I worked in newspapers for 30+ years. It’s all I ever wanted to do.
I left in 2011 because I couldn’t handle the grief of knowing the industry was doomed.
So I trained into an OTA role in a hospital. I worked through COVID in a Geropsych unit where PPE was nearly nonexistent. My other OT/PT colleagues were on the medical floors along with the nurses.
It broke everyone.
During this time, the conglomerate that had purchased our Catholic NFP community hospital continued to squeeze costs.
Long-term nurses, doctors, and staff left in droves after the pandemic. I finally crashed and burned a couple of years later.
This is a long way of saying that of all the storytellers I worked with in journalism, this is one of the best-written pieces I’ve ever read.
And as someone who watched the front-line of healthcare be decimated, I can say you nailed what it was like.
I’m covered in tears and snot bubbles again. I have a daughter - 27 years old with a son of her own - who is both medically fragile and because of that fragility is also financially fragile.
I’d like to be her safety net, except I am emotionally and psychologically fragile after a childhood of extreme abuse that I can’t seem to recover from, and after a retinal detachment that sidelined my career plans, and now I, too, I’m also financially fragile.
In December 2019, just as my grandson was turning one, I was invited to do a solo art exhibit at a new gallery space that was trying to gain footing way up in Fort Worth. It was slated to open March 1, 2020. I was dead center in the middle of a CPTSD collapse, one that started in 2016 when my daughter was first diagnosed, and then revealed her own childhood abuse that I was not privy to, and then my biological mother died, and then my daughter decided if she could only have a child when she was young she was going to go ahead and by God do it so she got pregnant at 19, and the Supreme Court got stacked and I knew exactly what that meant down the road. So I titled the show “fragile systems”. Every canvas started with me freeform writing about fragility versus resilience. Then covering it with a soft color. Big strokes that helped me breathe a little better. And then sometimes a little doodle about what a resilient system would look like. And then every painting wound up being flowers in a jar. Fragile things inside glass. Nature contained. I hung the show and scheduled some live paintings and opening events. And within two weeks Covid hit. “Fragile systems “ was closed.
My daughter just got out of the hospital last week. Again. And again she couldn’t get the medicine she needed and now your piece is pointing me toward some answers as to why this keeps happening. The staff does not know her yet. They can’t know her because it’s not the same staff. It’s a different hospitalist. A different infectious disease specialist. And a whole list of different nurses. Different doctors. Nobody remembers the precise anabiotic she needs and she misses weeks of work and time with her son and I can’t intervene because I’m in bed with tears on my face and snot bubbles on my lip, trying to hold my own brain in my head, and there isn’t an antidepressant on the market that can erase or put a blanket over this kind of grief. Then comes the shame. The feelings of failing as a mother. As an artist. As a person. I know this isn’t limited to my family, that we are one data point in a pattern that is so chaotic it just looks like static.
God bless Denise. Tell Patricia to tell Denise that there’s a woman in Texas who sees what she’s doing, who admired her greatly, and would love to hear any advice she has on resilience.
Wonderful article. Thank you for stating that great complexity so clearly. Every bit of it should be reflected on. One thing I will add, after working hospitals as an RN for 31 years, after the burn out, after the deadening, the awareness of the suffering of others can come back with such a vengeance it is breathtaking. Shore yourself up for that as best you can. I took refuge in drawing nature. It works for me somewhat. Please keep up your good work.
It is amazing, and not always obvious, how ingrained this healthcare issue is in the USAer's psyche.
I lived in Spain for nearly 20 years before I was finally forced, because of a life-threatening double pneumonia, to use the Social Healthcare System available here. I still sometimes hesitate before going to see my assigned "head doctor", though the reticence has mostly been packed away as one of those things that maybe can't be unlearned but can be, like I say, packed away.
So, when I was in utter pain this past weekend from trapped gases in my thorax, it was of no consequence for me to go to my local health clinic and ask a doctor to check me in case maybe it wasn't trapped gases, maybe something else. I was attended at once, that doctor could consult my entire medical history on his computer, he looked me over, did an EEG, checked the blood pressure, suggested some habit changes and prescribed a couple of pills.
