Preparation, Not Fear: Tips For Working and Living in Isolation during COVID-19

Hit the news right now and you’ll see almost nothing but sadness and negativity about COVID-19. Rightly so; it’s a pandemic; it’s a rapidly accelerating #globalhealthemergency, and not enough seems to be done by many leaders til it’s too late.

As we mentioned, it’s easy to feel despondent and helpless about the future. We can’t fix everything, but we can focus on the things we can. The current projections are that this will be around for at least a few months, if not, longer; and decisions on working, studying, travelling, and socialising are changing rapidly literally overnight. If you’re not used to working, studying or living in isolation or confined quarters, what can you do?

How are some ways to prepare for home isolation or working from home:

1) Keep up your exercise, eating and daily health routines

It’s absolutely vital that we keep up our immunity, whether we have access to gyms and sports groups in normal life, or steps, water bottles, exercise bands and barbells at home. Download a fitness app (such as this one, which has home exercises you can do without gym equipment!); watch YouTube for free fitness classes; do some starjumps, pushups, lunges, and squats every hour; do a few walking laps or light jogs within the confines of your home every hour; take a break from the screen every hour so your eyes can adjust. And yes, it’s okay to let the sunlight in (though wear sunscreen if you sit in direct sunlight); no one’s said that COVID-19 seeps through windows at present!

Obviously, if you’re in quarantine because you fit the criteria for recent overseas travel or immediate contact with a confirmed COVID19 case, which is what the current Australian Government guidelines are for testing, you will need to take it easy and self-monitor more closely for signs of symptoms, rather than exercising yourself through respiratory failure in the worst case scenario. But, you have good judgment; use it.

And, of course, use the chance to cook (or learn to cook!) some delicious, nutritious healthy meals for yourselves

2) Keep up your daily hygiene routines as though you’re still going to the office/uni/school

Seems like a silly thing to say, but it’s quite common when working from home to be tempted into staying in pajamas without a shower all day! The WHO Handwashing recommendations for preventing COVID-19 is not just for handwashing; taking a shower obviously will help wash off any germs just like washing your hands will. We were befuddled to see the local supermarket handwash shelves stripped bare, yet creaking with 1-litre bottles of shower gel right next to it!.

Plus, keeping your daily hygiene routine also helps reset your “home” mindset for “work/study”, and thus help you with your productivity.

3) I’m unemployed/a casual worker unpaid during isolation/unable to do my usual job at home because I’m a mechanic or otherwise

We’re not going to make light of this; it’s a huge issue for millions of people around the world, and there is a LOT that needs to be done by Governments, employers, insurers and other structures to help protect you in times like these. And, it is scary.

Instead of focusing on the negative, let’s think about the positive. The time off may just be for two weeks. Or even a month in some cases, or longer, which is daunting, and in the realm of what you CAN’T control. But think about the following, which you CAN control:

• Is there some skill or unique knowledge I have that I can turn into a product or service offering online or over the phone? Could you be a coach? A tutor? Write and sell an eBook? Sell an online course? Platforms like Teachable and Thinkific provide free classes on how to plan, create and launch an online course, simply with your laptop. It can take time, but it can be as simple as you need. You don’t necessarily need to film with your face in front of the camera if it doesn’t suit you. The best thing is, once COVID-19 is over, or even beforehand when quarantine is over, your product or service can still be there, running along in the background when you return to work, or when you hit the ground running looking for other jobs. That’s basically your side-hustle helping you with an additional income stream, no matter what your employment situation is at any stage in your life; no matter how small the income may be at first; and during isolation, it helps to keep your mind active and focused on a goal and outcome to prevent worrying about the unknown.

• What have I always wanted to do or wished for more time for, but couldn’t because I was working/studying? Barring the ones like “travel to Europe” or “hike Kilimanjaro”; perhaps you’ve wanted to spend more time with your children; organise your photo albums; learn to paint; reorganise your home; learn to dance; or other things that you could do at home. In fact, “travelling to Europe” could still be done, kind of, virtually, with a decent VR headset and travel film- search online for suggestions. Buy eBooks or read free travel blogs stacked with photos upon photos of Greece, Venice, the Caribbean… or write up your own travel memoirs into a blog or book yourself.
  And in terms of learning to dance or paint - online class portals like Skillshare and CreativeLive have thousands of free or low-cost classes you can take to pick up a new skill.

