This is what it's like working as an ER doctor in Canada right now
It's the calm before the storm — at least, that's what ER doctor Cathy Dorrington tells me.
Actually, she calls it "all dressed up with no place to go," which feels particularly poignant given the images circulating on social media of doctors clad in visors, masks, gowns and rubber gloves.
"I would say that our volumes are down," Dr. Dorrington says. "Somewhere around 30 per cent volume decrease."
That's not to say that ER doctors are kicking back and enjoying a box of Timbits in the staff room — there's still plenty of work to be done before the virus peaks.
This is not the time to relax our approach.— Tyler Shandro (@shandro) April 9, 2020
As Premier @jkenney said: "As hard as this will be, it is the only ethical choice when thousands of lives are still at stake." 5/5
In fact, Dorrington says that hospitals in Calgary are running multiple simulations where ER doctors practice capturing the airway of a patient with COVID-19, intubating them and resuscitating them — all while maintaining appropriate PPE.
Dorrington is no stranger to emergency situations. She's worked as an ER doctor for more than 20 years now, after earning her medical degree at McMaster University and then her FRCP. But even she is worried about what's coming.
"We've never encountered anything like this," she says. "Even though I've been doing emergency medicine for 21 years, we've never encountered the volumes that they tell us are going to come to us. We worried about it with SARS and MERS, but — particularly out West — we never saw it."
She has the skill set, Dorrington says, but not the experience.
And unless you've worked in disaster medicine or the military — particularly in a place that had mass casualties — then it's going to be an adjustment, she adds.
Fortunately, Canadian hospitals are using this time to prepare. Dorrington's emergency room is divided into two sections, and every patient is pre-screened before they get to triage. If a patient is showing COVID-19 symptoms, then they're kept in the second area until a doctor can evaluate them.
Similarly, only the patient is allowed into the ER. No family or friends, except in extenuating circumstances — the same policy that has been implemented across long-term care facilities in Alberta.
Strong outbreak measures are in place at continuing care facilities; 135 cases have been confirmed at these facilities. Family & friends can no longer visit these facilities unless a resident is dying or the visitor is essential for care that can't be delivered by staff. (6/7)— Dr. Deena Hinshaw (@CMOH_Alberta) April 7, 2020
Dorrington and her husband — also an ER doctor — even have a "decontamination" system set up at home.
"We change our clothes at the hospital and then when we get home, all of those clothes go into the washing machine," she says. "We shower. I want my house to feel like a clean zone and a safe zone, and if I have to kind of go overboard in order to make myself feel comfortable, then those things are harmless."
This is another side of Dorrington, you see; she's a mother with three teenage boys. And despite all of the safety precautions that she's taking to prevent bringing COVID-19 into the house on her clothes or skin, she worries that it might not be enough.
"You lie awake and you wonder, did I bring it into the house somehow?" Dorrington says. "Am I going to make dinner for my family and make them sick? Is hugging my kid-?" She pauses. "Have I still got some of the virus on me?"
"The intellectual part of me knows that that is exceedingly unlikely," she continues, "but it still does weigh on you."
Married doctors who are sleeping in separate rooms to avoid infecting each other and their children speak out about crisis: "It's hard to know where to draw the line, because I still feel like I could be infecting my kids. I still feel that I'm a risk every time I come home." pic.twitter.com/rdgra8mW02— CNN Tonight (@CNNTonight) March 28, 2020
Dorrington is upbeat, though. She tells me that she feels "lucky" not to have small children that lick everything they can get their hands on. She knows colleagues that have made the decision to move out of their houses, although she's not considering that herself.
"We try and balance what is logical and what is likely with the safety of our kids," she says.
We get on to the subject of PPE, and it's clear that Dorrington is well-versed in Canadian politics. She speaks eloquently about the 3M mask debacle and the Toronto nurse petition, and she admits that there is "uncertainty" around PPE.
"Do I think there's going to be a shortage?" Dorrington says. "We're told no, if we use it properly. But at the same time, it's hard not to be sceptical because everywhere that has encountered overwhelming numbers of COVID positive patients have run out."
At Dorrington's hospital, healthcare practitioners have their temperature taken and must answer screening questions about their health before they begin work.
Still, Dorrington says she goes through "mental gymnastics" over PPE — and it's not the only issue that's weighing on her mind.
She asks me if I've heard of imposter syndrome.
"A lot of physicians – and particularly female physicians – feel as though other people's expectations of what you're capable of exceed your own confidence in yourself," she explains.
Vancouver applauds our healthcare workers. Every day at 7pm. 💕 Thank you to everyone on the front lines. 👏#coronavirus #covid_19 #covıd19 #quarantine #quarantinelife #vancouver #yvr #canada #healthcare #healthcareworkers #healthcareprofessional pic.twitter.com/NYyJFPXlbO— Carolyn Rohaly (@CarolynRohaly) March 23, 2020
Firstly, because Dorrington fears that she might not be capable of dealing with 50 critically ill respiratory patients at the same time. And secondly, because Dorrington isn't actually seeing many COVID-19 patients yet.
"You would never wish that it gets busier," she tells me, "but in some ways, you feel like you want to justify people's accolades."
As we wrap up the interview, Dorrington chats about a free yoga app that she's trying and her running routine. She also wants to make it clear that these are her thoughts and opinions — not a statement from Health Canada.
"I'm not a COVID expert," Dorrington says. "This is how I feel as just a frontline doctor right now."
But Dorrington isn't "just" anything. She's a Canadian healthcare worker, helping to guide our country through a global pandemic. And — in my opinion — that makes her pretty special indeed.
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