H. Steven Moffic, MD

Dr Moffic talks about the coronavirus pandemic and the burnout epidemic and what those elements mean psychologically for clinicians. 

The burnout journey goes back all the way to the 1970s, it only applied to the general public at the time. Around the year 2000, the burnout rate among physicians was virtually nil compared with the rest of the workplace and that is because we were more or less in control of what we were doing. But then for profit managed care came to be.

Burnout in the medical industry arose later on with the main symptoms being emotional exhaustion, cynicism, and feeling ineffective. Treatments were ineffective, mainly because it is a systems issue, with oppressive enterprises creating disengaged workers and clinicians and who experienced micro-trauma on a daily basis. Wellness is often discussed to help burnout, but it doesn't do the job because it insinuates the cause of the problem is on us.

During these challenging times, physicians have to be proactive in helping ourselves, especially now that the pandemic is upon us. And that starts now. There are support groups online for physicians if you just want to talk or get advice about how to maintain your mental health, and you can form your own support groups. That is hard principally because we are so busy with our work, but there are ways we can take care of our health. If you find ways to make your system work better, try to share it with other people. We have to do what we can make ourselves safe, make ourselves healthy. 

We also need administrators who actually love us. Love is a strange word in medicine. When I received an administrative psychiatry award in 2016, that is what my lecture was about. On top of everything else, administrators need to love your staff, and medical administrators, love us in our work. That is the only way we can work together in a compassionate and caring way. 

Dr Moffic is an editorial board member and regular contributor to 

 He was a tenured Professor at the Medical College of Wisconsin until he retired in 2012. Since then he has functioned as a private community psychiatrist providing pro bono services locally, nationally, and internationally. Currently, Dr Moffic is focused on four major advocacy initiatives: physician burnout, climate instability, Islamophobia, and Anti-Semitism. He is co-editor of 

Combating Physician Burnout: A Guide for Psychiatrists

 with Sheila LoboPrabhu and Richard F. Summers.

Videos

During these challenging times, physicians have to be proactive in helping ourselves. And that starts now. 

The Paradox of Self-Help

If you are in your teens, the pandemic might feel like you’ve lost your world. You may even be sorry that you don’t actually have to go to school. You’ve lost that. You’ve lost seeing your friends, you’ve lost sports, and you’ve lost your freedom. And you may have lost them quickly becasue many schools closed in 15 minutes flat. Some of these changes can never be made up completely, such as events like graduation. And, you’re quaranteened!

What can make up for that? Potentially, a lot! First, it’s healthy to feel sad and mourn what has been lost, temporarily—or permanently. Then you can move on creatively and find new things. Also, think of the future. I bet when you return to your favorite activities, you’ll love and appreciate them even more.

Often, when someone graduates from high school, you get the book authored by another doctor, Dr Seuss’s, 

 Well, I want to give you some of the lines from that, but you can also read the rest whenever you want.

You’ll be on your way up!
You’ll be seeing great sights!
You’ll join the high fliers
Who soar to great heights.

You won’t lag behind, because you’ll have the speed.
You’ll pass the whole gang and you’ll soon take the lead.
Wherever you fly, you’ll be best of the best.
Wherever you go, you will top all the rest.

Except when you don’t.
Because, sometimes, you won’t.

I’m sorry to say so
but, sadly, it’s true
That Bang-ups
And Hang-ups
Can happen to you.

All Alone!
Whether you like it or not,
Alone will be something
You’ll be quite a lot.

And will you succeed?
Yes! You will, indeed!
(98 and 3/4 percent guaranteed.)

Today is your day!
So . . . get on your way!

Dr. Seuss is actually not a real doctor, but he is very wise. And this real Dr Doctor, Dr. Moffic, will guarantee 100% that if you are confident and get the support, you will come out of your quaranteen better and stronger. We call that resilience. To a great future!

 is an editorial board member and regular contributor to 

. He was a tenured Professor at the Medical College of Wisconsin until he retired in 2012. Since then he has functioned as a private community psychiatrist providing pro bono services locally, nationally, and internationally. Currently, he is focused on four major advocacy initiatives: physician burnout, climate instability, Islamophobia, and anti-Semitism. He is co-editor of 

, with Richard F. Summers and Sheila Loboprabhu.

Articles

First, it’s healthy to feel sad and mourn what has been lost, temporarily—or permanently. Then you can move on creatively and find new things. 

