Covid diary, a couple of weeks in

This has been a very strange time for the world. Sometimes when you pause, it's almost like nothing is really happening - is Covid really happening? When I am in the garden or stirring a pot of soup, I can almost forget. But then when it quietens down, the calamity that has befallen the world is so incredibly striking. So many people have become unwell and so many unfortunate people have died.

We have done incredibly well in Australia to stave off the crisis. With each passing day, we hear news of lesser numbers of new infections. I feel this quiet pride in being Australian - even there are plenty of idiots who are still doing the wrong thing, I believe the majority of Australians have listened to the government and done the right thing.

The hospital has become an eerily quiet place too. With most non-urgent elective surgeries cancelled, the wards are quieter than usual. The surge in numbers of doctors and nurses with the altered rostering means that we actually have time to pay attention to our patients, sometimes a luxury that we do not have with skeleton staffing. It has highlighted to us how over stretched we usually are, and how incredibly hard the staff work every day (even outside the Covid crisis). We looked after about a dozen Covid patients in the ICU, most of them requiring either a short stay for observation and not requiring intubation, or intubated for several days and then successfully recovered. A couple of patients died, and it was a strange feeling to read about them in the newspaper afterwards. People die in the ICU every day, sometimes I think, why don't we hear about those deaths?

I have been fortunate to have so much social support from people around me. Friends I haven't heard from for ages have texted to wish me well. I got some nice emails from music friends too, encouraging me to remember a time when we created music with joy and carefreeness. I have also been doing fun music projects with friends around the world, each of us recording tracks to be put together. I feel grateful for these little tokens of connection - we are not alone, and we will get to the other side of this. Life still goes on, it hasn't been put on hold - our human connections are still there despite all the difficulties that have arisen in these times.

In my kitchen: April 2020

How much has the world changed since the last IMK? My heart goes out to everyone, and definitely I am glad for the diversion for reviewing what I ate...

On the garden front, there has been some excellent vegetable growing in my dad's garden. When I left for "the war", I took a lot of photos of his garden, and looking back on them really sustains my soul now..

There are amazing bitter melons, both the "Chinese" kind and the "Indian" kind - a little shorter and more spiky (pictured).

There is also an incredible chilli plant from which I picked this bakers dozen of little chillis.

Lots of gorgeous cherry tomatoes for salads. The summer has been long this year and great for tomatoes.

These are some vegetables I picked one day - the loofahs on the left are called silk melons in Chinese, so soft and luscious. Also a couple of okra, shishito peppers, snake beans and in the back the purple weed vegetable that grows everywhere.

Flour is now a huge commodity as seemingly the entire world has taken up baking! I check every time I go to the supermarket and alas, I have not found flour at any of my locals.

So I have decided to ration my supplies and bake once a week. I've sliced the slices smaller so I can still have my 2 pieces of toast in the morning. How I look forward to the days when we can buy flour at will and bake any time!

Just before the madness of Covid started we had a vegan dinner at home with my beloved friend B. We had this crazy idea to have a vegan soup club - wouldn't it be nice to quit our jobs (we are both ICU doctors) and start a soup cafe to serve a different vegan soup everyday. We decided the soups would be

1. Pumpkin
2. Lentil
3. Tomato & red capsicum
4. Potato & leek
5. Minestrone
6. Pea
7. Vegan ramen

We discussed which one should be no. 7 so much that I decided to make it.

This actually turned out really well! I steeped a bunch of shiitake mushrooms in vegetable stock then made a base of onion/garlic/ginger with miso, blended it with some of the mushrooms for the base. Then the rest was just preparing the vegetables, crisping the tofu and plating up.

1

This was the other surprise find - miso glazed eggplant is so easy to make! Just a quick melting miso with mirin and sugar in a small saucepan, brushing it over the eggplant and grilling it. Such incredible flavours!


Onto the Food and Music series..

My friend Emily was visiting from Toronto and we had planned to spend 2 weeks together eating and playing music. Our plans were pretty much destroyed by Covid-19 and she ended up re-booking an earlier flight home.

Still, we squeezed in some playing with my usual quartet. The violist unfortunately couldn't make it so I switched to viola.

