Three mountains must be climbed to emerge unscathed.
Climb every mountain
Search high and low
Follow every byway
Every path you know.
-The Sound of Music
Imagine the coronavirus pandemic is a mountain as high and distant as the one the Von Trapp family climbed to escape the Nazis. Imagine, too, that Coronavirus Mountain is the highest of three to scale. Burnout Mountain lies in the back, and Trauma Mountain vaguely sits in the distance. There is no way to get to the Valley of Safety and Health but to climb the terraine, ready or not.
Coronavirus Mountain grabs our attention first because of its awesome ruggedness. In the good old days, now called BC (Before the Coronavirus), it drew climbers and sightseers. It is said that the virus has already arrived and lies in wait, but we can’t see it. Its land is empty of humans who fleed from undue fear, the kind that is a “mind-killer.” There are rumors that drove some to go mad.
We were foolishly delayed by the government in exile on April 1st. We got the go-ahead on April 8, the first day of Jewish Passover week and hope to reach the promised valley by Easter Sunday. However, we discovered supplies were both inadequate and old. There were no canisters of oxygen. Yet, there was nothing else to do but forge upward.
Too many are falling by the wayside, and others are passing away. The rest, too many to count, are trying to keep the “right amount” of fear to fuel their journey of flight. They are supported by safety workers and health care professionals, including mental health clinicians, who are stationed at rest areas along the way.
When we reach a certain height, we can dynamite the peak. We leave all the electronic medical records up there. We set off the explosion and wait for those too burned out to catch up. They have overcome obstacles created by the for-profit managed care companies, set up especially for physicians to keep them as productive as to increase profits. These administrators are also said to have a secret escape route so they can avoid getting too close to “the other 99%.”
About 25% of the general population and 50% of health care workers are burned out. They were hit by this psychological contagion years before the pandemic. They had to climb a smaller mountain first. Some got depressed and, tragically, a few die by suicide. But their extraordinary resilience, developed in caring for so many others, kicks in and they start to climb Coronavirus Mountain. Before they do, they set a wildfire at the top in case any administrators remain in their luxurious houses that oversee the lands. They meet the others on the plateau of Coronavirus Mountain, its curve flattened by the dynamite, and begin the descent. Halfway down, however, they are caught in a fog. When it clears, they see a smaller-yet no less mighty-mountain to climb.
The climbers are warned by the psychiatric advance scout who went ahead to warn there will be trauma along the way, but they can overcome these challenges, as long as they see a mental health caregiver when trauma hits. Those on the frontlines of psychiatric care have been supporting each other, sharing therapeutic stories, communicating ways to provide care on a mountain, and setting booby traps for any non-medical administrators that are trying to skip ahead of the line.
Therapeutic trekkers were loaded with ample supplies of empathy, compassion, morality, and some medications like propanalol and antidepressants (all they could find were samples). The scout found out the administrators set up detours to false promises of eternal life, but that fork in the road was littered with fool’s gold.
The heroic climbers see adversities ahead and sense pre-traumatic stress. Some who slip or lose their way are traumatized but still push ahead, knowing if they don’t get mental health care soon, full-blown PTSD may emerge days, weeks, months, or even years later.
The helpers are starting to call this phenomenon pandemic traumatic stress disorder, a variation of PTSD. Before they left, the psychiatrists brushed up on logotherapy, the technique taught by Viktor Frankl, MD, after he got out of the Nazi concentration camps. It is the best therapy to help find meaning in such existential crises. They finally see the Valley of Safety and Health in the distance. It may take 2 to 3 more months to get there.
We will continue this journey and document what happens. Stay tuned for the next chapter of this heroic journey. In the meantime, take good care.