94: Medico Warriors: Ash

 

This Article has been contributed by Doc Aggarwal (A Good Friend)

It provides a glimpse into the selfless service of medical fraternity in fight against the Pandemic

Ash

“The BP is dropping, we should start inotropes”, was the breathless interjection from the treating physician.

“SpO2 levels are also dropping, seemed ok some time ago”.

The patient, a senior citizen of great importance did not look good. He appeared a little listless, a little confused and frankly very ill. He is much liked, very popular and has done only good to people. Everyone is concerned.

They confer privately. “We need to get him to a better equipped centre… That is the only hope”.

“But it is a four hour journey. Will he be able to undertake it?”

“What is the other option? We’ll send a doctor along with him. It’s eight in the morning, if we start early enough, he will be at the hospital by noon. That’s not too bad”.

And so the decision is taken. We’ll send him with adequate oxygen, IV fluids, medicines and a doctor. The front section of the ambulance would be sealed, so that the driver stays safe. Air-conditioning will cause air circulation, and endanger the driver, so it will be switched off. The windows will remain open for cross-ventilation. The doctor would be exposed to COVID from the patient.

Ash was the natural choice. He is a doctor already suffering from COVID, though mostly asymptomatic, some mild cough, fever, bodyache. Nothing that cannot be handled.

Nothing, except of course, Murphy and his laws. The transfer kept getting delayed, hour after hour. First it was stabilizing the patient, then the paper-work, then ensuring adequate oxygen then adequate fluids and so on… By the time they finally started, it was 01:30 pm. The outside temperature had climbed to 42 deg Celsius. The patient was not as well compensated as he was in the morning. Ash, was hot and with the dehydration COVID brings in, thirsty. His fever had increased and he was not feeling too well.

Ash kept it together, though. Irrespective of his personal discomfort, he maintained hemodynamic stability, maintained oxygen levels, kept the patient’s fever under check, made sure he remained lucid.

On the other hand, Ash himself was hot, thirsty, badly feverish and had severe bodyache. He held on steadfast.

The final leg to the hospital was a little more torrid. The patient’s BP started dropping a little and oxygen saturation suffered. Ash made the necessary adjustments. They reached safely. Phew… what a relief.

After the patient reached the ICU, Ash finally breathed. He spoke to the DMO, “I need a room for 15 min or so”.

Inside the room, he disregarded the fever, the bodyache, the dehydration, the awfully sick feeling. He folded his pant cuffs, washed his hands and feet and turned west.

“Bismillah, in the name of Allah the most merciful, the benevolent”. He prayed, and had his first sip of water since sunrise, as he opened his Roza fast.

Tomorrow is another day

 

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93: Medico Warriors: Lila & Tibs

 

This Article has been contributed by Doc Aggarwal (A Good Friend)

It provides a glimpse into the selfless service of medical fraternity in fight against the Pandemic

 

 

that’s really good news

Lila and Tibs… The silent bastions on whom it all has been resting for the past month. Ever since the second wave broke, they have been at it. Day in and day out, sleeping, living, eating, breathing COVID.

Lila is the elder one… by some one year or so, and would never let Tibs forget that. Tibs is a little younger, considers himself a little stronger. She is bubbly, charming, enthusiastic, easy to smile and vivacious. Tibs on the other hand is the silent, quiet type. They are both efficient, knowledgeable, concerned and above all caring.

They are the two doctors at the Station Medicare Centre (SMC), at an Air Force Station, somewhere in the heartland. There are others, but one has got COVID, while the other was, well, out for some time. So just Lila and Tibs. Usually, its not that tough. Oh, they do have a clientele of 8000 or so, but they manage. What tipped the balance was April.

In the month of April, the SMC has had 230 cases of COVID, positive on Rapid Antigen Test (RAT). This means that there would be another 1000 lurking around here and there, some asymptomatic, some scared to come over lest they are quarantined, some missed by the RAT, whatever. But 230 is a lot.

Lila is newly married, her husband Sudhir is posted far away. She could barely squeeze in a honeymoon before the China virus played spoilsport. Tibs managed a brief trip to his steady girl and came back with COVID a few months back. Hasn’t managed to meet her since. They still remain cheerful.

So let’s see what it means, looking after 230 COVID patients, by two doctors. 15 min to 30 min of questions by relatives for 230 patients… CHECK. Getting basic protocol tests ie Blood counts, Renal Function, Liver function for 230 people, regularly, sifting through results, ensuring you don’t miss anything… CHECK. Monitoring SpO2 levels for 230 patients four times a day, keeping track, making sure none are missed… CHECK. Rechecking after a six minute walk test… that’s eight times a day… CHECK.

Then the first person starts showing a little low SpO2 and the next struggle starts. The overloaded local hospital’s first reaction is, we can’t. You manage. Give oxygen in the SMC. So then that is a sudden huge demand on the limited number of people available. But they manage. Running from patient to patient, attending some meetings on hygiene or sanitation or sewage or water, all the time worried about the patient on an oxygen concentrator at the SMC.

Lila develops a cough. Fever is 102 deg. She has been double masking, hand sanitizing, social distancing, covering herself. But she knew this was coming… someday, somehow. She walks up to Tibs, to find him coughing, bodyache, fever is 100 deg. They sit down. Now what? What happens to the 230? They sit silent, drinking nimbu-paani after nimbu-pani, trying to figure out what to do. Obviously, there is no logical answer. If they see patients, they could be super-spreaders. If they don’t, who does?

Lila resolves. Pops two tablets of Paracetamol, asks Tibs to go home and relax. She stays, does her work. Her RAT test is negative. She will get an RT-PCR tomorrow. She wades through the day. It was horrible, high fever, outside temperature 42 deg Celsius, cough, bodyache.

The next day both Lila and Tibs undergo an RT PCR. Buzzed with Paracetamol, wade into the day, like they have over the past month. Fever varies between 99 and 102 deg for both. The bodyache is killing. The cough is bad. Exhausted they go back home.

Lila is in bed hugging Sudhir’s photograph, waiting for sleep to come. Tibs calls… RTPCR results came back. It is NOT COVID. It is just exhaustion, he says.

Oh… that’s really good news, she says. She hugs Sudhir’s photographs tighter and goes to sleep.

Tomorrow is another day

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