I've had the last 10 days off since my friend E was visiting from Toronto. We had many things planned but it all fell apart when Trudeau's wife tested positive and Canadia started to crack down hard on Covid. When Trudeau made his speech imploring all Canadians to go home, E went home early (a lot of stress involved indeed). I then spent the next few days in a reverie, doing some gardening in my dad's garden and tidying up my things.
At the end of the reverie I said goodbye to my family. I had decided already that I would not return home, because I could not risk infecting them. It was heartwrenching to tell them that I would see them again only when it was all over, or if I had been infected and had immunity, or if any of us were gravely ill and it was to say goodbye. I felt like I was never going to see them again.
I knew that I would be jumping straight in the deep end of the covid crisis, and I tried to mentally brace myself. But still I did not feel prepared to walk in in the morning, straight into a patient who required intubation for mechanical ventilation.
Being the most risky time of the ICU admission by virtue of the greatest aerosol generation risk, I knew it was going to be a tricky exercise. Ordinary folks in the community might think the government has given us all the gear to cope with this, but with the very first intubation of a known Covid-positive patient in my ICU, we already had equipment shortages. It was depressing to think of what will come in the coming weeks.
Putting on the PPE (Personal Protective Equipment) took almost an hour for the whole team, and the actual intubation task itself was short. An audience of around 30 doctors and nurses gathered to watch, though I wasn't sure what they were watching! It was theatrical and psychologically taxing, I felt like I was in the Big Brother House. Overcoming my own Impostor Syndrome at that moment was hard, but I managed to hold it together.
My current stressors are that we will run out of equipment (though I know we actually can't cross that bridge till we get there) and the fact that our PPE is vastly different to what we see on television, and what our colleagues have used overseas. One only has to turn on any TV channel to see doctors in hazmat suits with full body coverage and proper fitting goggles. We have to make do with a knee length gown which exposes our lower legs and neck. Even with balaclavas that we sourced from theatre, there was still a good amount of skin exposed. Our goggles are poorly fitting and my goggles fogged up which made me question whether my mask was fitted well. I scrubbed my face to drynses with soap afterwards and felt that I was not satisfactorily protected. Afterwards, every person I spoke to said something along the lines of
1. The government decided this
2. All the hospitals get the same gear
3. There is no evidence for more gear anyway
The more times I repeated my concerns about infection, the more frustrated I felt as everyone repeated the same official standpoints. One of my colleagues thanked me for being the "guinea pig", which did not help. Eventually about 3 hours after the intubation, I completely crashed and had a cry at work, not something that happens to me very often. Then my other colleague told me that the only way I can protest is by refusing to work or quitting my job.
All in all, it has been a very emotional first day. I coped by going for a walk, getting to the supermarket and realising I forgot to bring any cash or a card to pay for groceries, watering my own garden and cooking a healthy vegetable soup to nourish the soul. I'm still thinking about my own death, and I guess I will be thinking about this for the next few months...
At the end of the reverie I said goodbye to my family. I had decided already that I would not return home, because I could not risk infecting them. It was heartwrenching to tell them that I would see them again only when it was all over, or if I had been infected and had immunity, or if any of us were gravely ill and it was to say goodbye. I felt like I was never going to see them again.
I knew that I would be jumping straight in the deep end of the covid crisis, and I tried to mentally brace myself. But still I did not feel prepared to walk in in the morning, straight into a patient who required intubation for mechanical ventilation.
Being the most risky time of the ICU admission by virtue of the greatest aerosol generation risk, I knew it was going to be a tricky exercise. Ordinary folks in the community might think the government has given us all the gear to cope with this, but with the very first intubation of a known Covid-positive patient in my ICU, we already had equipment shortages. It was depressing to think of what will come in the coming weeks.
Putting on the PPE (Personal Protective Equipment) took almost an hour for the whole team, and the actual intubation task itself was short. An audience of around 30 doctors and nurses gathered to watch, though I wasn't sure what they were watching! It was theatrical and psychologically taxing, I felt like I was in the Big Brother House. Overcoming my own Impostor Syndrome at that moment was hard, but I managed to hold it together.
My current stressors are that we will run out of equipment (though I know we actually can't cross that bridge till we get there) and the fact that our PPE is vastly different to what we see on television, and what our colleagues have used overseas. One only has to turn on any TV channel to see doctors in hazmat suits with full body coverage and proper fitting goggles. We have to make do with a knee length gown which exposes our lower legs and neck. Even with balaclavas that we sourced from theatre, there was still a good amount of skin exposed. Our goggles are poorly fitting and my goggles fogged up which made me question whether my mask was fitted well. I scrubbed my face to drynses with soap afterwards and felt that I was not satisfactorily protected. Afterwards, every person I spoke to said something along the lines of
1. The government decided this
2. All the hospitals get the same gear
3. There is no evidence for more gear anyway
The more times I repeated my concerns about infection, the more frustrated I felt as everyone repeated the same official standpoints. One of my colleagues thanked me for being the "guinea pig", which did not help. Eventually about 3 hours after the intubation, I completely crashed and had a cry at work, not something that happens to me very often. Then my other colleague told me that the only way I can protest is by refusing to work or quitting my job.
All in all, it has been a very emotional first day. I coped by going for a walk, getting to the supermarket and realising I forgot to bring any cash or a card to pay for groceries, watering my own garden and cooking a healthy vegetable soup to nourish the soul. I'm still thinking about my own death, and I guess I will be thinking about this for the next few months...
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