I remember clearly when the long deserted Covid ICU was filled in with patients — again. It did not take long before we were running at full capacity and as the number of referrals kept going up, our spirit and strengths were completely heading in the opposite direction. That morning I slowly dragged my feet to ICU for a Covid shift (which felt like walking into Mordor) trying to brace myself for the long rounds in full PPE. However, the commotion outside the unit made me donned quicker than lightning (thanks to all the practice) and I hurried to the patient’s bedside only to see a critically breathless and lethargic looking woman, on maximum oxygen support.
“Will I be OK, Doc?” she asked. Her eyes locked on mine as she tightly held my hand.
“Yes, God willing you will be okay. Don’t worry now.”
When becoming fully fledged doctors, I remember reciting the Hippocratic Oath and one of the pledges was,
“I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”
This has never been more true, especially during those days. Although the Covid-19 pandemic felt like Armageddon, I think it is somewhat a blessing in disguise : the way it has taught us to be grateful even for the littlest things and how it proved that we can do wonders when together. As long as I’m with my team of comrades, I am confident that we would have done it again for all of our patients, a thousand times over.
DR WAN AIZAT
LONDON HAS FALLEN
10th March 2020
Roti King, Euston, London.
The best Malaysian hang-out place ever, even right here in central London. Now…wait for it… it has to be…Mamak, of course! At that time, no one knew that this awesome spot will be shut down in less than 2 weeks… for a very, very, long time.
As we were having roti canai and teh tarik like there was no tomorrow (I am sure glad we did), London witnessed its first Coronavirus-related death. The following day, the WHO declared an emergency health crisis and announced that the COVID-19 outbreak has now become a pandemic.
This was only, just the beginning.
*
23rd March 2020
High Dependency Unit, Queen Square, London.
Today marked the first official day of the United Kingdom in lockdown. Panic hits London. Hard.
Never have I seen the streets so empty, lifeless, similar to the scenes from World War Z — the only difference being — there was no Brad Pitt.
One word to describe the situation in our hospital — chaos. There was an overnight change in the Consultants and Registrars Rota, where everyone will now only do a 12-hour shift with standby days in between to cover for sickness or isolation. All elective cases were cancelled, theatre colleagues reshuffled to fill up the Intensive Care Unit, Consultant Neurosurgeons included.
In less than a week, the ICU that previously dealt with mainly patient with SAH did a 360o changeover to having only ARDS patients. A hospital that has always been a tertiary neuroscience centre has to adapt quickly to a change in the management of its patients. Permissive hypercapnia and fluid restriction were equally as scary as Coronavirus itself, if not, scarier. They cracked jokes and laughed nervously when the ETCO2 crept up to 7 kPa… “Let’s put ICP bolts in everyone, just to make sure.” However, I am positive they were secretly praying that someone willactually do that.
In a matter of days, we became experts in donning and doffing of PPE, as well as proning and un-proning patients. As the trust revised and re-revised our guidelines, our PPEs remained the same. The first time I heard about PAPR was from my Malaysian colleagues. All we had to don was a surgical gown, cap, visor, three layers of gloves, and an FFP3 mask. Nonetheless, I am thankful that we always had enough supply of PPE and never was I in a situation where I needed to do as the notion “No PPE, No CPR.”
That same week on Thursday, at exactly 8 pm, millions of Britons stood at their doorsteps and balconies applauding and clanging their pots and pans to show support for the NHS and key workers as part of the Clap for Carers nationwide campaign. I remember walking home that night to people clapping and cheering, and for a moment there I felt like Maximus when he won against Commodus in Gladiator.
As I felt a growing sense of responsibility, there was also a growing sense of fear and anxiety. I fear for myself, but mostly, I fear for my loved ones back home. Some said, when you are facing death, you will experience a phenomenon where the entirety of your life flashes before your eyes. I hope if my time comes anytime soon, the only image that I will see is that of my children, in repeat.
It was hard to believe that only a month ago, life was completely normal.
*
3rd April 2020
Hampstead Heath, Hampstead, London.
The NHS Nightingale at the ExCel London officially opened today. It was one of the seven temporary hospitals set up by NHS England to fight against the COVID-19 pandemic. None of us got deployed despite volunteering, and I suspect because there were too many volunteers.
The “Rona” had gotten to the heart of the government when first, Prince Charles was confirmed positive followed by Boris, who eventually got admitted to St Thomas Hospital’s ICU after his symptoms worsened. Rumour (read: work Whatsapp group) has it that he only received NIV. Those who shared the same podium as him at 10 Downing Street, Health Secretary Matt Hancock and England’s Chief Medical Officer Professor Chris Witty were also tested positive.
It was also the month where I started taking long walks in the parks, after being inspired by the 99 year old, retired Captain Tom Moore, who completed 100 laps in his own garden in Bedfordshire, to help raise more than £30 million for the NHS. I can’t help but wonder – like that also can ?
The following week, the UK coronavirus death toll hit the 10, 000 mark, and later had the highest declared death toll of 32, 000 surpassing Italy which previously had the most deaths.
*
23rd April 2020, First Day of Ramadhan
Anaesthetic Registrars’ Office, Queen Square, London.
At this point, I am still not sure how I could survive an 18-hour long, fasting in full PPE. Everytime I doffed, I will be drenched in sweat – even in places I didn’t know could produce sweat.
This was definitely not the Ramadhan that I had imagined when I made the decision to pursue my dreams. However, it will be the Ramadhan that will resonate for a long time, in my memory. This was a Ramadhan that made me realise even more that as humans, we can make all the plans in this world, but ultimately, God is the still the best planner. Not only I learn, but I came to terms with the true meaning of surrender.
I find myself repeating my favourite verse from the Quran, especially during times like this.
“So verily, with the hardship there is relief. Verily, with the hardship there is relief.”Al-Insyirah 94:5-6
*
30th June 2020
Finsbury Park, London.
As the UK reached 100 days of lockdown, every soul in London, both dead and alive, looked forward to the reopening of restaurants, retail shops, and for the locals – pubs, in a few days’ time.
As Liverpool ended their 30-year wait and was crowned the Premier League Champions, I could hear in the background the radio blasting :
“At the end of a storm, There’s a golden sky,
And the sweet silver song of a lark,
Walk on through the wind,
Walk on through the rain,
Though your dreams be tossed and blown,
Walk on, walk on, with hope in your heart,
And you’ll never walk alone, You’ll never walk alone.”
*
16th September 2020
Finsbury Park, London
It is raining outside as I am finishing writing this article for my dear friend. The UK daily cases had risen to 3103 yesterday, and they said that UK could not possibly endure a second lockdown. However, all the hospitals in London are making preparations, in case of a second strike. It is always good to be prepared, but for now, let’s not allow ourselves to worry about something that has not happened yet.
DR WAN AIZAT