National Doctors’ Day: Delhi doctors recount the horrors of second wave
The second wave of the coronavirus disease (Covid-19) pandemic left even the most experienced doctors in tears as shortage of beds, medicines, and oxygen forced them to take a call on whom to save. On National Doctors’ Day, celebrated each year on July 1 to commemorate the birth and death anniversary of great physician Dr BC Roy, HT shares the experiences of doctors from city’s emergency and critical care teams who treated the most severe Covid-19 patients.
So far, 798 doctors have died in the second wave of the pandemic, according to the registry by the Indian Medical Association, shooting past the toll of 748 recorded during the first wave.
“Papa ghar ajayenge na?”
Dr Ritesh Aggarwal, principal consultant of critical care at Max Hospital, Saket
For Dr Aggarwal, the most prominent story during the second wave of the pandemic is that of two young girls. He recounts a day in April when a woman in her early 30s with a six or seven-year-old girl walked up to him in the hospital.
“We have been briefing the families of the patients on the phone so I did not know them; they saw my name and came to speak to me. I realised that they were the wife and daughter of one of my young patients – a 33-year-old engineer. Just as I was about to leave, the girl said ‘papa ghar aa jayenge na? Mere friend ke papa ghar nahi aye. (Will my father come home? My friend’s father did not.)’ I did not know what to say; why should young children have to deal with loss and death?”
The other young girl was his six-year-old daughter who would usually complain about him not playing with her after work. “One day she came to me and said first you finish Covid and then we can play. My wife told me that she has been saying that papa should treat more Covid-19 patients after their class found out that their teacher died of Covid-19,” said Dr Aggarwal.
He took his daughter’s advice seriously. When asked how he managed the emotional fallout of so many deaths and the sagging morale of team members, he said, “The best thing for me was to work hard. I knew there will be misses, I just tried to stay professional. As for my team, I led from the front. Whenever I saw the morale sagging, I would go into the ward and work with the team---put in a few extra hours, take some load off the team,” he said.
However, working through the pandemic and having his phone buzz a few times every night during the second wave meant not much time for exercise in the morning. “It has definitely taken a toll on me. I have put on weight, my blood pressure has shot up, my lipid and renal parameters are haywire.”
“We did not have time to cry, we kept working like zombies.”
Dr Ritu Saxena, head of the emergency department at Lok Nayak Hospital
For Dr Saxena, the city’s biggest Covid-19 treatment centre Lok Nayak Hospital, it was the death of a colleague’s wife that hit the hardest.
“When one of our own doctors came to the hospital emergency department, we realised that his wife’s oxygen saturation was also low. But they had a nine-year-old son, so she decided to go home and wait for her family to come before getting admitted to the hospital. She was admitted a day later with just 84% saturation, she died the next day in front of her husband who was in the same ward,” said Dr Saxena.
The second wave of the pandemic, she said, was like war. “The hospital was full; sometimes we had four patients sitting on one bed taking oxygen from a large cylinder because we had run out of oxygen ports. We had to triage; we had to take in patients whom we knew would have a better chance of survival. We were taking in younger patients,” she said.
“When the oxygen crisis hit and we were asked not to take in any more patients, my doctors went outside the hospital gate without their coats and I took a round in my car to see whether there were sick patients we could help; we took patients in,” she added.
Along with a gruelling day in the emergency department, she was also tasked with ensuring that all the bodies were disposed of on time. She recalled a day when there were nearly 100 bodies at the hospital and she kept dispatching ambulances throughout the day. “I had deputed 20 ambulances, yet I kept getting calls for more. That night, I dreamed of having to carry the dead in my car.”
She said she had never faced a situation like the second wave of Covid-19 despite Lok Nayak being a high volume centre.
And amid the entire crisis, there was no time to process grief. “We lost family members, we couldn’t even cry. We did not have the time. We just kept working like zombies,” she said.
“We never thought there could be oxygen shortage.”
Dr Rahul Kumar, associate consultant of the critical care department at Sir Ganga Ram hospital
What he remembers about the second wave is the sheer number of patients. “The biggest problem – and I think this was true for all hospitals – was the huge number of patients and they were coming in when they were really sick. Patients who needed ICU care had to be admitted outside the ICU with non-invasive ventilators. We had to triage based on who was likely to survive and who wasn’t. There was staff crunch because people started testing positive. There was a shortage of beds, medicines, and even oxygen,” said Dr Kumar.
He had never seen medicines or oxygen running out, he said.
“Never in my life have I seen oxygen shortage; no one even thought such a shortage could arise. We had to plan for eventualities of oxygen running out, we had to have staff and oxygen cylinders on standby to take over if there is a dip in oxygen pressure,” he said.
For him, the deaths of young doctors were the hardest. “There were young doctors admitted from other hospitals and seeing them die despite doing the best we could was hard. There were also these two pregnant Covid-19 patients under my care. One of the mothers survived after two months in the hospital; the other died. Both were young. The most difficult part is to tell their families, especially when a patient is young.”
“After our shift, we were consulting patients over the phone or looking for medicines, oxygen for family members. It was traumatic.”
Dr Abhijit Kumar, senior resident of anaesthesiology at Safdarjung Hospital
Despite being a high volume centre, he said he had never seen such long queues outside Safdarjung Hospital. There were queues of ambulances waiting to bring in patients, he said.
“The number of cases just shot up suddenly within a short duration. Preparations were made but none of us had expected the numbers that we received. The ICUs were full, there was a huge waiting list. There were patients in the wards who needed ICU care but we weren’t able to take them in. In a government hospital, we cannot really do triage at admission but we were trying to focus on younger, healthier patients who were more likely to survive,” said Dr Kumar.
He remembers the four or five nights at the peak of cases in April when his phone kept buzzing incessantly. “It was friends, family, people I know asking for beds. But I knew the situation at our hospital and the others nearby. There just weren’t enough beds. It was traumatic emotionally for the doctors. Knowing that a patient needs care and having to refuse them. Knowing that if we left patients on their feet, they were likely to not survive,” he said.
He said in a bid to help, he was working 24*7 even from home. “I would schedule consultations after work or try to find beds, oxygen for family members.”
It was the hardest for him when despite putting in his best efforts when his friend’s father succumbed.
“It was shattering for me to see him (school mate) deteriorate day by day despite my best efforts.”
Dr Amit Kohli, intensive care specialist at Lok Nayak Hospital
Dr Kohli, who was also dealing with the devastating second wave, had his school friend admitted in his ward and his father at another hospital at the same time.
“One of my school mates – someone I grew up with, studied with for several years with, shared so many memories with – was admitted to my own ICU. I used to go up to him before my shift and talk a little. We would stay in touch on WhatsApp. It was shattering for me to see deteriorate day by day inspite of me doing my best. He died after 12 days,” said Dr Kohli.
His father has recovered since and has come home. He still continues to need some oxygen from time to time.
“Denying family members a bed or telling patients that some medicine or therapy would not work because it was too late was the hardest part,” he said.