The Happiness Lab with Dr. Laurie Santos - Helping the Helpers

Episode Date: April 16, 2020

The heaviest burden of Covid-19 has fallen on the shoulders of medical staff, first responders and others who care for the sick and vulnerable. These people are saving lives, while putting their own h...ealth and mental wellbeing at risk.Several doctors and nurses have written asking for advice on the small ways they can make their daily lives a little easier to bear. So we asked cardiologist and wellbeing expert Dr Michael Rocha to explain the ways he's preparing for shifts on a Covid ward. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

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Starting point is 00:00:00 Pushkin. that one filled with show tunes. More of you finding Gemini's because you know you always like them. More of you dating with intention because you know what you want. And you know what? We love that for you. Someone else will too. Be more you this year and find them on Bumble. Welcome to a special set of episodes of The Happiness Lab. The now global spread of coronavirus is affecting all of us. This disease has brought a host of medical, economic, and political problems. But it's also given us a ton of uncertainty and anxiety, which are beginning to have an enormous negative impact on our collective well-being. But whenever I'm confused or fearful, I remember that looking for answers in evidence-based science is always the best way
Starting point is 00:01:05 to go. And that's where I'm hoping this podcast can help. I often get emails from listeners asking for specific advice, but one of the ones I received recently really struck me. It was from the director of a hospital emergency department, someone who had spent the last few weeks on the front lines fighting COVID-19. He talked about the fear and anxiety so many healthcare workers were facing right now and asked if I could devote a special episode to helping medical staff and first responders with some science-based tips specifically designed to protect their well-being during this crisis. Like many of you, I've been wondering what I could do to help the brave folks who are working on the front lines of this crisis. But I also didn't want to give
Starting point is 00:01:49 such advice lightly. And so while I desperately wanted to help, I also wanted to make sure that I understood what those heroes were really going through. So I put out a call to a number of my longtime doctor friends, a science buddy from college who's now a leading oncologist, and my best friend from elementary school who's now a leading oncologist, and my best friend from elementary school who's now a board-certified family physician. I asked them to share the specific challenges they were facing and what questions they and their teams had about how to protect their mental health during this crisis. And then I put out a call to someone who I knew would do a great job walking me through all these questions, Dr. Michael Rocha. Dr. Rocha, or Mike as I know him,
Starting point is 00:02:27 is a successful cardiologist. But I know Mike in a different capacity. We went to high school together back in my hometown of New Bedford, Massachusetts. Since graduating, Mike's gone on to become one of my town's heroes. He founded a group called the New Bedford Wellness Initiative, which provides free resources to our community about happiness and healthy living. In doing so, he's basically retrained as a wellness expert and one that really practices what he preaches. He lost over 80 pounds through healthy diet and exercise. He meditates regularly and he practices many, many of the tips that I talk about in this podcast. practices many, many of the tips that I talk about in this podcast. But the reason I really wanted to talk to Mike for this episode is that he and his medical group have also been on the
Starting point is 00:03:09 front line tackling COVID-19. And like many specialists, he's been asked to help out beyond his own area of expertise in order to best treat coronavirus patients. Since I knew Mike was dealing with these challenges directly, I thought he'd be the perfect sounding board for some of the tips I wanted to share. I called him at home in his study to record our conversation. All right, so you can start it. Got it. Yeah, it says continue here. I'll just hit continue, right? That's all. Yeah, that should work. Here we go. Yeah, so I wanted to start at the beginning because we, Mike, you and I actually met in high school, I think. That's right. I wanted you to start with just give me a sense just on the ground, just really generally,
Starting point is 00:03:50 like what is it feeling like to be someone who's in healthcare right now? The feel is, is that it's trying to ride a roller coaster because the information is coming in incredibly quickly. We in medicine are seeing, you know, one study that's positive and then the next study that's not so positive. Things keep changing. And also in certain places right now, there is a very high anxiety. As a cardiologist, you know, two months ago, I would never have thought that I was going to be in a situation that, you know, going into a patient's room was potentially going to be something that I was going to have to wear a gown and, you know, a mask and a visor
Starting point is 00:04:26 and gloves. And so there's a lot of anxiety around that. I mean, it sounds like just the normal care that you would normally give, which was just kind of like normal and routine, it potentially even could be deadly now. I mean, not even to take an extreme position. Yeah, I have a friend of mine. I have someone I trained with that was in the front lines of New York, and she's been admitted to the hospital down there for about 10 days. She's doing better, but, you know, she's my age. So, you know, that's actually for doctors, especially younger doctors, has really caused us to pause because we're young, we're healthy. It's not something we would actually expect to have to deal with. And so I want to walk through some of the things that the science of happiness can help with in this incredibly scary time.