• Speak to your local welfare sources; to your employer; to your bank; to your service providers (electricity, etc) about what sort of assistance they can provide, if any. Some may be willing to defer or freeze payments temporarily while you’re in sudden hardship, though this may be more difficult when the rest of your country is in lockdown. But if you don’t ask, you don’t know. And some employers in Australia have committed to paying their casual staff if they are suddenly isolated or quarantined due to COVID19.

4) Keep your mind healthy. Meditation; mindfulness; yoga; deep breathing; and other calming techniques are useful in all kinds of situations, and for all ages and demographics. Isolation can be tough; you may miss the everyday social interactions you didn’t realise you get from the workplace or school or study institution; learning a meditation technique can be incredibly helpful for keeping your mind and body strong. Yes, meditation has significant health effects on the body, including lowering blood pressure, preventing illness, and improving your immunity. It may not prevent you from falling sick (including from coronavirus, unfortunately), but can help your mindset and physical health if you do happen to fall unwell, or if a loved one falls ill.

5) Keep social. Home isolation doesn’t mean you have to switch off your phone! Make time to call a friend each day. If you’re home with family or friends, make time for just having your usual meals together; exercising together; learning a fun new activity together; or playing board games together. An interesting article in the BBC recently showed some unexpectedly positive benefits from working from home and spending more time with loved ones in forced isolation in Wuhan and other parts of China.

6) Talk to someone for help. It’s also okay to speak to a phone or telehealth counsellor over Skype, Facetime or other platforms if you’re having trouble coping. If your employer offers an Employee Assistance Program (EAP) or other free confidential counselling service for their workers, you can access this over the phone or video call as a benefit of your employment. The Australian Government has finally approved funding for Medicare-enabled telehealth consults for GPs to see possible coronavirus and chronic illness patients remotely without having to physically come into the clinic, where they may be exposed to coronavirus or potentially infect others. There are numerous online psychologists and counsellors, with varying fee structures (mostly private out-of-pocket funding in Australia at the time of writing); and other telehealth services in other specialties including Psychiatry, Endocrinology, Rheumatology, Dietetics, Physiotherapy, and other specialties, which, if you see a current Specialist, you may be able to access. All it takes is a quick phone call or email to find out.

7) Your temporary quarantine/isolation is a gift that others don’t have. It may not seem like it immediately; but if you think about the poor doctors who died in Wuhan during the initial outbreak, while the world was trying to figure out what this mysterious new virus was; what the incubation period was; and how to prevent its spread; if you think about the several months’ head start you and your country have in identifying the cause and knowing more about what to expect from COVID19; we are truly, incredibly fortunate, and if we all act together with #compassion and #kindness, we still have time to fight this and stop this horrible disease from spreading and worsening its effects on the world.

These are just some tips to start out with; we may well add more but for now, enjoy this post, let us know if you found it helpful!

Thank you, 2018 :)

It’s strange sitting here, 1.5 hours before midnight in my home city, 2.5 hours til 2019 in my current one.

But it’s a great time for reflection, particularly when you and your other half saw the Early fireworks as he’s oncall tonight.

2018 was a huge year for me.

One of my faves, Ariana Grande herself said it best- “I find it interesting that this has been one of the best years of my career and the worst of my life.”

I guess personally, it wasn’t the absolute worst it could have been for me, but it definitely had a huge amount of challenges that really rocked me- but also gave me the extraordinary chance to reset and reframe the difficult situations in my personal life.

You can dread each day and its challenges, or you can reframe it to be uplifting for someone else who’s going through a hard time.

Every day counts.

I really believe that, no matter what challenges your career throws at you, you and your loved ones come first.

They’re your anchor, they’re your reason, your “Why” in most cases.

And you should never be ashamed of putting your wellbeing first.

Because no matter how big your career gets- and I believe that your career is your startup - you’ll enjoy it more when you respect yourself.

If you need more time before saying “Yes” to a project, ask for it.

If you feel pressured to work weekends and public holidays because that’s “the startup way,” but you’re actually more productive just working on odd weekdays, go ahead and set your boundaries.

If your personal circumstances mean it’s more favourable for yourself and your family if you work a bunch of part-time and casual freelance roles, go ahead and do it.

If you feel your co-founder’s doing something dodgy, reassess and consider trusting your instincts.

If someone’s being two-faced, don’t be afraid to call it out.

If you love doing several other things along with medicine, allow yourself to do it.

Give yourself permission.

And many more examples like this.

Everyone will be better off for you owning your power.

