masters yet? Have you done
your journal club? Don’t forget
that exam you will probably
fail. Registrars are pawns racing
to cross the board in a training
system bursting with study
requirements, drowning in
assessments and crippling us with
after-hours demands. And yet
somehow we press on, swimming
against the tide, exerting ourselves
on borrowed time.
Those who have reached this
point of the pandemic, who are
now throwing up their hands to
say “I’ve had enough. I cannot
do this anymore” are rightly
applauded. “They’ve earned a
rest”, we may say. But it does little
to cushion their sense of failure
or shame. And what about those
of us who needed rest when the
wave of the pandemic was rising?
Were we simply too weak to
go on? Or was it that we were
already operating above our best
and the added stress was always
going to topple us?
Burnout has become a
tolerated way of doing business
in healthcare, and in particular
in medical training. It is a hazard
we have allowed to become
embedded in our 50+ hour
weeks. The shame I felt through
being unable to withstand the
demands of COVID-19 is the
same shame that we continue to
permit to occur year after year. It
is one born out of a system that
demands too much and returns
too little.
We do not need to “earn”
our right to feel burnt out. A
pandemic is not needed for us
to see that our training system
is already well overstretched.
We need to lower the levels of
underlying stress to allow for our
system to tolerate shocks. Tending
to ourselves and prioritising
our wellbeing should be seen
as strengths, not weaknesses.
Moreover, we ought to be
advocating for change to redesign
the fundamental nature of our
burdensome training system to
prevent burnout in our trainees.
Only then will we shift the shame
so many of us continue to face
whilst sitting on the sidelines.
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