Pausing Panic: Lessons for Mindful Physician Leaders in this COVID-19 PLUS Era

In short, be kind toward yourself. Be compassionate toward yourself. Give yourself a break. Finally, reflect upon what you have accomplished, who you have comforted, who you have encouraged, and who you have wrapped with a blanket of psychological safety and care.

Life as we knew it suddenly and dramatically changed for many of us around March of 2020. It felt as if Spring halted. In the place of Spring, a long, dark winter ensued characterized by COVID-19, then overstretched hospitals, then cancelled elective surgeries, then lack of PPE, then “stay at home” orders, then businesses shutdowns, then an increasingly volatile stock market, and then massive unemployment and furloughs hit most of us like the proverbial “ton of bricks.” The summer of 2020 is upon with rising temperatures, intensifying summer storms, and increasing COVID-19 case counts, hospitalizations, ICU admissions, intubations and tragically deaths. Amid all of these external changes, the murder of George Floyd in Minneapolis sparked what may appear to a cultural revolution focused in part on race, racism, and police brutality and perhaps a revolution about income inequalities, opportunity gaps, and the lack of a social safety net which seemingly forced our nation and states to choose between “opening up the economy” or “slow the spread of COVID-19.”

After reading this first paragraph, several feelings may be bubbling inside including any of the following:

• Sadness

• Anxiety

• Loss/Grief

• Anger

• Bewilderment

• Elation (strange but true especially those who see the silver linings in the clouds)

And for some, feelings are not “top of mind” but perhaps some physiological sensations such as a mild headache, perhaps neck pain, maybe a bit jittery, even a bit fatigued, and maybe a little bit of GI disturbance. And for some you just feel “numb.” Whatever the thought, the feeling, and the sensation, then it’s OK. And it’s OK not to be OK. How could you really be OK with unprecedented changes confronting all of us regardless of your leadership role?

COVID-19 Plus: A Real Threat Facilitating a Real, Survival Reaction

During stressful times and uncertain times, our “fight or flee or freeze” psychophysiological process kicks into high gear to respond to both real external threats such as concern about exposing your family to COVID-19 to internal threats such as wondering if your team believes you are supportive as a leader although you have no evidence to suggest that you are not but you wonder and worry.

In times of a crisis and injury, we all may benefit from First AID. Below is the AID model which may be useful for you, your loved ones, and those that you lead.

• Accept the fact that you are human and subject to things both within your control and outside of your control. Pause judging your reactions but craft your responses.

• Identify that which is under your control and that which is outside of your control or influence. Pause seeking to control everything and knowing for sure all future events.

• Deploy all resources available to you as a physician leader to move the agenda forward, revise the agenda given COVID-19 PLUS, and to support your team both instrumentally and emotionally with their safety being first and foremost. Pause throwing up your hands and acting as if you have no resources and as if you have no formal OR informal influence.

To pause panic, it is critical that you AID is strengthened by connection and support. If your past behavior has been to “go it alone,” this may be the time experimenting with “going it together.” (Accept, Identify, Deploy) remembering that you are a resource to yourself, your loved ones and your team based upon who you are as a person first and as a physician leader second. AID

Who Helps the Helper? Give AID to Yourself

Over the past 3 months in my role as a mental health disaster consultant and mindfulness coach, my goal is to encourage frontline healthcare workers including physicians and physician leaders to not forget about their own health and well-being while focusing upon others. In short, be kind toward yourself. Be compassionate toward yourself. Give yourself a break. Finally, reflect upon what you have accomplished, who you have comforted, who you have encouraged, and who you have wrapped with a blanket of psychological safety and care. As you reflect upon your acts of kindness and compassion, be sure to nurture yourself and give AID to yourself to hit pause on the panic.

William “Marty” Martin, MA, MS, MPH, Psy.D., CHESDirector and Associate Professor, DePaul UniversityMARTYM@depaul.edu

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