—-

Someone wise I met recently gave me that wonderful piece of advice.

“Own Your Power.”

Own your decision-making capability, your strengths and skills, your relationships, your identity.

People will try to take advantage of your vulnerability.

So-called “friends” and “partners” in startups and medicine will show their true colours to you, even when the rest of the world can’t see it immediately.

It’s disheartening. It can be isolating, and you can question yourself and your perception, wanting to believe you’re wrong.

It’s okay, because questions are healthy, and I’ve learnt how valuable it is to be mindful, and become more self-aware.

It’s a great defence mechanism, mindfulness. I’ve found it’s a great decision-making tool, productivity booster, and mental health balm. (Ooh, I should package that! Next to the lip balm jars!)

But I guess my rambling here right now is to say,

THANK YOU.

Thank you, 2018, for teaching me even through my weaknesses and dark times this year.

Thank you for giving me the chance to grow stronger.

Thank you for helping me to speak my truth.

Thank you to every single one of you who stumbles across my page; who reads my articles from way back when; who follows and likes (for real) my stuff on social media; who has become a true friend from this crazy journey; who has bumped into me at some event or clinic somewhere around the world and said hello; who believes in me even when I don’t; who believed in me even when it doesn’t all make sense.

I can’t wait to share 2019 with you all.

Have a wonderful New Year and enjoy the celebrations :):):)

*I think I am serious about the mental health balm!

Best Reads This Week, September Edition

We’ve been quiet for awhile! Hello again :)

It’s great to be back!

We’ve got a lot happening at The Medical Startup- thankyou for bearing with our site facelift as it happens.

For now, entertain yourselves with a roundup of some great articles we’ve enjoyed from around the Web this week.

• Beth Comstock’s a CEO- and an introvert. Tips and strategies at Girlboss.com.

• Clinical trials are underway for novel early-stage cancer screening through a simple blood test. (The article’s from January but still relevant!)

• Our friends at Lysn have been listed as one of the top 5 Mental Health social enterprises in tech to watch, along with other inspiring startups. Check out the full list at Social Change Central.

What are some articles and resources you’ve enjoyed recently? Share your finds below!

Celebrate Crazy Socks for Docs Day on June 1st

First published June 1, 2017

“June 1st. #CrazySocks4Docs. But not just for Docs only. This day is for nurses, dentists, pharmacists, social workers, physiotherapists, psychologists, dietitians, speech pathologists, audiologists, respiratory therapists, anaesthesia techs, paramedics, medical students, veterinarians and all other specialties that work in the health care industry for patients. Doctors are dying by their own hands. The overall physician […]”

via Crazy Socks for Docs — Dr Eric Levi

Thank you to Dr Eric Levi for your articles on your blog, which recently relate to physician suicides and the challenges we face as healthcare workers in a challenging industry.

Embrace your personality and your colleagues’ health this June 1st. Wear odd socks. 

Doctors, You’ll Never Be Good Enough- And That’s Okay

First published May 12, 2017

Like many in the medical world, I’ve been deeply saddened by the suicide of a Brisbane gastroenterologist, the father of four children, the husband of a loving wife.

I don’t know them personally, but am touched by the email that his wife wrote and son sent online- which has triggered a flood of goodwill from his patients (the Facebook comments on the CourierMail post are so heartening) and from other health professionals and members of the public, who, like me, may not have known him personally, but felt devastated by this very unnecessary loss.

So what can we do? How do we stop others from thinking the only way out is suicide?

What’s the worst that could happen if you choose NOT to die?

Your patients may be looked after by other colleagues, or will find other specialists.

Your family will be concerned and worried about you, but they will be happier that you’re taking time to recover.

Your colleagues will most likely be concerned about you too, not mean-spirited. (If they are, why choose to work with them or choose to listen to them? What do they know about who you really are?)

Maybe part of it is our fear of delegating responsibility for our patients to others when we’re too crushed or sick to continue. Handover is so complex- even more as a consultant in private practice for many years. You would have built strong relationships with some of your patients who’ve grown with you; with your staff; with your routine. You would know their test results and the dates of their treatments off by heart.

And of course, when a patient dies, it is never easy.

Just because you’ve dealt with a patient’s demise or deterioration over and over again during the years, it doesn’t mean your feelings will be bulletproof forever.

And then, you also may fear delegating the responsibility of your struggles to others, to psychologists, to counsellors, to psychiatrists, or to a friend who’s a listening ear.

