National Doctors' Day: Mumbai doctors reflect on pandemic year trials, lessons, and the likely third wave

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As people around the world grappled with a new and unknown virus at the height of the pandemic in early 2020, Dr Aarti Subramani, a first-year resident medic in the city found herself in the thick of things. It was unlike anything she had expected or experienced before. "I stepped into the Covid-19 ward in May 2020 as a fresher in the peak of the first wave with fear and chaos, as it was a department where most people were unwilling to work. Everyone was skeptical and so was I," recounts Subramani, who describes it as a rollercoaster ride, which was not only challenging but equally exciting to be in.

Without any waste of time, she acclimatised herself with the situation at hand, put her training to use, and got down to doing what she was meant to do. Getting through eight-hour shifts without food or hydration became the new normal, she says, as she found comfort and safety in the PPE suit, while dealing with an enemy that had already wreaked havoc around the globe.

"The real challenge was not just keeping the patient's oxygen saturation in check but mine too. The risk and fear of contracting the virus while donning and doffing PPEs on a daily basis was something we eventually had to get used to," the 26-year-old adds. It was only the start as her judgement was put to the test after the first wave, when she was shifted to the Emergency ward in the second wave. "It became extremely difficult to admit patients as there was a constant waiting list because the cases kept soaring and a call to channelise resources that maximised clinical outcomes, keeping humanity in mind was a difficult situation to face."

Most doctors have been to hell and back in this period but they have soldiered through it. For many, they have been saviours as their vocation requires them to deal with the worst to help cure people. Every year, India celebrates National Doctors' Day on July 1 to honour noted physician Dr Bidhan Chandra Roy. It is also celebrated to thank doctors who work tirelessly to make people well again. With the last one year having been one of the most dramatic ever experienced, Mid-day.com spoke to four doctors to understand how they dealt with the Covid-19 pandemic, what gave them hope, and their concerns about the third wave.

Many doctors have shared accounts on social media about how the pandemic has taken a toll on their mental and physical health. The pandemic definitely took a toll on Subramani too but she isn't the only one. Even older doctors have realised that they were dealing with a different kind of monster. This monster didn't take expertise into account and simply made everyone who was stepping through the doors of a hospital feel like a novice and challenged them at every step of the way.

Even all the years of experience couldn't prepare experts of the respiratory system for what they were about to face. Dr Radhika Banka, a consultant pulmonologist with P.D Hinduja and MRC, explains, "The sheer number of people affected, lack of scientific evidence in the early part of the pandemic, risk and scare of infecting family members, and the workload has been stressful. To see patients dying alone in COVID wards without their loved ones by their side has been very disheartening."

The doctor admits that even after a year and a half, the way the virus is mutating and the newer variants being discovered is adding to the fear and anxiety of experts.

Ray of hope
However, there are others who are hopeful and have looked at the bright side of the hardships from the past year. It is probably what the virus failed to account for when it took over the world. These doctors who were risking their lives were armed with resilience, training, and families who were praying for them.

Dr Aditya Agrawal, pulmonologist with Bhatia Hospital has seen the brighter side of the challenging times. "The last one year has been very rewarding for academic medicine as we have learned that you have to be constantly learning, reading, and exchanging ideas to stay on top of things in our changing world," he explains. "We actually learnt how to manage an entirely new medical condition within a year. Patient and family counseling has become a priority even more than before."

The joy of being a doctor and curing people is also what helped Banka remain hopeful. The respiratory physician found comfort in the old adage ‘this too shall pass'. "The hope and joy of helping patients recover, to see them go back to their families is what motivates me. At the same time, learning to evolve myself as a person and a doctor completes me as an individual," she adds.

While Agrawal and Banka found confidence in medicine, Subramani has found hope in her friends and family. They were wishing and praying for her during the time, though they understood that she was at risk of contracting the virus at any time. She adds, "My mother would always insist that I read this Bible verse of Psalms 91. It was my faith in God which brought me solace."

It wasn't easy for senior paediatric surgeon Dr Ketan Parikh, whose practice came to a complete standstill in 2020, as many patients, who were from out of town weren't able to travel to the city. He opines that through all this, the doctors have been tested, but it was most difficult seeing patients go without timely care. So, he decided to do something about it and launched PyraMed, a doctor-to-doctor telemedicine platform. "I wanted to bridge the rural-urban inequity in healthcare. Partnering with paediatricians in non-metro areas, patients can connect with a paediatric specialist, getting all the benefits of an in-person consultation, locally." It was also this initiative, to help patients with fewer resources to be able to access quality care, which kept him positive during this time.

Preparing for the third wave
Now as the second wave seems to have subsided, doctors are already preparing for the third wave. However, they can't do it alone and are pleading that people take the necessary precautions.

"We need to realise that the only way to curb this pandemic is by taking necessary precautions. If we do not take the necessary precautions, we are only going to propagate the pandemic and also put our loved ones at risk," Banka expresses. Agrawal iterates Banka's need for precaution and Covid-appropriate behaviour after experiencing the effect of the pandemic in the last year. Ahead of the third wave, he reminds patients to not panic and if one does experience a symptom, it is best to isolate and seek timely medical intervention.

Amidst discussions of the third wave affecting children, Parikh, who has been practising for 36 years, says parents need to be cautious and immediately start limiting their children's exposure. He adds, "Even paediatricians need to prepare themselves. Some were caught off-guard during the second wave as they could not deal with complexities of the virus. Navigating COVID-19 is a team sport and they should not hesitate to reach out to child Covid care specialists for an opinion when required."

While Banka, Agrawal and Parikh have years in the field which will help them deal with the third wave, Subramani is going to rely on her experience of the last one year. "I have been preparing myself mentally to have a sound balance between my clinical judgment and maximise benefits of patients with available healthcare resources," says the doctor, who echoes the voices of several others who started their practice during the Covid-19 pandemic.

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