Alberta ICU doctor fighting the good fight
Physician shares stories of life and death hidden behind hospital walls
EDMONTON—The woman takes her last breath as she is pulled off the stretcher.
She is rushed into the acute care area at the Royal Alexandra Hospital in Edmonton due to complications from COVID-19, while a medical team that specializes in treating people who are experiencing cardiopulmonary arrest springs into action.
Her oxygen levels are low. The responders use epinephrine, or adrenalin, to get the woman’s heart pumping. But it’s not looking good.
Dr. Darren Markland, a nephrologist and physician in the intensive care unit, happens upon the scene. He can tell by the colour of the woman’s lips it won’t end well. An emergency room doctor looks at him pleadingly.
“She’s looking at me like, OK, we need to send (this patient) to the ICU. And I know that it’s futile. I know that no matter what we do up there, it’s not going to work,” Markland said, because at that point she cannot be oxygenated.
“I don’t have enough beds. Even if it was a long shot I would do it, I would do it for the family because dying in the emergency department is horrific. But now I don’t have that (luxury).”
These are the stories that stick with Markland, and that are becoming increasingly common as Alberta grapples with a vicious fourth wave that many medical professionals have called preventable, if not for low vaccination rates compared to the rest of the country and inadequate public health measures over the summer.
Alberta currently has the highest case count in the country with 10,974 cases over the past seven days as of Sept. 16, more than double the number of Ontario. It has the second lowest vaccination rate among the provinces after Saskatchewan, with 60.52 per cent of Albertans being fully immunized. On Friday, the province announced 2,020 new cases and 18 deaths reported over the past 24 hours.
There are 911 people in hospital due to COVID-19.
The situation is so dire in Alberta that officials have warned the skyrocketing cases could overwhelm the province’s intensive care units and cause the provincial health agency to implement a triage protocol, which would prioritize who receives critical care based on their chance for survival.
This week, Premier Jason Kenney declared a state of public health emergency and announced new public health restrictions, including the introduction of vaccine passports, which he was previously opposed to.
Markland, who has worked in the ICU for some 20 years, previously split his time in hospital and his own kidney practice. This week, he announced he’d be closing his practice to help boost physician staff levels in the ICU.
The doctor has gained a following on Twitter by sharing his thoughts on the pandemic and the harrowing stories of life and death that are mostly hidden behind hospital walls. It’s the details, rather than the interventions themselves, that stick with him.
In the case of the woman who didn’t make it to the ICU, Markland would later learn that she was a single mother of three who between school closures and night shifts likely just did not have the time to get vaccinated.
The woman had been sick for several days when she called 911, sounding desperate and confused. When the paramedics arrived, they found a home in disarray, with the woman slumped over a sink and her child trying to give her a glass of water. The lunches she made for her kids that day were still sitting on the kitchen counter.
There was the young man connected to a ventilator, saying he couldn’t breathe and insisting it was a bad reaction to the antibiotics he’d received.
When Markland said no, it’s COVID, and it’s really bad, the man spat the words “f--- you” at the doctor as tears streamed down his face.
He then pleaded for his mom. “That’s just another example that re-establishes the humanity of the situation. This man is looking for support from anywhere he can get it … these are humans. I don’t think anybody’s malevolent. There’s a very small fraction of people who politicize this for their gain,” Markland said.
“The rest of them have just been taken along a dream that took them down the wrong road.”
More and more, Markland is seeing people in the ICU who deny the existence of COVID, or don’t take it seriously.
“This is unique to the fourth wave,” Markland said. “We’re seeing that anyone who had a moderate opinion about this has gotten vaccinated, so they’re not part of this population … these people coming in honestly believe that COVID” is a hoax.
“What we’re seeing here in Alberta is that we have a lot of rural populations, which are very strong and independent cultures unto themselves, they’re great communities. These people go for coffee together, they know each other, but they also share a common delusion that COVID isn’t really a big deal.”
That delusion manifests as a mix of anger and fear when he is treating these patients in the ICU. Getting yelled at is a regular occurrence.
“Never did I think people would be mad at me (for doing my job) … what I do, inherently, is just believe that they got it wrong,” Markland said. “And once they get through it, they can get it right and maybe bring some other people along on the journey.”
He feels a mix of disappointment and frustration every time he hears of an unvaccinated patient in need of intensive care, but when he looks into a patient’s eyes, all he wants to do is help. Because he also understands their anger.
“This is a disease of misinformation and lack of critical thinking and poor political leadership,” Markland said. “This is the base that was lied to and told the summer this is going to be the best summer ever.”
It comes with a feeling of helplessness — no matter how hard he tries in the ICU, he feels powerless to fight the political decisions he says have led Alberta to this point.
“I’m standing on the train tracks screaming at the train and not seeing it slow down,” Markland said.
So the doctor works diligently, completing his 12-hour shifts while battling exhaustion and frustration. And yet he still finds time to write his emotional Twitter threads, which he says are “absolutely essential” in the battle against COVID-19.
“My biggest crisis of faith right now is wondering if I can actually reach the people who have already made up their minds,” Markland said.
“Without truth telling, we’re not going to fix it. This is going to go on for a long time unless people truly believe that this is a problem.”