IS COVID A HOAX?! FT. #MyCOVIDDutyDiaries

I admit it – when I started writing this with such a title, I knew this was gonna be a clickbait – but then I can’t help facepalm when I get to see the picture of anti-maskers protesting in Marine Drive, Mumbai on my twitter feed the first thing after completing a week of COVID duties. Maharashtra, a state where the case load is 1.43 million with 37,758 deaths already – having a bunch of twats holding placards asking India to wake up, when they literally shouldn’t be sleeping at the horrific situation they are in. What irony!

Image courtesy : mid-day.com

I was also a different person a week or so back – of course I understood the disease, I understood the problem, but the seriousness of the situation didn’t make it into my head properly. How can it! Being a doctor’s daughter I have literally seen and seeing my mom putting patients before self first. She has been working throughout the pandemic relentlessly without a damn care for her health when she is the one person who should be taking care thanks to her co-morbidities; but then who cares?! Indian patients never do. They will give you a mithai ka dabba when the delivery is successful or break your head if there’s an unfortunate turn of events. We’re sacrificing our lives for people who wouldn’t hesitate to harm us. (Ref to Dr. Anoop, a young budding orthopedic surgeon who committed suicide after a patient he treated selflessly died and he had to undergo a social media trial.)

My own non medico friends didn’t hesitate on making sarcastic comments when they saw me my pictures on outings on social media. How do I explain how our brain works – when every single day we work in a hospital with high viral load and risk of exposure. When the very patient I examine on a Saturday comes COVID positive on Tuesday, days before I am supposed to start duties in a ward full of COVID patients.

I always thought in COVID duty the biggest battle will be my ability to breathe given my history, but it wasn’t. Then came the task of bearing the brunt of a PPE with multiple tapes to seal any chance of contamination – Belgaum saved me there with it’s ever-cool weather normalizing the temperature in there. Even bladder control wasn’t much of an issue even after 10 hours of duty. I guess the biggest fears I had were psychological and I got over once I felt at home in the place with supportive co PGs I got to work with. Even my interns were sweet enough. Just the duties were exhausting and the PPE made it even more dehydrating, and coming back to my room no matter at point of night I had to follow a daily ritual of bathing, decontaminating myself and my clothes that had been in the high risk area. A constant headache accompanied me 24×7 because of lack of hydration. Every night I had to take 5 tablets for prophylaxis having to work for 7-10 hours in a high risk area when the minimum threshold for getting infected from a COVID positive person without protection is 15 minutes. Some days I got to say to my patients their reports are improving and it was the high point of my day.

But what really, really disturbed me in there – was the way I lost my patients! The biggest battle was me trying to salvage the patient’s oxygen saturation!

I started my duty with two deaths all in a span of minutes. Anyone who has been in COVID wards can vouch for this fact now – COVID deaths are scary as fuck. When the saturation starts dropping – it has a steady and steep fall. The steady progression of the patient from oxygen mask to NRM to HFNO to CPAP can result in a steep fall to need ventilation; and ventilation is the last and final resort which is dicey when it comes to patient survival with post venti saturation coming down by 10-20 points. After careful observation I have to conclude that the patients most at risk of crashing are 45+, obese patients with co-morbidities like diabetes and hypertension. I have worked 24x7x7 days in an Intensive Care Unit during my MBBS but losing patients wasn’t so mortifying then – as you literally see patients who have been maintaining fine until one night crash in the next. The mere fragility of a human body got to me.

When I saw a patient attender kiss her husband’s forehead goodbye, it broke a part of me. I ended up crying when I came back to my room at night. We deal with patients, agreed – but these patients are people outside the hospital, with family and kids. Just like we have a family. COVID has broken up so many families. So many patient attenders came up to me and requested me to update about their loved one’s survival status. It takes a great deal of patience to have to deal with a patient attender not only as a doctor but also a human being who knows that their frustration stems from losing a loved one and financial incompatibility. On night duty I am crippled by anxiety and make multiple rounds to check if the patients have taken off their mask – which they usually do – as it’s extremely irritating to have an oxygen mask stuck on your face; especially a CPAP mask which has the lowest tolerance among patients. Patients literally beg me with folded hands to take off the CPAP mask and I just stare at the monitor with their precarious saturation helplessly trying to gather words to counsel them. Wasn’t it simpler when they could just social distance and wear masks?

Now that my duty is done – I do not feel the same towards this disease anymore. It’s different to view something as a textbook case or a newspaper headline and extremely different when you have to treat it in real time.

So, my dear anti-maskers, I really hope you take a trip into the COVID wards in a PPE suit that barely suffocates you the way the disease is actually suffocating my patients in the ward – see for yourself the despair on the face of my attendants scared for the life of their loved one, the multiple ways a patient tries to convince that he was a fit army man till date and never been to hospital so their must have been a mistake in the report – but even he knows what the disease is when he now reaches out for his mask as his lungs grasp for air. I hope you see my ever-smiling favorite Ajja in the ICU who I had weaned off high flow oxygen to normal oxygen but has deteriorating again with ascent in oxygen requirements. I hope when you see all this and come out to doff, painfully taking off the tapes off your face feels exactly like the resounding slap I want to give you right now for taking a disease, that made countless people all over the world lose their loved ones, lightly.

Cheers,

Dr. P

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