Medical marathon: Doctors deal with their own stress so they can fight COVID-19
From public health to the ER, doctors are steeling themselves for long, difficult battle
First thing in the morning, while still in bed, Dr. Monika Dutt checks her email.
It comes with dread, but it's part of her job — trying to contain the spread of COVID-19.
It is just over one month since COVID-19 was declared a pandemic, and it's been a time of physical distancing and virus vigilance. Doctors feel the strain like everyone else.
Dutt reviews overnight laboratory results to see whether new cases of COVID-19 have cropped up in central and western Newfoundland, where she serves as acting medical officer of health.
"It is this immediate feeling of who is the person, where are they, what do we need to do next," Dutt said from her home in Sydney, N.S., where she also works as a family doctor.
If the days were normal, she would commute between Cape Breton and Corner Brook, N.L. But nothing is normal during the pandemic.
The regions of Newfoundland and Labrador where she works have been spared the worst of the virus, but the province has lost three people to the disease.
In Nova Scotia, it hits closer to home. COVID-19 has killed nine people.
"Each [death] is just such a sad outcome, and it is hard not to feel somehow connected even though it's other people I don't know," Dutt said.
For doctors, the medical marathon has brought an emotional grind.
The "extraordinary stress" of doctoring during the pandemic is a concern that Doctors Nova Scotia is tackling.
For the past three weeks, the association has been hosting COVID-19 web sessions and daily lunchtime Zoom chats, covering topics such as mental-health coping strategies, and mindfulness. One session last week attracted approximately 300 doctors.
The group is finding that many doctors are experiencing similar emotions.
"The first thing that we are fearful of is becoming ill," said Dr. John Chiasson, director of the professional support program. "Second, we're afraid of taking it to the people we love, and, thirdly, we're afraid it will infect our patients."
Nurturing resilience in doctors
Chiasson, who practises family medicine in Antigonish, N.S., says his mental-health medicine starts with asking physicians to care for themselves first in order to be able to care for others.
"What we tell people is the things that keep us resilient as physicians in normal times, we have to continue them through this because resilience isn't a trait you inherit, it's one you have to nurture every single day."
Dr. Lois Bowden is on the front line at Valley Regional Hospital in Kentville, N.S., where she serves as the head of emergency. She felt a pang of anxiety after the first patient with COVID-19 came into the hospital.
"We've all had our middle of the night, several hours a week … thinking, you know, is this the end of it?" she said from her home in Port Williams. "What's going to happen to me and the people I love."
The fear experienced during the first frenetic weeks has now given way to fatigue. The end of the marathon isn't in sight and that leads to uncertainty.
She appreciates community support in the form of donations of scrubs, handwritten, laminated cards, and parades of emergency vehicles. But still, there's trepidation about "when is it going to explode?"
Bowden is trying not to give in to the worries. She's reducing her risk at home by living in a separate area of the house from her husband, who's also an emergency doctor at Valley Regional.
They have recently updated their wills. Having their affairs in order, she says, is decreasing her anxiety.
She is preparing herself for the possibility of personally treating a COVID-19 patient.
"They're still people that are scared, and the most crucial thing is to connect with them on a compassionate basis."
'I wanted to be part of the effort'
Dutt is also taking care by sticking to her pre-COVID-19 habits. She exercises every day and reads something unrelated to work morning and night.
She's well aware that physicians have paid a heavy price fighting COVID-19. Last week, a public health doctor in Quebec died of the virus.
Dutt is among the physicians who joined the Doctors Nova Scotia mental-health coping strategies session.
Her eight-year-old son, Kail, whom she's raising on her own, helps her to stay grounded. They enjoy exploring Cape Breton island, but these days they're exploring the forest right by her house, and practising being good homebodies.
"He's sick of COVID-19 because he hears me talk about it all the time, and so he considers himself an expert," she said with a chuckle.
Steeling herself is more important than ever as Dutt mentally prepares herself for front-line COVID-19 patient care. She's signed up for shifts at an assessment clinic when it opens.
"That gives me a focus for my energy," she said. "I definitely felt like I wanted to be part of the effort."
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