Kevin McKennie Nelson, BC. I am a family doctor
Nelson BC A mysterious mountain town in the southern interior of the U.S. is where I’ve had the privilege of working as a rural family therapist for more than a decade. My colleagues and I practice a fading style of medicine that allows us to care for patients of all ages, at all stages, both in the community and in the hospital. The work is gratifying and quite rewarding, and I never thought I would question my plans to live my career here. Sadly, the events of the past few weeks have taken me by surprise.
Until recently, the pandemic had largely spared our community. Due to our remote location and blindness, the number of cases remained low. I had a patient who spent five weeks in the ICU, but his case was an exception, and a handful of localized cases were generally mild and self-resolving. Our hospital wasn’t overcapacitated, our workloads weren’t overly burdensome and the will to address the pandemic pulled the community together. Then, a few weeks ago, everything changed.
Since early August, Nelson and its surrounding communities have seen a rapid increase in COVID-19 cases. Our ICU is overcapacitated, our hospital is full, our emergency department is seeing record daily visits, and our testing site can’t meet daily demand. Worse yet, modeling data suggests that the number of cases may continue to rise for the next four to five months. Nearly all local patients requiring hospitalization for COVID-19 have not been vaccinated, and public-health data demonstrate that continued spread is almost entirely through those who have opted not to be vaccinated. option is selected.
My job as a family doctor in this city has become more challenging as a result. Today, like most days last month, I started early and finished late. Among countless other encounters, I attempted to admit a 23-year-old woman to the ICU with worsening COVID-19, but failed because all ventilators are in use. I called a patient to tell him that his aneurysm surgery had been postponed indefinitely because the hospital had no more capacity. I started a normally resilient and lively patient on antidepressants because, after 18 months of trying to remain optimistic about his future, he is drowning. I saw a member of our clinic staff being verbally abused by an irritable and angry patient, who is hurt by our clinic’s mask policy. I was asked to write a “medical exemption” letter for a patient with no significant medical condition. I tried to reassure an expectant mother who was terrified of delivery at our COVID-positive hospital. I canceled a planned house call (for the second time) with a bed-bound stroke victim who wanted to discuss medical assistance in dying, as I was called back to the hospital at the end of the day at my clinic.
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I care a lot about this city and the people who live in it. I am committed to providing my patients with the highest quality medicine that I know how to deliver. I take care not to allow bias or differences of opinion on the care I provide. I stand ready to work tirelessly to help bring this pandemic under control and restore our city to its idyllic past.
Unfortunately, I am finding it difficult to maintain my motivation. My non-judgmental attitude is starting to fade. I am exhausted and deeply demoralized. The personal and professional toll on me, my colleagues and everyone working in the health care sector of our community is enormous.
We have a tool to end it all, in vaccines. Data are irrefutable. If sufficient numbers of uninfected people are vaccinated, we can control our growing local outbreak in a matter of weeks. Unfortunately, our city still has one of the lowest vaccination rates in the province, and opposition to a vaccine passport program is vocal and strong.
I urge the illiterate citizens of my community and other similar communities to step up and do the right thing. Denying the reality of what my colleagues and I are seeing every day is untrue, demoralizing and harmful. Please prioritize the health of those around you. Please put aside specific arguments about the erosion of civil liberties or the sanctity of personal health information until we are free from this devastating crisis. We are not being asked to go to war. We are being asked to accept only real-life evidence, believe in proven science, and take a shot at hand.
In the meantime, I will continue to work in my hospital and my clinic, and do all the small things I can to help those affected by this pandemic. I hope our city gets back on track, and that tolerance, respect and compassion will once again become a defining characteristic of our community. I love my city, and I really want to be around.
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