Between treating patients and churning out a record number of scholarly publications, the COVID-19 pandemic has seen a productivity peak for many medical professionals. In this poignant essay, Debanjan Banerjee, a practicing psychiatrist at the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, talks about the many levels at which such hyperactivity affected professionals.
Another ‘ahead of print’ issue was out. I was anxiously scanning it for my article. There it was! The next obvious thing to do would be to announce this exciting news on all possible social media channels, ‘humbly’ displaying my scientific and literary skills, proud of my name leading the decorated list of authors.
“One more,” I said, as I silently thanked the pandemic for turning an unusual year, clinically speaking, into an equally productive academic one. From the time COVID-19 was declared a pandemic, the rate at which I have churned scholarly articles is perhaps only second to the rate of the viral infection itself. Adding my two cents to the academic discourse around mental health issues stemming from COVID-19, I have rightfully earned my share of the pandemic pie as a young researcher.
With endless concepts and theories, innumerable correlations and associations, COVID-19 statistics have piled up faster than researchers can digest. As a medical professional, I witnessed an unprecedented quest to learn, write, explore and get to the bottom of every possible angle related to the pandemic. Specialties and duties have blurred: even as a psychiatrist, I speak about the viral structure, my pathologist friend comments on the behavioral effects of the virus, while virologists debate on treatment protocols. We are all involved in COVID-duty. COVID-19 has been a great leveler: first, it renamed physicians and healthcare workers as “front-liners” imposing an enhanced sense of responsibility as well as perceived stigma about them; second, it created almost universal expertise about the virus.
Information became an essential commodity. Almost everyone knew something about the outbreak, and none wanted to miss the chance to display that knowledge. Definitely not me, the pandemic added publications to my credit and I was secretly enjoying the closure of out-patient departments.
Busy in such self-obsessive ruminations that stemmed from the freshly minted publication, I didn’t hear my pager ring twice, then thrice. Finally, an irritated nurse in the emergency room mumbled something that sounded like “clinical duties first priority”. Reluctantly, I dragged myself out of my ‘ahead of print wonderland’, to hear some shocking news that made me dash to the COVID-designated ward. I barely had time to slip into the Personal Protective Equipment (PPE) as I digested the information – a famous business tycoon’s son had succumbed to the infection. Management of such ‘high profile’ cases is always a nuisance, and throughout my graduation years, I wished we had a chapter dedicated in the medical curriculum to this lesser discussed challenge of medical practice. I marched into the ward like an astronaut, media persons waiting outside to be briefed.
COVID-19 deaths have extra formalities to take care of. I met my masked and suited colleagues, each clumsy in their ‘gas chambers’, and visibly edgy as the businessman’s family and followers waited outside. I was the treating resident in charge of the patient the week before, and hence my presence was necessary for the last ‘medical rites’. India’s death toll had just crossed one lakh, and I was trying to guess what number would be assigned to this death, all the while impatient to get back to my just published paper.
As the clinical obligations lingered, I looked at the dead body of the cheerful young man with whom I had discussed cricket, gardening and romantic post-recovery surprise plans for his fiancée. Death is neither uncomfortable nor strange for my profession but I suddenly shuddered at its uncertain nature. When we heralded 2020 amid celebrations, did we know that more than two million of us would not see another new year?
As a psychiatrist, communicating with patients and their families is a large part of my job. I prepared for the ensuing tough dialogue with the bereaved family. The father and the uncle were waiting outside the ward, surrounded by family members in a distinct circle, all in PPE, masks and gloves. For a second, I mistook them for physicians. Then I realised that the circle was to ensure social distancing from potential infection carriers like me.
An elaborately rehearsed explanation of the death has always fallen short during such conversations. In what seemed like a very lengthy discussion, the family wanted to know of precautions for future (do we need to fumigate the house?), pondered over possible instances of transmission by their now dead kin, and the statistical chances of them being infected already. The concerns seemed a bit illogical to me considering a paid caregiver was in charge all this while. As a matter of courtesy, I asked if they wanted to have a last glance at their family member through the COVID-ICU window. They seemed to tighten the circle and left abruptly saying the cremation formalities would be handled by a separate team. I felt sorry for the young man, who was accorded a celebrity status in the hospital till yesterday. His corpse had no such privilege.
I was going back into the ward when someone tugged at my PPE. A boy, maybe all of five, in a tattered T-shirt and barely anything below the waist, was standing there, right next to the infectious diseases ward without a mask or gloves! Before I could react, a hospital guard came running, apologising for the transgression, “Sorry Sir, I tried my best, this fellow just ran past me”. Cautious of guarding the child from any possible infection from my PPE, I stepped back, crouched and asked him what he wanted. He was sniffling and mumbled something in the local language pointing towards the general ward. He had come looking for his father, another COVID-19 fatality. He lived in the slum next to the hospital. The motherless child was not allowed to stay with his father and his attempt to bypass the hospital guards succeeded only today, when it was too late. I explained to him that it was risky being near the COVID-19 ward without protective gear. He smiled, his teeth darker than his skin, and unfolded his little hands to show a facemask darkened with days of use, strings torn and numerous tiny holes on one side. He had exchanged his silver bracelet with a local vendor for this mask and taken it to a nearby temple for prayers. He believed it would protect his father from the killer virus.
I don’t know how the guards managed to take care of the child. I had to leave, breathless and feeling sick. Together, the choke of the PPE, a distended bladder, blurred vision and a burdened conscience had taken a heavy toll on me.
Half an hour later, I managed to get back from the reflective phase into being the stoic physician, the iron-willed ‘front-liner’ who has seen it all. Proud of my unceasing contribution to pandemic literature, I started re-reading with content my latest title: “COVID-19: The Great Equalizer”.
(Debanjan Banerjee can be reached at Dr.Djan88@gmail.com.)