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Who Cares for the Caregiver During COVID-19?

We have lost any sense of control we thought we had. We have lost our ability to plan for the future, our agency about what we can and cannot do with our time and with our bodies, and what we are allowed to do in our communities.

As caretakers, health providers, and service workers, we have also lost our own sense of safety. We have continued to throw ourselves into the fire, hoping that someone else will be there to put it out. It is unsurprising that our minds feel full of noise, inundated day in and day out by unrelenting emails, notifications, media soundbites, and more importantly, by constant messages of fear, anxiety and uncertainty. Now more than ever, we may feel compelled to maintain a sense of stability in order to offer words of reassurance to our patients and our families. While we try our best to care for them, who takes care of us?

My own experience has felt a bit like wading through a swamp of hysteria, grief, misinformation and lack of leadership (locally and globally) while attempting to find clarity in the mire. This has unintentionally prompted me to re-evaluate my own toolkit of coping mechanisms and the ways in which I can maintain my own semblance of sanity. Whether you are feeling overwhelmed, anxious, scattered or even just bored, listless, or helpless. I hope that one or more of these cognitive approaches can be helpful.

Acceptance

One of the first and most difficult challenges to maintaining our mental well-being is based in radical acceptance. This is not the same as resignation or giving up on everything you’ve worked for, but instead involves letting go. Letting go of what you thought you had control over. Surrendering to what is, that this may be a new normal for a while. Acceptance also goes hand in hand with easing up on our resistance. Resistance to the fact that we may have lost our routines for now, that we may not be able to see each other in person, or exercise, eat, or participate in society the way we did. Resistance prevents us from feeling the peace of surrender and causes unnecessary and prolonged suffering. One way to generate acceptance is to remind yourself of where you are in the present moment, noticing your surroundings, and even telling yourself that you are here right now and there is nowhere else to be. Acceptance can also look like catching yourself thinking about future worries or past regrets and simply bringing yourself back to the here and now. One of the benefits of a meditation practice is the cultivation of surrendering and ultimately acceptance of what is.

Self-Compassion

Having compassion for yourself, despite the way it sounds, is far from selfish or self-centered. Self compassion as a practice can take multiple forms, however the ways in which I have found it the most effective at easing my mental mess is through the lens of forgiveness and allowing yourself to ease away from the words “productivity” and “accomplishments,” even if it is temporary. Having compassion for yourself can be as simple as having a genuine kindness for yourself as a human being. It can mean that your worth and sense of self are not measured or defined by your productivity or how much you are able to do. If you haven’t been able to learn an instrument or a new language in these last few weeks, forgive yourself. If you haven’t written a book or perfected your home work out routine, forgive yourself. Contrary to how we’ve been molded, by a society that values productivity and output more than presence and balance, we do not have to “do” in order to be enough, whole, and complete as human beings. Whatever you have done is more than enough. For those of us still making the trek to work and adjusting to this new normal, whatever we are able to do is also enough, we may not know all the answers, we may not be able to see the end of this arc, we may not even be able to save every patient, but our best is enough. Another act of self-compassion is giving yourself a break in the practical sense. Allowing yourself to take a break from the news, social media, or even conversations that tend to circulate anxiety.

Compassion for Others

One of the most powerful ways to ease one’s one suffering is to ease the suffering of someone else. It can be as simple as checking on a loved one or a neighbor, allowing a friend to vent about their own stressors and fears, or donating what you can to people or communities in need. You may not be able to physically go out and volunteer, or even give someone a much needed hug, but the time you take and the act of reaching out itself is enough to stimulate your brain’s reward pathways making you feel good and simultaneously reducing your stress levels.

Gratitude

Time and again, gratitude has been linked to increased subjective wellbeing, improved interpersonal relationships, and a shift in bias towards a more positive interpretation of life’s events. Some unintended consequences of this pandemic have been truly remarkable, including a dramatic drop in air pollution and greenhouse gas emissions worldwide. We have the potential to shift the way we go forward in our lives, in the way we treat the environment, how we treat each other, how we value our time and ultimately prioritize what is important to us. It is up to us to sustain the positive changes that have come out of a trying time and continue to practice gratitude for the silver linings in life.

Looking Forward

Although it can be disheartening to hear about how fragmented the response has been to this pandemic in our health care system, in our government, we cannot deny the coming together (separately) of human beings. Looking out for each other, raising money, expressing words of support, and even using their own supplies and materials to feed and protect others. We are not giving up on our collective desire for a better future. Maybe this means making a commitment to being active in the political process in order to change it. Maybe this means coming together with others to amplify our voices when we see injustice. But looking forward could be as simple as redefining what is personally important to us in our own lives and unapologetically following our passions. Individually, this could mean making a plan for how you would like to do things differently in your own life. It could look like setting forth a plan with specific goals that align with your own personal values.

Eventually the clouds will clear — just like those that have cleared the view of the Himalayas — and we will go back to our routines and the lives we’re used to, but should we? Perhaps dredging through the mud and fighting our way to the other side is the harsh wake-up call we did not know we needed. As we mourn for the loss of life and the helplessness we all feel, particularly as caretakers, there may be true beauty in what we can become — self-aware, generous, mindful, patient, and always striving to be better, both for ourselves and for others.

Saba Malik, MD, MPH (5 Posts)

Resident Physician Contributing Writer

Harbor UCLA Medical Center


Saba Malik, MD, MPH is a 2nd year family medicine resident at Harbor UCLA Medical Center. She earned her MD with a distinction in advocacy from Albany Medical College in 2018, prior to which she had completed a masters in public health with a concentration in community health sciences from the UCLA Fielding School of Public Health. She has an undergraduate degree in Neuroscience also from UCLA. She is passionate about health disparities, health justice, holistic and integrative medicine, LGBTQ issues, and improving the health and well being of vulnerable and disadvantaged communities.