We relish working with the sickest patients & are privileged to walk the most agonizing paths with their families. It’s the impending sense of being overwhelmed at any moment that is grinding us down. It’s that we are here again, as though we have not learned that’s demoralizing.
I am constantly amazed by the heavy lifting our administrators do to adapt and keep things running. They must be feeling this weight as much as we do. The added pressure of being in a leadership role must be immense. I hope they have support too.
You won’t hear it from them. That job doesn’t allow a lot of disclosure, but they are fine people, doing their absolute best in really difficult situations. It’s a job I could never hack, and it is essential to keeping our hospitals running.
I say this knowing that if they feel even close to the way I do right now that they will need kindness and support as well. I think we are all showing the strain. We are all looking for higher moral leadership from our government.
So, how am I going to help? I think that it’s time to acknowledge that cracks are showing. That my temper is shorter, and I’m not leading as well as I should be; acknowledging my frustrations and my limitations. Acknowledging compassion fatigue as more than a buzzword.
The solutions will be harder. Insight is only part of the journey to self improvement. We all need a viable plan. Mine has always revolved around my family and the outdoors. Healthcare workers often suffer guilt around being tired or unavailable. I’m not going to oversimplify it.
Yes, this is complex. It’s taken me awhile to get here, but the purpose of this thread is to acknowledge your pain and suffering, & to give you a little space to grieve, even if you’re not there to take it just yet. Because I think that’s what I’m doing right now. #PeaceAndLove

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More from @drdagly

23 Apr
As we speak our @CMOH_Alberta and health minister are betting on vaccinations to temper hospital and ICU admissions despite our exponential case numbers. That is a high risk wager if they get it wrong. Based on current hospitalizations and past experiences we should lock down.
This is a similar situation to last wave. Though I hold optimism that vaccines will save lives, using lagging indicators just means we wait for young people to start overwhelming the system. Even though they tend to have better disease outcomes, this remains a percentage game.
This is predictable math. To make infection control an all or nothing game is naive and irresponsible. Lock down now. Continue aggressive vaccination. Open up at 80% vaccine uptake, regardless of how low case counts are. Better yet push for #CovidZero.
Read 4 tweets
22 Apr
The Covid situation in Ontario is making people pretty jumpy, so let’s focus on some positives.
- GenX showed up like crazy for their vaccination
- Our elderly are vaccinated
- We have had a 2 week head start
- Our population is younger
- We have lower population density.
Now let’s focus on what we can do about it in the short term.
- don’t let your mask slip.
- support and advocate for racialized and essential workers
- enjoy spring while following the rules
- push for #covidzero
- help curb vaccine hesitancy (be nice about it)
- take the jab.
When your brain isn’t overloaded, in those quite moments, think about long term solutions.
- wage disparity
- marginalized populations
- health and social equity
- socialized healthcare and health prevention
- mental health and addictions stigma
- political polarization
Read 4 tweets
18 Apr
Everyone keeps telling you that the side effects from AstraZeneca and Jansen vaccines are rare and you should get the vaccine. I totally 100% agree with this, but trust is only part of the equation. So here’s what I know about #VITT or vaccine induced thrombotic thrombocytopenia.
Let’s start with the name, because it tells us a bit about the problem. Thrombocytopenia means a low platelet count, which can happen for many reasons, and thrombotic refers to the generation of blood clots. When you understand that platelets are what start most clots ....
You really are a leaky meat bag. No offence. Platelets are constantly plugging tiny holes in blood vessels and maintaining vascular health. They are kind of like clotting grenades. Super effective at what they do, but you don’t want them going off in the wrong place.
Read 14 tweets
1 Apr
As #COVID19 escalates, & predictably hospital and ICU admissions follow, I am being asked to do more interviews. Please, let me be clear, physicians are not saying, “I told you so”. We have been here before, and this is all so predictable. It’s hard not to sound frustrated.
We want the best for our patients. We’ve advocated for plans that would have avoided this situation. We’ve seen other provinces do this the right way. We are left pleading with people to do the right things at great personal cost, but they are fatiguing from this harassment.
Most of us will make it through this alive, but we all will have scars from it. Physical, mental, social, financial, we will all be marked by these half hearted measures. Death is only one marker of this pandemic, but right now it’s the one I’m most focused on.
Read 5 tweets
13 Jan
Ok. Educational thread. #COVID19 #vaccine #strains #Mutation

First a caveat. Until we have good data most of this thread is theoretical, but to keep you out of suspense, I believe that our current vaccines will protect us from evolving strains of coronavirus.
The reason for this is that the target chosen for these vaccines was its virulence factor, the thing that makes this normally annoying old virus deadly. The capsid spike protein that interacts with our bodies ACE2 receptor.
Viruses need a way to get into cells to infect them. Previous generations had spike proteins that opened doors on tissues of the throat and nose. The ensuing infection and inflammation is the stuffiness that we associate with a cold. You can survive a sore throat.
Read 13 tweets
27 Nov 20
A short tread on community.
You might know that I am a champion of @coffee_outside. It was a simple idea that brought people together every Friday morning in a local park. Most arrived by bicycles and some even drank tea but that wasn’t it was all about.
It was really about being connected with people who were once strangers. It helped that we were like minded souls, but given time and commitment it flourished just as those relationships did.
Like other things in this crazy time, it has dwindled. Despite being outside by nature our group has gotten smaller. Like a seed that drys.
Read 6 tweets

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