• A California doctor questioned why his compassion for patients was waning after hesitating when faced with a seriously ill man covered in Nazi tattoos.
• The experience stuck with him, and he realized that the pandemic, hoax rhetoric, and insensitivity is taking its toll on healthcare workers.
• Dr. Taylor Nichols talked to Insider about what those on the front lines can do to check in on their own mental health and continue to provide the best care they can.
• Visit Insider's homepage for more stories.

Dr. Taylor Nichols joined the emergency department staff at Mercy San Juan Medical Center in March, at the beginning of the COVID-19 outbreak in the US.

Nine months into the tiresome pandemic, the weight of all — the lost lives, the conspiracy theories, the lack of compassion for each other — is taking its toll on healthcare workers in more ways than one, he told Insider.

When Nichols was faced with another seriously ill COVID-19 patient at the Sacramento, California, hospital last month, staff helped change the man into a hospital gown, preparing him to be incubated.

The team noticed several Nazi tattoos on the man's body, and they caused Nichols to pause in his tracks.

The patient begged the team — comprised of Jewish, Black, and Asian healthcare workers — not to let him die.

"I see the SS tattoo and think about what he might think about having Jewish physician taking care of him now, or how much he would have cared about my life if the roles were reversed," Nichols wrote in a Twitter thread about his experience.

This wasn't the first time that Nichols had had to treat a patient with Nazi tattoos, nor was it the first time he was faced with someone so seriously ill, but it was the first time he hesitated, the doctor told Insider this week.

In the past, when faced with a patient who might have been hateful, he was able to hold himself together.

"They came here needing a doctor, and dammit Taylor, you're a doctor," he said he'd tell himself in similar situations.

But this experience was different. It was harder to look past the messages of hate permanently seared on the body of a patient he was trying to keep alive.

Provided by Taylor Nichols

'You felt like people just didn't care as much about us'

The encounter stuck with him for weeks. He thought about the man, and questioned whether his own empathy toward his patients was wearing thin.

"I sort of laid awake in the morning unable to sleep, and I was thinking a bit about what had happened," Taylor told Insider. "I had this thought, that this pandemic has really worn on me. This moment with this patient struck me so deeply because it was a real representation of sort of what it felt like to be on the front lines at that moment, where you felt like people just didn't care as much about us."

It's not just dealing with a wave of patients that's making life difficult for healthcare workers, as their job is always hard and in the emergency department it's always busy.

This pandemic, though, has changed the demeanor of how people are interacting with each other, Taylor said.

Some patients think COVID-19 is a hoax. Some aren't treating others with the same compassion that healthcare workers fight each day to show those in their care.

When Taylor realized that it was the culmination of all those feelings that made it difficult carry on that day last month, he took to Twitter to share his thoughts.

He didn't know the thread would go viral, but hoped that sharing his story might prompt people to take a pause and be more considerate to those around them.

"To reach into their compassion and consider their fellow neighbors and the frontline workers who are working hard to stay wise," he said.

Healthcare workers have to carry on fighting a deadly virus that some don't believe is real

Nichols said he feels lucky to live and work in a diverse community where, for the most part, people are taking the virus seriously, wearing masks, and being conscious not to spread COVID-19.

There are, though, conversations "in the public sphere" in which people deny that that the coronavirus is a threat and refuse to abide by safety measures.

That kind of disinformation is dangerous, and it's weighing on the mental health of those on the front lines, he said.

At least 19,447 people in California have died from the coronavirus, according to Johns Hopkins University.

"Having people, you know, really not listening, not taking precautions, not caring beyond wherever their own sort of disinformation has guided them: It's really hard to hear, knowing that we're doing our best," Nichols said. "We're really seeing the effect of this. To have people denying it is really disheartening and makes it just a little bit harder to do what we do, makes us all just a little bit more stressed or broken."

MARK FELIX/AFP via Getty Images

Nichols said healthcare workers are left trying to dig deep to continue to provide that same compassionate care all the time.

During normal times, hospital workers have outlets outside of work that they lean on to stay healthy. During the pandemic, though, they have been mostly limited to work and home, he said.

Nichols said people on the front lines need to make sure they monitor the signs of when they might need a break or help, no matter how that manifests.

Being able to share his experiences with people at work and online has been helpful to Nichols. So has being able to ask for time away.

"I think it's really important for folks who are on the front lines, who are stressed by this, and are feeling that maybe their well of compassion is running a little bit low, to lean on their colleagues and work family," he said. "That has been so important to me, to be able to ask to take some time off, or ask people to cover for you."

Now, it's even more important to lean on loved ones and their "work family" when times get tough, he said.

"As physicians, as healthcare workers, we don't like to talk about what we see, or how we feel, or how we feel about what we see. And in more normal times, it's easier to go though your day to day without the stress, without feeling the need to put that out there," Nichols said. "In other times, when we're not affected by a pandemic, we don't need people to sort of hear us and consider us the way we do now."

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