The screaming had stopped, at least that was one thing. We could all take a second to catch our breath. On my right, my arm clung to my patient who sat rocking backward and forward on the chair. On the other side, my colleague - mirroring my position, my posture, my heavy breathing. The only difference; the fogged up glasses on her face. There had been crying, there had been grabbing, there had been attempts to harm themselves. We had prevented it. We had stopped it. We had helped. Hadn't we? The pandemic was in full swing. We had at least 50% of patients on our ward with a positive test result. Most of them were self-isolating in their bedrooms, with the others barely daring to come out. The ones that did tended to be acutely unwell and simply did not or could not understand the current situation regarding COVID-19. Our ward was locked down, nobody in, nobody out. PPE on, changed after every patient interaction, all safety measures put in place.. until they weren't. What do you do when a paranoid patient thinks you are a robot hiding your face with a mask? You cannot remove it. For both your sake and theirs. They become upset, distressed. They scream, they shout. They retaliate, they lash out. They are medicated, sedated. They wake up, and go again. What do you do when a patient feels so hopeless that they will use any means necessary in an attempt to end their life. They try to swallow toilet paper, so we have to remain in possession of it. They try to snap pens, so we hide them. They try to use clothing to stop them from breathing, so we limit access. But what do we do when we have to go in wearing masks, gloves and aprons? An abundance of opportunities for the patient to obtain and misuse. How do you tell their loved ones that you literally provided them with the means to devastatingly hurt themselves? If you figure it out, please let us know. What do you do when a patient is so thought disordered, they cannot even remember to eat and drink. They spend most of their time rolling round their bedroom floor, eyes darting round the room, too engrossed in what they can see and nobody else can. They will not even take medications for you, to get themselves better. They see you in your mask, your visor, your gloves, reaching toward them, touching them. They are scared. They are dismissive. They are unwell. 12 hour shifts, 4 days a week. Masks on constantly, chafing at the ear. Hands dry, cracked and swollen from the prolific hand-washing going on. Dehydrated, both our palms and our bodies. Changing in and out of uniform before and after shift. Washing uniforms on abhorrently high temperatures, just to be safe. Persistent home-tests to ensure we are still virus-free. The extra time it takes to shower both before and after your 12 hour shift, losing out on sleep. But we are here. We are helping. We are the NHS. Inpatient mental health facilities are challenging places to work at the best of times, never mind in the midst of a global pandemic. Patients do not suddenly stop being psychotic or depressed, just because the world is in lockdown. They are not able to socially distance. Some of them rely on proximity and closeness in order to stop themselves from hurting - both physically and mentally. Some of them have no sense of personal space. We cannot administer medications in a socially distanced manner, we cannot monitor and record physical health observations 2m apart, we cannot stay home. So here we are, and here we will continue to be.
Delhi, a city reminiscent of medieval splendour and behind it, a hereditament of a colourful history in abundance.Yet the colour that currently painted it with was a red full of dread.The wailing of the ambulance faded away as the sobbing kith and kin became more audible.I had been in the room for twenty-four minutes, with another to go before I had to put on the PPE yet again, a ten hour vigil lay ahead.My gaze shifted to my version of Pieter Brueghel the Elder's bee painting that I had begun before COVID-19 had incapacitated the train of thoughts as well as had hijacked the proceedings of a normal day at a hospital. I suited up and ascended along the stairs for the lift was being disinfected.There I saw her, clad in bright yellow and eyes partly open.Entering the ICU, I found her being prepared to be ventilated.Frail as the situation was, it was parallel in strenuosity.Something that any emergency physician would have done a thousand times before, yet the delicate nature of human life and the weight it impinged upon the concentrating brain was disparate. Once she attained stability, it was time to attend to the first of the three more emergencies that arrived in the meantime. It was all facile a month back, three physicians ever present and never more than three emergencies in a span of an hour. Soon two of them were down with the virus.And now, as the Sun rose and made its way right above my vertex, there would be a dozen fatalities