26hrs

By Dr. Rebecca Hay

A lot can happen in 26 hours.

Many of life’s most significant moments happen in the hospital; a baby is born, a major surgery, a trauma, a loss. As physicians working 26 hours, we are with patients and families as they go through several of these moments, sometimes all in a single shift.

To experience this and to be present with families in what may be one of the best or worst moments of their lives, is both difficult and an incredible privilege. Some days are harder than others and there are certainly times when the emotional toll feels very heavy. But to be there for people, to be allowed into these moments—to provide guidance, reassurance and care – this can be the best part of medicine. Along with the best and worst moments in a person’s life come the most intimate and beautiful brushes with humanity.

The purpose of the ‘26hr’ photo project was to explore this concept and to show the very human side of medicine. It is a wide spectrum: from blissful quiet nights, to shifts where you can’t spare a moment to eat or rest your eyes. It is post-call days curled up under a blanket. It is 4 a.m. conversations, 11 p.m. resuscitations and everything in between.

What began as a project to explore 26hrs, became a project exploring the stories of physicians from experiences in the global pandemic, to messages of hope, to experiences with death and dying, and connections with patients and families. I learned so much from these incredible people and loved learning about life and medicine through their eyes.

These are some of the stories, with photos before and after call:

“I think 26hr call is really hard, because it doesn’t matter if you actually sleep or if you are awake the whole time—I worry how sharp my brain will be. When you’re shaken from sleep, it takes time to make sure your brain is focused and you are thinking about everything you need to for the patient. Similarly, when you are awake and don’t get to rest and it’s hour 20, it takes so much mental energy to make sure you are not missing anything. It’s a crazy feeling and there’s an anxiety that’s built into that, of what’s going to come in — am I going to be ready for it? Am I going to be able to give it the thought and energy it deserves?” – Dr. Grazyna Burek

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“In ICU, it’s always been the physiology and the medicine I really love – that’s my background and that’s how my brain thinks. But what I’ve really learned to love the more pediatric ICU that I’ve done, is meeting the families in the most vulnerable and sometimes horrific situations a family could experience; to be a part of those conversations and a part of their support team. It is both very humbling and very inspiring.

The greatest thing I’m struggling with in COVID is the barriers to doing that well. With all the personal protective equipment we have to wear, there’s less body language and it feels very unnatural to me. I am one of those people that likes to sit with people, hold their hands and pat their back, and it’s awful to not be able to do that. It’s harder for me and harder for the families. They are admitted to ICU when their kid is very unwell and are not able to have support and family at the bedside. I understand why it happens, but some of it feels inhumane. When COVID was on the rise initially and there was all this concern over PPE, I was so nervous to come in to work and protect myself and my family. But now, I feel like I am not as good as a doctor as I used to be because I am limited in my human interactions. I am hopeful it is not the new normal. I can’t imagine how hard it is for families in the critical care units.” – Dr. Jackie Harrison

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“Residency is hard. I never really had anyone in my family in medicine to ask; so I never could have imagined that residency would be this hard emotionally and mentally. Some days, when I’ve had a long week, I may say sarcastically, “Oh you know just living the dream!” I have to catch myself, because years ago when I was a child, I would drive by this very hospital and wish I worked here as a pediatrician. So, I am literally, living the dream. It makes me so grateful because not everyone gets to do that. In hard times, if you start with gratitude, the struggle gets a lot easier.” – Dr. Paulina Podgorny

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“I enjoy palliative care because you get to listen to people about their lives. That kind of wisdom and experience; you can read all the books in the world, but you just can’t get that real life perspective anywhere else. These reflections and the fact you are constantly around death are humbling things. It helps me not to be so attached to superficial goals and gives a different perspective of the world and a reminder that nothing is permanent. Not in a nihilistic way, but realizing any big failure doesn’t have to be the end of the world. We are so hard on ourselves and when we’re successful we brush it off. I don’t know enough yet, but I like to think that most people come to these realizations; for a lot of people it happens at the end of life. To talk to and learn from people in this real way is a privilege, and well I don’t know where else you can find that.” – Dr. Hussain Khimji

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“As a woman and mother in medicine, post-call I’ve had to ensure that I sleep and take some time. It’s very easy to turn a 26-hour shift into a 36-hour shift by not sleeping and continuing, continuing and continuing until you can’t. So, I’ve had to say, I just need to sleep. It’s by making sure my son is in daycare post call and protecting the time to take care of myself, otherwise there’s always one other thing.” – Dr. Karen-Rose Wilson

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“Practicing and travelling in other countries has given me a unique perspective. Last night I was caring for a high risk C-19 patient, and there’s a protocol in place and I had PPE available and I just felt grateful, to be able to live and work in a place like this. Where I felt like the threat was taken seriously and I was supported. I was thinking a lot about my colleagues practicing outside of Canada and what they’re going through and the fact that they have to balance their want to take care of people and their need to stay safe and keep their families safe. I just feel so blessed that I didn’t have to make that choice and that I get to live and work here. Every shift I come in now, I just feel really lucky and really lucky to be healthy every day that I am. I don’t take that for granted.” – Dr. Sarila Sanhan

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“I think that it’s a crazy world that we’re living in. Things seem to be changing at this rate that is just so difficult to comprehend. There’s a lot of unknown and a lot of anxiety and a lot of fear – not only for my colleagues and my family and friends, but also for our patients, the children that are vulnerable in the community that we take care of. It’s challenging some days, you get caught up in a lot of worry about those people – the special people in our lives and our special patients as well. If anything, this pandemic has shown me a lot of good in people too. I’ve never been so proud to be a physician, to be a physician in the Pediatric training program here and the group of people I get to work with are so inspiring. I’ve cried tears of pride and amazement when it comes to seeing how our resident body has stepped up. It makes me scared, but it makes me proud, and that’s a strange mix of emotions.” – Dr. Paige Burgess

 

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Dr. Rebecca Hay is a a Pediatric resident physician at the University of Calgary. To view the full ’26hr’ series, visit her Instagram page here.