”There aren’t enough doctors up there”: A finance worker turned ER doctor flew to the Northwest Territories to work the front lines
When I was 12, my family emigrated from Kuwait to Montreal. After high school, I went to Marianopolis College, a CEGEP in Quebec, and enrolled in the health sciences track. I was thinking about going to med school: I’ve always been an empathetic person, and I wanted to use that in whatever job I ended up in. In 2005, I applied to med school at McGill, and got in directly though CEGEP’s fast track. Only about 80 people in all of Quebec get into medical school through the fast track every year. I didn’t write the MCAT or even start an undergrad—I would have become a doctor at 22, maybe 23 years old. I started med school, but within two months, I was overwhelmed with anxiety about the linear path I was on. I was worried I wouldn’t know anything else but medicine. Soon, I was so anxious I couldn’t even study. So I spoke to the administration. They were so kind. They sat me down and said, “It sounds like you’re burnt out. Why don’t you take a year off?” It was a relief.
I couldn’t just loaf around, so I ended up applying to the John Molson School of Business at McGill for a bachelor’s in commerce. My brothers and fathers were all in business, and I thought maybe it was in my genes. I started in January 2006 and fell in love with the program—the group projects, the presentations, the problem solving. After a year, McGill’s med school called me and asked if they should hold onto my spot, and I turned them down. I ended up doing a finance degree, and in 2009 I started an MBA at night, which the school funded. As much as I loved it, I kept wondering if I’d been wrong to give up on medicine.
I graduated with my finance degree in 2009, and I was the valedictorian of our class. Even in the middle of the great recession, I was lucky to get a job at Pratt & Whitney, which manufactures airplane engines. I worked in both financial planning and supply chain management until 2011. By then I’d seen my friends from medical school graduate and become doctors. That could have been me, I thought. So I went to my supervisor at Pratt & Whitney to ask her opinion. She said, “You’re 24. If you don’t go back to medical school now, you never will.” And then I realized I had luck on my side, at least for a little while. McGill didn’t require you to write an MCAT, and my health science credits from my previous college courses would be valid—but only until the end of that year. It was now or never. So I decided to apply to McGill again; if I didn’t get in, I’d stay in finance. In my application letter, I said I’d be a better physician than I was when I was first admitted to medical school, that in the years since I’d gained confidence, plus communications, teamwork and conflict-resolution skills. And for the second time, I was accepted.
By my third year of medical school, I knew I wanted to be an emergency room doctor, where I’d treat undifferentiated cases and do high-pressure detective work. I fit the profile: I love doing many things at the same time, thinking critically, solving problems, being a medical MacGyver. An ER doctor needs to know about every specialty, which makes it the best one. I did a two-year family medicine residency at Sunnybrook in Toronto, and then one year of emergency medicine in Ottawa. Since then, I’ve worked as an ER doctor at a hospital in the GTA.
In January of this year, a colleague who specializes in disaster medicine drew my attention to the novel coronavirus. At first we were all saying, “It’s not serious, it’ll be fine.” But then we started seeing it up close. The first Covid patient I saw was an otherwise healthy woman in her late 20s with an upper respiratory tract infection, who’d just taken a cruise through Asia. She looked fine, but had a runny nose, a cough and a sore throat. The patient said she wouldn’t have even seen her family doctor about her symptoms, but on her plane ride home, people around her were coughing and looked unwell. She lived with elderly parents, and she didn’t want to harm them. I put on a full set of PPE and saw her alone, gave her some Tylenol for her aches. We tested her and told her to self-isolate.
Now I’m assigned to the hospital’s Covid clinic. Patients with Covid-like symptoms are referred to us. We test them and ask them a series of questions. We need to make sure, for example, if they’re health care workers or work in a nursing home, that they’re negative before they can return to their jobs. Luckily, I haven’t had to intubate someone yet, though my colleagues have. I see about five patients an hour and swab maybe 20 per day. It’s very clean—in many ways, the Covid clinic is the safest place to be in the hospital. We take what are called droplet precautions, which means that every time we see a potential Covid patient, we don and doff a gown, gloves, a surgical mask and eye protection, and we cover our hair with scrub hat or bonnet.
