Being a physician we are encouraged to be strong but it becomes emotionally overwhelming when you are taking care of their impatience providing support to the families who cannot see their loved ones and going through the pain of losing too many young lives. Oh my goodness and i received it to me in births of this it was a big sum of money to a maybe the only children it is simple meichi it is so hard its slow idea that the disease evolved ensue over mostly these developments and. I know for me personally this is different and my experience in responding to the evil outbreak in west africa in that situation i thought a lot about their risk to myself personally in a situation my mortality in this situation is different because i know i dont have the option of necessarily insulating my family from the associated risk because i kind of work that ideal. Of a subgroup of the family in the loss of a national but actually global recession we all need to see understand that our environment is coming more as i use than want to use up as a baseline we can be sure to take the time and weve got to change perspective that will help us cope. For fear of running out of people. The fear of facing down a colleague. Several which is already happening and not even being able to attend the funeral because weve come here. And asked to do this feeling of hopelessness in many of the cases that are coming and because no matter what we do how are you going to try to auction it down where i mean bone in their mark of success over time repeatedly can be very demoralizing. You know watching this team im femi oke a we asked medical professionals around the world how are you doing and what you heard is what they told us city day we are focusing on medical professionals on the front lines of the crown of i was pandemic and the emotional fallout that theyre experiencing the reason were doing that imaging this tweet is a mistake a part of that Online Community and he says another group of people whose Mental Health coop be affected our Health Care Workers those in the front line who spend hours even days trying to tackle this disease i pray we emerge stronger after all the that was his suggestion for a discussion we should have and the mistake edgy about to have that discussion if youre online and youre watching and streaming vine you jumping the Comment Section we will try our best to put your comments into they said let me get the guests introduce themselves dishonest tell everybody. Im market gonzales im a scholar in residence at Stanford University school of medicine i also recently spent 2 weeks volunteering in an intensive care unit in the. Good to have you and i dr west welcome to the strange tell everybody. Hello im calling west im a professor of medicine medical education and biostatistics at the mayo clinic and ive been working on physician wellbeing research for more than 15 years. Good to have here and thats our lead at makes a return visit to the strain good to have you back our metellus remind our audience. I mean back home and also working in intensive care and imagine some medicine in london or so a journalist. Can i show this to you. Annette and its from one of our online humility and they knew that we were talking about you and your fellow professionals and colleagues around the world and writes no i cant hear the other guest list are the worst not breaking no one cares about terrorists thats the message i am hearing how do you feel. I think theres been overwhelming support from effect on wider Public Community stores going on with doctors and nurses as well in terms of the pressures that were under unfortunately this does support what outside doesnt actually sometimes reflection of whats happening and reality because we are suffering in terms of hours overworking the patients seeing that but the Emotional Trauma of seeing patients who shouldnt really be dying in any other situation who are. Not really being able to do that so they are now kind of reflection is something that we really need to consider how we can help support each other as doctors and medical professionals this is really disturbing headlines dr west about psychological trauma recent pictures of people in ice intensive care units looking incredibly distressed their colleagues are going into intensive care some of the family members their friends youve been studying the stress that medical professionals are under for some while now. Could you have. What would happen in Something Like a pandemic to medical professions. Absolutely and i think. This is one of the features that were dealing with is that this has all occurred on a baseline of some trouble in the medical profession this is an amazing profession all Health Care Workers are engaged in this deeply meaningful activity helping patients their families their communities live better lives the challenge with the pandemic is that the stressors that were leading to challenges even before the pandemic dont go away but then. As we as we just heard there are these additional stressors that can be overwhelming doctors other Health Care Professionals are highly trained to deal with stressful situations its sad but we deal with suffering we deal with deaths what the pandemic brings though is a magnitude that is different than what almost any other Health Care Professionals had to deal with but i think with that baseline that was well recognized the fact that those pandemic related stressors would would hit us in such a deeply emotional way i think was predictable. Other than you were on the sidelines and there hit the United States and that didnt sit well with you say you volunteer can you take us into thinking when you volunteered when when you knew it was going to be and then what did you see. Sure so i as you mentioned im in this role which is a non clinical role as a scholar in residence so i dont currently see patients and when the demick hit the United States i really felt a deep sense of guilt that i wasnt caring for patients and not on the front lines and really wanted to help im so i looked into ways