The Trip Before the World Shut Down

It’s hard to forget my time in Turkey, (not just because of the good times, the people, the food and the experience).

But because I casually left the Uk on the 1st of March aware there was a pandemic, but not consciously living out the reality of the pandemic; only to return on the 8th

to be so aware that I wondered about why people were packed closely and coughing with reckless abandon at the Immigration point in UK. I wondered why no one was screening us for symptoms, why no one wanted to know where we came in from etc. And that was where the fear began. I looked at our whole arriving flight as a potential missile that landed in the UK. And I extrapolated that to all other flights coming in from everywhere else without checks and I knew, sadly before the leaders realised it, that we were sitting on a ticking time bomb. And right after that trip, life changed: at work, with travel,

and even at home! By the 10th of March, I was fit testing for FFP3.

By the next month, my skin was breaking and it took me a while to realise the connection...and each peppered hand wash, a reminder of the weight of the pandemic!

I had to keep moisturising my hands...and this took months to heal, only to heal into a scabby rash that I constantly touched😂.

Whilst I never got to experience working from home...I still marvel at how easily ‘we’ adapted to this. I literally can join our teaching sessions from anywhere on Teams. . More personal to me, I remember presenting part of the NHS long term plan at the conference on this trip and

talked about the long term plans to adopt virtual consultation which was probably at 5-10% at the time of my presentation. The article had a 5year plan for execution that was to be achieved by 2021.

Lol. Ms Rona said: ‘hold my viral envelope’. We all adapted to virtual consultation in no time!

You see, when your back is pushed to the wall, you face the music....all those challenges listed were non issues in the grand scheme of events. Comfort was speaking when they thought they had 5years to execute the plan! If I’m not mistaken, by as early as May, primary care was virtual. As at when I joined in August, it was fully functional. (Not without its hitches though). The pandemic has had a few good products but on a global scale these would naturally pale in comparison to the devastation that has gone on. It’s akin to being at war. A war no one signed up for or was prepared for! No one, not the West, not my poor fatherland.

Mentally, the pandemic/past year has been draining, the cycle of loss of hope, and then going back to positivity mode and then back.....I mean, Jan 1st, I was so hopeful that the vaccines would fix all the problems of the past year. Lol. MsRona said watch me re introduce you to my unidentical twin from last year! I’ve had to say more silent prayers for strangers since this pandemic hit and that’s mentally exhausting! I spoke to a nursing student via telephone consultation and whilst they had offered them at work ‘that thing they put on the hand’ as she described it, somehow she didn’t know her sats of 87% was abnormal. She only tested positive ahead of being symptomatic using he lateral flow test. In the time it took me to call her an ambulance and call her back and she didn’t pick up...I’d feared the worst. She picked up later as the ambulance was there all in less than 5mins. They’d blue lighted her. What (the blue light) was supposed to be reassuring became more scary. . I’m sat there reminding God that she’d not even advanced in the profession enough to know a pulse oximeter...she was too young to die o. Like a negotiation was going on in my head....and then I had to clear this all out as I picked the next patient. Sigh! And then I heard of accounts from ICU. And my heart break cycle reset.

When I moved to a practice post I thought it was the worst possible time to be in a practice post because of the amount of home visits I had to do (Fancy seeing a patient, and then get a message later that the Covid test for the patient turned out positive and then you automatically have to relive the entire consultation: were you fully protected, did they cough in your presence (a patient once moved her mask aside to cough in my office🙆🏾‍♀️, why would she🤦🏾‍♀️?) Did you wipe down everything used on them or that they touched? If in my office, did I open the windows or did I see them in the treatment room(I’d usually have done this if I’d adjudged them to be of increased risk of having it). Was the patient one of those that felt they could take off masks once with you(you don’t want to hear the examples)? And then despite reassurances, you carry out your home self testing more regularly and then reinforce your vitamin D intake that has probably been skipped. Lol. And then, the bargain with God: Baba God, remember I did not come to this country to die...I’m not trying to make the news with death from Covid...’another black doctor....’, NO, ‘she was a kind and caring....’ mba. Pls epp me. Na only two my mama born. ..).

At a point, (when I was rational enough), And then towards the end, I realised I was protected to an extent by having my own office in the practice: protected from colleagues who often times may be the source of a medics infection! Because your guards would naturally be up with patients, more often than not, (in my experience) you are safe. Only for that relative safety net to get threatened with my return to the hospital where more diagnosed patients abound. With the new strain, the number of colleagues I knew in hospital that had contracted the virus was on the steady rise. You see, I’d managed to avoid the virus so far (and believe me, avoiding it, the calculation it took, the precautions etc had been mentally draining) and I just wasn’t ready to test my immunity, (and good thing I wasn’t testing it as I’ve realised recently I’m not as healthy as I assumed I was)! This hospital return was coinciding with our dear Chief Medical Officer in line with the ‘greater good’ declaring that the vaccine administration should be 12 weeks apart. Pfizer had again come out to state they had not tested efficacy beyond 3weeks. I could understand the rationale behind their targets with 1 dose. What I could not understand was the failure to understand that health workers had no choice but to leave home daily during the lockdown. That ensuring we were fully immunised could ensure healthcare could continue. But instead the response was ‘military are on standby to step in’ Lol. Reminded me of when Chinese doctors were employed to take care of the problem of striking doctors back home in dearest Nigeria.

Anyway, it’s back to hospital now, and seeing the Covid patients, the fear present is totally different from the fear I envisaged. Because my patients are now mostly pregnant...I’m usually there worried for the baby and the mother...but then the studies so far are not disproportionately terrible...but it doesn’t stop the fear. Seeing the number of successful outcomes, women you see at delivery who had had Covid in the weeks before was reassuring.

So it’s been one year. This trip signifies the last time my freedom was in my control. It signifies one year since I’ve fully lived the pandemic. Whilst I’m more or less a couch potatoe, socially, the pandemic has been hard. I hate the loss of choice. The fact that I want to eat out and I can’t, that I know a trip may fix a mood and I have to stick with other options because that’s off the table etc. For some others, the annual count started earlier than march. For some others, they’ve lost the fight, they’ve lost loved ones. They’ve suffered losses that cannot be described. I’m usually not able to process several deaths. So I stop. Because I’m never able to imagine how someone moves on after losing several members of the family. And for some, it’s the breadwinner, an only child, a significant other. Someone’s everything, someone’s world. And it’s hard. Every aspect is hard from dying alone (felt by the patient), to the family prevented from being present at a loved ones end, to the doctor who sometimes has to fill out that DNAR form. The nurses, the HCA, the porters(often stuck with these positive patients in the lifts). It is hard for everyone. Last week, in ED, a positive patient was told she’d not be leaving the hospital. Family members were making the tough decision to pick the husband from a distant location and still arrive the ED before a transfer to the ward where no concessions would be made for visits. They were willing to all isolate if only they’d be allowed...because they never knew it was ‘that bad’, that that was the end. And then I overheard someone else saying ‘but she doesn’t look that bad’....I resisted the urge to look into the cubicle, to form an opinion myself, to determine if this woman was dying or not just by looking at her. I picked my next patient and kept moving...trying my best to push the conversation out of my mind. And I remembered my discussion with someone, the worst part of this pandemic would not necessarily be the deaths that occur now, or the financial losses that occur now. It would be the loss of fight that would manifest in the future. For some healthcare professionals, all they know about medicine would be all they’ve seen in the pandemic because that’s when they started practicing. And it’s easy for the futility of care to take over. To assume people would die despite your best efforts. And then carry this on and translate it to minimal effort put in, and lose the curiosity, the quest for answers, the fight for each patient.

It’s my prayer that all essential workers that survive this are able to heal mentally, not just for themselves, but for the patients waiting. No one was designed to see such degree of death in a lifetime!

It’s been one year, and my most important lesson is to do what you want to do today. Because tomorrow is not guaranteed.