So, when that utter pain had not subsided the next day, and who has utter pain for two days from trapped gases, it was of no consequence for me to have my mate drive me into town to the hospital ER, where I was triaged, then put in a room, examined, given some meds, observed for a while, had an x-ray, another EEG, yup, it was trapped gases, confirmed, take this pill and we'll give you some paracetamol in an IV. Recovered the next day.
The entire thing cost me €4.51 ($5.30). That was for the two prescriptions. The potential cost of all the attention I had received never once crossed my mind, I could ask a professional to check me out, he or she would do so then suggest a remedy, I could take that remedy and find myself once again on the road to health, and it cost me less than a fiver.
I just can't understand why USAers are so hard-headed about not wanting to create the same kind of system for themselves. Really. This type of system works, it has its flaws, it is not free, costs will be shared by everyone, but for heaven's sake, it's really hard to hear stories like Tom's here knowing that that story has been told because hard-headed USAers are so hung up on their gosh-darned "freedoms" and "rights". Those two concepts have become the catalysts to the demise of American Empathy.
Had I not moved to Europe 40 years ago, I would not be here sharing these thoughts. People might be fondly remembering who I was, but I would not have survived that first dire illness. I am so thankful to a community like Spain that understands the importance of caring for the guy or gal who lives next door and created a healthcare system that reflects that care.
When I was stationed at Rota, my mother-in-law came to visit from Florida. While she was with us, she became very ill. We took her to the local hospital, where they diagnosed her and prescribed some medication.
The hospital didn't charge her, even though she wasn't a Spanish citizen, and the pharmacy only charged about 500 pesetas (at the time about $5) for the drugs.
We cannot have this because too many who vote on it represent voters who believe in their christian hearts that somewhere, sometime, a person who is not as white as they are will be able to take advantage of such a system, and their Jesus just cannot have that. See also, expanded Medicaid in red states.
I was led to your blog by a poster at a political Website I frequent.
This hists close to home (really, since I live east of Scottsbluff).
As many socialists have noted in the past, "A system is what it does." Capitalism (the system our healthcare is built on) extracting value is what it does best. It's why the USA ranks at the bottom of OECD countries in healthcare outcomes.
No matter how hard I try, I can't get my conservative neighbours to see it. They can't. Conservatism is their religion, and socialism has been equated with godless communist heathenism all my life. "American exceptionalism" is very exceptional at creating stock market crashes, gutting communities, and extracting wealth and funnelling it up.
You can put all these figures, all these personal stories in front of them, and they can't process it. It's very much like Orwell's Nineteen Eighty-Four, where they don't even have the language to understand why thing are the way they are.
The same is true with other government services ("government should be run like a business" should die in a fire). When the Postal Service moved to close our post office, my wife and I mounted a campaign to save it (we were successful). The flunkies sent in from Omaha talked about things like Return-on-Investment, using faulty numbers and when called on it, blaming computer software (my wife was a software engineer before she retired).
The first rule of conservatism is you never take responsibility for your decisions.
This was difficult to read, but what really sticks out to me was "moral injury". "Compassion fatigue" bothers me because it feels like it's my fault and that I don't care anymore. Which just isn't the case. Frankly I feel like a zombie when I go to work now. These years since COVID have actually had its own devistation. There has been a deep moral decay and loss of empathy because our society has been suckered into believing they're being cheated out of they're due share. I can't count how many times I've listened to patient's talk about how doctors and nurses are puppets to the political machines and that is our only motivation for stealing money from "the hard working people of this country". "You were lucky to have a job during COVID" All while watching FOX News and president "IIm smarter than doctors". And I must say nothing that will provoke anything that isn't to the goal of getting them out of the hospital. Although this is not the majority of the people I've taken care of, but a stab wound has its scar.
I find myself escalating and continue to bring back so much stuff, but I know better. Those things won't be heard and I need to check my attitude. Bury it.
I've been in healthcare for 39 years. 36 years as an RN. I have 734 shifts left before I retire.
