Correspondence Address:
Kirti Singh
Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi
India

Full Text



The circle of light was rapidly enlarging in size, its laughing face welcoming the rushing train. As the train carriage broke through the circle, the darkness was swept aside, all was bright again.

As a child, I always used to count each of the 102 tunnels bored into mountains, on the narrow-gauge railway track from Kalka to Shimla, a trip we took every year during our summer holidays. As the gaping black hole on the tunnel entrance swallowed our carriage, I would squeeze my eye shut and peep through, secure in the knowledge that the circle of light would soon appear.

On April 17, 2021, when I was wheeled into the yawning semicircle of the computed tomography (CT) machine, I was transported back to my Shimla journey with a difference. I was no longer secure that the circle of light would appear, as my sanguinity had been extinguished during entering the lift which would took me up to the CT floor. This same lift had disgorged a lonely zipped plastic body bag, of someone’s loved one, before accepting the waiting wheelchair, along with its precious accoutrement of me, the nursing orderly and oxygen cylinder. It looked like a carousel train which just keeps following its path, in complete oblivion or perhaps disdain of the riders journey.

My first reality check, life is mortal, all life is mortal. This virus, as all others, showed no consideration or respect to your profession, worldly connections or work left undone. The mighty black jaws of this COOVID tunnel suck in all without a qualm, with no refinements.

As the CT gantry arm revolved around me, I was outwardly stoic but inwardly shattered. What would be my CT score, what would be my fate? So much depended on the dexterity, responsiveness and expertise of my health team. For the first time, I was on the other side facing an uncertain disease. I had been trained to treat sickness, to brave death, to empathize, to soothe. Now I was the one needing this training.

The nightmare started from the time when that fell mail: RTPCR positive, came on my mobile phone. Followed by wait in the casualty to be admitted for isolation and observation, with doctors scurrying around, patients in stretchers, anxious relatives asking desperate questions. It was competence amid chaos. Our hospital had rallied to the pandemic, battling incessantly, with so much at stake, with stretched out resources and dwindling warriors.

I rode to the special ward, accompanied by the PPE clad nursing staff (I was told that as a protocol, this was essential, since many patients ran away during transit). During my admission to the ward (a clean oasis), I clasped my sheet anchor − the pulse oximeter. It was to become my constant companion. Fever monitoring, inflammatory markers, food trays, oxygen saturation, it all became a number game. I became part of the faceless juggernaut, a yet another patient, albeit a VIP one, on account of me being a faculty in this Olympian institute named MAMC.

Days 1 to 5, relief replaced anxiety, my SPO2 remained above 95, and all was well. Day 6, the pulse oximeter punctured my painfully acquired confidence, with the fell numbers of 89 to 90. How can that be, it must be the oximeter which has gone bad, wondered me. So more machines were found and used but in a couple of hours, it was clear that my lungs were complaining at the viral foreign visitor. Now started that CT scan journey (as recounted before), the steroids and Remdesivir ! Fever resurfaced, at greater heights than before. The search for the elusive Remdesivir started in right earnest. Phones, WhatsApp messages to contacts, their contacts and their leads, an ever widening circle. One contact arranged to get six doses for couple of lac rupees, other promised to pull strings to get it from the manufacturers at cost price. A friend travelled at midnight to an obscure pharmacy with a single vial at an exorbitant price. His statement, “I have brought it, but I am not sure you should take it as it has labels suggesting illegal import from a neighbouring country.”. These episodes brought mixed emotions, loss of a hope laced with strong support system of our fraternity. Finally, good Samaritans in my hospital helped and my medicines were arranged. The palpable relief was singed, with the grim reality −- all were not so lucky. Spurious medicines, black marketing, hoarding, callousness regarding sanctity of life laid bare. Human vultures were so visibly exposed.

Thereafter started the daily battle with figures of SPO2, with the reapers scepter looming every day. Though my body temperature heated up, I froze at the news clippings showing long queues at crematoriums, disregard to dignity of the dead, oxygen crisis. At ground level lack of simple nursing care exposed, determination and dexterity of sleep-deprived doctors, battling their own anxiety alongside clamor of patient needs. It was enough to increase the pulse rate, respiratory rate, and anxiety levels. Life’s flashback occurred like a cliché Bollywood movie, the regret of what all was left undone, of people hurt, of journeys incomplete. The sheer helplessness, the fear, and the dependence on doctors were awakening.

Some nursing staff never bothered to check, while others will greet you and check how you are even if you were on the medication list for that visit. Some seniors worked through remote control, some were hands on while a lot of work was left for junior doctors and contractual staff. Personal safety was predominant for some, warm empathetic care for others. Wheat and chaff were soon evident, who all cared for a patient who required aid and who all had only cared for this person who had been a doctor who could provide aid. Who cared, who all touched base? It was a deep learning on “Who would cry for you when you die!”

A weak link exposed was the lack of nursing care, primarily for ICU cases. The focus of accountability, accolades, and brickbats on doctors could be a reason, which needs to be looked at. Inventory check for key details was another Achilles heel exposed. Absence of mere two drops of fluid in the D-dimer testing vial, made my blood reports invalid. So much time wasted in sample collection, transit and reporting with these faulty vials. The onus lying solely on beleaguered doctors was unfair. Technical staff need to shoulder this responsibly, to prevent such wastage.

One fond memory I retain of that turbulent, traumatic times was the smile on face of the contractual worker who came to give me my food tray, my turmeric flavored milk with the admonition, “Drink it up hot, it will make you well.” Little do we realize the immense impact of such small gestures laced with empathy? My other memories and gratitude to the doctor team who monitored me, arranging medicines, organizing support, my fellow patients (especially resident doctors) who willingly took on sampling and monitoring. The work ethos of the casualty team, the untiring support of biochemical and microbiology staff.

Being in shoes of a patient, facing uncertain future, re-emphasized the responsibility we as doctors bear when we treat.

My thanks

Prof Suresh Kumar − his care for all patients’ right from casualty his leadership, including that human touch of providing turmeric milk and herbal concoction.

Prof Sandeep Garg and his team − who took on the arduous task of becoming my personal physician. Whose care included sending in his residents at ungodly hours to start my infusions.

Prof Anju Garg, Prof Binita Goswami and her team, Prof Sonal Saxena and her team, Prof Seema Kapur and her team of pediatric residents.

Dr Anand Jaiswal − who stood beneath the window of our room after arranging all help to both me and my husband.

Ms Shyana (the smiling food giver) and cleaning staff who made our room spick and span.

So many others, who enabled me to walk back to health.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.