text: As Pilgrim prepared her ward, about an hour's drive away, in Hamilton, Cathy Risdon sat down to write three emails. Risdon is a vice-chair in the Department of Family Medicine at McMaster University, and the school's director of health services. She's been in the department itself for over twenty years, focusing on building collaboration, communication, and professionalism within the medical field. She'd need all those skills now as she tried to distill one of the most catastrophic, unprecedented crises in modern history. Even as most of us were compassionately, robotically swapping "Cheers" and "Best" for "Stay safe" and "Be well," to Risdon the once-simple act of emailing felt loaded, impossible. What do you say when safety and wellness are so deeply uncertain, so compromised—especially for those on the front line? Risdon's first email to her physicians and residents was, more or less, the warm-up act. She explained the importance of handwashing and talked about the power of prudent care in protecting the community. The second email, sent about ten days later, praised their work. She told her staff they were doing a great job and commended the way they were mobilizing and looking out for each other.
  
  But as she sat down to write her third email, the world felt like a different place. There are people in our professional circles, and in our clinics, that could die from this, she thought. The slimmest of margins, and a whole lot of luck, might be the only thing stopping Hamilton or Toronto or Vancouver from becoming New York or all of Italy. It was the lull before SARS-CoV-2 had infested Canada. People might have wanted to use the pause to grow sourdough starters, or learn a new language, but what they really should be thinking about, she became convinced, was if their wills were up to date. Risdon began to type: "Based on the experiences of other countries, we need to be prepared for the possibility that some very hard, sad things will happen to people in our work circles and our family circles." Warning of overwhelmed hospitals and a shortage in care, she continued: "A lot may happen without our ability to prevent or control it." The best thing her staff could do now was break the taboo on discussing death—before it was too late. "Do you have a will?" she asked her staff, encouraging them to have an honest, compassionate conversation with their loved ones. "Powers of attorney for finance and personal care? Are all your insurance policies and financial documents organized and easy to find?" If the worst happened, what kind of death did they want?
  
  She pressed send. "I'm not one for candy-coating everything," she told me. "And, it certainly provoked strong reactions in all directions." Some of her staff felt grateful that she had broached the subject in such a direct, open manner. Others wished they'd been given a warning that they, and their own staff, were about to have a frank conversation about what might be ahead. Knowing would have allowed them to better support the staff that was already freaked out, they told Risdon. She thanked them for their feedback—it was a fair point. But she doesn't regret sending the email; she needed to acknowledge the gravity of the situation. And it was grave. Throughout March and April, Risdon's days felt soaked in terror. Months later, when I speak to her during the summer of 2020 as Canada's daily case counts dipped, she almost laughs at that word, terror. Removed from those early weeks, it feels like such a dramatic choice. But she also can't deny that's what it was. She worried that the healthcare system in Canada might make the same mistakes as elsewhere: namely, sending every sick person to the hospital, neglecting both primary and at-home care, and creating accidental hotspots. She worried that both COVID tents and testing centres would enable the virus to cluster and spread. One wrong step could wreck every good, careful intention. She worried that hospitals, public health agencies, and other medical experts wouldn't get it right.
  
  "I feared that our actions would make us have a COVID tsunami," Risdon said. "It was this actual terror that we would be the inadvertent authors of our own demise."