Covid diaries of young doctors

Renu Sud Sinha

Dr Ankur Goyal (35), a lecturer of pharmacy at Government Medical College and Rajindra Hospital, Patiala, is also a member of the Dead Body Management Committee of the hospital’s mortuary. He has to take sleeping pills to forget the horrors he encounters daily. The tragic stories just won’t stop pouring out of his mouth, and don’t get erased out of his mind either.

If young deaths in the second wave are bad enough, it’s the sight and plight of the affected families that haunt him. “There was this 16-year-old boy from a village in Patiala district who was taking care of post-death formalities of his father all alone, as relatives, friends and neighbours were too scared to accompany him. At that time, there was no hospital ambulance to spare to transport his father’s body. The private ambulances were asking for Rs8,000. I helped to get the amount reduced to Rs2,500. Even that, the kid said, he would have to borrow after reaching his village. There was another 17-year girl from a village near Mandi Gobindgarh facing a similar plight. Her only brother was in Canada.”

As a nonchalant savage virus goes about taking lives with impunity, the uncontrollable death count of the Covid-19 patients is leaving not just their grieving families behind, but also a devastated society trying to make sense of this apocalyptic world. There is another community, watching in agony this dance of death — the doctors who have been quietly, and resolutely, fighting this invisible enemy for over a year. Only one phrase is constant on their lips, whether it is the young medical recruits or those with a bit of experience, “We feel helpless, frustrated, angry...”

The ferocity of the second wave has been overwhelming for medical professionals battling on the pandemic front.

“The first week of May this year was crazy,” says Dr Amit Panwar (37), a medical officer with the Delhi Government on Covid duty since April 2020. “For the first time in my life, I was getting insistent calls not just for help in arranging hospital and ICU beds, oxygen and ventilators but also for medicines, injections. In the end, I even started getting calls for getting a spot in the crematorium and arranging for pyre wood. That was the time I felt I had hit the nadir. I was emotionally drained. I just switched off my phone,” says the man who had volunteered for the first Covid duty last year, when everyone else was shying away. He has sought refuge in numbness and silence in the face of deaths he might have prevented but couldn’t because of lack of resources.

On the other end of the spectrum is a young resident, Dr Swati Verma (26), a first-year MD (anaesthesia) student at PGIMER, Chandigarh. She has been on Covid ICU and OT duty only for a month but is already feeling the blues. “When I am on duty, there is no time to feel because of the overwhelming number of patients. It’s only when you get back to your room that it hits you. You do develop a bonding with your patients and when some of them die, the loss seems personal.” However, it is the lack of appreciation, abusive or violent behaviour of relatives and people’s growing mistrust in doctors that wear her down even more than the fear of getting infected and passing it on to her parents, she laments.

But the most dreaded thing they all feel frustrated and angry about is what they call “ICU assessment”. In the initial weeks of the second wave during April this year, Delhi-based Dr Piush Girdhar (34), consultant, critical care, Akash Healthcare Private Ltd, in charge of Covid ICU since last year, was feeling helpless over the huge number of deaths, particularly of youngsters. “I am not the only one. Most doctors in Covid wards are feeling frustrated, even angry, at not being able to save lives due to lack of equipment, beds, etc. During the initial part of the second wave, I felt depressed. However, by mid-April, I realised this helplessness was not going to work. Work is work. If I feel demoralised or I quit, then I won’t be doing what I have been trained for. At least save those who can be saved.”

Dr Deo Shankar Patel (43), consultant, critical care, Fortis hospital, Vasant Kunj, New Delhi, on duty in a Covid ICU since June last year, too, feels suffocated by this helplessness. “The clamouring for ICU beds in the second wave was overwhelming. Out of 300-400 distress calls, at least 30 were for ICU beds and we had to refuse, knowing well that if the patient doesn’t receive the required critical care, he/she would die. But we were helpless.”

Dr Deepak Kumar (32), a forensic medicine resident at Government Rajindra Hospital mortuary, Patiala, has nightmares of dead patients. “During work hours, there is so much to do that there’s no time to harbour emotions. It’s only when you go to bed that despondency sets in. We had a Covid-positive mother and son in the same ward. The mother expired and we had to prepare her body with her son watching in misery. He, too, died, a couple of days later.” So, what makes it bearable? “The hope that our investigations about the cause and symptoms can help in preventing more deaths,” he adds.

For Dr Pavny Chawla (30), Artemis Hospital, Gurugram, as well as many of her young colleagues and even some older ones, this is their first close encounter with death, that too on such a massive scale. She has not been able to get used to this loss unlike its stoic acceptance now by some of her senior colleagues. “Every time, it hits you equally hard. I could fully relate with my patients, particularly with those of my age, and would often cry when they died. There was this young mother, educated, beautiful. And we would make video calls with her 10-year-old son. One morning, I came to the ward and there was a new patient in her bed. She had died the night before.”

