Thread by @medicalaxioms

Don’t take responsibility for decisions you didn’t make.

Escaping this pandemic psychologically whole and spiritually well is going to be a monumental task. It will require you to assign responsibility correctly.

#covid4MDs

First, you didn’t make this virus. It wasn’t your idea.

Nature did that. She does things like this from time to time. She is powerful and does things like this from time to time.

More than likely, you did not initiate the response of you country, state, city, or hospital. If you had, you might have done it differently, but you were not assigned that authority.

If you take responsibility for decisions you didn’t make you will get injured—guilt, shame—in ways you don’t deserve.

You must be clear about the parts you control.

In the next few months, you may have to make decisions about life and death that you should never have to make. Who gets a ventilator. Who gets oxygen. Who does not receive care.

You’ll carry these decisions to your grave. At the moment you make them, they will feel like yours and your alone. In fact, they were not your decisions at all.

The decisions we will make as front-line providers will not be “our” decisions. They are the culmination of thousands of decisions made in the months leading up to that moment.

Assign proper responsibility. The people who made those decisions will be asleep home in their beds.

You can not own the decision you will be forced to make in the ER, ward or ICU at that moment.

To own that decision is to take on responsibility you were never granted. To take responsibility for nature and decisions over which you were never given authority.

I will predict we will lose some healthcare people to illness during this pandemic. We already have.

I will also predict we lose more by number in the few years after to PTSD, depression, addiction and suicide.

Clearly defining your role and responsibility now and assigning blame to those who have already made mistakes will help you keep from drowning in guilt during this horrible time.

I learned this from a Vietnam veteran I knew. He taught me this. He said if he took responsibility for the next soldier he couldn’t save, he would have melted in shame and guilt.

He had to remember this was not his idea. This was not his war. This was not his battle. He did not decide how many bullets they should carry, or what time they should do this patrol, or which trail to take through the forest.

He was left with the results of those decisions. At a significant disadvantage. Not able to remake bad decisions made before. Handicapped by time and preparation. Left to make a handful of last minute choices too little too late.

That left a smaller problem in front of him and the freedom to disentangle himself from taking responsibility for it.

An essential act in self preservation. A necessary honest act of assigning blame outside of yourself.

Don’t take responsibility for the whole thing. It’s not yours and never was. Stay aware of who owns those choices and remind yourself its not you.