Podcast

Sound Mind: Death threats and safety protocols: the troubling new reality for many physicians

December 22, 2021 CMA

Physician advocates never imagined being the targets of intimidation and death threats for supporting public health measures during the pandemic. But it’s happening. Three doctors -- Nili Kaplan-Myrth, Naheed Dosani and Jennifer Kwan -- open up about the impact these violent threats have had on their wellness and the steps they are taking to protect themselves, their families, their staff and patients.

“In my office, we added cameras indoors and outdoors. And we keep our door locked, which is sad because if we look through the door and don't recognize the patient or person standing on the porch, we don't open the door. And sometimes that is a patient. It's just not somebody we were expecting to arrive at that time.” – Dr. Nili Kaplan-Myrth

In this episode, host Dr. Caroline Gérin‑Lajoie holds a candid conversation with the three physicians about what it’s like to live in fear of an attack, how peer support is helping them cope and what social media platforms and governments can do to condemn the violence and threats aimed at health care workers.

This episode is available in English only.

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Death threats and safety protocols: the troubling new reality for many physicians

Dr. Caroline Gérin-Lajoie:

Welcome to season two of Sound Mind, a podcast about physician wellness and medical culture. I'm your host, Dr. Caroline Gérin-Lajoie.

Dr. Caroline Gérin-Lajoie:

In our first episode of the new season, we looked at a troubling phenomenon that is directly impacting the wellbeing of physicians. Many of our colleagues have become daily targets for online trolls, conspiracy theorists, and ideologues throughout the pandemic. Opponents to public health measures have protested outside hospitals, attacked doctors on social media, and even issued death threats. At the same time, physicians continue to work with an overwhelmed healthcare system during a pandemic. The online harassment and threats of violence have escalated to such a degree. We are taking a second look at its impact on the profession and are exploring possible solutions to ensure the physical and psychological safety of doctors joining me for a panel discussion are Jennifer Kwan, a family physician in Burlington, Ontario, Nili Kaplan-Myrth, a family physician in Ottawa and Naheed Dosani, a palliative care physician in Toronto. Welcome to all of you, and thank you for joining me today. Nili, you recently admitted, in a national Canadian newspaper, that as a doctor promoting vaccination, you live in fear. What has caused you to feel this way, Nili?

Dr. Nili Kaplan-Myrth:

Well, the article that I wrote in The Globe and Mail, and when I spoke on CBC, I was talking about a death threat that was sent to me by somebody who said I deserved to be killed because I've been very busy through the pandemic immunizing my patients and community members in Ottawa, reaching out and doing jabapaloozas to give COVID vaccine to everybody who was eligible and asking to have help to get the vaccine. The person who sent the death threat sent it through the College of Physicians and Surgeons of Ontario. It was also steeped in antisemitism. We've seen that, a lot of vitriol that mixes racism, misogyny, and violent rhetoric in the face of our work as physicians during the pandemic. So I spoke out, I said, this isn't acceptable. I had spoken earlier, even in the summertime, I had spoken about the increased, emboldened attitude of anti-vaxxers and anti-science rallies, where there were swastikas and there were all kinds of white supremacists and other violent trends mixed in with this movement against our medical efforts to end this pandemic.

Dr. Nili Kaplan-Myrth:

So for me, it was a natural thing to speak publicly about this because I knew it wasn't an isolated incident. I was warned not to speak publicly about it because this was such a strange threat. There was concern that there would be copycats. But the truth is that this is happening all the time and we're having to deal with it privately all the time. And unless we talk about it, unless we say this isn't acceptable and we won't stand for it, it won't change. And it's increasing not decreasing globally, the kinds of threats and the ways in which racism and especially antisemitism and all this reference to Nazi is tied into pandemic discourse is really problematic.

Dr. Caroline Gérin-Lajoie:

Naheed, what's been your experience with threats of violence?

