Even The Best Physicians Cannot Heal Themselves: A Lament for Dr. Lorna Breen

In late April, Dr. Lorna Breen who headed the emergency medical department at New York-Presbyterian Allen Hospital became one of the casualties of COVID-19 when she suddenly took her own life. Here is part of what I wrote at the time of her death:

While most doctors and health care workers will not abruptly end their lives there is no doubt that a critical mass will experience PTSD. There are those who will argue that COVID-19 cannot be compared to war. Yet with the sheer amount of death associated with COVID-19, I am sure the experiences of doctors, nurses and other health care professionals have similar experiences to medical personnel who have treated our soldiers in WWI, WWII, Korea, Vietnam, Afghanistan and Iraq.

COVID-19 has been a profoundly life changing experience for all of us. For doctors, nurses and other health care professionals who have had to treat COVID-19 patients it is infinitely more so because of the loss of life they could not prevent and the risk of contracting COVID-19 themselves. Some health care professionals will be less able to cope with these conditions than others. Simply put, Dr. Breen will not be the last health care worker who will take their life as a result of what they experienced.

A couple of days a follow up article was published by The New York Times regarding Dr. Breen based on discussions with family and friends. It was revealed that Dr. Breen believed people knew she wasn't mentally well, that it would ruin her career and she was embarrassed about her condition:

Dr. Breen was a consummate overachiever, one who directed her life with assurance.

When she graduated from medical school, she insisted on studying both emergency and internal medicine, although it meant a longer residency. She took up snowboarding, cello and salsa dancing as an adult. Once, after she had difficulty breathing at the beginning of a half-marathon, she finished the race, then headed to a hospital and diagnosed herself with pulmonary emboli — blood clots in the lungs that can be fatal.

In addition to managing a busy emergency department, she was in a dual degree master’s program at Cornell University.

Dr. Breen was gifted, confident, clever. Unflappable.

But the woman speaking to Ms. Feist that day was hesitant and confused.

Ms. Feist quickly arranged for her sister to be picked up by two friends who would ferry her to Baltimore, where Ms. Feist could meet them to take her to family in Virginia. When Dr. Breen finally climbed into Ms. Feist’s car that night, she was nearly catatonic, unable to answer simple questions. 

Her brain, her sister said, seemed broken.

Continue reading the main storyThey drove together for a few hours, heading to the University of Virginia Medical Center. When they arrived, Dr. Breen checked into the psychiatric ward.

Dr. Breen, 49, had missed work in the past for torn knee ligaments and the pulmonary emboli. But this absence felt like a shameful fall from grace. She had suffered a breakdown when the city was desperate for heroes. And she was certain her career would not survive it.

Her family members tried to convince her otherwise. After all, she had no apparent history of mental health problems, and the past month had been one of extremes for everyone.

Dr. Breen was doubtful. An insidious stigma about mental health persisted within the medical community.

“Lorna kept saying, ‘I think everybody knows I’m struggling,’” Ms. Feist said. “She was so embarrassed.”

Dr. Breen was a deeply religious person and perhaps she heeded The New Testament which says "Physician, heal thyself." But this isn't always possible even among the most gifted of doctors. All of us are fallible. There should be no shame in asking for help nor any stigma associated with it.

COVID-19 has challenged the medical community like no other disease has before. Right now doctors, nurses and other health care professionals don't have the answers for COVID-19 and might not anytime soon. The lack of answers are compounded with all the death health care professionals have been exposed to over the past five months and with all the deaths still to come not to mention the high risk of testing positive for COVID-19 (which Dr. Breen did).

If doctors, nurses and other health care professionals do not think they can ask for help without risking their careers then we have a problem as big as COVID-19 itself. In which case we are going to have a lot more casualties than Dr. Breen.