Supporting Clinicians During Their Most Challenging Moments: Witness to Witness, by Dr. Laszlo Madaras

By Laszlo Madaras, MD, MPH

[Editor’s Note: Witness to Witness is celebrating its two-year anniversary this week. Migrant Clinicians Network’s Laszlo Madaras, MD, MPH, Chief Medical Officer, reflects on how W2W has supported his work as a clinician on the frontlines. Learn more about W2W at www.migrantclinician.org/witness-to-witness.]

TS Eliot once wrote that April is the cruelest month, but I would put in a bid for July. While I have spent many happy summers on the shores of Maine and Cape Cod in July as a child, there were several past July months that were full of sorrow, expected and unexpected deaths, natural and man-made disasters, such as the Julys in Rwanda and Srebrenica that often come to mind at this time of year. Now the ongoing COVID-19 pandemic is another addition to this series of events that require heavy physical, emotional, and spiritual investment. Often, busy medical clinicians working in such circumstances are too preoccupied to spend time immediately processing what they just experienced, and may not have the tools to even begin.

Luckily, we health care professionals now have access to Witness to Witness (W2W), a program  founded and directed by Kaethe Weingarten, PhD and sponsored by Migrant Clinicians Network, that is celebrating its second anniversary this month. W2W has helped not only clinicians but social workers, attorneys, journalists and other professionals process and cope and learn from their experiences in such troubling times with helpful insight, discussion, and information to help recognize our capabilities to move forward.

It has been helpful for me to participate in W2W webinars offered by Kaethe Weingarten. There are two important concepts that have been useful for me. First, Kaethe put into words some of the feelings I’ve had around the difficult medical work involved with COVID-19.  I needed to continue my job while at the same time trying to decipher those feelings. Kaethe’s explanation of these feelings using concepts of empowerment and awareness was very helpful. I learned that at times we clinicians are both aware and also empowered to make changes, but often we are not empowered to make the changes that we want to see in our treatment of patients, and that there are emotional consequences that such situations create within us.

Second, the fact that a professional could put into words such things as I was feeling meant that I was not alone in these feelings but that many clinicians were going through the same feelings. W2W helps normalize the feelings that come from having to work in an environment where you have major responsibilities but not enough control, information, nor authority to complete those responsibilities. This has helped not only in my current work with COVID-19 but also in making sense of past experiences that were not under my control but for which I was responsible. I write this around July 21; the date triggers memories of another overwhelming medical experience 26 years ago that elicits another W2W concept, that of Moral Injury. The rising body count in different parts of the world -- whether from cholera, COVID-19 or starvation -- can be very distressing to a clinician who wants to help but feels helpless under very difficult circumstances beyond one's control. I am glad that MCN can offer this opportunity with Kaethe Weingarten and W2W and I hope that W2W will support many more clinicians in the next two years, as it has in its first two. Please take advantage of W2W’s offerings – take a look at the W2W webpage, watch our archived webinars on grief, stress, and COVID-19, and be sure you are subscribed to MCN’s mailing list to be alerted for upcoming trainings and support.

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