Bonnie Larson is a community family physician who works at CUPS, in medical outreach across Calgary, and as the Lead for StreetCCRED, a University of Calgary O’Brien Institute for Public Health frontline collaborative that catalyzes care for Calgary’s most vulnerable.


 

Some of us may have fantasized from time to time about how luxurious it might be to be quarantined in our home for two weeks and not have to go to work. You might have even heard someone wish out loud for a minor car accident – one that only harms you enough so that you could have a week off to sleep (at a physician suicide-prevention workshop I was taught to look out for the colleague who quips this, with a laugh and poor eye contact; it’s a red flag).

Recently, I’ve heard physicians in Alberta thinking out loud about quitting, moving, closing up shop. Political agents have lately ruined relationships with health care workers and educators. Many of us have had the quarantine fantasy.

And now we are facing a pandemic.

Now we need civil servants to want to show up en force for the greater good. Yet it is known that it is extremely difficult to lean into contempt.

Our family had a pandemic wake-up call last week, which prompted my husband (an anesthesiologist) and I to invent a ‘personal pandemic plan’.  A family doc, I belong to a small community of practice that looks after several thousand homeless patients in our town.  We are striking a working group, because history and evidence have shown us that people who are homeless are at high risk for, well, everything under the sun, including a pandemic coronavirus.  Neither health nor social systems, which don’t play together nicely in the best of times, have pandemic preparedness policies and supports for shelters or folks who sleep outdoors, nor for their caregivers.

Fighting for health equity for my patients is not new to me.  What is new — and not in the least refreshing — is how antagonistic our provincial government has been towards physicians in the past months (our service agreement was unilaterally torn up by the government), with Alberta’s health minister actually vilifying family physicians in the media – the same people who will be expected to work tirelessly in the face of a looming pandemic.

We will step up without a doubt. Not for the money (there won’t be any extra), but for our patients, for the greater good, which is why we are physicians.  We took an oath to do this come hell or high water.   Recently our Premier stated that he thought physicians would not dare leave the province as some had said they would, because they would still make more money in Alberta than in most other places.  That comment was both laughably and dangerously obtuse.  Our Premier, who will ultimately call the shots during this unprecedented pandemic, thinks doctors do our jobs for the money and nothing else!  His comments made my blood run cold.  It’s not just that he sees business as being more important than other things, but that he thinks it is valued singularly.  Business interests over anything else, including human lives.  Even with federal funding for the pandemic response, the government has already completely alienated its health workforce and the health minister has lost all credibility with them.

We are a two-physician family with school aged children and aging parents in the very early days of a new viral pandemic.  We reside in a free land that, right now, seems to be governed by doctor-haters. I’m ashamed to admit it but a very loud voice in my heart and mind is telling me to close up shop and protect my family.  Be like everyone else and stock up, settle in with Netflix for a few weeks – or years – and let it all pass on by.

The reverie is short-lived however:  that is not me, it’s not us.  That is not what my husband nor I signed up for on our first day of medical school at McMaster University in 2003.  Today in our home we are out of TP but we have one “PPP” (Personal Pandemic Plan – we docs love acronyms) which is as follows:

  1. Keep the anesthesiologist in our family healthy for as long as possible;
  2. Show up for our patients (and staff) every single day we can;
  3. Do everything in our power to prevent virus transmission (this has, and will continue, to mean hours of extra unpaid clinical and committee work);
  4. Be available for any family or friends who need our help.

Our family, including our children, have agreed to these priorities even though it means (hopefully nothing more than) less socializing and somewhat more stressed parents.  Even children know that some things are worth the sacrifice.  Elected leaders should heed that lesson.

Tomorrow we will stock up on our child’s asthma medications (and maybe butter), and we will roll with it and know we may get sick at some point.  We will occasionally dream of rest and Netflix binges, but such fantasies will be fleeting.  The truth is that any doctor isolated, quarantined or otherwise sidelined, during a pandemic is in pure misery because they cannot satisfy their true calling.

Governments come and go but physicians in this country hold fast to their end of a social contract that includes a duty to care.  We won’t, because doctors generally don’t, go down without one hell of a fight.