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Blessing

This week sees me in the office only for a few hours. I decided to drive across the city yesterday to meet with supportive friends for lunch. All three of us are fully vaccinated.

Along the way in the suburbs there were still people parked at strategic barriers erected to prevent free movement into the suburbs. Some of the residents still stood guard. There was less traffic on the highway and very much less traffic in the suburbs.

Our lunch, the sharing of a simple meal, was punctuated with intense discussions about the ethics of what has happened to our country, and about the wisdom of the courts. Although we are close friends and understand each other, there were differing opinions. We are also generally a positive group, which is why we are friends. Somehow there was not the same energy of positivity amongst us this time.

Later in the afternoon after we had eaten and spoken, I drove to the nearby La Lucia Mall to see if I could get some grocery shopping done. The shops where I stay had been closed all of last week and I thought the upmarket area might have better stock.

The parking area was empty and there were no queues to get into Woolworths. Everyone, shoppers and workers, were subdued. I spoke to a lady shopping. We were in the meat and poultry aisle.

“Isn’t it just crazy?” I said to start the conversation.

She paused. I was still in my scrubs. She looked at me. “Hectic. I am Muslim and there is no chicken. The meat is not Halaal.”

“Get some frozen fish? I am not sure if there is any?”

“Have you just come from work?

“Yes, I closed the office. It is so quiet.” There are other reasons, like I am overstressed and have withdrawn to have time to myslef, but I chose not to tell her that.

“OK, be safe”. I echoed the greeting and moved on. I got most of what I wanted except garlic to ward off evil spirits and chicken.

On the way out I stopped talk to the manager. I asked about stock and staff, and he was positive. He stood in front of the empty in-house coffee shop.

Happy to have enough groceries for me and others that I could share with, I pushed my trolley out into the dusk of Durban winter. 

“Doctor, doctor” I heard a voice calling out. No one should know me around here as I haven’t lived in the area for five years. I turned. A young man was running toward me. He was small, and wearing a worker’s overalls with reflective safety strips.

I stopped pushing my trolley and faced him.

“I just want to thank you for what you do for people. I am so happy you studied so hard to do what you do. God bless you.”

I had tears in my eyes. I really did not know him. Yet I felt an instant connection.

He rolled up his left sleeve and pointed to a scar on the funny bone of his elbow. “I have had a debridement” he said and pointed to his elbow. “I have met doctors like you.”

Lucky Ndlovu had no idea I was an orthopaedic surgeon. Thirty years ago I would have treated young men like him for injuries with debridement, a French term for removing damaged tissue. I debride aggressively now, and then hand over big skin defects for my plastic surgeon to close.

Our country needs a debridement, I thought to myself.

Lucky was truly grateful. I was moved. I took his number. We chatted a bit. When things are better I will go back to the La Lucia Mall and have a meal with him and talk. He inspired me more than he knows.

He alone, with his open gratitude, has given me hope to carry on.

My cherished messages from a stranger.
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The Naming of People

T.S. Elliot wrote a collection of poems on cats. One of the poems is called “The Naming of Cats” and it starts like this:

The Naming of Cats is a difficult matter,

It isn’t just one of your holiday games; 

You may think at first I’m as mad as a hatter 

When I tell you, a cat must have THREE DIFFERENT NAMES.

Luckily I am not a cat and only have one name. However there are more than three Basils in my family. I am one of six first cousins named Basil after my maternal grandfather, the late Basil Moutsatsos, who had come to South Africa from Greece. His legacy was one of love and generosity. He also loved to watch his children (he had five daughters and four boys) perform Greek dancing.

So Basil is from the Greek word meaning “Kingly”. In Greek my formal name is Βασίλειος (Vasileios). The shortened version is Vasili. When I was at university I liked Vasili. Many years later a Rumanian colleague would call me Vasili. He would also call on every 1st of January to wish me for my name day. 

