THE EXECUTIVE DIRECTOR’S DESK Adam Levy

hen I began working at ACOEP over seven years ago, some of the first stories I heard from EM residents were about the first time they couldn’t save someone’s life in the emergency department. It floored me. To hear these stories firsthand, as opposed to examples in entertainment or the media was difficult to comprehend for myself, and apparently for them as well. My initial reaction was and still is, “Are these people OK?”

Over the past five years, we’ve seen a renaissance of discussion surrounding mental health. We see it from business professionals, physicians, trade industries, entertainment, and certainly from individuals and families. Destigmatizing what it means to seek help has been incredible for those who otherwise would have remained silent and hurting.

At ACOEP and many medical societies, we’ve discussed the topic of physician wellness and watched as it’s been said over and over again (appropriately so). Physician suicide hotlines. Free counseling services for physicians. Message boards on the internet. It’s clear that physician wellness, and mental health specifically, has been put to the forefront and it’s long overdue.

As far as we’ve come with regards to physicians and any other group in removing the stigma of

THE EXECUTIVE DIRECTOR’S DESK Adam Levy

seeking mental health, we have a long way to go as a society and human race in creating greater access to mental help – foundationally, financially, and with how its regarded. With COVID-19, on top of an already demanding and draining career as emergency physicians, I have had many conversations with our members about their wellbeing and how they are “holding up.” At first, depending on location, some of our members were working 24-hour shifts, intubating multiple patients per hour. Others hadn’t seen a single COVID case yet. That was over three months ago and, unfortunately, we’ve seen how quickly things are changing one way or the other and back and forth repeatedly. It’s safe to say that everyone has felt the impact.

PTSD is something we mostly talk about with regards to military personnel and veterans, but it’s finally coming out more with regards to any traumatic experience we as humans experience. Personally, I am not a physician, however I have five direct family members who are physicians, including my father-in-law who is a CMO in the Bronx in New York. He tested positive for COVID during the first weeks of the New York City outbreak and became severely ill. Luckily, he avoided critical care components (intubation/ventilation) and, after nearly four weeks, began to feel better and returned to work. My father-in-law is a reproductive endocrinologist and an OBGYN by trade. He’s an excellent physician, but after practicing medicine for 40+ years and creating new life for so many parents, he was not prepared to be loading corpses into refrigerated trucks for weeks at a time. As he put it, “never in my lifetime.” We’re grateful he is alive, but what comes with that? When will he be able to slow down, reflect on what just happened, and take care of his mental health?

The same question applies to all our members and the thousands of physicians who may be suffering mental trauma from COVID-19. Will those who need help feel comfortable seeking it? Will their employers ensure that if they seek

mental health they do not suffer

repercussions to their jobs and practice? Will congressional funding and safeguarding ensure our true heroes on the front lines of COVID are taken care of? I’m not sure any of us know these answers perfectly but I can tell you that ACOEP, as a staff and Board of Directors, is fiercely advocating for these.

I’ll share with you a personal perspective. When my wife was pregnant with my twin children, she was diagnosed with two extremely rare issues impacting the placenta and we were quickly referred to an MFM practice which we visited at least four days a week. At 20 weeks, she experienced preterm labor and a visit to the ED. Steroids, magnesium – you name it. We spent two weeks in the hospital on bed rest. After going home at 24 weeks of pregnancy, the same thing happened again and we spent another two weeks in the hospital. After returning home, my wife, Rachel, went into full labor at 29 weeks and delivered our twins via emergency c-section at 4:00am. My girls are happy five-year-old kids now, but they were born under 3lbs.

We experienced the joy of pregnancy for about twelve weeks, before everything was turned upside down. After that, it was nothing but intensity and worry. I interacted with just as many OB residents as I did with ACOEP’s residents. After 60 days in the NICU, my girls came home to two parents who were already exhausted and burnt out.

There was an immense amount of PTSD between delivering the babies and keeping them alive. Besides the physicians in my family, we also have two social workers. They encouraged us (essentially forced my wife and I) to seek therapy for what we had been through. For ourselves as individuals, and as a couple to ensure we were setup to take care of our incredible, miracle babies. I can tell all of you reading this – friends, colleagues, strangers – that without months of ongoing therapy, I’m not sure I’d still be married, or as healthy as I am today.

Why am I sharing all of this? Because there is absolutely nothing wrong with it. Zero. I’m not ashamed to have suffered something out of my control. I’m not ashamed to have admitted I needed help, no different than how I wouldn’t be ashamed to visit any of you in the ED if I had a broken femur. I am no less a person. I’ve surrounded myself with those who support my decisions and I realize that I only have one life on this earth and I’m going to make sure I take care of it.

I hope that if any of our members are suffering now, or into the future, that you seek out help. Talk to someone – anyone! But especially the mental health professionals who truly are miracle workers in the same way you all are as emergency physicians. Some people may be fine with a certain level of trauma, but that doesn’t mean something is wrong with anyone who is more deeply afflicted by it.

Remember, we at ACOEP are a community – a tight-knit one and a unique one. Our physicians are trained with a different mindset. Our events welcome families and friends as more than just people in a big conference room. Our staff is deeply committed to treating you like a human and not just a number, and we want to understand and meet your needs. We are missing that community more than ever right now, but we are still here.

If you aren’t sure of where to turn and are in ANY way suffering mentally due to COVID or life in general, email or call me anytime. I’ve told you about my own trauma, my own vulnerability, so you can be assured that the only thing you’ll get from me is an outstretched arm. My direct email is alevy@acoep.org, and my direct work line is 312-445-5710.

Remember: You take care of others without pause. Make sure to pause for a moment, and ensure you’re taking care of yourself now more than ever. We’re here to help. –• –