Airline attendants say it well: if the plane hits turbulence and the oxygen masks come down, place a mask on yourself first before turning to help others. This is absolutely critical. If we don’t, we may not be able to help anyone.
Well, we’ve all hit the same turbulence, folks, and we all need to take good care of ourselves, our bodies, and our minds.
Healthcare providers on the front lines of the coronavirus pandemic absolutely have to be functioning well in order to do their jobs well. At such a stressful time, with so much change and uncertainty, combined with the pressures of patient care during this pandemic, it almost seems like too much. How are people like doctors holding it together? Could we all learn from their tips on coping?
This week, I reached out to my colleagues in the Massachusetts General Hospital Healthy Lifestyle Program to find out. We’re all primary care physicians within the Division of General Internal Medicine who have been urgently redeployed to new and different jobs, such as staffing our makeshift COVID-19 surge clinics, learning new technology to provide much-needed telehealth, and creating serious illness plans with our most at-risk patients.
During a period when stress and fear are running high, these six strategies from my colleagues can help.
Acknowledge the turbulence
Ben Crocker, MD, is the medical director of a large primary care practice and a healthy lifestyle advocate. “Social distancing and the loss of work and/or routine are tremendous pressures, both physically and psychologically,” he says. “At the same time, our society tends to specifically reward heroic efforts that show that we can continue to perform at the same level, all while keeping a brave face. Many people are struggling to work full-time remotely while simultaneously caring full-time for their family at home. Those who continue to work on the front lines may feel the need to overload their schedules, or commit to too much.”
His advice on this is relevant to everyone, not just front-line providers. Check in, he urges. Mourn your losses. And check out, too.
“Check in with yourself,” says Dr. Crocker. With so much news and instructions flying around about what to do and how to do it, take time to listen to what your body and mind need.
During such frantic times we may tend to ignore acknowledging the loss of “the way things were.” We forget to mourn, or grieve, or simply express our sadness about not being able to socialize, see a close friend, attend a favorite exercise class, interact with neighbors and family, or worship collectively. Grant yourself the time and space to acknowledge your loss. This can help you stay grounded with the current state of life.
“And allow yourself to physically, mentally, emotionally check out on a regular basis,” he adds. “Intentionally create ‘shutdown’ time in your schedule. This can be healthy time alone, for meditation and quietude.”
Fuel your body with healthy food
Helen Delichatsios, MD, has a degree in nutrition and runs healthy cooking classes for her patients.
“In times such as these, nutrition and healthy eating can easily fall to the wayside,” she says. “However, if anything, it is more important than ever to appropriately fuel our bodies and to do so in a mindful way. We have increased physical and mental stress, and healthy eating is vital in supporting our immune system to stave off illness and recuperate faster if we fall ill.”
Anne Thorndike, MD, usually works in the cardiometabolic center, helping people at high risk for heart disease change the way they eat and live. “We’re all eating at home more,” she notes. “This is a great time to explore new recipes you’ve been meaning to try. Be creative with what you have stocked in the house. Plan your grocery list so you have the basics on hand for healthy meals. Frozen vegetables and fruits are a great option when you can’t buy fresh produce on a regular basis.”
Amy Wheeler, MD, is also certified in obesity medicine and runs healthy lifestyle sessions for patients. At home, she’s been adapting healthy recipes she usually makes with fresh ingredients by using simple substitutes. Try her easy, adaptable recipe for Quarantine Chili for a family of five:
“Last night, I diced an onion and potato, then added one chicken breast cut in chunks, 1/2 small can diced green chilies, 1/4 cup salsa, 3 to 4 teaspoons paprika, 1 teaspoon cumin, a sprinkle of cheese, some leftover rice, 1 can yellow corn, and 1 can tomatoes. Once the chicken is cooked, try a dollop of Greek yogurt on top instead of sour cream.”
Use fresh ingredients if you have them, or canned or frozen if you don’t. Goes nicely with tortillas, but it’s also great right out of a bowl.
Move your body
“We are all spending less time commuting, driving our kids around, and doing errands,” says Dr. Thorndike. “Use the extra time to take a walk or do some exercise at home. Even housework can be a way to be physically active!”
Dr. Wheeler finds it helps to set SMART goals: Specific, Measurable, Achievable, Relevant, Timed. These are by definition small steps that are easy to achieve, and thus fuel motivation.
“I have been making little SMART goals for myself,” she says. “Daily goals like ‘I will take a 20-minute walk outside at 10 am today, while wearing my mask and performing social distancing.’ Or ‘I will find three flowers with different colors on my walk.’ Helps me get out of my PJs, off the laptop, and appreciating nature — very relaxing!”
Our bodies need sufficient sleep in order to function. Me, I’ve been working hard to keep a schedule, setting my alarm for my usual early morning time, and going to bed just after my kids. This helps to ensure I get a solid eight hours of sleep, so that I’ll be at my best when I’m called into clinic.
It can help to see the light — and dark (literally). “Spend time outside in nature,” Dr. Crocker suggests. “Exposure to the visible diurnal rhythms of the day/night is an added benefit.” For additional tips on getting the rest you need, see this blog on sleep strategies for uncertain times.
Find ways to connect socially
Dr. Delichatsios loves to cook at home and has been having virtual dinner parties.
“Why don’t you invite some people over for dinner?” she suggests “In our family, we call them FaceTime Dinners, Zoom Dinners, or Skype Dinners. These platforms have allowed us to ‘go out to dinner’ and connect with many friends and families, when before we were often too busy to meet up in person.”
Dr. Crocker has a great suggestion that can be a win-win for working parents and their relatives. “With school out, if you have kids and any extended family, invite the relative (grandparent, aunt, uncle) to teach an online lesson once a week on the same topic or a rotating topic. Allow that special bonding time between your child and their relative to unburden your time.”
He also found a way to continue choir singing from home. “Try a different way of connecting with friends and colleagues — a chat room, or Zoom meeting over a meal. I joined a 20-voice choir that I’ve never physically sung with and sang in a recorded five-part arrangement — all from my home!”
Find ways to ease stress
Everything you’ve read to this point can help you manage stress and anxiety. Eating healthy, being active, and getting enough sleep all help us to mitigate the effects of stress and anxiety on our bodies. One more technique is positive thinking.
Remembering and acknowledging the good in our lives is a powerfully positive action. “Practicing gratitude for what we still have — our health, our families, our homes, food, whatever it may be — rather than rehearsing the daily ‘loss’ of life and routine as we know it, is an important health practice,” notes Dr. Crocker.
In our household, we take turns saying grace before we eat dinner. One part of grace is to state something we’re grateful for, and usually it ends up being a bunch of things, sometimes silly ones like our cats cuddling with us, or the sun shining. But it always makes us smile!
By: Monique Tello, MD, MPHMonique Tello, MD, MPH
Follow me on Twitter @drmoniquetello
For information about the coronavirus or COVID-19, see the Harvard Health Publishing Coronavirus Resource Center and podcasts.