Psychological Distance

The true cruelty of this disease lies in the increase of psychological distance; the commodification and depersonalization of staff and patients due to infection control measures.

Personal Protective Equipment takes away our smiles, muffles our voices.  We only have worried gazes and a bit of crinkled eye to tell how someone is feeling.  We can hear the lightness or heaviness in voices when the background chaos finally stills and we listen to each other in the quiet.

 All my distinguishing marks – new nail polish every two weeks, the proudly visible tattoos for my children, are gone.  No blinged-out badge holder on one of my floor favorites. Just barrier protection, fingertip to footwear. We even have started the smell the same – the hospital gym now providing mass laundered scrubs and bulk-supply shower gel as we scrub down after COVID rounds. (Not that you can smell anything but 2 hour old stale coffee inside your mask)

There are no more flowers at the bedside, no mementos or notes scratched in wives’ handwriting – “ask doctor about blood pressure pill!”

We are reduced to our Roles.  

“Dave got pulled from 4N last week, didn’t you hear? We have some new RT now.” 

“Where’s the nurse?  I don’t know her name, she had the purple scrub cap on”  

“I don’t care who their normal doctor is, I need someone now.”  

When your numbers are depleted and replenished 3 times a week you only come to know people by the way they fit into your work flow.

It would be one thing to endure this loss of identity, the ability to pick up on a detail that turns someone back into a person instead of “that patient” or “this pulm doc” if it weren’t for the physical removal from all these people.

Having to consciously re-train movements that have become such a habitual part of my care – a reassuring grip of the hand after checking a pulse is different now, neither party knowing what the risk/benefit ratio of that contact really is.  

I definitely can’t sit on the edge of the bed anymore when the conversation gets ugly.  Hell, I can’t even be face to face for some of the ugly if I want to help people make Big Decisions in a time-sensitive manner.  Giving bad test results via phone from 100 feet away is ugly, for the record.  

6 weeks ago, I would have stated that “watch my superiors or residents break down into tears and I don’t rush to hug them” was a Never Event.  And yet, this is where we are – 6 feet apart, with our eyes and voices being so miserably inadequate for the task of comfort and reassurance.  

But most unsettling is where the loss of self and tribe along with physical isolation leaves us at an emotional level.  We are social creatures but again and again we have seen that fear divides us. The “Us” vs. the “Them” getting drawn in smaller and smaller circles of who we can or will protect and share with as anxiety and scarcity increase.  We cease to see the commonalities that shield us from this less than noble nature.

I came to the position I’m in because I had that connection and support with the folks in my hospital before this – I had the opportunity to find out who the people were around me, who I could talk with about dogs or favorite restaurants.  So now, I trade on that and hope that my Psychological distance from the person hasn’t become a barrier – that I still have definition and connection and avoid the label of “other” So they, when they are worried about their share of a scarce resources will see me as person too, and include me – and who I fight for.

It shouldn’t be a surprise when a disease that is ultimately defeated by isolation would be the most effective at damaging our humanity.   

I’m sure many will look back on this time and observe the irony of Spring blooming in most of the world affected by this pandemic, the Earth bursting into colorful celebration of renewal as its population faces their greatest threat, but I take solace in that constancy.  That hope and courage of something surviving dormancy through the cold, dark isolation to do what it was meant to do; flourish.

4 thoughts on “Psychological Distance

  1. Thank you so much for putting into eloquent words, the thoughts and feelings so many share. These feelings are what bind us as families. Whether it be social, biological or professional.


  2. Very moving and beautifully written piece. Thank you Dr. Zecchar for all you do each and every day. You are an inspiration to many!


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