DFCM Blog: Stories from the Frontlines
In recognition of the work that our faculty, residents, students, staff, and others are doing during this unprecedented time, the University of Toronto Department of Family and Community Medicine has created a page to share their stories with others. By sharing these stories, we hope to connect our community, support each other and show the important work our primary care health care workers are doing.
Whether it is about an experience with a patient or colleague, a tool or resource you developed, something that inspired you, the little things that brought you hope, or overall thoughts or concerns about this time - the topics are endless. If you have a story you would like to share, please submit it through our webform or send it to email@example.com with a short submission (around 250 words). You can also tweet your story with the hashtag #dfcmstories, and we will review, post and share on our website.
I am a family physician. I work in the COVID-19 Assessment centres. It is difficult. I am used to working in a context where I am able to greet my patient, smile to offer a sense of comfort, listen to their concerns and worries and collectively come up with a plan on how to manage their identified issues. I was not able to do any of those things. I am rarely closer than one meter to my patient, so I am certainly not able to shake their hand or put a comforting hand on their shoulder. The nurses on the team remind me not to get too close, otherwise, I will need to change my personal protective equipment and we do not have enough to change between every patient. I look like an astronaut, covered from head to toe in a gown, gloves, and a face mask and shield; maybe they can see the concern in my eyes through the face shield and my glasses? Patients are scared, of course they are, it is an unprecedented time. We are still here for you.
Submitted April 2, 2020.
The two of us – married with 3 children, one a family physician and the other a general internist – left for a family vacation to Panama on March 7th. It is not an exaggeration to say that health care in Canada changed more during the 2 weeks we were away than it did during the 2 decades since we were medical students.
The COVID-19 pandemic will go on for many months, and we hope to share our thoughts here each week. In this initial blog, we will share our thoughts about travel, based largely on our recent experience in Panama, Miami and Toronto.
In Panama, the government decided to shut down all international travel just 10 days after its first COVID-19 case. When we heard the news, we hustled to get an earlier flight home.
In Toronto, as in many other cities in Canada and the United States, the coronavirus crisis is twinned with a different crisis: homelessness.
Sometimes all it takes is one person to illustrate how the system is failing.
Miriam* has struggled with housing for years. A couple of years ago, when her landlord ended her lease, she was unable to find another apartment that she could afford. Despite days and days on the phone with central intake, she could not get into a city shelter in Toronto. She was eventually advised by a housing worker to go to London, Ontario (a city of about 400,000 two hours drive away) – where she still could not get a shelter bed. She spent several nights in a McDonald’s until she was taken in by a local church.
If you are feeling like the information about COVID-19 is coming fast, changing quickly and overall…overwhelming. Join the club, we all do. Yes, even health care workers. My brother is a paramedic and has been working endless hours at the Toronto Paramedic Command Centre. He has passed on this great resource all about the facts, just the facts with the Canadian facts first. As the information changes, so do we. We have to continually change our behaviours. Let’s talk about CHANGE.
Wellsense is a blog created by faculty Dr. Julia Alleyne with daily messages to maintain wellness, but with a common sense, evidence-based approach.
Welcome to the Medical Residency Twilight Zone:
My hands are raw. No, I am not moisturizing them during the day and, yes, they are showing cracks. I am turning reptilian. These masks make me so hot, I can barely breathe. My glasses are constantly foggy. Oh hey, I didn’t recognize you with the mask on. Leaving the hospital and coming home are newly ritualized. Wash hands (arms, neck?), then take off scrubs, then take off shoes, wash hands again, put street clothing on… wait did I miss a step? Did I contaminate myself? Will I contaminate my home? Get my wife sick? I don’t know. I have internal monologues about how often to sanitize my equipment. Is my cell phone going to survive all this virox? It is the least of my worries right now, but it would really suck if I broke it.
It’s hard to believe that our practice lives have been upended for just over a month. I am measuring the time past in units of learners lost. My first casualty was a PGY2 who scheduled a 4 week elective last month. Owing to an out of country trip, he was on 2 weeks of quarantine. By the time the final week came, our clinic was 80% virtual and there was little I could offer in the way of patient care. He was deployed to another service. The second casualty was a 3rd year clinical clerk scheduled for selective 2 weeks from now. Due to the impacts of COVID-19, the MD program has cancelled all 3rd year elective placements. For many of us, our days are now filled with Virtual Visits by phone or video. We are socially distancing from our colleagues and staff. The loss of our learners is felt deeply. The enthusiasm of our learners , the joy of mentoring and the thrill of observing new skills acquired is a loss for both myself and my patients. After 35 years of supervision, my patients actually look forward to their role in helping to train new doctors. I don’t know when we will return to more normal practice, but I am certain I will be more mindful of the joys of sharing my practice with our learners.
