When COVID 19 hit home

 When COVID 19 hit home

Vijay Gopichandran

When the family members of a doctor providing care for patients with COVID 19 come down with COVID 19, some very fundamental changes start happening in the doctor’s life. I am writing a narrative of what happened to me, when my elderly parents both in their early seventies, came down with COVID 19 pneumonia one after another in a matter of a week.

My hospital became a designated COVID 19 treatment centre in the latter half of May 2020. I have been on the ground providing triage services for all patients attending the hospital from late March 2020 and got more actively involved in caring for patients with COVID 19 from May. I made a few drastic changes in my lifestyle since that time because I was going to work from home, where I live with my elderly parents. I quarantined myself in my room, where my parents were not allowed. I started washing my clothes, dishes separately and stopped putting them in the common washing machine. My interaction with my parents was just a hi and a bye occasionally. While the pandemic was ravaging the city of Chennai in June-August 2020, we stayed relatively safe and healthy, given that I was doing active duties in the COVID 19 unit in my hospital.

From mid-October the number of cases in Chennai started reducing. The gloomy feeling was starting to lift, and some semblance of cheer was setting into our home. I started coming to the living room to briefly chat with my parents and catch a few glimpses of the television now and then, but made sure I didn’t sit too close to them or spend too much time in the same room as them. It was when I thought, the most difficult times are over, that COVID 19 entered my living room. First it was my mother who developed a fever with severe body pains and extreme weakness. She started having a bad cough, which was dry. She also stopped having an appetite and suffered from loss of smell and taste. As soon as I found out she was down with the illness, I isolated her in another room of my home and asked my father to quarantine himself in my parents’ room. I assumed the role of cook, housekeeper and cleaner in addition to treating her with medicines for her fever, cough and vitamins and Zinc for improving nutritional status and immunity. Then within 3 days my father also developed a fever with the same symptoms as my mother. I now had the home to run and two elderly patients with COVID 19 whom I was treating and caring for at home.

Right from the start of the pandemic, I was aware of the fear and anxiety associated with it. But when COVID 19 struck home, I experienced the acute fear. I had reassured hundreds of patients in the hospital and asked them to not be afraid, but suddenly all those words of reassurance failed to do their job on me. As I was caring for my parents, I was sitting up all night, unable to sleep, constantly checking their temperature, oxygen saturation, peeping into their rooms every now and then to just stand and watch them breathe. Even one long inhalation would drive me into a panic attack in fear that it could be the beginning of a breathing problem. As I sat there next to the window at 1 and 2 AM in the morning, I would visualize the CD4 and CD8 cells waging a battle in their bodies and the cytokines, especially IL6 about which we have heard so much during this pandemic, surging down their veins. I would imagine the blood clotting. All the schematic pictures of these phenomena that I had read in the journals would flash across in front of my eyes. I would find myself desperately praying that these things would not happen in their bodies. The 10 days from Nov 9 to Nov 18 passed by in a blur with no distinction between days and nights.

After the initial few days, when my parents were well enough to be on their own, I would finish household work, keep medicines and other stuff by their side and leave to work. At work, there would be patients and families with COVID 19. This time when I saw them and spoke to them, I could feel a heightened sense of empathy and capacity to relate to what they were going through. Just a week before, while admitting patients with COVID 19, I would reassure them that everything is going to be alright. Those words of reassurance would come out with a lot of detached confidence. Now, every time I reassured a patient and their family, I felt it giving energy to myself. When I said “do not worry, this will just be a mild cold-cough like illness and you will come out fine in a few days” – I felt like I had just surfaced from deep under water and took a deep breath of life giving air. Each time I reassured a patient, I was reassuring myself.

On 16^th November, an incident happened in my hospital, which I will never be able to forget. A patient whom we had admitted about a week ago with COVID 19, a 70-year-old lady, had succumbed to the illness. The horrific thing about deaths during this pandemic, especially deaths due to the COVID 19 illness, is that the family members do not get the opportunity to say their goodbyes to the departed. The son of this lady stood outside the mortuary where his mother’s body was kept before handing over to the city officials for sanitary cremation and was crying loudly in grief. The mortuary happens to be just adjacent to the room where I sit in my department. So, as I sat there preparing the death audit report for his mother, the young son was speaking out his grief and crying. At home, my own mother was still coughing, finding it difficult to even lie down because of the cough and was having severe body pains and was losing weight drastically. His grief went and hit my directly where it melted my heart. My eyes were filling up with tears and I could not write my death audit report anymore. I stopped my work and found myself sobbing unconsolably in my chair. Even now as I write this blog, I can still feel that young man’s pain and my body shudders to think about it.

My parents are confident people. I am not sure whether their confidence stemmed from an inherent courage, blissful ignorance about the medical havoc that COVID 19 could wreck in their bodies, an adamant denial that anything adverse could happen to them or a combination of all these. They quietly underwent all the supportive treatments that I had to offer. Over the ten-day period, they started recovering slowly and COVID 19 would only be a mild illness in my family, as it has been in most households in the world. But this journey from being blissfully protected to having COVID 19 pass through my own corridor, and now sitting in front of my laptop with energy and courage enough to write all this, has taught me a very valuable lesson about medicine. I learned that all humans are the same. Diseases and illness unify all of us more than anything else in this world. That day I sobbed along with the son of my deceased patient, I could feel the boundaries between us just vanish. He and I were the same. If we zoom out the focus from all the differences between us, we land up seeing that our pleasures, our pains, our sufferings, all are same. The educated doctor providing medical care so easily and effortlessly to the patients, suffers from unexplainable caregiver anxiety when it comes to his/her own loved ones. It is when the doctor can experience the same level of empathy while caring for his/her patients that true medical caring happens.