In Greece the villagers who had been to the United States called all the Vasilis “Bill”. So I became Bill, Billy or Billaco in Greece. Bill came from their arrival at Staten Island in New York City. The immigration officers spoke no Greek, so they asked with which letter of the alphabet the name of the immigrant started. Vasileios starts with a “B” in Greek. So they were all called Bill. 

The seven cousins needed to be distinguished from each other. So we had Big Basil (or Sili) and Little Basil, who was the youngest Basil until two younger ones came along: JB and Sil. In the middle was me and cousin Basil, son of my Uncle Basil. I had a few nicknames besides the Bill derivatives: Budgie, Charlie and maybe a few others I cannot remember.

Oh , and my cousin Big Basil married Athena whose brother Basil shared my birthday, along with JB.

Names are important. Sometimes they make who we are. A name can mean recognition and connection.

When we were in the second wave from December 2020 to February 2021 at Netcare Kingsway Hospital, the hospital was all Covid except for one small ward. We all wore full PPE including visors all the time. Everyone looked the same in gowns and visors. Everyone was tired.

“Hey you” was not a polite way to address nurses when at work, and patients had no idea which angel was caring for them. Remember, as a doctor during the Covid wave I was working with teams I had not worked with before as an orthopaedic surgeon.

I decided that we should label everyone’s visor with their name and position in the hospital. So even the head of the gastroenterology unit in theatre got her label: Sister X, Theatre Gastroenterology Sister. She ended up heading up the Rest in Peace Team, so her patients did not see the name on the visor.

My receptionist used my label machine and five cartridges of labels supplied by the hospital to make labels for the whole hospital nursing and administration staff and the doctors. Each cartridges has a ribbon that is twelve meters long, so she printed sixty metres of labels.

Covid-19 has presented like a cricket game with the statistics. All sorts of useful numbers have been extracted and then equally so, misinterpreted and used as a foundation for some outlandish conspiracy theory.

We are now preparing for the third wave at our hospital. Many of the staff have new visors in preparation for the battle. Most have been vaccinated. My labelling machine is doing the rounds as people print their name to stick on their visor. 

What the label does not say is that these nurses are angels. They are the ones sacrificing themselves and their families as part of their calling to care for the sick. The sick are arriving again at our hospital with Covid pneumonia, grey skinned with wide-eyed white eyes searching for oxygen and help.

Thanks to our nurses they will receive more than just help. They will be cared for and connected to their families by these superheroes with names we should remember.

Grass cutting visors from the local hardware store have become the preferred from of protection globally.

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The Tree of Life

I had been searching for a year. Because of the pandemic, in spite of the pandemic and to heal from the pandemic. Finally in May this year I was gifted what seemed to have become an impossible task.

I messaged the hospital manager : “the trees have arrived. I’ll come by later in the week to chat about where to plant them.”

“Excellent” was her answer.

We have a garden of remembrance as you enter our hospital. It has two benches, three tall aloes and a variety of African indigenous lilies. There are two glass walls with stainless steel plaques for anyone to pay homage and remember the departed. One wall has become the Covid-19 Memorial.

A few days later I popped into the manager’s office. 

“Hi.”

“ Oh hi Dr Stathoulis” . She always calls me that. We asked about each other. “Can we do a walkabout to see where to plant the trees?” 

“Sure”. She always makes time for me.

We walked into the sun of autumn, a warm day, with the trees huddled in their black plastic uterine bags.

Ziziphus mucronata. The tree of life. That’s what the Zulus call it. uMphafa. If someone dies  in the hospital they bring a  branch from the tree of life and reverently capture the spirit to take it home. They even pay for an extra bus seat on the way home. The branch that has captured the soul of the person who has died is tucked into the eaves of the roof of the homestead to rest. 

I have a plaque in memory of my father’s passing in 2008 on the first glass wall. It reads in Greek: “Η αιωνιότητα είναι ποιότητα, δεν είναι ποσότητα, αυτό είναι το μεγάλο πολύ απλό μυστικό” from Nikos Kazantzakis, who wrote Zorba the Greek. Translated it means “Eternity lies in the quality, not the quantity; that is the great secret.” When I finished school in 1980 I planted a  Ziziphus in the garden of our family home. After my father was buried in Johannesburg I took a branch from that tree and left it at my grandfather’s house in our village in Greece. 

