She is Dead

She is dead.
     

     The phrase I had uttered without hesitation during my time as the resident doctor in Palliative Medicine were the same words I was trying to avoid saying. She, a middle-aged mother of one, on life-support a few wards away from where I stood, had ceased her struggle with the virus. Sitting before me, occupying a bed each opposite each other were what was left of the woman’s nuclear family. Her son on one side and her husband on the other side of a Covid general ward. The situation where, amidst a global calamity, entire families were admitted to the hospital, where a Psychiatry resident was called upon to care for medically unwell patients, wearing a dehydrating space-suit seemed something out of a dystopian novel. But the terrible update I was privy to wrung me back to the pages of reality.

 
     The nursing staff and I were in possession of the knowledge that the third member (first?) of this small family was no more. The husband eagerly pulled out an old discharge summary of his wife hoping that it might help the doctors taking care of her in the ICU. A simple gesture concealing an anguish hitherto unknown to him. Ideally, I mean before and after the pandemic, Critical Care physicians would go through the mostly uncomfortable and occasionally positive discussions about prognosis and perhaps even the death of a patient with the family members. Given the countless restrictions of the pandemic, the father and son unfortunately could not have such a conversation with the ICU. Joining him in the distress of not being able to visit their loved ones were hundreds of thousands of people around the world.

     

     My job that day was to deal with two such souls.  
     

     First among them was the son who sat on his bed across the floor, in the same boat as his father in many ways but experiencing the agony in his own terrible way. Unknown to the visible universe are the countless thoughts and tears that the lady in the Covid ICU thought and shed. The one person who could have provided her warmth and love concentrated his efforts on the least he could do, providing an old discharge summary. The son, who could listen to her cries in a way no professional ever could, held his mobile in eager anticipation of an update from inside the ICU. The news reached the ears of my staff first and then mine, the duty doctor.
     

     That she was dead.
     

     'Dead' is raw language, I know. ‘Expired’, ‘No more’ ‘I’m sorry’ are the expressions professionals use to introduce a bereaved family to a new normal. Nothing about Covid-19 was normal. But in that word lies a real sense in which the tragedy was felt. Or would have been felt had I declared the news to them myself. 'I was their treating doctor, not hers' was my meagre excuse. The news, ideally, should be uttered by my counterpart in a different frontline. But the dilemma lingered in me. Should I or should I not tell them. 
     

     Health care workers in Covid wards appeared like duty-PPEs rather than duty-doctors or duty-nurses. The polypropylene, the face mask and the face shield did their best to filter out the virus but failed utterly from preventing the humans underneath them from experiencing the most basic boon of humanity, empathy. There was sadness at the plight of the patients and the utterly helpless caregivers, anger at the failures of the national health system, awe at the scale of the disaster, and apprehension of having to work in an area not close to one’s parent department. But lurking behind each of these was an urge to do everything our double gloved hands could do to help them.

     Why would a resident working in a covid ward dare the anger of the gods and attempt resuscitation? Why would a duty doctor spend hours calling every hospital in Bangalore pleading to take a patient in? Why would a third-year medical student decide to wear the dreaded kit and work in the Covid wards? Why would a postgraduate student who had seen more deaths than she should still report to duty the next morning?
     

     Why was I standing in the ward contemplating life given the tragic situation I was facing? I believe it was because a virus with unprecedented impact on the world could not pare how I felt as a human being.

     And in that very human nature I became glad to be told that both the son and the father were getting discharged. Why was I glad? Was it because I believed the two would be put out of their current misery and pushed into an even greater one? Or was it because I didn't have to break the news myself?

    

      I was sad, I was introspective, I was glad, I was sweating; because I was human. 

-Sam