ring of 2020, I was in New York City, so I was practicing in two different institutions, (siren blaring) both in Manhattan and in Queens, New York.

We were pretty much inundated with patients, a lack of information and a fast-moving virus that was killing our patients and our colleagues.

And the normal sources of information that we relied on were generally delayed.

By the time we would see something, and we'd look to our hospitals or the CDC for information, that information was one or two weeks behind what we were seeing on the ground, so we really relied on what was a more informal social network of colleagues, ER physicians that we knew, that I trained with in residency that were now dispersed around the country.

And we had a text message thread between the 15 of us, because we couldn't rely on so many formal outlets, we had to rely on each other.

What are you seeing?

How are you treating this?

How is your hospital dealing with this?

And trading that information really became a lifeline for keeping us up-to-date on what we were seeing and how to deal with it.

The telling us not to wear masks in the hallways, because we're scaring the patients.

Are you guys wearing N95's for evaluating each rule-out case?

We're being told just to use surgical masks unless doing an aerosolizing procedure.

There's clearly no real plan.

There was a lot of physicians and providers across the country that were actively told not to wear masks in the early stage of the pandemic.

And the idea in the early stage of the pandemic was that we would scare the patients away, which always sounded funny to me, because wearing masks should reassure patients that we're taking all the steps to protect them.

And yet, many hospital administrators across the country took the opposite tone.

(somber music) (somber music continues) It makes me so angry the lack of state and federal planning.

Why are clowns representing us?

The testing situation is bananas.

(phone notification chimes) I haven't been scared of the virus as a pathogen, I've been scared, because it seems like no hospital administrator knows what's going on.

Anybody have any good news regarding any of the patients they have admitted with COVID so far?

I stopped following up, to be honest.

None.

Yeah, same.

Guys, is it bad to use work health insurance for a psychiatrist or therapist?

I'm gonna need actual help to deal with this.

That is pretty clear to me already.

There was a lot of trauma in those early days.

(siren blaring) I think, inevitably, the shear morbidity we were seeing, we were seeing patients get very ill, seeing patients die, seeing colleagues die because of their infection with COVID in those early stages, and that takes a toll inevitably among anyone that's witness to that.

I do think there was a particular twist to this early stage of COVID that made many of us particularly prone to that trauma, and it was the general sense that our institutions and our hospitals were asking us to take this step forward, put this effort in and put ourselves at risk to help our patients and our community, which we were glad to do.

But at the same time, there was the sense that our hospitals were not meeting us halfway and contributing to our protection.

And in one of the hospitals I worked in, there were colleagues that died, and the emails we received from our hospital was not so much having some sort of memorial or acknowledgement of the deaths of our colleagues, but just simply reminding us not to speak with the news media about those deaths.

Things like that send a message that the hospital might be caring about something different than what we're caring about on the ground when we're trying to deal with these patients and see these very difficult cases.

And I think that's what contributed to a lot of people feeling the way that they did with that acute trauma in those early stages of COVID.

(somber music) (somber music continues) There was a lot of people that had never sought mental health care prior to this, that in this moment felt that they needed to.

As much as we might have lost some trust in our institutions in that moment, there was a widespread amount of community support.

There was offerings of mental health support for ourselves and each other from mental health professionals that said, "Hey, we can't work in an ER, but what we can do "is support our ER colleagues during this time."

And they often donated their time and offered free mental health care for those of us who felt that we needed to.

And I had never pursued mental health care in my life until that moment where someone offered it more casually, and I took them up on it.

And for me, I could say yes, it was tremendously beneficial in that moment of acute stress to be able to speak with someone about it.

(siren blaring) We often see very sorted and morbid things in the emergency room, and for whatever reason, given the culture of medicine, we simply don't discuss them.

We don't bring them up, and we just move along with our lives.

I think a lot of people view that as a coping mechanism.

They might think that if we dwell on this stuff, if we think about it too much, it'll paralyze us.

We have to see these things.

We have to move on in our jobs.

I think these things need to be discussed.

Failing to discuss them doesn't make them go away, and it's something that we often do too little of.

(gentle music) - [Healthcare Worker Voice-Over] I can save them, but who saves me?

It feels impossible to keep up.

What if I get my kids sick or my parents?

- I think we need to remember that 60% of emergency medicine physicians report being burnt out in this moment, three years out of the pandemic.

If one person has a problem, we could say, "Well, that person has an issue."

But if a community has a problem, we can't say that the community has an issue, we must say that there's a systemic problem going on within that community that we must address.

I've dealt with burnout in many ways.

I wrote this book first and foremost, which helped me process a lot of the thoughts and feelings I had during those moments, and it was tremendously beneficial to me.

But I also, I found it very important to work for a hospital for which I felt supported.

Working in a place where you feel supported, I think goes a tremendous long way to helping with any issue of burnout.

There's many hospitals throughout this country, given our healthcare system, that allow people to go on feeling unsupported.

I made it an important point for me to go and seek one out that I thought would be a supportive place, and I did find one.

But I had to go from New York City to New Hampshire to make that happen, and not everyone has that option.

The hospital that I'm working at now is Concord Hospital in Concord, New Hampshire.

(somber music) (somber music continues) - I have long believed that healthcare is a right for all, not a privilege for the lucky few, and this Congress is putting that belief into action.

- So in 2019, I did testify in Congress in the House Rules Committee at the Nation's first Medicare for All hearing.

My name is Farzon Nahvi.

I'm an emergency medicine doctor in New York City, and I support Medicare for All.

And it was the first formal exploration by our Congress into the waters of Medicare for all.

Obviously, there's a hot political issue that people have many different thoughts on, but I'm heartened by the idea that it's now being formally considered and discussed in a way that it wasn't before.

But 45% of Americans live in fear that a health event could lead to bankruptcy.

But I see these numbers every day on the ground level.

I have to look these patients in the eye.

COVID was a tremendous wake up call from which we certainly woke up and learned a lot of things, but sometimes it seems like we fell back asleep.

(chuckles) We learned a lot during that time.

We learned that to protect one another, we have to provide more access to care.

We're all at risk if some of us are at risk.

We're right now, right back in the system that we were before COVID ever happened.

And yet, patients, doctors, politicians, we haven't changed our system at all from what it was prior to COVID.

It serves as kind of a clarifying lens to show us, hey, these things were strange and tragic during the pandemic, but if you take a step back and think about it, (siren blaring) if we're saying that our healthcare system provided untrustworthy institutions during the pandemic, well the truth is they're doing the same all the time during regular periods of life.

Our patients often fail to come to the emergency room when they feel that they need to, because they're worried about the cost.

These things are normal parts of our healthcare system in our society that are not normal parts of other people's healthcare systems and societies across the world.

We often talk about the supply of healthcare workers coming through the system.

What we fail to acknowledge is how many people are leaving the system.

And I think that departure from our healthcare system is largely incumbent on people feeling unvalidated, unsupported by our healthcare system.

(people clapping) - [Reporter] After two weeks at home, recovering from COVID-19, (gentle music) Dr. Paul Saunders gets a hero's welcome back at the hospital.

- And I think we could go a long way in retaining the staff we already have if we showed more respect for the people within the field and more support by our hospitals and our hospital administrators.

I think currently what we're doing is we have a barrel full of water.

There's a huge puncture at the bottom where all this water's leaking out, and we're just trying to fill it from the top.

I think another way to do that is to patch that hole up, so people aren't leaving all the time.

Workers are there, because they want to do their job, they want to help people, but it's tremendously difficult to do that job when they feel unsupported in the process.

(bright music) - Next up, "Peanuts" cartoonist Charles Schulz