Dr. Naheed Dosani:

Right from the very early days of the pandemic, I noted that the messages I was receiving online and my social media channels, direct public replies, direct messages, emails were starting to increase. They were focused on anti-science rhetoric, which turned into anti-vaccine rhetoric. But as a person of colour, often focused on the colour of my skin, my Muslim background, my faith in calling me all sorts of racial insults, the vitriol of violent attacks.

Dr. Naheed Dosani:

And as the pandemic went on, I feel this community was often emboldened by our political leaders. I live in Ontario. In many cases, our government has chosen to not stand in solidarity with science and health workers. And this led to more vitriol and more attacks, really leaving us out in the open with no cover, no protection. A person even when as far as to write a letter to my office with my tweets and have commentary about how I shouldn't be able to be practicing and I should watch my back, to another person who sent me a video of them spitting on a camera, to another person who went as far as to fax a letter of hate to my place of work. Using a fax machine that's going above and beyond. Like, that's a lot of work, man. So there's been a continuum of hate and it's only been something that we've seen more and more of as the pandemic has gone on, is people from this hateful community have felt more emboldened.

Dr. Caroline Gérin-Lajoie:

Jennifer, to what extent have you become concerned for your physical safety?

Dr. Jennifer Kwan:

I would say that it's been a privilege to advocate over the course of the pandemic and meeting other amazing physicians like Naheed and Nili. And I would say that most people have been very appreciative of the work of physicians, but because it's been a challenging year, not just for us, but also for many members of the general public, there's a lot of anger. And sometimes that anger is misdirected at the people who are trying the most to help these people, right? Unfortunately, I've also faced many hateful, sexist and racist remarks. People say that as a woman, that my opinions don't matter, or that I am spreading foreign propaganda or just things that really don't make sense when we are just trying to share public health information and keep people safe. There have been threats about you should be tried and sent to jail or face punishment for your crimes against humanity, just these kinds of comments that are not just on social media, but also received in emails to my clinic, and we've also had phone calls from people.

Dr. Jennifer Kwan:

There are even people that we're so concerned about that, we post their pictures up so that if they ever show up that we know that we had to contact authorities. So it's definitely a concern. We've all had to take precautions to ensure our safety, the safety of our staff and the safety of our patients and families. But the positive thing coming out of this is that many advocates have been very supportive of one another, sharing ways to stay safe and joining together to form a cohesive voice, to speak up. And I think that I want to emphasize that even despite all these comments, that we are still going to do the right thing, advocate for the safety and health of our patients and the public.

Dr. Caroline Gérin-Lajoie:

What impact have these threats and intimidation had on your wellbeing? Maybe Naheed, we'll start with you.

Dr. Naheed Dosani:

It's not that wild to think that people can look up where we work and show up. That's definitely crossed our minds. I've had family members reach out and tell me that I should not be posting as much on social media, watch my path to work, where I'm walking. This is just wild in a pandemic that people who've been labeled the healthcare heroes have to be thinking this way.

Dr. Naheed Dosani:

I also work in Toronto where there were protests, not too long ago, by anti-vaxxers where people were yelling, swearing and some cases even spitting at health workers as they walked into healthcare institutions. This creates a sense of concern about your physical safety, but also your mental wellbeing in a pandemic where so many colleagues are dealing with moral injury and compassion fatigue. And we're asking our health workers to do more and more as we go through the pandemic. So I think it's taken a real toll. It's demoralizing, it's stressful. And then on top of that, you have governments, like our government here in Ontario, who continues to stand with anti-vaxxers frankly, and not with health workers and in solidarity with science. It doesn't help.

Dr. Caroline Gérin-Lajoie:

Jennifer, any thoughts on that question?

Dr. Jennifer Kwan:

Even early in the pandemic, physicians had to face many challenges, right? We had troubles accessing PPE, we had to work extra shifts, expand outside of our usual roles. But then the burnout only worsened throughout the pandemic, as it dragged on. And people originally may have clapped for healthcare workers, but eventually, we became the enemy that was seen as taking away people's freedoms. So I think that has, as Naheed said, added to the moral injury that even though we are really trying our best, going beyond what we normally do and really taking our toll on ourselves, that we can be seen as enemy when we are really just trying to help the public.