In addition to my emerg work, I do locums in northern Canada, which are often underserved by health care workers. I’ve gone to Moose Factory, Kenora and Fort Smith, near the Alberta–Northwest Territories border. I’ve also been a part of something called Health Force Ontario, in which doctors go to understaffed hospitals all around the province. In late April, I was set to return to Fort Smith to work in the hospital there for 10 days. Fort Smith is a beautiful little town about an hour’s flying time from Yellowknife with a population of 2,500, many of whom are Indigenous. I love the people—it’s such a special place. There are lots of national parks nearby, and the Northern Lights come out at night. At the hospital there, you’re expected to be an everything doctor: a family physician, a hospitalist, and an emergency room doctor all at once. I’d see patients during the day and be on call for emergencies at night.
When Covid hit, I wasn’t sure if I should still go. Since I work in a Covid clinic, I was terrified of bringing the virus to the Northwest Territories. In Yellowknife, there were just five Covid cases and zero deaths. In Fort Smith there were none. But there aren’t enough doctors in Fort Smith without the ones who fly in from out of territory like me. I emailed the hospital management, and told them about my concerns. I was told they desperately needed out-of-territory doctors, and had protocols in place to protect against Covid. There were three other doctors who were coming in from out of the territory to work in the hospital, and to protect everyone, we would all behave as if we were infected—so anytime I was working in hospital, I’d be in full PPE, all the time. The other plan was for me to teach everyone else at the hospital how to deal with Covid and run drills with them. If I even developed one symptom, I’d be out of the hospital, done. In the evenings, I’d be confined to the inn where I was staying, not allowed to go anywhere except to and from the hospital. I wouldn’t even buy my own food.
On April 19, I left Toronto for Fort Smith, via Edmonton. My journey was bizarre. Pearson was completely empty. There are eight TV screens for arriving and departing flights, normally filled, but on the day I left, there was just half a screen’s worth of flights. It felt like a ghost town. The stores in the airport were closed, and there was only one gate open. There were about 15 people on my flight to Edmonton. In an attempt to physically distance us all, everyone had a row to themselves. I wore a mask and face shield out of an abundance of caution, to protect my fellow passengers. When we landed in Edmonton, the airport was just as empty. The plane to Fort Smith was tiny—I think it could hold about 20 passengers, but there were only a few of us that day, all essential workers.
When I arrived at 4 p.m., a car was waiting for me, the keys set aside at the tiny Fort Smith airport. It wasn’t very cold—I only needed a light jacket. I drove to the Wood Buffalo Inn, the lovely little hotel where I would be self-isolating. My room was more like an apartment, with its own little kitchen. The local grocery stores did a food-delivery service for essential workers like me. On top of that, I was fasting for Ramadan, so people from the community were great about dropping off meals for me when I could eat after sundown, which is quite late up north, around 9:20-ish. One friend up there even brought me homemade sushi. Believe it or not, there’s a great shawarma joint in Fort Smith, and the proprietor always dropped off lots of delicious stuff for me. The owner of the inn was so sweet, too, and tried to help me with my bags. I had to say, “No, no, no,” and spray his hands with my sanitizer. One day, he barbecued for the whole inn, where all the doctors were staying. Normally Fort Smith is quiet, because it’s small, but suddenly it was spookily desolate. I was impressed by how seriously the NWT took physical distancing. Their five cases in Yellowknife had resolved by the time I arrived; now, the territory has zero cases, all because they imposed strict measures early.
When I showed up at the hospital for my first shift, I was amazed to see that they’d already run through their Covid drills, which I thought I’d be teaching the nurses for the first time. They were very well prepared. I ran two Covid drills on a mannequin that you can intubate. The key is to keep yourself safe while you treat the patient, donning and doffing the PPE properly. The nurses did great. Seeing patients, I took extra precautions to keep everyone safe. Most of my consults were over the phone. When I had a patient who needed to come in, I’d speak to them from an adjoining room, over the phone, and limit my contact with them as much as possible, only going in if I had to and wearing full PPE. The patients were really appreciative.
When my shifts were over, I’d walk back to the inn, which was lit up with Christmas lights at night, and I’d read or listen to audiobooks and podcasts; I read The Silent Patient, a medical thriller. I’d watch Friends on Netflix, and I started BlackAF. I’d chat on the phone. It was never lonely—the opposite, really. My flight home left at 8 a.m. on a Thursday. It was just as eerie arriving in Edmonton that morning, and then Pearson. The next day, I was back in the Covid clinic.