Category: Wellness – Care
Date: April 20, 2021
Mark Shapiro, MD, joined us for a Wellness conversation about his experience with COVID as a hospitalist in Santa Rosa, California. He vulnerably shared the personal and professional impact of COVID, his own takeaways and broader advice we can all use to emotionally start over, cultivating preparedness for any time we feel embattled while coping with and managing upheaval or tragedy.
COVID In the US
With the arrival of COVID, Mark’s hospital, located in Santa Rosa, adapted and immediately went into disaster mode, thinking about the resources available and how to support the workforce. They created a COVID unit, a part of the hospital dedicated solely to taking care of COVID patients while being segregated from the rest of the population.
Mark experienced the multitude of trials and tribulations around testing: quality, access, methods, reliability, etc. He rotated into COVID service, working with infected patients in the unit for a month and then was placed elsewhere. He coped with an inordinate amount of stress, as he constantly considered his likelihood of getting sick or coming home and infecting his family.
He acknowledged that he and his colleagues discovered the depth of their courage; they put on their PPE every day and had to trust it. The fear never entirely dissipated, as each day Mark and his colleagues worked closely with extremely sick patients who would inevitably cough directly in their face. Mark never contracted COVID.
Appreciating & Understanding America
After this past year, Mark is even prouder to be an American, as America’s mettle was tested and stood up to that test. People did the work. Despite a failure of leadership at the federal level, people physically distanced, wore masks and stayed home, which is particularly inspiring considering the sheer size, diversity, scope and scale of our nation.
COVID is both a direct threat and a threat amplifier. Previous threats such as gender inequity, race in the U.S., and wealth distribution were all amplified by the virus, and we are now facing a reckoning.
Mark shared that we are in the next phase of the pandemic – the vaccine-available phase.
He has tremendous confidence in all 3 vaccines: Johnson & Johnson, Moderna, and Pfizer. Mark received his first shot in December and his second in January, and immediately felt a significant shift in the dynamic of working at the hospital. He continues to wear PPE and take precautions but it’s a fundamentally different experience.
As the goal is to get “needles in as many shoulders, as fast as we can, around the world,” it’s essential to understand the relationship that people have with vaccines and vaccine science. Mark implored us not to give into anger or frustration when interacting with someone who has concerns about vaccines. Anger is ineffective at driving change.
Instead, try and understand their concerns, their past experiences. The whole dynamic of this potentially volatile conversation shifts when you approach with understanding, and it is urgent that peers, parents, friends approach the vaccine-hesitant with the intention to understand, because that is what can drive change. There are not enough physicians to persuade those who are reluctant to be vaccinated; friends and family can be the catalyst for change.
Mark provided thoughtful questions and statements to direct to unvaccinated loved ones, such as “Help me to understand,” “What do you mean by ‘it works?’” and “Who would you trust as an expert?”
Remember, people who are hesitant about getting vaccinated are primed for an argument, so avoid giving them a reason to be defensive. They are already subjected to a lot of pejorative language and condescending tones. If they feel understood and heard, they will be more amenable to being vaccinated.
Be mindful of your personal limit. You will not be able to reach everyone, and herd immunity does not require 100% of the population to be vaccinated. We need 75-80%.
The Next Epidemic
Our next epidemic in America is one of grieving. Both collectively and individually, we have an unfathomable amount of loss to grieve. Half a million Americans died.
We’re approaching the one-year anniversaries of an unfathomable number of deaths, and families will have to acknowledge the days they lost a family member under the cruelest of circumstances.
Compounding the tragedy is the fact that Americans lost the rituals behind how they grieve. Because of COVID, we all remained alone and isolated with our grief, unable to join, process, console each other, or celebrate a life as a community.
If you are trying to be present for someone who is experiencing the anniversary of a loved one’s death, do not try and imagine what they need. Ask what they need. You can say, “I don’t know what you experienced – how can I support you?” Communicating with inquiry and care is particularly important now, as acknowledging their needs restores the sense of agency which they lost.
The Playbook for Any Disaster
The specifics of what actions are necessary differs based on the details and science of the disaster, but if you follow the 3 suggestions below, you can rest easy knowing you did everything you could.
1) Trust the science.
2) Look out for the people next to you.
3) Work hard.
Mark currently hosts his own podcast, Explore the Space, in which he looks into issues of healthcare, gender inequity, gun violence, anti-racism, climate change, and anything that stokes his curiosity. You can explore episodes in the archive: https://www.explorethespaceshow.com/the-podcasts/. Mark can be found on Twitter at https://twitter.com/etsshow.