Submitted April 16, 2020
The patient who threw a pop can at staff saved their lives.
My practice "sits" in a walk-in clinic. While I run a regular family practice with appointments and full care the majority of the 22 rooms are for the adult and paediatric walk-in. Over the years there is the occasional very agitated patient who shouts at the front desk staff. Mall security is often called. I believe it was getting particularly bad with one patient one day and he threw a pop can at the staff.
Submitted April 17, 2020
I have never been so grateful to be part of a team.
Every day, I feel overwhelmed by the mountain of information coming to me via the newspaper, radio, social media, and worst of all, my own email inbox. Sifting through what is important and deciding how to change practice often seems like an impossible task. But thankfully it’s one I don’t need to do alone.
In my clinical practice, I have the luxury of being a follower.
In the last month, our primary care team has rallied to change the way we deliver care several times over. Like others, our focus has been on providing accessible, equitable patient care while keeping patients and staff safe. These changes have only been possible because of the leadership of many.
I am a family medicine resident in my third year of the Integrated 3 Year Residency Program. My residency includes the core family medicine residency in addition to a concurrent Master’s in Science from the Institute of Health Policy Management and Evaluation. Next year, I will be completing an additional year of training in Care of the Elderly at Baycrest Health Sciences.
I have been working in a COVID Assessment Centre and I am presently on the medicine wards at my site hospital. In addition, I have continued to provide longitudinal virtual care to my family medicine patients.
It’s hard to believe that it has only been six weeks of the pandemic. I thought I would share some of my observations from my perspective of being both a family medicine resident and a health policy master’s student:
Submitted April 21, 2020
Read the stories of this week's CBC Toronto 'Front-line Heroes' by Taylor Simmons
Several of Dr. Nadine Laraya's colleagues wanted to send her a shout-out for being a hero on the front line of the COVID-19 pandemic.
Laraya is a family physician and the community family medicine liaison for St. Joseph's Health Centre in Toronto.
One of her colleagues, Dr. Edward Weiss, says she's been instrumental in ensuring all medical professionals — from family physicians to emergency doctors — in the community have the latest developments when it comes to tackling the crisis.
Today is National Doctor’s Day and I salute you all in the incredible work that you do. Being a doctor is truly a privilege, and we are privileged to be entrusted with the care of people in their most vulnerable moments. Our cause is a noble one, our feats often outstanding, and we work with an admirable ethic, tirelessly to meet the unending need.
We are heroes.
A hero, by definition, is “a person admired or idealized for courage, outstanding achievements, or noble qualities”. Some heroes, in fiction, are superhuman.
We are heroes, but we are not superhuman.
"It does not take much to realize that it all adds up to a dangerous and explosive concoction if the Coronavirus arrives here. Vulnerable communities like this are most likely to drop even further into poverty if the virus hits. It is virtually impossible for them to social distance so it could spread like a wildfire.
Now into February, the Coronavirus was now a main topic all over the globe. But unfortunately, this is still not a main concern for the people in the areas where I work. No one really understands what the big deal is about handwashing and hygiene.
Each day we see three-year-olds walking around with constant runny noses, open sores, ringworm. Kids are all sharing cups and spoons, there are no wipes or tissues for coughs and, of course, there is very little handwashing in most locations."
“The personal impact of this pandemic has been pretty significant. I have a three year old and a three month old at home. As we’re having this conversation, one daughter is napping in her bedroom, and I’m rocking the other one in my arms. This rarely happens, where they’re both asleep at the same time. It’s hard not to worry about their future, especially now.
My nephew is now three weeks old – I haven’t gotten to meet him. These pieces are a reminder that life is continuing to happen. People are getting married, and babies are being born.
These things that we’re used to celebrate collectively – we’re finding ways to connect with each other despite social distancing, until we can actually physically gather.
This is a profile on faculty member Danyaal Raza by Arnav Agarwal.
As my city braced for our local COVID-19 onslaught, I had the strange experience of facilitating the final session of this academic year’s undergraduate reflective curriculum. As part of this curriculum, my assigned group of medical students and I had been meeting regularly for the better part of two years, coming together to reflect and commiserate on their most poignant and challenging training experiences. Over that time, I had been repeatedly impressed by the students’ insight and candor, and grew to anticipate our often-transformative discussions.
That last afternoon clearly felt different to us all. In adherence to novel social distancing requirements, we congregated virtually, making use of one of a number of increasingly popular online meeting platforms. Instead of crowding around a small table, elbow-to-elbow, in a sunny room on campus, each of us huddled in solitude at our personal computer screen, gazing at familiar faces against unfamiliar backdrops – kitchens, bedrooms, a backyard. It was awkward and bizarre, and I was struck by how deflated the students seem. Having completed their required clinical rotations and examinations, they are on the cusp of graduation and the beginning of residency.