Open Letter to Quaranteens: Oh, the Places You’ll Go!

President Trump and others have said we are at war with this virus. On May 25th, we honor our soldiers who have fallen while serving. Since once a physician, always a physician, let’s also honor our psychiatrists on this Memorial Day who have fallen from the coronavirus.

We purposedly left out a detailed eulogy about one physician colleague who relates to psychiatry in a different way but should still be remembered for the painful connection—the emergency physician who died by suicide after a bout with the virus. Her story was covered extensively in the public media, and it would be inappropriate and likely a violation of the “Goldwater Rule” to speculate more about her suicide. Still, we mourn her loss.

Of course, we also take a moment to think about the patients, usually inpatients on a psychiatric ward, who we have heard about contacting and dying from the coronavirus. Again, for privacy sake, they are not identified, but they are part of our psychiatric extended family.

Although there may be more victims, here are a few of our colleagues who have lost their lives during this pandemic.

Dr Lancaster was apparently the first (and oldest) psychiatrist who died from COVID-19. He died at the age of 98 on March 17, 2020, one of two psychiatrists who passed away at an early 

of Lambeth House, a retirement community in Uptown New Orleans.

Known as “Dr Bob,” he contributed to psychiatry for over 70 years, including tying psychiatry together with religion and literature. One of his earliest contributions was aiding soldiers returning home after serving in World War II. A late focus was on helping physician colleagues who struggled with substance abuse. At one point, he was president of the 

In his later years, he turned toward spiritual endeavors, including being a founding member of Luke’s House Free Clinical Medical Ministry in the wake of Hurricane Katrina. Even into his 90s, he volunteered clinic time there.

He also loved to read Shakespeare and other books. That led him to consider Shakespeare to be “the first psychiatrist because he understood the dual nature of humans.”

Dr Smith died the day following Dr Lancaster’s death at the age of 92.

Like Dr Lancaster, Dr Smith was also well-known in New Orleans for his many interests. Having studied in his younger years at the Academy of Fine Arts, he later served on the Board of the 

. He was connected to many cultural events for which New Orleans is known (and that I loved), including the carnivals and the famous Galatoire’s Restaurant, where he celebrated many special occasions.

Born in Guatemala City, Dr Castaneda served on the front lines of psychiatry in private practice before he was infected by the coronavirus, dying on March 25 at the age of 64. Before that, he worked as Director of Inpatient Psychiatry at 

Perhaps he was best known for his artwork, especially caricatures. He could be seen creating them wherever he was—from concerts or park benches—giving them away freely as gifts. He used his talent to illustrate books on psychiatry and addiction.

During the pandemic, he switched to seeing patients through telemedicine. When he went into the hospital, he apparently took his computer with him in order to continue contact patients. According to his wife, he texted a last message: “I have patients I have to save.” It turned out that he himself was a patient who could not be saved.

Dr Gullattee died after testing positive for the coronavirus in early May. She was an esteemed faculty member at Howard University for more than 50 years.

She started medical school at a California school, but after becoming disillusioned by the racial attitudes, transferred to Howard. Unusual for a would-be psychiatrist, her anatomy dissections during a US Public Health summer fellowship were so good that they were recorded for teaching films.

Dr Gullattee was a socially oriented psychiatrist and civil rights activist. She often wore African-inspired attire. She consulted during the Attica prison uprising in 1971, international medical missions, and attendance at a Pan African conference.

Clinically, she specialized in substance abuse, becoming an expert on the cocaine epidemic in the 1980s. She reached out to the most vulnerable, even going to the streets and alleys in Washington, DC despite the risks.

All of these psychiatrists had significant artistic interests: Shakespeare, music, art, and fashion. They all involved themselves in their communities in other aspects besides their psychiatric practice.

Although their numbers are small, they represented different cultures, almost at the respective prevalence of their communities: 50% were white, 25% Hispanic-American, and 25% African-American. Let’s hope the overall numbers remain small.

If the reader notices anything in these eulogies that need revision or knows of other psychiatrists who have died from the coronavirus, please let us know, as we want to honor them appropriately. Send information to 

This article was originally published on May 24, 2020, and has since been updated. -Ed

One was a civil rights activist. Another, a book illustrator on the side. A third practiced medicine for over 70 years. All served as mentors. No one loss is less profound. Their families and psychiatry mourn them.

