What can change in the life of the doctor and every healthcare professional in a pandemic situation such as the current one for COVID-19?Advertising message Certainly the situation we have been experiencing for almost two months, everyone says it now, is inevitably changing many aspects of our life, of our existence. Each significant change brings with it changes in the way we see and think ourselves, to see the world and others, changes in the way we feel and live reality, changes in our personal and social behaviors. And rightly it may be worth asking: are there and what can these changes be that is going on and probably going to be facing the doctor and the healthcare staff in general?
I venture to make some reflections in this sense since in my professional career I have known and experienced the demanding and dramatic aspects of an intensive care. Subsequently, after specializing in psychotherapy, I began to deal, for years, with investigating, studying and evaluating the effects and psychological reactions in the face of difficult or problematic situations that the human person can find himself experiencing.
So what is changing? In the first place, I would say the self-image, which inevitably and necessarily reflects a change in the perception of the other and in the relational experience with the other. I would say these changes can concern three aspects: one’s health, one’s goodness, one’s power.
Regarding one’s own health, I would emphasize that taking care of sick or needy people can mean postulating one’s health or one’s sufficiency. I can cure because I’m healthy. Precisely because I am healthy and I have sufficient defenses against diseases, in particular of the disease I am treating, and I know how to deal with it, I perceive myself and build my ability and possibility to cure the other, the sick.
In this line, assisting a needy person can obscure the awareness of one’s need or of the risk one is facing. Perhaps many of our colleagues, at the beginning of this dramatic pandemic, had no way of realizing their need for self-protection. And taking care of the health of others, in this case, entailed compromising one’s health (and in any case there is always the risk of being able to compromise it). So in this situation the other’s disease no longer postulates my health, but rather invalidates it, puts it at risk: it underlines how much I, a doctor, nurse, psychologist, too … am not immune from the disease, but I can be vulnerable fragile and weak.
Regarding the second aspect, goodness, I would say that being and feeling a benefactor or savior can contribute to guaranteeing a good self-image, as a good person, who knows how to be welcoming, understanding, knows how to embrace and support. In a pandemic situation such as the current one, the patient, who is a source of possible contagion and therefore of disease, becomes an enemy, a threat, becomes the greaser from which we must keep away. In this case my goodness, my understanding and welcome can fade; instead of feeling good and welcoming I can feel tense, hostile, or cold, distant, or even cynical: the patient is looked at with suspicion, one must keep his distance from him! And I could even get angry feelings towards him because it makes me feel bad, because in some way he is undermining my goodness, the image of me as good and welcoming. In other words, the difficulty or impossibility of helping (because I have to keep at a safe distance, because I cannot or cannot have all those precautions and delicacies and affection that I may usually have towards a patient) facilitates the onset of the doubt about my goodness and I can even go so far as to perceive myself as cynical or even evil.
Advertising message The last aspect, your own power. In general, the doctor, or anyone who carries out a care-giving profession, can propose himself as an omnipotent father, who is able to solve more or less everything and therefore able to have a certain power over the disease and the psychophysical state of the patient. But the encounter with a pathology for which it is not easy to have adequate therapy, with a disease that is therefore not easily resolved, attacks the image of the powerful savior, generating feelings of helplessness and depression in the professional: the discovery of his impotence can make the patient’s illness live as unbearable or persecutory!
In summary, I would say that this pandemic is having not only clinical but also psychological effects, and not only on those who have been affected by the virus, but also on those who take care of those affected. On the one hand, therefore, I believe that all this can help us doctors, and all healthcare workers, to a useful and perhaps appropriate reduction of the idealized vision of our profession. On the other hand, it seems important to me to be aware of the fact that there may be changes in the perception of self-image, of the other person, of one’s profession and role.
Therefore, adequate reflection and awareness of the changes that this pandemic is generating, I think can certainly help us to reduce the tendency to an idealized vision of oneself, but at the same time it can warn us, protect us and preserve us from feelings of deep frustration that could open the leads to more serious and dramatic phenomena such as those of burnout.