During one unseen moment in the pandemic, an ICU nurse walked out of a hospital at midnight, saw a baby rabbit shivering on the sidewalk and stood still. She had spent her shift with three young men who were struggling to breathe when they arrived at the hospital, and she didn’t know if they would survive.
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She stared at that rabbit, unsure what to do.
“I finally gently nudge it under a nearby bush and hope it stays sheltered. I hope. I hope. I reach my car and realize I’m crying. This is the first time I’ve cried in months,” she later wrote. “I find I am not alone in this; I tell my co-worker about the rabbit. He nods and says, ‘It was the Christmas dishes for me. I dropped a box of them moving and just broke down.’ Another nurse adds, ‘I cried over burnt chocolate chip cookies, and I don’t even like chocolate chip cookies.’”
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That piece of writing and hundreds of other powerful pandemic confessions from health-care workers exist because of a project a Washington-area psychoanalyst launched a year ago and saw grow into something she never expected. What started as a way to help a few D.C.-area medical professionals process pandemic pain and loss is now reaching health-care workers, refugees and others across the world.
“I’ve been blown away,” Kerry Malawista says when we speak about the project. “I’m glad I took the chance and just did it.”
The idea for the project came to Malawista a year into the pandemic. At the time, through her therapy practice, she was hearing from people across the Washington region who were stressed, exhausted and struggling with grief and loss. One of those people was an ICU doctor.
During a Zoom therapy session, Malawista listened as the doctor described with horror how she couldn’t help a 28-year-old woman breathe and watched her die. Malawista doesn’t normally assign homework to patients, but that day, she offered the doctor a suggestion: What if she tried writing about her experience?
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Nothing could have come of that moment. The doctor could have avoided that additional work, or she could have done it and found it made her grief no more bearable. But a few weeks later, as Malawista tells it, she listened as that doctor described finding “meaning and solace in the act of putting words to all that she experienced.” She then heard a similar response from another client, an ICU nurse who spoke of feeling numb before she started searching for the words to describe what she had witnessed.
Malawista knew from her own experience how writing could help a person process grief. She wrote an entire memoir about a personal loss before deciding it would be too painful to publish and that she would rather, at least for a while, keep those words to herself. That experience and hearing from those two health-care workers were enough for her to come up with the idea of creating online writing groups, led by therapists and writers, for front-line workers in the medical field.
She ran the idea by her husband, and then she sent an email about it to members of the D.C.-based New Directions in Writing program, which is part of the Washington Baltimore Center for Psychoanalysis. The program, which Malawista co-chairs, has a membership that consists of therapists and writers, and within a day, more than 100 of them expressed interest in leading sessions. Within a week, the number of volunteers grew to 120.
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The participants came quickly after that. Malawista created a website, and health-care workers in the D.C. area started to sign up for sessions. Then, she says, she started hearing from people at medical centers outside the region who were saying, “Our doctors need this. Our nurses need this. Our aides need this.”
So far, more than 700 people have participated in the free writing project. They have come from across the United States, as well as Africa, Brazil, Mexico and Pakistan.
Each group consists of a therapist, a writer and fewer than six participants. The groups meet at least three times and in those sessions talk, write and share their work with one another.
“What gives you comfort?” is the writing prompt they encounter during their first meeting. The questions then get more difficult with each gathering, prompting participants to search their minds for the kinds of moments that haunt them.
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“Somewhere out there his family has no idea that the man they kissed goodbye this morning is now gone,” wrote a participant of a man she had promised she wouldn’t let die. “I picture them, going about their daily lives, unaware that those lives are now forever changed. For now, I am the keeper of this terrible knowledge. The ghosts appear: those hundreds of people whose lives have intersected mine in these moments, these life-altering, terrible moments. And I know I just can’t absorb any more.”
Museum curators know that there is an art to archiving the emotions of a moment. They have to carefully consider what signs left over from a protest capture the tone of it. They have to sift through the gifts that arrive after horrific events such as mass killings or natural disasters and pick the ones that will later tell a generation how people mourned. In that same way, the pieces of writing that have come from the project are an invaluable archive of grief and loss as told by those who experienced the most of it during the pandemic: health-care workers.
But what makes the project more than a unique archive are what those pain-filled account also offer: healing.
Malawista named the effort “The Things They Carry Project” as a nod to Tim O’Brien’s novel about the Vietnam War because she noticed how the pandemic was causing health-care workers to experience similar symptoms as soldiers who had gone to war: anxiety, panic attacks, depression, irritability and exhaustion. And she has since seen participants describe writing as helping ease those symptoms.
“The impact of the project on the lives of participants was far more powerful than imagined,” Malawista wrote recently about the project. “Paradoxically, while our participants recalled painful experiences and feelings — guilt, anxiety, dread, grief, fear and longing- — they also related feeling more enthusiastic at work, with less fatigue, less burnout, and a greater sense of meaning. Processing trauma through writing and reflecting allowed them some control over what happened. Sharing within a group provided the support and validation that they are not alone, and it gave them the opportunity to laugh and cry together. Rather than feeling isolated, writing connected them with others.”
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I first heard about the project while speaking to an ICU doctor about her continued efforts to get people vaccinated. She shared with me the writings she had produced during her group sessions. But in talking with Malawista, it’s easy to see how such a simple format — people coming together to write about personal and collective trauma — could be used to help individuals who might not otherwise have easy access to mental health care.
In D.C., children are growing up surrounded by gun violence and there aren’t many therapists in the field who share their experience. I told you in a previous column about a former football player who is trying to become a therapist to change that. But he is only one person.
A football player couldn’t find a therapist who understood Black, urban trauma. So, he decided to become one.
Malawista is also working with a group of people who want to create writing sessions for women in Bangladesh who are refugees from Afghanistan.
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“People of every age, every race, every level of education have participated, and it doesn’t matter at all,” she says. “They’ve all experienced the same things, and that’s what makes the difference.”
The project started with Malawista speaking online with a D.C. doctor, and on a Sunday later this month, it will again find her at her computer.
That morning, she will wake up, log on to Zoom by 7 a.m. and hold a group writing session. On her screen will appear a doctor from Alabama, a nurse from Tennessee, a pharmacist from North Carolina, a hospice worker from Texas and two medical providers from Africa.