When The Things They Carried Kept Them Sane: Holding Space for First Responders

More than 5 years ago, my now 20 year old nephew was a junior in high school. During his Christmas break we were shopping in a bookstore and he shared his required reading list. I recognized that one of the books on his list as one I already had in my library. A professional colleague had recommended this book years prior in reference to our work with PTSD. The book is The Things They Carried by Tim O’Brien. I was excited and told him, “Let’s read it together!” Not sure if he was excited as I was. First, I thought it would be a great way for us to bond and chat about something meaningful. Second, I wanted to make sure he read it and didn’t use the cliffnotes or sparknotes edition. Last, I had procrastinated in reading it as well and this would hold me accountable. We agreed.
 
Flash forward five years to April 2020 and we are living in, moving through, surviving a pandemic crisis, identified by the CDC as COVID -19, or the coronavirus. We have lost through death and grieving the lives of thousands of loved ones. And on the front line, are our first responders who are mentally, emotionally, and physically drained. Our front line health providers live with the fear of contracting the virus and of contaminating their loved ones or worst, dying.
 
Why do they do what they do in spite of the risks and danger?
 
A first responder is someone designated or trained to respond to an emergency. This includes paramedics, nurses, physcians, EMTs, police officers, firefighters, rescuers, military personnel, and other trained members of organizations connected to this type of work, i.e. mental health professionals. At this very moment that I am writing this story, a nurse, a doctor or family member or spouse of this person is crying, anxious and completely drained. In the media we are witnessing photos of bodies being placed in refrigerated trucks to be buried, doctors and nurses with their heads in their hands crying, some barely eating enough to stand up. And yet…they continue to fight. I’m tearful as I write this just thinking about each of them in this very moment.
 
Here are a few comments and reports made by first responders as shared by the writing of Don Meichenbaum about the coping strategies for health care workers in the midst of the COVID-19 pandemic:
 
“Besides the grimness, I try to keep my mood positive. I ask my colleagues about how their families members are handling their stress. I ask them what they may need?”
 
I rely on my “battle-buddy”-my fellow worker who keeps tabs on me and for whom I do the same for him/her. We check on each other frequently at work and at home.”
 
We need to look after each other. We have new Med students joining us, so we set up a buddy mentor system.”
 
We have end-of-shift ‘campfires’-a kind of debriefing where we can give voice to our experiences, vent and problem solve. We have created a kind of social support group.”
 
“I am scared all of the time, but I have learned to accept my feelings.”
 
“I feel like I am going into a slaughterhouse on a daily basis. This shakes my sense of security.”
 
Dr. Meichenbaum shared that in the aftermath of traumatic and victimizing experiences, most individuals are impacted, but some 75% go onto evidence “resilience”, and the ability to confront and handle ongoing adversities. In fact, some go on to evidence “post traumatic growth.” Post traumatic growth is “the experience of persons whose development, at least in some areas has surpassed what was present before the struggle with crises occurred.”
 
Enter the book reference, The Things They Carried. (I bet you were anxiously anticipating when this would be unpacked, no pun intended…well maybe it is). In brief, the book is about the variety of things Tim O’Brien’s comrades/fellow soldiers carried with them on their missions. Many of these things were intangibles, such as guilt and fear. Other things were specific physical objects such as matches, M&Ms candy, morphine, weapons, and even a photo of a woman, a college crush O’Brien admired. The book tackles death and dying and grieving, rejection, coping, love and loss and moral injury. Several of the stories is told from the life reflection of O’Brien 20 years after the Vietnam war where he was living as a writer in his hometown of Massachusetts.
As I was re-reading this book last month, I began to reflect on the ways in which each of us are impacted by the coronavirus crisis. Specifically, the front line health care providers from physicians and nurses who are directly witnessing and treating the gravely ill and dying in overwhelmed hospitals and make-shift medical care settings to mental and physical health care workers including our funeral and mortuary professionals.
 
And I asked myself, how do they do what they do in spite of of the inherent dangers and risks of being on the frontline, like our combat soldiers who are on the front lines? I believe if you ask them, he/she will reflect on what they “carry” mentally and physically that reminds them of their why. Perhaps, it’s the compassion for the field of medicine, or healthcare, or wanting to create a safer or healthier environment for their children and grandchildren, or maybe it’s more of an existential crisis or narcissistic desire , “to save the world!” Whatever that thing(s), tangible or intangible, that they carry with them is refuge in the belief of connection, love and the power to choose to contribute to healing and “doing what I can do” (my duty, my commitment). “I’m going to do what I have to do and what I can do, with consequences and I find peace in that.”
 
I encourage all frontline workers to focus on the meaning and his/her own story behind the gift in the suffering. So much of our lives has taught us to deny, ignore, suppress suffering and pain, or the opposite, to immerse ourselves in our suffering. But I believe their is a gift in suffering. It may not be readily apparent to most, but with delicate and sensitive exploration, you will discover those parts of yourself and this experience that lie dormant or unexamined that are now exposed for you to look at more closely, or that which unfolds like rose petals one at time when the sun shines on it. There may be some ugly parts, but I am sure there will be lessons learned.
 
Be kind and compassionate with your being (human frailites, vulnetabilities) who you are right now. The work is hard, exhausting, and times you may feel under appreciated and scared. Your hands, your mind, and your body (the work we do) is gift from God. In this life, there will be trials and tribulations and suffering, but He (God), has the final say.
 
Take heart. We stand with you.
 
And by the way, would you like to read this book with me? We can hold each other accountable (smile) to complete it, but more than that, it is a powerful way to engage and connect around helping you process your emotions and feelings right now.
 
Inbox me. I’m here…reading…
You can reach out and connect with Dr. Angela Clack @clackassociates2005@gmail.com or through her website @www.clackassociates.com.

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