Welcome Back to Doctor-Patient relationships - a COVID-19 Edition!
It has been quite a while without new posts - while I do not have a simple understanding or explanation for the hiatus, I do notice that in the last few months, I have conducted several webinars on Self Care in the time of Covid-19!
For Psychologists - sponsored by PPA
For Family Medicine residents and faculty - sponsor: Family Medicine Dept.
For Veterinarians - sponsored by PMVA
I have no doubt that all other healthcare professionals have similar needs to these three groups. And the need for self care has never been greater! The emotional pain and toll that healthcare professionals have experienced is unprecedented.
I have also recently written several papers for The Pennsylvania Psychologist about what psychologists have reported experiencing in this last year as well as a reflection looking back at how Covid-19 has impacted us personally and professionally (“Witnessing History”). There have been many others writing about and discussing the challenges of healthcare of any kind - and one of the most helpful and significant (I think) is an interview of Christine Runyan, Ph.D. by Krista Tippett for the podcast “On Being” (https://onbeing.org/programs/christine-runyan-whats-happening-in-our-nervous-systems/). I’d like to highlight some of what she said and add some of my own commentary:
We all read and hear about the pervasive nature of depression and anxiety among so many people during the past year, the increased demands for psychological services, and the increase in suicidal thinking and even deaths. Dr. Runyan’s comments about the impact of Covid-19 are helpful because she explains what has been happening to us physiologically. They are significant because if we do not understand why we feel like we start our days with less than a full tank of gas or feel like we are down a quart of oil (what are your metaphors?), it is human to wonder what’s wrong with me or why am I having such difficulty getting through the day!
The physical and psychological toll that Covid-19 has taken is real, it compromises our capabilities, it has taken away our “go to” remedies of social and physical connections with family and friends, and according to Dr. Runyan, it has even compromised the connections between our mind and our body. Every aspect of what we do and how we do it has been changed, our routines have been modified, so many parts of our personal and professional lives that we took for granted can no longer be assumed, and it feels like, in some ways, we really are starting over to recreate the lives we have been living.
A stark reality is that our reactions have been normal responses to abnormal situations - Dr. Runyan correctly reminds us that we should not interpret these normal reactions as pathology. Another stark reality is the we will not be returning to “the old normal.” We have all changed - we will be searching to establish a new normal. The adaptations we have made to manage our lives during a pandemic plus social upheaval plus political disruption will not all be temporary. Compared to an ‘old normal,’ in the post-pandemic world, there will be more working from home - there will be more meetings conducted virtually - there will be more attention paid to health and safety precautions - there may be more geographic dislocations - and there may be many other changes or shifts in how we live and work and play yet to be seen. And hopefully, there will also be more attention paid to self care, especially for those health care professionals who take care of others.
At the same time that I’m busy talking and writing about self care for others, I am also confronted by my own increased self care needs! While beginning the preparation of the first of several webinars, my co-presenter sends to me a list of topics we might consider including. This occurred pre-2020 election, and I was experiencing so much personal emotional disruption from the combination of my own sequestration (my garage door did not open for days at a time!), the maddening and increasingly extreme political environment and the surfacing of multiple racial divides. It took several days plus a long email diatribe back to my co-presenter for me to be able to orient to the task at hand! This response gave him permission and/or the example to unload the multiple frustrations he was experiencing as well. We had never before seen these challenges or limitations before planning or organizing our combined efforts. And then we realized that Covid-19 struck again. We could not get back “in gear” until we realized how and why we were “out of gear.”
Stay tuned for additional posts - I have lots of ideas and thoughts about so much that has had an impact on doctor-patient relationships, and I plan to share them with anyone who cares to read about them.
Finally, whether or not you were wondering, I have no personal or professional interests in recommending Dr. Runyan’s interview other than highlight information and resources that I believe are valuable. We do know each other as respected colleagues who do and did similar work in Family Medicine residencies and beyond.