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CityWatch: Gowns, masks, sanitizer — but where’s the emotional PPE?

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One doctor, a busy internist, said she’d seen too many patients die already. “There’s just a limit,” she said, “to how many deaths I can absorb, how many I can push out of my consciousness.”

Another physician recalled how hard it was last summer getting his sick patients admitted to the overwhelmed hospitals in Queens, patients sick with anything other than COVID-19. A third hadn’t yet taken advantage of the peer-support Zoom
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sessions. “But I have to tell you,” he said, “I’m happy knowing it’s there. I may be needing it pretty soon.”

The deaths are easy enough to count: 30,471 in New York City, 48,773 statewide. That’s as of Friday. And those numbers are still rising at a clip of 60, 70 or 80 a day. Statewide, it was another 87 on Thursday. But as America’s former COVID capital enters its second year with that grim title, the patients and their families aren’t the only ones suffering. So are the doctors, nurses, med techs, aides and other health professionals whose job it is to care for them.

Where’s their emotional PPE?

These are people who normally pride themselves on their ability to push through anything. Hardly any of them want to be named publicly. But some of them are beginning to acknowledge that the past 12 months and counting have been bleaker than many of them were prepared for. And they’re reaching for support.

Joining therapy groups at the city’s private and public hospitals. Scouring resource guides from the American Medical Association and other organizations. Several private psychotherapy practices, including one marketing itself as Caring for Caregivers, have now staked out the niche. The region’s medical-malpractice insurance industry is also taking notice.

It’s been nearly a year since Dr. Lorna Breen, the emergency-room medical director at New York-Presbyterian Allen Hospital in Upper Manhattan, died by suicide. Her family said she felt overwhelmed by all the COVID patients she wasn’t able to save.

“She tried to do her job, and it killed her,” as her father put it at the time.

But for every Lorna Breen, there are hundreds, maybe thousands of physicians who’ve been seriously shaken by this unprecedented challenge. In a General Hospital Psychiatry survey of New York City physicians, 57% said they were suffering from acute COVID-related stress. Forty-eight percent reported symptoms of depression and 33% cited elevated anxiety. There was one positive note: “Sixty-one percent of participants reported increased sense of meaning/purpose since the COVID-19 outbreak.”

But at what cost?

No other company has staked out this territory with the focus of EmPRO, the Long Island-based medical-malpractice coverage provider. Besides covering doctors accused of performing poorly, the insurer is committed to helping their clients avoid problems before they come up.

Pre-COVID, the company was already offering peer-support counseling for physicians confronting burnout and other frustrations of the medical practice, according to Dr. Tristan Mueck, EmPRO’s assistant medical director, who also co-directs its peer-support programs. “But when the pandemic hit,” he said, “we knew there was going to be an increased demand. Suddenly, COVID was affecting everyone, whatever your medical specialty. We started offering more groups and not just for doctors who were insured with us. For all physicians and other healthcare workers too.”

The signups immediately increased threefold, he said.

There are online group sessions led by a psychiatrist or psychologist. There are peer-to-peer referrals that allow stressed physicians to share stories and trade advice from other practitioners, one on one. “We remind people we aren’t doing psychotherapy,” Mueck said. “But there’s a tremendous benefit in sharing these experiences and just talking about them. Isolation has been such an issue this year.”

In the early going especially, he said, “people were often isolated from their colleagues. We have had a lot of people living apart from their families, in separate locations or making mini-apartments in their own homes.” Treating an infectious disease during long shifts in a medical office or hospital, of course they were constantly worried they might put their own family members at risk. “The groups have provided a format to come together and have these conversations, to share support and share ideas,” Mueck said.

How much longer the pandemic will be with us, how much worse it will get, how deadly the variant strains will be, how many people will actually get the vaccines — those are all open questions still. But the traumas are already here, and they won’t go away on their own.

The company hasn’t done any formal surveys about the peer-support program during COVID, Mueck said. “But people keep returning, and we keep hearing them say, ‘This is my lifeline from week to week.’”

Ellis Henican is an author based in New York City and a former newspaper columnist.

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