Dr. Caroline Gérin-Lajoie:

How about for you Nili? Have you noticed any impact on your wellbeing?

Dr. Nili Kaplan-Myrth:

Yeah. So much like Naheed and Jenboth said, early in the pandemic, we were struggling because we didn't have PPE and we didn't have income stability and all of those things. And yet, we persisted and now the idea that we're told and exactly as Naheed said, our family members say maybe you should lay low, maybe you shouldn't speak out. Our legal counsel says, yeah, you might want to just not say anything. We're being told to stay safe and we can't stay safe and continue to do the work that we have to do. So we have to put ourselves out there. We have to be vulnerable. So when I say, well, then I'm going to be lying awake at night, worrying, yeah, the police told me if somebody attacks me, I should phone 911.

Dr. Nili Kaplan-Myrth:

Well, last week I held a junior jabapalooza. We had 150 kids coming through our office. We're immunizing them. And at the back of my mind, I was thinking the entire time, make sure that door is locked between every patient because if somebody comes in here, 911 isn't going to help us. Right? We're already going to be dealing with a really serious situation if I have to push the little button that I have in case of an emergency. So there's this disconnect between what we have to do because our work has to continue and we have to keep advocating. We go and we speak to boards of education about the importance of letting educators wear better respirators because COVID is airborne. We go and we speak about paid sick days. And we do all of these things because it matters in the immediate lives of our patients and our communities.

Dr. Nili Kaplan-Myrth:

We can't just stop doing that because there are some bullies out there and some racist threatening people out there. So we have to live with that fear and push through it, which is not resilience, it's grit. It's just the sense that there is no option not to. You can't let the bullies win. And as Jen said, there is also a sense that there are very few people who are actually that horrible. Most people are quite supportive of us and that does energize us. So even if we're lying in bed worrying about, will we be okay as we go to work, will we be okay in our offices, will our staff be okay, we also know that there are thousands and thousands of people out there who are saying, thank you for doing what you're doing, it matters. And so we get out of bed and we go and we do it. So I think that's the balance, is knowing that the only way that we will be safe is if we continue to speak out and knowing that also means that we're in danger.

Dr. Caroline Gérin-Lajoie:

And just to continue on that Nili, what measures have you had to take then to continue to do those things, but to feel safer and to reduce the level of harassment?

Dr. Nili Kaplan-Myrth:

Yeah. In my office itself, we added cameras indoors and outdoors. And as I said, we keep our door locked, which is sad because if we look through the door and we don't recognize the patient or the person standing on the porch, we don't open the door. And sometimes that is a patient. It's just not somebody we were expecting to have arrive at that time. I walk to work, but I no longer walk to work on my own. My husband comes with me, which as a woman, walking the streets at night can sometimes be scary anyhow. But I've never before had to worry about, well, my face is recognizable, this is a small town in Ottawa. And my children have been in the public eye because they volunteered.

Dr. Nili Kaplan-Myrth:

We've had to talk to them about what they need to do in terms of their safety. That's a hard conversation to have with a 12 year old who has spent her pandemic helping her mother immunizing the members of the community and to say to her, "Hey, look, you're not to walk on your own either if anybody stops you. And we gave out these jabapalooza shirts. Well, we thousands of jabapalooza shirts and they have a bullseye on them. It's just the design. And now I worry about it. I don't really want my kids walking around in their jabapalooza shirts in the neighbourhood. Right? So those kinds of things. It's just never in a million years, what I've imagined that would be where, at this point in the pandemic.

Dr. Nili Kaplan-Myrth:

But also daily, my life continues. We live with the notion that there are bad people out there and the police are not investigating the hate aspect of the death threat that I received and it's a very slow process for them to deal with charging somebody who threatens to kill a physician. So I know that really the onus is on me to protect myself, but I feel like the safety issue has been heard. It's been heard by the Canadian Medical Association, it's been heard by our member of parliament here, it's been heard by the prime minister. We are gaining traction in terms of this being an issue that needs to be addressed. And so hopefully our safety will be something that we can take comfort in other people having our backs.