Starting point is 00:05:06 You know, sadly, there are major structural problems in terms of the amount of PPE access and what hospitals and administrations are doing. Like, you know, as a podcast host, I can't help with those. But I think there are certain things we can help with in terms of making sure that physicians and first responders are protecting their mental health. And so I wanted to dig into some of the stuff that you just talked about. First, give me a sense of the kinds of emotions that physicians and first responders are going through right now. I mean, one of them that I hear a lot in my emails is anger that just like, you know, this is an awful angering situation. Yeah, I think that there's no doubt that there's a lot of anger out there. And I think that if people get caught in that situation where they're angry, they're not actually able to be most effective.
Starting point is 00:05:45 But the sense that we don't feel protected in the United States is a big thing for people. And it's understandable to be upset about that because we should be prepared better than what we are. And I think that there is a lot of disappointment. Let's just leave it at that, that certain people or organizations that could have made changes and could have prevented the potential risk didn't. And I think that that emotion rises up and affects the way people are feeling these days, especially docs and nurses. And then I think another emotion, I mean, we already talked about it a little bit, is fear. I mean, talk about the ways fear is playing out among first responders right now.
Starting point is 00:06:27 People are, you know, breaking down. They're crying. They're afraid. You know, again, we have to take that extra pause. You know, I actually had a situation the other day where I needed to call 911 on a patient that was unresponsive. And I had to make sure that I told them up front that there was a concern that that person may actually have COVID. And that causes everybody to kind of sit there and go like,
Starting point is 00:06:50 oh my God, right? You know, again, I think there's a fear amongst cardiologists that we, you know, it's really hard to tell whether the patient actually has a COVID manifestation on an EKG or their presentation, or they're actually really having a heart attack. So now we're kind of like second guessing ourselves, because if we take somebody to the cath lab to put in an emergent stent, and they actually don't have a blockage, well, then we just expose potentially six people to an infection. And that's anxiety provoking, because we know that COVID can affect the heart. And we keep hearing over and over again how it affects the respiratory, the lungs, but it can affect almost every organ system.
Starting point is 00:07:28 And it seems like you're not just afraid for your own health and safety. There's a real fear for first responders bringing this home to their family, to their kids, to people that they care about. Right. Right. Absolutely. You know, it's caused a lot of isolation. So you could be walking around your house with your family and your concern is that, well, I could have COVID. I don't know yet. I don't have symptoms. I certainly don't want to give it to my family. And I think that a lot of people in healthcare and first responders are actually taking extra measures when they come home at night and they may be in their own room. Or actually some people in healthcare are going and staying in hotels to stay away from their families. That's a tough one.
Starting point is 00:08:06 And so I want to talk about strategies that can come from the science for how you and other healthcare professionals can regulate some of these emotions. I mean, I think maybe the first thing to say is that obviously all these emotions, the fear and the anger are completely justified. Like, it's awful that you're in these situations and you're really facing a threat that's like incredibly real. And so it makes sense to be afraid. The problem, I think, as you know, for doctors, it's also not good to be angry and afraid. Like it feels yucky and it affects your decision making. And so if there was something that could be done to regulate those emotions, it seemed like it would be a smart thing to do. The story I'm always reminded of when I hear tales of healthcare workers who are facing this stuff is this Buddha story about the second arrow. I don't know if we've talked about that before, but, you know,
Starting point is 00:08:48 this is this idea, you know, Buddha's telling his followers the story of, you know, if you get hit with an arrow, you know, is that really bad? And the followers say, yeah, that's terrible. It's like, well, if you get with a second arrow and a third arrow, is that worse? And the followers say, yeah, that's worse. And Buddha goes on to say that, you know, the first arrow is the circumstances in life. That's like the circumstances in life that's like the actual bad things that are happening you can't control those but in some sense you can try to control the second arrow which is your response to those horrible circumstances and i feel like in health care now it's not an arrow like you all are getting shot with like ak-47 you know like the
Starting point is 00:09:19 first arrow is much bigger than like a regular arrow but i think there's still there's still a world where there are strategies that could be useful to regulate these emotions. And I think it's really important. And, you know, one that I've been talking with a lot of folks about is just this ability to kind of regulate the threat response generally, like in the body, like what folks can do to sort of shut off their or at least kind of calm down your sympathetic nervous system a little bit. And so can you give me a two seconds on like the sympathetic nervous system and just like fight or flight response? I mean, I could do it too. You're the doctor.
