A tweet from a doctor in Australia, @seemathewombat says: “I’m a Dr. I’m about to separate from my family within my home for ?? months. So that I can keeping treating you, whilst trying to keep my family safe. It hurts. No hugs from my girls, no cuddles from my partner. PLS socially distance NOW, to make my sacrifice worth it.”
While such precautions for doctors are still in the planning stages in India, we asked medical professionals what goes through their minds when a pandemic is declared and they are at the forefront of testing and caring. How do their partners react?
Vaccination healthcare concept. Vector flat people illustration. Family and hero doctor with shield, vaccine syringe on white. Design element for medicine banner, poster, background, web, infographic.
Dr Adarsh Pratap, president of the Resident Doctors Association at AIIMS, Delhi, positioned at Emergency, says it is the reason they signed up for the profession. His mother, who is over 60 and lives in Etawah, Uttar Pradesh, is worried, but “I tell her it’s like being in the Army in times of war. Ye to karna hi hai (This has to be done).”
Dr R Sajith Kumar, Professor and Head of Department of Infectious Diseases, Government Medical College, Kottayam, is a part of the Corona Clinical Management team for Kerala. He now treats four people in the isolation ward of the hospital. He says that his time at work is unpredictable. “It depends on the condition of my patients. After the Corona pandemic, there are days I have gone home at midnight. But that does not mean that I am not working when I am not in the hospital. I get calls from my juniors asking doubts or to update me on the condition of my patients.”
He is not worried that his interactions with the patients can put him or his family at risk. “I work with infectious patients everyday and I always make sure that I take enough precautions. My wife is also a doctor and so she understands,” he says.
Doctor Do-a-lot
In Madurai, Praveena Manimuthu, who has been married to Dr Prabhakaran Rathinam for 15 years, is worried though. Her husband is Professor and Head of the Department of Respiratory Medicine at Madurai Medical College and Government Rajaji Hospital, and while there are no cases yet in the city (at the time of going to press), it’s the tension of waiting that takes its toll. “I am not anxious that he will bring infection home, but I certainly worry about his health,” she says.
She has made him a small kit containing dry and wet tissues, a bottle of sanitiser, and a small bar of soap, to keep in his car. Even on regular working days, he is away from 7.30 am to 11 pm. “I keep reminding him his health is most important to all of us and get our kids (12 and seven) to speak to him at least once during the day over the phone,” says Praveena, who runs the household single-handedly.
She says she stopped complaining after one particular night emergency. “I heard him take a post-midnight call and say that he’d be at the hospital immediately. I lost my cool and asked why somebody else couldn’t be on call. He told me my father was admitted in the ICU. That moment I realised the importance of all patients in a doctor’s life.”
Another partner, Dr Sujatha Sangumani, says it is easier for doctors to relate to the fear during an epidemic, given that they understand the spread better. As the wife of Dr J Sangumani, Dean of Madurai Medical College & Government Rajaji Hospital, the gynaecologist is matter-of-fact about work. “We habitually wear masks and are constantly washing our hands after examining every patient. Unless we ourselves are convinced that these precautions work, how will we convince patients?”
Ethical considerations
Doctors on their part are conscious of health and hygiene at home, and also of keeping their own immunity up with supplements at times like this. “I share the common area with my family, so I make sure that I am not passing any potential infection on by touch. Hand hygiene is the most important. My clothes are washed separately and put into the washer immediately as soon as I’m home,” says Dr Om Shrivatsav, Unit Head, Kasturba Hospital for Communicable Diseases. He says at times like these he does put some physical distance between himself and family members, until such time that he is sure he is not carrying any infection. “This will require effort, but has to be done. If you say everything is fine, I am just going to be getting on with my life as if nothing will happen, then you are setting yourself up for an infection.”
An article in the European Respiratory Journal talks of high-risk emergency situations, where “the doctor is subject to a number of competing duties: 1) a duty to patients; 2) a duty to protect oneself from undue risk of harm; 3) a duty to one’s family; 4) a duty to colleagues whose workloads and risk of harm will increase in one’s absence; and 5) a duty to society.”
That’s a great deal of pressure, but Dr Pratap says doctors keep conversations professional, talking about how to contain the virus if it turns from contact to community transmission.
“We keep thinking of innovations,” he says, adding that AIIMS is now producing their own masks and sanitisers. A few days ago though, the doctors did ask the AIIMS management for better personal protection equipment (PPE).
Despite the concerns, Dr Shrivastav says, “The satisfying part of our professional duty is that we are in a position to make a difference. We must embrace that.”
With inputs from Susan Joe Philip, Soma Basu and Sweta Akundi
