Something med school did not cover...
Today's blog post requires very little in the way of introduction other than to say the Emergency Room doctor that wrote it is an inspiration. Lindsay Bisset describes what the pandemic has been like for her on the front lines. These stories are sometimes difficult to hear and read, but I never get tired of them. Lindsays' truth and poignancy is needed as a beacon in a sea of mis-information. Starting with a Taylor Swift lyric doesn't hurt either...
Something med school
Did not cover
Holds your hand through plastic now
Doc, I think she's crashin' out
And some things you just can't speak about
Taylor Swift, Epiphany
It has been a long year.
My career in emergency medicine has had many times given me experiences I can't speak about. Paediatric deaths. Devastating diagnosis. Failing to save someone whom you love. But those are things I knew I would eventually encounter. This…this was different.
As with most of my colleagues, I had been following the developments of a novel virus in China since late 2019. When Canada declared its first case, I spent the entire day on twitter on January 27th, trying to wrap my head around what was to come.
In March everything changed. The roads were empty no matter what time I went to the hospital. The parking lot and halls were vacant. My constant was the smell of sanitizer and caviwipes and my mask. Teams of doctors, nurses, and respiratory therapists practiced and practiced simulations of caring for the sickest patients so that we could without risking exposure to ourselves or our teams. Our resuscitation rooms went from the organized chaos of too many people, to just three dedicated staff as the rest of the team communicated to us by baby monitors through glass like in a fishbowl.
Medical school did not prepare me for this new normal. This incredible loneliness and isolation as we delivered health care. In the Emergency rooms death and tragedy are part of the package but never have we had to work with patients and families in essentially solitary confinement.
Young or old. Healthy or frail. When they end up in one of our negative pressure, resuscitation rooms, breathless and scared, we know that intubation is the only thing to help. We also know that many will not survive regardless. We help them gather their last thoughts. Communicate with tearful families over iPads for hasty goodbyes. You don’t forget someone’s eye looking at you as they let you know they are ready. Ready for a medically induced coma that they may never wake up from.
I know that this loneliness and isolation is something that COVID has touched everyone with. The lockdown made us keenly aware of our need for socialization and how we all had taken it for granted. This virus thrives on this need for social interaction and with the sharpest irony, this same need to be with people is what will cause more people to die in isolation. As an extra layer of sneakiness, COVID is very contagious before you have symptoms. So this is the mental challenge: as cases rise we need to convince everyone that increasing their bubble of close contacts beyond their immediate household, is in fact very, very dangerous. In our COVID assessment center, extended families are shocked to find out that they have given it to each other at a small wedding. Disbelief is the response for many when we call them with a positive test result. Because therein lies the rub: just because we long for days where we can see other humans without masks and a 2 meters distance, just because this loneliness is very, very hard, we cannot bend the rules just because it seems kinder to our children, or friends, our parents, or ourselves.
COVID is NOT over. At best it’s half time. You don’t call it a win at half time no matter the score.
It’s been a long year. We are not finished. We mightn’t even be at half-time. Wear a mask. Minimize your social contact. Get your flu shot. Stay home if you feel sick.
We are in this together.
Lindsay Bisset MD CCFP-EM