Starting point is 00:09:53 Yeah, so the fight or flight response is, you know, I deal with that quite a bit. And, you know, honestly, I mean, actually, I can't tell you how often that comes up in cardiology where, you know, your blood pressure goes up, your heart starts to race. You know, again, you start taking blood away from various peripheral types of arteries. So it's really, again, that heightened sense of awareness. Hopefully, though, that's only a very brief response. And you don't want to be in that mode for a long period of time because it's very detrimental, right? You may be able to do that quickly and it may save your life. But if you're doing that the whole time, it's not saving your life. It's usually going to hurt you.
Starting point is 00:10:35 And the beauty is that even though for the most part, we can't really take much action on our autonomic nervous system other than removing the threats that are out there, which obviously if we could do that with COVID-19, we would. But the beauty is there is one way that we can kind of chill out our sympathetic nervous system. And that is through our breath, you know, the action of kind of taking, you know, a couple deep breaths, you know, especially deep belly breaths where you're going really slow and breathing not into your chest, into your belly, that can actually activate the parasympathetic nervous system. And the act of doing that we know
Starting point is 00:11:05 can regulate, again, these emotions that the catecholamine system are signaling, like, you know, that fight response, which is all this anger and those kinds of emotions, or even the fleeing response, which is the fear and the anxiety and that panic. Just the act of taking those deep breaths can really make a difference. Do you think that's something that kind of doctors in the trenches could potentially use in this time? Yeah, I think, you know, that type of breathing is very important. And in fact, patients in the office where, you know, again, they come in, their blood pressure is up, their heart may be racing, and I will go through that. Sometimes you can bring the blood pressure down by just 20 points that way.
Starting point is 00:11:38 So, you know, again, activating the vagal nerve and the parasympathetic nervous system can be one of our best allies to combat the increased adrenaline and the fight or flight response. Which I think is important. I mean, it's ironic that you say that you do it with your patients, but I probably would say that it's been more over the last five or six years. It's absolutely critical. And it's really made a huge difference in how I'm able to approach is for them to get self-care in all these different domains. So I'm thinking about, you know, their sleep, like them eating right and all these things. So talk through what you're kind of seeing among your colleagues, like in terms of how hard it's been to engage with self-care during this battle. I'll just give a for instance, in terms of nursing, for example, you know, some of the nurses that are on these COVID units are actually in full regalia or the full personal protective equipment. And just by having that on makes it really hard
Starting point is 00:12:51 to take a break. So, you know, you've got people that may be doing your entire eight to 12 hour shift on their feet with really not even eating well or drinking well. And if you're in that situation for eight straight hours at that kind of intensity, you've basically got your fight or flight response on the whole time, unless you have some adaptive mechanisms to be helpful. And then the other thing is, is that no doubt when you're faced with these kinds of traumas, trying to wind down at night and trying to find the ability to kind of be able to decompress to sleep is a big problem. And then, you know, if people are working longer shifts and not getting out till late,
Starting point is 00:13:28 you know, their sleep is being reduced. You basically, you sleep, you go to work. And, you know, there's not a lot of time for people to be necessarily exercising or, you know, again, meditating for an extended period of time. So this schedule that is forcing people into is really not one that's conducive to self-care. And so I guess, you know, from my science of happiness perspective, the advice would be that people just need to make some of these things non-negotiable, you know, especially sleep and rest, exercise, you know, healthy eating. I mean, these are the things that
Starting point is 00:14:01 we need to double down on when our mental health is in jeopardy. I mean, they're also the things we need to double down on when our immune system, you know, needs a little rev up too, right? So this is exactly the time when healthcare workers need to protect their immune system with all these different practices, and they're not doing that. And so what would it look like on the front lines to really make these things non-negotiable right now? That's a real challenge because, you know, we don't have reinforcements. We're actually currently asking doctors and people that have been out of medicine or maybe have been retired, we're asking for volunteers to fill in. So we're really at a place where, you know, it's survival mode, unfortunately. And, you know, you can't be in growth mode when you're in survival mode. And that's the real challenge. I mean, one of the reasons I was excited to have you on the show is I feel like you've
Starting point is 00:14:48 been really good at practicing what you preach, even during tough times. So eventually, folks are going to come home from these long shifts. What can they do ahead of time to prioritize sleep? I think simple things like staying off the internet when you get home, positive sleep habits, like putting the phone away and trying to get to bed, maybe even healthy eating, like not eating a huge crazy meal or drinking, like, what does it look like in your own life to prioritize some of these things? Yeah, no, I actually, I usually eat pretty healthy. But over the last four weeks, I don't think that I could eat much healthier. I have been like, ridiculous. Every day,