It was difficult to find the trees. I had asked far and wide of nurseries and tree growers and finally a friend of mine, Jane Bedford, who had trained as a traditional healer with the Zulu’s, gifted them to me. A few days later the local nursery found another three small trees for me.

Jane delivered the first three trees as soon as  she got them. The thorns tore at her car seats. He forearms had bright red spots where the thorns had drawn blood.

The tree of life has a straight thorn that points to the future and a curved thorn that connects us to out past. The branch has a zig-zag pattern, much like the path we follow in life.

I had a dream in the beginning of the Covid-19 pandemic. I was moved by the pain of families who could not visit their loved ones in hospital. I thought of these trees after my dream, and knew I should plant them in our Garden of Remembrance. I finally found them. Rather, they found me. So Rachel the gardener at the hospital planted them. Three in a row. The other three small trees were planted in a group a but further away.

This weekend I mixed some concrete and planted a sign to remember the reason we planted the trees of life.

A sense of peace descended over me. Now my soul can rest a little easier.

Rachel, our gardener planted the trees of life.
The tree of life….
The Garden of Remembrance

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Some Good News

I have been distracting myself since the second wave. Our hospital has quietened down as far as Covid-19 cases go, and we started doing limited planned surgeries. After my last post which detailed the overwhelming and horrific difficulties we faced during the second wave, a friend of mine suggested my next post should be about some good news.

So I thought of telling you about a touching visit by a medical student to her grandfather. He had been admitted with Covid pneumonia and is now recovering at home. I also thought I would write about how we have resumed planned surgeries, and how it feels different to when we resumed after the first wave. In the background I have been working on a document detailing how Covid-19 has affected me as an orthopaedic surgeon. I think the latter post would not be good news.

But there is good news for this post: I received my Johnson and Johnson vaccine on Friday. It was injected into my left arm by a community clinic nurse at Prince Mshiyeni Memorial Hospital, a provincial general hospital in the south of Durban, KwaZulu-Natal.

There is so much to say about the vaccinations for Covid-19. The scientific endeavour and ultimate production and licensing is nothing short of miraculous. The first time use of mRNA vaccines in the Pfizer and Moderna vials is science exploring the envelope . The Pfizer story is worth reading. It details a humble event. Albert Bourla is a Jew born in Thessaloniki, northern Greece, who steered Pfizer as CEO to be the first to release and use a vaccine for Covid-19. The story of who was the first person to be vaccinated in Greece is where much respect goes to Mr Bourla. Mrs Despina, 95 years old and also of Thessaloniki, is a Jewish-Greek holocaust survivor. She received her vaccine in early January 2021.

The Astra-Zeneca and Johnson & Johnson vaccines both use the older technology of inactive adenovirus with the DNA of the Corona virus incorporated. Unfortunately the Astra-Zeneca vaccine gave less protection for the new variants of the Corona virus, including the variant which caused South Africa to explode in the recent second wave. The adenovirus DNA vaccines are more robust than the modern mRNA vaccines, whose cold chain storage at -70 degrees Celsius is difficult in a developing country. South Africa had already taken delivery of one million doses of the Astra-Zeneca vaccine as the studies unfolded about it not being as protective as we had hoped for. It was an disheartening blow to the nation’s health care workersw who were relying on a vaccine to give them real protection.

Before the dust had settled on the unused Astra-Zeneca vials ( which were sold to other African countries) South Africa took delivery of 80 000 doses of the Johnson and Johnson Vaccine. This is a single dose vaccine as opposed to the others which rely on two doses, given at an interval of a few weeks to a few months. Over the last week the Department of Health co-ordinated the distribution of the Johnson and Johnson vaccine under the umbrella of a trial for health care workers called Sisonke. Sisonke in Zulu means “together”. It is a Phase 3 (b) clinical trial which is pragmatic and set in the real world. Perhaps a little more real in Africa.