You’re good at curing patients. Why can’t you cure yourself?

You’re feeling enormous responsibility. Why burden others with that terrible weight?

There’s so much blame in medicine. We constantly want to be better. It’s the mark of a true professional, a craftsperson even in other professions. You want to better yourself.

But even doctors are only human.

Maybe we think it’s the absolute end, there’s no way out if we step back for a few days, weeks, months, years- it’s too terrifying at that moment to deal with the enormity of a future you don’t know.

We try too hard to control our futures and our patients’ futures, but as doctors and health professionals, and even startup founders, even we can’t control everything.

Maybe it’s time to recognise that and embrace it as something positive we can learn to live with.

But don’t do it alone.

Please seek help, no matter what your journey is.

Condolences and respects to Dr Bryant and his family. 

People may look like they’re doing okay on the outside, but are actually screaming for help inside. Please be kind to each other and ask directly, “are you okay?” 

Some useful sites/resources in Australia if you’re seeking help or contemplating suicide:

– Lifeline

– BeyondBlue

– Mens HelpLine

– Mindful in May

– R U OK? suicide prevention

– Victorian Doctors Health Program (please reach out even if you’re not living in the state, people are always happy to suggest other resources)

– your GP

– a psychologist

– a counsellor

– the AMA, which has other links to Drs4Drs which lists resources for Doctors in each State/Territory, and other sites; and the Australasian Doctors NetworkAustralasian Doctors Network which advocates for doctors’ health.

– Online video calls to a psychiatrist (you’ll need a GP referral but it is bulk billed)

– Lysn, a provider of online video calls to a psychologist

– your work’s Employee Assistance Program (many public and private companies including public hospitals in Australia, possibly in your country too, offer this free confidential service through external providers. The RACP also offers this, and probably other fellowship colleges do, too. Don’t be afraid to ask your HR or Workforce managers about this; it’s your right as an employee, and they are human, too, and know everyone goes through stuff.)

Feel free to list other resources you’ve found helpful below in the Comments. 

Interview with Dr Gregory Sam, Psychiatrist and Director of Conduit Health: Part 1

First published April 26, 2016

 Dr Gregory Sam is a consultant psychiatrist who founded Australia’s first bulk-billing telehealth psychiatry consulting service, Conduit Health, in 2014. Focusing particularly on rural and remote communities, Greg currently runs Conduit Health along with his private practice work in the city. In this three-part interview series, Greg kindly shared his tips for success, the road to Conduit Health, mixing business with medicine, and rising from failure.

Image credit: Dr Gregory Sam

How did you get the idea for Conduit Health?

I think the idea started during my rural rotation of training in 2009. It was often a whole-day affair to see these clients, 4-5 hours’ trip each way, and that was disheartening to see people suffer so much. It’s supposed to be easy access. But they had to wait ages before seeing a psychiatrist.

So I aimed to fill that gap.

I started because I was so frustrated at the way things were.

I found so many deficiencies in rural mental health care, and thought, how do I improve things? There area lot of difficulties and shortcomings in the system. I was always into tech stuff. So I tried to think of the amalgamation of the healthcare and mental health care sectors. Telehealth was in its infancy then. So I thought, why can’t we assess the patient through telehealth conferencing?

I struggled to get through my exams, failed 3 or 4 times, and started to get a bit disillusioned about my career in general. I wasn’t sure why I wasn’t getting through. A lot of thoughts were going through my head. Is this the life for me? Should I be changing careers? A whole heap of stuff. But I thought, there’s still good things I can do in this field, whether it’s as a registrar or consultant or not. I’ve learnt a whole heap about my specialty through this. 

How long did it take you from having the idea to taking action, alongside your clinical work and studies?

Honestly, a few years. My idea has been since 2009, and it’s very tempting to get distracted by training. I was so focused on training that all these other things I could do fell by the wayside. I had the idea for a few years, but only started something solid in 2014.

I think 2014 was when overcoming all the inertia of starting a business occurred, planning and actually doing things. 

Failing my exams gave me that opportunity to start thinking outside the box. I took 3 months off work to have a break. I think that’s the best thing I did during training. I focused on badminton and other things I like doing, and started to make moves on my company. I had meetings with colleagues and friends in business, picked their brains, tried to absorb as much as I could from them, both guys and girls, to understand what it’s like to get into business. My business friends said, “it sounds like a brilliant idea, why don’t you do something about it?” So that gave me a kick to start.

