Managing Anxiety, High Stress and Covid – [Tales from the ER]

Hello Tomodotchi’s!

I’m a guest contributor to the site and hope to add a different perspective on all thing’s mental health and well-being.

First, some background info:

I’m an ER physician who’s been working in the field for 12 years. I’ve got a family. I’ve got kids. And I’ve got a lot of stress in my life that I’ve had to learn to manage, just like the rest of us.

I’m just a regular person and, to reiterate Tomodotchi’s initial message, please do not take this as professional medical advice; I just hope that you can take something away from my experiences both in life and at work.

So, call me Turk. Turk Turkleton.

Addressing the COVID in the room

Yes, I’ve been dealing with COVID for what seems like forever. Yes, it’s completely changed what medicine is like. It’s changed how we practice medicine but it has also changed how we in the emergency department see and feel about medicine. And not all for the better. 


When COVID first broke out, everything was scary and new. We didn’t know exactly what it was doing, how deadly it was, and how to effectively treat it. I kind of just resigned myself to the likely fate of contracting it. I was young(ish) and healthy, so the rational part of me knew that I should be fine, but this was early 2020; many people were dying in New York and in Italy. And not all of them were patients.


Don’t get me wrong. I’m not self-righteous. I didn’t see myself sacrificing my life for the greater good like some medical martyr. But I couldn’t just quit. People needed help, and this is what I signed up for.


This is what all of us signed up for, but after 2, going on 3, years of supply shortages, staff shortages and verbal abuse, a lot of us have burnt out. To a crisp. More and more, I’m seeing colleagues – friends – leave the ER or leave clinical medicine completely. And I can’t blame them. I know exactly how they feel. Smiling and patient on the outside. Hollow on the inside.

So just quit

To be honest, I had been thinking about quitting even before COVID. A lot of the problems are systemic. They’re a fundamental part of medicine. They’ve just been amplified.


But I couldn’t (can’t, am too afraid to) quit. So I had to find a way to coexist.


I’m an introvert at heart. I grew up as a middle child. My siblings were 8 years older or younger than me. I just learned how to be by myself.


Working in emergency medicine is a social job, though. Literally, everything I do involves interacting with people. I listen to patients’ stories, their concerns. I take the time to interact with their families. Then I coordinate care with the hospital staff, trying to make things as efficient as possible without being a nag. And I feel like I do it well. I’m not the greatest doctor in the world, but I pride myself in my bedside manner and treating people like people. But after a shift I’m both physically and mentally fatigued. Nothing is more draining to an introvert than having to interact with others.


It got to the point where I would dread going to work. I started to get tired even before starting my shift. I started to prejudge patients by their chief complaint (reason for coming). And I started to internally lose it over minor inconveniences that delayed care.


I thought I hid it well. Happy on the outside. Hollow on the inside. But it eventually wears you down. 

There(apy) is a point

I’ll never forget the day when one of the other docs I work with confronted me about my mental health.


He had just signed out to me but asked if I had a minute to talk about something in the back.


He started off with a simple question:

“Are you ok?”


He followed this by mentioning how the others in my group were worried about me. Little sarcastic quips here and there. Downish demeanor. Quieter overall.


Again, I thought I hid my struggles well enough. I didn’t want to burden anyone with my overthinking, my self-doubt, my feelings of being trapped. So, I let it fester within me, like a cancer. It got so bad that I would just spontaneously cry after a hard day. I would pity myself but wouldn’t do anything about it. 


So, I was caught off guard. I was even embarrassed. But I also felt validated. I didn’t feel alone anymore. So, I cried. A grown man crying in front of another grown man, someone I work with but wouldn’t normally open up to.


He recommended talking to a mental healthcare professional.

I never really considered it before. Many physicians rarely do. We can diagnose depression but fail to see what’s in the mirror. We don’t think we need help. But we do.


So, I saw a therapist. Someone who had experience treating patients in healthcare. It was initially awkward. Kind of like a first date. I’ve been living with all these “crazy” thoughts for so long, but I didn’t want to just unload it like a dump truck on this poor, unsuspecting soul. I’m also not used to talking about my feelings. Again, introvert. I even started to wonder if it was worth how much I was paying each session. (Contrary to popular belief, my health insurance is not only horrible, but pricey to boot.)


There was a feeling out process. But as I became more open, dark thoughts and all, it became more therapeutic. I could say what I felt without fear of judgment. Just speaking my mind was cathartic. Thoughts and insecurities no longer festered. I was able to air them out and see the flawed thinking behind them. Getting the help, I needed and having the ability to share my thoughts and feelings helped me more than I can describe. Having a community and relying more on those around me truly helped me cope and deal. While I can’t say that everything is always great and that I never feel hollow, I can definitely say having people who care makes the going a bit easier. We’re all works in progress and we need to keep taking steps forward, no matter how small.

You are not alone - Dear Evan Hansen

Help is available, even if you feel alone. You always have community at Tomodotchi, and we don’t have to go on this journey alone.


Talk to your doctor about local mental health resources. If you don’t have a primary care physician, call a crisis hotline. If you can’t find the number and are struggling, come to the ER. We’re here to help you.


Don’t let your pain fester and grow like I did. Talk to a mental healthcare professional.


You are not alone.


Anxiety and depression is not isolated to just certain people. We can all experience it at anytime. Regardless of how you perceive societies expectations of you, we all need help and community. Remember to be kind to yourself and care for your mental well being and know that while we all experience anxiety and depression in our own ways, you are not alone.

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