In Memoriam: Psychiatrists Who Are Coronavirus Casualties

Although recognition was delayed, it soon became apparent that the infection and outcome of 

 was being influenced by the metaphoric racial virus. On top of the harassment of Asian-Americans as we discussed in the 

, much higher death rates are occurring in African Americans and Hispanic Americans than their percentage of the population where they live.

Racial virus has spread to the police department in Minneapolis and beyond after the killing of Mr George Floyd. As protests and riots are met by the police and the National Guard, crowding and lack of wearing masks will make a spike in viral infection inevitable.

While all viral epidemics have dissipated in 2 to 3 years or less, the racial virus has persisted for at least 400 years, with some reduction over time, but in times like now, the problem is exacerbated. No wonder. Racism and scapegoating of others are part of human nature; infectious viruses come and go.

Given those comparisons and connections, it might be advisable not to bring in federal active-duty troops right now, but rather to bring in the psychiatrists. We very well might have a better understanding of how to deal with our inborn tendencies.

 is an editorial board member and regular contributor to Psychiatric Times. He was a tenured Professor at the Medical College of Wisconsin until he retired in 2012. Since then he has functioned as a private community psychiatrist providing pro bono services locally, nationally, and internationally. Currently, Dr Moffic is focused on four major advocacy initiatives: physician burnout, climate instability, Islamophobia, and Anti-Semitism. He is co-editor of 

, with Sheila LoboPrabhu and Richard F. Summers.

It might be advisable to bring in psychiatrists to keep the peace and not federal troops.

The Coronavirus Meets the Racial Virus

 on the Navajo Nation and the coronavirus, and the news was not good. Sunday was within the 57-hour home lockdown, albeit in crowded conditions. It was called for by the tribe because of the rising death toll, inadequate resources, and the highest infection rate per capita in the country (I first wrote 

The Navajo population vulnerabilities include a high rate of lung disease due to decades of exposure to uranium mines and the use of wood or coal for heat and cooking. It is also hard to wash your hands as often as recommended when you don’t have running water, as 40% do not.

Interviewed was a physician from the tribe who was working on the front lines. What was so different and poignant about that from what we have typically seen in the media is she personally knew most of her patients in one way or another. In general, physicians are ethically discouraged from familiarity with patients because it can compromise objectivity, and if anything goes wrong, the guilt and grief increase. However, as I experienced when I was only one of two psychiatrists on an Army base in a small Alabama town, you sometimes not only have no choice. The higher ethical principle is trying to save a life no matter what.

We in mental health care shouldn’t be surprised with these pandemic statistics if we are familiar with the psychiatric ones, though maybe most are not with Native American reservations separate from mainstream communities. The suicide rate is well above the national average.

 The prevalence of substance abuse, domestic violence, postpartum depression, and PTSD is also high, while resources are low.  These concerns are true of most tribes, in reservations or not.

The casinos are now closed, adding to financial stress. Some Native American tribes received federal relief funding, but 6 weeks after it was promised and only after a suit was filed.

When we think about reparations in the United States, we should not forget the needed repair from the damage that the Navajo Nation and other Native Americans received during the later settling of this country.

1. Navaho Epidemiology Center Update, Vol. 1, May 2016. Accessed May 29, 2020. 

https://www.nec.navajo-nsn.gov/Portals/0/Announcements/Navajo%20Epidemiology%20Center%20Update%20May%202016.pdf

The Navajo population are vulnerable to lung disease due to decades of exposure to uranium mines and the use of wood or coal for heat and cooking. It is now vulnerable to COVID-19.

The Navajo Nation and Our Country in The Coronavirus Pandemic

Different groups are more susceptible to 

 both socially and medically, which is why cultural sensitivity is so important, especially now. H. Steven Moffic, MD, shares some important insights about the topic.

He was a tenured Professor at the Medical College of Wisconsin until he retired in 2012. Since then he has functioned as a private community psychiatrist providing pro bono services locally, nationally, and internationally.

Currently, he is focused on four major advocacy initiatives: physician 

, climate instability, Islamophobia, and anti-Semitism. He is co-editor of 

 with Richard F. Summers and Sheila Loboprabhu.

Different groups are more susceptible to COVID-19, both socially and medically, which is why cultural sensitivity is so important during this time.

