How can we keep a cool head and warm heart in the face of covid-19?

Lucy Harrison explores how doctors can keep calm and look after themselves during the covid-19 pandemic

“Kindness begins with the understanding that we all struggle,” — Charles F. Glassman

We are working in truly unique times. We are bravely entering uncharted territory. Covid-19 brings fear, almost as big a threat as the virus itself. We are, however, more resilient than we give ourselves credit for. 

Paradoxically, the times when coping strategies are vital, they can become marginalised. It is essential that we plan ahead and ensure that we are equipped to take care of ourselves. Rest is a skill; deliberately make time for it. 

A common thread linking us together is the intention to be compassionate while at the same time safeguarding our vulnerability. How do we remain calm when we are faced with the prospect of uncertainty, ambiguity, long hours, distress and unimaginable suffering? We may not always be able cure, but we can alleviate suffering though being present and compassionate. Focusing on how things can go well can help balance our energy.

To take care of others, we must feel well and think clearly. We need to nurture our inner resources within a supportive environment and accept that all we can actually influence is what is happening in any given moment, which then influences the next.

It is not selfish to self-care. In times of trouble we need to be kind to ourselves. Afford yourself with the same understanding and patience you would give to others. Make a list of what really matters. Adequate nutrition, hydration, and exercise are fundamental. Sleep is essential for our wellbeing, but crucially our immune system needs it to function well.

Limit caffeine and alcohol and ensure, where possible, you have time with family and friends who can support and encourage you. Take a break from the 24/7 media coverage, use this time to nourish and replenish. 

Be creative about how you unwind; create a menu of activities you enjoy (hobbies, exercise, books, TV, meditation). Access nature and sunlight where possible and keep some routine in your day to day life as best you can. Consider setting up a buddy system with colleagues to share experiences and feelings. Recognise accomplishments, even small ones. 

Be open with senior colleagues about how familiar and confident you are with your role and have a realistic view of what is achievable. Where possible work in teams rather than alone. Consider an occupational health opinion if you are concerned that you may be in the “at risk” vulnerable group. For those needing further mental health support the Practitioner Health service is free and confidential.

We cannot control all stressors, but we can control how we relate and respond to them. Self-awareness is key; being able to consider emotions as they arise, label them, and sense them in the body gives us more choice in how to deal with them. Feeling emotional is normal and natural, we are human beings as well as doctors. 

“Resilience” does not mean never showing you are tired or stressed. By noticing and acknowledging emotions we can make space for them, even when we feel full to capacity. Crucially, we need to pay attention to signs of exhaustion, burnout, and loss of focus. Our bodies often indicate when we need to stop long before we accept it on a cognitive level. 

We often confuse effort with effectiveness. Suppression of emotions can negatively impact on performance. Get into the habit of monitoring yourself and your mood. Know your limits and when you need to take action to self-care. This is self-compassion. Saying you are not OK, is OK. 

Certain behaviours can help us develop a good degree of self-awareness. We can train our minds to be our ally when we are stressed. Prioritise tasks and focus on one task at a time. Practice intentionally pausing for a moment and sense what is happening in your body and mind and what is happening around you. 

If you doubt yourself, know that, more than ever, others are looking at you as an inspiration. Believe in yourself. We can all make a positive difference in our own ways. In the midst of uncertainty and fear, awareness and compassion can help us to cultivate calmness. From a place of steady awareness, we can in any moment, ask the questions, “What would be a helpful response here?”, “What would support my wellbeing and the wellbeing of others?”

Doctors who can keep a cool head in a crisis are no less emotional, worried or invested than those who struggle. We need to be able to respond with both a cool head and a warm heart. This will support our wellbeing and the wellbeing of those around us. 

Lucy Harrison is a GP and Mindfulness Therapist. @lucy_mbct

Competing interests: None declared

*Footnote* With special thanks to Willem Kuyken, Riblat Professor of Mindfulness and Psychological Science at the University of Oxford for his valuable contribution.