she/her. Internal Medicine Doc. American in Canada. Steelers fan. Cool Runnings is my favorite movie. I like kind people. Views are my own.
2 added to My Authors
Jul 31 • 11 tweets • 2 min read
This is where I grew up. A home filled with so much love, memory, support. That still houses my family. A home 2100 miles away from where I live now.
I begin my journey back to reality today, after almost four weeks surrounded by so much love. Reconnecting with friends I haven't seen in decades. Watching my kids be kids... Grass stained clothes, sticky ice cream faces, playing with the deer every morning in our backyard.
Jul 3 • 9 tweets • 2 min read
Burn out -- it's not a surprise nor uncommon amongst myself and my physician colleagues. It is always one of the topics of conversations when we meet, see each other in the hallways, at events.
Chronic burnout is a decades old problem in medicine, with alarmingly high rates of occurrence over the last 3 years within in this pandemic. With no tangible solution in sight.
Jun 24 • 10 tweets • 2 min read
Recently, my colleagues and I at my clinic had to make a difficult decision to temporarily stop accepting new internal medicine referrals until 2023.. which is where are currently booking into.
Between the demand for Long COVID referrals, the volume of complex other internal medicine consultations, and increasing inpatient demand on our time, the situation hit a breaking point.
May 17 • 14 tweets • 3 min read
Why is the healthcare system collapsing?
You've heard many HCW talking about the system at the "brink of collapse." But what does that mean and how did we get here? People and System. Let's explore.
Firstly, the system. And when I say system, I am going to speak specifically to medicine (internal medicine/hospital medicine), the literal safety net of any hospital.
May 10 • 12 tweets • 2 min read
I know you are scared, worried, and even frustrated. You either have a diagnosis and are waiting critical treatment, or you are still waiting for the specialist/tests/procedures that can give you those answers. The wait is excruciating. 6-12 months. Of uncertainty.
You call us...upset at us, the system, all of it. I get it.
I hear you, see you, and want to expedite everything I can... But I can't. The system is broken. I am only one human. I cannot fix this.
Apr 26 • 12 tweets • 2 min read
Post call delirium is setting in, so while I'm still slightly coherent, I wanted to share my observations of the last 24-36 hrs-- much of which isn't going to be new information, but definitely underscores the ongoing slow decay of our healthcare.
Internal medicine call, especially in Edmonton, is busy. All. The. Time. We are the default admitting service 24-7, with no caps to number of patients we can accept or admit, even when our teams are overflowing with patient volumes some might consider approaching on unsafe.
Apr 20 • 5 tweets • 3 min read
Another Wednesday, another conference filled with misinformation.
@JasonCoppingAB says not all hospitals are overcapacity. Only some in #yyc and #yeg ... And okay, perhaps that true. But that should not be reassuring to anyone, and here's why.
#YYC and #YEG contain the main tertiary car centers for AB, where specialized surgeries, procedures and transplant medicine occurs. It's where resources such as telemetry beds, specialized equipment exists as single point access for all Albertans.
Apr 17 • 12 tweets • 2 min read
I just finished my 24th week of COVID unit over the last two years.
For context.... That's A. Lot. Of. COVID.
At this stage of the pandemic (yup, we are still in a pandemic), we have far more tools to manage severe COVID, we know more about the disease course, and I've been able to fine tune my clinical gestalt.
Apr 12 • 6 tweets • 1 min read
I am not well.
My healthcare colleagues are not well.
Not only is our system collapsing, but so are the humans who are trying to hold it up.
I walked through the halls of the hospital today, and each physician I ran into had the same story to tell. "Neeja. I am done. I cannot continue like this. I am at my breaking point."
Apr 10 • 12 tweets • 2 min read
I dread Sundays. It wasn't always like this. Sundays were family days, filled with connection and good food with the grandparents.
But now, every Sunday morning, I am forced to manually count the number of internal medicine patients at RAH, assess how many "off service" wards these patients are on.
Apr 9 • 6 tweets • 2 min read
Powerful read - thank you @AmyTanMD for this piece. As a cisgendered BIPOC physician, I am one of those 75% that has experienced racism from within the walls of our institutions, from our colleagues and leaders. /1
The recent publication highlighting just how racist the physician community in Alberta can be was sadly not eye opening, but rather a sad reminder of how far we need to go. A line from Dr. Tan's piece really hit this home:/2
Apr 6 • 9 tweets • 1 min read
I was born, raised, trained and worked as a physician in the US. I had lived private healthcare for over 30 years.
Were there advantages? Sure. You could get a CT scan the same week. Your knee replacement may happen in 1-2 months from assessment.
Mar 25 • 8 tweets • 1 min read
As we see more Long COVID patients, we are adapting our intake to reflect common patterns we have been noticing.
One of the questions we had to add was : Are you able to work?
Mar 23 • 10 tweets • 2 min read
WE ARE STILL OVERCAPACITY.
Used all caps for dramatic effect. But in reality, most of us have quickly dwindling fighting power anymore. You might remember my words from this thread:
It's been 11 weeks since my outpatient team and I opened our Long COVID clinic. In that time, I've had the privilege to meet so many people with such powerful, sad, and gut-wrenching stories.
Not being able to work due to brain fog and cognitive delays. Not being able to complete the 6 minute respiratory walk test due to fatigue, high heart rates, and chest tightness.
Mar 7 • 8 tweets • 1 min read
7 days. The number of days our internal medicine team got a slight repreive, and were sitting at *only* 108% capacity.
As anyone who has been in the throws of this since 2020 would expect, I was hopeful, mostly because my mental health can't afford to be anything but.
Over the last 48 hours, it became apparent that this reprieve was just a fluke. And that we are not anywhere near easing, simplifying, "returning to normal."
Feb 24 • 7 tweets • 1 min read
My heart breaks for those that don't get to "turn off the news" because it's happening to them.
My heart breaks for those waking up halfway across the world to explosions and not alarm clocks.
Feb 18 • 12 tweets • 2 min read
My twitter break was needed, and I'm not sure in ready to wade back in fully. But I needed to get something off of my chest, and can feel the emotion building.
Jan 26 • 8 tweets • 2 min read
Today, I heard strangely high number of folks tell me that "it's just time to get back to normal. COVID is done. We need to get back to our lives."
When they say comments like this- it's as though the 2.9million Canadians that have had COVID in LESS THAN TWO YEARS means nothing. (And we know it's likely more than that given our current lack-of-testing strategy.)
Jan 25 • 9 tweets • 2 min read
5th wave rants. A thread.
Feeling a bit "done" today. Comes in waves (no pun intended), but this particular COVID wave has been extraordinarily challenging, personally and professionally.
When we entered March 2020, there was apprehension, uncertainty and a incredible sense of duty - to respond, suit up, assemble. (couldn't resist an Avengers reference 🙂)
Jan 2 • 6 tweets • 1 min read
We are not lying about COVID.
We are not lying about the state of the healthcare system.
We have nothing to gain despite many saying we do.
Trust me. I would not wish my own experience as a frontline doc or physician leader on anyone.