Dr. Dawn Lim
Dr. Dawn Lim, UHN Emergency physician, says being called a superhero leaves some healthcare workers little room to show their vulnerability and ask for help with their mental well-being. (Photo: Courtesy Dawn Lim)

By Dr. Dawn Lim

Warning: This essay contains a graphic description of domestic violence, which could be triggering for some readers.

Like a superhero, I have an alter ego. Several actually. Mom, wife, daughter, Emergency doctor, wellness educator, storyteller. But parts of me are so vulnerable, I can hardly show these sides to others. Especially not in the midst of a pandemic when every role I play demands I be the superhero.

As an Emergency doctor, I initially found courage in finally being appreciated by the public when the COVID-19 pandemic was declared. No longer was I the dumb doctor downstairs. We on the ground floor were the brave ones, the ones to tirelessly sort through the maze of coughing and breathlessness at great risk to ourselves. We were there to help. I felt essential. That was the story I told myself. The term superhero fit perfectly.

Until it didn't.

Don't call me a superhero if you expect that to mean that I don't need help. Or, that I'm fearless. My medical colleagues who still remember the taste of wearing N95 masks throughout SARS tell me that COVID-19 is worse than the painful but short-lived spring of 2003. "Never again" has become "yet again."

'Our underfunded healthcare system was not prepared.
And that broken system fell on healthcare workers.'

Our underfunded healthcare system was not prepared. And, that broken system fell on healthcare workers. COVID has seeped into the hospitals with a vice-like grip forcing healthcare workers to make sacrifices in the act of caring. When we go home, the fear of COVID remains. Every sniffle and dry cough reminds me that I can easily bring this virus back to my children.

I expect many hard years ahead. And, I'm afraid that many of my colleagues won't ask for help. The shame culture of medicine doesn't allow that weakness.

When I was a medical student, I immobilized the twisted neck of a woman while the trauma team leader intubated her. Her husband had smashed a hammer into her left eye and then waited for hours in the kitchen while he debated whether to call for help or let her die. When the metallic earthy smell of her blood and brains didn't make me faint, I thought I had the guts to become an Emergency doctor. I wanted to be that person – that heroic figure who works in the narrow space between life and death.

So, I listened to the unexpressed expectations of the good Emergency doctor. Be fast. Don't back down when others give you a hard time. Don't call in sick. Be decisive. Be smart. Don't be too emotional. Like so many doctors around me, by the time I graduated from residency I suffered from i-used-to-itis. I used to love seeing my friends. I used to read for pleasure. I used to dream of becoming a writer.

I swallowed that story, until my body told me "no more." My burnout seven years ago was the greatest gift. At the time, I felt anger toward others and pity for myself. But it was the pause and reset I needed.

Now, COVID is my test.

The shifts covered in personal protective equipment are tough. Some days, my throat is so dry I can barely speak loudly enough. My hands are cracked, but I still I give them a vicious scrub. When I eat, if I eat, if I can find a space to eat, I swallow so quickly I get hiccups. But I'm not afraid of the medicine. I did the tough work to climb back to a place of joy and gratitude in my career. When I connect and laugh with my patients, and am present in their story, I remember how it felt to be a scared medical student holding the thread of a woman's life in my shaky hands. Because my hands were shaky. I know that now. I end most days thankful for what my patients taught me.

But I am not unscathed from COVID.

I'm afraid because a part of me still wants things to look perfect on the outside. No matter how desperately I grasp, somewhere, something has to fall.

pandemic perspectives

Over the coming weeks, UHN News will present a series of essays on the effects of a year of COVID-19 and its legacy for UHN's vision of A Healthier World.

My husband and I decided to home-school our two children this year. We don't have outside help and we keep a safe distance from our families. I even learned how to read Chinese and play the violin with my son in order to make the long days without friends more fun for him. I was in control. But while I could see that the image of a superhero doctor was not real, I couldn't let go of the image of a supermom at home.

"Mommy is angry every day like Gerald." My son, Gabriel, is five. He has the most joyful laugh when we read Mo Willems' Elephant & Piggie series. Last week, he pointed to the gloomy elephant character and looked at me. I thought I had hidden my stress so well, but my innocent child could see me so clearly. I was not thriving at home. That night, I went on a numbing escapade to dull the pain.

I'm not yet where I want to be. I have much more to learn. But I'll listen to those whispers of wisdom. Sometimes they come from a child. Sometimes from a stranger in Room 14.

'Connection. This is what matters.'

"Doc," said my patient, "I'm not a baby. I haven't told my wife or doctors how I feel because I don't want to be too emotional. I've had a good life. But this – this is not living." Then this man, twice my age and weight but with half my sense of hope, reached for my hand and whispered that he wanted help to end the cancer rotting him from the inside. He saw my eyes through the goggles and face shield, shiny wet. I couldn't wipe my tears, so I held on and listened and cried. Sir, through your vulnerability you reminded me of my own. You could be my grandfather, my father, my friend. I thank you.

Connection. This is what matters. This is what I will think of with my last breaths.

On most days, it works. Not perfectly, but imperfectly enough. I try my best. Despite everything I know, despite knowing that I am good enough, I still crave the control of perfection. But don't call me a superhero. I might hate it, but I will ask for the help I need. I have that voice now.

Will you find yours?

Dr. Dawn Lim is a staff Emergency physician at UHN, as well as a Clinician Teacher and Assistant Professor of Medicine at the University of Toronto's Faculty of Medicine.

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