Stresses, Maintaining Wellness and Coping Strategies For Physicians in the Midst of a Pandemic – A Personal Experience and Perspective

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The COVID-19 pandemic has changed our lives in unprecedented ways with physicians facing a new work reality and daily routine. I am a hospital-based cardiologist and work in both inpatient and outpatient settings.

Over the past three months, I experienced an escalating personal stress and anxiety. I have always described myself as Type A personality.

However, this was the first time I felt I had no control over a situation and that was very scary.

The stressors for me accumulated quickly once the virus started spreading in Europe: fear for my parents, both in their sixties with underlying medical condition, who live alone in Greece; concern for my sister, who lives and works in Germany, a country hard-hit from the virus; and stress for myself, now considered "a front line" worker and having to work with limited personal protective equipment at the beginning of the crisis; and fear for my personal health and the potential risk of spreading the virus to patients and colleagues.

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The stresses further escalated with the transition to telehealth visits. For the first time in my clinical practice, I had to take care of patients with heart failure and chest pain over the phone and try to make correct medical decisions without in-person evaluation, vitals, physical exam or electrocardiogram.

Emails regarding potential redeployment added to my rising stressors due to my concerns on whether I would be able to provide competent medical care in a medical ICU with vented COVID-19 patients.

And finally, the deluge of information: emails overloaded with information, protocols, social media and traditional news outlets that focused primarily on the virus added to the pile of stress.

How could I breathe through this?

The first few weeks of the crisis, I frequently caught myself lost in thought focused on the stresses and fears outlined above. I would return from work and do nothing but spend time listening to the news for hours, receiving overwhelming and sometimes wrong and misleading information.

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I would frequently count the numbers of new cases and deaths – the John Hopkins' map was constantly on my screen and checked 50 times a day. I would wake up in the middle of the night, unable to return to sleep and consumed with thoughts of uncertainty and worry for my loved ones and myself.

I stopped my exercise routine for fear of potential virus spread and started skipping meals, sometimes even forgetting to eat. I soon realized that this was not a way to cope with the crisis and I would not be able to survive this for a long period of time. In order for me to keep going, I had to feel well and think clearly.

I had to focus more on myself and less on the virus.

After a couple of weeks of inactivity, I resumed my morning jogging. Maintaining social distance, I run for an hour every day. My daily run helps me decompress, elevates my mood and clears my mind.

I try to cook at home as often as possible. Prior to COVID-19, I would frequently share dinner with my boyfriend who lives in New York City. Due to the restrictions imposed by the crisis, I have been unable to see him in person.

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Face time has helped us surmount this hurdle. Exercise and healthy diet (especially fresh fruit, vegetables and homemade food) have improved my sleep significantly.

I also take the time to connect with my parents and sister in Europe. It gives me comfort to see them (virtually) and talk to them often. I try to avoid talking about the COVID-19 crisis with them.

Instead we focus on positive subjects and make plans for a future trip together when the situation improves. I have arranged video calls with friends over the weekend. This has helped my mood tremendously – I can share with them (most of whom are also doctors) my fears and discuss issues that they are going through.

One of the most important steps I took in reducing stress was cutting down on social media and traditional news. I have resisted the urge to chase the number of infections and deaths.

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It is not that I refuse to accept the reality – I know the virus is out there and killing people – I just refuse to be consumed by fake news, inconsistent information, drama from the journalists, and thousands of Facebook and twitter posts from people that all of a sudden have emerged as specialists.

I have opted to focus on my needs, my family, my work, my community and myself. I want to continue to be kind and helpful, and once a week I check out by phone one of my colleagues in the group.

A nice word, a supportive line, and the feeling of caring makes us stronger and brings us emotionally together to help us get through the crisis.

To view the COVID-19 ACC Well-Being Portal, which may provide resources for physicians dealing with the COVID-19 PTSD trauma, click here.

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This article was authored by Eirini Apostolidou, MD, FACC, cardiologist at Brown University in Providence, RI.