The Department of Health distributed the 80 000 doses between 14 state hospitals and used these initial doses to protect frontline health care workers. Their EVDS (Electronic Vaccination Data System) website allowed me to register as a health care worker. My hospital then stratified staff into risk levels, and then I was able to register on the Sisonke website to be part of the trial. Besides entering personal details this also involved digitally signing an informed consent. After this I received a voucher number and a booking to get my vaccine on Friday 26 February 2021 at Prince Mshiyeni Memorial Hospital. It was not all as simple as it sounds. 

The logistics of the vaccine delivery process has been difficult globally. South Africa has discovered the limitations of the public-private health care system. Some provinces allocated appointment times. When I received my invitation it was open ended: from 8 am until 4 pm. My heart sank as I thought of my visit two years ago to the Department of Home Affairs to apply for renewal of my passport. For that I arrived at 5 am to be close to the front of the queue. It could not be that bad, so I arrived at Prince Mshiyeni Memorial Hospital, 10km away from Netcare Kingsway Hospital, just after 7 am. I was relieved and reassured to see our nursing manager at the entrance welcoming and directing me. I was number 184 in the queue. Two hours later I received my injection. Then I had to wait the obligatory 15 minutes to ensure I did not suffer an adverse reaction.

I walked out feeling empowered. I had survived a mild dose of Covid-19 at the end of last year,  and now with the vaccine I was protected. As data comes in I will in turn protect others. But until a significant proportion of our population is vaccinated I will continue applying the appropriate precautions. We should all continue to wear masks, wash hands and maintain social distance. In the hospital and my office the minimum requirement remains a mask, visor, plastic apron and gloves. 

We still have a long way to go with this pandemic, but the vaccine is the most significant step in our battle to gain control of this novel corona virus.

I am grateful to the scientists who developed the vaccine and the South African government for choosing to protect us. Special thanks to the manager of Netcare Kingsway Hospital, Mrs Demetriou for her efforts to get her staff vaccinated.  Health care workers have seen a different reality to the rest of the population.

Thanks to Sister Nompumelelo Molefe
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In Their Memory

I cannot find a title that encapsulates what has happened at my hospital without being alarmist. This is all about death. 

In early January 2021 my hospital was overwhelmed with Covid-19 cases as the second wave of infections hit our coastal holiday town with devastating force. 

The senior emergency doctor contracted the disease and was unwell. The remaining doctors were stretched to cover the extra load. Our infrastructure was stretched. My measure of how we were coping was based on a few rough gauges: 

How many people were lined up outside the emergency department on oxygen? 

How many people were in the emergency department waiting for a bed at my or another hospital? 

A few weeks later I added another measure: how many people were waiting for ICU? 

We were stretched, no doubt. So I went to see how I could help. 

The nurses and doctors knew what they were doing, but it seemed chaotic just because of the sheer deluge of ill patients. We had a ward that was empty and accessible to those needing urgent care for Covid-19 symptoms. But we did not have the staff.  

As I walked through the ward I discovered the real measure of how overwhelmed my hospital was. There was a dead body in each of many rooms. Out of respect for the departed our staff were leaving the dead alone in a room. Their desire for those in the afterlife was to rest in peace with space. 

I am not at liberty to give the statistics as they are part of the information that the Department of Health disseminates. But I can tell you how it affected us. 

To make space for sick patients I seconded a porter and we started moving all the dead bodies into one room. A holding area. As we did this I met some of my operating theatre staff who were delivering a shrouded body to the new holding area. Beds in the ward were at a premium so it was more efficient to move the body to a holding area where the many professional undertakers have taken them away timeously. 

4180. 

That is the switchboard extension the ward staff call to get the RIP (Rest In Peace) team from theatre to prepare and move the body.  

The RIP team is made up of skilled theatre nurses, scrub sisters, recovery and anesthetic nurses. Once they get the call on extension 4180 they go to the ward where the patient has demised. They check the paperwork. They ask the family if they want the clothes left on or removed.  Then they wrap the body in two layers of plastic, each layer with three patient stickers identifying the body. Then they shroud the body with a white bedsheet. The remains are respectfully transferred to the holding area. 

