After having served in medical profession for over two decades as a neurosurgeon, I got the chance to play dual role of a Covid warrior and Covid caretaker recently inside Covid intensive care unit (ICU) of my hospital.
How it all started: My mother in her 80’s contracted Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2) infection from unsuspecting asymptomatic patient during her haemodialysis (HD) sessions for acute kidney injury. Yiddish proverb says “Der mensch tracht, un Gott lacht” (Man proposes and God disposes). One fine day during her HD session, she had chills, Chest X-ray showed pneumonitis. Over next days, desaturation occurred and oxygen support was required till sudden dip in saturation to 70% necessitated shifting to non Covid-ICU of hospital.
She was suddenly surrounded with personal protective equipment (PPE) kit clad doctors and paramedics (HCW) in no time and shifted out away from my sight. It was an unforgettable experience to see change in behaviour of health care workers (HCW) at first news of Covid positive report. Area was immediately cordoned off, and no one dared to come close making me feel like a pariah and helpless in seconds after Covid report.
Next 96 hours in Covid-ICU changed her and our lives. Covid set ups have restrictions and care is often suboptimal partly due to fear of getting exposed and partly to suffocating /blinding PPE kits. As an elderly lady cut off from family, all my mother saw with open eyes and quiet face were some similar looking faces clad in white scary PPE kits coming and going out of her room. She was probably thirsty, hungry and wanted to see her children there but apparently all that the treating team concentrated on was looking at monitors to keep SpO2 above 95%.
After 4 days in this Covid ICU she worsened and was put on invasive mechanical ventilation. Total lack of interaction resulted in her lying with her eyes open and a helpless look as she watched people come, prick her, do suctioning on endotracheal tube when she would certainly wince and cry out.
My first visit to her as Covid caretaker was painful and shocking. When I tried to kiss her right hand from under the blanket, I noticed she had developed radial artery thrombosis. Over next 3 weeks, her hand which she often used to bless me and others became black and dry and doctors advised amputation.
After 4 weeks, my mother improved and became Covid negative and shifted back to non Covid facility. Unfortunately, the next morning she developed an unexplained airway bleed after suctioning. This lead to acute airway obstruction and she was declared dead within the next hour.
As she was now Covid negative, her body was handed over to our family for performing her last rites as per Hindu religion. I felt relieved as body of Covid positive deceased was not handed over the relatives by the hospital.
Lessons learnt: We need to introspect to improve outcomes. Clear vision is imperative and fogging of the eyepieces must be prevented. Fear of contacting Covid while treating, frequent shift changes interrupts continued care to sick and fragile ICU patients. If disinterested or not-experienced person enters the ICU, the entire care of patient gets affected and good and devoted hard work of others is negated.
Loss of a parent is the worst tragedy in anyone’s life. Covid deaths are deadlier than natural deaths in elderly persons as they leave behind many scars. I am not sure if my mother defeated Covid by becoming Covid negative a day before her death. I am sure that she has left behind a deep desire in me to be more caring to my patients. I will dedicate part of my neurosurgical practice to produce caring, empathetic and compassionate doctors.
I resumed my surgical work 2 weeks later and encountered a covid positive 3 year old girl with large brain tumor requiring emergency surgery. The first thing I did was I kept mother to be with the child while in Covid Care as I understood very well how it feels to keep mother away from her child by then. I went ahead and did over 10 hour long operation in that girl child in Covid OT and saved her life. This was the best homage I probably could give to my mother I feel. I am continuing my surgeries both in covid and noncovid neurosurgery cases since then, started writing blogs on covid education for doctors/residents/ helping friends and whosoever contacts me for covid related help off late. I am waiting for a day when Covid will be eradicated from India and World……Will take some rest. Till then… I am 24×7 hrs on the job to save and educate as many as I can, for as long as I can.
Dr Deepak Gupta
Professor Of Neurosurgery,All India Institute of Medical Sciences, New Delhi Adjunct Faculty IIT Delhi, Visiting faculty and Professor Neurosurgery, Italy
