Mekalai, family physician

"I didn't want to get my patients sick. I didn't want to bring something home to my family that I knew nothing about"

Mekalai’s story

My name is Mekalai Kumanan. I’m a family physician. I practice in Cambridge, and I also serve as the president of the Ontario College of Family Physicians. 

I’ve always been told I’m a serious learner and I come across as very serious about my work. I think medicine draws people who are hardworking and to some extent, overachieving . I definitely fit that mold of wanting to always give it my all and make sure I know everything I need to know in order to do my job well. 

When I first heard about COVID there was an element of, you know, this is a really scary thing. It seems really scary and I don’t need to worry about it yet.

I felt like overnight we shifted so dramatically in how we were approaching our work. There were so many things we didn’t know, but then we knew at some level we had to protect ourselves and protect our patients. No matter how much we saw and read and understood before we got to that point, it felt like it hit us like a ton of bricks. 

I mean, it was honestly very overwhelming. 

I don’t know that I ever felt quite that level of sudden stress and sense of overwhelm as I did in the early days of the pandemic. And I don’t even know if I felt like I had the time to stop and think about how I was managing it.

You just kind of did what you had to do. And it may not have been the healthiest thing at the time.

I think I just kind of tried to roll with it as much as I could. There were always those fears and kind of thoughts. I felt very strongly like I had to do what I had to do as a physician and as a leader.

But I also had fears. I didn’t want to get my patients sick. I didn’t want to bring something home to my family that I knew nothing about. There were a lot of what ifs, and I learned to push those to the back of my mind a little bit.

There was a time in the first few weeks of the pandemic where I thought I was balancing reasonably well and keeping work as separate as I could. But I don’t know if I fully understood how much that was affecting my kids. It often would show up in my daughter’s writing, where she would speak about my mom’s a physician or a doctor and this is what she’s doing, but then she would talk about not being able to hug me and not being able to cuddle with me.

We were balancing so many things as physicians and really trying to do the right thing and maybe not always fully appreciating how it was affecting us and how it was affecting our families and our personal lives. 

I remember so many headlines of otherwise healthy people who contracted COVID and passed away, right? And so for me, there were a lot of what ifs and do I need to speak to my husband about this? Do we have our affairs in order?

I think there were times where — and it wasn’t often, because I pushed this to the back a little bit — but, you know, what if something happened, what if I brought home, what if I was asymptomatic and brought an infection home, brought COVID home to my family? What might our family look like if something were to happen? And how would we deal with that? What would our new family look like? Like these are thoughts that went through my mind. Sorry.

When I look back, I don’t think I realized it at the time — very much in fight or flight mode. There was so much coming at us, such high stress and such. I don’t want to say pressure, but this feeling of wanting to do it right, wanting to get it right, not wanting to get my patients sick, not wanting to get my family sick.

I just went into this mode of “What do I need to do?” And I was always on, and really never, in retrospect, felt like I could really slow down and turn my mind off. I know there were days where I just needed to get away, and so I would just get in the car and drive.

I don’t know if I knew where I was going. Like a few times I drove to — I remember kind of landing in a grocery store parking lot, and of course everything was shut down, so it was pretty quiet. There was really nothing for me to do at that time, but it was just getting away from all of the stuff coming at us, all of the information, all of the stress that we were feeling. I just really felt that need to remove myself from it to some extent.  

So we were initially asked to pivot to virtual care, so we could do whatever we could to keep our patients safe and really try to minimize exposure for them. 

I can think of a number of patients who delayed care, and then by the time we saw them, they were much sicker.

I can think of one patient in particular who I was on the phone with her and her husband. The husband, towards the end of the call, said something about her falling. When I asked more about that, it came out that she had had a number of falls over the prior month.

So I said, “Okay, let’s bring you in.” They were reluctant, but they were willing to come in. I was able to review everything we were doing in the office to keep people safe.

When I saw her and assessed her, it was very concerning for Parkinson’s disease. We were then able to get things set up for her. She was then able to see a neurologist, and ultimately was diagnosed with Parkinson’s.

What stood out for me with that example, and many others, was the early stages of the pandemic took away that relationship piece that we have with our patients. As family physicians, that is so important in terms of the work we do. It changed how we practice so significantly. 

And I think feeling that, you know, a need to run into it, rather than away from it. Because as a healthcare worker, I felt a really strong sense of — maybe I would say obligation for lack of a better word — but this need to care for my patients. Like, we’re in the middle of a pandemic. We can’t walk away from this. 

I think there’s a lot of work to do in terms of addressing burnout in healthcare workers. But I do feel like we’re starting to understand that it’s important to recognize it and build in the right supports.

I think as physicians we’re doers, and we just find a way to keep going and push through. One of the ways that I’ve been able to work through my hardest days is remembering those interactions with patients that are the most meaningful to me.

A special note of thanks from Healthcare Salute

Over the course of the COVID-19 pandemic, healthcare providers from across Canada have participated in our research on “COVID-19-Related Stress, Moral Injury and Minority Stress in Healthcare Workers and Public Safety Personnel in Canada.” Their struggles, heartbreak, courage, and resilience have inspired and moved us, and formed the bedrock of our research for this project. We are deeply grateful and committed to sharing their experiences.

We would also like to express our heartfelt thanks to our funders, the Public Health Agency of Canada, for giving us the opportunity and the autonomy to share our research with the larger Canadian audience without bias or restriction. This work would not have been possible without their generous and arms-length funding support. We also wish to thank our collaborators and supporters — McMaster University, St. Joseph’s Healthcare Hamilton, Homewood Health, and Homewood Research Institute.

After viewing, visit “Applying cultural competency in practice,” an education module for mental health providers and peer supporters.