Starting point is 00:15:22 it's been regimented. And, youed and lots of fruits and vegetables and nuts and beans and lots of water. And I've really tried to actually mentally prepare and physically prepare in such a way that's really important. So eating healthy is not just good for our physical well-being, but we do know that it's good for your mental well-being. So if you're coming home and eating sugary snacks or having a bunch of drinks, it's first of all, those things are going to interrupt your sleep. You're not going to sleep well. You're not going to feel any better and you won't be prepared. So, you know, again, I personally really believe that the work that I did beforehand to get me in the space to be able to
Starting point is 00:15:59 eat healthy and regiment that has been important. Sleep by making sure that, you know, seven hours and trying to balance all those things is always still a challenge because again, next week, some of those things may not be completely in my hands, but I'm going to have to do the best I can within those circumstances of what I've prepared to do. I love two things that you said there, I think are so important. One is this idea that, you know, even if the system is against us, there's still a lot of things that we can control is against us, there's still a lot of things that we can control. There's still a lot of agency that you can take over what you're putting into your body, over how you're going to bed and when you're going to bed. But I also like that there's some self-compassion there. You said you're going to do the, you know, increasing your sleep by 15
Starting point is 00:16:45 minutes, or, you know, grabbing a piece of fruit instead of a candy bar, like those small changes are actually going to have a big difference on your health, but also on your mental health right now. And so these baby steps can be so important. Yeah, I've also in this happens, I've done this before in various weeks that they get busy, I make sure that I exercise, I'll do a four or seven minute workout, I make sure I walk as much as I possibly can, you know, in make sure that I exercise, I'll do a four or seven minute workout, I make sure I walk as much as I possibly can, you know, in that and that can be a good way to de stress coming home after work, you know, maybe my workout in the morning isn't as long, maybe my meditation practice is cut a little bit in half, or there's some of the stretching that I do, instead of doing
Starting point is 00:17:19 you 30 seconds to jump a jacks, I'll do 10. But trying to make sure that I still maintain that, because that actually has made a big difference for me in the past when I've been in situations you 30 seconds to jump a jack, I'll do 10. But try to make sure that I still maintain that because that actually has made a big difference for me in the past when I've been in situations where I've had to alter the way I do things in order to fit the time, the timeframe. So in addition to the issues with finding ways to prioritize self-care, I think we also have to just recognize that healthcare workers, especially healthcare workers who are on the front lines of this virus are seeing an incredible amount of suffering. I mean, healthcare workers obviously face life or death situations in some cases all the time, but in some ways it's different now. So I want you to
Starting point is 00:17:52 talk a little bit through the differences and the way that that suffering is kind of affecting people psychologically. It's the difference between drinking from the faucet and drinking from the fire hydrant right now. As you can see, it's happened in New York and I have friends of mine down there. The overall volume of suffering is on a level that we've never had to see. I've heard stories and very heart-wrenching things that it was really sad for me to see that the ER doctor in New Jersey actually passed away from this. My experience when I was a resident in a medical intensive care unit at a very, very busy tertiary care hospital at Tufts, we would see lots of sick people.
Starting point is 00:18:34 But it was always, even on your worst night, you could still get through it. It was manageable. It wasn't enjoyable because you were dealing with some sick people. And unfortunately, people die in those settings. It wasn't enjoyable because you were dealing with some sick people and unfortunately people die in those settings. But I think that the volume is so high that it's just so loud out there in terms of, you know, the suffering that's going on. I mean, we can even hear it, you know, here in New Haven and friends of mine in New York. They say, you know, all you can hear are the sirens. Right. You know, and that's what we're hearing. And it's scary.
Starting point is 00:19:02 I can't imagine what it's like to be on the other side of those sirens and be dealing with those people when they're coming in. And so, I mean, the good news, though, is I think the science really gives us a clear thing that we can do about that point in particular, the sort of dealing with other people's suffering. And it comes from a form of meditation. I know, Mike, you're a big practitioner of meditation, but the particular kind of meditation, I think, can be really powerful right now for dealing with that kind of suffering is a form of meditation known as loving kindness. So this is a kind of meditation I think can be really powerful right now for dealing with that kind of suffering is a form of meditation known as loving kindness. So this is a kind of meditation we've talked a little bit about before on the podcast, but it's a form of meditation where rather than just focus on your breath, you try to pay attention to what it feels like to experience compassion. And you do that through a set of different mantras.
Starting point is 00:19:41 You think about people in your life and you wish them health. You say, may you be healthy, may you be safe. And you kind of just like watch your body in terms of what it feels when you're doing that. And what the data suggests is that that kind of meditation can bump up your emotion of compassion. suffering in this awful way where you're kind of taking on their suffering and feeling it yourself, you actually get a motivation, like almost like a call to arms when you see people suffering in these contexts. Like compassion can actually build in a motivation to take action. And the amazing thing is research from folks like Tanya Singer suggests that this practice of loving kindness meditation can reduce burnout, particularly in healthcare professionals, because those are the
Starting point is 00:20:23 folks that, you know, if you're just paying attention to other people suffering day in and day out, it can really, you know, burn you out in the way that you're talking about. And so, so do you think that that's the kind of practice that, you know, if more healthcare professionals knew about it, they could kind of squeeze in? I mean, this is the kind of thing you can do two to three minutes a day, or maybe even in between patients when you walk out of the room, you know, you might not be able to take your mask off and take a break and, you know, grab something to eat, but you actually can sit there and watch your breath and kind of feel compassion. Is that something that people could reasonably add in in this time? I do. I think they can. I actually have kind of adapted my own way of doing, I do a gratitude
Starting point is 00:20:57 meditation and then I kind of close it out with may all people be free from suffering. So I kind of, I roll all of that together and it does, it makes a huge difference for me. I do that every day. You know, I do think that with some practice, it could be very helpful for people. And I agree it does, it does have a very profound effect to be able to think about that. And I think that the gratitude meditation for me has been very important because it really causes me to go back and look at all aspects of my life. And it also helps me to realize that we're not alone out there in this. And that I kind of think that this is almost our, you know, as people face these challenges of World War I, World War II,
Starting point is 00:21:35 these kind of uncertain times at such an intensity level. I really thought a little about my grandfathers who both of them served in World War II, because this is the kind of event in our lives that is called us to step up in a way that's very different. Yeah. And I love that strategy for beating burnout because, I mean, it does a couple of things. One is, you know, if you think about folks who've been through things like this before and made it through, like that gives you confidence that you can do the same thing, right? It's almost like seeing your own resilience in the mirror, which is really profound. But also I think gratitude can be a complete like medicine for the other things we were talking about earlier, things like anger and so on.
Starting point is 00:22:13 You know, if you're experiencing the things in your life that are a blessing or the people around you who are doing great things, it can kind of curb the anger at parts of the system that could be really problematic. Again, not to say that that anger is not justified. I think it completely is. It's just not functional. So anything we can do to kind of curb it is really helpful. So we focused a little bit on the emotions that people are facing in healthcare right now, and also how to deal with some of the suffering you're experiencing and some strategies you can use for that. When we get back from the break, I think we'll talk about the
Starting point is 00:22:41 even harder things like the existential part of this challenge of, you know, doctors actually facing their own death and what they can do to deal with that challenge in the best way possible. And so the Happiness Lab, we'll be right back. Ugh, we're so done with New Year, New You. This year, it's more you on bumble more of you shamelessly sending playlists especially that one filled with show tunes more of you finding gemini's because you know you always like them more of you dating with intention because you know what you want and you know what we love that for you someone else will too be more you this year and find them on Bumble. So Mike, I wanted to focus in on a different struggle that I hear a lot of healthcare professionals facing, which is kind of more of a personal one, which is it seems like a lot of healthcare professionals are kind of beating themselves up right now about a lot of different
Starting point is 00:23:40 things. Like from kind of survivor's guilt to folks who are feeling like, you know, they're working long hours and they're not there for their kids. It seems like a lot of the folks I talk to are just kind of not giving themselves the compassion they need right now. Do you see that as a problem among your colleagues too? Hopefully medicine changes after this in some ways, because in general, you know, we've kind of always been trained to be like, ways because in general, you know, we've kind of always been trained to be like, you suck it up and, you know, just do your job kind of thing. But there's a lot of data out there that, you know, about 50% of doctors before this happened were burnt out. And that's just doctors in practice.
