I was reading this article in the New York Times about Dr. Lorna Breen (https://www.nytimes.com/2020/07/11/nyregion/lorna-breen-suicide-coronavirus.html), and it literally took my breath away. This awful pandemic has claimed so many lives, in so many different ways.

Sadly, it made me think of a medical school classmate of mine who took his own life a few years ago. He arranged for this to post to Facebook the next morning:

I didn’t know Dr. Breen, but I did know Brandon (not his real name). And from what I’ve read and from what I know, it seems they were both forces to be reckoned with. And my thoughts keep going to that final dark moment, when there didn’t seem to be any other option. And it haunts me.

At the time, our ED was struggling with all the usual things…albeit, not pandemics, but all the other things that affect our jobs, and in many ways our lives, on a daily basis. I wrote the following email to my co-workers:

As I have struggled through this week in the ED with difficult patients, challenging consultants, and near record numbers, I think about Brandon and what he must have been going through, the pain he must have felt especially at the time he wrote this post, knowing what he was about to do. And one simple thought came to mind:

I get it.

It doesn’t matter if you have been doing this 2 years or 2 decades…we have stressful jobs. I don’t think people can truly appreciate what we do and how we feel. I don’t think people…even some other physicians…understand that we don’t punch a clock and leave these patients behind when we go home. I am willing to bet that every last one of us has woken up in the middle of the night at least once thinking about “that kid you saw”, wondering if you had done the right thing. Any of you who have been on the receiving end of “hey – remember that kid you saw?” as I have, know that feeling in the pit of your stomach, and are familiar with the cold sweat that breaks out, even in a few seconds. And, any of you who have been involved in a bad outcome as I have, knows that those cases…those families…those children…stay with you forever.

So, as I have gone through my shifts this week, I have dealt with disgruntled families with unrealistic expectations (often times, the result of advice from another physician); I have physically restrained 2 nine year olds and physically pulled the mother off one of them as she was hitting him with her shoe; I have felt belittled by consultants, my approach and management plan questioned; I have given families news they didn’t want to hear, and I have had to repeatedly say “I don’t know”; all with the backdrop of 20-30 patients in the waiting room seemingly at all times, in the back of my mind wondering which of those triage level 4/5 are getting sicker.  I was fortunate that I was not involved in any of the 4 codes that resulted in deaths we had in the department this week. My heart goes out to those of you who were…each one more heartbreaking than the last.

This is my plea to you. We have tough, tough jobs. Few can truly understand our professional lives. But we do.

We have all taken varied roads to get here, but now we are together. We are a large, sometimes dysfunctional family, and everyone has their individual struggles and frustrations. I am the first one to say that I have let those struggles and frustrations get in my way at times. We don’t always get along or see eye to eye, but I know that if I were at the point that Brandon was last week, this group would drag me out of the dark place I was in and make sure I was safe and knew I was supported. I know that because it has happened to me.

We don’t have to love each other…we don’t even have to like each other. But, we do have to support each other. No matter what. There are plenty of people out there that are willing to Monday morning quarterback what we do, and if we don’t have each other’s backs, I truly worry about our longevity, our happiness, and our well-being.

I apologize for the length, and for the gravity of this email. Again, do with it what you will…take it to heart, delete it, whatever. But one thing I have learned after being here for 20 years is that if we don’t stand together, we will slowly fall apart.

So, as I read about Dr. Breen, saddened by the fact that we have been robbed of yet another young, promising, motivated physician, I am reminded that as bad as this pandemic is…and truly believe it is awful…when it gets better (and I have to believe that it will), we can’t forget. Because all the other things that have always been there but got shoved to the back burner by COVID will be there again. And no matter what kind of medicine you practice, there will be unique (and some not-so-unique) stressors.

We are always expected to be kind to our patients. But my plea to you is to be kind to each other and, more importantly, yourself. You’re worth it. And I promise there is someone out there who understands what you are going through.

Sometimes you just have to ask.

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