You know that number the way Denise knows where the crash cart is. The way a person knows the only number that matters in a room.
You are right about compassion fatigue. The name is wrong. It implies the caring wore out. What actually happened is that the caring kept going and the system that was supposed to hold it didn't, and what you're describing,the zombie feeling, the burying, the 39 years of bringing it back,that is not a failure of caring. That is what caring costs when nobody is keeping the account.
The moral injury you named is the real thing. Being called a puppet while you are holding the phone so someone's family can say goodbye on a screen. Saying nothing because nothing you say will get them home faster and getting them home is the job. Burying it. Showing up the next shift and burying more.
The stab wound has its scar. Yes. And you showed up anyway for 39 years and you are going to show up for 734 more shifts and that is not nothing. That is not a small thing. That is the whole thing.
I see you. This essay was written so people like you would feel seen.
I agree that compassion fatigue is less than accurate & can imply voluntary fatigue. It’s more like compassion impedence (stealing a word from our electrical world). It is the environment that impedes compassion. Yes, trauma history & other dynamics feed this outcome but the environment is the ultimate trigger, or so it seems to me.
Healthcare for profit? What could possibly go wrong? They know it's broken, they know how to fix it (or at least make it better) but they don't. Our representative government does not work for the people anymore. So the question is, who does it work for?
I worked in health care for 34 years (oncology). I have watched corporate America decimate patient care in the name of profit. I was not patient-facing, but I worked with the nurses and doctors and saw their struggles. For-profit medicine is a travesty. Capitalism at its worst.
From an anthology that a former student compiled and convinced me to contribute. "The Post COVID School"
For adults and children alike, a new psychological phenomenon has cropped up. While counselors and teachers have studied and introduced trauma informed care to students who by virtue of their environment and/or relationships, experience severe trauma and post traumatic distress disorder, there is a new version of it - Complex PTSD. The difference is there is no “post.” “With CPTSD you’re having a traumatic stress reaction, but the trauma is still happening. Unlike a car crash, and assault or other event, this keeps happening.” “The impact of complex trauma is very different to a one time or short-lived trauma. The effect of repeated/ongoing trauma – caused by people – changes the brain, and also changes the survivor at a core level. It changes the way survivors view the world, other people and themselves in profound ways.”
In the pre-covid world almost 60% of US students experienced some form of trauma. More than two thirds of children reported at least 1 traumatic event by age 16. https://www.samhsa.gov/child-trauma/understanding-child-trauma This aligns to negative impacts on academic performance and overall health. In my part of Western Illinois and Eastern Iowa, schools have had to adapt to the needs of refugee students who have migrated from many trouble-laden parts of the world. Many of them have lived in refugee camps and have had to move many times across the world. These students have now experienced a “double dose” of trauma. “Nobody has gotten hit with the mental health side of the pandemic worse than kids,” said Paul Gionfriddo, the president and CEO of Mental Health America, an organization that supports people with mental illness. “This is an ongoing traumatic event that kids have faced without the perspective of, say, 65-year-olds, who have lived through other kinds of trauma in their lives and have some perspective.” https://www.nbcnews.com/news/education/covid-having-devastating-impact-children-vaccine-won-t-fix-everything-n1251172
Still working at 75 as a RN discharge planner. 2 shifts a month. Worked full time through the COVID. I am not the oldest person in my department. Covid broke us.
For the love of God, can we please stop discussing Covid like its an event in the past which is no longer causing disability and death? Until we face the reality that it still exists, we have no hope of it ending.
Outstanding writing, award winning,actually.
Thank you!!
I agree ......
I worked in newspapers for 30+ years. It’s all I ever wanted to do.
I left in 2011 because I couldn’t handle the grief of knowing the industry was doomed.
So I trained into an OTA role in a hospital. I worked through COVID in a Geropsych unit where PPE was nearly nonexistent. My other OT/PT colleagues were on the medical floors along with the nurses.
It broke everyone.
During this time, the conglomerate that had purchased our Catholic NFP community hospital continued to squeeze costs.
