Could COVID provide a health kick to medical culture?

April 8, 2020

Dr Caitlin Weston

Doctor, Board Director and passionate clinician wellbeing advocate.

I recently had to take a couple of sick days from work.

I wasn’t dying.

I wasn’t so sick that I couldn’t leave my bed.

I didn’t have uncontrollable diarrhoea that would make working impossible.

I had a headache, a runny nose and a sore throat. That’s it. I had been swabbed for SARS-CoV-2 having developed a cold after exposure to relatively high-risk patients without PPE.

Until cleared, I was isolated at home for public safety, and my psychological discomfort with the situation was extreme. Not because I was especially worried about the illness itself, but because it’s basically unheard of for a junior doctor to take time off work because of a mild cold.

Despite knowing logically that getting tested was the right thing to do to ensure the safety of my patients and the community, I couldn’t help giving myself the third degree. Had I really been sick enough to justify testing? Did I do it out of genuine concern about my patients or had I just subconsciously wanted an excuse for a couple of days at home? Would my patients suffer worse outcomes because of my absence? Would my colleagues judge me? Would it endanger my job prospects?

But my supervisor, who kept in touch regularly with phone calls and text messages while I was isolating, was clearly just looking out for my welfare- expressing empathy for any anxiety I might be suffering while waiting for my results and encouraging me to take the time I needed to recover.

After two days’ isolation I got a notification from the clinic that I was cleared. I returned to work (with much more fastidious PPE use this time) where my colleagues all checked in to make sure I was feeling better and wasn’t shaken by the experience.

A couple of days later a close medico friend came down with a cold. As they work with vulnerable patients and had just one flimsy degree of separation from a confirmed case, I advised them to notify work and present to the Covid clinic, just to be safe. It took quite some convincing as they, too, felt caught between the guilt of potentially exposing patients to Covid and the guilt of taking time off work while not actively dying. But they agreed and were tested and instructed to isolate until their results came back clear.

Unfortunately, my friend’s experience with colleagues was quite different to my own. Their senior registrar was appalled that they had gone for testing. They referenced other colleagues who were working just fine with colds and reminded my friend of the rostering catastrophe that would ensue if they tested positive.

I was absolutely outraged. The registrar’s attitude was not only antiquated but outright dangerous. Framing a possible Covid diagnosis around rostering issues rather than genuine concern for a colleague and patients displays a total lack of insight into the seriousness of the public health catastrophe currently evolving around the world. And yet, this attitude is so deeply ingrained in medical culture that the words echoed my own internal monologue and that of my friend who needed so much convincing to undergo the test.

We have known for quite some time that there is something deeply unhealthy about medical culture. But perhaps this pandemic can force us to re-evaluate our reflex assumptions and guilt surrounding sick leave. Not only is it necessary to assume the worst when we get a sniffle (we’re a high-risk population and potential super-spreaders), but we’re in this for a marathon not just a sprint, and more than ever it is important that we put on our own metaphorical oxygen masks so that we can bring our best, healthiest and most robust selves to our families, our patients, our colleagues and our communities.

Let’s use this as a health kick for our culture. Re-examine your reflex thoughts and treat your colleagues and yourself with some compassion. We’re going to need it.

Download Burning Out – a report into clinician Burnout and wellbeing.

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