Starting point is 00:24:21 So, you know, we're actually a group of people that, you know, one of our biggest challenges is self-compassion. For doctors, the idea is we're supposed to be able to use technology to keep everybody alive. And that's not gonna be possible right now because we don't have control. And I think some of this loss of control in a situation where it's just so much that's happening is really negatively affecting people. And I do think that people are beating themselves up out there.
Starting point is 00:24:43 I do see that that's a real concern and something that's going to throughout this crisis is going to play itself out with a lot of people struggling to cope with those things. Which I think is unfortunate generally, because, you know, health care workers are complete heroes right now. And it's awful to feel like they're beating themselves up. It's also just bad in terms of their competence on the job, because, of course, if you're second guessing yourself, if you're kind of feeling bad about things, that's going to be a challenge for the kind of care you're giving, because that doesn't lend
Starting point is 00:25:10 itself well to good decision making if you're kind of constantly second guessing in your head. But again, here, I think the science of happiness can help a little bit because there are lots of techniques that folks can use, practices that you can use daily to improve self-compassion, which I think can be really powerful. One of those practices is just a variant on the loving-kindness meditation that we talked about before. And so a typical loving-kindness practice is that you're giving compassion to all the folks out there, compassion for the world or compassion for people around you. But at one step in that process, you're supposed to take a pause and give compassion to yourself. You're supposed to say, may I be happy, may I be safe, and so on.
Starting point is 00:25:49 And what's funny is that that part of the process, it affects people differently. Some people find that one really easy, and they tend to do that one first because it's so easy in their meditation to get started with giving compassion to themselves. But for me, and maybe for other folks, it's kind of hard to say that you should be happy that you should be safe to kind of put yourself in the priority list but my sense is that it's a technique that could be really powerful for your physicians right now is to not just be worried about the suffering of everyone else but just to be making sure that they're giving themselves some compassion and giving themselves the benefit of the doubt generally but especially during this
Starting point is 00:26:23 really challenging time. Yeah, absolutely. Because you can't pour from an empty cup. I used to be my own worst critic by far. There was nobody even close to second. But what I realized is when I'd stop bopping myself in the face that actually I was more effective. And I think that one of the things is that it's not about just working harder, it's working smarter and being more compassionate.
Starting point is 00:26:44 Because the truth is when it's not about just working harder, it's working smarter and being more compassionate. Because the truth is, when you're in a situation where you're, like you said, you're going to lock up and you're not going to be able to take care of those around you, you also will be in situations that you're not able to be connected to your family because you're just so isolating yourself if you can't be compassionate to yourself. So not only just at work, but also at home. The other way clinicians can help with self-compassion is to remind their colleagues to have some self-compassion, too. I think this is another time where, you know, reminding your colleagues that you're grateful for them, reminding them that they're doing a good job, like those kinds of things can help. If there's someone on your team who's having
Starting point is 00:27:23 a really hard time with self-compassion, expressing gratitude, doing these nice things can really help them during this really scary time. That's actually something that I've seen that's really been remarkable over the last couple of weeks is to see people's ability to reach out to one another and be supportive. Interestingly, each doctor thinks they know more than the other doctor, but actually what we've realized now is that we all have to pool our resources. That never was true, but that's kind of how we've been trained, which makes it a problem. We now have to collaborate in a way that we've never done before. And I can tell you that it's happened, you know, even if it's not a phone call, but, you know, I greatly appreciate when I get text messages from friends
Starting point is 00:28:01 of mine that just say, hey, how are you doing? And randomly, and just showing up, just it's being present. I wanted to save the question that I'm getting that I've struggled with the most from healthcare workers, which is what the science of happiness says about kind of these real existential crises that I think doctors are facing right now. A lot of people, especially doctors in New York, who I'm hearing from, you know, they're really afraid of dying because they're seeing young people that they're taking care of die all the time. Talk about the impact that kind of seeing death so closely has had on physicians and the way it's affecting them in terms of their performance and in terms of their mental health. Yeah. So in healthcare, we usually deal with people that are older. And, you know, when you start to realize the people that you may be taking care of the younger, you have this kind of transference that you could put yourself in that bed, situation where, you know, I may need to face death or face illness in a way. But actually, that really caused me over the last couple of weeks to rethink
Starting point is 00:29:10 that, hey, you know, there is a possibility that I could actually get sick. And that has permeated throughout the profession, that everybody's asking themselves the same question. And, you know, again, we have doctors that are actually falling into not just the younger doctors, but we have doctors in their 60s, 70s, that, you know, again, we know based on age that people are at higher risk for complications. So truth is, is that, you know, still if a younger, if a younger physician, the chances of getting really sick are still very low. And I think that people, we still realize the data, the data says that we're still going to be mostly okay, but not everybody. That's just the matter of percentages,
Starting point is 00:29:51 right? You know, you just don't want to be the unlucky person. But we do know that we've asked some of our colleagues that are older to continue to practice and put themselves at risk, realizing that their risks may be higher. There's also doctors and physicians out there and nurses in healthcare that actually have underlying chronic diseases. But now there's a huge concern to say, well, what happens if I get sick? And I think that it's really caused a lot of people to relook and say, you know, this profession is a calling. There is, you know, to be a doctor is, or to be in healthcare, to care for other people, it's beyond a job. And I've never looked at it that way. And it is showing up in ways that, you know, when people need you to be there. And I think that at this point, even physicians that
Starting point is 00:30:42 I think that, you know, may have higher risk of having a complication, I can tell you that they almost universally are saying that they're going to show up in the face of danger. And that's courage, right? You show up when you show up, even though you know you may be in danger, that's courage. And we usually have equated that with with our police officers, with our firefighters or our soldiers. But this is really the first time that we've really had to answer that calling in a way that in the face of danger and people are doing it. And they're doing it in such a way that is really powerful and is really going to bring physicians across the world together at a time that it's necessary. and is really going to bring physicians across the world together at a time that it's necessary. And I've said this before, doctors largely have kind of gone to work and done their job and worked really hard for their patients. But we haven't really been great at advocating for the things
Starting point is 00:31:36 that really need to change out there. And I think that this is actually going to really solidify doctors as a voice that's going to need to be heard from now on. And I love your answer to that question, because I think that what the science suggests is that you're doing exactly the right thing to do when you're facing a big existential crisis, which is to double down on the things that you find important, that you find meaningful, that give you purpose in life. And it's a strategy that I think doctors can use right now to kind of face this existential threat with some dignity, right, to see, you know, this is the reason that you jumped into this because you were courageous, because it mattered a lot, because, you know, it was a calling. And so I think it can be really
Starting point is 00:32:17 powerful to kind of look at it from that perspective to realize that, you know, that that's what this is about. And I love the idea that doctors are realizing that they might even have more of a voice than they thought before, right? The idea that when we get out of this mess, now doctors will maybe have a voice to fix the things in their professions that were going wrong or kind of make things better for the next generation of doctors. All those deep, meaningful things are the kinds of things that psychologically speaking, get you through an existential crisis. So the more that doctors can double down on those big picture things right now, I think all the better. Another cool thing I saw when I was looking more about the work on people who work in palliative care and see a lot of suffering and
Starting point is 00:32:53 see a lot of death is that it turns out that the act of facing death in your profession actually has, in some cases, can have a strong benefit to your mental health because what it does is it allows you to have this greater appreciation for life. So nurses who work in palliative care report that they've gotten so many benefits out of this because they savor their own life so much more the people who are in the trenches right now, one that you might not see now. But after you get out of this, it will cause you to look at life in a completely different way. And that kind of appreciation is pretty rare. You know, we should all have that kind of appreciation, but we don't. And so the opportunity to see that so closely might bring a powerful mental health benefit that health care workers don't expect in the years to come. Yeah, I agree with that. I think that it's really important for us to be able to think about that.
Starting point is 00:33:51 And I've meditated, I had that meditation before. Just imagine that today's your last day. And I think that what it does is it really puts things in perspective that you start to put what's really important in your life together. And I do think that this has caused us all to hit the pause button. You know, we've taken our environment for granted. We've taken people for granted, right? You know, we've really placed, unfortunately, certain times we've put, you know, money or technology in front of people. That hurts. That hurts as a physician to see that certain certain populations are going to be more vulnerable with this. But I do think that taking stock of all the things and all the blessings and all the things that really matter is going to make
Starting point is 00:34:37 a big difference afterwards. And I do think the world be kinder and more mindful after this happens, not during. There is going to be great suffering. And so, you know, I think that the world will change, no doubt. It's been great that you've been able to see these deep benefits and to get meaning out of these things. But I just wanted to add one strategy for any of our healthcare workers or first responders who are really struggling with how to do that. And this comes from a scientist that we interviewed during the first season of our podcast, Jamie Pennebaker. And he does a lot of work on the power of journaling for allowing you to kind of get to these self-transcendent emotions. And so what he's
Starting point is 00:35:13 found is that just the act of taking time to sit down and talk about your situation, you know, write down about your situation, write down what you're feeling, it can kind of get you to that bigger picture to kind of see the big purpose in it, to see that these things are your calling and to see where you're getting your courage, or even just to take a kind of more future perspective on things that can allow you to like make sense of these things that feel really out of control. So if you're listening out there and you need a good technique to get to the point that Mike has so well through his meditation practice and all the work that he's done, you know, just sitting down to scribble it down and journal it can be really powerful. And that can be a great technique to add into a routine or even as a ritual at the end of the day.
