A Day in the Life of a Resident Doctor

I am a residential doctor at a Delhi government hospital. Just like any other student of medicine I was waiting eagerly for my final year post graduation exams just a couple of months away. Life is so uncertain! Who can know it better then we doctors. On a daily basis we are exposed to the warming sunrays of life, living and healing on the one hand and the gloomy shadow of death on the other. I don’t know which one is more substantial. When life and living prevails against all odds with our support, it seems life is the strongest force. But come one swipe by death and it manipulates the very air in the ward. Over a period of time, a kind of detachment builds up towards both life and death. I know we all have to die. But more importantly, I know that we have to live before that.

The initial panic build-up in the hospital designated as a Covid care center left us clueless. It was a viral blast equivalent of an actual explosive blast. There you see the wounds and physical destruction. Here the wreckage lies in minds as panic and hysteria creeps up the walls of logic and common sense. So we jumped up and tried to salvage all that we could. The fear of the unknown manifests in full strength in case of a new and incurable disease. We ourselves were as helpless as the patients. But a doctor has to try to save lives and we did all we could.

Pushed to the corners, we turned even operation theaters into Corona patient care yards. Through the sheer strength of mass fear, the word ‘Corona’ was gaining more and momentum in its avalanche type of march across the routine and normal yards of our lives. We flailed our arms like the ship is sinking and you are in an emergency mode. Usually we doctors feel empowered against the routine diseases as we handle the mission to save a life. However, in this case, we were as much of a prey liable to fall to the new virus as anyone else. Usually, we give our best to save a life. Here we have to devote a lot of energies to save ourselves also. Divided attention. The debilitated mission.

With hundred beds on a floor, it appeared scary to we resident doctors. There was a separate donning area to get decked up like astronauts, where they help each other into the PPE kits. You get suspicious of your hand-washing skills as you go on rubbing and rubbing. You aren’t sure about anything. The nasty microscopic organism might be lurking around to lay ambush. Precaution raised to the power of above normalcy results in paranoia. Let there be the littlest chink in your armor and you are slain. So we padded up like soldiers going to bloody medieval wars and hid behind heavy metallic armor of the uncouth, unsuitable PPE kits. The first layer of gloves goes over the excessively rubbed soft skin. You are scared that some soldier of the evil might have remained behind. The shoe covers appear to make you lose your footprints. You try your level best to steady yourself to be confident of your walk. The overalls take you into the folds of strange anonymity, like you are an alien in a queer setting. The possibility of things going wrong lurking well over the benchmark of calculated risk in medical parlance. You then go faceless to the outside world as you put on an N95 mask followed by a surgical mask still followed by the cap. The withdrawal into the womb of anonymity isn’t still over as another layer of gloves and a face shield or goggles turn you into an altogether different species. You are an thickly armored soldier, cumbersomely space-suited astronaut and a heavily donned firefighter all mixed in one. That’s how I felt.

As the pandemic and the panic arrived like a sudden Tsunami strike, the initial PPE kits were inhumanly cumbersome and suffocating. It shows how unprepared we are against emergencies. You felt tightly squeezed and thrown into the hostile environment of a strange planet like a guinea pig. You lose on something precious to your sense of freedom, making you feel depressive, indecisive and suffocated. Like a lumbering snowman forced into a snowless, sweltering hot valley, you lose your focus as the goggles turn foggy due to your labored breathing. Nervousness and heat turn you a sweating pig inside. You don’t have the liberty to wipe your sweat or clean your goggles. You speak like from a subterranean vault. You are barely audible from behind the covering and hence have to shout to be audible. It scares both the nursing staff and the patients. In case of managing the health of severely ill patients, you are highly responsible for what words you use in your communication. To avoid sounding bullying and rowdy to the patients and nursing staff, we force ourselves to communicate through sign language and hand gestures. Once you go into the cockpit of your PPE kit, you cannot eat, drink or visit bathroom for six hours at a stretch. Sweat drains like tiny rivers over the face. The air-conditioning system is put off to avoid the virus aerosolizing in the central ducts. 

The virus creates Silent Hypoxia, wherein the oxygen level silently creeps down unnoticeably. The patient stays asymptomatic till the oxygen level plummets to a critical point. The normal oxygen saturation level is 99-100%. If it falls below 90%, one needs oxygen support to avoid organ damage. What makes Corona quite fearsome is the fact that the patient doesn’t show any signs of restlessness, drowsiness and difficulty in breathing even when the saturation level has fallen to 80%. This ‘air hunger’ makes it almost fatal.

It’s an ordeal to face dead scared patients arriving with a look as if they are being forced into gas chambers. This acceptance of fear, this surrender of the life force to the veritable agent of death makes the virus all the more powerful as the psychological trauma eats into the vital reserves of energy that would have been used by the soldiers of immunity to build up a counter attack. Inserting oropharynx or swab in the patients’ nose was like performing a big surgery. Not that we found it so difficult. It’s an innocuous cotton bud intended to touch the inside of the nose. All it takes is 20 seconds. But the look of fear turns it into an intolerable ordeal for the patient as if this little medical process is the thin line between life and death.

As a resident doctor, I’m relatively new to see people dying. I was happily awaiting my post graduation exams and get onto the medical bandwagon like in normal times. It’s traumatic to see the first patient dying under your care. The situation makes it all the more painful. They gasp like fish out of water. You are alone on the night shift. The patient dies all alone in isolation beyond the sympathy and support of her near and dear ones.  

You yourself have to keep yourself isolated and quarantined after 12 hour shifts. Imagine two doctors and four nurses for more than hundred patients. As you lumber out of your anonymity, you just try to hydrate yourself as if you have been in the driest desert for months and you simply prey upon water bottles and ORS. You just sleep, work, sleep, work in an interminable sequence.

More than the onerous duties, it’s the paperwork that traumatizes the soul of we doctors. I cannot understand why doctors have to do so much of paperwork themselves. It can be safely designated to some other staff. Doctors doing data entry isn’t too promising for any country’s healthcare system.

The true nature of we humans comes naked during such critical times. We needed blood for a critically ill patient and made a pleading announcement in front of a crowd. They simply vanished. One haggard old man came forward with a few hundred rupees to help.

Nursing orderlies have to carry out the bodies of Corona victims. They think it’s more burdensome than an ox ferrying hundreds of tons of cargo in a rickety cart. They are scared of the corpses and dilly-dally and slip around their responsibilities. The dead body stays in the yard as a ghastly reminder to the patients who get more panicked. We have to run around to somehow get the body sent to the crematorium to salvage some respect for the dead as there are no family members around.    

All I wish is the return of our normal world of six months back. It’s irritants and problems now appear well digestible and worthy to have around.