Post-call days are always a battle. Do I sleep and recuperate physically, or do I wake up after a quick nap and have a day, attempting to recuperate mentally? It seems a burden of resident life that you can never attend to both aspects of your health. You must always choose. Regardless of which direction I go on a given day, the trusty Lie In Bed And Doom-Scroll Social Media has to be part of the itinerary. On one of these afternoons, my half-hearted run-through of Facebook and Instagram revealed a colleague with a left shoulder exposed to a needle, and a thumbs up to the camera. The COVID vaccine.
I don't think I was ready on this December day, in my glucose- and sleep-deprived state, for the fountain of emotions my brain foisted upon me. I was astonished they were already rolling out, but perplexed as to how I had not heard of it. I was thrilled to see a friend and colleague get the vaccine, but also concerned I had missed the boat. There was relief that we were actually approaching this light at the end of the tunnel, but there was also, ashamedly, jealousy. Then there was another colleague on Instagram, and two more on Facebook, all in the same pose, wearing the same smile, flashing the same vaccine ticket.
I searched every email of the last four weeks: nothing. I searched my inbox for all emails from my chief resident: nothing; from my site director: nothing; from my program director: nothing. I even reached out to some of the people in those photos to find out. Sure enough, emails had been sent out, waitlists created, and lotteries drawn. I just wasn't on them.
It turns out that because I was away from my base hospital, I was not receiving communications last month for their lottery. My current hospital had not started a roll out. That's understandable. What I could not reconcile was the radio silence. Save for one late-December email from an obscure administrator that my institution was "in talks" regarding the vaccine for residents, I had received no updates. I was confused at the time, partially because I felt left out of The Conversation, but also because I felt neglected by my employer. I was able to get more accurate updates on the vaccine rollout from Instagram and a CBC article than I was from the people signing my checks. Thirty minutes was all it took to find out I was not the only one.
Below is an email I sent to my chief resident that evening. They are one of the people that has been the strongest of supporters and protectors of junior residents such as myself. The purpose of the letter was both therapeutic and practical. I needed to reconcile the cacophony of thoughts and emotions in my head; I also felt I needed to advocate for colleagues, and myself, who seemed to have been left out of even the discussion regarding the vaccine rollout. If anything, I didn't want my institution to turn into another Stanford.
Hey -----,
I have been having a few struggles lately regarding COVID in general, which has all come to a head with the vaccine lottery, and I am not sure who to express it to. You have always been there for us so I figured it is best to blurt it out to you first.
The protections put in place for frontline residents has been very inconsistent, and I've experienced it all being at five different hospitals in the last five months. Each site has different face shield policies, different N95 policies, and different swabbing policies for incoming patients. These aren't just theoretical differences. We are taught at each site that these measures are for our safety as well as those around us, only to switch sites and be told what we have learned is wrong. The most glaring example happened to me last night when seeing a high risk-for-COVID patient (cough, SOB, desat, ground glass changes, from a nursing home with an outbreak)... I asked a nurse for an N95 in ED and was refused while being told "those are only for airborne precautions or AGMP." On top of all this, each site's Infection Control has different guidelines for precautions around PUI/COVID patients. I am left with two options in these scenarios: 1) Do what I think is right based on the science I have learned/been taught, and risk the ire of staff at a particular site, or 2) follow site guidelines and adjust my comfort level overnight because how I am protecting myself is different from what I was doing the day before.
I genuinely thought early in residency that during the second wave, the thing that would scare me most would be getting COVID. It is not. I am habituated, and I have internalized this risk along with all the others present in our workplace. What is actually causing me the most stress is the idea that my employer, along with all its affiliate hospitals around the city, seems to be making up the rules as they go along.
Which brings me to the vaccine. The first word I heard on [province] healthcare workers getting vaccinated ([city] & [city]) was through CBC News. Only after this did we get an email from [employer] confirming this pilot project. We received subsequent emails detailing how [administrative body] and the Ministry of Health were planning the roll-out, but that no details were yet released. Only after this did I hear through social media and personal contacts that lotteries for spare vaccines at multiple hospitals throughout the city were underway, and that people were already receiving them.
I am not here to advocate for myself receiving an early vaccine. I do not deserve it any more than my colleagues I have worked with throughout this year. My issue is that [employer] never seems to be the first one to break any news to me, and it is making myself, along with some other residents, feel a little bit left out in the cold. To be told that "talks are ongoing" and see pictures of residents getting vaccines at the same time is jarring. On the one hand, it's frustrating not knowing what is going on at all; at the same time, I feel guilty for having any negative thoughts around my friends finally getting this vaccine. I guess what I am ultimately trying to say is that I wish we had been given more detailed, timely updates on the current state of affairs. The lack of information is all the more poignant because it seems my base hospital is actually out there getting spare vaccines and getting our people protected. The only reason I didn't hear about it from them is because I am based elsewhere for this block.
I am not sure what to do about these frustrations. They are almost universally based on a lack of communication, which is a nebulous thing to take issue with because "the message" doesn't ever come from a single person at [employer]. I am writing to you because I have felt very much supported by you since Day 1, and felt you were the best person to unload this on, even if all it accomplishes is screaming into the void.
I hope you are well and getting some time off. Please don't feel any pressure to answer this. I am happy to meet up when we are both at [hospital] and discuss it. Stay safe and happy holidays,
For the sake of full disclosure... 1) Within 48 hours of sending this, all Internal Medicine residents received emails regarding signing up for vaccine waitlists, whether they be for a lottery, or a regularly scheduled vaccine. I do not think my email had anything to do with that (it is too big an endeavour to have shifted that quickly). I do, however, choose to believe that maybe our administration is emailing us more frequently now regarding the vaccine because they know residents are willing to stand up for themselves.
2) I, along with most front line residents, have finally received our first dose of the vaccine, two weeks after I sent this email. There are now robust plans in place to support any residents frequently switching sites in getting their first dose.
3) "SOB" in my letter stands for "shortness of breath"; I do not routinely refer to my patients as sons of bitches.