Dear Frontline Providers

05/18/2020
Dear Frontline Providers, a letter of support

Dear Frontline Providers,

I don't presume to know your individual experiences and feelings during this time of ongoing crisis, or the impact of unremitting demands of stamina and skills or consequent emotional toll….but here are some thoughts:

Experiencing the unfathomable and enormity of devastating loss generates many feelings including disbelief, shock, hopelessness, fury, utter despair – and for some giving up. How the aftermath of those experiences unfold over time is shaped by many variables – but the imprint is indelible.

Witnessing others' profound suffering while often evoking empathy and compassion can also stir up feelings of helplessness, anger, anxiety, fear or even terror in the witnesses themselves i.e. that this could happen to me, to us, to our families Further, for some, there comes a jolting recollection of equivalent past experiences, a reminder that unexpected tragedy or loss has happened before and therefore might happen again.

The loss of someone is never a singular loss. It's of course the physical absence of a person – but when losing a loved one, it's also the loss of a future envisioned, a shared ongoing experience of living life. Traumatic loss can and often does extinguish our illusions about control and serves as an explicit reminder of inevitable endings and the constancy of impermanence.

These aren't new revelations – but frequent and often enduring ones, it seems. Since the inception of the Center for Homicide Bereavement at CHA 18 yrs. ago, our small staff of 3 clinicians have worked with hundreds of family members, friends and witnesses – survivors of the abrupt and violent death of loved ones. They come to our program seeking assistance, seeking solace in often undefined ways as to what might help - or pleading with us, with God, with the universe to ' fix it,' to bring the lost ones back, to stop the unbearable pain, to offer an assurance that pain and grief have an endpoint. After hearing and witnessing the palpable suffering of person after person, we came to fully know the imperative to examine our own frailties, our own strengths, our own fears and vulnerabilities – and to realize how much we needed to keep learning.

In the beginning years, fears and feelings of anxiety and vulnerability, questions about life, death, afterlife, faith – of injustice, unfairness, randomness– of guilt alongside relief/gratitude (not my turn) surfaced with some frequency and in many ways that were distressing and saddening. Over time, and especially it seemed in this Program, I began to more fully recognize that the cumulative impact of witnessing, of seeing, of listening to the past, present and anticipated life-long legacies of traumatic, incomprehensible loss had begun to alter, distort, and at times skew my way of perceiving others and of perceiving the world.

It wasn't just the victims and survivors, I realized, who had to explore a whole different landscape; I had a learning curve, too. It wasn't their curve; it wasn't comparable. But it was one that paralleled in some respects, and one that I couldn't do alone. I needed the help and support of trusted others – and I still do.

During this pandemic, we are seeing very brave providers – likely not fearless, not without grave worry, not without anger, not without mixed feelings – but good, decent, skilled people who are giving all of us, up close or at some distance, life-affirming experiences of generosity. I'm hesitant to call you heroes because that designation can constrict and streamline your individuality, your unique elements, the entirety of each of you. It doesn't leave space for the complexities of the multiple roles, professional and personal, that each of you inhabits. And yet, or in spite of these sometimes competing feelings, you show up, and offer gifts of humanity to those who struggle and suffer.

Public/Institutional narratives and individual/personal narratives are not necessarily in sync -especially as crises and responses unfold over time. There can be and often are significant disparities between the two, and we need to routinely pause, take note, and acknowledge this. While initial cohesion is usual in a collective crisis, differences understandably surface. And when the institutional narrative eclipses the individual, or feels insistent, there is a real danger over time. Suppressed voices, unheard differing perspectives and overshadowed individual experiences of traumatic impact impede a broader unifying movement forward. I believe an ongoing invitation for individual input can inform, enrich, guide and ultimately support those in leadership roles.

For all of you, for each of you, I sincerely hope you feel accompanied. I hope we as a community and as individuals can both offer and partake of some refuge from time to time when wanted or needed.

Enduring gratitude to each and every one of you.

Ellen Holly Aldrich, LICSW

COVID-19 mental health support is available for free from the Pandemic Crisis Services Support Coalition.

The Center for Homicide Bereavement is supported by the Massachusetts Office for Victims Assistance through the 1984 Victims of Crime Act (VOCA) grant from the Office for Victims of Crime, OJP, US Department of Justice.

Cambridge Health Alliance

Contributed By: Cambridge Health Alliance

Cambridge Health Alliance is an academic community health care system committed to serving all members of our communities. We have expertise in primary care, mental health and substance abuse, and caring for diverse and complex populations. CHA patients receive high quality care in convenient neighborhood locations, and have seamless access to advanced care through CHA’s affiliation with Beth Israel Deaconess Medical Center. With over 140,000 patients in Cambridge, Somerville Everett and Boston’s Metro North, CHA is working hard to offer the integrated services its communities need now, and in the future.