We managed to staff and open the ward the next day and take patients from outside on oxygen and put them inside in a bed on oxygen.  

The odd thing is the number waiting outside remained the same for many days.  

It was sobering that number of dead arriving in the holding area was much more than we ever anticipated. 

The Holocaust Memorial in Berlin

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Sometimes I Think

Sometimes I think and nothing happens. That seems to happen a lot during this period of the second wave of Covid-19 that has hit my hospital. Netcare Kingsway Hospital is a community private hospital and has been overwhelmed in caring for patients with Covid-19.

Sometimes I think and something happens. That’s when a story takes shape and I wonder how I will tie it together to make it work.

Sometimes I think about the pandemic. I focus on the problems we face and work out solutions. I reflect on all we have done. I reflect on what we have learnt. Although we were all tired after the first wave, at least for the second wave we had systems in place. Systems to protect staff with PPE, systems to control the flow of patients and systems to deals with patients waiting outside and waiting for an ICU bed.

Sometimes I think that it is affecting everyone. It is affecting every nation. Uniting some and dividing others.

Sometimes I think that it is not only about the nurses and doctors and first responders. It is about the cleaners and security staff, about the porters and the kitchen staff. About the switchboard operator and the admission clerks. They are the ones that make up the scaffolding from which the nurses and doctors flesh out their caring and compassion. Without them risking close contact with sick patients health care workers could not do what they have had to do. 

Sometimes I think about the undertakers I see moving around the hospital. Death certificates in hand if they are lucky, otherwise their unfazed search for the source of that important document. I have seen families cry as a body has been transferred to the undertaker’s van. It was eerie to see a full length leg prosthesis pushed like a spare part above one body.

Sometimes I think about all of these people. I just have not written about them. Now I will write about them.

It may look like it’s only sometimes that I think about them. But today I walked out of my office holding a tray doughnuts. A patient brought them yesterday to celebrate his birthday with us. I didn’t save his life. I am just an orthopedic surgeon. I only fix bones as my clever anesthesiologist insists. I was grateful my patient thought of us but I never got round to having the doughnut.

Sometimes I think clearly. This time I took the doughnuts to the security guard that directs people in crisis to the back of the hospital for them to be triaged. He remains calm and polite and cares as much as any nurse or doctor. I know that because I see him every day he comes on duty. I wave as I drive in and he salutes me.

Sometimes I wish I could do more for them. The doughnuts for the security guard were a start.

Moving mannequins at a Durban outdoor market
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Superlatives

I could use superlatives to describe our nurses at Netcare Kingsway Hospital.

There are fancy words like  unprecedented, incredible, amazing, unbelievable, conscientious and self-sacrificing.

But I will not.

I will just tell you what they do:

Our nurses work twelve hour shifts. They arrive early and leave late. They wait in line to  sign in with a thumb print for work. Then they log in on their cell phones to be screened for Covid-19 symptoms and checked for fever. They queue up to sign in. Then they wait to be screened. 

From there they walk to their ward. There is not as much noise as before. It is quiet as they put their bag and food in their locker. Before they used to leave their phones in the locker. Now the phone is a vital tool to connect. Not to social media, but to hospital and doctor groups. Orders, stats and death notices fill the small screens.

They don PPE to start work and care for their patients. They wear a mask, visor, gown and gloves all day. It gets hot. Their throats become dry.  Tea and lunch breaks are short and sometimes missed because they are busy. They cannot sit with friends. The tea rooms only allow two nurses at a time. I see them walking to their cars to eat lunch. There is no life in how they spend the time which is meant to recharge their soul.

The wards are full. We can give each patient an oxygen mask or rebreather. Not everyone can get high flow oxygen because our oxygen supply system will fail. This even after we installed a huge tank and free flow piping that we hose down every hour to prevent the freezing of the pipes. I do not need to explain the cap we face if we need to escalate breathing support. There are a fixed number of ventilators with a waiting list.