Starting point is 00:35:49 You know, scribbling down your feelings is a great thing to do even before maybe you go to bed because you can kind of get it out on paper and let your brain process something else so you can fall asleep too. But I wanted to end with asking, you know, this is an awful crisis and people really are suffering. And, you know, as I said, when we started my metaphor about the second arrow, I think it's not a first arrow that our physicians are getting hit with right now. It's like an AK-47. But do you think that through some of these interventions, we can make it a little bit better? Again, not perfect, but these are things that physicians can do to improve things at least a little bit during this challenging time. that physicians can do to improve things at least a little bit during this challenging time. Yeah, absolutely. My friend George Mumford, who I spoke with a week ago, who is a meditation and mindfulness specialist, he has the concept of the eye of the hurricane. And I think that that's the important thing. Can you be the calm within the storm? You know, ultimately, you know, the storm is going to be there. And there is no way to wish this away. But it is our ability to stay calm and peaceful, despite the things that are happening.
Starting point is 00:36:53 And also, actually, you have to be comfortable being uncomfortable. And also, you have to allow yourself to not be perfect on all of those things. Because I think that, you know, it's not about pushing emotions away. It's about sometimes just sitting there with that. You know, I was I was out for a walk the other day and and there was a certain amount of sadness that just kind of came up out of the blue. And I just sat I just was there with it. I let it go. And then eventually it passed away. You know, it just moved. And, you know, one of the things is, is our emotions don't always stay. They're fleeting. You know, we're not happy forever. We're not sad forever. We're not fearful. We're not angry. You know, if we stay with those things and we realize that it's just an emotion and realize that it too will pass, that it's for me, that's made a big difference for me. And I think that that will help me in the coming weeks, despite whatever storm is going to come, this will pass.
Starting point is 00:37:44 coming weeks, despite whatever storm is going to come, this will pass. That's awesome. And I think it's powerful because, again, there's not much we have control over in this situation, but we do have control over how we react to it. There's a lot of work in science that suggests that what you resist persists. If you try to push away your fear, push away your anger, push away your emotion, it's just going to come back to hit you. So just say, this is the way this is and it's yucky, but freaking out and fighting it isn't gonna help. Let me just get through what I need to get through in as healthy a way as possible. And so Mike, thank you for helping our listeners
Starting point is 00:38:15 get through what they need to get through in as healthy a way as possible, which I really appreciate. And thanks so much for coming on the podcast. Well, thanks for asking me. I'm really, I appreciate the opportunity to speak with you, but also, you know, to share what's going on, because I think it's important for people to realize that it is a unique position in healthcare to be sitting where we are that we've never faced.
Starting point is 00:38:38 I wanted to end this episode by expressing my gratitude to all the medical professionals and first responders out there. Thank you so much for your bravery and service. And I really hope you heard some tips that might help you in this fight. And if you're not on the front lines, but you still want to help, there are lots of things you can do. You can start a campaign to get hospitals more life-saving protective equipment. You could consider donating blood, which I'm told is running really low right now. Or you could even see if your local hospitals are accepting food donations for their tired workers. But the biggest thing you can do is just stay home, which will help flatten the curve and keep everyone, including our healthcare heroes, safe.
Starting point is 00:39:22 The Happiness Lab is co-written and produced by Ryan Dilley. This episode was mixed and mastered by Evan Viola, and our original music was by Zachary Silver. Extra, extra special thanks to the medical professionals who helped me with this episode, especially Dr. Sanjay Shavekramani, Dr. Tanya Feek, and Dr. Amy Commander. As usual, deep gratitude goes to Ben Davis, as well as the rest of the Pushkin team.
Starting point is 00:40:05 attitude goes to Ben Davis as well as the rest of the Pushkin team. with show tunes. More of you finding Gemini is because you know you always like them. More of you dating with intention because you know what you want. And you know what? We love that for you. Someone else will too. Be more you this year and find them on Bumble.

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