The time is 4.26 pm. I am sitting in the cold environs of the ICU I work in. Right over my head is the blower of the Air conditioner, which almost draws a parallel between my not-so-comfortable situation and that of a dressed broiler chicken tucked away in the recesses of a deep freezer in one of those meat stores! The pitter-patter of the first rains of this year’s Southwest monsoon outside adds to the shivers. But, keeping me on tenterhooks, and preventing my brain housed inside my artificially-created bald skull is a patient to my left. He had come to the hospital to undergo colonoscopy (endoscopy of the large bowel). Unfortunately hyponatraemia-low sodium levels had him throw a seizure followed by cardiac arrest. As part of resuscitation he has been connected to the ventilator. Having suffered a stroke years back, this man’s brain is already on the back foot. He is yet to wake up despite cessation of sedation. It looks like it might take some more time. But, fears of the cardiac arrest having caused some damage to his brain, already compromised, thanks to the stroke weighs heavily on his treating team, which includes me. He must wake up somehow. We couldn’t afford a patient who had walked in for an investigation to end up in a coma. The only silver lining of hope is the neurologist’s opinion that he might come around with time. More days on the ventilator could have him undergo a tracheostomy (a procedure that places a tube into the trachea) to help doctors wean him of the ventilator. But, a tracheostomy is too high a price, and an unfair one to pay by a person who had come for a colonoscopy. It would have been ideal if tracheostomy is avoided. If only he woke up. A stroke survivor myself, I am familiar with the nuances of brain damage. The uncertainties. The real and glaring possibilities of disabilities that the patient might have to content with.
It is next afternoon. Here I am in the same ICU. On my chair. In the same uncomfortably cold conditions. The patient hasn’t made much headway. His doctors couldn’t keep him on the ventilator forever. His children were briefed about the lack of any improvement to talk about, and the need for a tracheostomy. The man was tracheostomised. A price to pay, seemingly unfair. But a tracheostomy, which his doctors hoped he would do without will do him a lot of good in terms of weaning him of the ventilator. Just as I was coming to terms with the disappointment that shrouded his children’s faces on being told about the decision to go ahead with tracheostomy, my attention was taken captive by a recorded message played through the hospital’s public address system. The message reminded patients, staff and attendants within the hospital to maintain social distancing to limit transmission of the virus-SARS CoV-2 that had taken the world, including the tiny Indian state of Kerala where I reside hostage since January of 2020.the word ‘COVID’, the pandemic caused by the virus from China has become an integral part in the televisions, newspapers and conversations. COVID has turned our world, as we had known it since the day I was born topsy-turvy. Rules, written and unwritten made way to strange ones. COVID made us hesitant to sneeze. To cough. Even to talk and sing out loud. COVID bolted places of worship, which is beyond imagination of the human race which races to God to get things done, and of late, more often than naught, to set man against man in His name. COVID shuttered cinema halls, modern-day malls and multiplexes- the Meccas of the so-called new-gen. COVID clamped brakes on celebrations. On festivals, on extravagance at weddings, baptisms and birthday parties. Those paled in the sheer terror the unbridled virus unleashed in terms of death and infection-mortality and morbidity as men and women in white coats refer to. Just as I am writing this, the world has lost 524,751 from among the 11,017,084 infected. India lost18, 213 from 626000 infected, while Kerala lost 25 from the 4,753 infected. More than ‘COVID’ being heard all-around like thunder peals during summer rain, what’s unnerving is the magnitude of the trail of death and disease it continues to leave behind its disastrous trail. Men and women in the white coat have been buried under statistics that appear demoniac. Worse still, they have drowned in unsubstantiated jargon, claims of having developed a vaccine, and effective drugs spewed from social media the wheels of which have been turning overtime since late December of 2019, when the virus first débuted in China’s Wuhan. Many drugs have participated in the catwalk; Hydroxychloroquine, vitamins C,D, Zinc, Aspirin, heparin, clopidrogel, dexamethasone,Favipiravir, Remdesivir, early oxygen therapy, prone ventilatiom and Convalescent Plasma Therapy. In India, cow dung, cow urine and Patanjali’s ‘Coronil’ too has joined the queue, but none has been crowned clear winner.
None has secured the crown. A distinct game changer is missing in the crowd. More sordid is the emergence of an effective vaccine. Right now, nations are inching forward to touch the ribbon in the race to develop a vaccine. Will there be a clear winner? Or will it be a photo finish? Even if there’s a winner, will it prove its efficacy against a virus known for its propensity to mutate? Will we have credible answers to these questions that seem difficult? Until then, as shouts of ‘COVID’, ‘COVID’, ‘COVID’, echo about us, it is likes of the patient I had mentioned earlier that will repose semblance of sanity in me, as a healthcare provider, though it will be tough for his family.