Despite maximum drug and ventilatory support, his blood pressures and oxygen saturation were showing minimal change, peripheries cyanosed. My nursing staff interjects ‘let this one go, we have others to work on, we’ve done everything we possibly can’- it’s not his fault, the staff to patient ration was now 2 nurses for 20 ICU patients.
Two hours in the shift a seemingly healthy patient suddenly starts dropping saturation, he is young, early 40s, so most likely a full code patient, we have to do every measure possible to save him, the anesthesia team has been given a call. He’s been put on ventilatory support
Dr, MR927, that patient you used to ask about has expired... how? He had a cardiac arrest
‘Is your breathing any better today?” “Dr, yeh Urdu nahin bolti, sirf Pushto” (Dr she doesn’t speak Urdu, only Pushto). Speaking is the only connection in this place. A respirator that covers half my face, and layers of protective gear which make me all look nothing short of an outer space being, I try to comfort her by holding her hand and speaking a few words of whatever little Pushto I knew. (Singa ye, ama jee) How are you, ama? She held my hand and started crying and saying things in Pushto that I was unable to understand. I would make sure to spend a part of my day with her, holding her hand, comforting her in silence. She passed away three days after that. Around strangers who did not understand her mother tongue.
MR 84, MR650, MR900... The list goes on, I know them all by names, their faces seared in my brain, young, with children, newly married, just graduated. All of them having had to die in a hospital ward, alone. The burden of that was something I took home everyday.
‘Dr. this is the third Covid casualty in my house, please tell me I won’t have to look for a space in a graveyard for the third time, we don’t have men in the family to do the last rites, all of our family is in Iran, what do we even do?’ 38 year old woman who’s husband has been on the ventilator for a week showing no signs of improvement.
‘Dr. 908 has been put off the ventilator and he’s being given a trial of breathing on his own’ I couldn't believe my ears, this patient had been on the ventilator for 15 days and at 56 years of age, it was nothing short of a miracle. Tears stung my eyes. Exhausted and emotional, finally a glimmer of hope.
the woods are lovely, dark and deep,
but i have promises to keep,
and miles to go before i sleep,
and miles to go before i sleep.
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