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Like Rats in a Cage, Are We Witnessing the Collapse of the Healthcare System?

A classic laboratory experiment involving rodents goes something like this. These smart little caged rats quickly figure out if they press a bar, they are given some food but they also get a shock (because the floor of the cage sends an electrical shock). Like for us, the stress of the electric shock can be painful, but it’s predictable and can be controlled by pressing the bar. Subjects know when the shock is coming.

On the other hand, when these little creatures are sporadically and episodically shocked and cannot control the stress, they essentially give up. They curl up in a fetal position, their stress hormones are depleted from the adrenal glands, and they die.

We aren’t lab rats, but we know that the uncertainty of stress can kill us. Here’s how I know. I see it every day.

Study subject 1. While on the walk between the main hospital at Mayo Clinic where I have worked for forty winters and the parking ramp, I heard some quickening steps behind me. I peered over my shoulder and was delighted to see a beloved, almost sacred clinical colleague who is a household name in the profession. He is viewed as a clinical savant, a doctors’ doctor.

We talked about the NFL playoffs but then got into some serious stuff. His typically brisk walk with an almost military demeanor was now a tepid shuffle toward yet another long shift in the ER. He explained flat out with no reservations whatsoever, “I am totally depleted, the tank is dry, there is nothing left.” (A rat who has received too many surprising, uncontrolled shocks.)

This was one of those sacred moments to simply keep quiet as he shared with me the disheartening reality of COVID-19. When fully vaccinated and with the booster shot, approximately 90 percent of us will be spared the misery of this nightmare. But now, among the unvaccinated, the emergency rooms are overwhelmed, the ICU beds are filled, and there is essentially no room at the inn.

Routine care is essentially nonexistent, and elective surgeries are put on hold. And these miseries are almost always totally avoidable. Our heroic healthcare gladiator has simply run out of gas.

This was a Thursday, and he was frank that over the weekend he would be touching base with his financial wizards, the accountants, and the actuaries to see what he needed in his piggy bank to walk out the door. He also shared with me that he was willing to decrease his quality of life and his standard of living to save his life (to make the shocks stop). In effect, we cannot give what we do not have. And he had nothing left.

Study subject 2. The world of the hospital chaplain is vital to the soul of any healthcare delivery system. The Mayo brothers had gone on record that at some point in a patient’s illness, religion and spirituality may be as important as traditional medical interventions.

The average professional shelf life of a hospital chaplain is approximately four seasons, but I met up with a chaplain who had impeccable academic credentials and was entering into her sixteenth season of this type of work in the healthcare setting—a survivor “rat” who had withstood far too many shocks.

Yet she too was drained, broken, and could not bring her gifts and skills to the bedside any longer. That clinical expertise was fractured, and she was emotionally unavailable, especially recognizing that almost all these patients who refused to be vaccinated essentially had a self-inflicted illness that was crippling healthcare. She was to be another of COVID’s victims.

The healthcare workers won't be there when we need them

Are these isolated experiences? Absolutely not. Much like with teachers, a significant percentage of healthcare workers—my beloved colleagues, doctors, nurses, chaplains, medical assistants, and associates—will be exiting from the profession sooner than they had expected and wanted.

We cannot put a price tag on experience. But this is another dimension of this crisis that we need to recognize, and this often does not make the medical literature or the cable TV news.

Throughout history almost every spiritual leader of either Eastern or Western traditions goes to the mountain, to the desert, to the sea to seek solace and serenity and time to restore the battery. The healthcare practitioner today does not have this luxury especially with the current COVID crisis. The shocks in the cage are becoming intolerable. Being “out of office” on email is never true for them. No one is off the grid.

Bottom line: We need to take a page from the playbook of the little furry rodents. Each was relentlessly subjected to a stressful environment in terms of the electric shock. When these creatures had some control over the shock, some control over their stress, and when they were fed and given a break, they did just fine.

On the other hand, and now for the hard part, when the stress was relentless, when it was unpredictable and unavoidable, these rats became depleted, drained, and could no longer function.

Although this situation may not be healthcare at its best, the heroic efforts of healthcare providers have shown their finest hour. But for how much longer? How many more shocks can these heroes withstand?

If our healthcare heroes do not take care of themselves, if they cannot seek solitude for rejuvenation, they will not go the distance in a sacred profession, which is now perilously close to collapse.

Yes, this is another blog about vaccination, masking, and doing the right thing for ourselves and our fellow inhabitants of the earth.

Image from Shutterstock.

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