of volunteer ing locally here in california where i live and what quickly we sheltered in place very early here and didnt end up having the big stressors of the Healthcare System here that have happened in other places like new york in detroit and chicago so to me it was kind of a no brainer that i wanted to help i needed to be able to go to one of those places and so i decided to volunteer in new york. And how do people manage how do they cope with the stress of a Global Pandemic with people who were dying and certainly from new york the ficus went up and up and up and up and then now beginning to stabilize somewhat in thames the people passing away. Yeah it was a very challenging situation to walk into but i always try to emphasize that as a volunteer i chose to go there and i was only there for a limited amount of time and could leave basically whenever i wanted to which is a pretty different mental space and have it from the people who live and work there and have this all drop in their laps and they really have no choice but to show up every single day and try to get care patients and as was described in the package one of the things thats really challenging is when people are the people who get really sick from around a virus its almost like we cant help them if we only have a limited set of tools which are you know our ventilators and in about a and other medications typical Critical Care that we provide and they just seem to be insufficient in this situation and sometimes we cant get enough oxygen and theyre lying sometimes attack and the Carbon Dioxide out of their lines their kidneys start to fail and then were left in this position where we as helpers as people who like to solve problems find ourselves without the tools that we need to solve this problem and then we see people dying day after day so i was there for 2 weeks and in the entire time that i was there there was one patient who left the i. C. U. And went to a different part of the hospital because he was well every other patient who left went to the court. Guilty to age im just im just looking at you face right now and if i could just read you know face its just pure hell. The intense if you will mood what you need how you doing. I think its in terms of i mean im able to like. Kind of distress when i do get a woman like im like a ship but in terms of exhaustion you know exist the hours are long and its just kind of go to work go home sleep go back to work and its just kind of like a repeat cycle. To me at the peak time when that was literally the most intense i guess periods of my work across the world before and so seeing it here in london that this bad it was quite an intense period so in terms of the movie for me ive been able to turn to manifest as the moon when youre working is when its really difficult some of the patients that youre seeing whom you cant even get their families to come visit them and they just sat there dined alone and it sometimes can even grasp how unwell they are they feel like there were when you telling them that there may be a chance that theyre going to die in the next few days they can really grasp that and that was really strange about this disease as well. I remember one patient who was an elderly gentleman and i had to call his wife to tell him that and this this is something theyre really like kind of got to me and theyve been married for 60 years and i just ill tell her that he was an apostle and she was never going to be able to see him and she just sat there on the phone normally his patient solemn face to face give him a tissue i put your hand on the shoulder or Something Like that this patient was just crying on the phone and i had literally nothing i could say or do in that situation and that really just took a toll on me at the time. Doctors let me put this into all of you because it is its this is a conversation on egypt right now so not trying says is is is watching all of you doctors other plans to have periodic psychological exams during the crisis. Dont do unhandled. Is an event wants. Me to do yes so i think from a formal standpoint im not aware of the you know sort of mandated psychological assessments that said i think what were talking about here are some of the unique features of this virus and this pandemic in isolating people and patients and Health Care Workers in the midst of a really severe illness and so whether its formal or informal i think there certainly is discussion about how do we restore that sense of community that sense of connection for our Health Care Teams medicines a team sport so as were being pulled apart as were hiding behind personal protective equipment as were maintaining physical distance saying how do we ourselves maintain a sense of connection that sense of social connection and so if thats informal. Thats wonderful for more serious sorts of events of the the suffering the dealing with waves of death and the uncertainty thats being described more formal processes may definitely be helpful there are some hospitals that are talking about you know deep briefing sessions after shifts or after particular traumatic events with the idea being that rather than internalizing these and allowing them to fester we can try and share those experiences and and bear some of the burden together but ultimately this is about the environment and how do we sustain ourselves and our colleagues with a in an environment thats filled with so much uncertainty so much suffering bring our skill sets to bear to be able to help our patients and do whats so meaningful to us as well. Theres a little bit ambitious and. Yeah ill get on to pisgah had. I just wanted to climate one thing which is that ive seen a number of Centers Medical centers that have added after hours Psychiatric Care thats available or there thats available and i think thats a great 1st step but one of the challenges that i saw when i was in new york was that the doctors who are in such long hours that when they went home they really were not what the last thing they needed was to talk to someone on the phone about