Surviving the year of rage

Some say 2020 is the year of disasters. Others say it\’s the year of change. To me, 2020 is the year of rage. In 2020, rage overtook the world, consuming us and hurling the leftovers against each other.

The right is angry with the left. The social distancers are angry with the beach-goers. The mask wearers are angry with the mask haters. The protesters are angry with the system.

Like a lid on a boiling pot, the lockdown intensified the pressure. The upcoming elections turned up the heat, spurring strangers to feud on social media, destroying old friendships,  and making loving families spew hate over the dinner table.

What does that mean for us, the healers, who already struggle with a failing medical system, COVID, the lockdown, the lack of PPE, the racism, and the riots?

First, we must recognize that we are not immune. Whether you\’re black or white, Democrat or Republican, female or male, and whether you see it or not, you are likely infected with the rage devouring us all. Denying your anger won\’t make it go away. It will only make it harder to manage. Whether you see it or not, the endless string of bad news shortened your fuse too.

And unlike others who may have the luxury of time, you and I live and work on the front line. We can\’t retreat to consult our inner wisdom and get in touch with our feelings before we act. In our line of business, we need to be ready for whatever comes through the door, whether it\’s codes, traumas, or angry people.

Patients are anxious and worried. They hate to wait; they loathe the mask; they become impatient, unreasonable, sometimes violent. They want their family. They ask for a COVID test for their sprained ankle. They request hydroxychloroquine with the Z-pak they need for their cough.

Nurses are angry. They\’re exhausted. They go home to home–school after their shift, instead of sleeping. Their spouse got furloughed, their mortgage is due, and they worry about their mom in the nursing home. They\’re tired of dealing with angry patients. And it\’s just so damn hot under all that PPE.

Doctors are angry. They\’re exhausted by fighting COVID and reusing their PPE; they\’ve had enough of avoiding their family for fear of getting them sick; they\’re enraged by seeing their hours cut, the unpaid mandates piling up and their vacation plans fall apart.

Your family is angry too. They\’ve had enough of social distancing and being cooped in the house. The kids got the heebie-jeebies and want to be out with their friends. Your spouse is tired of home-schooling them, watching bad news on TV, and eating in.

So, in this world consumed by anger, how can you manage to stay calm and professional and keep everybody safe?

1. Recognize your anger, so you can manage it before it blows up on the floor, taking your career and your reputation with it.
2. Get enough rest. It\’s hard to be professional with the patient asking for a Viagra script in the middle of a code when you\’re tired.
3. Don\’t postpone your bathroom breaks. Rushing to see patient after patient on a full bladder will make you resentful and shorten your fuse.
4. Don\’t go \’hangry.\’ Plan ahead. Smoothies, fruit, string cheese–whatever you can manage. Not coffee. Coffee is not food. It\’s life, but not food.
5. Take a time-out when you feel you\’re losing it, even if it\’s taking a two minutes walk to the furthest bathroom.
6. Don\’t say yes to unreasonable requests, like bad shift changes, giving medical advice in the elevator or writing scripts you know you shouldn\’t. Decline, and move on, otherwise your frustration will catch up with you.
7. Practice circular breathing, meditation, or relaxation.
8. Work out—the harder, the better. Kickboxing works for me, but running, hiking, or biking will do. Get rid of that adrenaline.
9. Laugh. Laughing diffuses tension and softens lousy situations, and not many situation are so bad that you can\’t laugh at them. And it\’s good for the soul.
10. Talk to a friend, a spouse, or a coach. Investing in a career/life coach can be cost-effective. A few years ago, when I struggled with burnout, I hired a coach. I paid for six sessions, but I only needed four. Work got easier, life got better, and I recovered my smile.
11. Do things that nourish your soul. Not the news or violent movies. Make a date with yourself: visit a museum, plant a tree, play the violin, take a photography class, go parasailing.
12. Play. With the kids, the dog, your significant other. Playing brings back the child in you and brings light to the darkness inside.
13. Practice compassion and gratitude. Remember how lucky you are to be who you are and have what you have.
14. Recheck your malpractice. The time of healthcare workers being heroes is about to be over. Before long, we\’ll be talking about how the medical system failed us. Cynical, I know. But bad things happen to good people. Be prepared.
15. Ask for help before it\’s too late. Healthcare professionals, especially women, have high rates of divorce, substance abuse, and suicide. Yes, it\’s the stress of the job, but it\’s also because we\’re so bad at asking for help.
16. Cut yourself some slack and reward yourself for good behavior. Be proud for keeping calm, and don\’t berate yourself for losing it. Learn something and move on.  You\’re only human, after all.

Finally, remember that this too shall pass. Hold on to the things you cherish: your family, your career, your sanity, and wait for the times to change. Because they will.

Rada Jones is an ER doc in Upstate NY. She lives with her husband and his deaf black cat Paxil. She is the author of three ER thrillers, Overdose, Mercy and Poison, and “Stay Away From My ER,” a collection of medical essays.

A version of this essay was previously published on Doximity.com.