Family Doc, Anesthetist, Mom of 4. Past-President
@OntariosDoctors
. Masters in Health Econ, Policy & Mgmt from LSE. Tweets are what I see, learn & do.
When I was 5 or 6, a man told my dad I could not be a doctor because I was a girl.
My dad said, βWhy not?β
Thus is my life defined: βWhy not.β
So I teach my daughter:
Dare to be.
Dream big.
Be fierce & fire.
Use her strength in service of others.
#IWD2019
#InternationalWomensDay
Today my son was cornered at school by kids who wanted to βtestβ him for
#Coronavirus
just because he is half-Chinese. They chased him. Scared him. And made him cry.
I was the same age when I was bullied for being Pakistani.
Itβs 2020. I thought things had changed by now... π
Iβm starving. Thirsty. Tired. I wore my N95 mask for 7 hours straight. Careful to conserve my
#PPE
.
Then I go see a 72 yr old man with poor lung function &
#COVID
γΌ19, on oxygen.
βI donβt want to die on a machine. I want to see the blue sky.β
So I sat. And we watched the sky.
Update: my son is okay. Confused but okay. A Chinese friend and his brother were also targeted.
This morning, we talked about what racism is.
I will talk to the principal. There is hope for education, perspective and compassion. Hereβs to making a better world.
#coronoravirus
Update: I spoke to the Principal.
She apologized. By then, she had learned of similar incidents in other classes. She immediately informed relevant parties and went to each class in each grade to talk about
#racism
,
#coronavirus
, and
#compassion
. This is leadership in action.
Itβs
#Christmas2020
. I worked at my local hospital yesterday. Iβll work at the
#COVID19
assessment center tomorrow.
The hospitals are full. Totally full.
We need help.
Iβll do my job to care for the people of Ontario. Please do yours:
#StayAtHome
.
#FlattenTheCurve
.
#WearAMask
.
In the OR, watching over elderly lady with colon cancer in for surgery.
I miss my kids.
Iβm tired.
This is my 3rd call in 6days.
Money is NOT why any of us are here.
Itβs more basic than that: We want to give this brave woman a cancer-free Xmasπ
So weβre here & Iβm glad.
I am grateful for the support, and overwhelmed by the response to the tweet. Iβm so sorry that I wonβt be able to respond to all the tweets.
More than that, Iβm struck by the stories from others. Of
#racism
experienced in the
#Ebola
crisis. The
#SARS
crisis. Now.
This is real.
@BrennaDarazs
He is still alive. He wants medical management. We are βproningβ him β having him lie on his stomach from time to time. A Hail Mary pass, but he wants a fighting chance. I will do whatever I can to give him that chance.
Iβve given him a piece of my heart. I want him to live too.
This is devastating.
#DrKarineDion
died by
#suicide
. Her family wants people to know.
βShe has saved many lives over the years, but now the pressure of the
#COVID19
pandemic on her work as an emergency physician has unfortunately pushed her to end hers.β
We did a procedure and a patientβs life changed.
Cancer. All his future plans, on hold. Replaced by worry, doctors, medications, surgery. Fear.
He watched me take off my gloves, clean my hands. He started crying.
I didnβt think. Reached out. Held his hand. Forgot:
#COVID19
.
Dear government: your healthcare workers are working flat out. We are exhausted.
So stop expecting us to work 7 days a week to fix the capacity issues created from years of not funding and properly managing
#ONhealth
the healthcare system.
Because we already work 24/7.
#ONpoli
I have mixed feelings about
#COVID19
lockdown.
In the hospital, I intubate people hungry for air as the disease destroys their lungs.
In my clinic, I see people hunger for life. I have never before seen such fear, depression, suicidality... and theyβre younger every week.
π
Today was a good day... and a hard day.
I was part of an amazing team that helped many people. But it took 12 hours before I had a chance to eat and drink. I started at 7am. Itβs nearly 10pm. Iβm still here. We have 2 more cases. 2 more women labouring.
This is the job I love.
It is Sunday. And Iβm working.
Surgeons, anesthetists, OR nurses, RTs, housekeeping, etc β we already work nights & weekends.
Our weekday ORs already run from 7am well into the night. Will we get more funding to hire more staff to work more?
#Burnout
I know of many doctors & healthcare workers putting their lives on the line to fight
#COVID19
.
What can you do?
#StayAtHome
. Be bored. FaceTime friends & family. Watch Netflix. Ride a bike. Stay 2m away from others.
#SocialDistancing
will
#FlattenTheCuve
Help us, I beg you π
Last night, ~150 family docs held an online seminar.
It wasnβt venting.
It wasnβt political action.
This was a serious talk on how to leave
#familymedicine
by β¦doctors who had left or were leaving.
#ONpoli
now is the time to step up for family medicine
People have asked about my recent silence on social media.
Iβm taking a Twitter break: I had surgery on Monday and Iβm recovering. But there is significant family stuff that I must attend to. And of course, the projects that I couldnβt find coverage for.
Iβm okay. Iβll be back.
#IStandWithPicard
We all have a duty to call out misinformation & fearmongering. Doctors. Journalists. Teachers. Govt. Everyone.
The evidence on hydroxychloroquine is shaky. The need for
#COVID19
vaccine is real β even if the ability to produce it is uncertain.
#InThisTogether
It's quite shocking to see a Canadian physician leader
@dockaurG
saying we don't need a
#coronavirus
vaccine, we just need t-cell immunity, hydroxychloroquine and "The Truth."
#Covid19
For the past 15 years, I saw myself as a family doc through & through.
β¦ standing by my patients through the beginning, middle & end of their stories.
β¦ bearing witness to their lives through illness & health.
I cannot believe Iβm this close to quitting
#familymedicine
.
I have to say. Iβm pretty fed up with
#FederalElection
. The mud-slinging. The hypocrisy. Dredging up the past. Schoolyard fights is all it looks like.
None of this has to do with the pressing issues this country faces.
* Climate Change
* Healthcare
* Jobs/ Economy
#CdnPoli
The fees
@ShopprsDrugMart
charges are more than I make doing an annual review!
And in my instance, I do
- a complete check
- a physical exam
- investigations
- adjust medications by removing unnecessary ones and adding necessary ones.
So this is what a family doctor is worth π€¦π½ββοΈ
According to this Reddit post,
@ShopprsDrugMart
is racking up publicly funded payments for MedsChecks, getting students to cold call ppl so they can bill what look like annual MedsCheck fees.
IMHO, most MedsChecks are not useful, but SDM has found a way to make them profitable.
I donβt often use such language. But this resonated.
I donβt know if Iβm strong enough. Or smart enough. Or slick enough.
But I am determined.
This is my job. These are my patients. This is my community.
So
#COVID19
. Back up. 6 feet. Now.
#FlattenTheCurve
#SocialDistancing
My day ended with a house call.
82 year old man. Lost his wife, the love of his life, this year.
We chatted, had a cup of tea. As we did, I checked
- his heart & blood pressure
- there was food in the fridge
- his flat was clean
- he was safe
This is the joy of
#familymedicine
Ontario now has 96 patients with
#COVID19
. Growth is exponential. Community spread confirmed in a handful of cities.
What can you do?
*stay calm
*stay home
*donβt hoard
*wash your hands
*donβt steal masks
*cancel everything
*look out for each other
*go to ER if severe symptoms
Family doctors are quitting comprehensive care.
Rural ERs are closing.
Wait times are sky-high.
Hospitals are overloaded.
We see severe shortages in nurses & other healthcare providers.
But yes, letβs waste healthcare dollars to feed corporate greed.
Becoming a doctor is one of the best decisions I ever made.
Itβs tough.
Itβs humbling.
Itβs inspiring.
Itβs beautiful.
This is humanity.
Thank you to the patients who let me care for them. Thank you to all the doctors who stood by me in this job.
Happy
#DoctorsDay
π
Ontarioβs Basic Income project was a carefully designed experiment to see if
#basicincome
could change a personβs health,
#mentalhealth
, income, work effort, housing etc.
Stopping it means we lose the answers to all those questions.
Not okay.
#ONpoli
#COVID19
and non-COVID intubations. A busy OR list. No time to sit, breathe, much less eat.
Then, my last patient, a big strapping lad, COVID+, getting emergency surgery, said βI want to be a nurse.β
βOne day,β I said, βYouβre gonna be one of us.β
βYou bet.β
He made my day.
Dr. Walter Reynolds died in a senseless assault last night in Red Deer, Alberta. He was working in the walking clinic, caring for patients when it happened. Please consider donating to his Memorial Fund
Iβm tired. Call. Then busy work day. Patient texts:βDoc I need a housecall, breathing off.β
I want to be selfish. Human. Go home.
Havenβt seen my kids in 48h.
Havenβt eaten in 12h.
But I go. Pleural effusion. I manage his care.
He hugs me.
And Iβm lighter
#ShareAStoryInOneTweet
Itβs hard to believe a manβs career was torpedoed over allegations in the media and social media. Not investigated by the police, just ... Twitter.
Itβs hard to believe this is the world we now live in.
My colleagues and I work 24/7 to allow
#ONhealth
to be open 24/7.
Stay safe this
#ThanksgivingWeekend
:
- wear a mask
- stay home if sick
- do not drink & drive
- do not take cannabis & drive
- double down on prevention: get your
#vaccines
, eat well, sleep well, go for a walk.
π
Just heard: Alberta Public Health officer recommends isolation for 14 days after travel anywhere outside Canada. Anywhere.
This makes absolute sense.
#COVID19
#FlattenTheCurve
On call for anesthesia yesterday. I had minutes to win peopleβs trust before putting them to sleep, to show that I see them and care.
A scared teenager, first surgery, told me about his drug use. His mom held his hand.
A scared pregnant woman wept, mourning her own momβs death.
As a GP-Anesthetist, Iβm called to put people on life support measures like ventilators.
As a palliative care doctor, I keep people comfortable during the last phase of life, dying, whether that takes days or years.
Both skills are being put to the test in
#COVID19Pandemic
.
For all the docs, nurses and RTs and allied health caring for patients with suspected
#coronarovirus
, thank you for the selfless work you are doing. Stay safe.
#CoronaOutbreak
Sunnybrook Health Sciences Centre is caring for a patient who has a confirmed case of the novel coronavirus that originated in Wuhan, China.
The patient is in stable condition and has been admitted to an isolation room. More info:
At house call for one of my favorite patients ... who just turned 100.
Part of my job today is to figure out whatβs wrong. Part is to bear witness to the extraordinary life this woman led.
Folks ask why I fight for
#ONhealth
? Itβs cuz I love this job.
#ONpoli
#NotaSecondLonger
Iβm in the OR tomorrow and on 24 hour call. And for the first time in a long time, Iβm looking forward to work.
This is what
#burnout
looks like.
This is also what getting help looks like. Twas a long, difficult road. But Iβm feeling stronger than ever.
The
#AmberAlert
woke me last night, and my heart broke as I realized what it meant.
Watching my kids play this morning, my heart breaks even more for
#RiyaRajkumar
βs mum. My thoughts and prayers are with their family.
What a tragedy.
On 24h call for anesthesia.
Itβs been a long day. But unlike some of my colleaguesβ patients, mine have been grateful for the care & kindness.
Aching feet, stiff back & a hungry tummy, all fade with the words βthank you.β
Remember this when you see the next tired doctor/nurse.
Happy
#VictoriaDayWeekend
.
Here in my beloved community hospital, I am blessed. For a job I love. For Canada. For family & friends.
We are short many things: Doctors. Allied heath workers. PPE. Medications. Money.
But.
Weβre alive. Weβre together.
#Grateful
, even in
#Covid19
It worries me that so many family medicine residency spots went unfilled.
It suggests a dropping interest in family medicine β and thatβs a big problem. More family docs mean a healthier population.
#ONhealth
#ONpoli
Iβm better this morning. I slept. Showered. Drank tea. Makeup to hide the bags under my eyes.
βYouβre home!β My kids yell before burying me in hugs.
I leave for my family medicine clinic.
Tonight, Iβll be home, Iβll hear their stories, put them to bed. And that is something.
This. β€οΈ
βPartners and spouses will be paid up to $25.50 an hour to look after ill or disabled family members under new changes announced today by Prime Minister Jacinda Ardern.β
#caregiving
#caregivers
We had a potential
#COVID19
patient at the office this week.
So here it is:
If you think you have covid19, stay home. Stay home. Stay home.
Self isolate.
Call your doctorβs office or Telehealth Ontario at 1-866-797-0000 for screening.
Do not infect others.
Headline should read: βToronto neurosurgeon charged with killing family physician ordered to stand trial.β
#ElanaFric
is no less a doctor for having been his wife or for being murdered. Her achievements remain.
π
Sheβs 17. Sheβs got it all: family, grades, friends, sports.
She wants to die.
I say, βIβve known you since you were a kid. I know youβre strong. I know how good you are at looking happy even when you feel broken inside. You donβt have to pretend here.β
She cried.
#FamilyMedicine
This is heartbreaking.
I get pandemic fatigue. Iβm tired too.
But 7 people just died and 202 residents and staff are infected in one nursing home.
The provincial numbers are rising. Ontarioβs current strategy is not working.
#COVID19
#FlattenTheCurve
#ChristmasEve
call:
Kind patients & kind families
Good humoured surgeons, assists, nurses & OR team
Unexpected goodies like a bag of homemade jams & jellies from our X-ray tech
A 20 min run between cases in the hospital gym
I miss my kids, and yet am grateful.
#MerryChristmas
One day, we will look back and understand what we did right.
What we did wrong.
We will mourn those who sacrificed. Those whom we lost to
#COVID19
.
And most of all, we will celebrate surviving.
One day, we will rebuild our world β post-
#COVID19
.
#WeGotThis
#OntarioStrong
.
I could cry.
Thank god.
Hospitals are running out their pandemic stock. N95 respirators are used for high risk procedures in the sickest
#COVID19
patients. Every time I wear one, I think, βthis is one less N95 that I can use later.β The anxiety is overwhelming.
Thank you.
This patient, this man. It shocked both of us:
My hand holding his. Human touch. Human comfort.
Once I took such things for granted.
He teared up. We talked some more. My heart broke: cancer.
βOne step at a time,β I said. He nodded.
And then I washed my hands. Careful again.
Thank you to my kids for being patient with 2020.
For making the best of a bad situation. For sacrificing to keep their grandparents safe.
For accepting a shadow Halloween instead of the real deal. For this and for always being my sunshine.
#halloween2020
οΏΌ
#COVID19
Thursdays are house call days π
While I could rebook some, a few patients had to be seen today. 3 of the 5 avoided an ER trip this way! So, well worth the drive for this
#familydoc
That said, it was scary when my car slid sideways down a hill. Please stay safe.
#CanadianWinter
We are on the cusp of another
#familydoctor
crisis.
The work is hard and complex. It is under-appreciated by many, including other healthcare providers. You are made to feel like you are replaceable by mid-level providers or worse, Dr. Google.
As a female family doc who puts in 60-80 hours of work each week, who provides excellent care, who is raising a young family with a husband who is my equal, who cares for frail elderly parents, who leads
@OntariosDoctors
β
I call BS on Dr Tiggesβ condescending comments.
Published in this monthβs Dallas Medical Journal.
These kinds of views - that women are paid less because they are less productive and distracted by their family obligations - are not supported by actual data.
The gender pay gap is not βfair.β It is discrimination.
How is this not front page news?
No staff to hydrate, feed, care for our frail elderly. Half the nursing home has
#COVID19
-- but they'll die of dehydration and other iatrogenic causes first. This is devastating.
How we treat our frailest defines our humanity. Fix this
#ONpoli
.
Tonight is 3rd night of no sleep since I went into a
#LTC
in
#onhealth
with 100s of
#COVID
+ residents, almost no staff. So far, my other LTCs have avoided outbreaks, but what I witnessed yesterday is needing words I don't have. My brain can't rest, and I think I'm in shock. 1
I was on call yesterday for 24hours, caring for people whoβre hurt, sick, dying, afraid and in pain. I am back on call tomorrow night to do the same.
I am tired of the disrespect shown to
#ONhealth
staff.
We. Are. More. Than. Effing. βEye Candy.β
#NotaSecondLonger
#ONpoli
Ontarioβs Finance Minister Charles Sousa opens todayβs hospital funding announcement with βWelcome and good morning everyone. Thank you for being here. Thank you for the eye candy behind me.β
#onpoli
March Break. So many people in Ontario travel β across Canada, to the US, to Europe and beyond.
This is the first year Iβm dreading it. And itβs because of the potential all that travel has to bring
#COVID19
into our homes, schools and communities.
Yesterday evening
@townofoakville
βs generosity meant that 50+ clinics drive thru and got masks, gowns, gloves & face shields. Now, these family docs & specialists can serve patients who need care in the community!
Thank you Mayor Burton,
@OMSAofficial
&
@OntariosDoctors
!
Just put another sick, unstable patient on life support, transferred them out. No itβs not
#COVID19
.
Family asked, βWhy canβt we request transfer to X hospital?β
Because beggars canβt be choosers. We take whatever bed is free wherever we can.
#ONhealth
is full and in crisis.
12,000 appointments are available in Toronto for the
#CovidVaccine
over
#EasterWeekend
.
What Iβve heard from patients & doctors:
- difficult online booking system
- difficulty getting to large vaccine centers
- desire to go to a trusted family doc
- unanswered questions
#COVID19
Iβd love to tell my patients when and where to get their
#COVID19
vaccines.
However, well-connected and knowledgeable as I am, even I do not have this information.
Perhaps my patients should contact
#ONpoli
MPPs to get more details?
#flushot
is β25% effective against the most common strain, H3N2. It's 42% effective against influenza B viruses and 67% effective against H1N1 viruses.β
It decreases risk in kids 6 months to 8 years by 59%.
