The Death of Empathy

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You used to come to us struggling to breathe and begging for our help, and while we stood over you preparing for intubation, we would feel all the feels while looking into eyes that we knew might never open again. We would break down and cry while telling your family that you didn’t make it or celebrate with high fives and exclamations of relief when you pulled through.

You used to wait in our waiting room while we anxiously saw it getting backed up, and we would do everything we could to move the department faster or find ways to get you back to us faster as we fretted and advocated for the seriously sick and injured patients that might be getting worse while waiting for a bed to open.

You, as our family, friends, and acquaintances, used to come to us asking our advice about your Great Aunt Berta’s cancer or the rash you’ve had for a month or to look in your fussy toddler’s ear and we would be happy to help, and we would feel a sense of satisfaction that we could give you some relief or peace of mind.

You used to come to us asking us to give presentations at your schools or community events about healthcare professions or public safety. We would happily volunteer our time to help our community and our community’s children.

You used to see and hear us talk with joy as we passed on our trade to the next generation of caregivers. We loved our jobs and couldn’t think of anything else we would rather do than care for our communities, and we would pass that on to our trainees.

But then COVID denial, anti-masking, and vaccine refusal entered our world, and everything changed.

And we became frustrated and angry and sad and horrified. And then, as we became just plain exhausted, we watched our colleagues leave one by one for myriad very valid reasons from what we had always considered our second family. And while we don’t blame our former colleagues at all for those decisions, it has added to the pain that was already so great that now we are just numb.

Now when you come to us struggling to breathe, we still go through the actions and do what we can to save you. But our empathy and hearts are tucked away and protected to only come out for our own loved ones because we don’t have much of it left to spare.

Now when we see our waiting rooms backed up to 5-hour waits and closed to EMS traffic and turning away transfers from rural outside hospitals, and see patients who have been boarded in our ED for days deteriorating rather than improving in an appropriate ICU bed, instead of fretting and trying to find ways to get out of the mess, we have learned that there is little more we can do about it (especially when our communities are doing nothing to help us and do not seem to care at all).

Our mantra, for our own self-preservation, has become “I just have to get through this 8- or 10- or 12- or 16-hour shift” while trying to turn a blind eye to the madness.

Now when you ask us about your Great Aunt Berta or your rash or your kid’s ear, and we know you have ignored the rest of our advice for the past 21 months, instead of feeling a sense of satisfaction that we can help, we feel frustrated, angry, and sad that you only want our advice when it is convenient for you.

Now when we approach our schools or other community groups to advise on how to best approach a public health crisis and keep our community safe, instead of leaving feeling respected and having a sense of fulfillment in giving back to our communities, we leave disrespected and humiliated after being booed down and yelled at while those same people who asked for our volunteered contributions in the past sit there in silence today.

Now when we have trainees, you see our skepticism at their eagerness to learn our trade and hear our mumblings of, “Are you sure you really want to do this?” Soon, there will be too few to take our places.

It is not just patients dying within the walls of our hospitals. Empathy is also dying one by one in the hearts of even our most empathetic healthcare workers, and being replaced by apathy.

And while all of us would love to get that empathy back, we need help from our communities.

Because we have nothing left to give, there will soon be no one left to give it.

And we should all care about that.

Julie Swartz, MD, is an emergency physician.

This post appeared on KevinMD.

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