Louisville Medicine Volume 69, Issue 8 - Page 26

AUTHOR Mary Barry , MD
DOCTORS ' LOUNGE

DOCTORS ' LOUNGE

SPEAK YOUR MIND If you would like to respond to an article in this issue , please submit an article or letter to the editor . Contributions may be sent to editor @ glms . org . The GLMS Editorial Board reserves the right to choose what will be published . Please note that the views expressed in Doctors ’ Lounge or any other article in this publication are not those of the Greater Louisville Medical Society or Louisville Medicine .

Unless we have survived life in a war-torn country or combat itself , most of us have never faced trauma on a mass scale , until the onslaught of SARS-CoV-2 ( COVID ). Even the most vociferous believers in the “ only the flu ” fallacy have seen their communities ravaged . When they look in the mirror , I wonder , do their eyes tell them the truth ? That this will last longer and kill more people than the 1918 Flu ? That they are in fact afraid to get it ? That guilt will devastate them if they give it to a little one ? We can all lie to ourselves for years . But somewhere inside , we know what really happened . When the full realization hits , we all face the horror of our mistakes .

The vaccinated and careful among us have different regrets : for all of the people we have not communed with , for all of the events we have avoided , for our lost sense of freedom , and for all of the help we have been too selfish or scared to offer others . We could have done more - though we still have a chance to make that up .
The last time this country suffered major trauma , for many of us , was with Vietnam and the divide it produced between the people and the veterans who came home . They were not just unsupported , they were reviled , and for many , years of alcohol and nightmare was their reward . Both for us and the younger generations , 9 / 11 ignited a fury of collective grief , followed by 20 years of lives lost in the desert wars of the Middle East . Our recent exit from Afghanistan revealed the intensity of that trauma as allies got left behind , while more Americans were killed at the airport : many veterans reported fresh attacks of flashbacks and anxiety at that .
The last time the whole world suffered together was World War II , which killed on every continent but destroyed millions of homes and untold lives across Europe , in Britain and the Pacific , plus the six million people murdered in the Holocaust . Unless you
24 LOUISVILLE MEDICINE

THE MASS TRAUMA INSIDE US

AUTHOR Mary Barry , MD
got interned for merely being Japanese , or drafted into lowly units for merely being Black , that war united Americans as “ good guys ” against the evils of fascism . That unity helped our recovery . Some of the pain got better with the prosperous ‘ 50s , the era of mass production and good jobs in steel - if you were white , that is . If you were Black , nothing changed except maybe you ’ d lost a leg or an arm or your eyesight . You were just as despised across America , and very often just as brutalized .
COVID is universally evil . Its ability to attack , to steal your very breath and to render you voiceless and prone , to terrify your loved ones and your caregivers alike , reminds me most of the Dementors , the demons who steal your soul and your every happiness in Harry Potter . More than a third of COVID survivors have reported ongoing disabilities , many lasting for months . Mixed in with the terror is fury - the unvaccinated gave me this ! - and the worry , will I get it again ?
Those who work in COVID ICUs have had to choose whom to save and whom to let go . For months there were shortages of PPE with horrific images of dead bodies lining the floors and halls of rural Italian hospitals - no one could stop caring for the living just to cart out the dead . There are mass graves on New York ’ s Hart Island , and all over the world from the winter of 2020 . In my youth I had to choose whom to bag and whom not to ( the power went out at Louisville General and I have only two hands ) and that ’ s not a decision I have yet forgotten : imagine having to make it , over and over again . ICU staff work with the constant fear of contagion , all the while aching with the loss of their former coworkers , COVID victims themselves .
Where does all this trauma live ? In our heads , is where : in our too-quick to judge others , in our too-angry-to-speak at the talking heads of Liar TV , in our cascade of grief at losing yet another human being . We mix our tears with rage and resentment and carry it all around inside our heads . We hope , as we try once again to persuade