By Brent D Wolfrom MD CCFP

The following was distributed to the physicians in the Queen’s Department of Family Medicine earlier this week and has since found its way to a broader audience. Please feel free to distribute it you think it will be helpful. The context is based on my experiences as a Medical Officer in the Canadian Armed Forces, in particular lessons learned during a couple of tours to Afghanistan:

As we head into this pandemic I thought I would share a few thoughts based on my past experiences with crisis planning and management in prolonged stressful environments involving complex systems and little control. These are completely subjective lessons that helped me cope in prolonged stressful experiences and they may not relate to you. That said, I would have really valued receiving a variant of this email 12-13 years ago.

  1. This event is unlike anything we have lived through before and we all expect it to be drawn out, especially if social distancing does what we hope it will. It is likely that at some point we will all transition from an acute to chronic crisis mentality. This can be a difficult transition because it can feel like defeat. It’s not. It’s us getting better at beating COVID-19.
  2. Plan now for wellness and stick to your plan rigidly, however, also set expectations at a realistic level.
  3. Find supports who will talk about non-COVID, or ideally non-medical, related topics and stay in touch daily, even if just by text or email.
  4. There will be long and dark days ahead and people will all cope differently. A small word of encouragement or appreciation from a colleague will make all the difference.
  5. Support each other. If you have the time or capacity to help someone just do it.
  6. Communication. Communicate with those who need the information and minimize with those who don’t. Be deliberate about your email distributions and who you include on the To vs CC lines. Information overload is going to happen and we need to be deliberate about protecting each other.
  7. Brushup/readup now on the skills you consider outside, but proximal to, your normal scope. We don’t know where we will be needed in the coming weeks.
  8. Remind yourself daily that you are trained to deal with this situation, even if that means lying to yourself a little bit.
  9. Grief doesn’t equal failure. Bad outcomes don’t equal failure. Say those two phrases daily.
  10. There will be many changes and constraints over the coming weeks-months. Sports, clubs, social events, etc that used to recharge you will not be available. Try to find a replacement for each joyful activity you lose.

As a discipline we have just come out of a few recent years of public assaults, difficulty and infighting. Now we are the face of our nation’s defense against this threat. How times change quickly!

Watching our department, and specifically the physician group, come together over this pending crisis has been so encouraging. I truly believe we have a fantastic group and we have a great team supporting us. We will be even stronger and better at the end of all of this.

Dr. Wolfrom is a family physician, former Course Director for our Year 1 Family Medicine course, and currently Postgraduate Program Director for family medicine at Queen’s University. He was previously a full time Medical Officer in the Canadian Armed Forces.

A version of this post was shared earlier on the CMAJ blog.