My little child cries several times when he sees his parents going out for work, and his mother and I have also started fearing about his safety from the risk we are carrying from our workplace. My son is not old enough to understand that his parents can get the coronavirus infection and can die from it, if the disease becomes severe.
We have learnt that cancer patients are more at risk to developing a severe or critical form of Covid-19. The risk of acquiring the infection during cancer treatment at the workplace, however, is less compared to people working in Covid-19 areas. There are fears and worries about bringing the virus home to the family with media reports on problems with availability and quality of personal protection equipment. But we have no choice as we all took an oath as doctors to perform our duty and do the right things.
Doctors around the world continue to risk exposure and many of them are falling sick, several requiring quarantine, some needing admission in the wards and ICU, and a few have lost the battle while attempting to help their patients win back their lives. Doctors are well aware and concerned about the safety of their loved ones, though children generally present milder symptoms of Covid-19 compared to adults. ICU beds and ventilators are not readily available and if the crisis expands more healthcare workers will be at risk and this will be compounded by the shortage of PPE in a full-blown pandemic situation. As cases are rising every day, many reports of doctors running to different hospitals to get admitted are disturbing. This is another challenge, to get admission in a hospital when you or a family member becomes symptomatic as most of the institutes are overburdened.
Although doctors are wearing personal protective equipment as per their area of work, the fear is always there. Doctors generally leave stress at the hospital when they head back home after long hours of duty. But Covid-19 has constantly occupied our minds.
News of corona-related deaths of doctors are widely circulated on social media platforms and I am painfully aware that more than 250 doctors involved in Covid care have lost their lives in our country. I, along with my wife, cannot escape from our responsibilities and working in Covid hospitals, but I feel a surge of anxiety for my father who is a cancer patient, my mother and my three-year-old child.
Last weekend, I was at home and was talking to my friends about the worsening situation at the workplace and how it is affecting the health of healthcare workers. Detailed discussions made us understand the severity of the alarm raised about Covid-19 in our community, with the disease having led to closing down of schools, businesses, and organisations while leaving people nervous and scared.
Some doctors cried and were terrified that they had Covid-19 and a few demanded to be tested. We have many reasons for wanting us to be tested and the most important among all is the concern for our family members. Many times, doctors are denied testing by authorities at hospitals in which they work.
We have learnt about maintaining a distance of six feet at the workplace, but it seems unmanageable in a scenario where three people are trying to stand six feet apart in an examination or consultation room.
It is expected that this pandemic is going to get worse before getting better. Most doctors have never seen this level of angst and anxiety in their careers. As the coronavirus spreads around the country, doctors have started asking themselves, "Will I survive?" The worries have increased with several young doctors falling prey to the disease. We are quite used to feeling and understanding this uncertainty of life when we have heard our cancer patients urging us to save them. Many times, we have assured our patients about doing all possible interventions to save their lives when we have seen them in fear, anxiety and uncertainty. I have not forgotten the faces of many of our patients who strived to live their life to the fullest. The fear and psychological stress of working in hospitals where Covid-19 patients are being treated are beyond comparison right now.
It worries us more when we hear the news of doctors getting infected with coronavirus despite wearing personal protective equipment and dying of it. Hundreds of doctors have tested positive in India and many of them have died, but nothing can be done except being optimistic and mentally strong. The fear becomes more palpable when some known doctor passes away. Many doctors have isolated themselves to stay away from their families to protect them and this has taken a further emotional toll. There is a need to address the psychological pressure on doctors and this should not be ignored.
One of my friends, a passionate gynaecologist in Kanpur, took a patient for surgery on an emergency basis without waiting for the Covid-19 test report, thinking in the best interest of the patient. She was able to help the patient survive with her efforts. But she started worrying for her family when she saw the Covid report was positive. She did her best for the patient but will she be able to do her best for the family she loves the most? There are more questions than answers with every doctor who is working as a front line worker.
A doctor’s role towards patients has changed in this pandemic and it ranges from treating them medically to dealing with their fear of the coronavirus. We have been instructed to try and limit our close interactions with patients, but we have not been trained to work like this and every doctor is finding it difficult and stressful to adjust and adapt to the rapidly changing situation.
There have been several attacks on doctors in India that have made all of us even more worried. We expect love and respect for the work we do, not fear and hate. There have been reports of discrimination against doctors in certain communities due to fear of infection from those who are working with Covid-19 patients. There were reports that some doctors have been forcibly evicted from rented flats by house owners fearing transmission of infection. After everything, we are incredibly grateful to our Prime Minister, who urged everyone nationwide to clap and appreciate the amazing dedication of doctors and other workers who are working 24x7 to make our nation free of Covid-19.
It is one thing to say that we took a Hippocratic Oath to do this, but our kids and families didn’t take an oath.
This pandemic will probably end in the times to come, but the learnings from it have helped us work closely with each other across boundaries, to love our near and dear ones, and work for our people in this crisis. This positive change will certainly help us work more closely for our patients and be there for our families.
Disclaimer: Views expressed in the article are personal. Abhishek Shankar, MD, is an Assistant Professor in the Department of Radiation Oncology at Lady Hardinge Medical College & SSK Hospital, Delhi, India. He has worked at All India Institute of Medical Sciences, Delhi from 2012-2019 in different capacities i.e. Resident, Research Fellow, and Faculty.