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Now what?

So we are more than eight weeks in. All of our lives have been changed in unfathomable ways: Our daily activities, how we work, how we play, and how we connect with each other. Many important life events have been canceled, postponed, or have been drastically transformed. Who knew that a few months ago, we would be talking about crushing the curve, getting to the crest, pivoting, physical distancing and that we would be perceiving our clinical environments as a war zone from which we need to protect ourselves and our families.

Leaders in academic medicine in Canada have done an absolutely amazing job, at a frantic pace, making important decisions to support physicians and researchers in training, faculty members and staff. We have worked collectively and collaboratively like never before to face this invisible enemy. I am now seeing though, that even the best amongst us, are becoming weary and fatigued in the face of the reality that life will never be the same again.

So now what? What is this new normal? And what is our role in shaping it? Well as I've said dozens of times since the middle of March: let us look at the opportunities, let us find the silver lining, and let us not let a good crisis go to waste. I'm at the point where I am even tired of saying these now. 

What I think we know for sure is that we have made a huge leap in finally offering virtual care. And I hope we keep it up, as appropriate. What is not clear to me, and what I believe we need to strongly advocate for, is that our students, residents and fellows become fully engaged in virtual patient encounters so that they learn from these clinical encounters and about how they will be providing care in the future. It is our responsibility to ensure that this takes place considering appropriate preparation for learners, supervisors, and patients.

Just about all other aspects of the process of producing a physician can be, and likely will be, undertaken virtually. This includes admission processes for medical school, large group and small group teaching, learner assessments, and many informal activities. Even social activities will be virtual as demonstrated by the onscreen games night I had with my medical student mentor group a couple of weeks ago. We have also confirmed that the process of matching to residency will also take place virtually, including interviews.

What is also clear is that virtual care cannot entirely replace face-to-face encounters with patients. Medical education must continue to encompass the entire experience of patient care including the laying on of hands and all forms of communication with patients and family members. In person human to human interaction will become even more sacrosanct than before.  What we will not be able to replace, ever, is the need for those close interactions with patients where we must put our hands on a patient's hand and demonstrate our deep compassion and empathy for a difficult moment in our patient's life.

So while we soldier on to ensure we create positive change in our realm of influence and protect and support those in our care, we need to appreciate the impact of this rapid fire change environment on ourselves and on those we work with and be as kind and compassionate as we can.

After we have mourned all those we have lost, all of the things that will never happen or that we don’t know will be able to happen, and have recovered from the “changed induced” stress, I hope we can find that our new world, our new normal, actually allows us to focus on what is most important, what is truly core, those who mean the most to us, and maybe live a calmer and simpler life, at least for a while.