It feels so wonderful to finally be able to come together like this. And really, that feeling of community and shared experience is what we hope to build on today. We’ve been through a lot. There is no denying that these have been hard times.I want to begin with a patient story. One that I couldn’t have imagined happening a few years ago. My patient, who over 10 years, we had navigated her cancer diagnosis, lung resection, disease recurrence, radiation, and recovery. She had knitted the softest-imaginable sweaters for my son, born 2 years after we lost our first pregnancy. Her church’s prayer list included my name whenever I got sick. She felt like family to me (1).I was smiling under my mask as I walked into the exam room. She rolled her eyes, then glared at me. She pulled down the hospital-mandated mask and spat, “Oh, take off your mask! What are you afraid of ? You of all people should know this is all just a moneymaking scheme.”In that moment she disappeared. She blurred into a swirled haze of hatred. Flags, guns, co-opted mottos. I felt a very real and fiery anger swell up inside me.I took a breath and said only what was true. “I do have a desire to protect myself based on what I’ve seen, and I will be keeping my mask on, and I wonder, what has this experience been like for you.”She began to describe how her son had barred her from seeing her grandchildren, the only thing in the world that mattered to her. She wasn’t following safety protocols and was not vaccinated. She admitted to feeling disposable and abandoned.I recognized myself in her words. I too felt disposable and abandoned. Our grief vibrated between us. Different frequencies but recognizable to each other.We are so often asked to demonstrate an emotion that is different from what we feel. We are feeling anger and must show compassion. This can put us at real risk of depersonalization, moral injury even. But if we can access something that is true, even if it’s just the barest curiosity, that can be self-protective. The act itself is changed by the intention with which it’s performed.We are so accustomed to healing others. In exhaustingly difficult times, when we have nothing left to give, we treat the person in front of us with all the humanity we can muster. We treat the shooter and the victim. The drunk driver and the passenger. We have been trained to refrain from judgment. Medicine trained us in altruism and self-sacrifice, too. We may be so practiced, so adept at this that it’s become a hindrance. We may have lost sight of how to care for ourselves.I’ve heard people (colleagues, nurses, patients) describe this time as having scarred them, but I’d rather us reconsider and think of ourselves as perhaps wounded instead. Because the period between when the terrible wounding damage is inflicted and when the scar inevitably forms, and pain becomes memory, is a time when we can actively reexamine and rebuild ourselves.And so we pause, here, to regard our wounds and choose how we will be reshaped by this time. What form the scar will take. And I know, it can be hard to consider our own wounds/suffering when there is so much suffering around us we are busy attending to. It can be tempting to just lock it away. Focus on the work.We were each handed a set of tools to function in medicine. For those of us who are physicians, we were taught the necessity of cultivating a measure of clinical distance. A measure of clinical detachment, Aequanimitas. Maybe, like me, you learned how to over-function in a time of crisis. These tools, they aren’t all bad. They may have even been the tools that were needed at the time. That boat got us across the river. But, and here I will share one of my Life Rules with you, when you make it to the other shore, you don’t pick up the boat and carry it with you on your back. Because then it’s no longer a boat, its baggage. You thank it and leave it behind. The tools that got us to this place are not the same ones that will heal us in this new place and time.We were fed a hero narrative. Remember the signs, the applause, the parades? We were given a boat and taught to row it alone. So much of what we were taught is about how to “excel” or achieve individually. Our world, our healing, depends on people working collectively in service of something larger.This is a run chart of our COVID census over the past 24 months in Detroit. It is almost impossible to absorb from this the weight of these numbers. I’m reminded of the teaching of beloved physician-writer Abraham Verghese: the map is not the territory. There is no way to look at this chart and understand what happened to us. To know the suffering, that is different territory. And it is territory that requires community.I’ve written a lot about my own critical illness and recovery, the lessons it taught me. I came out the other side believing that we had to bear witness to suffering. As if bearing witness were somehow transformative. I now believe that bearing witness is one rung up from the very low bar of being a bystander to trauma, of being just a spectator. It’s not sufficient. It’s not healing. Healing is having moral imagination; healing is learning to validate the experiences of strangers as our own. And I believe that our honesty, our vulnerability, our humility about our