You may have heard of PTSD before. This is more complex.

We health care workers were stretched to our very limits even in the best of times, and then COVID-19 happened. Now there are hundreds of thousands of people doing what needs to be done because if they dont, nobody will do it; because if they dont, people will die.
Maybe youre wading through the muck right now that feeling of I cant take off, I cant rest. That feeling of waking up in the middle of the night (or the day, if you work nights) sweating and shaking because you cant remember if you did that one thing right, and if you didnt do it right, it will have consequences, and theyre consequences that feel like life or death, that are life or death, and if it goes wrong, youll have to live with it. Somehow.
Full disclosure: I am a social worker, not a nurse or a doctor or a respiratory therapist. While the work I do has been affected by COVID-19, I do not work in an emergency room or an ICU. I have never held anyones hand as they died.
But I have, in the past, experienced work-related PTSD that completely changed the course of my life, and watching the events of the past several months unfold has made my heart twinge. Not just at the raw horror of what is happening every day when I wrote the first draft of this essay a few months ago, we were at 20,000 deaths, and every time I edit it, I change the number, and now weve just passed 240,000.
Now 20,000 seems almost small, but when I first wrote this, it was horrifying. People were crying daily and cheering for health care workers and thinking, surely it cant get much worse, and now we are at the point where people are assaulting minimum-wage workers for daring to ask them to wear a mask. People are protesting at the state Capitol every week in the state where I live, demanding their right to not only get sick but to infect everyone around them; armed right-wing militias threaten those who are outraged that a wallgets more justice than Breonna Taylor a slain EMT who was working double shifts during COVID-19.  
Even though these are deeply unfamiliar times, it all feels achingly similiar to my past bouts of PTSD. I worked until I couldnt. I worked until I broke. This bad thing happened, and everyone else took off, everyone else went home, and someone had to be there, so I stayed. This other bad thing happened, and I feared what would happen to the clients if I left, so I stayed. I felt like everything would fall apart if I didnt stay, so I stayed. I started smoking cigarettes again after 10 years abstinence. I physically could not feel joy anymore. Everywhere I looked, I saw potential traps, dangers, tidepools full of human misery.
With C-PTSD youre having a traumatic stress reaction, but the trauma is still happening. It continues to happen. Its not related to or caused by an isolated incident like a car accident or an assault. It just keeps going and going.
I remember first learning about complex PTSD, or C-PTSD, as opposed to regular PTSD: The difference is there is no post. With C-PTSD youre having a traumatic stress reaction, but the trauma is still happening. It continues to happen. Its not related to or caused by an isolated incident like a car accident or an assault. It just keeps going and going. Its in your family, your neighborhood, or your job. It hasnt ended and there is no guarantee that it ever will.
Theres that feeling: Maybe if I dont eat, dont take bathroom breaks, work doubles, I can save them. A lot of people get stuck here. You can do your job perfectly, or as close to perfectly as possible, with no one noticing, no one saying thank you. You can hold that strangers hand, sing to them, FaceTime their relatives so they can watch their loved one gasp for breath in restraints so they dont rip their breathing tube from their throat and it doesnt matter at all, because they still die. There is no controlling this. Its too big and too unfamiliar. Its too much.
To sit with someone at the moment of their death, or at one of the worst moments of their lives to hold that pain, and not to look away is a sacred act. It is a gift one with pointy edges, a gift that can, at any second, shred your hands, puncture a vein, open an artery. It is one of those tiger cubs that so enthralled most of America a few eternal months ago, the day after it stopped being cute and started to become a liability; the day its teeth grew sharp enough to remove a finger. It is a gift that is remarkably heavy; one that might begin to feel like a burden if you have to hold on to it long enough.
One tenet of my therapy practice now is that I absolutely refuse to let my clients trauma-shame themselves. The second that someone starts talking about their trauma and they veer into the Well, its not as bad as what happens to refugees or trafficked children or homeless people or… I interrupt them and say that it does not matter that they have the highest amount of suffering of anyone in the world. It matters that their trauma is causing them significant pain that they are struggling with. To paraphrase something I read on Twitter once: Someone who drowns in two feet of water is just as dead as someone who drowns in 20 feet of water.
I say that to somehow negate myself I know that the amount of suffering I witness at work is absolutely nothing compared to what health care workers in COVID-19 hotspots are witnessing right now. I also know how profoundly I suffered in the months and years during and after my own work-related trauma, which occurred in the faraway galaxies of 2014 and 2016; how much hard work I needed to do to become even remotely OK again, how I am still not OK, how I will probably never go back to how I was before (I was no stranger to trauma and brutal realities even then, but this particular one broke me). The idea of that multiplied by 100, by 1000, by 240,000 terrifies me, even though trauma is not quantitative like that. 
If you are alive and aware in 2020, its important to remember that you are doing the absolute best that you can in a completely insane situation.
Dear reader, if you are a front-line worker right now if you are half-scanning this after youve been awake for far too long, if you are finally in bed after a day that cannot even be put into words, a day that bled into a night that bled into another one in an endless stream of days, if you are looking at the internet to distract you before your sleeping pill kicks in Im here to remind you that you did not sign up for this. None of us signed up for the complete mess that is health care, housing and social services, just as our clients and patients did not sign up to have COVID-19, cancer, schizophrenia, addiction, or any of the other tragedies that befall us humans.
None of us signed up for the impossible choices we have to make each day. None of the nurses, doctors, cleaning crew, social workers, chaplains, EMTs, grocery store clerks, or security guards gazed into their crystal balls or communicated with their spirit guides or saw the answers spelled out in an unusually shaped cloud formation or got a text message from their psychic medium to predict this complete and utter disaster. Nobody signed up for the piles of bodies, the bodies in refrigerated trucks, the bodies in mass graves, the bodies that were once a human being that someone was once in charge of keeping alive.
If you are alive and aware in 2020, its important to remember that you are doing the absolute best that you can in a completely insane situation. Even if youve made mistakes. Even if you were just too tired sometimes. Even if you gave in to despair. Even if your coping methods look messy.
I am hoping that you live through this and, when it is over (whatever over may look like), you can integrate the memories into your body, you can transfer this energy back into our Earth, who is strong enough to hold it, and that you may once again know something like peace. I hope you are able to engage in some somatic exercises like humming, drumming, dancing or breathwork to let that stagnant pain out of your body, to remind you of safety. I hope, for you, safety is not an illusion. I hope you are able to fall into a restful and easy sleep and rise from bed to do the work you did sign up for: the work of helping people walk through the world with less pain.
Ocean Capewell currently lives in Sacramento, California, where she works in community mental health. She is the author of the queer punkhouse novel The Most Beautiful Rot and the zines High On Burning Photographs and Its Not The End Of the World!: Building A Life With Limp Wrists. Her writing has previously appeared in MRR and Autostraddle. She holds a B.A. in creative writing from SUNY Purchase and an M.S.W. from Humboldt State University. She is currently working on her second novel. For more from here, head to
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