We ate these massive delicious prawns with chilli garlic and coriander as part of our extraordinary Aussie seafood feast (also featuring salt & pepper calamari and fresh deep ocean perch for mains). This feast was accompanied by the Faure piano quartet no. 1 - one of the two best piano quartets ever, both of them in C minor, Schubert's Death and the Maiden and a little light Beethoven Op 18 No.1 to finish as dessert.
  

Another day we had a gathering where we ate some Barry (son of Barney) the sourdough belonging to the cellist, with guacamole; goat tagine with couscous and salad. This feast was accompanied by Beethoven's Op 18 No. 4, probably the piece for our quartet, the other best piano quartet in the universe the Brahm's piano quartet in C minor and Aus Meinem Leben by Smetana, just an incredible work.

PS. If you are reading this and wonder what music is perfect to accompany the anguish that the world is feeling over Covid-19, please give the Smetana a listen

Before I departed for the covid-19 war, we had our very last gathering. We were sad that our little string quartet would not be gathering for some time. Our last hurrah featured a simple but delicious dinner of fish with veggies and potatoes

Our hearts were heavy but we take solace in our friendship, music making and merry meals. So much joy came from the last musical menu, Bach's Goldberg variations for string trio (is there another more perfect piece in the universe?), Dohnanyi's Serenade Op. 10, Dvorak's Piano trio Dumky and finally a couple of movements of the Mendelssohn Piano trio no. 2 in C minor.

I am trying to make sense of this world that we live in, and I am writing some of my covid thoughts down too. I know this too will pass and we will come out the other side (when there is flour and string quartets again!) I'm sending this to Sherry who hosts the monthly IMK event - thanks Sherry!

Covid diary, end of the first week

We are in an eerie place at the moment.

Australians have been watching the crisis unfold in front of our eyes – first in China, then in Europe and now in the US. It feels close to us because of the frightening numbers escalating every day in the news, at first 100 felt like a benchmark, then 1000, but now we are almost numbed by the numbers and their inevitable increase.

Let me tell you something from the frontline. There is nothing like something is real, until you see it with your own eyes.

It is only real when you stand, for the very first time, face-to-face with a patient infected with Covid-19. When you see them coughing, when you see them wiping their mouths, when you realise that their respiratory droplets are not just near you, but on you.

When you realise that you are shielded from the virus behind just a piece of plastic, or a corner of a gown, that is when it is real.

When you need to tell them that you have to put them on a ventilator to help them breathe, when they ring their families crying and saying goodbye to them for potentially the last time, that is when it is real.

When you walk out of the room wondering if you had put your gear on right, when you think maybe I am going to be one of the infected healthcare workers in the news, that is when it is real.

For the vast majority of the public, the coronavirus is still something that is happening to somebody else. The people going to the beaches and having house parties make me so angry. When I went into that room to be with a Covid-infected patient for the first time, for the second time, and then for the number of times that I cannot even count, I am not just “doing my job” as people would expect me to. I have a sense of professional responsibility to these people, this is what I am trained to do. But I am appalled by the behaviour of those people who put themselves at risk, who knowingly increase the burden on the health system with a nonchalant attitude of “it won’t affect me anyway because I am young”. Do these people not have parents, grandparents, friends and neighbours who will be affected by the virus? Do these people not wish for their loved ones to receive health care when it is needed? How little disregard do they have for the wellbeing of healthcare workers who are risking themselves to help the community?

There has been just a slow trickle of patients this week, one here and one there. The rate of admission into the ICU is slow enough that we have time to pause and reflect on our practices, trying to finetune everything so we know what to do when the rush of patients arrives. We have been preparing for weeks and the preparation itself is mentally exhausting. It feels deceptively slow right now, the ICU cleared of patients in anticipation for the tsunami that hasn’t hit. I found myself even wondering at times if we over-reacted, but just a quick glance at the news shows that the tsunami is real in other places. We are just on the flat part of the curve, and we desperately hope our social isolation measures have been enough.

