Gratitude and Hope in Challenging Times

It has been over a year since the start of the COVID-19 pandemic; our daily lives have changed in innumerable ways, many of which are likely permanent. Over the past year and a half, we have faced unprecedented challenges related to not only the coronavirus, but also dramatically changing social, economic, and political landscapes worldwide. The cumulative effects of this climate on individual and collective psychosocial wellbeing are immense.

Prior to the start of the pandemic, professional burnout, which has been defined as “long-term stress reaction marked by emotional exhaustion, depersonalization, and lack of a sense of personal accomplishment” was evident in up to 50% of physicians, a rate greatly surpassing the general population.[1,2] Factors contributing to clinician burnout are numerous, but include a lack of autonomy, time pressures, and responsibilities to others both in and outside of clinical practice. Each of these factors has been taxed greatly by the wide-reaching effects of the pandemic, with a concomitant decrease in opportunities for self-care.[3] In this context, mild depressive disorder is evident in up to 40% of frontline medical staff and major depression in up to 10%.[4]

From alterations in the ways we provide care to the methods by which we educate our future partners and leaders, the craniomaxillofacial surgical community has faced pandemic-related challenges head on. As we embark on future endeavors, we should all take a moment to express gratitude as part of our daily personal and professional lives. Gratitude, as a concept, is well studied, but not universally conceptualized. Contemporaneous works have loosely defined gratitude as an emotional response directed toward appreciating helpful actions of others.[5] The positive downstream effects of gratitude are demonstrable in both those expressing gratitude and those receiving the appreciation. Gratitude and hope are inextricably linked; gratitude fosters hope and hope helps us navigate through adversity.

In this context, we should all consider those to whom we are grateful ... Our public health officials, who have had the unenviable task of establishing guidelines in the setting of incomplete and often imperfect information for a society that is increasingly skeptical of scientific methods ... Our frontline medical colleagues, who have made extraordinary changes in their day-to-day practices, often at significant personal risk, to ensure continued exemplary care in the setting of limited resources and commensurate increasing clinical complexity ... Our CMF clinical teams, who have supported patient-care activities in the midst of ever changing guidelines and regulations, ensuring that patientcentered care is not compromised ... Our trainees, who have adapted to an evolving paradigm for individual and group instruction in the setting of limited person-to-person contact, reduced operative volumes, as well as unanticipated and altered clinical responsibilities ... Our families, for their continued sacrifices to allow us to care for others and the increased risks that providing such care brings into our homes ... The list goes on and on.

As we move forward as a community, the future remains uncertain. However, we can all remain optimistic and cultivate that optimism with gratitude toward our colleagues, friends, family, and communities at large.

With gratitude to our cranimaxillofacial community,