As pandemic surges, where do 鈥榝ront-liners,鈥� business owners聽find hope?
| Sacramento, Calif.
A public defender in San Diego marvels at the resolve of her clients. A doctor in Providence, Rhode Island, draws strength from the stamina of her emergency room colleagues. A bookstore owner in Minneapolis gives thanks for the loyalty of his customers. A middle school teacher in Los Angeles cherishes the enthusiasm of her students.
Nine months into the coronavirus pandemic, as the number of cases soars, the economy sputters, and everyday life refuses to come unstuck, they face the same obvious yet complicated question that shadows each of us: Where does a person find hope?
Their answers, if varying in details, revolve around the common theme of connection. Our daily interactions 鈥� deprived of spontaneity and typically filtered through masks, Zoom, or both 鈥� remain a source of reassurance as the uncertain present lurches toward a blurred future.
Why We Wrote This
The coronavirus outbreak has inflicted an emotional toll that can extend to what鈥檚 known as moral injury. Many people are seeking the perspective 鈥� and the human connections 鈥� to address a hope deficit.
鈥淭here is a sense of being in the foxhole together,鈥� says Dr. Megan Ranney, an emergency physician at Brown University in Providence,聽referring to her fellow health care workers. 鈥淚t sometimes feels like we鈥檙e in a war for our patients and for ourselves. That tightens the bond.鈥�
Still, even for the most resilient among us, persevering week after week in our socially distant existence poses a struggle as聽another round of stay-at-home orders hits several states. The country鈥檚 vast political divide further inflames our grievances as officials at every level send聽聽about the pandemic, giving rise to personal distrust and, at times, public animosity.
The damage inflicted to the spirit and a loss of faith in others can contribute to people experiencing moral injury. Mental health experts describe the condition as a 鈥渨ound to the soul鈥� that exhausts an individual鈥檚 emotional reserves and provokes intense doubts about life鈥檚 worth.
Editor鈥檚 note: As a public service, we have removed our paywall for聽all pandemic-related stories.
Mending that internal rupture requires a deliberate effort to reassess our expectations and search for purpose as we await the post-pandemic era, says Dr. Wendy Dean, a psychiatrist and co-founder of the nonprofit group聽.
鈥淎ll of us have the need to feel normal,鈥� she says. 鈥淏ut we鈥檙e continuing to demand as much of ourselves as we did before 鈥� to be the perfect parent, the perfect worker, the perfect student. People have to find a way to have forgiveness for themselves and recognize that they鈥檙e doing the very best they can.鈥�
Bearing witness
Dr. Ranney has learned to downshift from the 18-hour workdays she pulled during the early months of the outbreak. Yet as cases spike again,聽聽aimed at doctors and nurses by those who question the severity of the disease 鈥� or its existence 鈥� marks an unsettling contrast to spring, when the country united in lauding front-line responders.
鈥淚t鈥檚 a very dark, difficult time for health care workers, who are working at the edge of their physical and emotional capacity,鈥� she says. More than聽聽have died from the coronavirus, and thousands more聽. 鈥淚t sometimes feels like we鈥檙e the Little Dutch Boy. We鈥檙e trying to keep our finger in the dike to stop that dam from breaking 鈥� and now we鈥檙e having tomatoes thrown at us and being told we鈥檙e making this up.鈥�
Moral injury,聽a term most often linked to veterans of military conflict,聽occurs when individuals commit, fail to prevent, or witness an act that violates their ethical beliefs, or when those in positions of authority betray their trust. The behavioral, emotional, or psychological toll that lingers聽can at once distort self-identity and sow suspicion or disdain of others.
A new report from National Nurses United examines聽聽for moral injury among medical providers as the pandemic drags on. The list includes inadequate preparation by and support from government agencies and health care employers, lack of social support, and聽emotional trauma聽related to the deaths of patients.
Beyond the failures of聽, the backlash from large numbers of Americans and limits on hospital visits deepen the plight of providers, who act as proxies for the loved ones of patients stricken by the virus.
鈥淭he feeling of betrayal is one thing,鈥� Dr. Dean says. 鈥淏ut there鈥檚 also this feeling of 鈥業 can鈥檛 do it all. I can鈥檛 pull this train by myself.鈥� We鈥檙e asking them to take care of people where prevention has fallen short 鈥� and in some cases has been ignored 鈥� and we鈥檙e also asking them to bear witness for all of us.鈥�
Dr. Ranney seeks to ease her unseen burdens through public advocacy and private diversions. She serves as a聽聽for CNN, offering insight into the hardships of front-line responders, and works with Get Us PPE, a nonprofit she co-founded that provides free personal protective equipment to medical organizations.
The mother of two young children, she exhales at home by watching 鈥淭he Mandalorian鈥� with her son and 鈥淕ilmore Girls鈥� with her daughter, and by taking occasional turns on the family trampoline. Weekend hikes with her husband and kids allow her to briefly slip free of聽anxiety鈥檚聽orbit.
The perils and pressures of work aside, Dr. Ranney聽nurtures a cautious optimism, encouraged by the prospect of a vaccine and a cohesive pandemic plan from聽President-elect Joe Biden. 鈥淭his is the most urgent public health crisis of our time,鈥� she says. 鈥淚鈥檓 honored I get to do what I do. It is an absolute privilege.鈥澛�
鈥淲e鈥檙e all connected鈥�
A similar sense of dedication and gratitude sustains Dr. Jessica Lu, a third-year family medical resident at University of Washington Medicine, a health care network in Seattle. Many of her patients live in nursing homes, and while safety measures preclude in-person visits with most of them, Zoom calls enable her to alleviate their social isolation.
