Long hours of work in the Intensive Care Unit (ICU) and erratic sleep rhythms have caused the under eyes of Dr Naman Jain, 35, to turn puffy. Other marks have faded. “While wearing the PPE suit, I had to tape the second one mask which I wore above the N-95 mask under my eyes in order that it would stay in place. While taking it off, the skin under my eyes would steadily tear,” says Dr Jain, of the critical care branch at Fortis Hospital in New Delhi’s Vasant Kunj.
It’s a drill he has now transform better at. It would take him around 10 minutes to wear the PPE suit, which includes six articles of protective gear to be worn in a sure sequence; he now does it in three.
Delhi is the state with the fourth highest number of confirmed Covid-19 cases in India; the first confirmed case was once detected on March 2. At the beginning, the Delhi government designated Ram Manohar Lohia Hospital and Safdarjung Hospital as the only Covid-19 care facilities. Fortis, like many other private hospitals, began to attend on patients of the viral disease only in April. Dr Jain has been on Covid-19 duty since April.
In pre-pandemic times, he either worked the 9am-5pm shift or the 5pm-9pm shift with a weekly day off, when he would stay home with his wife Shilpi. “From April, I’ve been working seven days and then spend seven days in quarantine. I’ve to totally isolate myself in this period. The first two months, April and May, I didn’t return home and quarantined in a nearby hotel in Vasant Kunj.”
That the health crisis would pose a enormous challenge to health-care professionals dawned on him gradually. “Like everyone else, I had heard the news on TV. But there was once no question of not being mentally prepared. This is what we do. There was once no question of not going out or staying back home it doesn’t matter what the risk. I telephoned my mom and told my wife it is imaginable I would possibly not escape infection and live on. Had my wife not been courageous, it would have been difficult to carry on my tasks whether I had to fight on both fronts,” says Dr Jain. “With time, I think I know the way to retain myself secure”. But he all the time adds this caveat; there are no guarantees.
This may be what he tells patients and their attendants. “Medical illiteracy is without doubt one of the challenges at this time,” he says. “Each and every doctor faces difficult questions from families who at times turn on us. It’s nearly a year since the crisis broke over all our heads, people will have to realize that overnight things can turn serious in Covid cases, particularly whether a patient is aged and has comorbidities. Whether the patient gets into a cytokine storm where the body’s immune system turns hostile and more than one organs get affected in conjunction with the lungs or there is massive pulmonary embolism, there isn’t much a doctor can do. The medical field has its limitations.”
Being a doctor in the ICU, death isn’t new to Dr Jain. “It is all the time tough losing a patient, it’s just that now you are losing a person faster. And that does cause stress”. But lessons have been learnt on the job. “Day-to-day, we get new studies that help us understand the disease and its progression,” he says. With time, he has also learnt how to “carry on for long periods without food and water, or having to relieve myself to take a toilet break. This isn’t to say that it isn’t tough or that there aren’t poor days.”
To start with, the stress was once overwhelming when colleagues too started getting infected. So far, he has known fear, he says, only twice. “When a colleague in the ICU who was once working on the same shift as I used to be got infected. And another time when as my breath was once fogging the mask and clouding my vision, I had to take away my shield to intubate [the process of inserting a tube through the mouth and then into the airway so as to put him on the ventilator] a patient so I used to be in direct contact with the patient. But the effort paid off as he walked out of our hospital alive,” he says.
There may be on-the-job pressure when relatives get admitted. “To make my 76-year-old uncle understand his condition was once a hurdle. He survived.” Even his own circle of relatives got the same line, Dr. Jain says. “I had told them there were no guarantees that he would come out alive, but we can try our best.”