Long-term nurses, doctors, and staff left in droves after the pandemic. I finally crashed and burned a couple of years later.
This is a long way of saying that of all the storytellers I worked with in journalism, this is one of the best-written pieces I’ve ever read.
And as someone who watched the front-line of healthcare be decimated, I can say you nailed what it was like.
Thanks for what you do.
Thank you!!
I’m covered in tears and snot bubbles again. I have a daughter - 27 years old with a son of her own - who is both medically fragile and because of that fragility is also financially fragile.
I’d like to be her safety net, except I am emotionally and psychologically fragile after a childhood of extreme abuse that I can’t seem to recover from, and after a retinal detachment that sidelined my career plans, and now I, too, I’m also financially fragile.
In December 2019, just as my grandson was turning one, I was invited to do a solo art exhibit at a new gallery space that was trying to gain footing way up in Fort Worth. It was slated to open March 1, 2020. I was dead center in the middle of a CPTSD collapse, one that started in 2016 when my daughter was first diagnosed, and then revealed her own childhood abuse that I was not privy to, and then my biological mother died, and then my daughter decided if she could only have a child when she was young she was going to go ahead and by God do it so she got pregnant at 19, and the Supreme Court got stacked and I knew exactly what that meant down the road. So I titled the show “fragile systems”. Every canvas started with me freeform writing about fragility versus resilience. Then covering it with a soft color. Big strokes that helped me breathe a little better. And then sometimes a little doodle about what a resilient system would look like. And then every painting wound up being flowers in a jar. Fragile things inside glass. Nature contained. I hung the show and scheduled some live paintings and opening events. And within two weeks Covid hit. “Fragile systems “ was closed.
My daughter just got out of the hospital last week. Again. And again she couldn’t get the medicine she needed and now your piece is pointing me toward some answers as to why this keeps happening. The staff does not know her yet. They can’t know her because it’s not the same staff. It’s a different hospitalist. A different infectious disease specialist. And a whole list of different nurses. Different doctors. Nobody remembers the precise anabiotic she needs and she misses weeks of work and time with her son and I can’t intervene because I’m in bed with tears on my face and snot bubbles on my lip, trying to hold my own brain in my head, and there isn’t an antidepressant on the market that can erase or put a blanket over this kind of grief. Then comes the shame. The feelings of failing as a mother. As an artist. As a person. I know this isn’t limited to my family, that we are one data point in a pattern that is so chaotic it just looks like static.
God bless Denise. Tell Patricia to tell Denise that there’s a woman in Texas who sees what she’s doing, who admired her greatly, and would love to hear any advice she has on resilience.
Wonderful article. Thank you for stating that great complexity so clearly. Every bit of it should be reflected on. One thing I will add, after working hospitals as an RN for 31 years, after the burn out, after the deadening, the awareness of the suffering of others can come back with such a vengeance it is breathtaking. Shore yourself up for that as best you can. I took refuge in drawing nature. It works for me somewhat. Please keep up your good work.
Thank you!!
It is amazing, and not always obvious, how ingrained this healthcare issue is in the USAer's psyche.
I lived in Spain for nearly 20 years before I was finally forced, because of a life-threatening double pneumonia, to use the Social Healthcare System available here. I still sometimes hesitate before going to see my assigned "head doctor", though the reticence has mostly been packed away as one of those things that maybe can't be unlearned but can be, like I say, packed away.
So, when I was in utter pain this past weekend from trapped gases in my thorax, it was of no consequence for me to go to my local health clinic and ask a doctor to check me in case maybe it wasn't trapped gases, maybe something else. I was attended at once, that doctor could consult my entire medical history on his computer, he looked me over, did an EEG, checked the blood pressure, suggested some habit changes and prescribed a couple of pills.
So, when that utter pain had not subsided the next day, and who has utter pain for two days from trapped gases, it was of no consequence for me to have my mate drive me into town to the hospital ER, where I was triaged, then put in a room, examined, given some meds, observed for a while, had an x-ray, another EEG, yup, it was trapped gases, confirmed, take this pill and we'll give you some paracetamol in an IV. Recovered the next day.
