What to Say (and Not Say) to Workers on the Front Lines

“How are you doing?” a text message alert on my phone reads. “Thinking of you.”

I’m a doctor caring for Covid-19 patients in the intensive care unit of a New York City hospital. I’m OK, I tell my friends and family. But OK is a relative term.

Physically, aside from fatigue and a raw nose bridge, I am fine. Emotionally, my work has a sense of vital purpose. Even tending to the dying, as hard as it is, has a moral clarity that lifts my spirit. To dignify another human in such extremis is why I became a physician. And while others are isolated at home, I am working face-to-face with my colleagues. The camaraderie of our work and the nightly cheers we receive bring me joy.

But in another sense, I am not OK. My mind has taken photographs of the horror wrought by Covid-19 and they replay at random. I wake up from haunting dreams of being smothered by my N95 mask and face shield. I get through the day by holding reality at a distance. When I allow it to penetrate my mind on my walk home from work, I often cry. I am moving in slow motion through a trauma that has no end or escape in sight.

“What was it like in the I.C.U.?” colleagues in other fields ask me again and again.

I tell them it is unlike anything I have ever seen. So many intubated patients, so many going into multiorgan failure, so many who are young. It is awful, heartbreaking, tragic.

I use my own cellphone to FaceTime with a patient’s wife. She cannot believe he is dying, and I have to show her his closed eyes, his ventilator, the multiple medications keeping his blood pressure just high enough to sustain his life. I hold my phone close to his ear as she cries in Spanish, “I love you, I love you.”

Every time I enter a patient’s room, I am anxious that the virus will enter my lungs. Fortunately, I have always been provided adequate personal protective equipment (P.P.E.). But our risk of exposure is never completely zero. I hear about other physicians becoming sick and dying and can’t help but worry I will become one of them.

The acknowledgment and appreciation I’m receiving through daily messages buoys me through the heart-wrenching, traumatizing work of trying to save my patients from this ruthless virus. But sometimes I am overwhelmed and emotionally drained trying to respond to all the messages I receive. And some messages compound my stress.

Based on the enormous range of messages I’ve received, I want to share my personal suggestions for those reaching out to support health care workers, in the hope that it may be helpful for those wondering what to say.

When someone who cares about me asks how I am doing, it feels rude not to respond. But often I don’t have time or energy, with everything else going on. My favorite messages say something like, “Hey, have been reading the news from New York City and thinking of you. Sending you my love. No need to reply, I’m sure you’re working so hard.” Or simply, “Sending love.”

Every single one of these messages makes my day better. Sometimes I don’t respond until my day off. But receiving them in the moment truly is balm in this awful situation.

Offering donations and supplies is wonderful, but also creates logistical challenges. We have had so many meals donated to us that my colleagues now manage a spreadsheet to keep track of what meals are coming to the hospital lobby and which staff member will pick them up from the lobby and deliver them to various hospital workrooms. Depending on the institution, it might be better to donate through an established organization. I always appreciate offers of donations, and I hope I don’t offend if I’m not able to accept them.

The way questions are received can vary depending on your relationship with the health care worker and that person’s emotional state. But in general, being asked repeatedly what it is like in hospitals right now risks retraumatizing health care workers.

Ask yourself why you are asking a health care worker about their front-line experience. Will your question help them process the experience? Or is it to address your own fears or curiosity, which may create more emotional labor for the health care worker?

An alternative is to share a news story you’ve read about the health care worker’s city or hospital and say, “I read that this is going on. It made me think of you. I hope you are doing OK. I’m here for you if it’s helpful to talk.”

Another option is to say, “I’m happy to hear about what it’s like in the hospital right now if you want to share. But we can also talk about other things if you’d like to get your mind off it.” I have found that sometimes I really want to talk about what’s happening in the hospital, and other times I want to talk about a TV show I’m watching. It is deeply comforting knowing my friends and family are there for me in either circumstance.

Though we are often called heroes these days, most of us feel as if we should be doing more to stave off illness and death. In the I.C.U., I feel guilty that I don’t have the skills to intubate patients, one of the most essential and important procedures for critically ill patients with Covid-19. At home on my days off, I feel guilty I’m not at the hospital.

I can’t speak for everyone, but I find it awkward to be called a hero. I personally prefer a simple “thank you for the work you are doing” than to be praised as a hero, when I don’t feel like one.

I know it can be hard being isolated at home. On my days off, I am restless and long for walks through the city, nights at the theater, eating out at restaurants. It can feel like watching TV and making another frozen dinner are insignificant in the face of a pandemic.

But as a physician, I know that prevention is the best medicine. Your daily commitment to public health guidelines truly saves lives. When I go to work at the hospital with the knowledge that my family, friends and neighbors are following those guidelines, my spirits are lifted knowing that we are all in this together.

Colleen Farrell is an internal medicine resident physician in New York City.

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