At the beginning of 2020, Vivian Fischer, a family physician in Minneapolis, expected a calm end to her nearly 30-year career.
In January, the Allina Health clinic she worked at was closed, and Fischer transferred to urgent care. The routine work would be a good way to wind down and start planning for retirement, she thought.
Then COVID-19 came to Minnesota, and her shifts intensified.
Anxious Minnesotans came asking to be tested for the new virus – despite few tests being available.
“You’re sitting in the room with all of these people who are very infectious for long periods of time, because they really want to argue with you about why they need what they need,” Fischer said.
“As a physician that’s incredibly stressful.”
Before COVID-19, medical workers already experienced high levels of stress. American physicians have a suicide rate twice that of the general population, according to a study from 2018.
And with new pressures – from frontline workers’ fear of getting their family sick to the financial squeeze of being furloughed – there’s no shortage of potential stress.
To cope, some Jewish medical workers have leaned on their heritage; in ways intentional and unintentional. Their experience is a window both into the heterogeneity of Jewish identity, and the multi-layer effect COVID-19 has had on Minnesota’s health care system.
For Fischer, the increase in stress left her struggling to be compassionate with patients. So she turned to a Hippocratic Oath-like text attributed to Maimonides, the 12th-century physician and rabbi.
The most important line of Maimonides’ Oath for Fischer? “May I never see in the patient anything other than a fellow creature in pain,” she said.
Fischer printed the oath out and posted it at her desk. And when her non-Jewish staff saw it, they asked her to make copies for them.
But for other physicians, stress relief via Judaism has been less explicit. Michael Garr, a cardiologist who has worked in St. Paul for over 20 years, is usually too busy to think about his heritage at work.
“You’re just trying to get your day figured out, doing the best thing for your patients,” he said.
Since the pandemic began, Garr has been less worried about his regular patients getting COVID-19, and more concerned about them surviving with pre-existing conditions while social distancing at home.
Across Minnesota, hospitals have delayed elective, or non-emergency, procedures. While some patients can wait for tests, surgeries, or treatments, the question is who – and for how long. And though Gov. Tim Walz gave the OK on May 5 for hospitals to begin doing elective procedures again, patients are likely to still face wait times.
“The [medical] practice has been totally skewed to trying to put out fires and staving off anything that can be put off for a couple of months,” Garr said.
And Garr is not entirely sure how his patients are doing. He sees patients virtually now, rather than physically in an office. The distance makes it hard to tell if patients are downplaying symptoms of their chronic conditions, which Garr thinks may be driven by fear of catching COVID-19 if they get unwell enough to need to visit a hospital.
“Medicine is a hand-drawn art and science,” he said, “and to stare at somebody via video camera; there’s some clear limitations to that…there’s a lot of anxieties about that.”
But away from work, the communal aspect of Judaism gave Garr some breathing room from his stress.
The two seders of Passover, the holiday that commemorates the biblical Exodus from Egypt, were comforting, if only because “it was people spending time really talking with each other,” Garr said. Though the family couldn’t gather in person, they celebrated the holiday using the video-chat service Zoom.
Garr was also surprised by the meaningful experience of participating in a shiva, the traditional seven-day mourning period for the death of a loved one, also held over Zoom.
“Nobody was in a rush because they were already at home,” he said.
For other medical workers, staying at home is the main challenge of the pandemic.
LeeAnn Ancier is expecting to be among the thousands of medical workers furloughed by HealthPartners, which owns the Park Nicollet clinic where Ancier works as a licensed practical nurse.
Ancier is a casualty of both the heavy financial losses hospitals have suffered by delaying elective procedures, and the lack of work at the clinic now that patients are staying home and seeing doctors virtually.
“My days are now horrible,” Ancier said. “There’s no need for nurses anymore in the clinic setting.”
A 2003 study of the psychological effect of the SARS epidemic on a Canadian hospital concluded that staff who worked less felt “isolated and ineffective in contributing meaningfully to the crisis.”
When asked if the study described how she felt, Ancier said yes. “I feel good, I want to work,” she said.
To cope with the uncertainty of being furloughed – if it happens, Ancier expects the end of her 35-year career – she keeps a copy of Tehillim, or the Biblical book of Psalms, with her at all times. Reading the prayers makes her feel better.
“Maybe that is my anxiety, maybe it’s a little OCD. It’s a tough one, this pandemic, but I do believe we will get through it,” she said.