This is the fourth and final entry in the Perspective series, a collection of interviews detailing people's experiences with the COVID-19 pandemic.
Read "Concern" to get caught up with Sarah, a nurse who had to get tested for COVID-19.
Dr. Layla works at a small clinic in Ontario. Since before the province was in a state of emergency, she has been adapting to new rules and regulations tailored to the treatment of her patients in a world infected by the coronavirus. As a family doctor and physician, she shares the struggles of restructuring her clinic from taking in-person assessments to prioritizing virtual diagnoses.
The virtual consultations occur over the phone (videotelephony included), an innovative measure enacted by hospitals all over Canada. This protects clinic visitors from interacting with COVID-19-positive patients while also guaranteeing the health and safety of doctors on call. Some nurses are also allowed to work from home similarly, assisting the doctor and patient with any pertinent follow-up questions.
“We are not trained to manage [the pandemic],” she says. “[But] physicians are people of action.”
Aside from technological challenges, doctors deal with the stress of finding a balance between prioritizing contagious coronavirus patients and patients with run-of-the-mill medical conditions such as diabetes, chronic heart problems, terminal illnesses, prenatal issues, etc.
Dr. Layla recalls treating a cancer patient recently and the difference it makes when the consultation is over cellular feed instead of in-person. She was checking up on his health when she noticed something was off about his voice. She requested the phone call be switched over to FaceTime so she could visually observe him. Having prescribed him opioids, the cancer patient was unable to feel any pain associated with his respiratory distress, but his visuals told another story. He was immediately recommended to come into the clinic for treatment.
“That makes me kind of nervous because I can't explain what made me switch to FaceTime,” she elaborates on the clinical judgment all doctors in her position will now have to practice.
Virtual appointments make it difficult for doctors to narrow in on potentially life-threatening developments in their patients, requiring them to be in a state of constant vigilance. For COVID-19 patients, the virtual screening process is similar. They call in and are asked about their symptoms. Regardless of travel, should they show any symptoms similar to John, Scott, and Sarah’s coughing, fever, or shortness of breath, they would be moved to the next stage of assessment.
The severity of symptoms is indicative of a patient’s referral to the emergency department. If determined to be high, they are instructed to head on over while the ER is called and given a heads up of the patient’s arrival. The swab tests are then administered by ER physicians and nurses alike, with PublicHealth being responsible for organizing these processes. Dr. Layla keeps her afternoons free for on-site visits from patients who have other serious illnesses, her health being compromised with every interaction.
Medical procedures to treat these conditions require her and her associates' physical presence, along with numerous team simulations she initiates to prepare the minimal staff present at the hospital.
An example she provides involves preparing her team on how one runs a code blue if someone has COVID-19. In other words, she trains them to efficiently deal with a potential COVID-19 patient who is experiencing cardiac arrest. The resuscitation process requires a group effort and the exercise informs each staff member on how to save the patient without contracting the COVID-19 virus themselves.
Her job’s expectations are not lost on her family, with her six-year-old pleading, “Please don’t die” before she leaves for the office.
But Dr. Layla firmly believes in making a difference and will continue to be available to her patients and her loved ones in any capacity. Her closing comments emphasize the importance of social responsibility and community assistance during this time of need.
To learn more about how to help others in your community, here are a few Ontarian resources to consider:
The coronavirus pandemic has bred confusion, mass panic, and paranoia, giving rise to a time where people’s dependence on each other is restricted to being six feet apart. But concerned citizens are learning to value patience over fear, to value perseverance over seeking validation, and to value their oaths to protect over their self-preservation. It is during this time of great distress that sticking together as a community, supporting each other’s efforts, and facing this enigmatic challenge with the resources available is just what the doctor ordered.
Personal information such as name, date, age, and place of work has been changed, abbreviated, generalized, or removed for privacy reasons.