PERSPECTIVE: Learning to take care of ourselves
Nicole Boutilier, MD
Earlier this month, I read about the suicide death of Dr. Karine Dion, a 35 year-old Canadian emergency physician. I was so unbelievably sad to read this, and her husband’s description of her death as pandemic-related. He said that she felt like she wasn’t doing her part, like she was letting people down. For her, the stigma of being a physician who needed help was too much.
Was it because I was once a 35-year-old emergency department physician? Or was it because I haven’t stopped worrying about all of you since the pandemic began and how I feel responsible for keeping you safe and well? The words her husband used just felt too familiar.
Physicians carry these things in their heads and their hearts. We somehow learn that we are supposed to work when we are ill, care more about our jobs than we do about our health, and then worry about the burden we place on others with our own illness. We forget that we are human with all the emotions, frailties, and vulnerabilities that come with it.
I want you to know that I have my own personal stories as I am sure most physicians do. I hope that any of you who are feeling alone or ashamed or stigmatized will feel comfortable to reach out for help if you need it.
I once miscarried in a call room during an ER shift and went back to work. During another injury, I was in a wheelchair — non weight bearing on both legs — had a deep vein thrombosis, and still held meetings in my living room. On other occasions, I didn’t give myself time to grieve over the loss of a loved one or just carried on during an acute situational crisis in my personal life as though I had no choice.
In these stories, the theme is the same. With the physical illnesses, I kept quiet until I had no choice. I felt so guilty to miss time, as we were understaffed. I never once considered that I might need the time to recover and take care of myself. I worried about what people would think if I took time off, or that I was not doing my part.
The difference in the last scenario was that in my personal distress, unlike my physical health issues, I didn’t share. I kept quiet and internalized the shame. As a result, there was no outpouring of support or visits. There were no check-ins or quiet moments of understanding. I was too afraid of what others would think about me, and I felt that I should be at work no matter what else was going on in my life.
I don’t know how Karine felt and I don’t want you to think my examples are in any way comparable to what she or anyone is going through. I shared because I want physicians to know that it’s okay to not be okay. It’s okay not to be perfect. It’s okay to show your vulnerability and talk about your fears. It’s okay for the pandemic to be testing the limits of what you can emotionally handle.
As Karine’s family wants us to know, there is no shame in asking for help. Talk to your colleagues. Ask your leader for a few minutes of their time. Reach out to each other. Check in. Take part in a wellness seminar. Notice if someone is struggling and ask how you can help. Let people you care about know that you are there for them.
Let’s show that we are learning that, as a profession, we can do better at taking care of ourselves and give ourselves permission to be simply human. Tell someone your stories and what you hope would be different for them.
Stay safe. Stay well.
Author
Nicole Boutilier, MD, is vice-president of medicine at Nova Scotia Health.
Correspondence to: