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The Dilemma Doctors are Faced with

Dr. Neela Bhattacharya | August 20, 2020
The Dilemma Doctors are Faced with

“Why? Was my life already not challenging enough?” This is the common refrain of all doctors in 2020.

There are tens of thousands of diseases in the world and about 40 to 50 new drugs that enter the market each year. Disease patterns keep changing and with it, the management options. In an era when knowledge is just a google tap away, doctors face a herculean task of constantly updating themselves and keeping abreast of all diseases and their treatments, to remain relevant. Furthermore, they need to consult, operate, dress and counsel of all their patients.

Doctors too are human

And then, along comes a new virus — Covid-19. Not just some flu, but one sinister enough to cause a pandemic and serious enough to kill the healer. Doctors manage infectious disease all the time with gay abandon, thinking they will not be affected. Be it tuberculosis, chicken pox, measles or the more dangerous HIV, hepatitis B and C, doctors administer treatment to their patients in crowded OPDs without fear. They even treat people dying of multi-organ failure with septic shock due to poly microbial infection (infection with virulent bacteria, virus and fungi) starting intravenous lines, intubating them and even administering CPR without a passing thought that these organisms can infect them.

But now, Covid-19 has killed doctors at an alarming rate when compared against the general population. The death rate among doctors is 10%, which is nearly five times more than the national death rate. At the time of writing, more than 250 doctors have succumbed to Covid-19 and the numbers are increasing with each passing day. Doctors too are human; they too fall ill and are scared. Unfortunately, many are unaware of what goes through a doctor’s mind during these times.

Doctors work with an undercurrent of constant fear

There are doctors who have temporarily shut their clinics and have decided to wait it out until the worst is over. But, with the pandemic showing no signs of ceasing, they are progressively becoming fearful of remaining relevant and facing ridicule from their peers.

There are also those who have been continuously working but since April 2020, no doctor can truly say that they are enjoying work. Their job, which earlier gave them passion and joy, now feels a chore that must be done. At the back of their minds, a voice constantly advises, “Don’t go too close to a patient, examine as fast as possible, wash and sanitise after every patient, don’t operate until it is a dire emergency, wear PPE, wear an N95 mask.” But after donning all of this, you are hardly audible to your patient and can barely see through the face-shield. Furthermore, wearing a full PPE overall causes dehydration and breathlessness and even then, there is significant risk of contracting the virus.

Working under these conditions, almost all doctors develop sore throats, fever, body aches and fatigue and then panic begins to set in. “Did I remove my mask at any point while in the hospital? Did I maintain distance in the crowded OPD? Am I infected? What will happen to my family then? Will I live? Will I have a decent funeral? Will my family face social ostracism because of me?” As news of their friends and colleagues who have lost the battle against Covid-19 trickle in on a daily basis, these thoughts are aggravated leading to depression and insomnia.

Doctors have a reasonable working knowledge of managing disease, but this new virus has challenged that very knowledge on a fundamental level, leaving the medical community perplexed and frustrated. They see the symptoms and signs, they manage with whatever means are available to them, but they are still not able to handle the sheer numbers or the severity. Added to the fray are a lack or shortage of tests, hospital beds, drugs, infrastructure and personnel. The ability of not being able to offer relief and save lives–while having to constantly fight constraints–feels as though medical professionals are staring at a tsunami but with their hands and legs tied.

The times are changing

The lockdown and resulting travel restrictions have greatly reduced patient inflows for a lot of doctors. Used to rigorous work schedules and patient appointments often until midnight, many doctors who are not on the pandemic’s frontlines, suddenly find themselves with a lot of time on their hands with no clear idea of how to use it. Initially the forced holiday seemed providential but with time, boredom starts preying on the mind, bringing with it an unrest in mind and body; joints feel stiff, muscles ache, guilt and uselessness begin to grip the mind.

With so much of “free” time, a lot of doctors have taken to social media and are venting out their fears, frustrations and opinions in Facebook and WhatsApp forums. Almost all medical organisations are arranging webinars which not only give an opportunity for upgradation of skills, but more importantly provide a platform for some much-needed social interaction with peers. Virtual conferences are a welcome change as anyone and everyone can participate from the comfort of their homes. Doctors who have been able to embrace this new normal and even innovate and excel in it, have been able to stay focused, optimistic and content during these times.

A patient cured is the biggest motivation

Despite the trials and tribulations, pandemic or no pandemic, nothing can motivate a doctor more than the sight of a patient cured. A therapy that worked, the breathless patient who got better, the 90-year-old diabetic who became Covid-19 negative, the birth of a bonny baby, the cancer from the stomach that was fully removed, the complex fracture that had set well, the three stents successfully placed in the 60-year-old who had a heart attack and is now stable, the badly crushed hand that was repaired — the list is endless. Amid the prevailing uncertainty, it is moments like these–of relief and elation–that help deal with the helplessness and other negative emotions that play out in every doctor’s mind.

These are indeed strange times to be a doctor.


Dr. Neela Bhattacharya

Dr. Neela is a plastic and reconstructive surgeon and had started the first department of plastic surgery in North Bengal. She is the Project Director of the Smile Train Program wherein she operates on infants and children with congenital cleft lip and palate free of cost. Over the past 13 years, she has restored smiles to more than 4500 such children across North Bengal, Sikkim, Bhutan, Bihar and Nepal. Dr. Neela is also a TEDx speaker.

 

In 2019, she was the proud recipient of the Woman Icons India Global Award in Healthcare awarded by the Governor of Tamil Nadu, the Shakti Sammaan Women Achiever’s Award given by the Governor of Sikkim and the Excellence in Plastic And Reconstructive Surgery Award from The Venus International Foundation.

 

In 2017, she was recognised by the PMO, Niti Aayog and the UN as one of 25 women transforming India and named among Best Citizens of India by the International Publishing House.

 

In 2016, she was recognised by the Ministry of Women and Child Development, Govt. Of India, as being one of 100 women achievers in India and was felicitated by former President Pranab Mukherjee. She is also recipient of the Bharat Ratna Dr.Abdul Kalam Excellence Award by the India International Friendship Society.

 

 

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Dr.Suhasini
Dr.Suhasini
3 years ago

Well written

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