A support line allows physicians to speak about helplessness, rage, depression, anxiety, loneliness, insomnia, and — often — the uncomfortable sense that they no longer recognize themselves.
“I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses,” the Hippocratic Oath begins in unpronounceable syllables, “that I will fulfill … this oath and this covenant.”
The oath is brief (doctors don’t have a lot of spare time), and full of honorable trumpets in the background. It is also full of higher purpose. In only a few sentences, the needs of humanity are crystalized. Attention is sworn to their care. Reciting it is thrilling.
“For the benefit of the sick according to my ability and judgment, I will keep them from harm and injustice,” one translation of the oath says. Another puts it a little differently: “Whatever house I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice.”
Caregivers are owed a covenant, too; someone needs to care for them in a time when they have become (sometimes to their own surprise) exhausted, demoralized, petrified for their families, and fatigued by death due to the coronavirus pandemic. They may feel resentful — and ashamed for resenting — and they may feel unable to reconcile the intensity of care they give in hospitals with the unmasked carelessness they see outside the doors. These are combat blows in a war no one was prepared for.
Last March, several psychiatrists created a free peer-to-peer national phone line. The Physician Support Line has been running seven days a week since then; staffed by volunteer psychiatrists across the country who sign in for shifts, then sit in front of their desks — or, with phone in hand, proceed to the tasks of their days — and wait.
Any physician from any state can call in without giving a name and talk for any amount of time. (Other medical specialists are directed to other resources.) The line is open for their concerns. They can speak about helplessness, rage, depression, anxiety, loneliness, insomnia, and — often — the uncomfortable sense that they no longer recognize themselves. It is the highest level of anonymous intimacy.
These are not therapy sessions — though the website offers resources in every state for telepsychiatry — and medications are not discussed. In a way, we do very little: we just listen. But the listening is luxurious, almost antiquated, because it comes without productivity requirements and without 15-minute curfews. We listen short and listen long, sometimes with respectful inquiries into self-care, sometimes with attempts to help formulate the crisis that brought a caller to dial that day, sometimes with coping strategies — because even crisis physicians can forget how to cope during a crisis.
Calls came constantly in the beginning, then tapered down. During the weekly debriefing meeting, volunteers were puzzled: were providers feeling less overcome? Abler to endure? Simply too tired to punch numbers? Recently, with a spike in COVID-19 cases, calls are filling the line again. The tenor is a little different, though. Hospitalists and ER doctors and ENT doctors and pulmonary doctors and infectious disease doctors and doctors in almost every other specialty broke themselves in ICUs and inpatient units to treat their patients the first time around. Now the preventable war is back.
The Hippocratic Oath ends like this: “If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and the practice of my art.” Please, if you are a physician who feels the weight of war, call. Someone hopes to listen.
Elissa Ely is a psychiatrist. Doctors may reach the Physician Support Line by calling 888-409-0141 or visiting it online at physiciansupportline.com.
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Caring for the caregivers who feel the weight of the pandemic war - The Boston Globe
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