These are things I have read before. I spend most days calming my nerves in the face of them, so I can be a guiding force for my patients. I know my friend sends these articles because she’s worried and wants me to stay safe. But with each one, a freezing chill seeps in through my pores and I am shaking again.
As a pediatrician during the greatest pandemic of our time, I understand that it’s hard to find the right words. Some of my friends and family process their fears for my safety with me, as we’ve always processed everything together. Others ask whether I also worry after each trip to the grocery store. Or whether I’ve picked up new hobbies.
I know they are frightened — for themselves, for their families, for me. And I know everyone is wrestling with the quarantines. These struggles are real. But what can be difficult for my loved ones to realize is that, although this is a collective plight, we are not sharing the same experience.
Years ago, my friend Margi watched her husband die in a car crash. They were caravanning home from vacation, he in the lead and she with their children behind. Her pain felt unbearable. As soon as we had a moment alone, I asked what had happened at the scene of the crash. I shared my shock and devastation. We had always talked like that — no holds barred. But this conversation changed our friendship for years to come. Everything I said seemed to worsen her agony. I was heartbroken. I couldn’t figure out how to reach and support her.
Finally, I came across an article about “Ring Theory,” written by Susan Silk and Barry Goldman. In this construct, we imagine a person who is suffering, like Margi, sitting in a small circle surrounded by concentric rings. Her dearest relatives sit in the circle closest to her. Best friends sit in the next larger circle. More friends and colleagues occupy the next one. And so on.
According to Ring Theory, a person in any given circle should send love and compassion inward, to those in smaller circles, and process personal grief outward, to those in larger circles. To Margi and her mother, I should have said, “I love you, and I’ll do everything I can to support you.” And only when talking to others should I have said, “Her suffering feels impossible to bear.”
Comfort in, grief out.
Ring Theory works for supporting health-care providers during the trauma of covid-19. We are grappling with a complex duality of mission plus terror. We are proud of what we can contribute and passionate about our patients’ well-being. But we are frightened — for our safety, for our patients, for the spouses and children we might expose.
When I imagine the covid-19 Ring Theory, I picture my emergency room colleagues in the center circle. Their spouses occupy the ring closest to them. Next come their parents. Then their friends like me, who work in lower-risk fields. Then my family. And then everyone else who is worried but is not tying back their hair and putting on scrubs each morning.
I may want to tell my ER friends how scared I feel for them. But as close as I am to the battleground, they are closer. So instead I say, “If you take no risks, you will stay safe. I am here for you, every step of the way.”
If you care about a health-care worker on the front lines of this crisis, imagine the circles and decide where you land. Then send your love in. Tell us you are proud and you believe in our mission. It’s fine to say you are worried. We feel loved when you ask about our days and remind us to be careful. But if you are having a dark moment full of doomsday predictions, if you are crying for fear we will die, please know this increases our anxieties. Please process your worst nightmares with others. And please, don’t forget to call us once you feel better.
Yesterday I received this message from a relative:
I am holding you in my heart being on the front lines of these difficult times. The professional skill, kindness, support and tenacity you give your patients and your medical community I am sure is a comfort in this darkness. Sending much love, appreciation and admiration.
My heart rate slowed and my skin warmed over as I read the message. Then I pulled my mask over my face and opened the door to the next patient room.