Courage is Moving Forward Despite Your Fear

I watched the Jordan Peterson YouTube video below about fear and anxiety. In it, he says, “Everyone has the ultimate reason to be anxious– because we know we are going to die.” And, when facing real danger, sensible people don’t become less afraid – but they can become braver. That’s because courage is about how you ACT, not how you feel.

The dictionary defines cowardice as excessive self-concern, which overrides doing or saying what is right or what is of help to others in times of need. Cowardice is a failure of character in the face of a challenge. Courage, on the other hand, is not the absence of fear – quite the opposite. Courage is moving forward despite your fear. The COVID-19 pandemic has exposed both cowardice and courage among healthcare workers.

As the shadow of the pandemic approached, there was a lot of fear. How trustworthy were the news reports? We knew the Chinese were lying about a lot of things – totalitarian states do that. But what was really happening in Italy? The early data out of Italy just didn’t make sense – could the infectivity and mortality curves be accurate? They actually publish a lot in critical care and have good doctors. However, the last time the Italian government executed a disciplined response to an enemy, Italian men were wearing togas and sandals. So, maybe the virus would behave differently when it got here.

I Don’t Want to Die

I was afraid of what was coming. I started waking up at 3 am every night with my heart pounding. I called my father and my brother-in-law – both Army veterans who served in Vietnam and Afghanistan. “I really don’t want to die,” I told them. My brother-in-law comforted me with, “Well, the enemy usually has a pretty bad aim. So, for the most part, they miss.” I tried to channel my fear into useful activity. When I would wake up at 3 am, I would read the latest e-publications — the fastest way scientific authors can get a written paper disseminated. They provided nearly contemporaneous reports about the disease. I started running on pure adrenaline, sleeping only about four hours a night. That’s why it was almost a relief when my “call of duty” came. To my own surprise, I ran to the front line. I wasn’t less afraid. I kept telling myself, “Usually the enemy misses.” But I knew sometimes he doesn’t.

I Have No Patience for Cowardice – I Am Afraid, Too

Some doctors and nurses who ran headlong into the fight were taken down fast with COVID-19 infections. The ranks started to thin early on, so it’s easy to understand why some doctors and nurses ran in the other direction. You can see fear in the eyes of your colleagues – partly because that’s all we can see of each other these days – the mask covers every other part of the face. Since death is something most of us are afraid of, in the beginning, I was philosophical about the different responses I witnessed. I told myself that we all process things differently. But, after spending weeks and weeks on the front line, I find have no patience for cowardice anymore. Because I am afraid, too. What I have learned is that how we act in the face of our fears is a CHOICE.

I will paraphrase Jordan Peterson by saying that the question is not why some people are cowardly, but why does anyone behave bravely? When the natural response is to run the other way, why are there more heroes than cowards in the face of this terrible disease? And what does heroic action look like in the time of COVID-19? It doesn’t look like an action movie. It looks like nurses who keep nursing the way they were taught, not wavering in the face of COVID-19. They help terrified patients with panic attacks, hold their hands, give them a cool washcloth, and hold up their smartphone so they can FaceTime their last words to their families before they die. Heroes look like respiratory therapists (RT) who tirelessly suction, intubate, extubate, nebulize, oxygenate, and chest percuss COVID-19 patients all day long. Their lives are on the line all day – and their salaries are not high. We doctors discuss ways to “minimize aerosolization of the virus,” but the RTs swim in it. Every day they come to work like Marines with an attitude that says, “I love the smell of COVID-19 in the morning.” Interestingly, not one respiratory therapist has gotten COVID yet. I pray every day for God to protect these brave and uncomplaining therapists.

Medical Cowards Fail Themselves

There’s a behavioral pattern that is common to medical cowards. They act like they are working hard and appear to be busy, but they push others in front of them, limit face-to-face interactions with patients, and take on duties that keep them as far from possible exposure. They are not fooling anyone except perhaps themselves. During morning “COVID-19 Huddle,” a multidisciplinary meeting where we try to keep each other informed about what’s going on in the battle, the medical cowards chime in, trying to sound relevant. However, they are quickly shot down by those of us who have actually touched COVID-19 patients. This is a weird disease, and you have to be close to these patients to begin to understand it.

Not only do medical cowards fail the patients, they fail themselves because they are choosing not to learn what they can about a novel disease. I suppose instead of being angry with them, I should pity them. Because to quote the Bard, “Cowards die a thousand deaths. The valiant taste of death but once.” I don’t want to die, but I am determined to live courageously in spite of my fear — and to only die once.