The entire thing cost me €4.51 ($5.30). That was for the two prescriptions. The potential cost of all the attention I had received never once crossed my mind, I could ask a professional to check me out, he or she would do so then suggest a remedy, I could take that remedy and find myself once again on the road to health, and it cost me less than a fiver.
I just can't understand why USAers are so hard-headed about not wanting to create the same kind of system for themselves. Really. This type of system works, it has its flaws, it is not free, costs will be shared by everyone, but for heaven's sake, it's really hard to hear stories like Tom's here knowing that that story has been told because hard-headed USAers are so hung up on their gosh-darned "freedoms" and "rights". Those two concepts have become the catalysts to the demise of American Empathy.
Had I not moved to Europe 40 years ago, I would not be here sharing these thoughts. People might be fondly remembering who I was, but I would not have survived that first dire illness. I am so thankful to a community like Spain that understands the importance of caring for the guy or gal who lives next door and created a healthcare system that reflects that care.
Thanks, Tom, for the read.
Cheers!
revel.
When I was stationed at Rota, my mother-in-law came to visit from Florida. While she was with us, she became very ill. We took her to the local hospital, where they diagnosed her and prescribed some medication.
The hospital didn't charge her, even though she wasn't a Spanish citizen, and the pharmacy only charged about 500 pesetas (at the time about $5) for the drugs.
We could have this, if we had the will to do it.
We cannot have this because too many who vote on it represent voters who believe in their christian hearts that somewhere, sometime, a person who is not as white as they are will be able to take advantage of such a system, and their Jesus just cannot have that. See also, expanded Medicaid in red states.
I was led to your blog by a poster at a political Website I frequent.
This hists close to home (really, since I live east of Scottsbluff).
As many socialists have noted in the past, "A system is what it does." Capitalism (the system our healthcare is built on) extracting value is what it does best. It's why the USA ranks at the bottom of OECD countries in healthcare outcomes.
No matter how hard I try, I can't get my conservative neighbours to see it. They can't. Conservatism is their religion, and socialism has been equated with godless communist heathenism all my life. "American exceptionalism" is very exceptional at creating stock market crashes, gutting communities, and extracting wealth and funnelling it up.
You can put all these figures, all these personal stories in front of them, and they can't process it. It's very much like Orwell's Nineteen Eighty-Four, where they don't even have the language to understand why thing are the way they are.
The same is true with other government services ("government should be run like a business" should die in a fire). When the Postal Service moved to close our post office, my wife and I mounted a campaign to save it (we were successful). The flunkies sent in from Omaha talked about things like Return-on-Investment, using faulty numbers and when called on it, blaming computer software (my wife was a software engineer before she retired).
The first rule of conservatism is you never take responsibility for your decisions.
Brilliant piece. Thank you. You've captured what it's like to be inside a system that doesn't care and you still do. It's hard.
I say it again ... your writing is exceptional. Thank you
This was difficult to read, but what really sticks out to me was "moral injury". "Compassion fatigue" bothers me because it feels like it's my fault and that I don't care anymore. Which just isn't the case. Frankly I feel like a zombie when I go to work now. These years since COVID have actually had its own devistation. There has been a deep moral decay and loss of empathy because our society has been suckered into believing they're being cheated out of they're due share. I can't count how many times I've listened to patient's talk about how doctors and nurses are puppets to the political machines and that is our only motivation for stealing money from "the hard working people of this country". "You were lucky to have a job during COVID" All while watching FOX News and president "IIm smarter than doctors". And I must say nothing that will provoke anything that isn't to the goal of getting them out of the hospital. Although this is not the majority of the people I've taken care of, but a stab wound has its scar.
I find myself escalating and continue to bring back so much stuff, but I know better. Those things won't be heard and I need to check my attitude. Bury it.
I've been in healthcare for 39 years. 36 years as an RN. I have 734 shifts left before I retire.
I get what you said. ❤️🩹
You know that number the way Denise knows where the crash cart is. The way a person knows the only number that matters in a room.
