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Latent Grief

I was recently reflecting on the fact that most people now know someone who has been affected by or even died of Covid-19. There have also been deaths from other causes, which may have been related to health and social care provision challenges in the pandemic and the economic impact of Covid-19. Doctors have seen a significant rise in the number of mental health consultations since 2020. Apart from the consultations for worsening depression and anxiety, General Practitioners (GPs) also issue ‘fit notes’ (previously called sick notes) to allow people time off work due to bereavement, especially if patients are unable to concentrate and do their jobs properly while processing their loss.

Staff shortages in the labour force have caused increased stress and guilt for workers, so much so that they often do not think about taking time off work to process their thoughts after a family member or friend’s death. Compassionate leave is usually available to staff for the death of a close family member, but there are several other loved ones that have passed on and left holes in our hearts. In countries where there are close-knit communities and lower life expectancy, it is not uncommon to lose two or three ‘uncles’ or ‘aunties’ in one year, even before the pandemic. How do the thousands of healthcare workers with relatives abroad keep working after hearing such news? It probably feels worse for immigrants to lose someone they haven’t seen for years and were hoping to see again on their next trip home. Social media and phone calls make it easier to keep in touch and abreast with issues elsewhere, but do not make up for time spent together in person. Regular social media photo feeds might also make the loss of a loved one more painful. I sometimes wonder if patients would still want to be seen ‘urgently’ for that rash, if they knew that their GP had just lost her cousin or close friend through a sudden or violent death. Would I want to have my routine baby check with a doctor who just found out that his baby nephew died that morning?

Somehow, professionalism lives on, even at the expense of our feelings and time to grieve. Staff resilience is what has kept public service going for so long. Some professionals sadly turn to drugs, alcohol and other unhealthy habits to cope with such difficult emotions in pressured jobs and a fast-paced world. Others hang on to their faith, family, friends and expensive trips abroad that give them the strength to carry on. Even those who have not lost loved ones might be grieving the(ir) past - the way things used to be. Some doctors and patients are struggling to cope with new-style remote consultations and larger multi-disciplinary teams, which are very different from what they have known for years. Other workers are still struggling with the effects of long covid. We might also be going through the stages of grief for our old routines, freedoms, economy and status before the pandemic? Denial, anger, bargaining, depression, acceptance? Kübler-Ross’ stages of grief are now known to be non-linear and do not happen in one particular order.

Although there is a lot of support for mental health issues, even for professionals, we need to, first of all, recognise that many of us are in short supply of and sometimes ignore one of the greatest treatments - time. Our choices regarding how we make and manage money can also play in role in whether we are able to take time out, when needed, to heal. Sometimes, social interactions through work can be a good distraction to keep us away from the pit of self pity and depression, but time away from demanding jobs is sometimes needed for a mental break. Even if you cannot afford to take weeks off work to reflect and process your emotions, being intentional about discussing your feelings honestly with someone you trust can go a long way in helping your mental health and resilience.

Dr Afiniki Akanet

GP and author of Money and Mental Wellbeing

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