Burials: We can’t keep up!

Those were the headlines in one of the Sunday papers.

He was around fifty years old and with his wife. They stood in front of me in the supermarket. He was in shorts and a light blue t-shirt, wearing beach flip-flops. Standard casual wear for the holiday beach town where I work at Netcare Kingsway Hospital in Amanzimtoti, on the KwaZulu-Natal South Coast of South Africa.

I could see him reading the headlines. Then he shook his head and muttered something to his wife.

“News” was all I heard. It was accusatory, devoid of any connection to the surge in Covid-19 infections we are experiencing in this province. 

I was not in my surgical scrubs. I too wore shorts and a t-shirt, although not as smart as his. Instead of flip flops I wore my Crocs. Every day at the hospital I wear closed restaurant Crocs that I wash every day with my scrubs. It was good to be in my beach and bush Crocs.

“It’s true, you know” I said. “ I can take you to Kingsway Hospital down the road and show you the people waiting outside.” I knew they were there,  sucking on oxygen from  battered black cylinders. They would have been triaged by a team of nurses, vital signs recorded and placed on the oxygen as they waited for a cubicle in our emergency department. A colored sticker on their shirt or blouse would identify them: BLUE for family members, YELLOW for non-Covid medical problems ( the minority) and RED for COVID-19 patients.

“I don’t believe it. I don’t know anyone who has it. I don’t know anyone who has died from it. I know hundreds of teachers, and not one has it. But I do know people who have been murdered in the last year.” He was calm and spoke his truth.

His words hurt me.

I chose not to argue. He would not recognize me when he came to the back of the emergency department. All he would see is my eyes above the mask and behind the visor. I would be unable to help him. Not because he did not believe that Covid-19 was a real problem. I would not be able to help him because there would be twenty other patients waiting for a hospital bed. Maybe he would get one on the other side of the city, or even in another town. I would not wish ill on him. But he should see the eyes of those pleading for care and attention. He should see their eyes when the person lying on a stretcher next to them dies. He should see all the bodies waiting in the holding area.

They are waiting for the undertakers who can’t keep up with the burials.

The nurses at my hospital can’t keep up either. I cannot keep up with how many get sick with Covid.

One of the emergency doctors steeled himself before a shift. “I can’t do this anymore.”

He was tired of seeing patients and not having beds for them. He was tired of seeing people die. He was tired because two of his colleagues were sick with Covid and he had to carry the extra shifts.

Still he went out to face the death and destruction that this disease forces on us.

The man in front of me at the supermarket que would not believe any of this.

The amazing thing is he would still be treated at my hospital like anyone else if he needed help. He would be treated by nurses and doctors who just can’t keep up. 

He may end up with a RED sticker on his blue t-shirt…

Begrafnisse: Ons kan nie voorbly – Afrikaaans for Buritals: we cannot keep up

A Postcard to Covid

A Postcard to Covid

One thing has worried me during Covid-19 and initially no one understood.

To survive and heal after this pandemic we need to remember the story  of what happened. 

Our modern instant access to news feeds and  intrusive social media have overloaded us with statistics and disease progression.  In a few years’ time if we look back and do an internet search we will have access to all the details of what happened. We will be able to recount the spread and the death rates, the financial fallout and effect of the recession. The debate on wearing a mask will hopefully have been silenced. There will be articles on the development of a vaccine. Science and medicine and economics will dominate the records.

But the story of how we felt, how it affected us, the way our minds took a beating, all those stories will be lost in the millions of pages of data.

That is unless you send a postcard to Covid and let the virus know how it has affected you and how you feel.

I am sure that writing a postcard uses another part of your brain. It forces you to find a spot  to place the card on a table and pick up a pen. You may not put the tip of the pen in your mouth for inspiration because you are wearing a mask, but the ideas will come. There are different pathways in the brain that engage more cells than when you pick up your mobile phone to send a message. Trust me, picking up a pen in itself can be healing.

Yes our stories during the pandemic have the power to help us heal. 

We have all been traumatized. If I look at our little hospital that was closed by the Department of Heath early on in the pandemic because we had an outbreak, I knew already then that there would be suffering. I do not want to minimize the suffering that anyone has gone through, but our nurses are the ones who put their lives on the line. They are the ones who held the hands as patient after patient died from lack of oxygen on their watch. They are the ones who stood in for the family who could not visit. They are the ones who escorted the dying to the other side. They have a sad story to tell.

The idea of a postcard came to me in the last few weeks while I was studying a course hosted by the University of Cape Town on Medicine and the Humanities by Associate Professor Susan Levine and Professor Steve Reid. I have also been attending a  course hosted by Laurel Braitman of the Department of Narrative Medicine at Stanford University. It is Laurel’s inspiration ( and very likely one of her prompts) that made me realise that we had to find a way to tell our stories through this pandemic.

So pick up a postcard and tell us what Covid has made you feel. If you need to talk about it tick the box and we will get back to you.

I know the strength of the human spirit will prevail, and I look forward to sharing your inspirational stories.

A Note for Future Generations

Covid-19 is still with us. The South African curve is not flattening, and the number of new cases and deaths continues to rise.

I am seeing my first Covid-19 positive patient at Netcare Kingsway Hospital.  He is fortunately well. Unfortunately the surgery for his broken arm will be delayed for two weeks. I am not prepared to risk spreading the New Corona Virus in my theatre if it can be avoided. This said, if we needed to operate my team would do it safely.

I have consulted and seen other patients with Covid-19 before our hospital was closed and then reopened last month. But they had been admitted under other physicians, and were not strictly my responsibility. Although ownership may be a better word. We bear great responsibility as the doctors of these patients.

I was prompted to write this piece by Laurel Braitman, a professor and the Director of Writing and Storytelling at the Stanford School of Medicine at Stanford University. She hosted an emotional online writing workshop this weekend. The prompt was to write something for a  time capsule that would be opened by future generations. 

Back to my patient:

He was the last patient I saw on my ward round. 

First I see green patients, then yellow patients, and finally the red patients. Negative swabs, awaiting swab results and positive swabs respectively. 

Besides being red my patient is also black,  and I am white. Yes I notice that. Especially after all the other colors in my hospital. We are both born in the same country, but we come from different cultures.  We are the Rainbow Nation. Diverse and rich in color and ethnicity.

Our categorization of the disease in South Africa is also divided into race, as it has become all over the world. Black and white. I say this with great respect as America burns with human rights protest.

To save on PPE (personal protective equipment) I took him his breakfast. This meant a nurse would not have to don a special N95 mask, visor, gown, apron, hood, booties and gloves. No more pleasing hostess serving patient’s food on a tray with plates and cutlery in the hospital. Just a polystyrene container with food heated in the microwave. Delivered by an already tired doctor.

South Africa has always had constraints, and we all live in fear of not having enough PPE. So being able to serve the patient his food was my way of saving PPE for the tsunami we are expecting. It also allowed me to connect with him. I had to explain the delay in surgery. I reassured him that it was not going to jeopardize the ultimate result and clinical outcome of his injury. We also spoke about his work. His family. And Covid-19. We are all facing the same storm, yet each of us is in a different boat. 

Then my ward round was over. I spent thirty minutes with the nursing team going over the donning and doffing processes to be sure they were safe. Then I changed in the large change room the hospital has created for staff dealing with Covid-19 patients. I changed from hospital scrubs back into the new scrubs I wear to work every day. 

At home, after a  shower, I changed out of those scrubs into shorts and a t-shirt, and started my sanitized day.

Thank you to Laurel Braitman for the inspiration.

Durban beach baptism