I feel as if two cultures are competing for our attention. As a physician, it can seem like I'm living in two starkly different worlds.

The first world I see around me is one where people are tired after a couple of years of uncertainty and working to hold their heads above water. They avoid talking about COVID-19 and focus on the positive. They're in emotional survival mode.

The second world I see around me is a world of continued suffering and pain in the hospitals and a feeling by those who are faced with it directly that their suffering is not recognized. Years of uncertainty and feeling that things were at rock bottom have been followed by showing up to find the bottom has been newly redefined and is much lower than it was before.

Don't let those who are serving humanity in this stark time struggle alone. This Christmas, please do something extra to show our awesome heroes in medicine that you see them.

The nurses and techs and doctors scream out, "Look at this! Help us!" and our culture doesn't have the ability to do that. People looked about a year and a half ago, they briefly admired the heroes in medicine, then they got tired. Their struggles were overwhelming too; they had to find a way to move past it because they needed some sort of happiness in their lives.

It's hard to truly see what is going on and also to feel happiness and to laugh real laughter.

When bad things happen, like death of our known culture and years of mitigating a crappy pandemic, we are still allowed to feel happiness during our grief and bereavement over what we lost. Our happiness with other parts of our life does not devalue the profound nature of the sadness over what we are all going through. We can't ignore the ones who are carrying the load just because their message is a painful reminder.

The medical world is screaming louder than ever. CEOs of competing medical systems banded together to take out an ad in the Star Tribune with polarizingly bold and simple wording, because it's the truth. This is very uncharacteristic, and shows how isolated medical professionals are feeling. They're crying out for help.

In normal years, the ER team doesn't end up with a basket of holiday treats and cards from the patients they helped. That's an accepted part of being in the ER — you save lives, but given the nature of the drama and suffering that patients and families go through on the day of survival, it can be hard to connect gratefulness and thanks with the ER crew even though they saved a life.

Emergency medicine specialists must be able to acknowledge their own successes and let that be enough. Right now, with the pain that they're carrying, self-satisfaction for the positive effect they have on the world isn't always sufficient.

Has an ER crew helped you or your family?

Don't let these amazing human beings struggle alone. Show them you hear them, and keep your happiness too. Tell the ER folks in a card or a letter: "We got vaccinated and we appreciate you." Tell them: "We got COVID tests before our holiday party and are thinking of you this year while we are celebrating." Tell them: "My family was in the ER and you were busy, the wait was long, but you kept them alive and did what you could and we know it's tough right now."

Tell them you're wearing your mask to the grocery store, that you don't go out if you're feeling sick, that you are listening and aware. E-mail your doctor and your nurses to say thanks. It will not fall on deaf ears, and may be the first thanks they've heard in a while while they're putting on their scrubs and their N95 for another day in the hospital.

Erin Meyers, of St. Paul, is a physician of emergency medicine.