Dr. Caroline Gérin-Lajoie:

Naheed, have you had other types of experiences or other measures that you have had to take to feel safe?

Dr. Naheed Dosani:

In one case I actually had to change my primary practice address that's available publicly, because it's a generic address where I'm actually not at that address all the time because we're a mobile service. So that was a step that I took just to make sure that I'm safe and be clear about my boundaries, mostly for my family who requested it. In other cases, you start to think about how you're using your social media. Maybe pre-pandemic, if I was in a location I would post in the immediate time that I'm at a place, let's say a public event, a sporting event or whatever. Now, I would not dare to do that, actually. I would probably post later if I wanted to or not at all, just because you're giving away your location and, and where you might be, for example. So those are a couple of examples of things that have led me to change my behaviour and speak to the reality of what's happening for those who have chosen to be public, who have chosen to stand on the side of justice and science and moving public health along.

Dr. Naheed Dosani:

But I'm really grateful to the CMA and Nili and so many others who have done incredible work in moving the conversation forward. But we do need a conversation about hate in this country. We need a reallook in the mirror about the kind of hatred that's coming out, the white nationalism, the white supremacy, the antisemitism, the racism, the anti-black and anti-indigenous hate and how it's coming out in this pandemic at a time when many people are dealing with serious pandemic fatigue. Many people's jobs and businesses have been impacted. There is a side of this where I'm obviously very frustrated with the hate I'm receiving, but I feel compassion actually for the people who are sending it my way, in some cases. It sounds weird, but I do because it's been a real hard time for people. But that should not come at the cost of the safety and mental wellbeing of our health workers across this country.

Dr. Caroline Gérin-Lajoie:

Jennifer, at the beginning of the pandemic, you started a group to support and advocate for the use of masks and other public health measures. Presumably, some online trolls did not appreciate this advocacy. How has your group responded to this?

Dr. Jennifer Kwan:

Well, my group called Masks4Canada, we advocated early in the pandemic in 2020 for mandating masks in high-risk settings, such as indoor crowded spaces. At that time, it was a challenge because not only were there trolls and anti-maskers, we were also making recommendations that were not the current public health record recommendations at that time. Later, they did change and agree that masks were effective and helpful against COVID-19. So the members of my group have faced various levels of hatred, ranging from death threats to people having the sidewalk outside their home sprayed with hateful messages.

Dr. Jennifer Kwan:

So it has been difficult, but our group has been able to be supportive of one another through this, for example, by rotating through any media interviews so that not all the attention is on one person. And if there is any sort of targeted harassment towards one member, then we can all report that person and hopefully remove the hateful account if they are making threats. So having a group to support one another through the pandemic has been very helpful. And hopefully, this will also translate to post pandemic if there are any important issues to address that we have now learned from this and can better advocate in the future.

Dr. Caroline Gérin-Lajoie:

It almost sounds like your group also had a peer support component to it.

Dr. Jennifer Kwan:

Absolutely. Yeah.

Dr. Caroline Gérin-Lajoie:

Nili, what kind of support can physicians give each other in the face of these attacks?

Dr. Nili Kaplan-Myrth:

Well, we have public conversations and then we have private conversations, and both of those have really been helpful through the pandemic about everything. About how we're coping with pivoting to virtual care, how we're coping with going back to seeing patients in person, how we're doing vaccines in family practices. All of that peer support is vital. For somebody like me, as a family doctor, where I work in an office without a large group of colleagues around me, it's been really important to be able to have those conversations. And it's actually been cool. I put together the panel of Canadian healthcare workers who talked about access and equity to the COVID vaccine. We spoke to the prime minister last February. Those are physicians and nurses and other healthcare workers that I've never met in person, but we've had so many conversations through social media. It feels like we're now old friends. We've been bouncing ideas off of each other and supporting each other in these ways now for two years.

