My Covid-19 diary- second week

My normal daily routine has gone out the window and I am lacking the motivation to even get out of bed these days. I need to get back into gear soon. The roads in our turning and pavements have all had a council makeover, even though they haven’t quite finished the driveway at the entrance to our house yet. I wonder if they will finish the work now. The pavements glisten in the sunshine and the cherry blossoms which are in full bloom will soon be sprinkling their pink and white petals over the newly paved roads. Nature somehow doesn’t reflect life at the moment and actually is in sharp contrast with it. It feels a bit surreal connecting the two together. 

On the radio I hear worried people talking about their lost jobs, livelihoods, unwell relatives and lots more. Some are even worried about catching the virus from us, the health care workers, if they come into hospital. So far, all I have heard from my colleagues is the worry about how we can protect ourselves from the patients. This was an eye opener for me. I need to start wearing masks when I’m with patients, not only for my protection but also to show them that they won’t catch anything from me. With the roads clear, the drive to the hospital is a painless one. 

At the fruit stall in front of the hospital I buy a tub of blueberries and give the stall keeper a pound in change. She finds an American 25 cent coin in my change (same size as a 10p coin) and gives it back to me. The way she did this you would think I was trying to cheat her. Does she not realise how much that is worth in pence these days? 

I am doing a trauma list today. I haven’t done trauma lists in quite a while. Routine lists are all cancelled and I can’t find my theatre staff. I don’t even know where to go to find my first patient. In the ward the doctors are on their ward rounds with the nurses. There is no one I can ask about the patients. Three patients from the list are there but I can only find notes to one of them. I try to get some history from one of the patients without the notes. She has learning difficulties and the only answer I can get out of her is “Yes”. Yes to everything, what am I to do without the notes. Welcome to the trauma world, I tell myself. I find her notes eventually, but there is only minimal information in it. The ward sister shows me where to find an anaesthetic chart and directs me to a computer to log in and search for the patients blood results and clinic letters. There is nothing on the system. I have already now spent half an hour doing all this. The surgeons are waiting in theatre for me to start the case and I do not have time to ring the patient’s carer for more information. I ask the ward sister how I am supposed to anaesthetise a patient with no old notes or investigations. She advises me to talk to a trauma anaesthetist. Instead of getting her patients ready for theatre she wants me, who has almost 35 years of anaesthetic experience, to get advice from a colleague. There are times when I wonder if doctors and nurses in other specialities think that we anaesthetists have special psychic powers. They think that we can just look at a patient, diagnose any underlying problems and decide what anaesthetic we are going to give, with no history, no relevant information and no investigations. And as always the surgery cannot be delayed. They will find umpteen reasons as to why the surgery cannot be postponed. If only they used this initiative to get their patients properly worked up in the first place we wouldn’t be in this situation. 

Our work pattern is changing day by day. The intensive care is filling up with ventilated and non ventilated Covid positive and suspected patients. And so is the emergency department. In the midst of all this we have other emergencies to deal with as well. The buzzer goes off yesterday evening in one of the labour ward rooms. A lady has just given birth and has already lost half her blood volume. The obstetricians manage to control the bleeding while the experienced anaesthetic registrar who is on duty with me and I try to get a second venous access, take blood for investigations and pour in the fluids. The bleeding settles but then half an hour later they want to take her to theatre as she is still trickling. As we start the anaesthetic the patient gets hold of my hand and asks me if she will wake up from the operation. “Of course, you will. We will look after you”, I reassure her. On induction she promptly desaturates and looks mottled. We stabilise her. I am worried, but my shift is over and the next consultant is here to take over. He urges me to leave. Later I find out that she needed a hysterectomy to control the bleeding. 

According to Boris Johnson I am not allowed to spend time with my grandkids for the next three weeks, possibly longer. Even though I like my weekend lie ins, I think this will be the most difficult part. However the truth is, my little niggles are nothing compared to those patients whose cancer surgery and treatment are being postponed, those with painful joints waiting for replacement surgery which will now not be going ahead till all this calms down, people who are stranded abroad with no information about how or when they are going to get back home, people worried about paying their bills and of course those who are ill and those with ill or elderly relatives. And this is only the beginning. On the plus side I see Louboutin shoes on sale with 40% discount, even if there is nowhere to wear it to. 

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