Thatβs better than no protection.
#VaccinesWork
Tomorrow we'll officially record 1 million deaths from
#COVID19
worldwide. The actual counts are likely higher; not everyone can access a test.
So, stop. Think of all who died. Moms. Dads. Grandparents.
Kids.
Then get up and do what must be done to protect those who remain.
Iβm still glad I apologized. Some doctors in the harm reduction community contacted me. It mattered to them that I apologized.
And that is a bright light in my day.
Because it is
#IWD2022
#InternationalWomensDay
, I was going to tweet something brave & strong. And then it all went sideways. I was in tears.
Then out of the blue, a
@SamHillMD
sent this. It was exactly what I needed to see. This is why, even on days like today, I am grateful.
@bifnaked
Thank you.
Also, hubby and I love your music. Esp Spaceman and We Are The Lucky Ones. I still sing to them. And tonight, my kids sang to them too.
For anyone wondering:
Masks are safe.
Masks are not a political scheme.
Masks are medically necessary to fight
#Covid19
.
Evidence proves that masks save lives in the
#COVID19Pandemic
.
Doctors and nurses wear masks all the time in the OR.
Save a life. Wear a mask.
Many public health units have run out of high dose
#FluShot
. We're told "no more is coming."
Many frail elderly & seniors over 65 still need them.
Pharmacies may have them, but family doctors? We didn't get anywhere near what we asked for.
This is not a true
#vaccine
strategy.
The long-term consequences of
#COVID19
?
We know it impacts the heart. Even mild infections, even those without symptoms, even young people.
Prevention is all we have. There is no cure. So again - social distancing, wash hands,
#wearamask
, stay home.
Respectfully, I disagree.
Doctors tend towards urban areas not because of pay but because their spouses work there; their families live there; there are more health system resources available; there is more CME available.
All this other stuff matters.
I am Dr Nadia Alam and I didnβt train for 7 years to become a Family Doctor and Anesthetist β just to watch my
#patients
wait.
In pain.
In fear.
In uncertainty.
In disability.
Iβm done.
#NotASecondLonger
#ONpoli
: Time to do your job.
To me,
#InternationalWomensDay
is for my mom.
She immigrated to Canada to raise her daughters to their full potential. She worked hard. She endured racism. She survived illness. She accepted change.
She told us: fight for your dreams.
Looking at my own daughter, I am grateful.
Iβm so tired of how often
#familydoctors
are blamed for the problems in
#ONhealth
.
Our healthcare system has collapsed because of lack of foresight, planning, funding, transparency and accountability.
#ONpoli
I see sick patients ALL the time.
And this is why the term doctor should be reserved for ... doctors.
We canβt have confused cities funding naturopathic care over actual medical care with taxpayer dollars. What a waste.
#ONhealth
#ONpoli
6 weeks into the
#COVID19
pandemic with 12 000 procedures delayed per week ...
Add to that: 1000s of doctors at risk of closing their practices.
#Waitlists
will explode. I worry most about what this means for
#patients
.
Speak up:
I donβt know when my patients go to a pharmacy on a good day β how will I know when they go on a sick day?
Iβm all for team-based care. But without an integrated electronic health record, this decision will further fragment care.
#ONhealth
#ONpoli
Speaking today before Halton Region to recommend
#MandatoryMasks
.
We wear seatbelts. We wear helmets. We stop at crosswalks. We wear condoms. We don't drink & drive. We don't smoke indoors. We do this to keep one another safe.
Wear a mask. Save a life.
#MaskUpCanada
#Masks4All
My favourite quote:
βIf youβre in the coal mine and your canary dies, you donβt do resilience modules online. You get out of the coal mine.β
As a doc w
#burnout
, I agree.
#COVID19
tip
#SocialDistancing
means
DO NOT:
*have people over for game night, playdates, dinner or drinks
*hang out in groups in the mall
DO:
*keep a distance of 2m between you & others outside
*keep in touch over text, phone, FaceTime, etc
The key is *physical distance*.
I am starting a new political party in Ontario.
π€
π€
π€
Humans of Ontario?
Normals of Ontario?
I know.
Peoplekind of Ontario!
We already have a logo:
Itβs my sonβs birthday. Heβs 11 and beautiful.
And my heart squeezed hearing his first words to me this morning: βI want to be strong like you Mommy.β
#InternationalWomensDay
Oh my god.
This is just horrible. Iβm beside myself. I feel terrible for him, his family, his clinic, all of the people who cared for and worked with this physician.
β¦