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Editor's Note: Dr. Tsion Firew is a New York-based emergency medicine specialist. She is an ardent advocate of the advancement of high-quality global emergency medicine, an adviser to the Ethiopian Ministry of Health, and a member of her covid-19 response team. The opinions expressed here are his. Read more opinion at CNNe.com/opinion
(CNN) - Last weekend I was on CNN discussing the importance of supporting the mental and emotional health of medical professionals. I compared this pandemic to an invisible bomb that went off in our emergency departments.
Twenty-four hours later I learned of the death of my colleague, Dr. Lorna Breen. A day later I learned from media reports that she had committed suicide. It was a double blow, as if he had died twice.
Lorna had survived covid-19 earlier this month. As her physical symptoms improved, the mental cost of the pandemic continued to worsen. And so I spent Tuesday, my birthday, mourning the most recent devastating loss of a colleague, a friend. And while crying, I reflected.
The world acclaims medical professionals as heroes, and don't get me wrong - public praise has been a welcome change. Our jobs were heartbreaking long before this crisis and will continue to be long after we return to normal. I am grateful for the recognition.
But Lorna's untimely death is painful evidence of the hidden battle that so many frontline doctors, nurses, and workers are waging right now. A battle that words of praise, while welcome, simply cannot be beaten.
I see her unfold in front of me every day in the emergency department here in New York City. It is not the first time that I work in difficult circumstances. I saw many tragedies working as a volunteer medic in Iraq during my four weeks on the battlefront with US-backed Iraqi soldiers. But I never imagined a future where I would worry about so many colleagues unable to breathe, presumably due to coronavirus infection.
We treat everyone as if they have the coronavirus, that's what risk mitigation requires. I treated the father of a friend in critical condition, and on top of being in an already terrifying situation, I had to start the difficult conversations of end-of-life care. He survived, but discussions about whether to intervene and to what extent under such pressure leave scars.
I did not conceive advising a nurse I know in my work department in the face of their despair and helplessness after infecting their mother with the virus. Her mother also survived and left the hospital after several days of oxygen therapy, but the trauma of her fault will endure and it will take much, much longer to heal.
I never thought I would infect myself. To make matters worse, I didn't have access to the tests when I got sick. Fortunately, my symptoms were such that I was able to convalesce at home (chills, body aches that turned into a relentless headache and then exhaustion) and return to work a week later. No difficulty breathing, no respirator. Luck.
I couldn't imagine that I would see such an alarming number of older adults and nursing home patients die at a rate that none of us had experienced. I never thought that families of patients would be prohibited from visiting their dying loved ones; that he'd give them updates over the phone and offer last-minute video calls to say goodbye. How does one prepare to facilitate a goodbye through FaceTime?
We are facing death at such an accelerated rate that the expression "unprecedented" is not adequate, it is not enough. This situation is unlike anything that any of us could have prepared for.
To make the trauma even more profound, many health workers were promised personal protective equipment that never came. The emergency department I work for has been well-stocked, but other hospitals in New York City continue to experience shortages. We put ourselves and our loved ones at risk every time we go to work and we depend on the elements of personal protection to keep us safe, to reduce the risk of our families.
We reach physical and mental limits beyond imagination. The next day, we exceeded those limits. And we need help.
In Iraq, we provide care under immense levels of stress, often with limited access to resources. Prior to our deployment, we received training on what to expect and how to manage the mental and emotional stress of health care in a war zone.
Doctors in war zones return home likely to develop post-traumatic stress disorder (PTSD) and related physical ailments. The long-term risks are real and well documented. They are at a much higher risk of self-harm and are more prone to substance abuse and depression.
Now, in the midst of the covid-19 pandemic, healthcare professionals around the world face extraordinary levels of pressure that are not so different from those in a war zone. The trauma of this crisis is creating a new generation of war veterans at home, each of whom is serving our country and needs our support. But with the current capacities of our institutions and the cultural stigmatization of mental and emotional health problems, we as a country are not prepared to support them.
The sad truth is that the United States has never provided adequate mental and emotional health treatment, like PTSD, to brave citizens who put the country ahead of their personal interests. As we begin to imagine a post-covid-19 America, we must act better in front of all of our veterans, including the hundreds of thousands of health workers who have suffered the trauma of this pandemic. That starts by de-stigmatizing mental health issues and making it easier for doctors, nurses, and others to find the help they need.
As I mourn the loss of Lorna and so many patients, I acknowledge how fortunate I am to have been trained to practice medicine in contexts of conflict, to have received guidance that so many others did not. I keep my head down, but my eyes are wide open. Medical professionals are truly heroes, but we are also human. Many of us are suffering much more than we can express and the burden of this moment on our shoulders is too heavy.
Pay attention to our call. The front line of battle in this pandemic needs mental health and emotional support resources to process the destruction that we cannot avoid, that we cannot solve. The next wave is coming. We need help before it is too late for more of us.
#coronavirus # covid19Mental Health