experiences is what allows us to validate each other.During the darkest days of the first wave of the pandemic in Detroit, a group of us gathered in a conference room to talk about what was hard. We called these Peer Processing sessions (2). The room was a mix of nurses and respiratory therapists, with a few nurses’ aides and physicians. We had come together to share what was difficult—bordering on impossible—to process alone.One of our nurses described an experience of being the only nurse in the room of a patient with COVID who was arresting. She felt paralyzed, unsure of what to do first. Should she start chest compressions or give epinephrine? Should the patient be bagged? If she disconnected the vent, wouldn’t the risk of aerosolization of virus increase? She thought of her children. Should she be human and hold his hand? She knew he was going to die regardless of their efforts. Should she even be exposing herself to the risks? She described the anger she felt toward her colleagues. She could see them through the window, as they carefully, meticulously donned their personal protective equipment while she stood inside alone. “It’s not right,” she said. “It wasn’t right to put me in that position. I felt abandoned. I couldn’t do what my patient needed, alone.” She described an intense fight with her husband when she got home that night when he complained to her of the difficulty helping the kids with schoolwork while navigating his own online meetings. She hated everyone.The room went silent.A grizzled, gray-haired respiratory therapist began to speak of his time in Vietnam. He explained that things happened there, that he was a part of things that happened that were not morally defensible. They were indefensible then and they are just as indefensible now. It was a war.I don’t recall his words exactly, so what I will tell you now is what he left me feeling and knowing. The sense of his words.The sense that when they call it a war, they are signaling that all the normal rules are suspended. That’s why they were calling us heroes. That’s what they call people who are forced to betray themselves. In that room, the nurse betrayed herself. We betrayed ourselves. I say we because at some point, each of us found ourselves in that room. She, we, were in an impossible situation. Any decision we made would have haunted us forever. We would always carry that with us, just like he carries his baggage.What happened next was remarkable. Every person in the room reflected back to the nurse the values she demonstrated in that moment.“But do you hear who you rose to become? In an impossible circumstance, you filled a need that would have been a void.” “You exemplified what it means to be a nurse. You considered his humanity above all else.”And so I say that to you now. Do you hear who you rose to become? In an impossible circumstance, you filled a need that would have been a void. You exemplified the values of this profession. You served humanity above all else. Above even your concern for yourself, for your safety, for your family. Do you hear who you rose to become?This is something that is always available to us. When we reflect the values of our colleagues back to them, we move them ever so slightly away from what could be post-traumatic distress and into a possibility of post-traumatic growth. And the thing was, as we said it, we believed it was solidly true of her. We saw her goodness, and it helped us to believe that maybe we were good too. That got us through.I would propose that the nature of our suffering, the complexity of the suffering we are just beginning to acknowledge is such that it demands the community and the humility of others. It demands a container that can hold it without judgement. It needs to be surrounded by others who say “I may not understand the exact nature of your experience, the material circumstances of it, but I acknowledge that there have been situations in which I too have felt shame, isolation, moral distress.”Like my patient who did not believe in COVID, the material circumstances of her experience were not mine, but I too felt abandoned, isolated, and disposable. I can hold her experiences as my own. I can honor our sameness.I’ll tell you one thing the veteran said that I once believed that I no longer believe to be true, about the nurse’s husband. He said, “You have to stop trying to make him understand. Unless they were here, they can’t know.” We must dispel the myth that no one can understand except those who were there with us. Our society, our ability to solve our most complex problems, hinges upon our ability to understand what we have not experienced ourselves. Moral imagination. Holding the problems of strangers as our own.I have a different understanding of equanimity now and, forgive me, it’s not Osler’s version. It’s about having enough space for all of it, the good and the bad, the pain and the healing. Learning to survive together (in community) what is impossible to survive alone (in our own little boat). Having capacity. Having a heart that is big enough to hold all the experiences. When I think about the lessons of my illness, the lessons of COVID, it feels as if what I’ve been learning to do is grow a heart that can hold all of it.A heart that can live anyway. Even now.