Young Dr Vani Datta (27), an MD final-year resident, has been posted in Covid ICU at Sharda Hospital, Noida, since April last year. Even before she became a doctor, she always loved visiting a hospital — but not since the pandemic. “Now, I cry for an hour sometimes before I leave for work. I can’t see so much of death, so much of misery. I am really scared to go because you don’t know what you are going to see today — a kid dying or young parents dying in front of kids. I fear facing this misery much more than I fear getting infected. This apprehension our lot had faced last year when we were initially put on Covid duty, and justifiably so because when the whole world was hiding at home, we had to go and fight it. It was like reporting for war. We were just told to pack our stuff, without knowing for how long. This time it is this unknown shape-shifting enemy we fear more.”

However, for Dr Nitin Chhabra (35), on isolation duty since last year at Rajindra Hospital, Patiala, the fast mutating virus and death of a colleague have made him realise his own mortality. He has purchased health insurance so that his family is not left in the lurch in case of any eventuality.

So, how do these doctors who are yet to experience life in its entirety combat this mortal fear?

Dr Jonathan Ashawan (33), on Covid ICU duty for over a year at Christian Medical College, Ludhiana, finds solace in the company of his infant and spending time with family in face of heart-breaking scenes he witnesses almost every day.

For Dr Javed Ahmed (30), on Covid ICU duty since March 2020 at PGIMER, Chandigarh, the helplessness, mental trauma and the resentment against lack of infrastructure and facilities is best overcome by focusing on a parallel life outside work. “I listen to music, talk to my partner and friends, read (but about the virus!).”

Dr Mayank Kapoor (35), specialist, respiratory medicine, Safdarjung Hospital, New Delhi, has been on Covid duty since January 2020. The loss of young patients as well as doctors across the country has been difficult, he says. Over 1,000 doctors have died since last year, nearly 300 in the second surge alone. “I try to remember only the happy memories of colleagues and patients. If I keep thinking about deaths, I will lose my working rhythm. And I can’t afford that if I have to save lives.”

For many, death is not the only harsh reality they have encountered for the first time. Dr Moumita Ghosh (27), a young intern at Indira Gandhi Hospital, Dwarka, had been taught only theoretically about how to handle abusive or violent behaviour by patients. But nothing had prepared her for the real thing. “I was working in Safdarjung till last month. One of my seniors was slapped by a family member when he went to deliver the news of death of their patient. After this incident, we were told to make sure that security guards and bouncers were around and just deliver the news and run,” she rues.

For Dr Ashna Jaggi (26), an intern on Covid duty at Mahatma Gandhi Medical College and Hospital, Jaipur, more than the pandemic it is the abusive behaviour of relatives that has proved to be demoralising.

Dr Nidhi Goyal (25) has been working at a Covid ward in Jawaharlal Nehru Medical College, Wardha, for more than six months now. With a 14-hour shift, with eight to nine of those in a PPE kit, the pandemic has been a lesson in resilience. “It has taught me that I am stronger than I thought,” she says.

“There is no break, no Sundays or holidays for us. The only break has been the quarantine period for those who got infected. There’s so much load that many wish to get infected just to have some respite,” says an exhausted Dr Panwar. However, that does not stop him from giving free consultation whenever he can.

So what holds up their spirit when it wavers? Dr Panwar likes to fall back on a dialogue from Christopher Nolan’s “Interstellar” — “I know it’s not possible. It is necessary.” And that, perhaps, holds true for all of the medical fraternity on the Covid battlefront.

‘Deliver the news, run’

A senior was slapped by a family member when he went to deliver the news of death of their patient. After this, we were told to make sure guards were around and to deliver the news and run. —Dr Moumita Ghosh, Former intern, Safdarjung hospital, Delhi

‘I felt depressed initially’

With almost 40 young deaths daily, I felt depressed but realised if I feel demoralised I won’t be able to help those who can be saved. —Dr Piush Girdhar, Consultant, Critical care, Akash healthcare pvt ltd, Delhi

‘No beds for us’

Last year, we were fearful of passing it onto our family. This time there is an added fear of not being able to get a bed even in your hospital if you do get infected. —Dr Swati Verma, Junior resident, PGIMER, Chandigarh

‘Please get us pyre wood’

For the first time in my life, I was getting calls not just for ICU beds or injections but even for getting a cremation slot and arranging for pyre wood. —Dr Amit Panwar, Medical officer, Delhi government

‘Son saw mother die’

We had a mother and son in the same ward. She died and we had to prepare her body with her son watching . He, too, died soon. —Dr Deepak Kumar, Resident Rajindra hospital mortuary

‘I loved hospitals , not now’

I am scared to go to work because you don’t know what you are going to see — a kid dying or parents dying in front of kids. I fear this misery more than getting infected. —Dr Vani Datta, Sharda hospital, Noida