Health care workers need therapy
Looming over the PowerPoint presentation, in the corner of the screen, Dr. Ijen Chen’s face appeared, reassuring, constant, and serene. The presentation was sent out to thousands of members of the Taiwanese community, a community that he had brought together through a lifetime of work and his nonprofit, the Asian Senior Concerns Foundation. And now he was teaching them to fight—their own stubbornness.
“The most important thing to acknowledge,” he said, reading from one of the slides, “is that stress can impact everyone.”
While his presentation on the novel coronavirus and its impact was meant for everyone, this particular slide was meant for medical professionals who are coming into contact with infected patients.
“Allow time for you and your family to recover from responding to the pandemic,” he said.
But that was only the first step.
Medical professionals on the front line during this pandemic, said Chen, will face a variety of mental health challenges that may leave them groping with anxiety, depression, and even more serious illnesses. And other experts say it could get worse.
“In this crisis, there’s a lot of adrenaline going,” said James Chen, a local psychiatrist who is not related. “So some people may buck up, but at some point when things start to curve down, there is the recovery effect, and that is also when people have to be careful about depression and anxiety setting in.”
Care for self and others
As the medical director of the Kin On Rehab and Care Center, Dr. Ijen Chen knows how to make bold decisions —and difficult ones. He traveled to Taiwan in December, observed how the island was containing the crisis with high efficiency, then returned to Seattle in January.
Soon Kin On instituted similar measures—closing its doors to visitors well in advance of Gov. Jay Inslee’s order. Chen continues to make the rounds of nearly 100 patients, holding staff meetings and comforting the care team. He still sees patients in person: they need blood work, x-rays, and other hands-on medicine.
So when a major local hospital—which has put out repeated calls for masks and other protective gear for their doctors—put out another call for all retired medical personnel to come in and treat infected coronavirus patients, Chen made another bold decision. He would not go.
Not only was he in the high-risk age category—he is 68—most of his patients at Kin On are much older, some are frail, and all are entirely dependent upon his ministrations and personal contact.
Compounding the problem, the number of doctors that specialize in taking care of the elderly is shrinking vastly, said Chen.
“There is a national shortage of geriatricians,” he said. “Young people don’t want to treat old people.”
James Chen said decisions that prioritize the safety of the health care professions are correct, particularly for those being asked to work without adequate protective gear.
“If you feel your safety is compromised, I would not advise the person to be in that position,” he said. “If you are being asked to provide care without gloves or gear, you don’t want to put yourself at risk, which is putting others at risk.”
“Don’t do it, you want to take care of your people,” he said.
Signs of trauma
At the same time, health care workers need to be on the lookout for signs of psychological distress. Physical symptoms could include fatigue and illness, emotional ones withdrawal and guilt, said Dr. Ijen Chen.
“If this is affecting the function of the person, that is the time to seek treatment,” said James Chen.
That could include an inability to do one’s job or even take a shower.
In the long run, however, the stresses facing medical workers could get even worse. After the initial phase of the crisis passes and as things start to return to normal, even more serious traumas could ensue.
“When things are starting to get on track, that’s when people need to start thinking about getting help,” he said. People may experience anxiety, depression, and even post-traumatic stress disorder (PTSD).
“For people on the front line, their experience will be more intense,” he said. Signs could include nightmares and flashbacks, he added.
Still, not all will experience problems.
“A lot of people go through war, some people get PTSD, some people don’t,” he said.
Coping with stress and grieving
For health care workers in particular, self-care is vital during this time. Some of the measures they can take include sticking to a routine, getting enough sleep, exercising, pursuing relaxation, and reaching out to others.
Dr. Ijen Chen once led his community in huge gatherings of social dancing. Now he walks an hour a day.
“I’ve lost three pounds,” he said.
Caring for oneself will be even more important as the immediate crisis fades and the nation and world enter a protracted period of grieving.
“Everyone grieves differently,” said James Chen.
“The hope is certainly that we will grieve in a constructive manner,” he said. “But unfortunately, grief is neither good nor bad in nature.”
“Some people have complicated grieving and they never come out of their anger or resentment or depression.”
“And that’s why I’m saying hopefully, if we educate ourselves and be mindful of being helpful to each other and supportive to each, then we have a better chance as a society to come out of this in a positive manner,” he said.
The advantage of being an Asian American health care worker?
Still, Asian American health care workers might have more resources—both emotional and informational—to face these stresses. Family and community bonds might help them weather the pandemic with more resilience, said James Chen.
“If there is a stronger family bond, it might be easier to get through this. If you know someone you care about is checking up on you, a family or a care community, it will help you get through.”
At the same time, some Asian American communities might be better prepared to physically ward off contagion.
Taiwanese Americans, for instance, are “much more in tune with the news from Asia,” he said.
“They are ahead of the curve as compared with the general population, so most people knew about this back in January, if not in December,” he said. As a result, they started to wear masks and practice social distancing early on for the sake of the region.
Chen, who also serves as a representative to Taiwan’s government for his community, said there have been only a few cases and no deaths among local Taiwanese.
Another positive is that connections found within Asian American communities also provide hope. Take the PowerPoint presentation Dr. Ijen Chen sent out for example. Normally, a large group would gather in person to watch similar presentations about health insurance or travel to exotic destinations or even computer programming. Now they watched from home. But that didn’t stop Chen from encouraging them to think positively.
His final tip for getting through this crisis: “Plan your next vacation!”