Stress, pressure on healthcare systems due to hard-to-see covid paul simeone
Paul G. Simeone
In 1992, on a cold and windy spring day in Cambridge, Massachusetts, I attended a conference that still echoes loudly in my heart and soul. The affair was picturesque, almost genteel, typical of meetings of this type; you know, small crowd, light lunch, high calorie speech. Just my cup of tea (pun intended).
The speaker was Robert Reich, the eminent economist who had just been appointed Secretary of Labor by his former Oxford University classmate Bill Clinton. In earlier and exciting times, both were Rhodes Scholars who forged a close friendship born of shared values, big dreams and deep personal connections.
Her speech, simply titled “What We owe Each Other as Americans” was magnificent, 20 minutes at most, a beautifully embroidered tapestry of penetrating politics, economics, and social commentary. To date, I haven’t had such a nutritious breakfast.
Without ever naming it once, Reich laid out in surprisingly concise detail all the elements of the social contract. He never invoked Locke, Hobbes or Rousseau, nor did he dive too deeply into the murky waters of Rawlsian ethics, which recast the social contract – whatever version you approve – in terms rooted in contemporary American political philosophy. And, perhaps most interesting to me, he never once mentioned health care, an omission that I found fascinating.
You see, I believe health care is now at ground zero in the debate over our beleaguered social contract; it is, in my opinion, one of the last functional institutions of our culture. And now he is in grave danger, the victim of a deeply divided and toxic cultural state, perched on the precipice of an immanent collapse.
What do I mean by that? I would respectfully make a few observations:
Over the past two years, I have watched my friends, family and colleagues working tirelessly – and risking their lives – to take care of all of us during the pandemic. I especially want to recognize our army of angelic nurses who, day in and day out, hold the hand of the suffering and dying. Their loving touch is often the last human gesture that patients experience before leaving this troubled world.
My own doctor son contracted a severe case of COVID-19 while covering a COVID-19 intensive care unit for a large New England healthcare system. Despite the fact that many people in need of care have chosen not to follow the basic safety recommendations of our public health experts. He and his colleagues invested themselves and did the typical hard work of dedicated healthcare professionals with great compassion, empathy and selflessness.
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Now we are fighting everywhere; on airplanes, at school committee meetings, in restaurants, waiting rooms and other public spaces. The dividing line seems to be self-interest in the name of freedom from the social responsibility to harness, for the common good, a collective sense of “we-being.” Bill Clinton once said, “There is nothing wrong with America that cannot be fixed by what is right with America. “
Along the way, our body of health care providers and first responders became exhausted, demoralized and angry. Their feelings shifted from relentless care and concern for patients to frustrations that the public shunned their duty to safeguard public health, not to mention civility to one another. So many disheartening stories abound of patients and their families intimidating and abusing staff. This anomy has led to an epidemic increase in depression, anxiety, PTSD, and suicidality among health care providers. Our health heroes have paid dearly, supporting the oft-quoted phrase that “no good deed goes unpunished”.
So here we are at the start of a new year, facing yet another wave of COVID-19, with our healthcare system once again stretched to its limits with healthcare workers dropping out of their beloved profession en masse. My heart hurts for my friends and colleagues; I wonder how to keep my spirits up during the next tough months. The costs are huge in terms of treasury, morale, and resilience. I am also concerned about how we are going to staff our health care system which is reaching our physical, financial and emotional limits.
It’s what keeps me awake at night as a senior executive in a large and vital healthcare system.
Therefore, out of great concern and compassion, I humbly but emphatically ask you who can do more to help and support the system, two important questions:
“What do we owe each other as Americans? “
“Are we not our brother’s keeper?”
Your answers will say a lot about who we are as a changing society and what kind of future we will leave for our children.
Paul G. Simeone, Ph.D., MA is Vice President and Medical Director of Behavioral Health for Lee Health and Clinical Assistant Professor at Florida State University College of Medicine.