Because I used to be a practicing physician, I’ve tried to keep my finger on the pulse of what it’s been like to practice medicine at a time when it’s become more demoralizing than ever. Especially in the wake of the Covid pandemic, the fallout from both the physical and mental health consequences has been brutal for everyone involved- patients, their caregivers, nurses, doctors, therapists, and ancillary health care staff. I taught a whole class Healing Medical Trauma to minister to the wounds that get inflicted in medical situations. But many of the deepest wounds wind up inflicting our health care providers, who get traumatized during their training and are very much indoctrinated to neglect their own needs in service to the needs of others. The need for healing our health care providers often gets overlooked.
Unlike many in the general population who run away, avert their eyes, spiritually bypass, avoid or otherwise turn away from suffering and pain, doctors, nurses, midwives, nurse practitioners and therapists are wired to lean in and try to help. They find meaning in their work because often, they can be of service, and it’s nourishing to fulfill our callings in this way, easing suffering when someone is scared, vulnerable, and in pain. But Covid was rough for a lot of health care providers and therapists. We’re not so good at feeling helpless, powerless, and defenseless in the face of an invisible enemy we cannot beat, especially if we have to wrestle with feeling responsible for someone’s death, disability, or suicide. Every patient we lose can feel like a failure to them, and every loss can threaten our own mental and physical health.
What Is Moral Injury?
All of this can be quite traumatic for those who feel called to be healers, especially because the systems we practice under can lead us to suffer from “moral injury.” As I described in a former blog Doctors Aren’t Burned Out; We’re Morally Injured, what many think of as burnout may actually be a kind of wounding of the soul. First described as an injury to war veterans, “moral injury” is described by researchers as “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.” Journalist Diane Silver describes it as “a deep soul wound that pierces a person’s identity, sense of morality, and relationship to society.”
Harvard physicians Simon Talbot and Wendy Dean explain that “failing to consistently meet patients’ needs has a profound impact on physician well-being—this is the crux of consequent moral injury.”
Talbot and Dean write:
“Continually being caught between the Hippocratic oath, a decade of training, and the realities of making a profit from people at their sickest and most vulnerable is an untenable and unreasonable demand. Routinely experiencing the suffering, anguish, and loss of being unable to deliver the care that patients need is deeply painful. These routine, incessant betrayals of patient care and trust are examples of “death by a thousand cuts.” Any one of them, delivered alone, might heal. But repeated on a daily basis, they coalesce into the moral injury of health care.
Physicians are smart, tough, durable, resourceful people. If there was a way to MacGyver themselves out of this situation by working harder, smarter, or differently, they would have done it already. Many physicians contemplate leaving heath care altogether, but most do not for a variety of reasons: little cross-training for alternative careers, debt, and a commitment to their calling. And so they stay—wounded, disengaged, and increasingly hopeless.”
Let Us Help Heal Moral Injury In Our Health Care Providers
Moral injury creates “can’t win” double binds, and double binds lead to mental health struggles and Complex PTSD. Yet we expect our health care providers to just keep plodding along, which is what we’re trained to do- suppress our feelings, neglect our needs, ignore our bodies, and bully ourselves into a numbed out state of enduring whatever comes our way. Of course this not only hurts the health care providers; it winds up bleeding onto our patients and other health care staff in injurious ways.
What I’m observing from those I care about who are only just now being able to come up for air now that the worst of the pandemic is past is that they are like shell-shocked soldiers. Like morally injured Vietnam vets who returned from the front lines and were met not with a hero’s victory parade for the risks they took and the courage it required to stay in the line of fire but with angry hippies who spit on them, our health care providers, especially those who were working on the front lines, are not getting adequately supported.
No wonder many are thinking about leaving medicine, have already left, are inclined to addictions, feel depressed and anxious, and are struggling with physical health issues themselves. No wonder many have lost faith in the goodness of their fellow humans after many turned on them during the pandemic. No wonder they no longer feel safe, even when they’re not in the hospital.
We “Heal The Healer” At The Whole Health Medicine Institute
At the Whole Health Medicine Institute, we’re doing our part too. One of the three pillars of this training program for health care providers and therapists is “HEAL THE HEALER.” We provide trauma recovery programs, train our students to learn and practice cutting-edge trauma healing modalities like Internal Family Systems (IFS), Somatic Experiencing, NeuroAffective Relational Model, and the energy psychotherapy Advanced Integrative Therapy (AIT). We also train our students to practice a trauma-informed approach to treating patients with life-threatening and chronic physical illnesses. We bring practitioners together so they can share stories, feel safe, open up, be vulnerable, and feel less alone in the struggle to practice medicine inside a broken system, especially in the wake of a pandemic.
If you’re a health care provider in need of healing or you know someone who is, we have good news! The Whole Health Medicine Institute just opened enrollment for the Class of 2025, which will be a hybrid of virtual and in-person training. It’s possible to complete the whole program online this year, for those who can’t travel, cannot afford to make it to California for our optional in-person retreat, or can’t get the time off work.
If you’ve been considering getting certified to facilitate the Six Steps To Healing Yourself from my New York Times bestseller Mind Over Medicine, in addition to all the other offerings we provide, now is the time to apply for the Whole Health Medicine Institute here.
Learn more and apply for the Class of 2025 here.
A Huge Thank You To Those Who Serve Us In Health Care
Thank you for your service. Thank you for caring. Thank you for being so brave and compassionate and leaning in when others might lean out. Thank you for all those years you sacrificed to learn your craft. Thank you for the sleepless nights, the skipped meals, the strained relationships, and the impact this work takes on your physical and mental health. Thank you for your tender heart and your healing hands. Thank you for white-knuckling your way through, even when you’ve felt morally injured. Thank you for risking a broken heart.
Thank you for putting yourself at risk so the rest of us could know we’d be in good hands if we needed help surviving the pandemic. Thank you for all the hard decisions you have to make every day. Thank you for being a survivor, even though we know it’s taken its toll. We’re sorry it’s been so hard. We know you’re exhausted and need a break. We value you and want you to get the help you need to begin or continue your trauma recovery journey. We care about you. You matter. You are loved. You are cherished. May you be blessed by your service and may you know how many people really do admire, respect, appreciate, and feel grateful for all you’ve done.
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