PGY2 Perspective: An Interview with Dr. Alexandre Lavigne

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In this issue, we talked to Dr. Alexandre Lavigne at the University of Montreal PM&R Program in Canada. During the initial outbreak, Dr. Lavigne was a PGY1 resident in physiatry whose night float rotations put him on the frontlines at the tail end of the pandemic's first wave. As a young physiatrist, this experience gave him a unique training opportunity that no one could have predicted. The following article is based on his experience as of spring 2021.Dr. Alexandre Lavigne

Alexandre Lavigne, MD
PGY2, University of Montreal PM&R Program
AAPM&R PHiT Ambassador

When I think of the pandemic, I think of when it all started for me. In early March of 2020, I was visiting a mentor of mine in Kansas City, MO, named Dr. Michael Khadavi to gain experience in the field of sports medicine. He was one of my sports medicine physicians when I ran track at the University of Kansas, before attending medical school. I stayed in touch with him, and he is actually the one who convinced me to become a member of AAPM&R and attend the 2019 AAPM&R Annual Assembly. By the end of that trip, I learned in the news that the COVID-19 virus was spreading extremely fast all-over North America, and that all Canadian travelers had to come back home from Kansas City. I did my two-week quarantine at home, and then dove into one of the worst disasters of the century.

Surprisingly (or unsurprisingly!), even though I was just in my first year of residency, I had the same experience as anyone else dealing with the patients infected by the COVID-19 virus. No one knew what this whole thing was. We were all in the same boat, having to adapt to new protocols, wearing PPE as best we could, washing our hands all the time and respecting social distancing.

Here in Montreal, the pandemic's peak was between March and May 2020. At that time, I was scheduled for a one-month night float rotation. I couldn't have imagined that I would end up being on the frontlines of a pandemic, but my rotation allowed me to experience what COVID-19 was and help a lot of patients through this ordeal.

Throughout May 2020, I saw hundreds of patients infected by the virus, many of which passed away or were transferred to the intensive care unit. I saw how cruel this virus was, especially with patients who had chronic diseases. I saw them passing away without any loved ones at their bedside since it was prohibited, and I heard their families crying and yelling on the phone because they felt helpless. The treatment options were limited, but we could still do bedside tender loving care. 

After that intense rotation on the COVID-19 units, months went by, and I continued to do off-service rotations in several medical specialties related to mine, like all PM&R junior residents. Throughout those rotations, I noticed the COVID-19 impacts on patient's health, mostly because of the lock-down/sedentary lifestyle sequelae. For example, we had patients with knee osteoarthritis and spinal stenosis (just to name a few degenerative pathologies) who were doing fine with a conservative approach in the pre-COVID-19 era because they had an active lifestyle. However, they stopped being active when all the athletic facilities shut down, so their pathologies decompensated, pain became unbearable and some of them ended up needing surgeries because their bodies were falling apart.

At one point, I had a meeting with my colleagues at the Quebec Association of Sports Medicine Physicians (AQMSE) to find creative ways for people who were stuck at home to be active. We had the idea of creating educational videos that the general public could watch to find out why it is important to stay active and what kind of home exercises they could do to get in better shape without any athletic equipment. My team and I wrote scripts for the videos, and I recruited local Olympic athletes who were well-known in our community to recite those scripts in front of the camera. These videos were then shared on our social networks and the athletes' social networks in order to reach as many people as possible within the province of Quebec.

As physiatry residents, my colleagues and I motivated ourselves to stay active as well. We organized a 5k race in a big park of Montreal, that took place once the government had loosened the social distancing restrictions in the spring of 2021. Since there were no other organized races in the province of Quebec, that race kept me driven to go out for a run every morning before going to work. It was going to be the first event where we would see each other outside of the hospitals. This event also served as a fundraiser for the Montreal Rehabilitation Institute, so that we could help one of our institutions during these difficult times. All the physiatry residents at the University of Montreal participated, and got really into it. I was excited to share my passion for running with all of them. 

Speaking of running, I was pleased to see positive impacts of the pandemic in the realm of sports medicine. I often see injured athletes who rush their rehab because they want to get back to their sports quickly, and I can totally relate with them, I was doing the same during my track and field career. In this time of pandemic, though, most of the high school and collegiate athletes lost their whole season because all the athletic events were canceled. This situation allowed injured athletes to be more progressive in their rehab and take more time before going back to play, because they had nothing to lose. Later on, some of those athletes bounced back stronger than ever since their injuries finally healed properly. This whole experience is telling us the truth; it pays off to take rehab seriously.Alex and Dr. Michael Khadavi

Since March 2020, AAPM&R has offered great initiatives to support our physiatry community like its Care in the Time of COVID-19 forum, and I am grateful to be part of this amazing community. I stayed connected with other members of AAPM&R on social networks and forums, and I even got the chance to attend the Physiatrist-in-Training (PHiT) Ambassadors Zoom meeting hosted by PHiT President Dr. Scott Klass. On top of that, we got a virtual Annual Assembly in November 2020, which in my opinion, was by far the coolest virtual conference during the pandemic.

At the end of all of this, it will be nice to get back to in-person events, and see my physiatry friends and mentors from all over the world. I cannot wait to attend the 2021 AAPM&R Annual Assembly in Nashville and hear more about some of my passions like musculoskeletal ultrasound and sports medicine. With everything we've been through in the last year, it will be a well-deserved reunion for all of us and a great opportunity to keep the momentum going for the future of physiatry.