My name is Todd Tran and I’m an occupational therapist working at a downtown hospital in Toronto.
I love being an occupational therapist because I can practice full scope. The way I describe it is a combination of two professions that’s merged into one. We’re a bit of a physiotherapist and we’re also a bit of a social work/clinical role, providing supportive counselling. We focus on the holistic picture of the individual: their physical, their spiritual, mental health.
It’s a really interesting sociological perspective or phenomenon that occurred to me with the pandemic. Being an Asian individual, that’s my first identity. Already, I know it’s not a good light to be Asian during this pandemic. I know what I’ve seen on TV with violence against Asian people. My second identity is being a healthcare worker — so it was having to not identify yourself, and being more hidden away or being in the closet. My third identity, which is being a gay man, I’m already checking every so often in terms of the environment. Is it safe to self-identify as gay or not?
Those three identities really came out during the pandemic, which is interesting, because it’s a social phenomenon that has never happened. It’s almost as if it was three strikes against me. Not cool.
I laugh at the same time, but it’s not funny. It’s unsettling, right? It was scary for me to see the freedom convoy, the protest in Ottawa. Then coming to Toronto, the messaging from where I work was to try not to identify yourself as a healthcare worker.
I said to myself, “This is nuts. We help people, we support people, we keep people alive. We keep people independent, we maximize their functioning as OTs.”
Then to hear the messaging that on the weekend when the convoy freedom protests are coming to Queen’s Park, if you are around downtown in the area, try not to identify yourself as a healthcare worker.
It was familiar for me, but also unfamiliar for me. As a person who identifies as a gay individual in the LGBT community, I’m familiar with being in the closet. So I had to hide in the closet that I’m a healthcare worker. But at the same time, I had questions like, “Why do I need to hide myself as a healthcare worker?” The emotions that come with that are very unsettling. Frustration. More than anything, it’s really sad. That’s what I’m feeling right now.
Our redeployment to various types of COVID programs was very unique. It had never happened before. It was the first time in my career of working as an occupational therapist for 20-something years. It was exciting because you were doing something else.
But at the same time, there’s also anxiety or fear of the unknown, even for us to be redeployed in a hotspot in the GTA area. We were going to be doing certain things that were out of our normal routine and responsibilities. To me, the question was, “What’s that going to look like? For sure, I’d like to help out. How can I help out at my best capacity?”
There wasn’t really an alternative. There wasn’t a way for us to say, “Actually, we’re uncomfortable with that,” or “Could I negotiate something else with you perhaps?” or “I think I can contribute in this capacity versus this capacity.” There was a lack of negotiation and a lack of autonomy.
One time at a hotspot area — it was in a postal code that has a more marginalized, equity-seeking population — we were doing first doses. We had a whole bunch of people lining up. But then something happened on that particular day, which was that somebody posted to Facebook saying that first-dose vaccinations were available for anyone.
Thousands of people came into that hotspot from all over the GTA area. It was described as a rock concert without the music. People everywhere.
But my thought was, this is for a marginalized, equity-seeking population. So why don’t we focus on people with that postal code, versus those perhaps from Forest Hill or from a different, higher [socioeconomic status] area in Toronto? It triggered me because as a person of colour and also as a person who grew up in a marginalized area in Toronto as an immigrant, I said, “This is not equitable.”
With the COVID pandemic, there were a lot of inequities in terms of the marginalized population, the equity-seeking groups. They were on the fringes, they were impacted severely — homelessness, all of that.
If we don’t take care of that population, what does it say about our society as a whole? It was emotionally conflicting. In terms of ethics, what do we do? It was confusing. It wasn’t consistent. It was frustrating.
But I also understand that the leadership team was doing this for the first time. I sympathize with the decision that they made. But being in the front line, seeing all of this, it was conflicting. I think it’s morally distressing, actually, that’s the word I’m looking for. It’s quite morally distressing, witnessing this in front of your eyes. You just have to say, “Is this really happening?”
And wave after wave after wave. It’s pretty exhausting when you’re asked — they were asking for more and more and more.
At one point, I had accumulated about maybe five-to-six weeks of vacation days. I wanted to take a few weeks off here and there, but was not able to. We weren’t given permission to take vacation at that point in time because it was the peak of a wave.
I felt so resentful. If I can’t use my vacation, then I’m not going to be 100 percent. If that’s what you want from me, me being not 100 percent, that’s not right. That’s not cool. That’s a lack of autonomy. Anger came up, resentment came up. But at the same time, I’m like, “I have to play nice. I have to be helpful. I have to push myself a little bit more.”
But they were pulling quite a bit. Pulling a lot from me in terms of my attention, my resources. It was pretty frustrating. I get it. But I also realized that giving people time off so they can recharge and come back 100 percent is much better than working on 50 percent capacity mentally.
I was on a shift in the COVID vaccination clinic one day. I got a phone call and it was my therapist. He said, “We have an appointment today at such and such a time, and I’ve noticed that you’re not here.” And then I realized, oh my God, I missed my mental health appointment.
Another time when I was on another shift, my therapist called me again and said you missed a second time. And then I said to myself, oh my goodness, because I am pulled in different directions, I’m not even able to maintain my own appointments.
That gave me insight. That was when I realized, wait a minute here, if they’re not gonna take care of me, I need to take care of myself somehow. So my mindset shifted over to, if I need to call in sick, I will have to call in sick. Or if I need to take some time off, I need to take some time off going into work and not wanting to be there and going into work being resentful.
Lack of control, lack of autonomy — especially with the ethical implications that I witnessed — the moral injury and the frustration, [the inability] to really take some time off to reflect and to recharge and to ask yourself what is happening, and to give yourself self-compassion, was so important. To do that in order for you to come back into the raging pandemic, I would say, would’ve been a benefit. It would’ve been nice to just take a break here and there.
We need to talk about this. We need to learn from this. And if this happens again ever in the future, another pandemic, then we need to use this so that we can move forward with conscious and informed decision making or informed leadership so we don’t make the same mistakes again.
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.