海角大神

I can see the banner atop the Space Needle from my desk at home. It reads, 鈥淲e got this Seattle.鈥� While I am grateful that my city is no longer the epicenter of the COVID-19 pandemic, my thoughts turn to my former home and my colleagues in New York City living in the eye of this dark storm.

I emailed a number of front-line nurses at Manhattan鈥檚 Lenox Hill Hospital, where I once worked, asking them to describe how they are able to maintain a constancy of care when they are running on empty.

Their stories are gallant examples of听蝉颈蝉耻: a Finnish word meaning the extraordinary courage and determination that surface only in response to particular adversity, suffering, and hardship. The word is 500 years old, but it was revived by the perseverance of Finnish soldiers who fought in the punishing cold of the 1939 Winter War. They defied a powerful Soviet army invasion and preserved Finland鈥檚 independence.

Since then, sisu has become a key element in Finnish culture, though it is a capacity we all share. At the core of sisu is the idea that, in each of us, there is more strength than meets the eye.

鈥淣o time to be sad鈥�

Take Erin Dean, who details her evenings in the intensive care unit.

鈥淓very night, when I take the elevator up to my floor, I call upon an inner strength to get me through one more night,鈥� she explains. 聽鈥淚 became a nurse to help. I never believed it would require a special courage, but now I know that is true. 聽It鈥檚 not just me; the whole team, the whole floor, the whole hospital is calling upon a unique type of fortitude.鈥�

Ms. Dean describes how this 鈥渉orrifying disease has allowed me to witness acts of love on a scale I would not have imagined.鈥� She recalls a loving, long-married couple 鈥� each fatally ill 鈥� in beds on separate floors. She ferried the wife in a wheelchair to her husband鈥檚 side so that they could die together. By the time Erin returned to her station, the wife鈥檚 bed had been assigned to another patient.

鈥淣o time to be sad.鈥� Dean writes. 鈥淚 had another patient to care for. As nurses, we have all developed the ability to compartmentalize illness and death, but not at this extreme, unprecedented level. 聽We are drawing upon a heretofore untouched well of strength and determination.鈥�

I discovered the notion of sisu when I worked on a Fulbright grant at the Helsinki University hospital. There I encountered the work of Finnish psychologist Emilia Lahti, the world鈥檚 foremost authority on the phenomenon.

Ms. Lahti鈥檚 research details three key elements of sisu. Firstly, it enables us to move beyond our existing view of our mental and physical capacities. Sisu is also an action mindset that helps us to face up to fears, extend ourselves in moments of suffering, and take action in the most聽daunting circumstances. And finally,聽sisu is a second wind that allows us to draw upon a previously hidden, untapped source of聽strength.

Digging deeper

These three elements sing in the example of Lenox Hill front-line nurse Emily Fawcett, who describes working her fifth 13-hour shift in a row.

鈥淚 could probably sit here and complain about how my feet are swollen and throbbing, how I have a headache from the tight mask, how I have cried three times today already, or how I miss my family. But, I am choosing not to. And this is why: Today聽I had the honor and privilege to 鈥渟end off鈥� a聽Navy聽veteran 鈥� to give him the goodbye that he deserved.

鈥淚t was at this moment I had to call on my inner strength and courage. It no longer mattered that I was exhausted, that I had not eaten lunch, that I had charting to do. All that mattered was this patient and his family.聽They聽were my strength, my courage. If they could be strong in this moment, so could I.鈥�

Ms. Fawcett describes her team jumping into action. They called the family in, gathered hospital workers who were veterans, got the music ready. 鈥淲e all gowned up, the family said their goodbyes. We played the聽Star Spangled Banner and we all gave him his final salute. He passed away shortly after. It was beautiful and it is this moment that will carry me聽into聽my next shift.鈥�

I ask Emilia Lahti how she views the exceptional responses of front-line health care workers.

鈥淭丑别 sisu these nurses describe has appeared in a moment of extreme adversity,鈥� she responds. 鈥淚t is invoked by an experience that calls them to stretch and expand.鈥� Ms. Lahti thinks of sisu as the next gear beyond fortitude. It begins where grit and perseverance end, a 鈥渇riendly darkness of adversity鈥� that sparks our 鈥渁bility to channel a moment and open the pathway to a latent existing strength that resides within us,鈥� she says.

The COVID-19 pandemic is such a moment, Ms. Lahti suggests. 鈥淲e are witnessing a global expression of sisu. We see nurses and health care providers digging to reach layers of strength they did not know existed. They are stepping into their previously unpresented strength.鈥�

Consider a final example of sisu as defiant bravery. ICU nurse Rose May Coma compares her first day on a COVID-19 unit to being 鈥渁 civilian at war,鈥� toe to toe with the enemy virus. She addressed it directly.

鈥淭hat鈥檚 okay Corona, I was not ready today. Scoreboard:聽CORONA: 1 ME: 0. But tomorrow is another day. I鈥檓 made of tougher stuff than you, Corona. You won鈥檛 get me again. Enjoy your win; I鈥檓 in it in for the long haul. I will dig deep, deeper than I ever needed to. I will do it for my family, your family, my brothers and sisters at the front line, for me, for humanity.鈥�

More than 100 years ago, the American philosopher William James wondered 鈥渨hat keeps our lights burning and our hearts hoping during the dark night of the soul?鈥� When I listen to the stories of these valiant nurses, I hear eloquent answers. I can only express wonder and gratitude for the sisu that moves them to meet this unthinkable moment.

Barbara Mackoff is a Seattle consulting psychologist, senior faculty at the American Organization for Nursing Leadership, co-author of 鈥淭丑别 Inner Work of Leaders,鈥� and author of the forthcoming 鈥淲hat鈥檚 in Your Just in Case Book?鈥�

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