I. See. You.
“For medical reasons this patient will be unable to attend work. This will be reassessed in two weeks.”
Sometimes it was two, or three, sometimes four weeks. Often the notes got re-written. A new date set. Extensions in time. Healing slowing down the 24 hours of a clock, to intervals that weren’t sufficient to heal a broken mind.
Covid anxiety breaking those who had been holding themselves together with tape but now found with people panic buying, that they could no longer find any. All toilet paper, and pieces that could stick oneself together being pilfered. Snatched up. Nothing left to hold one as one anymore.
Before Covid, I would write this statement often enough. Time off would come written easily. Support given.
Divorces, someone struggling through an illness, an unwell child, someone saddled with anxiety, stress. A complete mental mis-hap. Neurons letting them down. Chemicals misfiring under duress.
Covid hit and I began writing it all the time.
From daily, to multiple times daily.
Appointments overflowed. I created a “stamp” in our electronic records. Efficiency toward those needing a break from production.
Calls coming in relentlessly. “Hello, family medicine land. I need to be booked in for urgent time off.”
Piles of letters.
20 patients a day, mixed into 30. Overflowing, piled on top of one another in the schedule. A gross need to keep up. A heavy need not to fail my patients.
A mental health system in a province where there is no oncall specialist for mental health. Where the Crisis Team is also in crisis.
Sore throat and headaches booked. Anxiety and depression the real reason after 15 mins of dealing with the other reason.
So far behind.
Notes left unfinished. Piled on top of notes left unfinished.
Hearing myself over and over: “It’s ok. Three weeks in a life time is no time at all if it brings you peace. If it starts the healing. If it enables you to get help. Take the time. Invest in yourself. Find some balance. I support you.”
Then. Hitting the wall.
Standing in an office not knowing where to look next.
Staring at my hands. Alcohol on, washing away any ability to concentrate through the endless relentlessness of need.
Doing jumping jacks to connect myself with the room.
Looking from inbox to schedule.
Piles of despair.
Pile ups of waiting people. Dying while waiting for Covid to end. Their cancers told to wait. “Stop growing a bit while we get this Covid thing under control.”
“Hello family medicine land. Have you heard from my specialist yet, my cancer has not taken the advice to stop growing. I think it needs to come out.”
Breaking while smiling.
Breaking while reassuring.
Just one more phone call to remind them their results haven’t been left behind. We have just not yet heard about when someone can see them.
“Hello family medicine land can you send my mom home in one piece tonight. She can’t read more about Covid, and our talking is hurting her brain. Her patients are making her worried. The system is stretching her so much that we can no longer find her. She needs total silence at night. We need our mom’s voice.”
“For medical reasons this patient will not be returning to work. This will be reassessed in eight weeks.”
A note written to myself. In the one empty recess of my mind. Along with “you are replaceable to everyone but your children.”
A locum booked.
Time taken scarily without pay.
Time to find myself. Find some creative space.
Speak to my partner and my children.
A lot. With kindness and full presence.
To myself. “I support you. Sorry it took me so long to do that.”
By Dr Jessica Mitchell
Family Physician, Nova Scotia