It has now been a week since I left my family in Sydney and quarantined myself. I feel a huge sense of social responsibility towards them, and I have decided not to go back to Sydney until I know for sure that I will not be giving them the virus. That means I have to wait for one of three scenarios to arise 

 

(1) The covid-19 crisis is over and numbers of infections have ground to zero

(2) I contract covid-19 and recover to gain immunity

(3) I or one of my family members becomes critically ill with covid-19 and we have to say goodbye.

The methodical analytical part of my brain has spat out these scenarios, but none of them feel real right now. The coming weeks will be a huge physical challenge if we must work massive hours, and an even greater emotional challenge being in social isolation and dealing with the stresses of work. I have never thought so hard about my self-care ever. 

I have also never been imbued with such a strong sense of survival – every fiber of my being is screaming I want to survive! I want to stay physically well and mentally well. I want to come out of the other side of this and chalk it up to another disaster I have experienced and learned from. I look so much forward to that day when we are talking about all this in the historical sense.

But right now, we must live one day at a time.

Covid diary, day 1

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...

In my kitchen: March 2020

Fires, Floods and Coronavirus.. what a 2020 we are off to! In between times, at least we can appreciate the IMK project around the world.

How I love hotpots! My dad's partner has a secret family sauce which comprises sesame paste, chilli and a secret leek flower ingredient she brought in from China. It's so secret that I didn't get to see it being made. This hotpot was a real treat for my dad's birthday.

I do like my random sourdough projects but I had never thought of making a sourdough cake till I realised the baking powder in my house had solidified into a giant rock. So I used Barney to raise this fruit cake for my dad's birthday cake. It worked surprisingly well!

We are also using sourdough for all Chinese yeast related projects, such as these delicious steamed  pork buns.

And these pan fried pockets stuffed with chive and egg. With a crispy outer, a soft bite (apparently the trick is hot water in half of the dough) and a delicious savoury filling, we couldn't stop eating these!

The garden has been a bit on the quiet side this year, possibly relating to air pollution from the fires? Our choko vine died in the extreme heat of early January and it doesn't look like there will be any chokos this year.

We do have lots of snake beans that we are fighting to save from animals that keep munching them through the night, and some of these lovely gourds that resemble zucchini in a lady like form.

And lots of okra for stir fry and for teas (Chinese traditional medicine says it's good for diabetes - who knows!)

Since moving to Newcastle I've also brought some tomato plants across from my dad's garden. Once they settled in I even got a few cherry tomatoes!

Onto the Food and Music series



I made these shallot pancakes using sourdough (of course) for a Chinese dinner we had. Rolling these out and studding the dough with shallots was super fun. These were crispy, flaky and just the right amount of chew.



Our Chinese dinner of steamed bream (left), tofu with mushrooms (top), garlic & chilli prawns (bottom right) and stir fried garden weed with snow peas went down a treat. We ate these with Schubert's Rosamunde, which came into my head one morning after a dream. We also played some reverse piano trios with me on cello and the cellist on piano - Haydn's Gypsy trio and Beethoven's Op 1 No. 3. Playing the cello is super fun and challenging!

Another piano duet, another plum tart! Stone fruit has been really good this year. We ate these with the next instalment of the Beethoven project (we are playing all the Beethoven string quartets arranged for piano 4 hand), the Op 18 No. 5, as well as a selection of modern dances.



I'll finish with one of the best loaves I've produced lately. This had a lovely rise and a golden colour with nice open crumb. I think sourdough teaches me to be patient and understanding of what the dough needs - pretty much a good philosophy for self care. I'm sending this to Sherry who hosts the IMK series - thanks Sherry!

Dream: Gunshot in a pseudo night club

In this dream, I'm in the nightclub district of a city that I do not recognise. But I think somehow it must be in Germany? I am there with Em and her ex, and the three of us are looking for a particular nightclub.


The first thing we must do is pick up some cash, and the cash is dispensed from a shop with no ATM in sight. The cash comes in the form of a stack of bills, nestled neatly inside a cardboard box. We pick them up, feeling the gentle rustle of ancient currency - is it possibly cash from another age?


We find the shop that we are looking for, and it actually looks like a card shop. Outside are large turning displays that show a wide array of cards each in their plastic sleeves - but the cash is from an age before plastic perhaps? I want to stop and look at the cards but the other two are in a hurry, so I glance longingly at their bright colours and move on.


