Shunned, unvaccinated doctor says he may have saved heart attack victim at Middleton Hospital
MIDDLETON, NS — While a man lay dying at Soldiers Memorial Hospital of heart failure, a doctor who might have saved him was raking leaves in his yard less than 10 minutes away.
Why?
The answer to that question goes back months.
Let’s start with this email.
“Soldiers Memorial Hospital-Middleton **Critical**”
That was the subject line of Cheryl Pugh’s message, which landed in the inboxes of about 100 Nova Scotia doctors five days before Christmas. Pugh, Nova Scotia Health’s medical executive director for the Western Zone, explained that the hospital’s emergency department was in dire need of doctors.
“Signaling an urgent need for emergency cover at Soldiers Memorial in Middleton,” she wrote. “Can you please let me know if there are any emergency room doctors who can help you?”
The emergency department had lost three doctors in the space of a year. Since June 2022, ER had been reduced to 7:30 AM to 1:30 PM every day. Now the hospital was struggling to keep even those hours.
Pugh’s email was never sent to a single doctor, who had worked in the hospital’s emergency department for years. We call him Dr. Smith. He asked us not to use his name after speaking to his attorney. At that point, it had been almost exactly a year since he’d taken a leave of absence from his duties in the emergency room.
It wasn’t long before Dr. Smith found out about Pugh’s e-mail. Later that same day, another emergency room doctor sent him a copy. A day later, Dr. Smith emailed Pugh to let her know he was willing to return to work.
The only thing standing in the way was Nova Scotia Health’s COVID-19 vaccination policy.
“I know there are several emergency room physicians in the Valley that are no longer working because of the policy, and the reason I know this is because I’m one of them,” Smith said. “I used to work at the Soldiers Memorial ED.”
“It makes me sad for the community because I live there, about five minutes from the hospital, and I drive past it all the time and see the ‘closed tonight’ sign. Honestly, I don’t need to work there, which was part of the reason I left. I do other things with my life, but I would go back because I want to help my community.”
He pointed out that most provinces had already lifted the vaccine mandate. Only British Columbia and Nova Scotia still require healthcare workers to receive two vaccinations.
Neither Pugh nor anyone else at Nova Scotia Health responded to his email. Over the next few weeks, he would talk to two MLAs in Annapolis Valley, seeking support. Both seemed sympathetic, but nothing changed.
Nevertheless, Dr. Smith continued to work as a general practitioner.
The hospital’s emergency room was open regularly during the time he worked there, he said. Most weeks he ran one or two shifts, sometimes two shifts in a row.
After his departure, things quickly went downhill in the hospital. One doctor retired, another quit because the workload got too much after the others left, he said.
The opening hours of the emergency department were further shortened. By January, the community had had enough. Community members held a rally demanding that the department be open seven days a week. Nova Scotia Health promised it would get better. It didn’t. In March, the emergency room was closed for most of the month because there were not enough doctors.
This month disaster struck. On the evening of June 15, there was no doctor on duty in the nursing ward and the emergency room was closed.
A man in a bed in the nursing ward went into cardiac arrest. With no nearby doctors available, the hospital had to call in volunteer firefighters and EHS. The staff called a doctor in Kentville, nearly 40 minutes away. Attempts to resuscitate were unsuccessful and the man died.
The city went out with the tragedy. For the second time in three months, the city wrote to the Prime Minister’s office about repeated emergency room closures at Soldiers Memorial Hospital. Mayor Sylvester Atkinson called for a meeting with either the Prime Minister or the Secretary of Health to address the repeated closures.
“The fact that our fire department had to respond and provide care to help save patients in our hospital is frightening. As a municipal body with a lot of responsibility on our shoulders, we are not okay with this,” Atkinson wrote.
Dr. Smith said he is not surprised by the tragedy.
“This would eventually happen,” he said. “It’s terrible for the community. If you don’t have enough people to take care of the patients, something bad is going to happen.”
The doctor was preparing his garden beds as the tragedy unfolded at Soldiers Memorial two weeks ago. He says he doesn’t know enough details about the case to say if he could have saved the man’s life. But he says it’s reasonable to consider the possibility if he had worked in the ER that night. Or if he – a doctor who lives less than 10 minutes from the hospital – was called before another, more than half an hour away.
If he is allowed back, he could open the ER at least twice a week, Smith said. He considers Middleton his home, but considers leaving the county to practice elsewhere.
Nova Scotia Health says that on the evening of June 15, Soldiers Memorial Hospital inpatients were fully staffed and there was “medical coverage.” It also highlights that a shortage of health workers was not a problem in dealing with the incident.
So why aren’t Smith and other unvaccinated health workers working?
The department said the vaccine mandate applies to all hospital emergency departments because they are high-risk settings.
“Our goal is to protect the safety of Nova Scotia Health team members, patients, students, visitors and essential care partners by reducing the risk of COVID-19 transmission,” said spokesperson Brendan Elliott.
“Data continues to show that the primary series of the COVID-19 vaccine is highly effective in preventing serious illness, hospitalization and death.”
Still, eight other provinces have decided to bring back unvaccinated workers.
We asked how many doctors are in the hospital’s emergency room. Nova Scotia Health wouldn’t say it. Elliott did say there is a small pool of doctors who provide emergency care in addition to their general practice and that other emergency room doctors in the zone sometimes fill in. He said it takes a roster of five to seven doctors to keep the department running. the clock. Nova Scotia Health is recruiting, he added.
We asked if Nova Scotia would consider ways to get Dr. Smith back into the herd, including by requiring him to wear additional personal protective equipment or be tested regularly. Nova Scotia Health did not respond to the question, although Dr. Smith said he would consider such requirements.
Middleton CAO Ashley Crocker said the city would not comment on Dr. Smith or whether there has been any progress since the mayor wrote a letter to the prime minister.
SaltWire asked Mayor Atkinson if he would support bringing the doctor back. He didn’t answer.
In April, Carman Kerr, the Liberal MLA for Annapolis, raised concerns with Health Secretary Michelle Thompson about the number of healthcare workers in his constituency being sidelined by the vaccine mandate. Kerr asked the minister on the floor of the legislature about possible ways to safely bring them back into the healthcare system.
“Are there options for those staff to either work in virtual ER or other ways where it can be[done]in a secure way?” he asked.
The minister knew about no one.
“Right now there are no options,” she said.
Kerr said there had to be a way to get people like Dr. Smith back to work.
“There has to be a place for someone who is this highly educated, who is local, who lives here and is respected,” Kerr said. “There must be.”
He says this is especially true given the healthcare crisis in his constituency. He believes many of the residents would rather receive medical care from an unvaccinated doctor than have the ER closed two or three days a week.
He gets calls.
“The demand has been consistent. Can we consider anything and everything? That is the situation we are in. I have too many paramedics on the phone. I have too many staff crying on the phone with me.”
SaltWire asked if the recent tragedy at Soldiers Memorial prompted Secretary Thompson to consider withdrawing the mandate. We also asked if she would look at options that would allow Dr. Smith could work in the emergency department again. Thompson did not address either question, but issued a written statement:
“I have every confidence that health authorities and long-term care facilities know what is best for their patients and healthcare workers and what action is needed to continue to protect some of our most vulnerable populations.”
