As Alberta’s healthcare system faces collapse, an ICU doctor leads his battle beyond the hospital walls

EDMONTON – The woman takes one last breath as she is lowered from the gurney.

She is rushed to the acute care area at the Royal Alexandra Hospital in Edmonton due to complications from COVID-19, as a medical team specializing in treating people experiencing cardiopulmonary arrest takes action.

His oxygen levels are low. Respondents use epinephrine, or adrenaline, to make the woman’s heart beat. But it does not look good.

Dr. Darren Markland, a nephrologist and intensive care unit physician, appears on the scene. He can tell by the color of the woman’s lips that it won’t end well. An ER doctor looks at him pleadingly.

“She looks at me like, okay, we have to send (this patient) to the ICU. And I know it’s useless. I know that no matter what we do there, it’s not going to work, ”Markland said, because at that point he can’t get oxygenated.

“I don’t have enough beds. Even if it was a long shot, I would, I would do it for the family because dying in the emergency department is horrible. But now I don’t have that (luxury). “

These are the stories that stick with Markland, and that are becoming increasingly common as Alberta faces a vicious fourth wave that many medical professionals have called preventable, if not for low vaccination rates compared to the rest of the country and inadequate public health measures. summer.

Alberta currently has the highest case count in the country with 10,974 cases in the past seven days to Sept. 16, more than double that of Ontario. It has the second lowest vaccination rate among provinces after Saskatchewan, with 60.52% of Albertans fully immunized. On Friday, the province announced 2,020 new cases and 18 deaths reported in the last 24 hours. There are 911 people in the hospital due to COVID-19.

The situation is so dire in Alberta that officials warned that the skyrocketing cases could overwhelm the province’s intensive care units and cause the provincial health agency to implement a triage protocol, which would prioritize those receiving care. critical depending on their chances of survival.

Earlier this week, Prime Minister Jason Kenney declared a state of public health emergency and announced new public health restrictions, including the introduction of vaccine passports, which he previously opposed. Alberta’s handling of the pandemic has become an electoral issue, and Liberal leader Justin Trudeau says it is a sign of how Conservative leader Erin O’Toole would rule.

Markland, who worked in the ICU for about 20 years, previously divided his time in the hospital and his own kidney practice. This week he announced that he would be closing his practice to help increase the levels of medical staff at the ICU.

The doctor has gained a following on Twitter by sharing his thoughts on the pandemic and the heartbreaking life and death stories that are mostly hidden behind the walls of the hospital. It’s the details, rather than the interventions themselves, that stick with him.

In the case of the woman who didn’t make it to ICU, Markland would later learn that she was a single mother of three and that between school closings and night shifts, she probably just didn’t have time to get vaccinated.

The woman had been ill for several days when she called 911, sounding desperate and confused. When paramedics arrived, they found a house in disarray, with the woman slumped over a sink and her son trying to give her a glass of water. The lunches she made for her children that day were still on the kitchen counter.

There was the young man connected to a ventilator, saying that he could not breathe and insisting that it was a bad reaction to the antibiotics he had received.

When Markland said no, it’s COVID, and it’s really bad, the man spat the words “F — you” at the doctor as tears ran down his face.

Then he pleaded for his mother.

“That is just another example that restores the humanity of the situation. This man is looking for support wherever he can get it… these are human. I don’t think anyone is malicious. There is a very small fraction of people who politicize this for their benefit, ”Markland said.

“The rest of them have just been led by a dream that led them down the wrong path.”

Increasingly, Markland sees people in ICU denying the existence of COVID or not taking it seriously.

“This is unique to the fourth wave,” Markland said. “We are seeing that anyone who has a moderate opinion on this has been vaccinated, so they are not part of this population … these people who come honestly believe that COVID” is a hoax.

“What we’re seeing here in Alberta is that we have a lot of rural populations, which are very strong and independent cultures in and of themselves, they are great communities. These people are going out for coffee together, they know each other, but they also share the common illusion that COVID isn’t really a big problem. “

That delusion manifests as a mixture of anger and fear when you are treating these patients in the ICU. Getting yelled at is common.

“I never thought people would be mad at me (for doing my job)… what I do, inherently, is just believe they were wrong,” Markland said. “And once they get over it, they can do well and maybe bring other people on the trip.”

You feel a mixture of disappointment and frustration every time you hear about an unvaccinated patient in need of intensive care, but when you look a patient in the eye, all you want to do is help. Because he also understands his anger.

“This is a disease of misinformation and a lack of critical thinking and poor political leadership,” Markland said. “This is the base that they lied to and told him this is going to be the best summer ever.”

He comes with a feeling of helplessness – no matter how hard he tries in ICU, he feels powerless to fight the political decisions that he claims have brought Alberta to this point.

“I’m standing on the train tracks yelling at the train and I don’t see it slow down,” Markland said.

So the doctor works diligently, completing his 12-hour shifts while fighting exhaustion and frustration. And yet he still finds time to write his emotional Twitter threads, which he says are “absolutely essential” in the battle against COVID-19.

“My biggest crisis of faith right now is wondering if I can really reach out to people who have already made up their minds,” Markland said. “Without telling the truth, we won’t fix it. This will go on for a long time unless people really believe this is a problem. “