Physician Support Line Lets Doctors Express Anxiety, Hopelessness, Rage During Pandemic

The pandemic has taken a grim toll on health care workers, who have spent months putting themselves and their families at risk.

They’ve witnessed many patients die, often holding their hand, or an iPad so they can talk to families that can’t come into the intensive care unit. And doctors, nurses and other health care professionals have also watched their colleagues get sick or die from a disease that so many deny or downplay.

While they’re praised as heroes, many health care workers don’t feel like they can open up about their struggles. So one psychiatrist created an anonymous support line where they can find a sympathetic, professional ear — and talk for as long as they want to.

Philadelphia psychiatrist Dr. Mona Masood created the Physician Support Line in March when she anticipated early in the pandemic that health care workers would need support. The hotline is staffed by volunteer psychiatrists.

“This is a nationwide service that is unapologetically created for physicians,” Masood says. “It's almost become a cliche among our circles that physicians are the worst patients because we feel that how can we support or take care or heal other people when we ourselves are unwell? It feels so antithetical to all of the expectations of what physicians do. And so it's very hard for physicians to admit that they need help, too.”

Dr. Nancy Burkey, a volunteer psychiatrist with the hotline, says calls are coming from all 50 states and physicians of all specialties. The hotline has received over 1,500 calls so far, with conversations ranging from 15 minutes to an hour and a half.

“Of course, as you can imagine ... they correlate with the surges,” she says. “These talks all start the conversation with an apology. You know, ‘I'm so sorry to bother you, I don't want to waste your time,’ because they're just so humble.”

On what health care workers are telling volunteer hotline psychiatrists

Nancy Burkey: “From medical students through senior attendants, what they're talking about is that they are quite used to death and suffering, having to deliver bad news. That is part of the job of being a physician, but this pandemic, the magnitude, the intensity, the risk for themselves and their families, you know, you mentioned people who've had to live in garages. I talk to people who've been in another part of the house, not able to be in the same room as their spouse for the last seven months with nothing in sight.

“But the real stress, one doc was telling me he'd come from a 12-hour shift in the ER and difficulty transferring people to the ICU because there's no available beds in his hospital. Can't get them to another hospital. You've heard these stories, multiple intubations in the emergency room. Finally, he gets his [personal protective equipment] off and is going to drive home. Driving down the street. And what does he see? He sees people in the street, in the parks, outside restaurants without masks, not social distancing. And he's just dumbstruck, feeling such an enormous disappointment. That's really taken its toll.”

On how health care workers feel like they’re living in an alternate reality

Mona Masood: “They do feel like there are two worlds that they're having to navigate. And the thing that has been the most shocking for them has been this dual narrative of being called heroes. They can't wrap their heads around being called heroes. And the reason is not out of humility. The concept of heroism carries so much pressure; it doesn't allow vulnerability. Heroes have superpowers. You're not allowed to express that you're tired, you're exhausted, that you are yourself afraid of this virus. And so they have the immense responsibility of wearing not only their mask, literally nowadays, but also of wearing the mask of bravery and courage, which internally they may not feel.”

On the psychological toll of having to block family from seeing their dying loved ones

Burkey: “What happens is nurses, respiratory therapists, docs, everybody [is] aware that the family has always played a very important role in a hospital. I remember one doc was talking to me about he had seen prior to the pandemic the very moving and impactful death of a neighbor in which the family surrounded this neighbor and really supported him and was able to carry him into his death. And then, you know, turned the corner, it's a pandemic, and this doc is now telling family members that they cannot go in with their beloved father, whatever, and knowing that they may never see that person again. And he was having to be the policeman saying, ‘No, you cannot come in.’ Even though he knew in his head that that was right in his heart, it was such a violation of what he thought was correct. And I think about him a lot and how it just went against his values and moral beliefs, even though he knew it was the right thing to do for science.”

On whether the helpline has saved a caller from harm

Burkey: “That's a tough question. We have the ability to obtain help if we need to. If I'm on the call with someone who I think is actively suicidal, then the Physician Support Line gives me back up, which I really, really appreciate, obviously. I have talked to docs who have lost friends to suicide or one who lost a father-in-law to suicide, who was a physician. And so, you know, it is a very hot topic that we discuss a lot within our group.”

Masood: “For a psychiatrist that's our heart attack. That's our stroke. That's our worst-case scenario. It is a topic that on our weekly debriefs with our psychiatrists that run the line that we talk about quite often. We have all known a colleague we have lost either by suicide or has suffered from mental health struggle. We do have one of the highest rates of suicide of all professions. But even that being said, it's not normalized, and a lot of it has to do with the medical culture.”

Burkey: “I think short of the suicide is my concern about what is happening in regard to a kind of hopelessness that we do hear about [from] the physicians that call us. And what I'm concerned about is that a lot of docs will not leave the practice of medicine during a pandemic. It's just not in their bones. But a lot of them are talking to us about leaving afterwards. And I worry about that. And I remember a call I just had with a doc who is just a brilliant person. It's just obvious. And he talked about wanting to leave afterwards. And I said to him that, of course, you need to do what is in your own best interest, but it's important that you know that if you were to leave medicine, it would be a great loss, great loss to all of us, a great loss to the community. And there was a silence on the phone that I thought the call had been dropped, quite honestly. And then he said very quietly, just whispered, ‘Can you please say that again?’ You know, he just needed to hear it, and it's not as if he hadn't heard it before, it was just something about this call and his needing to know that he was important, that I think gets lost in the pandemic and in the, like Mona talks about, the alienation that calling them heroes creates, but that a different kind of connection can help us keep our medical community healthy and working beyond the pandemic.”

Reach the Physician Support Line at 1-888-409-0141.

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting 741741.

Karyn Miller-Medzon produced and edited this interview for broadcast with Todd Mundt.  James Perkins Mastromarino and Samantha Raphelson and adapted it for the web.