By Aditi Jain
It was 5 A.M. Our phones lit up with a new message. The results of our corona tests were in. It read ‘You and your team have tested negative and are free to go home from quarantine.’ We’re relieved and started packing, eager to get home. Most of us opted to first call our families, many of whom had spent sleepless nights awaiting the report. Our team had just finished a week of Corona ICU duty and spent the next in isolation, in case of inadvertent infection. Fortunately, no health care worker in our ICU had tested positive so far. We were ready to head back, to start the day’s shift.
“Our patient Mrs. A, is desaturating. We have started her on oxygen therapy but we think she will soon require intubation and ventilation.” This may sound as medical jargon to most people. But as a doctor trained in the medical field for over ten years and as an anaesthetist in the last six years, this a routine call my team and I receive. Roughly translated, it means that the patient is unable to breathe properly and get the required and essential oxygen for her body. It requires us to take over her breathing by placing a tube that connects her lungs to the ventilator that then delivers an increased oxygen concentration to the patient’s body.
This along with other procedures comprise of delicate and precise tasks that take years of training so that they can be safe and efficient. But when the corona pandemic struck, there was suddenly an added dimension. We, doctors, were suddenly faced with altering our skillset in a manner that doesn’t compromise the patients’ safety or our own. This means wearing personal protection equipment (PPE). It adds a layer of impervious airtight clothing to prevent virus transmission. But it also means your skin can’t breathe in the sweltering Indian summer heat. We were warned about heat exhaustion and told to signal for help in case of extreme dehydration.
A colleague of mine who had to accompany a patient for a test in 40 degrees, was near fainting by the end, and had to be helped out of her PPE by others. Sometimes your eye shield fogs, restricting your view. The mask digs into your skin and many are left with bruises. Once you wear the PPE you can’t eat or drink or use the restroom. We have to learn how to adapt to this and have to do it in a fraction of the time we are accustomed to. Getting infected with contagious diseases like hepatitis or HIV is a professional hazard we are trained to prevent and deal with. But this virus is new. We are learning new things about how it behaves and affects the human body every day. And as part of the medical fraternity, we loathe the enemy of ignorance. We want to be sure about the decisions we take because the stakes are so high.
Armed with the ever-evolving knowledge about the disease, we rely on our prior medical experience and skill-set to treat our patients. And this is when the years of training kicks in. When faced with an emergency our team will fall into the roles we have been taught and operate as a unit. We are able to cope, to treat and cure.
Our patients are struggling to understand this disease too. They have to struggle with both their disease and its social consequences. Their loved ones can’t come to visit or care for them. In most cases, their homes are marked down and the movement of its members is restricted. The first response of an elderly gentleman when he recovered was a request for us to communicate this information to his daughter who had called him every day. His second was to invite us all for a cup of tea, unrecognizable beneath our PPEs as we were. Some patients succumbed to the isolation and loneliness often felt in intensive care units termed as ICU delirium. Tired of being prodded by syringes for sampling, a patient refused to let us sample his blood for necessary tests. He was particularly abusive to the female doctors and would only talk to the male staff. As a woman, you get used to being stereotyped by patients. As an intern, I remember many times feeling indignant on being considered as a nurse by default. Many men feel uncomfortable explaining their complaints and histories to a female doctor categorizing them as a ‘ladies doctor’- for women. It is at times like this you have to swallow your professional pride and remind yourself of your duty. And if the patient recovers, the reward is inherent and enough to make the work worthwhile.
It is only after your shift ends that you are struck with worry. Did you pay sufficient attention to your safety? Did some contaminated material sneak past your attention? Did you absentmindedly touch your face wearing infected gloves? And most worrying of all, will you take the infection home to your family?
Some opt for staying away from their families, when posted in areas where the infected patients are. Elderly parents are a particularly vulnerable population for the disease and so need special protected. For some, it was more difficult than others. My colleague, a new mother of a 6-month-old baby did rapid weaning off breast milk so that her baby could get used to top feeds in case she needed to get quarantined. Several staff members trained their children against the reflex hug on their return from work and dashed to the washroom for a thorough scrub before touching any home surfaces.
I have been brought up in a family of doctors. Ever since the virus crossed our shores we have tried to stay within our rooms and minimise physical interaction to prevent cross-contamination. We miss the family meals but we make up for it by sharing stories of days gone by. We are concerned for each other’s safety and have spent long nights waiting for the results of patients we have dealt with. But each patient recovering gives us fresh hope that we may yet win the long battle we are waging again the invisible enemy. It is a long road ahead peppered with adversities, but we too are adapting to the ‘new normal’. We know more today than we did yesterday and will know more tomorrow. And hopefully, together and responsibly we will be able to herald in a safer future.
