Our frontline heroes are still human. And we need to heed their cries for help | Opinion

Man and woman, senior man lying in hospital bed because of coronavirus infection, female doctor is giving medicine to a patient.

By Megan Malick

Stories about people rising up during times of challenge are powerful.

In this COVID-19 pandemic, headlines constantly refer to frontline workers — nurses, grocery store employees, social workers — as heroes, as they sustain us and literally save our lives. Our call for heroes in these days are great. But at what cost?

The expectations that come along with the term “hero” encourage our helpers and healers to believe they need to be invulnerable for our sake. In response, many of them build a shield of silence that prevents them from sharing their reality. So the public, although adoring, turns away rather than bearing witness to their struggle.  

The cost of the expectations placed on healthcare workers became evident on April 26, when Dr. Lorna Breen, who worked as an emergency medicine physician at New York Presbyterian Allen Hospital, died by suicide.

In an interview, Breen’s sister said that health care workers today believe they always have to be brave and strong, and not let on when they’re suffering themselves.

She believes this mindset motivated Breen and her colleagues to work longer than their 12-hour shifts, and take little time for themselves to recover from the mental and physical tolls of their jobs. She says she pleaded with Breen to care for herself, but her sister never let herself step away. 

Concern about burnout among helping professions is not new.

A 2019 paper by the Harvard School of Public Health named physician burnout as a public health crisis, and a 2018 meta-analysis of 47 separate studies concluded that burnout among doctors and nurses is associated with a decrease in patient care and safety.

As a therapist and former pastor, I am familiar with long shifts and the stripes and self-esteem earned from working long days caring for people in crisis, and appearing calm in a sea of strife. Too often the very institutions that preach self-care instead model working long days, and expect 24-7 availability. 

Like so many others, I prided myself on overworking and thought that I was building my resilience. But the price for this lifestyle surfaced over a ninth month period in which I earned three traffic violations—each of them after working a 12-hour shift.

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The scariest violation for me came on a May morning, after a particularly grueling night shift on my job as a chaplain — I had been running from death to death. I had barely left the parking garage when I was stopped for driving past a school bus stopped for boarding. I hadn’t even noticed the flashing lights. 

Thankfully, no one but my pride and ego were wounded in this incident. But instead of it serving as a wake-up call, my shield grew thicker. What would anyone think of a youth pastor and chaplain nearly losing their license?

Today I look back at myself with compassion. Although my behavior was not healthy, neither were the expectations of the systems I was in. My body was waving a red flag in response to too much work, too little sleep, and lack of healthy ways to cope with it all.

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Work was my worth, as our culture imparts. My identity was interwoven with what I did. The more praise I received, the more I perfected and pleased. This cycle convinced me that I indeed had superhuman capabilities, and maintaining this façade for others was part of my job.

The expectations placed on the hero shift weight meant for the entire community onto one group of people, like nurses, and the individuals within. As the hero feels this weight, they internalize their struggles and live with constant high stress: any strong emotion is a sign of weakness, any hint of vulnerability a flaw.   

The role of the hero, like all roles in dysfunctional systems, becomes enmeshed with personhood. The hero lives in a constant double-bind: how is it possible to feel the very real feelings of humanity—grief, despair, vulnerability, fear—and also remain super-human?

None of us can know all the factors that contributed to Breen’s suicide, but from what we do know, it appears likely she felt the burden to be super-human.

During this COVID-19 pandemic, we’ve all been plunged into collective traumatic grief, and the people on the frontlines even more so. None of us—no parent, no chaplain, and no doctor — can fully integrate this reality without space, time, and support. 

Feeling overwhelmed is a normal response to these very abnormal circumstances. Let us free our helpers and healers from the weight of the hero cape. To truly end the stigma of asking for help, counseling and peer groups should be as common as drinking eight glasses of water a day and taking a multi-vitamin.

Signs and symptoms of fatigue, burnout, grief, anxiety, and depression should not be viewed as unique or weak but rather as expected signs that frontline caregivers need to care for themselves.  Let us invite human stories and provide a safe space and time for them to be told.

Megan Malick is a marriage and family therapist in Lancaster, PA with Well Counseling and Consulting Services, LLC.  She is also an authorized minister with the United Church of Christ.  She is passionate about the intersection of psychology and spirituality.