Emotions & Vulnerability: A Leadership Reflection From More Than a Year of COVID-19

During the first two to three weeks of the pandemic in 2020, I was involved in a lot of meetings about the current status and future plans for the impending surge of COVID-19 patients we were anticipating. It was during that time we witnessed COVID-19 ravaging cities like New York City. In one of the leadership huddles on a Friday afternoon, I distinctly remember feeling exhausted and thinking I just need to get through this weekend without any major surprises or news so I can have a “peaceful” weekend at home.

One of the leaders running the huddle then made a statement “And, our system now has an external, refrigerated morgue that has higher capacity than what our hospitals can handle as we are anticipating high volume of deaths.” I was alarmed by that statement and almost blurted out, “Oh my gosh! Are you serious?!”, but I kept quiet. I was asking myself, “When have we ever needed a temporary external morgue as our current facilities were too full with dead bodies?!” I was accustomed to dealing with death in the hospital, but not at this projected volume, speed, and chaos.

I tried to control the expressions on my face. I waited for someone around me in this meeting comprised of leaders from across the hospital to react. I hoped that someone would give me eye contact, so we could share shocked facial expressions. But no one did! Not one person let out a sigh, grunt, or anything! I looked around twice, and everyone was fixated on the next thing on the agenda, ready to move on. I wanted validation that what I was feeling is real, but it never came. I knew at that point how serious things were, but I also quickly realized how numb we were becoming to the ongoing emotional trauma that COVID-19 afflicted on us.

For over a year during the pandemic, we were in fight mode, taking it day by day, week by week, and constantly bracing ourselves for the worst. We were forced to keep marching forward when the world around us seemed to be collapsing. As a leader, I faced more challenges than I could ever have prepared myself for both on the professional and home fronts. It’s clear to me now that the fight mode we had embraced ourselves with did not allow for vulnerability. It’s almost as if we felt that if we were to stop in that moment and react, then we would lose our momentum and give in to all of the emotions from witnessing the constant suffering of patients and the enormous stresses associated with leading and working on the frontlines during a pandemic.

After gathering my thoughts and composure about the temporary morgue that day, I relayed this information to my group along with other pertinent pandemic information. It was a firm, professional, and open-ended communication. I used this type of communication style for weeks until things became a bit routine as we braced for another surge. When I spoke to different hospital leaders at varying times around the hospital, we would always openly talk about our exhaustion, anxieties, and challenges with managing our teams, staffing woes, and not knowing what would come next. The reality was that we all were feeling similar emotions.  We would decompress individually, and it felt better. I also would talk to my colleagues independently and open up, chat about home stresses, pandemic fatigue, and everything that goes into taking care of these sick patients. It really was therapeutic in its own way.

I think back to that day when I heard the statement and plans about an external morgue. That may have not been the most challenging thing I heard during the year, and I don’t know if it even ever got utilized. But I do know that if I heard that statement again in a meeting, I would allow my reactions to be more vocal. I would pause, show emotion, and share with the team something along the lines of, “What we just heard is daunting, and it’s okay if we are all feeling some anxiety. How do you feel?” I would encourage a dialogue and open up conversations.

I realize that we need leaders that are firm, bold, directive, and that can handle a crisis. But, we also need those leaders and others to help us pause, reflect, gather our thoughts, and help carry our teams through the crisis as real human beings. It’s not fair or appropriate to expect a leader to hide emotions and vulnerability. As leaders, we can share news or updates firmly, but also have the power to encourage some vulnerability by talking about our reactions in real-time. This vulnerability is not weakness, but rather a strength as it allows a team to hear and experience the real human emotions.

During the first quarter of 2021, most of us in the hospital world marked “one year of the pandemic.” Specifically, as hospitalists, we rode out multiple major surges with increasing intensity from the first part of 2020 through the beginning of 2021. Now, as we are in an unprecedented fourth surge with the delta variant during the summer, we are all facing new challenges. I have the utmost respect for hospital leaders’ valiant efforts as they continue to navigate uncharted territory. But, this was also a personal leadership lesson for me. And, as much as I feel like I knew it was okay to be vulnerable as a leader, I certainly accept it more than ever, and am taking that with me daily as I lead and navigate through the current surge for myself and my team. The reality is that our healthcare teams across all disciplines are very fragile today, and leaders can make a significant impact by embracing the real human emotions resulting from the persistent stress, exhaustion, and burden felt daily.