When I went back to work, I left business for awhile and focused on passing exams. Once I passed, during our year of Advanced Training, I set learning goals on things like, “I want to learn more about drug and alcohol,” and other goals which I did in my day job, and also focused my energy on Conduit Health. That’s when the wheels started turning.

2015 was the launch date. Our first consult was February 2015, so 2015 has been a big year in that it’s a startup, and for most startups it’s about sustaining that growth, so 2016 is another big year. A lot of planning happens with regards to how to continue that growth, otherwise it’s too tempting to have a firework effect where it starts then fizzles up. 

Overcoming inertia is hard, but once you overcome it, things start rolling, and you can’t stop.  It’s a lot of commitment but so rewarding, more rewarding than my day job. I find treating patients rewarding, I can help them and their families as a psychiatrist. Whereas with Conduit Health, I’m helping so many more people across the country. We’ve had referrals from far and wide, from every state, and remote locations like the Kimberley and the Great Barrier Reef. I’m working with primary health networks (PHNs) across the country to expand our reach. 

How does a typical consult run?

Conduit Health, Telepsychiatry Service. Photo courtesy of Dr Gregory Sam.

Either the psychiatrist dials in (from their location), or the patient (who’s hosted at their GP clinic) dials into us, then the psychiatrist introduces the consult. We need to say at the start that we’re doing it via teleconferencing, that there’s no one else in the office, and check who’s in the office. This sets the scene so the patient can understand that there are no unseen people in the room. We discuss confidentiality, unless risks in which case we need to notify particular people. It’ll go between five minutes to an hour, we state our aims, then start the diagnostic interview.

The video quality is quite good, but if there’s any lag or dropout, we disconnect and call back. We check at the start, “can you see me? Can you hear me?” We check camera position so the webcam points directly at the patient and so the patient can see us. We also make sure it’s appropriate, eg. the psychiatrist is in a quiet isolated room, not at the beach. We set rules for our psychiatrists. They use the Conduit Health backdrop. 

Sometimes a mental health care nurse will be there. We offer to GPs, if you want to be present for the whole assessment or in the last 5-10 minutes, you can. Some GPs stay for the whole interview, others come in the last 5 minutes and ask the psychiatrist, “what’s your diagnostic impression and what’s your plan?” They can get immediate feedback, (and sometimes help with scripts and so on).

We also get constant feedback from other GPs. My role is partly to ask patients and GPs, “how are you finding the process? Can we make things better for you?” Constantly evolving the company.

One benefit of Conduit is confidentiality. You don’t need to go into a psychiatric facility where everyone knows it’s a psychiatry facility, and sit in a waiting room with other mentally ill patients. Patients have said that’s a benefit, so people don’t have to know they’re seeing a psychiatrist. In a way that’s also bad. We’re not trying to promote stigma of mental health, but unfortunately this is a barrier to receiving care.

How did the name Conduit come about?

I was building a house at the time, and working with the builders, one said, “I want to dig a tunnel under your garden to create a conduit for your electrical wires to go through.” Also from my cardiothoracic surgical rotation in med school, “they harvest the conduit” in bypass surgery, and they explained what a conduit was to me. I then thought about what Conduit Health does, it takes away big distances and gaps.

The logo is a bridge, to embody bridging gaps.Suddenly, 300 kilometres to go to an appointment doesn’t matter anymore. It’s a link, a conduit, from point A to B. So patients don’t have to travel.

I don’t think telehealth will replace traditional face consults, but it can address geographical barriers.

Would you expand Conduit to non-psychiatry services?

The immediate next need would be psychology. It would be great to have psychologists who can do tests and consults. But at the start, I want to focus on psychiatry. Some companies have one of every specialty, but I want to focus (for now). If there is demand later on, for say, neuropsychology, social work, we will expand to fill the need.

What about your plans for aged care?

A big arm we’re developing in 2016 is to work with residential aged care facilities. There’s such a huge need, patients can’t often go see a psychiatrist. Aged care services are often floundering, “can we get the psychiatrist to come here?” but not many psychiatrists want to do that to see one or two patients, it’s not feasible. But we can go in and have a session there, and it’s immediate. So 2016 will be a big year for Conduit Health Aged Care branch. We want to expand to all the big aged care facilities. 

To learn more about Conduit Health, click here. 

Stay tuned for Parts II and III of Greg’s interview, in which he discusses his business inspirations, his insights on failure, and running a business as a medical professional.