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Submitted by Anita Kumar on 1 July 2020

Dr. Anita Kumar shares her experiences and challenges as a doctor on frontline Covid-19 duty and how the few happy moments motivate her to keep going.

Working as a frontline worker during the Covid pandemic has perhaps been my most adventurous work ever. There have been several highs and lows that I have faced in life but none like the emotional mental and physical upheaval experienced during this pandemic.

A lot of times patients and their relatives feel/wonder if doctors have feelings. Do they feel pain, anguish, anxiety just like us?

Well we do. We go through the same emotions as you, just that we know (or hope we know) when to take a tough stand and when to stand down. Not all humans are the same, and the same applies to doctors.

While there are so many stories, I could narrate I'll pick a few which may give you an idea that doctors have a human side too.

Every day brings with it a new challenge. You all know how the covid numbers are only on a rising trend. There is no plateau visible even in the near future.

Imagine yourself on a rollercoaster ride . You just don’t know what lies ahead but the adrenaline rush is phenomenal.

To stay sane throughout the day, I start with a little meditation for about 2 mins with a hope to have a good day.

Dealing with Patients with Breathlessness and Hypoxia 

The problem is that more and more patients are getting breathless and coming in for Oxygen requirement. They are showing symptoms of hypoxia. It is not clear at the outset if it is due to Covid or non-Covid reasons. Hence every breathless patient is first admitted and treated for hypoxia because whether Covid positive or not, this can be extremely fatal. And that's when the fundamental thought of who is more important sets in. Often many patients come in together. It’s a challenging decision to determine who to attend to first. Is it the hypoxic patient or the one running a high fever or the one with severe anaemia or the one who’s bleeding severely?

If a group of 5 patients arrive at the same time within 5-7 mins we have to make a decision as to who is serious and who needs treatment first. How does one prioritise patients? How can we rely on the lessons learnt in practice when one is under pressure. Be it pressure from relatives or friends or superiors. Because this does not work on first come first serve basis. This is called triage where the most urgent and most salvage-able patient is investigated first. Hence not everyone who reaches the counter first is serviced first.

Frustrations run high during this period, it is hard to be calm and composed. Every day I hope that I'll see a better day tomorrow, but this doesn't seem to end just yet.

I empathise with absolutely all the patients but it is a herculean task to manage even one oxygen bed on some days because that's the kind of load we are dealing with. And this is perhaps not even the peak as yet. I was emotionally and physically destroyed thanks to very young patients requiring oxygen desperately and me having no choice but to do what best I could. Such situations lead to frustration. Not because of the workload but because of the sheer numbers of critical patients.

Dealing with Helpless Patients

I feel horrible when helpless people, especially the elderly literally fall at your feet to admit patients. I am (I believe) the softest person on this planet, but this feeling of helplessness several times makes me feel guilty. As if this wasn’t enough, there have been times when people have fought with us.

At the same time, we have to continue providing requisite treatment and sending safe patients for home quarantine. Now this requires adequate judgement and little experience so it can’t be done in a jiffy . It needs some calm thinking. There are days many of us have gone through 8 -10 hours straight without a washroom break.

The Happy Ending Stories  

While there are so many stories of heartbreak there are equal if not a greater number of happy stories. One day I had a police officer come over to the OPD with fear of having contracted the virus. Based on his symptoms it did not seem to me like it, but his fear was overpowering since many co-workers had been affected. I sympathized with his situation because thousands of police officers have been affected and many deaths due to the same. His fears were genuine. After a round of counselling, he was a little calm. The highlight of this conversation was that he gave me a salute at the end of it. I felt proud no doubt but embarrassed too and told him this was my job no big deal. He said deal or no deal this is my THANK YOU to you.

The very next day started on a sad note but ended on a happy one. This incident happened towards the end of my shift. I was desperately waiting for the next batch to take over. It was a pretty tiring and exhausting day. I had decided not to wait even 1min over 8pm. But as my luck would have it, exactly at 7:59 an emergency patient was wheeled into the OPD. As protocol and of course good moral values you never make a patient wait. This elderly well educated couple had been roaming with their debilitated mother right since the morning to get her some treatment . While they lived in Navi Mumbai, the general notion that "Mumbai" has better treatment (which is soooo wrong) took them to all private hospitals of Mumbai. But in vain. It turned out that none of them apparently were willing to accept their mother for fear of corona. 12 hours roaming without food searching for hospitals and perhaps having an argument with everyone is not easy. They were visibly famished. The moment the patient came in it did not take us more than 5 mins to decide that she needed admission. Mind you, at this point we were choc-a-bloc full with admissions. There were no beds left in the corona suspect area, but after some good management by my seniors the patient was wheeled into the ICU.

At this point the relatives were so in awe and thankful. They were so relieved and just wanted to fall at my feet. One thing that they said struck a chord, they said every hospital had bouncers to deal with us. They were muscular people waiting to throw us out. This is the first hospital where you as a doctor have interacted so nicely. We never thought this hospital will be good enough for my mother (kehte haina ghar ki murgi dal barabar). This hospital was just next door and we never took cognisance of it. Thus, ended my day on a happy note.

Whatever said and done we all know this is all temporary. At the end of the day we know we have made albeit a small difference in this pandemic. That makes us all happy and hopeful!

Thank you

Dr.Anita Kuma MSc MBBS MiPH(AUS) Resident Physician (Geriatric) MGM Hospital, KAMOTHE.