Laura Sang is a first year family medicine resident at McGill University.
“Do you have a cough, fever, sore throat, or have you traveled outside of Canada in the last 14 days?” has become the new greeting that replaces “hello” when I first get to the hospital. We silently queue one by one as the masked security guards ask the same questions to everyone and enforce mandatory hand sanitization. All visitors, non-healthcare workers, and anyone with symptoms are turned away immediately. With a flash of my badge and a dollop of hand sanitizer in hand, I’m allowed to begin my work day.
The hospital is alive, almost like normal, but so far from it. The entire atmosphere feels like the holding room before the start of a big exam, except the exam never comes and we hide our unabated anxiety with nervous laughter. I see the worried looks on people’s faces, the noticeably empty hallways, shortened cafeteria hours. All food and drink is now prepared behind the counter as an infection control measure. Chairs in waiting rooms and eating areas are taped off or removed to enforce social distancing. These tiny differences make a place that once felt like home feel almost unrecognizable. Colleagues pass each other in the corridors, coffee in hand. They smile and chat but don’t shake hands or hug like they used to. Meetings and case reviews happen from across the table and you don’t dare touch your supervisor’s mouse to show them a lab result. Not anymore. It’s hard to keep up with the never-ending string of emails about covid this, covid that, at all hours of the day. We are constantly receiving new guidelines on how to go about our practice. Family medicine consultations are mostly done by phone now. I mail my patients their lab reqs and try to avoid sending them for any non-urgent testing for the foreseeable future. All gonorrhea/chlamydia testing must be done by urine now so the swabs can be reserved for covid testing.
On the wards for now we are in the calm before the storm. The rest of medicine however continues to surge on. There are still people coming in with heart attacks, strokes, kidney infections, and everything else. But now every fever, every cough, every sneeze ignites collective anxiety. Treat everyone as possibly infected until proven otherwise. On the way down the hall I pass several rooms with patients on precautions (meaning healthcare workers must wear gloves, gowns, face shields, etc., to enter). Sign-in sheets are taped to the doors to keep track of who goes in and out. These measures are in place until test results comes back. I feel occasional guilt for using gloves to examine patients not on precaution because I do not know if we will run out of them in the future. Masks are already running low.
In hushed tones behind closed doors we discuss, we plan, and prepare. Seminars are given on how to swab people. Powerpoint slide decks and other learning resources are shared. I’m still learning how to manage patients who are in a critical condition so I’m privy to discussions of the next steps in care as the disease unfolds. I’ve even heard theoretical discussions on how we can hook up two people to a ventilator at once – just in case.
I struggle daily to balance the requirement of social distancing and maintaining sanity. Do I see my partner or am I putting him at risk? Do I go to the pharmacy to get a few creature comforts to help me cope at home although they are non-essential items, or am I being selfish? I am graced with the support of family and friends who call and check in regularly. Yet when you spend your whole day seeing everything firsthand and you don’t get a break, you just want someone physically there with you. That human presence that everyone craves when receiving comfort. But you can’t. In times of sleep deprivation the anxiety takes over and worst case scenarios trickle in. You flush them out with Netflix and other distractions until sleep finally comes.
In times of trouble I’ve always turned to nature and thankfully that’s one thing I don’t have to give up during these surreal times. As spring approaches, the sun shines a little bit brighter, the birds erupt into spontaneous song, and the air is fresher than I’ve ever known living close to the highway. This is a challenging time for everyone and it’s going to be rough, but humans are resilient. Despite all the uncertainty, I have no choice but to believe we will get through this together. Socially distanced, but standing as one. Just take things one day at a time, one moment at a time, one cough at a time.