As I write this, the words seem without aim.

I have chosen my words to reflect the staccato world of talking through masks and behind visors.

Yet somehow richer words appear. The intensity of the ICU’s is cloaked in an almost church like peace as these highly qualified nurses work around the clock to save lives. When I talk to them all I see are tired eyes above the mask line, yet there is a gentleness and concern that pervades their every action.

My theatre staff have lost all sense of stability. They have to work in wards, ICU, the emergency department, triage or screening. They also call the families to update them of the loved ones condition. My theatre staff have another duty: they care for those we have lost. They do this with great dignity.

This week I got some grass cutting helmet visors (I am holding two in the photo) for some of the theatre staff. We all know they are the most comfy and safe as well. They are bulky and ugly. One of the nurses put her visor on and walked as if on a catwalk. She was showing off her new visor as if it was a designer handbag.

As she walked she tilted her head to show the large blue helmet with clear plastic screen and said “fabulous!”.

Now that is a superlative I did not expect to hear.

Holding the grass cutting visors in a stainless steel hospital lift. See my phone in a plastic bag.
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Circles of Light

We had survived the first wave of Covid. The Covid admissions at my hospital were down and we had resumed elective surgery. Things were running as smoothly as they could in the new normal.

I washed alone in the darker scrub room. I always use this scrub time to focus on the case at hand. Surgery forces one to be very mindful, unlike other high pressure jobs where you may have to multi-task. In surgery all you have to do is focus on the next case.  

I looked through to my operating theatre, the room lights bright with the scrub sister positioning the brighter operating lights for me to make my incision. Over the decades these were the third ,and by far the best, set of lights to work with, I thought to myself. Was I thinking more today, or was I just more aware?

Surgery is a privileged profession, one which captivates and entrances. It is also a demanding discipline where failure stabs at your heart with no forgiveness.  But this morning I was captivated by the lights. For the first time as a surgeon I realised the operating room light is a representation of the primeval force of fire that bound humanity by giving light in the darkness. This light was the result of our forebears discovery of fire. Nothing less. 

Back to scrubbing. Palm to back of hand. Left then right. Then each thumb. Forearms then rinse. I always worry about the waste of water. I should change to a dry scrub. But I find the noise and sensation of running water soothing.

I glanced into my theatre. My eyes focussed and stayed there.

The light shone in a circle of circles, each emanating like a ripple in a pond from a stone thrown by some child. 

It is my twenty third year of operating here. I have survived a few medical mishaps of my own: a few kidney stones, a cardiac stent, amoebic colitis, surgery for arthritis to my thumb and now I think I have COVID.

It was as if I could see the virus now. There were halos I had not noticed before. Maybe it was from all the scratches of cleaning my visor. Last week I worked with a nurse in that same theatre for two days and they tested positive for COVID after that. 

It was five and seven days since my exposure. As a health care professional I could continue to work until I had symptoms. 

But the light does not shine on premonitions.

The next day I tested positive.

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H.O.P.E.

Even as the postcards started arriving the signs of the second surge were present. The statistics are anywhere to be found but a retired colleague of my brother has done his own programming and has a useful site to look at the numbers if you need to: https://www.covibes.org

Back to the postcards. They are being collected in a box held at reception at Netcare Kingsway Hospital. 

I have collected twice and will check again next week. I feel like an old fashioned village postman.  It tugs at the memory of the film Il Postino, a beautiful film about how words can change lives.

Each time I took the pile of postcards to my office and left them in the corner of my empty desk. When my work day was over and I could focus, I sat alone and read each one. I cried easily at the intensity of emotions expressed about  how events had affected staff at the hospital. 

After each reading I went to the front desk where my receptionist Anina is protected behind Perspex barriers and shook my head in disbelief as I spoke  of the trauma. Anina scanned each one in so that the card was digitized, and from those files I was able to make the first collage that makes up the picture that accompanies this article.

One postcard ended simply: 

“No words.

Only emotions.”