Dr. Nili Kaplan-Myrth:

So that's really important. We also have our own private supports outside of our colleagues. And then our families. I feel quite lucky because I do have that whole network that's already in place around me. And I can't imagine how I would've dealt with the stress of the pandemic without that. But it truly has been like the silver lining of the pandemic has been getting to know these other amazing advocates across Canada. And when we were immunizing the kids last week in the office, we were all decked out and we had confetti and I was wearing silly glasses to make the kids laugh.

Dr. Nili Kaplan-Myrth:

And all of a sudden, Dr. Katharine Smart, from the CMA, walked into my office with a big bouquet and she said, "Dr. Kaplan-Myrth, I'm here in town because with Bill C-3, but I just wanted to stop by and say hello." It was just this moment of, oh, here's this doctor who she's president of CMA, but like she's coming in from Whitehorse, she's showing up at my office. That wouldn't have happened two years ago. We weren't having these kinds of national conversations. And so that really helps to keep us going, helps me to keep going, and it means that we're not alone. And that's why, who has our backs is the ultimate question and I know that all of these amazing colleagues out there, we have each other's backs.

Dr. Caroline Gérin-Lajoie:

Naheed, what else do you think medical institutions and social media companies could do to support physicians?

Dr. Naheed Dosani:

I think one of the things that we pride ourselves on, and I've been thinking about a lot lately, is the concept of resilience. It's like, "Oh, like he's so resilient. She's so resilient. They're so resilient. Physicians and health workers are so resilient and cool." But I think sometimes that's a little bit of an excuse. We're glorifying resilience, and it's becoming an excuse to actually not address the actual root causes of why people have to be resilient to begin with. And so I think when it comes to supporting physicians and other health workers through this pandemic and beyond, I think we need to actually do the things that will actually allow them to be mental and physically well.

Dr. Naheed Dosani:

So I know that we've talked a lot about peer support, and Jen and Nili have been huge peer supports for me during this pandemic. So thank you both. We need to build on that. We need to formalize what that looks like from people across the country, people at different stages and phases of their careers and make people feel like they're together and they're part of one as a community and family. And it really does work. I'm part of a mentorship program at the University of Toronto for racialized medical students who are going through and feeling the imposter syndrome. And we see the impact of what mentorship and peer support can do there. Around social media companies, I think there has to be better metrics around the hate that actually is existing. Many of the social media networks don't even have misinformation buttons or appropriate reporting mechanisms to report hate. The CMA, to my knowledge, is the first healthcare body across Canada that's really taking online hate for its members seriously. I hope others will listen.

Dr. Naheed Dosani:

I know the CMA works collaboratively with other healthcare professional organizations. So hopefully, you guys can become like the Avengers and all team up and take this on, because I think it takes that national, even international, force to really get Meta and Twitter and other social media networks to really listen. And then I think there just has to be some raw repercussions for people who are actually spewing this hate. It's one thing to disagree with someone, it's another thing to make someone physically feel unsafe in their town, in their city. So there has to be some real repercussions to that from a legal perspective and I know work is underway to do that.

Dr. Caroline Gérin-Lajoie:

And Jennifer, what thoughts do you have about what social media companies can do? And also, what could the governments be doing better?

Dr. Jennifer Kwan:

Well, in terms of social media, it is an important tool that is a double edge sword. So it can be a great place to have conversations and discussions. Without social media, I would not have met Nili or Naheed. We would not have met advocates across the country. We would not have information about the pandemic. But at the same time, it's important to have free speech and disagree and have discussions, but it's not okay to target people, to make threats of violence, to make racist comments against people who are speaking. Then you are actually silencing discussions. There has to be a way that the social media platforms can filter through these. As Naheed said, if they have so many algorithms that they can even tailor ad content to get you to buy the various products, how come they cannot filter things that are clearly hateful or violent.