what theyve experienced at work what they needed with time away from him so we can figure out a way to incorporate those types of sessions in so i think that would be more manageable for all of you logistically challenging but i think it would be better than asking people to spend their nights and weekends reflecting back on all the trauma theyve. Hired recently have excellent point. Let me bring in dr king she is a psychotherapist and we asked her about this idea of the emotional fallout of medical professionals this is what she told us my greatest insight from working with doctors do independent has been that we need to stop wanting them more years and boards and even eating them from the rest of us by placing them on the desk to we make it impossible for them to eat or drink their own anxieties and we need to assimilate them as part of the same decided we belong to and how did you feel sad. At any time and to be able to offer them the same head that we expect harassment. Ok Health Care Heroes Health Care Worries are you sick and tired of those titles are given new stuff thats a much even looking at an altitude that you wrote Health Care Workers arent just heroes were also scared and exposed telling some truth telling a give and continue hes sick of of the way that youll get. Used because youre getting a lot of love on you tube as well i have to say people are really admiring you and thanking you. And you say back to them what. Oh i say and i think 1st of all i am not a hero i really dont think of myself that way and i dont think as i wrote with dr jesse gold in that piece i dont think it helps us like fully agree with that person that you have commenting there when we call doctors here as our Health Care Workers here were making it difficult for them to have space to express their emotions and fear and anger and sadness and we cant cope with everything that were seeing for not allow us express emotions i think were doing a job that weve been trained to do in very difficult circumstances that that doesnt mean that thats what we wanted to be doing you know i obviously i volunteered that was my choice that many other Health Care Workers are just thrust into a difficult situation and i think we need to ever suspect and acknowledge. Thats tonights. But you. Made a very interesting point because its not of the essence of being as he rose up as an extra added pressure and burden on you we are just doing our job but the problem with having that burdens that doctors almost feel like it doesnt have to kind of take a step in the pullman to to do more ships and all that stuff the reality is that should be the governments responsibility while there are so many reasons but if you see some doctors why do we have 100 for Health Care Systems and and when im not spittles why all this talk of many jobs and it really shouldnt be the kind of doctors shouldnt be having to do extra hours ition to be working 12 hour days for 7 days 7 days a week those jobs should have been filled in thats a Government Program not the doctors problem so doctors as heroes extra pressure and they do understand those. Kind of almost to get that we are also human we do need our rest breaks we do need our i want time or just like everybody else. Yeah i think another yeah any point is. Im sorry im sorry dr. I was just going to say let me point around this. Is so much of the issues with the balance between distress and wellbeing and Health Care Professions has been around the stigma thats associated with admitting that there might be stressors that we sometimes need help with and its also news to some doctors by the way that theyre human they dont like to admit that sometimes and so i think the more that we separate our Health Care Workers and not just doctors our nurses our cussed odile staff our cafeteria workers who are also taking personal risks being involved in these pandemic environments to serve others the more we separate those individuals and suggest that theyre different than other humans who are dealing with the same societal stressors and anxieties the more difficult it becomes for us to allow those people the space as dr silas mentioned to process whats going on. Something curious expected certainly when it got us commenters on you tube is that some people dont believe theres a Global Pandemic happening some people are. Skeptical and then youre having to do as well as having to deal with the Health Care Issues and treating people you having to deal with things like this let me show you this is what chase would draft have stayed and he was looking at Health Care Workers out on the street they these particular ones were in denver reminding people why they should stay at home and who and Pay Attention to the stay at home mandates and not be asking to go out go to the gym go to clubs go back to work see theres this is added pressure of can i call it politics a common sense lack of common sense i dont even know how to frame it other than you youre in the states how do you understand what is happening with that pressure on Health Care Workers as well as the pandemic. Yeah i think its so hard especially in places that have been hard hit that Health Care Teams have really been traumatized by the volume of death and dying that theyve seen and the loneliness that theyve seen with their patients and everything that was described earlier with the phone calls and trying to video chat with me since amys its really traumatizing i think that is the best word for it and then when you see in the streets that there are people gathering you know a couple weeks ago there were massive protests about the shelter in place orders and all i was thinking about im sure that like many of us with oh my gosh how many people are now going to be infected because they were just at this protest and then how much strain is there going to be on the Health Care System as they circle in to get their care and are we going to have enough of everything we need to take care of those people and its almost like putting salt in a wound or already really struggling to keep up and to