Inside there are more cards displayed on magazine racks, and also an assortment of clothes. We are still looking for the entrance to the nightclub, and I deduce that the entrance must be hidden somewhere inside the shop. I look around for more clues, but it seems like an ordinary shop selling knickknacks. There are lots of people around, but they all appear to be shopping.


Suddenly the lights go out, and it is almost completely dark even though it was a fading evening light outside. There is some dim blue fluorescence that illuminates people's faces, somewhat like the lighting of a nightclub. I feel confused by this sudden change in lighting.


Then just as suddenly as the darkness descended, the sound started. First it sounded like popcorn popping, discrete short staccato bursts. Then the sound comes even closer, and it is so loud my eardrums are hurting. I turn around and see Em holding a gun, and it looks like a fake gun.


I watch in slow motion as she raises the gun and points it at her ex. A real bullet (or at least it looks like a real one) comes out of the gun ever so slowly and hits him in the shoulder. He is frozen and time slows down so much that it seems like he could have dodged the bullet, but he doesn't and falls to the ground.


Next she turns towards me and there is a menacing glint in her eyes. I do not recognise this person, I think to myself. I hear the pop as the bullet is released from the gun, coming straight towards me. Again it is going in super slow motion, an elongated cylindrical copper bullet that looks almost comically like a lolly. I watch it come towards me with some kind of fascination. I lean back instinctively, hoping to miss the course of the bullet.


At that moment I glance up at the time and it is 1:30am.


Then I wake up. Did I get hit by the bullet? I don't know.

In my kitchen: February 2020

I have had a super busy month with the move to Newcastle, end of the clinical year and the chamber music society annual camp. It has just flown past, how could it be February already?

A couple of gorgeous loaves from my sourdough Barney to start 2020

So many snake beans from my dad's garden

A few chocolates my friend brought back from Russia

The last of the local beer from a brewery in Orange.

Since the dumpling master (my dad's partner) has returned to town, we have been having so many dumplings. She is truly the master of making the perfect dough (with sourdough too), the perfect filling and beautiful crimp.

Onto the Food and Music series...

We ate these lovely fresh plum tarts with my piano duet buddy who said "Sometimes in life, you just need a plum tart!" She is an incredible lady, always with some wise and sanguine words for young restless me! We ate these with a serve of the arrangement of Beethoven's String quartet Op 18 No. 3 (string quartets arranged for piano 4 hand are super interesting), Ravel's Ma Mere L'Oye and a few of Dvorak's Slavonic Dances.


One evening for my string quartet, we decided to have tagine. The other violinist made from scratch a wonderfully herbaceous chermoula and cooked it into a rich chicken tagine with deliciously plump olives and the sauciest potatoes. 

I discovered the trick to sourdough pitas. After rolling out the dough discs and letting them rest for 30min, blast them on full heat in the oven and the rapid rise creates the pocket!

A deliciously fresh fattoush salad which went so well with the tagine on this hot day.

Here is the tagine stuffed into the pita pocket. We ate these with the Mozart String quartet in D minor, Beethoven's String quartet Op 18 No.1 and the Clara Schumann piano trio.

Once a year, the Chamber Music Society runs a massive camp. About 110 people gather at the University of Wollongong for a 4 day extravaganza filled with music, food and wine. It truly is the highlight of the year. I stayed this year in a flat with my usual string quartet and Barney came along for the ride as well - freshly baked bread every day is a treat!

This cheese & tomato foccacia we enjoyed for one of our lunches. I think the sourdough at camp is going to become an annual feature. 

The highlights of my camp were not 1, not 2 but 3 Dvorak sessions (his string quintet "American", string sextet in A and piano quintet); the Brahms string sextet no. 1, an all time favourite; Death and the Maiden while drunk and the Faure piano quartet. We had such a great time playing the Faure piano quartet that we had to play the slow movement another time and I decided this would be the piece I would like played at my funeral.

I'm sending this to Sherry who hosts the In My Kitchen series. Thanks for hosting Sherry!