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Views And Reviews Primary Colour

Helen Salisbury: Dealing with covid trauma and grief

BMJ 2021; 372 doi: (Published 09 March 2021) Cite this as: BMJ 2021;372:n649

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  1. Helen Salisbury, GP
  1. Oxford
  1. helen.salisbury{at}
    Follow Helen on Twitter: @HelenRSalisbury

Doctors spend a lot of time being counsellors and agony aunts. We listen to our patients’ troubles and sometimes help them towards solutions. In some consultations there’s little we can do beyond witnessing, hearing, and acknowledging a patient’s pain, trauma, and grief.

A day in general practice can be an emotional rollercoaster. We may be helping someone to absorb a new diagnosis of terminal illness, discussing next steps with a couple celebrating a longed-for pregnancy, or trying to support patients who are in pain, crushed by the disappointment of yet another postponement of surgery.

The arrival of the vaccine brought to the fore a welcome new emotion: hope. My patients are starting to look forward, to believe that things may get better. The days are getting longer, and the prospect of hugging loved ones feels tantalisingly close. Although some of the thrill of running the early vaccination clinics has worn off for those of us fitting them in on top of our usual surgeries, there’s still palpable excitement among patients getting the jab. If—and it’s still a considerable “if”—the Brazilian variant can be kept at bay, and if we’re not overwhelmed by a surge in cases driven by schools reopening, we can begin to imagine rescheduling some of those postponed family celebrations, holidays, and parties, as well as meeting lockdown babies we know only as pictures on our phone.

Perhaps we should keep our eyes on that prize and put the past year behind us, but if I allow myself to step back and look at what’s happened in this country, the anger I feel is overwhelming. We simply should not be where we are—at the top of the table of lives lost to covid-19. It’s not about resources or population factors: we didn’t start out significantly fatter, older, or sicker than our neighbours. Leaders who brought their countries through the past year with relatively little loss of life and livelihood didn’t begin with a clear advantage, but they were ready to take tough decisions quickly and prioritise the safety of their population.

This is in marked contrast to the UK, where, in so many instances, a chorus of medical and scientific Cassandras was ignored. We watched in horror as the consequences of government delay and inaction played out as spiralling covid admissions and deaths. I’m trying to be mindful, to contain my anger, as it’s of no benefit to anyone. I almost succeed, but then I have another consultation with a desolate bereaved patient trying to understand why her relative died. I can listen and make the right sympathetic noises on the phone. I cannot voice my anger there—but I can here.