do the best that we chant in a limited resource setting and then people are saying that were making it up people have accused doctors of creating the coronavirus so that we could i dont know what i mean who would who would want this who would want to see people dying every single day i would say literally none of us its absurd. I want to bring into the conversation dr peter lou hes a surgical resident at new york presbyterian and Columbia University is a pretty mean piano player as well and the doctor is in the ninetys now health care. Is at new york presbyterian and Columbia University and using music as a healing element to listen to what hes out to some of our colleagues and loved ones have become our own patients in the midst of these unpredictable and difficult days a few of us have found comfort in the unifying and healing power of music so weve organized these concerts to share some of that music with our patients and colleagues in hopes that it might offer the comfort that is so desperately needed. I really want to see what they say looks like when staff are helping each other and say this is dr kato who until recently was on a ventilator hes still having trouble breathing but apparently hes having no trouble singing have a listen have a laugh high in. Britain where. I. Am a was. The are am. Not a to age the reason why dr kato sing in a whole new world was because he was so close to passing away and hes now existing in this whole new out of having to fight the crane a virus and that was why a he sang that song it was really its really hard not to well up when you when you watch that how do you do what do you and your colleagues do to keep while the to stay sang to to look after us else. I think theres Little Things that really positive for us to be able to do turns out. I was previously mentioned very few end up in i. C. U. But those that do eventually need the nerves thats in them they do like a card on a patient now and those little moments where you can see some small positive by the end of the time office for these patients it does motivate you to keep going for them but with the other patients who are some of them do turn around and thats what thats difficult to predict which patients will turn around but some of them do so those little moments that i guess positivity is something thats nice unfortunately there in a lot of political commentators in the u. K. One of them straight out and for example she shes actually for those going to like the one that youve just shown will insult doctors and nurses saying why are you wasting time and hospitals and singing songs and making dancing with us when you should be treating patients and their own doctor told him you know what im so glad you mention that because weve had those comments also a new chip and people like well you cant be that bad off because your singing or dancing is doing to it took that yes yeah exactly so those kind of comments are coming are no needed as respectful as it was suggests that doctors and nurses arent pulling their best efforts to treating patients but also demotivating because at the end of the day he is there doing his videos to almost celebrate how we are progressing and how we are trying to is to strive to do our best and theres no positive moments are what motivates doctors and nurses to keep going on as a team process just like you would in any other profession where you do Team Building exercises that this is one of them. That there is a line like that just for the government to write about the end of the show so it makes one sentence make it count. I was just going to say those videos celebrate our shared humanity and its hard for me to understand people who would tear that down. Beautifully set. And be bipasha back. Thank you very much for being on the show to sell us dr west dr twice and then let me just tell you what some of our audience is saying thank you so much from french vanilla on you tube to all the front line as all of the worlds many states healthy and fit and not a physical but also unventilated now sweats need the community commissions continue in the next episode of the state banks of. Business leaders therefore to buy no prospal. Business leaders just want to buy no prospal. If you want to help save the world. Sneeze and hero. Is going to the polls for general elections. But with the u. N. Concerned about the threat of violence many wonder if they can be free and fair. And what effect 2 phase of covert 19 have on tap. The indian accents on aljazeera. The arab. News. Hello im Barbara Sarah lunde then these are the top stories on aljazeera france and germany are jointly proposing a 545000000000 Dollar Relief Fund to help europe recover from the pandemic the proposal suggests the block or of the funds together and use it to support the hardest hit industries and regions the fashion but there has more of this from paris. Well the leaders of frogs in germany say that the aim of this 545000000000 dollar recovery fondas to try and help revive certain economic sectors in the European Union Member States countries regions that have been particularly badly affected by the coronavirus pandemic now the idea is that this money would be bored of the International Markets now both emanuel mark kroll and Angela Merkel said that it was absolutely fundamental that the European Union come together it is time and show solidarity with some Member States that have really struggled over the past weeks and months and will continue to do so in the future because of course the coronavirus pandemic is a far from over in many ways even though we have seen the numbers of infections and cases drop over the past few days in some European Countries while this initiative has been welcomed by the heads in the of the e. U. In brussels by the commissioner and the head of the e. U. Council who say its very much in line with their own thinking as they are formulating their own strategy it is also been welcomed on the International Financial markets because weve seen global stocks
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