Dear Diary: An ER doctor opens up on what keeps him coming to work each day

CBC Calgary wants to know how you are living these days. What are you doing differently? Have you learned, realized or observed anything?

This instalment of our series, Dear Diary: In a Time of COVID-19, is written by Dr. Eddy Lang. He's an emergency room doctor in Calgary. He is also the Academic and Clinical Department Head of the Department of Emergency Medicine, at the Cumming School of Medicine. This submission has been edited for clarity and length.

Prior to the COVID-19 pandemic, being an emergency physician involved a fair bit of apprehension for what the next shift might bring.

Will EMS bring in a patient my team and I can't save? Will someone be harmed by a delay in care tied to the load of admitted patients in the department who are waiting for unavailable beds upstairs? Will I, or another staff member, be harmed through violence by an agitated patient?

With COVID-19, concern over what the next shift can bring has reached new peaks. It has resulted in countless sleepless nights worrying about staff falling seriously ill, depletion of PPE (personal protective equipment) and an overwhelmed health-care system forcing heartbreaking decisions about who will get a ventilator. 

Fortunately, much of the unknown fuelling this anxiety has been replaced by more and more "knowns."

Emergency departments are safe for both staff and patients and we will certainly be able to handle whatever COVID-19 sends our way due to an awesome team of heroic health-care system colleagues and the support of a physically-distanced community.

At the present time, concerns have shifted. They relate to the likely prospect that the virus will be with us for many months to come.

Emergency departments are the canary in the coal mine, and as such we have been the first to see and care for patients who are severely affected by the repercussions of the public health measures. Not surprisingly, some of our patients arrive in crisis, unable to manage the social and economic strains that they are experiencing.

I worry about the remarkable reduction in the number of patients seeking emergency care of late and worry about who is staying home.

We have all cared for or know of a patient whose fear of contracting COVID-19 kept them from seeking help, despite suffering a medical emergency.

When I encounter such a patient, I am disappointed that the message about emergency departments being safe and not overwhelmed hasn't reached the public. Patients may be scared or feel that we'd be too busy with COVID-19 to look after them, and I feel sympathy because the delay has made them worse off.

I wish I could tell people, "You are at very little risk of contracting COVID-19 and your problem is important to us and we will take good care of you."

Perhaps surprisingly, this pandemic has been the catalyst for much good.

I have seen a renewed sense of cohesiveness in our emergency department team and widespread support among colleagues and families looking out for each other.

Intensive preparation, meetings and a steady flow of communications has created a "we got this" mentality, whatever the future holds for emergency care in Calgary.

While stress can flare in these times, kindness and generosity are sprouting well ahead of the spring flowers. Add to this the heartwarming and greatly appreciated show of community support for health-care and other front-line providers and you can understand what keeps us coming in every day.

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