Waking Up

Waking up, I smile …Thich Nhat Hanh

The last few months have been a time of personal and professional awakening.

Waking up to the physical reality of being human. Of having to accept I am not immune to the impact of the relentless pressure of the pandemic on my Emergency Department, nor to the devastation of the HSE cyber attack. And that even if I pretend otherwise, my body knows and sooner or later illness is inevitable.

It’s also been a time of pragmatic awakening. To the reality of life as a coloured doctor in Ireland. Acknowledging the presence of a systemic discrimination that is so deeply embedded it is practically invisible to those who perpetuate it. And more importantly, adapting to what is and isn’t deliverable to patients when their care is provided for by someone of colour.

Awakening is true when accompanied by action. And actions are true, when they come from a place of love, rather than from one of fear or hate.

For me, a first step is coming back to the core practice of loving kindness (“metta”). To hold in love and understanding the pain and suffering I see in and around me. And from this place of compassion, to explore how I can best use this precious life energy to alleviate suffering and discrimination.

Resilience 3.0 and Refugee Boats

A lot has been said about the “unprecedented” nature of the Covid-19 pandemic and of its impact on health care.

An Emergency Department perspective on Covid however is perhaps a little more nuanced. While the scale of the pandemic was certainly unprecedented for EDs across the world, the scope of Covid-19 wasn’t. Emergency Departments have regularly dealt with and / or prepared for viral outbreaks – influenza, SARS-Cov-1, Ebola among others.

To me, what is truly unprecedented in both scale and scope is the impact of the cyber attack on the HSE. Never before would we have imagined shutting down an entire network of computers across a national health care system.

As we move into week 2 of the shutdown, this is my perception of its effects on departmental energy levels.

Social energies are up. Replacing emails with actual conversations and a sense of coming together in a crisis are boosting connections.

Intellectual energies are recovering. From an initial feeling of “cerebral nakedness” – not having access to patient records, previous reports, test results or online clinical references – to finding work arounds and coming back to good old fashioned clinical medicine.

Physically, people are tired. This is a labor intensive environment – there is no getting around it. For now at least.

Psychological safety has taken a big hit. The timing of the cyber attack – just as Ireland was coming out of a lockdown that stretched since December – could hardly have been worse. National activity is rising, accidents and emergencies are rising in tandem, Covid measures are still in place – all while the ability of the ED to respond to this surge has been dramatically reduced.

Why am I writing about any of this ? Partly to keep my own note of these events. And partly to explore – how should I / do I respond ? Is my inability to gauge the spiritual energy level of the department a reflection of current conditions – or of me ?

Academics and researchers have written much about resilience. Yet for me, what a world wise friend shared this week is what resonates. Resilience is simply surviving. Surviving 15 months on the frontline facing Covid, surviving this cyber attack, surviving what else may come and doing so with spiritual strength. A spiritual strength that comes from remembering – these conditions too are impermanent.

So coming back to the root question of this reflection – what compassionate wise action can my best self bring to this situation ? I am reminded of a story from Thich Nhat Hanh and the answer emerges – presence and solidity.

“When the crowded Vietnamese refugee boats met with storms or pirates, if everyone panicked all would be lost. But if even one person on the boat remained calm and centered, it was enough. It showed the way for everyone to survive.”