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We all know that there is a scary new virus knocking on our doors. Well, that virus knocked on my door, literally, a few weeks ago when I was unknowingly exposed by a patient at the clinic where I work as a physician. Five days later, I got the first call from Public Health letting me know I was deemed “low risk” and I could self-monitor and carry on as usual. What a relief!
Then I got the second call...
My relationship with viruses has been more intimate than most. I was an emergency physician on the front lines during the SARS outbreak in 2003, donning and doffing (the strange terms for properly putting on and taking off) personal protective clothing and gear. I learned how to use the now-famous N95 mask properly – no, you can’t just put it on, there is a multistep system or you will get contaminated. I learned how to put on a spacesuit-looking respirator hood with a space-age motor on my back to keep the flow of air away from my lungs. I taught the residents at the hospital and the medics at Ornge (Ontario’s patient transfer service) how to do it. At EMAT – Ontario’s disaster relief service, where I also worked – we added infectious disease outbreaks to our disaster scenario exercises. After SARS, I was our clinic’s liaison with the hospital’s preparedness planning. Oh, and I should mention that I have a master’s degree in communicable diseases epidemiology.
So, when I got that second call from Public Health revising my category to “exclusion” – a scary-sounding euphemism for self-isolation – I felt my life had been turned upside down. Everything took a hit – my family, the clinic and its patients, my income. And, to be honest, my ego as well. Here I was, a highly trained physician with loads of experience, and somehow I got caught in the virus’s web. Did Public Health really make the right decision? It took some effort to have faith that there are people who know more than I do.
After breaking the news to my wife, I picked out spare clothes from my closet and toiletries and decamped to the basement, where we had a spare bedroom, bathroom and even an exercise bike. I cobbled together a desk to work on, and really only needed to go upstairs for food. I’d only see my family when I went upstairs to eat meals – sitting at the far end of the dining table, at least two metres away. This all felt a bit strange and reminded me of the danger I presented to them, but our dinner conversations were the same: I’d ask the kids about their days and get the usual one-word answers. These meals were also an opportunity to explain to the kids that I was not sick, but that we were being careful in case I might get sick and spread germs to them. This was the time of day I looked forward to the most. It was when we could connect and everything seemed sort of normal.
My seven-year-old son was a bit confused about it all and missed our bedtime routine. My 12-year-old daughter understood and kept her distance, and I noticed she would move away from me when I was around. Even though this was understandable, my heart sunk. I felt vulnerable. My wife shouldered the burden of the household and family duties, as well as having to deal with my guilt at feeling useless, which she quickly put an end to. She reminded me that there was nothing I could have done and that my guilt was just adding to her already full plate.
When the family left the house and it was my turn to use the kitchen, I became hyper-aware of everything I touched. I felt like a criminal wiping down a crime scene; one canister of Lysol wipes only lasted two days. I ran out of them so quickly that, until my wife could get more, I would clean my hands with sanitizer and then wrap my shirt around my fingers before opening the fridge and drawers. It was not ideal, but I had to improvise.
In isolation, I noticed I went through different stages, similar to the stages of grief. The denial phase (“This is a complete overreaction!”) and the anger phase were predictable. My bargaining phase was a lesson in the clarity of Public Health protocols. The conversation went something like this:
“Can I walk my son to school if I don’t touch him or talk to anyone?”
“Can I prepare meals for the family if I sanitize my hands extra well?”
“Can I end my isolation one day early on Thursday so I can keep my Friday clinic running?”
Banished to the basement, I became depressed. I had patients who relied on me. Not to mention that if I don’t work, I don’t get paid, which, after a few missed days, can become an issue. Life as I knew it was put on hold. I felt fine, but to my family I was an incubating bomb ready to go off each time I emerged from the basement. I really had to be careful of what I touched, where I went and what I did.
Then, finally, I reached acceptance. It was not fair to be angry at what had happened. My clinic had followed protocols, which were adequate during normal times, but have since been adjusted to reflect this new reality. We have all learned about how to decrease risk accordingly. I know I will think differently about protection for my patients and myself in the future – just as my procedures at home became more mindful and stringent each day I was isolated.
In the basement, I made a plan that allowed me to use the isolation as a rare opportunity to get the upper hand on many projects that I hadn’t had time for. I was more fortunate than most people in isolation – I wasn’t stuck in a tiny cruise-ship room, I wasn’t cut off or fearful, I had my exercise bike, a fridge full of beverages, a comfortable place to sleep, TV and, most importantly, my health. My grumbling vanished when I compared my situation to others'.
I was not immune from anxiety – every scratch in my throat or strange feeling in my chest filled me with momentary panic, and then it passed. My greatest fear was that I could have infected my family and those whom I saw before I went into isolation.
I emerged from quarantine with a greater appreciation of the importance of protecting not only myself and family, but also my patients and their families, from invisible but real threats. The consequences of complacency carry too high a cost.
Michael Wansbrough lives in Toronto.