Staying alive: Another Doctor’s Day

Had someone in the penultimate months of last year mentioned the changes that shall take place within six months in the usual doctor’s clinic, patient doctor-interaction, ward rounds, OTs etc, even as fiction. His postulates would have been summarily set aside.

From what used to be a polite and formal talk of the patient sitting on one side, and a doctor with a sober white coat, a stethoscope round his neck, and the Royal College ones with a thick refill ink filled pen popping out of the coat pocket as an added badge, all went on well. One took the pulse, measured the blood pressure, and if required, rolled the stethoscope on the chest. With relevant medications, necessary investigations, the patient would thankfully walk out with a smile. That the doctor would give half a smile or no smile at all, had an inverse relation with the higher his speciality.

Today the patient comes in, with a prescribed head cap, special goggles to prevent exposure, and N 95 mask, and mostly a face vizor as an extra precaution. Further, his chair is drawn backwards to maintain the prescribed medical distance. To avoid disparate psychological distancing that may hurt the patient, the doctor is similarly attired. In fact, in special clinics, even a high-quality polythene curtain is drawn. Shiny and secure as this material is, colleagues have described instances, were the doctor realized after a while that he was intermittently talking to his own reflection in the curtain, and the patient. Patients may have had the same experience, but a good response may be a reason they may not come out openly.

This being the basic, before the core medical interaction begins, no matter what be the complaint, be it migraine, spondylosis, epilepsy, an unseen but variably felt shroud of an unpleasant nature hangs between the two. For once, the realism may dawn that the doctor is as vulnerable to an unpredictable pandemic as the patient, his personal complaints for the consult apart.

Burdened with such extraneous (but essential) baggage, one has to work a bit hard in terms of conversation, giving extra-time to the patient to vent even some personal grievances, to convince him that the doctor cares. That the essence and outcome of the interaction has not changed.

Ward rounds, and post-ICU rounds are no longer the places to say, “How are we today Mrs Kapoor ?”.

Wrapped up in plastics from head to toe, with the nursing staff under strict orders, that you shall not loosen any of the ten knots (as though they were commandments), even by an inch.

That discomfort is worth it, because the mind has to be focused on the oxygen saturation, pulse, respiratory rate, temperature, and input-out put charts. That’ a lot of data, to be read on the upgraded monitors.

Perhaps the patient may not notice your visit, as it may not be recommended, to nudge those who have just come off their stupor. Hopefully there shall be cheers and claps, when the patient walks home. Free from the hospital, but still in a  cautious circumstance though less. One wonders how long it shall take theworld to get over.

The last four months, the lockdown, and the essential unlocking were great and timely steps. The way humanity shall respond to the disease is a different story. Not that I sponsor it, a sense of fatigue is setting in all quarters. But let me talk of doctors today. For those used to setting a brain stroke right, mapping for conducting epilepsy surgery for a cut-off of seizures, cardiac specialists reverting a massive heart attack by a timely angioplasty, the feeling of being of less use, or the imminent question as to what more can we do, sticks somewhere in the psyche.

It’s like standing at the crease in the shorter version of the game, and conceding two maiden overs!

The figures are all over.  One million confirmed cases, close to five lac deaths globally. India now crosses 5 lac infected, (close to half infected, cured as of figures now) , and 15,000 to 17,000 new cases reported daily.

Thankfully, those who can still see through this fog, have erected and commissioned the world’s largest COVID ward in Delhi.

With a huge capacity, the incremental protocol shall be to segregate those likely to infect. Medications, as antiviral drugs. Respiratory support, and antibody-rich plasma, and more that is I the offing.

Depressingly, the wait for a vaccine may be the shortest ever, but that still seems too much time.

Anything else beyond would only be a repetition!

Coming to the positives who set the pace. Dr B C Roy, who’s B’day (even demise), falls on the 1st of July. Along with Dr BC Roy’s name runs a parallel name Kalyani. The story is well known.

Kalyani is a meaningful word. May that start kicking in from this Doctor’s Day!

“rafta -rafta waqt ka sailaab badhta hei gaya,

Lamha-lamha ham doobta apna ghar dekha kiye”

Farhat Shahzad

(Gradually, the tide of time kept rising,

Each moment, I kept on seeing my abode drowned in the deluge)