Opinion
Momentum Builds for a New Soldiers’ Home
Make no mistake about it, when it comes to the tragic COVID-related deaths at the Soldiers’ Home in Holyoke almost a year ago, there are no silver linings. There is nothing that can fill the void left by lost loved ones, and nothing that can relieve the anguish visited upon staff members who had to endure that catastrophic sequence of events that led to the deaths of at least 76 veterans.
But sometimes, such tragedies eventually lead to progress, to improvements, to new and better ways of doing things. And it appears that this may well be the case with the Soldiers’ Home.
Indeed, out of the ashes of the calamity of last spring have emerged plans for a new, eight-story Holyoke Soldiers’ Home that will replace the 70-year-old facility that is, in many ways, inadequate and obsolete. Last week, the Baker-Polito administration filed a $400 million bond bill to move forward with the construction of the new home, the next big step in the process of making a new facility reality.
While the need for a new Soldiers’ Home has long been understood and embraced, there is no doubt that the events of last spring — when the virus overran the facility amid a series of questionable decisions that ultimately led to resignations and, later, indictments for criminal neglect — have helped pave the way for a proper, modern, 235-bed facility that will serve veterans for generations to come.
This project still has a long way to go before it becomes reality. There are stern deadlines to meet and more important votes to take place in the state Legislature. But there certainly appears to be sufficient momentum to see this initiative to the finish line. It has been generated by caring people who want to do right by future generations of veterans — but also, we believe, by a deep desire to “make things right” for the families of those who died last spring and the for the staff members who have long endured inadequate facilities, said the chairman of a coalition of former Soldiers’ Home administrators, families, and veterans advocates who have embraced plans for a new home.
Truthfully, nothing will really make things right. But this is huge step in the right direction.
Take Steps to Improve Your Mental Health During Pandemic
By Sandra Jacobs
With COVID-19 still a daily reality and the physician workforce exhausted, mental-health clinicians are emphasizing the importance of physicians being proactive in getting support for themselves.
“Physicians tend to be problem-solvers, and our first instinct may be to try to solve our own problems alone,” says Dr. Wendy Cohen, a physician health psychiatrist. “Physicians are human beings doing tireless work during a pandemic. Asking for support isn’t a sign of failure. It is a sign we are mortal.” She urges physicians to take stock of their feelings and reach out for help if they need support coping with stress and anxiety.
Cohen is the physician evaluation director at Physician Health Services Inc. (PHS), the physician health program that is a subsidiary of the Massachusetts Medical Society (MMS). PHS offers many services to physicians and medical students, including free, confidential consultations; referrals; and a listening ear.
“When physicians have their nose to the grindstone — and are all in with their face masks and COVID patients and the needs of their own families — they’re not thinking about their own mental health and well-being,” PHS Executive Director Bara Litman-Pike said. “It’s helpful to get people thinking about their internal experience earlier. You don’t want to wait until someone is overwhelmed.”
In a November survey of MMS members, “physician and staff well-being” was the highest-ranked operational challenge of the pandemic, cited by 76% of respondents. Asked what resources related to COVID-19 would be most useful, “physician wellness support” ranked second, narrowly behind “guidance on telehealth billing.”
Despite these numbers, physicians may not be quick to seek help. Cohen and Litman-Pike note there has been an increase in substance use during the pandemic. While alcohol continues to be the most problematic substance for physicians, use of marijuana and cannabinoids have increased since their legalization.
In the moment of use, alcohol and cannabinoids are sedating, but they are known to heighten anxiety, depression, and insomnia after the intoxicating effects wear off, Cohen said. “Many physicians are surprised to find how much their sleep, mood, and symptoms of anxiety and depression improve when they cut back.
“Physicians work in a safety-sensitive profession, and our health affects the quality of our work,” she added. “We need to consider how what we put into our bodies impacts our memory, coordination, and reaction time. For anxiety, depression, and insomnia, we have many effective treatments. Alcohol and marijuana are not among them.”
Beyond the current strains throughout society, from the pressure of children’s remote schooling to the burdens of daily life during a pandemic, physicians carry the extra vigilance of not exposing their own families to COVID-19. They may also feel the ‘moral injury’ that occurs when clinicians are expected, in the course of providing care, to make choices that transgress their commitment to healing.
The emotional work of treating and managing COVID-19 is something for which no one was prepared, Cohen and Litman-Pike note. This includes making ethical decisions about allocation of resources, caring for isolated hospitalized patients, and bearing witness to unprecedented levels of death and trauma. This secondary grief and traumatization on the pandemic’s front lines, they say, can lead to the ‘second victim’ phenomenon, described by the Center for Patient Safety as when healthcare providers “become victimized in the sense that the provider is traumatized by the event.”
“As mental-health professionals treating physicians, we expect to get busier as physicians have more time to reflect on their pandemic-related experiences,” Cohen said. “But physicians are having an emotional experience now. We want to promote intervention sooner rather than later. If addressed early, we can propose interventions that can have a big impact.”
Added Litman-Pike, “just giving the care provider the words to talk about their feelings is healing. We destigmatize it by talking about it. If we are not attending to the health of the physician, the physician cannot do the work as effectively.”
PHS is a nonprofit corporation founded by MMS that annually supports about 400 Massachusetts medical students and physicians experiencing health-related and other challenges that have the potential to impact their work. Callers receive confidential guidance and direction toward the most appropriate and helpful resources. –
Sandra Jacobs is editor of Vital Signs, a publication of the Massachusetts Medical Society in which this article first appeared.