鈥淔rom the beginning of the pandemic, I鈥檝e recognized how fortunate I am to do the job I鈥檓 doing,鈥� she says. 鈥淭hat kind of satisfaction keeps me going.鈥�
Dr. Lu holds measured hope that the country鈥檚 ordeal might persuade coronavirus skeptics to discard 鈥渂rute individualism鈥� as a public health policy. 鈥淲hat I think the pandemic has shown above all is you have to take care of each other,鈥� she says. 鈥淲e鈥檙e all connected.鈥�
A recent exchange with a patient illustrated that principle in an unexpected way. She asked a few questions of the young woman, who answered all of them 鈥� and then flipped the script. 鈥淗ey, Dr. Lu,鈥� she said, 鈥渉ow are you 诲辞颈苍驳?鈥�
Her evident sincerity touched the doctor. 鈥淓very day I鈥檓 looking for one good thing that happens, one little kernel of joy,鈥� she says. 鈥淭hat鈥檚 how we get through this.鈥�
Methods of coping
Tatiana Kline abides by the ethos of empathy in her role as a deputy public defender in San Diego. The pandemic prevents her and her colleagues from meeting with clients, who languish behind bars as courts delay hearings and trials, increasing their risk of exposure. An estimated聽 in jails and prisons nationwide have contracted COVID-19, and nearly 1,600 have died.
鈥淭he biggest hurdle is not having face-to-face access to our clients,鈥� she says. Most of her conversations with them now occur via video conference and phone calls. 鈥淵ou miss having that personal touch 鈥� shaking hands, looking them in the eye 鈥� because that helps make them feel human in a system that doesn鈥檛 treat them that way.鈥�
When Ms. Kline realized earlier this year that colleagues shared her frustration, she started a virtual wellness program, creating a space for them to discuss their concerns and methods for coping. The conversations serve to reaffirm their devotion to aiding clients, most of whom live along the socioeconomic margins, and she intends to continue the program after the office reopens.
鈥淎lmost everybody feels like they鈥檙e in limbo right now,鈥� she says. 鈥淭his is a way to help us keep going forward and advocating for the people we represent.鈥�
The virtue of persistence聽
A desire to persist motivates Jamie Schwesnedl, who with his wife, Angela, owns Moon Palace Books in Minneapolis. The shop stands a block from a police station that rioters burned down in the aftermath of聽George Floyd鈥檚 death at the hands of officers on Memorial Day.
During the demonstrations, Mr. Schwesnedl and his employees posted a large sign in the store鈥檚 upper windows that read 鈥淎bolish The Police,鈥� a signal of their support for the community. Moon Palace escaped the charred fate of聽dozens of nearby businesses that remain in ruins, and the neighborhood has rallied to the shop鈥檚 cause. The Schwesnedls, while forced to cut their staff from 41 to 12, have weathered the dual blows of the pandemic and protests on the strength of online sales and takeout orders from the store鈥檚 cafe.
鈥淧eople with small businesses are asking themselves, 鈥楽hould I keep doing this or should I completely reevaluate my life?鈥欌�� Mr. Schwesnedl says. He laughs before adding, 鈥淏ut you don鈥檛 have a chance to think about it because you鈥檙e trying to keep your business afloat.鈥�
Beneath his dark humor lies an economic horror story. One聽 found that more than 420,000 small businesses closed nationwide between March and mid-July. A Harvard University database shows that 29% of the country鈥檚 small businesses聽 since January.
Mr. Schwesnedl knows that, without healthy holiday sales and new federal stimulus funding, Moon Palace might join the ranks of聽. 鈥淏ut we鈥檙e doing what we love,鈥� he says, 鈥渁nd the idea that things could improve in 2021 has helped keep us going.鈥� He laughs again. 鈥淏esides, what are the options?鈥�
Facts and imagination
His cleareyed outlook aligns with Michele Levin鈥檚 view on adapting to pandemic upheaval. She teaches science to seventh- and eighth-graders at Daniel Webster Middle School in Los Angeles, and since switching to online classes, she has found her students more attentive and engaged. At the same time, the discretion of private messages has reduced their reluctance to share personal troubles with her, giving her a chance to enlist counselors or tutors when necessary.
鈥淲hat I鈥檝e seen with being online is that it鈥檚 a very equal setting that鈥檚 less scary for a lot of them,鈥� she says. 鈥淚t鈥檚 helping build their confidence.鈥�
Early research into remote learning draws less promising conclusions, with studies suggesting that online instruction could in academic performance and cause students to lose as much as 12 months of learning by the end of this school year.
Ms. Levin, a teacher for more than three decades, understands that the pandemic presents academic and emotional obstacles for her students. When they raise questions about the outbreak, she tends to respond with answers grounded in science, discussing progress on a vaccine or the public health rationale for wearing masks.
On other occasions, if she detects a collective unease, she might propose a virtual group hike to soothe their anxieties, and the class will set off online through a forest or along a river.聽
Her approach 鈥� with students and to life 鈥� balances a trust in the primacy of facts with an awareness of the solace that imagination provides.聽鈥淚 know from a science standpoint that things will get better,鈥� she says, 鈥渁nd I have an innate optimism that things will get better.鈥澛�
Now she鈥檚 just waiting for the science to catch up with the optimism.
