The Cost of Caring

Twenty-five years ago today, I was 6 months into being a social worker. I was in Ottawa attending training related to my job as a child protection worker. Like many people, I remember exactly where I was when I learned that planes had struck the World Trade Center. What I remember most, though, isn’t the television coverage. It’s the people.  

The person training me was from New York. Others in the room were too. As the day unfolded, people left to make phone calls, search for information, and try to understand whether their loved ones were safe. There was confusion, fear, and a sense that something fundamental had changed.   It felt like a new kind of fear had been introduced into our world. Until that moment, many of us had never considered that something like this could happen. Then suddenly it was on people’s doorsteps.  

That evening, downtown Ottawa felt like a ghost town. There was a strange uncertainty hanging in the air. Were we supposed to go about our day? Was it okay to walk around? Should we stay inside? Nobody seemed to know.  

Twenty-five years later, I find myself thinking less about where I was and more about who I was. I was at the beginning of a career that would expose me to some of the hardest parts of being human. At that point, I understood the helping part of the job. I understood wanting to make a difference. What I didn’t understand was the cost.  

Over the years, I spent much of my career in public service. I sat with people on some of the worst days of their lives. Sometimes I was there to support them through tragedy. Sometimes, as a child protection worker, I was part of decisions that made an already painful day even harder. Like many helping professionals, I entered the work focused on service, purpose, and helping. I didn’t spend much time thinking about what repeated exposure to trauma, grief, crisis, and loss might do to me.  

Twenty-five years ago, conversations about trauma exposure, secondary traumatic stress, moral injury, compassion fatigue, or burnout weren’t part of the culture in many of the systems where I worked. In fact, the opposite was often true.   Being stoic was valued. Being able to keep going no matter what was seen as a strength. The people who carried the heaviest loads without complaint were often admired. Sometimes exhaustion itself became a badge of honour—a sign that you were committed, dedicated, willing to do whatever was required.  

We didn’t spend much time talking about what happened after the crisis was over. We talked about the people we were serving. We talked about the work that needed to get done. We talked about being resilient. What we didn’t talk about was the impact.   The idea of routinely debriefing difficult experiences, processing what we had witnessed, or acknowledging how the work was changing us simply wasn’t on the radar in many helping professions. We were expected to move on to the next call, the next case, the next crisis.

Looking back, I don’t think the absence of those conversations was because people didn’t care. I think we simply didn’t understand as much as we do now. We hadn’t yet found language for what happens when human beings repeatedly bear witness to trauma, grief, loss, fear, and suffering.  

Today, I know that strength looks different than I once thought it did. Strength isn’t pretending something didn’t affect you. Strength is having the courage to acknowledge that it did.  

I think about first responders often. Firefighters, paramedics, police officers, emergency dispatchers, healthcare workers, social workers, and so many others choose professions where they know they will encounter suffering. Some run toward danger in ways that are visible. Others sit quietly across from people carrying unimaginable pain. The roles are different, but there is a shared experience in being repeatedly invited into the hardest moments of other people’s lives. We talk a lot about resilience in these professions. We talk less about accumulation.

The accumulation of stories.

The accumulation of images.

The accumulation of responsibility.

The accumulation of grief.

Much of it settles quietly in places we don’t notice until years later.  

If I could go back and talk to that young social worker sitting in a training room in Ottawa, I’m not sure what I would tell her. Part of me wonders whether I would have chosen some of the same jobs if I had fully understood their impact. I know I would have taken better care of myself. I know I would have paid more attention to the warning signs. I know I would have understood that caring for myself wasn’t separate from the work—it was part of the work.  

Today, as I reflect on the 25th anniversary of 9/11, I find myself holding many things at once.   I think about the lives lost that day and the families forever changed.   I think about the first responders who answered the call and the lasting impact that experience had on them.   I think about helpers everywhere who continue to show up when people are frightened, grieving, overwhelmed, or hurting.   And I think about what it means to be human in a world where difficult things happen.  

These days, my work allows me to sit with people as they make sense of their own histories and the ways their experiences continue to live in them. In many ways, I am doing for others what I have had to learn to do for myself: making space for the impact of what we’ve carried. Twenty-five years later, I think that’s what stays with me most. Not only how the world changed that day. But how experiences change us. And how important it is to acknowledge the impact of what we’ve witnessed, what we’ve survived, and what we’ve carried while caring for others.