My Experiences with Patients in COVID Times!

Science of medicine has its limits, not the Art of it!!

Dealing with patients comes naturally to physicians. That’s what our job entails and to do it well, communication with patients is a fundamental requirement. COVID19 is no different, or is it!

Few moments and interacting with some patients during my first round of the wards, I realized that this was not going to be the usual. This virus had created some unusual situations and challenges and my standard way of dealing with patients was not going to be enough.

A decorated war hero, now with a heart, weakened after multiple heart attacks and stents in his coronaries, a chronic lung ailment, was now inflicted with this dreaded virus, just a few days after his last coronary intervention. Having had frequent hospital visits and recovery from ventilator for his lung disease in the past, he was one strong man, confident that he would beat this virus too. Afterall, he had beaten the Paki tanks in 1971 war for which he was awarded MVC.  

He remained belligerent through his stay in ICU, undeterred by the patients dying around him, till he finally lapsed into a state when he had to be put on ventilator and breathed his last. Till his end, he was “passing orders”, wanting his way, something the doctors may not relish, but here, one had to occasionally relent and let him “win a few battles, while the war was being lost”.

Super veteran nonagenarian couple, parents to one of the most influential bureaucrats in the country, detected positive, although symptom free, were admitted to the ward for observation. A high risk for the Covid disease beyond doubt, but for an elderly couple, hard of hearing and with poor vision, prone to falls, and so used to a fixed schedule at home, being taken care of by the numerous attendants, were now here, alone in a room, amongst unfamiliar surroundings, unknown people, masked and covered in PPE. The ward staff was busy with many sicker patients to be looked after, and it was difficult for the staff to patiently listen to their long winded requests, often complaints and grievances. During my rounds, conversation with the demanding, attention-seeking old man had to happen using written notes on a paper, in large block capitals, visible to his fading eyes.

The grammar in these messages had to be correct. While the lady patiently listened and understood our problem, she was not the one to convince the angry old man. That was left to us. So, every round, morning and evening, some time had to be spent with them doing all this. While no drugs had to be given to them for the virus, per se, this was our only “treatment” and had to be given ad lib.

Elderly veterans, wife a cancer survivor, having recovered her strength and now more concerned about the health of her ageing husband who although looked strong outwardly, pretending to be fine, his frail interiors were afflicted enough to require oxygen to sustain. As he continues to fret over the health of his wife, who is comfortable, he is worse enough to be shifted to ICU. The world around the lady crashes, as there is no way she can know from him, how he is doing. The fear of the worst hounds her, which she shares with me in every visit to her. A detailed status report of her husband in ICU has to be given to her, and often not convinced, she insists on talking to him. Although not the usual practice, his phone is charged and taken to him so that he can remove his O2 mask and talk a few words with her, before getting breathless and going back to his life-saving oxygen.

Not all patients are as fortunate. Some of them have landed up in the hospital alone, often with scanty belongings, not having informed the relatives, and not carrying their phone charger, which has since gone off charge. While some of the neighbors may be friendly and cooperative, most of them refuse to share even something as trivial as their chargers or their phones to make calls. To see that even this pandemic hasn’t changed some people, or brought out their selfish traits is what is disheartening. Tracing their kin’s numbers from the admission documents and making calls to inform them of their patients well being is also left to the doctors to do, and the cheer that it brings to their faces, often works better than the drugs and oxygen that we infuse.

Concerned relatives calling up to enquire about the patients was much more than the usual. Considering that they were not allowed to visit the hospital, and communication from them was poor, this was expected. A few hours in the day had to be left for returning these calls and responding to these messages to allay their anxiety and apprise them of their patient’s condition. 

This virus hasn’t spared even the strongest of the soldiers, the BLACK CAT Commandoes who are known for their courage and valour. While these super fit soldiers are young and at a lower risk of severe disease, one still has to be careful managing them, as they would often underplay their symptoms, and continue to go about their fitness routines and exercises despite the illness. Also, the infection with the virus was perceived as a “weakness and failure” which led to a low mood, which required some assurance and uplifting chat during the rounds.

Then there are the VIPs, those that haven’t changed even in these times of the pandemic, and demand all luxuries, and for whom no discomfort is acceptable. These are the people, who would always blame the neighboring patient for coughing and spreading virus to them (while they themselves are infected), would want bottled mineral water as they don’t trust the hospital RO system, and would want the oxygen even if their condition didn’t warrant it. Even before they enter the hospital, their well-wishers and “influencers” would start calling for “updates” about their health and would want to be assured that the VIP has been apprised that they had called to ask about their condition. While one has to be very diplomatic and polite while dealing with such patients, one must remember not to waste too much energy on them, and save it for those who really deserve it.

Experiences are many, as are the kinds of people we face every day in life. How this virus has changed things is in the way patients and their relatives behave with each other and with the doctors. While a doctor is taught to be kind and empathetic as an inseparable aspect of this profession, these have to be applied far more emphatically while dealing with patients in this pandemic. Frequently, we may have to go beyond our call of duty, to fulfil patients and their relatives’ expectations, which in my opinion, we must to the extent possible. Only then we can heal the patient suffering from this difficult-to-cure disease.