Tolerance in a Time of Pandemic—2 Sides of a Coin

We don't know another person's circumstances, so it's important to be kind and patient
May 21, 2020 Updated: May 21, 2020

I’m a pediatric cardiologist. My patients are among the most vulnerable to infections. Several times over the past few weeks, my hardworking and dedicated staff have come to me on the verge of tears.

“A mother just yelled at me on the phone that I didn’t care about her child’s health,” my medical assistant said, exasperated, wringing her hands repetitively. “She accused me of refusing to provide needed medical care to her child and warned us that she was calling her lawyer.”

This mother was angered because we advised postponing her visit until her daughter’s cold symptoms resolved. Her pediatrician had referred her to us because of a heart murmur. Likely it was benign. But with children, you have to be careful. I called him to confirm. He agreed that, since the girl was otherwise healthy and showing no signs of heart failure, the visit was not urgent.

A different nurse called the mom back. I did, too. But there was absolutely no convincing this mom. She was belligerent on the phone. “I just don’t understand why you wouldn’t allow my daughter to enter your building,” she said. I reminded her that her daughter was coughing, which was a signature symptom of COVID-19. That in order for everyone to be safe, especially my high-risk patients, we had to be careful. She blamed me and my staff for being “heartless,” an especially cutting insult to a cardiology practice. Instead of realizing that our protocols were in place to keep people safe, she was furious.

“My concern,” I said, trying to be patient, “is that if your daughter came to the office while she’s not feeling well, we might put other people at risk.” We were on the phone, but I could envision the mom shaking her head. She just didn’t get it.

It’s not that we didn’t need the business. We did. Though hard to believe amidst a global health crisis, we’re struggling to keep the doors of our medical practice open. I know that many of my doctor colleagues are as well.

We’re losing revenue during these trying times. We have to be careful not to inadvertently catch or spread the virus. This means extensive handwashing, wearing disposable protective gowns, and disposable latex gloves, and donning an N95 surgical face mask. I put on a new gown and gloves in an isolation room before seeing each patient, which means each visit takes twice as long as it used to. Confronted with the economic reality of fewer patient visits, my longstanding practice is threatened.

I expected these stressors. The unexpected stress comes from patients’ parents, like that mom, who lack the empathy or courtesy to consider others during this terrible time. I hung up the phone feeling that the pandemic had taught me something: Some get it. Others don’t. In my practice and in the world around us.

Many do get it. They understand that we’re taking extra precautions for everyone’s good. These patients have been complimenting the staff for our conscientiousness.

Despite the concerns about contracting COVID-19 in a hospital, some of my little patients still require urgent heart operations. In order to get them out of the hospital as soon as possible, my surgical colleagues are discharging them to my outpatient care earlier than usual. “We truly appreciate that you guys remain open for us in the face of the increased risk to yourselves,” said the parents of a small infant who had just undergone such a heart surgery.

No one likes to be criticized. No doctor likes to let their patients down. At first, I felt resentful about the negative feedback. But then I realized something else. This is a complicated situation. Emotions are running high. The stress of this pandemic affects each of us differently. It shines a spotlight on us, revealing the often repressed conflicts in our lives. Faced with the threat of this virus, our priorities change. We become less tolerant. With far less room in our lives for pettiness and bad behaviors, we are prone to react negatively.

More emotionally tuned in, I’m coming to better appreciate those who consistently carry out their responsibilities at work and home. I’m leaning on those with strong moral character; distancing myself from the morally compromised. Perhaps we all are.

I admire and praise those toiling longer and harder than ever: the police, ambulance medics, health care workers, food distributors, and public utility employees. Nonessential workers have been virtually removed from society. They stand idle at home, less productive than ever. They’re doing their part, but they aren’t receiving comparable recognition for adhering to social distancing, currently the most effective public health intervention against this viral scourge.

Some personality types thrive during a crisis. Generous community-minded people have made it their mission to help others—sewing masks by hand and volunteering at food pantries. I find that remaining available for my patients, staff, and community helps my anxiety. I’m concerned that some of us are hidden in the shadows, alone. Overwhelmed people who may be more introverted are now recoiling in isolation from society—virtually invisible. They may be the most vulnerable to depression and suicide.

Rich, poor, old, young, everyone is suffering. Many are anxious and stressed. Many are experiencing deep misery and pain. Some people have health insurance to cover testing and treatments for COVID-19. Others have insufficient health insurance coverage or no insurance at all. The poor have minimal resources to fight the onslaught of this infection or the financial consequences of social distancing. The financially fortunate can stock their refrigerators, but groceries can’t quell the panic people feel.

Some people have personal confidence, emotional stability, and family support to help weather this storm. Others suffer from depression, anxiety, and loneliness—tossed and battered by analogous circumstances.

The pandemic has taught me that immense stress makes it all too easy to judge others. We rush to place them into basic categories that are easier to process in the midst of chaos. “Those who get it and those who don’t.”

But as much as we want to criticize some and praise others, putting people into boxes is shortsighted and misguided. We need to listen and communicate with our hearts in collaboration with our minds. If we employ this emotional intelligence well, the spotlight allows us to look deeper and be more compassionate. Things are not so simple.

Where are you today? Where will you be tomorrow? We need to treat ourselves and each other with kindness. In the midst of a crisis, we may very well find ourselves needing help. The pandemic reveals what we already know: circumstances can change quickly. We miss what’s truly going on in someone’s life when we jump to conclusions.

A week later, I reached back out to the mom who had been so accusatory to my staff and me. I called her to check-in, find out if her daughter was still coughing, and make a plan for when it would be safe for them to be seen. Through tears, she apologized for her prior interactions with our team. She told me she is an emergency room nurse, physically and emotionally exhausted at work by the pandemic. Her husband had just lost his job and her mother had been hospitalized with COVID-19. In the midst of all of this, she was panicked that her daughter may now have a life-threatening heart condition. “We’re here to help,” I reassured. And I meant it.

Dr. Eric Fethke is a pediatric cardiologist, author, and legal adviser who has been practicing in New York for 22 years. He received his BA from Princeton University and his MD from Columbia University. He has taught medical students and residents at Columbia, Albert Einstein, and now Touro universities.