You are right about compassion fatigue. The name is wrong. It implies the caring wore out. What actually happened is that the caring kept going and the system that was supposed to hold it didn't, and what you're describing,the zombie feeling, the burying, the 39 years of bringing it back,that is not a failure of caring. That is what caring costs when nobody is keeping the account.
The moral injury you named is the real thing. Being called a puppet while you are holding the phone so someone's family can say goodbye on a screen. Saying nothing because nothing you say will get them home faster and getting them home is the job. Burying it. Showing up the next shift and burying more.
The stab wound has its scar. Yes. And you showed up anyway for 39 years and you are going to show up for 734 more shifts and that is not nothing. That is not a small thing. That is the whole thing.
I see you. This essay was written so people like you would feel seen.
734 shifts. I'll be here when you get to zero.
-Tom
I agree that compassion fatigue is less than accurate & can imply voluntary fatigue. It’s more like compassion impedence (stealing a word from our electrical world). It is the environment that impedes compassion. Yes, trauma history & other dynamics feed this outcome but the environment is the ultimate trigger, or so it seems to me.
Healthcare for profit? What could possibly go wrong? They know it's broken, they know how to fix it (or at least make it better) but they don't. Our representative government does not work for the people anymore. So the question is, who does it work for?
Taxation without representation?
Hmmmm, why does that sound familiar?
One can’t help but think the reason the oligarchs want to create a civil war is that they want to avoid a revolution…
It's heartbreaking.
I worked in health care for 34 years (oncology). I have watched corporate America decimate patient care in the name of profit. I was not patient-facing, but I worked with the nurses and doctors and saw their struggles. For-profit medicine is a travesty. Capitalism at its worst.
From an anthology that a former student compiled and convinced me to contribute. "The Post COVID School"
For adults and children alike, a new psychological phenomenon has cropped up. While counselors and teachers have studied and introduced trauma informed care to students who by virtue of their environment and/or relationships, experience severe trauma and post traumatic distress disorder, there is a new version of it - Complex PTSD. The difference is there is no “post.” “With CPTSD you’re having a traumatic stress reaction, but the trauma is still happening. Unlike a car crash, and assault or other event, this keeps happening.” “The impact of complex trauma is very different to a one time or short-lived trauma. The effect of repeated/ongoing trauma – caused by people – changes the brain, and also changes the survivor at a core level. It changes the way survivors view the world, other people and themselves in profound ways.”
https//www.huffpost.com/entry/coronavirus-pandemic-ptsd-mentalhealth-n-5fad6f5ec5b635e9dea0038f?ncid=APPLENEWS00001((2020)
In the pre-covid world almost 60% of US students experienced some form of trauma. More than two thirds of children reported at least 1 traumatic event by age 16. https://www.samhsa.gov/child-trauma/understanding-child-trauma This aligns to negative impacts on academic performance and overall health. In my part of Western Illinois and Eastern Iowa, schools have had to adapt to the needs of refugee students who have migrated from many trouble-laden parts of the world. Many of them have lived in refugee camps and have had to move many times across the world. These students have now experienced a “double dose” of trauma. “Nobody has gotten hit with the mental health side of the pandemic worse than kids,” said Paul Gionfriddo, the president and CEO of Mental Health America, an organization that supports people with mental illness. “This is an ongoing traumatic event that kids have faced without the perspective of, say, 65-year-olds, who have lived through other kinds of trauma in their lives and have some perspective.” https://www.nbcnews.com/news/education/covid-having-devastating-impact-children-vaccine-won-t-fix-everything-n1251172
Thank you for that information
This resonates…. Beautifully written, gutting, true…
Outstanding writing again. Thank you Tom
Still working at 75 as a RN discharge planner. 2 shifts a month. Worked full time through the COVID. I am not the oldest person in my department. Covid broke us.
Thank you for what you did!!
For the love of God, can we please stop discussing Covid like its an event in the past which is no longer causing disability and death? Until we face the reality that it still exists, we have no hope of it ending.