I never thought that I would resign with my last day of work being the same day of my resignation. In fact, I did everything in my power to stay at my job, but the job didn’t want me to stay. COVID brought a sharp focus on the difference between my goals and my employer’s goals.
The meatpacking plants made my town a COVID hotspot. To minimize patient COVID exposure, we shifted to telehealth but took no precautions to protect the clinic employees. Every few days, we would hear of another employee’s COVID family exposure, coworkers who had been coming to work, and exposing the rest of us. Eventually, management offered employees masks and started taking morning temperatures.
My medical problems put me at high risk for COVID complications. I felt working from home would constitute a reasonable accommodation; after all, telehealth is telehealth, whether from home or from office. My doctors readily provided documentation and support.
So I filed a request for a reasonable accommodation: working from home. Shortly thereafter, I developed a cough, headache, malaise, and weakness (my immunosuppressant medications weaken my febrile response). I did the responsible thing, self- quarantined at home, protecting my patients and coworkers while I waited for COVID test results.
Still, management expected me to work, or to use sick/vacation time for self-quarantine. They would not allow leave without pay, nor would they allow work from home. While my coworkers chose to come to work after known COVID exposure, I could not ethically do the same. My accumulated sick time and vacation time came to less than the recommended 14 days of self-quarantine.
Management denied my request for reasonable accommodation during my self-quarantine. They offered me PPE, but would not specify what kind of PPE, nor for how long.
I appealed, they denied my appeal and offered, again, unspecified PPE.
I faced a decision: Return to work with the vague PPE offer, continue to expose myself to other potentially COVID exposed coworkers, while doing the work I could have done from home, submit my resignation, or be considered AWOL (absent without leave).
As a physician, I felt like a failure, to my patients and myself in the face of my employer’s expectations to put my health at risk. They felt I was making a big deal out of two physicians’ letters recommending that I not return to work in person. Underneath, I felt shame.
I took my feelings of shame to my healing circle for physicians, which I had started with a colleague for front line docs for support during this pandemic. I didn’t imagine that I would be the one coming for support.
I wept in that circle, surrounded by colleagues, saying, “I think I should just stop my immunosuppressant medication, and then I can go back to work and not worry about my immune status, how else can I go back to work feeling like I am putting my health at risk?” True to any healing circle, the participants only listened, without giving advice, while we all learned. As I listened to my own words, I realized how many of my own patients stopped their own medications out of shame. As both a physician and a patient, I knew what the right thing to do is: to continue my medications.
I didn’t want to resign from my job and leave my patients without giving them closure while they experienced the loss that comes during a pandemic. But, as a human being, I knew what the next right thing to do was.
I spent two weeks full of self-doubt. What would happen to my patients? And then, some words of wisdom from a patient I met years ago came to me, “It’s OK, doc. We are used to doctors leaving. I know you are trying your best to get us the care that we need. The system is broken way before you joined. It is not on you. It is what it is.” That patient modeled for me a sense of acceptance that didn’t sit well but that I could try to embrace.
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Other colleagues asked about my exit strategy. Did I just quit? But I didn’t have an exit strategy. I fought till the end to keep my job, but my job didn’t want to keep me.
COVID brought to sharp focus the fact that we physicians are dispensable to the health care system though we try to improve it, to help our patients while keeping ourselves safe. The COVID pandemic taught me that sometimes the best plan of action, no matter how otherwise well thought out, is to walk away.
I chose to remain healthy enough so that I can help the next patient, and the next patient after that. I would advise my patients that, faced with a choice of continuing vital medications or returning to an unsafe job, they would need to walk away from danger and towards health, and the life they want to build and have.
It may be time that we physicians heed the same advice that we give our patients: Quit putting your life and health at risk for a system that doesn’t value your best interests.
This essay is cited in the KevinMD record on COVID-19.
Nesrin Abu Ata is a psychiatrist and can be reached at her self-titled site, Nesrin Abu Ata.
Image credit: Shutterstock.com
