Confusion, fear on frontlines
Doctors say they are afraid of the ‘war’ to come
Last week, Dr. Laurie Mazurik, one of Toronto’s most experienced emergency physicians, sent a note to her colleagues and residents from a friend working at a hospital in Italy. Mazurik was trying to give her colleagues, especially the younger ones, a sense of what was coming here.
“Yesterday I had my night (in the sub-Intensive Care Unit) and it was terrible,” her friend wrote. “I sent three young men to (Intensive Care) and they’re dying now.” She had another two who needed critical care, but had nowhere to send them. “How long can we go like this?” her friend wrote. “I’m not even 30 and I couldn’t physically stand it. It’s a war. I feel like time is pushing me to grow up faster, but I’m not ready at all.”
Across Canada, emergency physicians and other frontline health-care workers are preparing for an onslaught unlike anything almost any of them have ever faced. At home, they are making decisions about who will care for their kids if they get sick. At work, they are thinking through how to ration care if their wards get overrun. And they are doing all that unsure, in many cases, if they have enough of the right equipment to keep themselves safe.
Over the past week, the National Post has spoken to more than a dozen emergency medicine physicians about what they’re seeing, what they need and how they’re feeling. What came across from some of them was something you rarely hear from doctors: fear.
They’re afraid of what’s to come. They’re afraid that too many Canadians still don’t get it. They’re afraid for their patients, for their families and for themselves. And they don’t always see that same level of fear reflected out in the world.
On Monday, the Post spoke to three Canadian doctors about the situation right now, where they are. Each reflected a mix of anxiety, determination, and frustration about poor communication and equipment shortages.
Their comments have been edited for clarity, space and grammar. Here are their words:
❚ Dr. David Carr practises emergency medicine in Toronto:
As physicians, our job in society is to remain calm and manage expectations and we’re stretched at this point. I’m doing everything I can to keep being that pillar of support for my community. But when a neighbour walks up and says, ‘how are you doing?’ I don’t even know how to answer. Because it’s fake to say ‘Well’ or ‘Great.’ It’s not great. It will be great when this is over. It will be great when we can reflect on lessons learned and be prepared for the next wave. But right now a lot of nurses and physicians are scared.
I love my job. I’m the most passionate emergency physician you’ll meet. Do I love being an emergency doctor right now? No. It’s frightening. I’m not embarrassed to say that. We’ve all seen patients with meningitis, tuberculosis, necrotizing fasciitis, diseases that are highly infectious. And none of us had ever been scared. This is a new kind of wave.
For the most part, my generation, 40-something-yearold emergency physicians, our kids are young and they’ll be OK. What we’re worried about is who looks after them if we’re not well. We can’t conceptualize the possibility where we get sick and we can’t look after our kids.
We believe that what we’re doing is right, but we just want to make sure that we have the supplies to do it. I need to make sure that I have the equipment to keep myself and my family safe and my patients safe. I don’t really care who’s in power. It just has to be more than promises that we have equipment. I need to know that I don’t have to ration equipment. We see in the United States, on social media, is people using garbage bags as masks. We’re afraid that could happen to us provincially, that we won’t have supplies. That’s the big fear.
❚ Alan Drummond is a family doctor in Perth, Ont., and co-chair, public affairs, for the Canadian Association of Emergency Physicians:
I think most of emergency workers feel let down by government. I think they feel let down by Public Health because we’re being rationed with equipment and we’re getting mixed messaging on a weekly basis. It’s like, do they really understand this? We get it. But nobody else seems to get it. So we’re hurrying around like rabbits trying to get our stuff together and we’re dragging government along with us.
The government has been extremely slow to understand the potential for this thing. Their response initially has been desultory, incremental, reactive — just little dribs and drabs of information as we come along. And I think that that’s really upset a lot of emergency physicians and nurses. Here we are in our own worlds knowing what this could look like and we have a government that’s serving pablum to the masses, trying not to provoke mass panic. But that isn’t helpful preparing for a natural disaster. It’s been leadership by news conference, which is not great.
There is some concern and anxiety, obviously, about exposure to the virus and, bringing the virus home to loved ones. So I think that’s a common theme that we’re hearing. It’s certainly not panic. There may be, certainly, some anxiety. There may be, in some circles, some level of fear, but you know what? We have no choice. We know we’ve got a little lead time and you can spend your time fretting and being anxious and wondering why you didn’t become a lawyer. But none of that’s going to be very helpful. This is the job that we’ve picked. This is a job that we’re in. It’s truly an essential service and we’re just going to have to do our job.
Dr. Laurie Mazurik practises emergency medicine in Toronto:
Everywhere people are increasingly aware of shortages. And what none of us know is exactly when our (Personal Protective Equipment) supply is going to run out. On the U.S. emergency medicine forums there is a lot of DIY tactivity. People are trying to figure out how they can make their own homemade masks. And some aspects of those may have merit but they need to be scientifically guided.
I think that the federal government should almost create a declaration of war on this virus and treat it like that and do whatever measures that come with that to get industry to make the equipment that is required to protect the front line healthcare providers. And if there are people that have been stockpiling we should find out who they are and secure those supplies so we can distribute them to the hospitals that may be affected sooner.
Those who don’t have the SARS experience definitely at the outset of this were not worried at all. Not even worried when they saw Italy. I think they only started to realize when it hit North America that maybe this was a threat. But now I think what they feel is that they haven’t had enough people talk to them about what’s coming. They don’t know what to expect and now their morale is really dropping. They don’t know how they’re going to be utilized in the fight. They don’t know what to expect because they’re young and they really don’t have these kinds of life-changing experiences. Although, I think they are going to go through one now. I think what they’re starting to realize is the impact of something like this on their whole framework in life going forward.
IT WILL BE GREAT (ONLY) WHEN WE CAN REFLECT ON LESSONS LEARNED.