Q&A: These Halifax doctors push back at being called 'health-care heroes.' Here's why

At the beginning of the pandemic, as the world shifted rapidly — the signs and slogans were ubiquitous: health-care workers were heroes, on the front lines of fighting the virus.

But a new book, written by the people who suited up in PPE daily and headed into hospitals, long-term care homes and other settings, pushes back at the idea of being heroic. 

The COVID Journals: Health Care Workers Write The Pandemic gives glimpses of what the people behind those N95 masks felt and thought at a turbulent time. Essays and poems detail their fears, worries and fatigue — along with dealing with how restrictions affected their patients, marginalized communities, and themselves.

The book is co-edited by physicians Shane Neilson, Arundhati Dhara and Sarah Fraser. Dhara and Fraser practise in Halifax and also direct Dalhousie University's medical humanities program, where they use creative writing as a training tool for medical students.

"Empathy is known as something that is lost during medical school," said Fraser. "Studies have shown that engagement with reflective writing, or even reading fiction, reading literature, has been shown to improve communication skills and help medical trainees to keep their empathy."

Dhara and Fraser sat down with CBC Radio's Atlantic Voice, to talk to host Lindsay Bird about the book.

This interview has been edited and condensed for length and clarity.

So this book starts and it ends with kind of pushing back against that idea that health-care workers are heroes. The two of you call that 'a dangerous narrative' actually— and I was wondering why. 

Dhara: So I think there are a few reasons why we kind of very explicitly called it a dangerous narrative. I think the first is that it removes people working in health care from their humanity. It turns them into sort of a paragon, or an archetype, or  something other than human.

And I think the stories in the collection reflect a really profound humanity that is really shared between folks that were working in health-care settings ... We were all in this sort of moment of uncertainty, and low-level panic maybe, and really just kind of struggling to get through day-to-day and whatever our work or non-work might have been.

And I think as well that the hero narrative erases the heroism of everybody else. So there were lots of people doing incredibly heroic things ... 'health-care heroes' has a nice little alliterative, catch-phrase quality to it [but] it really doesn't capture all of the other things that people were engaged in at that time.

Sarah, you wrote a poem for this book called Management Was Mad. I was wondering if you could walk us through what you wrote.

Fraser: My poem, Management was Mad, was about being in a hospital setting and a patient near the end of their life. And … that is a time where a person would want their family beside them and where their family would want to be beside them. And often that involves a lot of people who want to say goodbye to their loved one.

And this is one of the places where hospital policy and actually catering to the needs of the patient were not in line. When very little was known about the virus, public health interventions were, I would say, very conservative. And it had to be that way, because we didn't really know the effects. But then, as a physician who is trying to care for her patients, it's us who have to tell them that I'm sorry, you're not allowed in to say goodbye to your uncle and it feels so inhumane.

So the poem Management Was Mad was about me trying to provide care for my patient and their family and going against what management wanted me to do in that situation.

Letting unmasked uncovered people into to say goodbye over the limit.

Fraser: Exactly. And sort of shutting the blinds, and turning a blind eye and doing this for that individual family, despite hospital policy advising me otherwise.

In the very early days of the pandemic, April 2020, there were some African Nova Scotian communities — North and East Preston and Cherry Brook — they got called out very publicly on a televised press conference for being a COVID hotspot. It was the chief medical officer of health and the premier at the time saying these things. Aruna, you helped curate a conversation among leaders from the Preston area and what that time was like for them to make a sort of oral history for this book. Why do you feel that these voices should be in the book and what do they add to the narrative?

Dhara:
So, one of the things that Sarah and myself and our other phenomenal co-editor, Shane Nielsen wanted to do was to make sure that folks who hadn't been in that public dialogue were able to be there. And this piece to me reflected one of those missing voices. Because … I was there, I was listening to those press conferences, and I was working in hospitals and I was watching this all unfold. And I was like, but where are folks in the community?  I wasn't hearing that at the time. I remember thinking it's strange to me that I'm not hearing that voice talk about what that experience is and was.

And so when we were thinking about this piece in particular, I was thinking about a community that had not been well served by the health-care system. And … I think that the people who so generously shared their reflections really gave us a glimpse into what was happening in the community when … we were hearing a lot of … harmful stuff, frankly.

And I think that it did two things. One, it gave us this narrative about what is happening in the community. And the other thing it did, I think, is it really challenges folks to think about what does it mean to be a health-care provider or a health-care worker — and who's the hero and what is heroism? Back to that theme about … health-care workers are not heroes, but maybe these folks are, because nobody was giving them a ticker tape parade and there wasn't any, like, public accolades. 

You both wrote the conclusion to this book. I mean, it's hard to conclude a pandemic that we're still living with and in some shape or form. The thing that's very messy, almost without an ending. So I'm wondering what you felt you could conclude about the pandemic at the end of this book?

Dhara: So, I think you actually just said it. I think one of the most important pieces that I take away from this collection, and from that moment in the pandemic, and the kind of non-pandemic moment that we're in now, is that it's really messy. It's messy from the science perspective and it's messy from the public's perspective. It's messy in communicating what is happening because those messages kept changing. They keep changing. Are we in a pandemic? Is it no longer a pandemic? What are we doing?

... And these are perspectives of folks who are in caring roles, right? Folks who are supposed to kind of know what's going on. It was messy for them too. It was messy internally, even if they all presented a good face or we all kind of got up and on TV or wherever and said … 'We know what's going on.' It was really messy for them too, internally.

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