There are so many emotions that we have all experienced to a greater or lesser degree, from closer or further than others. I could identify with all of them, from the anger to the zeitgeist of social distancing and lockdown of our new era.

The sense of loss is profound. Loss of family members and friends stab into your heart. The loss the nurses felt as they were the only ones to guide patients into the next world hurts so much that tears flow. 

There is anger. There is a sense of growth and achievement. There is an acknowledgement of lessons learnt. My writers have defined what is truly important to them. 

Despair makes an appearance but is won over by hope.

So why H.O.P.E.?

Hold On Pandemics End.

Keep hope alive by wearing your mask and social distancing. Think very carefully about your festive season travels if you really have to. Remember it’s as much about not contracting the virus as much as it is about not infecting someone else.

Posted on by basilBLOGinc · 4 Comments

What Does “Closing Your Hospital” Mean?

Toward the end of last year I was reading an article on disruption from Singularity University. The writer challenged businesses to think how they would respond if their customer base was suddenly lost. The challenge seemed to be based on climate change extremes and technological advances. It was a good article,  and I thought about it.

My hospital, Netcare Kingsway, is set in the lush coastal bush of a tall dune on the South Coast of Kwa-Zulu Natal. I thought that even with a significant rise in sea level we would not be affected. The dune is at least seventy metres above current sea level. 

So what could else cause me to lose my patients? The answer is clear four months into the new year: the economic and political chaos that has followed the Covid-19 pandemic. 

I have seen fewer patients during lockdown than the fingers on my surgeon hands. For one week in April, the Medical Centre (a building adjacent to the hospital housing over fifty doctors) in which I work was closed. It underwent a deep clean by professional cleaners brought in by our hospital management. This despite there not having been a patient or doctor or receptionist who works in the Medical Centre testing positive for Covid-19.

Since the deep clean a handful of doctors returned to consulting in the Medical Centre during the last week of lockdown. They were seeing a fraction of the number of patients they normally see. Seeing these patients during the pandemic is difficult with protocols in place to enforce social distancing, wearing of masks and visors as well as increased hand hygiene for all. With the adjoining hospital still closed we cannot use the laboratory or X-rays department to help us make diagnoses. Worse still, we cannot admit our patients for treatment, be it medical or surgical

The patients we have cared for feel that we, the doctors, have abandoned them. I have cared for over twenty three thousand individuals and families during  the two decades I have worked at Kingsway.

My last operation was on Easter Monday, over three weeks ago. Shortly after that the hospital was closed to contain a Covid-19 outbreak. My patient was a ninety-two-year-old lady who shattered her thigh bone. The theatre staff and I were in full PPE (personal protective equipment) to protect her and us from Covid-19. She was discharged from Kingsway last week. Her thigh bone was fixed and she did not get infected with the New Corona virus in hospital.

I am pleased lockdown has been lifted in phases. I am not sure if I will be able to send her flowers for her ninety-third birthday next week.

I believe that Netcare as a group has been proactive with policy and protocol before Covid-19 was declared a pandemic by the World Health Organisation. Kingsway Hospital management has upped their game: they spent on more PPE, created more negative pressure ventilation cubicles, paid staff even though they are not working, converted a day ward of twelve beds into a Covid changeroom for staff, allocated only one patient to a cubicle even in three or four bed wards. This management team ran the hospital efficiently before Covid-19. Now they are risk managers as well, dealing with unimaginable crisis after crisis that has become the hallmark of this pandemic.

We have ongoing cleaning of the hospital including with an Ultraviolet Robot since we were closed to new admissions. We have emptied the hospital of all patients and closed the Medical Centre again from the end of April and have repeated the deep clean. We have trained staff and doctors in Covid-19 protocols. We have taken a team that has always cared and been cautious, and have made them better. 

All of us are dealing with all the unknowns of the Covid-19 pandemic. For us at Kingsway Hospital an additional unknown is when our hospital will be re-opened. We have lost a great part of what defines us as doctors.

Kingsway Hospital’s front door is closed.