By Whitney Dillon, Western Communications
Editor’s note: Visit the official Western COVID-19 website for the latest campus updates.
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It’s hard to drive to work every day not knowing what I will see.
Watching people out in their cars, coming out of stores with large carts full and talking with their neighbours – all within arm’s length of each other. That’s hard to see.
Please stay home. Because I don’t have the option.
To describe a day in the life of a doctor on the front lines of COVID-19, it helps to contrast this to a day in the life of a rural family doctor just one month ago.
Like many physicians, I decided on a career in medicine – more specifically family medicine – because I like to get to know my patients, helping them through happy and tough times. I like to work collaboratively with my team of nurses, dieticians, social workers and medical assistants to manage the health and wellbeing of my patients.
A typical day could include meeting a 2-day-old newborn, supporting a grieving spouse, making a house call to a patient over lunch, removing small skin cancers or helping to coordinate care for my complex patients.
Then March 2020 happened.
This should have happened in January, but it did not. As rumours and case reports came in after the New Year about this ‘coronavirus,’ the Western world, in general, saw it as a regional outbreak in one province in China.
But we are social beings (as everyone currently in social isolation laments) and we have the means to travel worldwide. Unfortunately, the virus traveled with us.
It became alarmingly clear we had a rapidly evolving epidemic – soon declared a pandemic on March 11. My family practice doors were then locked. The usually bustling waiting room had a deadly silence. Patients were knocking on the door, trying to understand how all of this had changed so quickly.
Today, a typical day for me evolves in one of two ways.
The first scenario sees me get up early and make a list of changes that need to occur at the office to keep up to date on precautions and protections. At my clinic, I manage cases via phone and video – no more in-person interactions.
There are a small number of my patients for whom this is not a possibility. They are escorted to my office wearing a mask and I greet them with a gown, mask, gloves and face shield to protect them and minimize the risk of potentially passing an illness from one patient onto another.
It’s a sad situation that brings anxiety and fear to my patients – the complete opposite of my intended goal of providing them reassurance.
The second scenario has me working at our COVID-19 assessment centres in the Niagara Region.
This is medicine like I’ve never practiced before. Patients are called in from their cars, one person at a time and with no accompanying family allowed. They are quickly masked, gloved and led into a sterile room. Again, I greet them in a gown, face shield, surgical mask and gloves.
They are quickly checked for fever or high pulse and, if stable, I proceed to stick a long, uncomfortable swab into their nose and down to top of their throat. This can cause sputtering and gagging which creates droplets.
On my first day, I had a new gown, mask and gloves to wear for each patient I saw. By the end of the week, our supply had dwindled and I was given just two surgical masks for my entire shift of close to 50 patients. There had been a looming worry about inevitable shortages of crucial personal protective equipment, but I was seeing it evolve first-hand in my hospital system, which services a community of 800,000 patients.
In a matter of a month, I went from doing things I felt confident in doing for my patients, to being emailed a list of skills I haven’t done since my training a decade ago and being asked to indicate one of three options next to each skill on the list – can do independently, needs phone assistance, needs in-hospital help.
There was not a column for ‘cannot perform’ for things that included running a ventilator or managing a patient in the intensive care unit on life support.
I could be deployed anywhere in my hospital system and community to do a variety of roles, most of which I never have, or have not recently had, to perform. The College of Physicians and Surgeons of Ontario has told me I could be asked to help elsewhere in the province – or even the country. There is a lot of uncertainty and that can create anxiety for me.
I come from a close-knit family. I have a young nephew and a baby niece. I haven’t seen them in over a month – and I won’t be able to for the foreseeable future as we continue to self-isolate. I had to say goodbye and good luck on FaceTime as my dad went in for his cancer surgery – alone.
My family is respecting the importance of self-solation; they know I don’t have the option.
I want to keep people safe, but I’m running out of equipment. I’m emotionally drained with worries for my patients, my family and myself and I have to be available for those chatting neighbours when they inevitably get sick.
Again, please stay home.
Dr. Whitney Dillon, BSc’08, is a family physician in Virgil, Ont., located in the Niagara region. She also practices palliative care and is currently working on the front lines at her local COVID-19 assessment centres. She lives with her husband, Geoff, BSC ’10 (Biology and Economics), who has converted his distillery from making gin and vodka to making hand sanitizer free to front-line workers in healthcare and beyond.