Cultural Matters and the Coronavirus

Dr Steve Moffic talks about about some of the psychological dangers clinicians are facing during the 

Dr Moffic is an editorial board member and regular contributor to Psychiatric Times. He was a tenured Professor at the Medical College of Wisconsin until he retired in 2012. Since then he has functioned as a private community psychiatrist providing pro bono services locally, nationally, and internationally.

Currently, he is focused on four major advocacy initiatives: physician burnout, climate instability, Islamophobia, and anti-Semitism. He is co-editor of Combating Physician Burnout: A Guide for Psychiatrists, with Richard F. Summers and Sheila Loboprabhu.

Dr Steve Moffic talks about about some of the psychological dangers clinicians are facing during the pandemic in this video.

COVID-19 and the Iceberg of Hidden Trauma

Most parents come to realize their children pay more attention to what they do, rather than what they say. Such elemental observations failed to make their way to the White House.

Recently, a valet of President Trump and his family 

 for COVID-19. Apparently, he and other valets do not often wear a mask. As we have seen, neither the task force nor the President have worn masks during their media appearances.

Such behavior is not unknown for those in power (mostly males) for fear of appearing weak. FDR went to great lengths to cover his polio immobility. However, if we want the public to wear masks for protection from the coronavirus, not complying with self-protective measures does not model safety.

Not wearing masks can only lead to more infection and deaths. We need a different show of strength.

If we want the public to wear masks for protection from the coronavirus, not complying with self-protective measures does not model safety.

Masks as a Show of Strength

“Southern trees bear a strange fruit . . . “ -

 reminded me that April 20 was the 81st anniversary of the day in 1939 the Great jazz singer, Billie Holiday, recorded the song 

. It is among the most searing recordings in history. It was written by a Jewish schoolteacher named Abel Meeropol (pseudonym: Lewis Allen) because he was disturbed by a picture of a lynched black man in the South.

But what does this song have to do with the Coronavirus pandemic? We no longer have lynchings, but do have a significantly disproportionate number of deaths of Black-Americans from the virus. Racism still kills Black-Americans. Maybe we need not only an updated song like 

Though there were attempts to include racism in our DSMs, that so far has failed to be approved. Regardless, psychiatry still has a role to play in reducing it through our understanding of scapegoating and prejudice. Perhaps we just need courageous partnerships like that illustrated by Billie Holiday and Abel Meeropol to do so.

Strange Fruit was written by a Jewish schoolteacher after seeing a disturbing picture of a black man, lynched in the South. But what does this song have to do with the Coronavirus pandemic?

The COVID-19 Pandemic Shows That We Still Bear Strange Fruit

It is one thing to hear from colleagues about how patients and the public are coping with the pandemic. It is quite another to hear directly from children. Five-year-old Adam, his parents, and I invite you to join 

With any widespread societal crisis, parents inevitably ask psychiatrists and other mental health professionals how to talk to their children about trauma. Of course, this has been true for the coronavirus pandemic. Because our everyday lives have been altered and the return to what was is nowhere in sight, answering such questions is even more challenging.

 has tried to address how our youth are feeling about this with recent contributions by 15-year-old 

. Now, we are sharing a unique communication by Adam and his mother, whose story first came to me by a friend of a friend. My friend worked in China for years and had a friend there who was an “American Israeli,” married to a “Spanish” woman. Together, they all left China about 3 months ago and are waiting out the epidemic in California.

When I read the “booklet” put together by the mother-son duo, I was moved to tears, both of sadness and joy. Indeed, it was so insightful and inspiring to me that it led to my last Coronavirus Chronicle, “

From Tragedy to Realism: The Role of Optimism in Pandemic Recovery

I thought the booklet would be a valuable resource in particular for child and adolescent psychiatrists, their young patients, and families. I hope it is helpful for others in mental health care who wonder what young children are worried about as far as the coronavirus and the accompanying flood of losses.

Beyond that, I found it to be a work of art, and an informal example of art therapy. The family wants this to be a gift to us and other families. As the father wrote to me:

“We would love to show Adam’s drawings to other parents and kids who are just now starting their ‘voyage’; we are sure it can do a lot of good.” I am sure, too, and hope you will find it helpful.

It is one thing to hear from colleagues about how patients and the public are coping with the pandemic. It is quite another to hear directly from children. Five-year-old Adam, his parents, and I invite you to join Team Earth. Here’s why.

Author | H. Steven Moffic, MD