Dr. Jennifer Kwan:

And oftentimes, we see comments that are very offensive. We make that report to Twitter or Facebook or Instagram, and we get a report back saying, well, this comment doesn't violate the rules, even though it's clearly making some very offensive comments. And sometimes, they don't don't even take it seriously, unless it's something big that hits the news. So I think that I do really appreciate the work that CMA has done in terms of pushing this issue on a government level, to have laws in place that protect healthcare workers. Not just physicians, but our nurses, our colleagues working in the hospitals who are facing this sort of harassment.

Dr. Caroline Gérin-Lajoie:

At the end of November, the federal government introduced a bill that if passed, would create two new offences under the criminal code. One for anyone threatening a healthcare worker, those who assist them and anyone trying to access health services. And a second for anyone caught obstructing access to a healthcare facility. Starting with you Nili, is there more that needs to be done?

Dr. Nili Kaplan-Myrth:

So one thing that I wonder in terms of this new legislation, when Bill C-3 is passed, that'll be fantastic. But what I know and what every woman who's ever gone to the police to report gender-based violence or whenever anybody racialized has gone to the police to ask for help, we all know that really it's whether or not the police are going to investigate, right? So you can have the law. We already have laws that say that hate mail is a crime. We already have laws say a death threat is a crime. When I sit here and it takes a week for the police to even answer my call, to say that somebody has threatened me and then now another month has gone by and nothing has happened, you do have to wonder if the people who investigate this and charge for these crimes aren't going to investigate and aren't going to charge, then it doesn't really matter how much great legislation we have.

Dr. Nili Kaplan-Myrth:

And then we also, as we've alluded to already, we have to look inward. It's not just the threats from the public, but we also have to look at the systemic racism and sexism and discrimination within medicine. So the kinds of things that we're dealing with, what we're talking about here is being threatened by members of the public. But we also have to look at how does media report on all of this and what happens within medicine and what are the repercussions when there are people who are discriminatory within medicine.

Dr. Nili Kaplan-Myrth:

So there is a doctor in Ontario who has been posting and posting antisemitic and anti-science, and horrible things online. And yet, he's still in practice. And Twitter actually took him down yesterday, but the College of Physicians and Surgeons has yet to tell him that he can't be practicing. And in Ottawa, I saw people reaching out to me and saying a group of doctors sent out a letter to all these patients saying that they're retiring because they don't want to be part of this horrible vaccine thing, and on it went, and all kinds of conspiracy stuff. So within medicine, we also need to see some real consequences for behaviour that is unacceptable. And unfortunately, as a woman who spoke up about sexism early in the pandemic, I can tell you that our medical institutions don't necessarily have an understanding of how serious this issue is in our day-to-day work and in our institutions. So it's not just the legislation. These problems have permeated society at all levels and we need it to be addressed at all of those levels.

Dr. Caroline Gérin-Lajoie:

Naheed, any thoughts from you on the role of government and Bill C-3?

Dr. Naheed Dosani:

I think this is a really important step in the right direction. I do reflect on the fact that it's a really sad state of affairs that we even need to do this, we even need to be here. How did it become normalized to hate health workers in a pandemic? I know that's such a simple question, but we need to ask it and we need to answer that question. Who is normalizing this and how can we prevent that from happening again? I think having real deal punishment and legal ramifications is an important outcome, but it won't necessarily solve all the hate. And maybe that's not even the goal. Maybe it's just giving people enough of a community that they can rise above hate when it does happen.I think we need to be thinking about that and what that means for people.

Dr. Naheed Dosani:

I also really hope now that Canadians who are listening to this know that hate exists in this country. It's real, it doesn't just happen in the United States. We are a hateful country. There's racism, there's bigotry, there's antisemitism, there's sexism and all types of hate. Everything under the sun, we saw it in the pandemic and it was directed at our health workers. Now stand with us, stand with science, stand with justice and support us as we move forward.

