Physicians, Heal Thyself

https://www.cathmed.org/pulse/2020-summer/

BY CYNTHIA HUNT, M.D.

The COVID-19 pandemic has increased stress tremendously for many physicians and health care providers in multiple ways that are unprecedented in volume and intensity. Considering 50% of physicians reported burnout prior to the pandemic, it is now increasingly important to follow the directive found in Luke 4:23, “Physicians, heal thyself.” This verse can be understood as a reminder to physicians to work on their own illnesses and weaknesses to be better able to help others.

The wisdom of Scripture is highlighted by a grim reality found in modern health care. The medical profession has the highest number of suicides of any profession, according to the American Foundation for Suicide Prevention. Male and female physicians are equally as likely to commit suicide by overdose, hanging and firearms. The number of suicides among physicians is twice the number in the general population, with psychiatry and anesthesiology cited as the two highest specialties affected.

Mental health issues are the driving force behind these statistics. Mood disorders, anxiety disorders, post-traumatic stress disorders, and addiction, coupled with burnout and depression, are among the issues that go unresolved and lead to suicidality.

Unfortunately, very few physicians seek professional help due to stigma, fear, isolation, shame, and perfectionism, creating a “culture of silence.” According to a 2017 study published by Dr. Katherine Gold in Family Medicine, some of this apprehension is due to the fact that many state licensing boards specifically ask about mental illnesses and substance abuse in intrusive and stigmatizing ways. It is essential that we help our colleagues and ourselves to reach beyond this stigma and shame to recognize the warning signs. We need to be present to one another and not be afraid to address concerns of mental health, addictions, and particularly, any potential for suicidality.

How can we “heal thyself” and others in our profession? There are fortunately many avenues, some of which are reviewed here. One of the more recent resources is that of the Physician Support Line (PSL) at 1-888-409-0141. PSL was launched as a response to the unprecedented emotional havoc caused by the pandemic, particularly following the tragic suicide of a frontline ER physician, to “offer free and confidential peer support to American physicians.” This hotline aims to create a safe space for them to “discuss immediate life stressors with volunteer psychiatrist colleagues who are uniquely trained in mental wellness and also have similar shared experiences of the profession.”

This support line is open to any physician across the country and is staffed by over 600 psychiatrist volunteers. The founders stated that physicians will see the need to take care of themselves and reduce stigma around seeking help long after the pandemic is over. PSL services are anonymous and it is not affiliated with any health system.

Other resources include the National Suicide Prevention Lifeline, 1-800-273-8255. Among the many good books available, I would recommend “A Catholic Guide to Depression” by Aaron Kheriary, M.D. Dr. Kheriarty beautifully integrates the biological, psychological and spiritual elements for understanding and treating depression.

A 2013 Zwack Schweitzer study found that physician resilience depends on spiritual practices, physician self-awareness, gratification in work, accepting personal limitations and learning to better balance and prioritize. Psychologically and spiritually, it is so important to know our limitations, to be humble and to depend more on Our Lord and less on ourselves.

In order to be true vessels of the healing power of Christ, it is essential that we attend to the “Temple of the Holy Spirit.” The term “self-care” has many good connotations but I find the term “THS Care” (Temple of the Holy Spirit Care) more meaningful, carrying with it a Christian responsibility and privilege. It is only when we truly work on the biological, psychological, social and spiritual elements of our own lives that we can be more available to our loved ones and our patients. In fact, many times the graces we receive go beyond what we may have thought possible!

It is necessary to care for our bodily well-being through daily exercise, sound sleep habits, good nutrition, and attentiveness to our own medical and psychological care. We also need to examine and implement healthy boundaries to achieve a healthy life-family-work balance. As part of this effort we can maintain and nurture good friendships, being open with colleagues about difficult experiences, and practicing financial prudence.

Most crucial is the necessity to care for ourselves spiritually. As we know, our profession is a vocation grounded in the healing ministry of our Divine Physician. As Catholic physicians and health care providers, we can prioritize our “THS Care” through prayer and living a sacramental life, including frequent confession and reception of the Eucharist. Many have found it helpful to designate a space within the home as a “chapel” either in a corner of a room or if possible, a room in which one is able to pray and enjoy solitude.

Expressing gratitude is a very healthy coping mechanism even according to secular psychiatry. I would recommend that this be done at least twice per day and especially during moments of stress and discouragement. In expressing our gratitude for our many blessings, we can also in a mysterious way include our suffering as a gift to offer to the Lord.

By knowing our own vulnerabilities and strengthening our interior life, we can be present to each other professionally and spiritually. We can truly be a community of clinicians committed to living our faith and participating in the ongoing mission of Christ as the Divine Physician.

Dr. Cynthia Hunt is a board member of the Catholic Medical Association and chair of the national CMA Opioid Task Force. Her professional experience has included board certification and practice in internal medicine, pediatrics and psychiatry. She currently maintains her medical practice at the Community Hospital of the Monterey Peninsula, where she is the Vice Chief of the Department of Psychiatry. She is also an Adjunct Faculty Member of St. Patrick’s Archdiocesan Seminary in Menlo Park, CA. She received an award this past year for “Lifetime Achievement in Catholic Health Care” for her work with the Opioid Crisis.