Connie Nugent MLS
Corresponding author: Connie Nugent
Contact Information: Connie.Nugent1@gmail.com
DOI: 10.12746/swrccc.v9i41.941
“Death is blowing around you like a tornado…”
Dallas nurse Megan Brunson wonders if she is making any difference in caring for her Covid patients; she feels overwhelmed by the pandemic and by the feeling that she can’t make a dent in the tornado of death that surrounds her.1 ICU nurse Nate Smithson suffers panic attacks from the stress and anxiety of trying to balance work and life, “I fall asleep and dream about my patients.”2 As the Covid-19 pandemic continues well into its second year, health care personnel nationwide are exhausted. Many are bitter and angry with the overall poor management of the pandemic by the nation’s health care system and by the perceived lack of support from the public, many of whom refuse to wear masks or to become vaccinated.1
In an article in this issue of the Southwest Respiratory and Critical Care Chronicles, Sarangi and Kim maintain that healthcare professionals experience “high levels of negative psychiatric symptoms related to depression, anxiety, fear, post-traumatic stress, burnout, and distress during infectious disease outbreaks.”3 They focus their attention primarily on ICU healthcare professionals who are coping with the current surge of critically ill Covid patients, pointing out that a lack of bed space, long work hours, and an above average rate of patient deaths “have been associated with high levels of emotional exhaustion, disengagement, and an increased risk of depression.”3
The Washington Post-Kaiser Family Foundation poll would agree. Three of ten healthcare workers polled are considering leaving the profession, and six of ten recognize that stress associated with the pandemic has negatively impacted their mental health.4 Matthew Trunsky, MD, for example, revealed in a Facebook post the emotional toll caring for patients was taking on him and his colleagues.4 After reading many Facebook posts from anguished health care workers, psychiatrist Mona Masood, MD, created a Physician Support Line that has fielded thousands of calls during this past year. “As psychiatrists, we were all seeing the warning signs,” she said. “Healthcare can’t just be about making patients well. We have to care for the healers, too.”1
New York Times reporter Katherine J. Wu interviewed healthcare professionals and concluded that “the very people whose life mission is caring for others are on the verge of collective collapse” and that the unrelenting stress has produced “a chronic sense of hopelessness and deepening fatigue.”5 Artist Vincent Van Gogh (1853–1890), no stranger to hopelessness himself, recognized similar feelings in his doctor, Paul Gachet (1828–1909). In a letter to his brother Theo, Van Gogh commented that Dr. Gachet was “fighting the nervous trouble from which he certainly seems to me to be suffering at least as seriously as I.”6 Van Gogh painted two portraits of Dr. Gachet; one is in the Musée d’Orsay in Paris, but the location of the more famous one is unknown.7
Van Gogh recognized a fellow sufferer and commented to Paul Gauguin (1898–1903), “I have a portrait of Dr. Gachet with the heart-broken expression of our time.”8 The doctor leans his elbow on a cloth-covered table with his head propped on his clenched right hand as if he is too weary to sit up straight. His left hand rests on the edge of the table next to a flowering foxglove and two novels with dispiriting content—Germanie Lacerteux (1865) and Manette Salomon (1867).8 Dr. Gachet’s “grief-hardened”6 face reveals his depressed disposition; his eyes slant downward as do the corners of his mouth. Even his mustache droops. His gaze seems vacant. Van Gogh uses dark colors and heavy brushwork to suggest feelings of oppression—perhaps of burnout? Were it available in the town of Auvers-sur-Oise, France, one could imagine from his demeanor that Dr. Gachet might be listening to Frederick Chopin’s Piano Sonata No. 2, the “Funeral March,” as he sits for his portrait.9
Painting is silent poetry,
and poetry is painting that speaks.
Plutarch
Vincent Van Gogh. Portrait of Dr. Gachet. 1890. Location unknown.
How do depressed healthcare personnel cope with these feelings of hopelessness and fatigue caused by the stress of the pandemic? Some turn to poetry. In a TEDxCambridge talk, Harvard physician Dr. Rafael Campo extolled the power of poetry to help doctors during crises, “When we hear rhythmic language and recite poetry, our bodies translate crude sensory data into nuanced knowing—feeling becomes meaning.”10 A poet himself, Dr. Campo has often been so exhausted that he actually can’t write, but that to him writing is healing, a way to explore his grief.11
Dr. John Okrent, a family practice physician in Tacoma, WA, creates sequential sonnets about his experiences during the pandemic. As his patient load increased, he wrote a sonnet a day—the last line of the previous day’s poem became the first line of today’s poem. He feels this format conveys the onerous sense of repetition of days blending into days. He calls these “dispatches from the front line to help me deal with the stress.”12 The imagery in the lines “It was gorgeous today, and marked the 52nd death / in the Evergreen state” juxtaposes the day’s beauty with the specter of death–the Evergreen state is shrouded in black.
Elizabeth Mitchell, MD, also recognizes the contrast between the beauty of the outdoors and the closeted existence of quarantined households and the encasement of healthcare personnel in their protective gowns, masks, and shields. The beauty of a blooming daffodil sparked her poem “The Apocalypse,” which contains the lines “This is the apocalypse / A daffodil has poked its head up / from the dirt and opened / sunny arms to bluer skies / yet I am filled with / dark and anxious dread.” As spring arrives, nature rejoices, but weary doctors and nurses have little time to enjoy the rebirth, remaining mired in the Covid morass. “Poetry speaks to the art of medicine,” Dr. Mitchell maintains, “versus the science of medicine.”13
Doctors and nurses are grappling with a relentless battle against a widespread Covid-19 epidemic. Many have chosen poetry as a means to comprehend this exhausting struggle and to synthesize their experiences in language that allows readers to participate in their emotional journeys. The power of poetry is evident in the words of Emily Dickinson, “If I feel physically as if the top of my head were taken off, I know that is poetry.”14
Keywords: Covid-19, pandemic, poetry, Vincent Van Gogh
Article citation: Nugent C. Exhaustion. The Southwest Respiratory and Critical Care Chronicles 2021;9(41):64–66
From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
Submitted: 10/04/2021
Accepted: 10/06/2021
Reviewer: Gilbert Berdine MD
Conflicts of interest: none
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