Dr. Caroline Gérin-Lajoie:

So this will be the last question for the panel and it'll be a bit of a shorter one. As I mentioned at the beginning of the episode, these threats are an added assault on physician wellness when many are already facing burnout from COVID-19. I'd like to ask each of you, what has been the most important thing that you have done for yourself to support your wellness? Nili, we'll start with you.

Dr. Nili Kaplan-Myrth:

It's a hard question, actually. I think the thing that I have done to support my wellness is truly the reaching out to connect with others. And through this networking, through social media, by the little podcast that a community member and I ran, the Rx: Advocacy, where we talk to other women leaders across Canada, like I think the way that I've taken care of myself, the way that maybe it's just my coping mechanism for dealing with stress is to reach out to others and say, "Okay, let's talk about this. We don't have to deal with this on our own." That, and I go to my cottage and I quilt and I play with my kids and all the other kinds of self-care stuff. But I don't think that I could have managed through the pandemic without reaching out and connecting with other physicians and other colleagues in Canada and around the world.

Dr. Caroline Gérin-Lajoie:

And for you, Jennifer, what's been the most important thing to maintain and support your wellness?

Dr. Jennifer Kwan:

Well, one thing I realized through the pandemic is the importance of being mindful and focusing on the little moments that make our life so great. There have been so many challenges through the pandemic on a professional and personal level, but I created a mental health initiative called Ten Ten Moment, which basic is it started when I was thinking, we always rate movies, how is it out of 10 or we rate food out of 10, but what about our moments? There are many moments that make life great that are small, whether it's just taking a walk on a foggy day or just the first shower after you come back from camping, just little things like that. Or when we receive positive messages from people who support healthcare workers. So I started the Ten Ten Moment to help myself and to help other people to be mindful and to focus on the positive things that are happening because of the pandemic.

Dr. Caroline Gérin-Lajoie:

And Naheed?

Dr. Naheed Dosani:

Before the pandemic, I used to that participate in these circles called grief circles. I'm a palliative care doctor who provides healthcare for people experiencing homelessness and poverty. And due to the increase and uptick in opioid overdose deaths, COVID deaths and deaths from homelessness, frankly, we saw more loss and suffering for health and social care workers in our Toronto based community than ever before. And so actually I continue to work with colleagues to facilitate these grief circles. And we were actually tapped on the shoulder by the City of Toronto to become the main provider of grief circles for care workers who were supporting the COVID recovery hotel programs for people who are unhoused. So we light a candle, we hold a minute of silence and we cry and we laugh and we tell stories of what it's like to care for the person, remember what it was like to care for them, reflect on what it was like to care for them and think about how we can renew and reinvest in each other.

Dr. Naheed Dosani:

And when the grief circle is over, we go out and do it again. And this has been a really powerful opportunity for me to be part of and facilitate structured spaces for people to grieve and be together. And I know that grief circles won't solve all the problems in the world, but it's a little example in my corner of the world of how we can take reflective practice and actualize it for people on the front lines. So I'm really grateful to be part of grief circles and structured spaces like that, and hope they're more common in healthcare.

Dr. Caroline Gérin-Lajoie:

Thank you all so much for your time and openness to speak about this issue.

Dr. Nili Kaplan-Myrth:

Thank you.

Dr. Naheed Dosani:

Thank you very much.

Dr. Jennifer Kwan:

Thank you.

Dr. Caroline Gérin-Lajoie:

Jennifer Kwan is a family physician in Burlington, Ontario, nili Kaplan-Myrth practices family medicine in Ottawa, and Naheed Dosani is a palliative care physician in Toronto. You've been listening to Sound Mind, a podcast about physician wellness and medical culture. PodCraft Productions produces Sound Mind. If you're looking for resources, tools, and research on the topics covered today, please visit the CMA Physician Wellness hub at cma.ca. And however you're listening to us, please think about giving a rating or review. This makes it easier for others to find the podcast.

Sound Mind: Death threats and safety protocols: the troubling new reality for many physicians

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