Is Clapping From Windows What Healthcare Workers Need?

“To make large sacrifices in big things is easy, but to make sacrifices in little things is what we are seldom capable of.” — Goethe

I was jogging yesterday evening when I heard a burst of applause. It was 7pm, and neighbors were clapping from their windows to show thanks for healthcare workers.

As a doctor caring for coronavirus patients at a Brooklyn hospital, you might have thought I would feel nothing but gratitude for this lovely gesture.

And while it was indeed heartwarming to see the show of support, my feelings were complex. Why? Because window applause is one example of how people love to support doctors and nurses — but from a distance.

Everyone knows that healthcare workers have a higher risk of catching coronavirus. But you might be surprised by how that can affect our daily life.

One of my physician colleagues has two young children under five. Every day she comes to work and puts her own family at risk to save the lives of strangers.

This week, her nanny didn’t show up. The nanny said she didn’t feel safe being around a woman who was exposed to coronavirus all day.

My colleague explained about all of the precautions she took: special COVID shoes that never left the hospital. Stripping down to her underwear in her office and putting on scrubs before going into patient areas. Then reversing the process in the evening, so the clothes she wore seeing patients never came home.

The nanny still wouldn’t come to work. For days her husband, also a physician, had to stay at home, arranging telemedicine sessions to treat patients while simultaneously watching his own young children.

Another physician I know used to do a weekly jog with a friend. After social distancing was implemented, the physician suggested that they continue to jog together but on a wide car-free road in Prospect Park, where they could maintain 6 feet of distance between them.

The friend demurred. Maybe it would be safer to run alone for a while?

A week later, the doctor saw her jogging with a non-doctor friend of theirs.

For some, these stories make us wince. For others, they seem like reasonable responses to an unreasonable time.

Either way, the impulse to avoid someone at high risk of having coronavirus is completely understandable. If you have a doctor or nurse in your life, you’re probably worried about catching the virus from them. Maybe you even took a small step to limit your contact with that person.

Each avoidance or withdrawal from a healthcare worker is understandable, but together they add up to greater social isolation for us. And that puts a significant extra burden on precisely the people who most need emotional support.

As with microaggressions in other contexts, the tiny act of pulling away seems invisible to the person who enacts it, but it’s palpably real to the doctor or nurse who experiences its effect. When all of these isolating behaviors are added up, they can pile onto healthcare workers and make it difficult for us to manage our lives, maintain our physical and mental hygiene, and cope with the emotional stress of social distancing.

Healthcare workers, it’s true, are at greater risk of transmitting coronavirus. From an epidemiological standpoint, maybe that means we should be more socially isolated than everyone else.

But doctors and nurses are going to work every day and watching young people die, with no way to save them. Do we really expect them to cope with this stress while being more isolated, and therefore having less emotional support than other members of society?

Our politicians like to say that fighting this virus will be a marathon not a sprint. We cannot expect our healthcare workers to finish that marathon alone.

My girlfriend had an opportunity to work remotely from her family home in Los Angeles, but she turned it down to stay in Brooklyn and quarantine with me. A few of her friends found this admirable, but most pressured her to stop spending time with me. She was taking her life into her hands, they said, by sharing an apartment with someone who worked in a coronavirus-infested hospital.

Think of yourself, they said to her. Don’t put yourself at risk.

What if doctors and nurses thought this way? What if they were unwilling to put themselves at increased risk?

If a doctor walked off the job in the middle of the COVID epidemic, we would probably judge that person harshly. Shouldn’t we feel the same about the nanny who allows that doctor to do their job?

In this time of social distancing, we think about risk more than ever. Empty front yard? Reasonable. Crowded subway car? Never. Grocery store? Not ideal, but necessary.

If a friend invites us to take a socially-distanced walk on a sunny day, we think about the risk. And if the friend happens to be doctor or nurse, we take that into account. We consider the increased risk to ourselves.

Perhaps we need to start thinking of that tiny increase in risk as our contribution to the battle against the virus.

We all have a role to play. No matter what happens, I will continue to go to work. I will continue to put myself at risk of getting catching coronavirus, and so will every doctor I know. No one at my hospital has quit since this pandemic started.

But I can’t do it without support. My colleagues and I need childcare; we need the occasional exercise companion; and we need spouses and partners to quarantine with us.

If we want our healthcare system functioning in a month — which might be the day your mother or grandmother gets sick — then we need to start caring about the mental hygiene of our healthcare workers.

Right now mental hygiene is getting pushed aside, in favor of obvious and urgent physical health needs. But if doctors and nurses start getting burned out and quitting, we might suddenly start caring much more about it.

There’s nothing wrong with applauding for healthcare workers. It’s an uplifting gesture that touches all of our hearts.

But let’s try to go one step further. Take a walk with a doctor or nurse. Stand six feet away and talk with them. Show up for them when they need you. It will make a difference, I guarantee it.

Assistant Professor of Medicine at SUNY Downstate Medical School. Attending Physician at University Hospital of Brooklyn

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