The invisible strings of RNA that halted the pacing world

– Dr. Manasi Rege


Our internship began with an orientation on what to
expect and how to deal with various situations. It was
our entry into the world of medicine. I was excited.
After simply taking and presenting cases, I would get
the opportunity be part of the team treating these
patients.


When we began internship in February, COVID 19
wasn’t a big deal in India. In fact Mumbai didn’t have a
single case that time. I had a normal low-key internship
in those 2 weeks before COVID struck. One day we got
a notice that read: In view of the ongoing pandemic, all
interns will be relieved from their current postings and
will be posted on COVID 19 duty until further notice.
And that’s how COVID made it’s rather dramatic
entrance into our lives.


Everything changed after that. All of a sudden people
were made to stand 6 feet apart in queues. All
non-emergency procedures stopped overnight. Body
temperature and symptomatic history became the
passport to enter any hospital building. Mask became
the norm. There was fear in the air, fear for self and for
loved ones. People began staying at home, reluctant
to step out. We, however had no choice. We had to
continue working. my workplace was the same, my
colleagues were the same and yet, everything was
different. Not in a million years had I envisioned an
internship of this kind. After spending 4.5 years buried
in books, I had hoped to learn all the practical aspects
of being a doctor in this one year but it all went out of
the window due to these invisible strings of RNA that
created havoc in the world.


I have been posted in various places now. I started my
COVID duty by working on the municipal helpline for
Mumbai. After that I went to work under the Medical
office of Health in one of the wards (sectors) of
Mumbai. I helped screen migrant laborers who wanted
to go home. I worked in the COVID ward. Right now I
am working in the Emergency room of my hospital.
As soon as I enter I collect a PPE kit from the nurse
in charge, head to the donning area and carefully
don my PPE. Once I am sure I am fully covered and
protected, I enter the emergency room. While it had
always been overflowing with patients, this time
around, it is overflowing with patients overwhelmingly
presenting with only one disease. My hospital caters to
both COVID and non-COVID patients so the workload
almost doubles. Each time a patient walks in we take
their history, perform the mandatory blood tests, draw
IV lines, take ECG and insert catheters and tubes as
indicated and try to find them a bed. That is a problem
in itself. Well, we are a government hospital. We’ve
always been overcrowded. We’ve had to keep more
than one patient per bed at times. This time we also
have to manage to try and keep COVID suspects away
from non COVID suspects and COVID positive away
from all of them in a chaotic ER. We do not know who
in the room could be positive and yet we cannot refuse
treatment to any patient.


After that we monitor the patients, try to make them as
comfortable as possible manage the patient as per the
reports of initial tests. We have a 6 hour shift which
in the PPE seems like 6 years. After about 3 hours I
begin to leave puddles of sweat seeping out of my
PPE overall and shoe cover where ever I go. Surviving
without water and trying to breathe through the N95,
trying not to blackout or succumb to the disorientation
that sets in is no mean feat. Even after our shift, we
spend time making sure we discard the used PPE
carefully, get home and head straight to the bathroom,
wash every surface I touched in my house, my clothes,
shower and then finally crash.


The first time I stood all ready in my suit of armor
outside a COVID ward, I was filled with apprehension
almost to the state of panic. As doctors we are not
supposed to think twice before helping a patient but
this time was different. This time we feared for our
lives, our own health, the health of our families and
loved ones. My parents are in the high risk category,
what if I inadvertently carry the infection home? This
thought ran through my mind continuously. But then
I entered the ward and it all vanished. Inside were a
bunch of people all looking like astronauts working
hard to save each and every patient in the ward. I went
for my routine blood collections and ECGs.


But what I saw changed me forever. These patients
were humans, humans who had contracted the most
feared disease in the world at present, who had been
isolated from families for days and the only semblance
to the outside world was people scurrying around
covered from head to toe to in white and blue. There
was fear written on their faces. Fear of the unknown.
Fear for the health of their families. Fear of losing their
lives. My fear paled in front of theirs. Yet every time
I walked up to them, they smiled, spoke to me, told
me about their families and lives, cracked jokes with
me and invariably asked me the same question: “Yeh
corona kab jaayega?” (when will this corona go?)
There’s a sense of helplessness. This disease has
no cure. Seeing people with such severe breathing
difficulty is enough to break anyone. Medicine makes
us all resilient and pragmatic. We’ve seen death and
sadness at work. But this situation is different.
One incident that will remain etched in my memory
forever was that of a young man who was tested to
be COVID positive. His wife was pregnant and in her
third trimester. When she delivered the baby she came
to the hospital and begged to let her husband see
his new born. They did not have any smartphones.
So I took a photo of his wife and his new baby on
my phone and showed it to the man. He broke down
when he saw his baby girl for the first time. It was
heart wrenching. He spent a long time just staring at
the photo and crying. He told me,
” please make me better fast so I can hold my daughter.” This is what
COVID does. It separates loved ones. But humanity will
prevail. Humanity will win.


This is the first time I fully understood the responsib‐
ility that a doctor carries. From neurosurgery fellows,
to interns, everyone has been working together. I
always wondered how soldiers felt when they went
to a war zone, knowing they could lose a limb or two
or worse, lose their lives. I think I found the answer.
Bravery, dedication and commitment- I truly learnt the
meaning of these words during this pandemic. I finally
understood why they say Medicine is not a profession,
it’s a lifelong calling. This truly is a unique and an
honorable time to be a healthcare worker.


Just before I left for my first day in the COVID ward,
my parents told me they were immensely proud of me.
They have had to adjust a lot. Since we have not been
provided accommodation, I have to come home after
work. They make sure I have a hot meal waiting for me
when I get home exhausted and distance themselves
from me especially till I have disinfected myself. They
have had to adjust to my erratic duty hours and did
so without complaining. I almost broke down when I
couldn’t hug my own family on my birthday. They have
been my strength through it all. Families of front line
workers should be appreciated just as much, without
their support, I don’t think many of us would have been
able to continue working in this stressful environment
without cracking.


This pandemic has made me realize the importance of
small things we take for granted. The fact that we have
the luxury of staying in a comfortable home, with good
food and water. I realized the importance of family.
Now that we are stuck together we’ve begun to learn
new things about each other that we would otherwise
have been to busy to notice, we’ve bonded so much
more. I have become more aware of my surroundings,
more grateful for my blessings and for the ability and
opportunity to be able to serve on the front lines of this
pandemic.


I genuinely miss people, hugs, things I never thought
could be taken away and simply every aspect of a
normal day.


All I wanted to add is that there are many deficiencies,
giant gaps in what we need versus what we have
to fight in this pandemic, many aspects that need
improvement and many incidents that should have
ended differently. But we are trying. Each and every
person on the front line is. We all are trying our best
with the resources we have, to save each and every
person. All we want is your support. This pandemic
started with a single person but it needs all of
humanity to end it.
Stay home, stay safe!


Dr. Setu Dagli
Intern
Lokmanya Tilak Municipal Medical College and
Hospital (Sion hospital)

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