and as the Moon waned, the figures would triple. To my way of thinking, it seemed the subsidence of an already decrepit medical system.Along with that, the fear component had crippled the effectiveness of action.A quarter of an hour later, when there arrived no fresh entries, I walked over to the woman in yellow.She seemed better, her eyes fighting the bright sunlight and as I drew the curtains down, she scribbled something on a piece of paper.Expecting a routine courtesy of thanks, I read it and was left confounded.I bowed in response, folded the note and carefully placed it in a pouch I carried and diverted my attention to the other invalids. After my routine rounds at the assigned block which had twenty-six critical cases, I made way to get my head down, the length although obscure.A loud knock broke my slumber and at the door was the head nurse, her eyes inundated with quandary.Acquainted with the picture, I took three minutes to get myself wrapped in a ton of plastic and raced ahead.The yellow lady it was, her heart shutting down and the urine bag heavy with red no more just a tinge, the kidneys failing.A Doppler ultrasound would have taken a painful five minutes and the climacteric scenario demanded a quicker display if she were to live.The limited knowledge science had been in possession of so far about the virus, yet a prothrombotic milieu was well known of. The beeping of the monitor clashed with my thoughts, a war between all possible interventions ensued and in half a minute, I knew what to do. There was no use checking the D-Dimer levels.The incessant thought of the three minutes roamed all around my thinking capacity.If I were suited at the time or maybe even a thirty second head start would have been convenient.The dose had to be heavy to restart her crashing heart.The history her kin provided had no mention of any previous instance of bleeding and the risk was ineluctable. A minute later, her heart rate improved and the beeping ceased.A smile saw premature abortion and as I stood still, a paroxysm of shock had sent my sanity into a deluge. She was bleeding.The history was wrong. Time proved a a hoodwinker, for a simple test of twenty-five minutes would have saved her.My attire no more white, as I washed my hands, the mirror of catharsis in front refused to let my pain see the daylight that was breaking in, taking all the visible darkness with it. The concealed darkness and the discernible voices remained deep inside, forming another memory in the tenebrous gorges of the gyri and sulci. This one the deepest. Between sunrise and sunset, with more and more bodies being buried or cremated, cemeteries running out of space, ambulances and cadavers, and as healthcare crumbles, doctors and patients infected alike, hope seems to be on the platter of the disease.As I retire at night, the afflicted relatives, the affrighted healthcare workers and the affectionate eyes of the woman in yellow hover around in circles. The paper read: Dear roll number 88, Yes, how could I forget those eyes, teeming with curiosity for the entire six years.I know it will shatter you, but remember the thesis, the bavardage, discussions and the plan to visit Egypt for our interest in the place.Life was and is short.Dreams many.Death solitary.A multitude of memories to accompany.Take care.Madam yellow as you named. Tears flowed, wrestling each other, the space very little to let out a sigh when the beep sounded again and the peregrination recommenced.
Yes it's so nice when you're trying to get a new life together and you've got a million things running through your mind like; how to market yourself in a diverse market and how to fund myself for this new change in career focus that I'm embarking on, when the flu hit me and sent me straight to the toilet. It's never fun! lol So here we are now a few days later and I still feel crummy. I didn't get a wink of sleep and all I can do is sit and write which is a good thing right now. For 15 years it has taken me to strengthen my back and get myself to where I can sit up and write for awhile without too much pain providing I sit up a straight as possible. That gets hurt some too at times and then I take a good break. Good thing I get up frequently to stretch my limbs! But in all honestly the flu has me writing. I'd love to be helping someone right now. I wish I could offer my services in support work. I loved my PSW position with Paramed Oakville. But that was 18.5 years ago now. Wonderful people to work for and my job was fulfilling and my patients delightful. Last night, I laid in bed and thought about many things and the one question came to mind was, "How many people have a version of the flu right now?" I guesstimated that probably in my city at least 300 people. Thank goodness I'm not in need of the ER. I feel for the people who do. Well, I just needed to say Good Morning to you and I hope you're feeling well! LOL Thanks for the chat! :)