The People and the news have been spending weeks talking about the crisis, for beds, medication, the number of dead bodies being taken into graveyards and crematoriums, governments blaming each other, but we haven’t spent, unfortunately, enough time talking about the healthcare workers – doctors, nurses, people on the ground collecting samples. Many of the doctors have talked about how after putting in everything they had in them during the fight last year, without taking leave, seeing their family members, getting sick themselves, passing on the virus to the family members and losing them in many cases, most doctors say that they can’t find it in themselves to fight all over again, but that they have to since they have no choice. Most doctors haven’t, in fact, taken a break, at all, for over a year and now they find themselves in a fight that is ghastly and much worse. We have had senior doctors of leading hospitals breaking down on camera in front of the media, which never happens given the fact that doctors are taught how to deal with bad information as part of their training. Obviously, what they are witnessing and going through now is much worse than any training has ever covered. Much needs to be said about the impact this will have on their mental health, about the grief they experience every time they lose a patient, about the trauma of having to constantly communicate bad news to family members. And considering the fact that this is worse, because doctors normally say “We did everything we could”, but when there’s no supply of enough oxygen, which is the fundamental basis of treatment for a Covid19 patient, how do they say that they did everything they could! Doctors in Delhi are now having to tell the family members to take their critically ill patients elsewhere because they don’t have Oxygen and hence can no longer be of any help.
There was one doctor on Twitter who said, “In medical schools they didn’t teach us Oxygen-politics, they only taught us medicines.”
On being asked about what the doctors are going through at this point and what that trauma is like from the other side for them, Dr. Rajani Surendar Bhat, Pulmonologist said, “Nothing in our lives have prepared us for a crisis like this. What has happened now, for most doctors is that they have neverhad been through a period in their life where they had to refuse oxygen supplies to patients, knowing fully well that if they had the resources they would be able to have a fighting chance to help a patient get back to good health.”
She further narrated an incident that took place two days ago, when one of her acquaintances reached out to her about an employee who was in Delhi, a young man who required Oxygen and were searching for hospitals which would have availability of it. Each one of them were trying and eventually they did get him to a hospital bed but it was hours too late and he couldn’t make it. There was grief, anger, shame and a sense of having failed the people collectively that engrossed the mind of the doctor. Dr. Bhat said, “We, as doctors, haven’t been taught to process this welland it’s going to stay with me until my last breath; I would never be able to erase these horrendous experiences from my mind.”
The guilt and the trauma that doctors go through every time a patient is lost is inexplicable. Isabel Paul, a clinical psychologist said that one of the reactions they had whenever something traumatic happened to them was that theygot hyper-aroused, anxious and became hyper-vigilant. Some of them have other reaction of anger too when they are trying and working towards saving a life but in vain; they feel responsible for them. She said, “The ‘guilt’ for us is not so much because of what we, as doctors did, but the fact that we know this was preventable.”
The situation today has made me recall how we didn’t have enough ventilators a year ago and how eagerly we needed the lockdown for all that time to prepare for the current situation. How crippling and pathetic it feels to realise that we are, yet, one that same page without oxygen and ventilators even after a year later!The concept that a lot of doctors are actually struggling with is that of ‘moral injury’ where they know that the crisis is preventable but are unable to do so. The thought of being able to do their job that they have been committed to has taken a toll over their mental health.
Most of the doctors who are on ground working in PPE kits for long shifts are doctors younger than 24 or 25 years of age. These are girls who are living away from their homes, in hostels, who merely have each other as their support after a long day’s work, live on pre-made meals provided to them by the hospitals after their shifts and so and so forth. These boys and girls are real soldierssoldiering on without whining about their day to day problems of not being able eat and drink in their PPE kits, and holding each other up to keep carrying on.