How to maintain your sanity in the 4th wave. A work in progress from an non expert.
First. Go outside. It’s fall. The leaves are changing. Find some trees. Don’t just look at them, take a deep breath. That earthy smell is an anchor. If you are lucky enough to find just the right light the petrichor and the autumnal palette will elevate your spirits instantly.
Next, find a good mycologist. If that fails find a trusted friend who owes you a favour to show you their secret spot to find morel mushrooms. It’s been a perfect year for mushrooms, and those who know will probably not tell you their secret, but it’s worth a try.
Now find the biggest cast iron pot you can. Add shallots and enough garlic to keep the hospital administrators at bay 😉 and cook those treasures up. Add more cream than a sane health care advocate should and do it all outside with a beer in one hand.
Now, boil up a little angel hair pasta, combine with some Parmesan and a little black truffle oil, and enjoy with a cheap yet boisterous Barolo. Don’t overcook the pasta. Especially if you respect the mushrooms.
Take a moment to look up at the night sky. Realize the millions of souls are looking at that same star. Accept that despite being small and battered by the waves, there are moments of pure joy. Savour them. Keep them private, or share them. That is the control you have. 🙏

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More from @drdagly

30 Sep
“I know you’ve been avoiding me, I understand why. Your heart must jump into your throat when you see the hospital’s number come up on your phone.”
“Please tell me he’s getting better.”
“Your father’s heart is failing.”
“He promised to help me with my schoolwork.”
The tears are welling up in our eyes now, but I know how to block them.
“You have to do everything. He worked two jobs to keep me in school.”
He is shrinking now. Only anger bolsters his impossibly thin frame from collapsing. His fists are clenched.
I stumble for a second, seeing my son in the flash of his eyes. That connection swamps me with empathy. I can’t give into it, or I won’t be able to go through with what I need to tell him. So I brace myself. I break the connection by stepping back.
Read 5 tweets
27 Sep
What keeps us away from the brink that is triage is the number of people who are dying in our ICUs. I have had to show them that though not yet dead they will never get better. I have extinguished their hope. I have had to console their children, and bear their partner’s rage.
This responsibility I bear without anger. It’s always been part of the profession, but we can all survive a little dose of poison. Right? It is the confessions that break me. The vignettes of banal failings that I identify with, that I could have easily been complicit in.
“She was so busy with the kids”

“He was working two jobs …”

“His friends had told him otherwise.”

“His doctor was unsure.”
Read 8 tweets
17 Sep
Quick thoughts about how to get us out of this mess. We know that Twitter is an echo chamber. We tune our threads to hear reinforcing opinions. What is clear, is that the majority of Albertans are reasonable and pretty damn considerate. They support vaccination and passports.
The problem is that in a pandemic, minority behaviour sets the bar for all of us. So how do we reach them? First is understanding our audience. In reality, very few are immovable, and it’s the moderates that need to be swayed.
Passports may motivate people to seek out more mainstream information, and that’s why education and access to truthful and peer reviewed information is essential. We also must open up our hospitals to vetted media. Health care professionals can only do so much to show the truth.
Read 8 tweets
15 Sep
An open letter to my kidney patients….

First, let me thank you for all of your support. You never once complained that I was late, or a little disheveled. You asked how I was doing even though you were the one in need.
Let me assure you it was because I was running my clinics overtime to catch up with you after we had lost touch during the previous three waves. And I thank all of you for listening to me when I talked about vaccination despite the fact you had already done the right thing.
I thank you for the cards, the cookies, and even the gifts from your garden, not just for me, but for my staff, who were always rearranging my schedule and feeding me lunch. (Cuz apparently I get “hangry”)
Read 8 tweets
15 Sep
She was a single mother of three girls.
Between the school closures and night shifts she hadn’t found the time to get one shot, let alone two. She did make her daughters lunches that day. They were on the kitchen table.
Her eldest called 911 when she slumped over the sink and couldn’t get up. That’s where the paramedics told me they found her, with one of her children trying to give her a glass of water.
Read 9 tweets
14 Sep
We are clearly on a dangerous path, especially considering we are moving into fall which will further exacerbate COVID and influenza spread. We are looking at further expansion and different staffing models but at the cost of downgrading care. edmontonjournal.com/news/local-new…
We are looking at transferring patients to Calgary, and potentially to other provinces. The only surgeries that are being done are emergent, and that will bring us another wave of severe illness in a few months.
Triage will not be enacted until we use up all ICU resources, but there is differing opinions between what the province says we can staff and what we really can provide. This means that on some level or another physicians will have to make hard choices.
Read 9 tweets

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