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The danger persists. The contagion has won.

Rizwana Khan, MD
Conditions
August 21, 2021
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A subtle vibration permeates the still air, a thumping that melds with our heartbeat. The drumbeat becomes constant, louder, deafening, echoing the chaos around us.

The sounds initially emanate from a far-off land. There is news of a contagion. There are images of bodies in hospital wards, health care workers in full-body protective suits. Some health care workers release clandestine videos on social media. Are they whistleblowers? They disappear from their social media feeds before we can heed their warnings. Did they succumb to the virus? Or were they silenced?

The sounds grow louder and closer, now emanating from neighboring lands. Images of naked bodies on hospital beds stacked close together, in crowded hospital wards. Bodies lying on their bellies, faces obscured by tubes and lines, bodies sitting up in bed, with hoods over their heads, faces fatigued by the effort of breathing. Bed after bed, crammed with bodies, in close proximity, health care workers ministering to them in the now-familiar protective armor. Bodies with terror contorting their faces, health care workers’ expressions mirroring their horror.

As the sounds become deafening, we witness bodies pile up in our own hospitals, and beds become short. There is an effort to allay our fears. We are coddled with cookies and cakes and platitudes of heroism. We are admonished and instructed not to wear masks unless in the proximity of the bodies.

We are reprimanded when we say, “We have families too and want to protect them.” We are ordered to recycle N95 masks. We keep our precious cargo of one mask per day, per week, per month in paper baggies.

We label the baggies with our names, and we carry them with us all day and all night, everywhere we go. We cannot afford to misplace them. Some of us defy the “rules” or speak out, only to get fired. Some of us settle for pay cuts. Some struggle to find jobs. Some are funneled into areas beyond our expertise. Some of us adapt to changing times with telehealth.

We flock to social media. We create groups to disseminate and share information. We scramble to read every night. We try new medicines that show promise in theory, but in practice, prove to be harmful. We struggle to keep up. We are failing. We are flailing.

Our families become isolated. We want to protect them from contagion. We don’t hug them. We don’t share their bed. Some of us move out to keep them safe. We do it for them. Yet, what should make us stronger makes us weaker. We succumb to depression. We drink to excess to numb the pain as we lie alone night after night counting the bodies in our heads. Some of us give in, we end it, and there is peace.

Some of us go on. We suit up and enter the rooms with the bodies. Some bodies can talk, and they beg for life. They plead with their eyes, with their hands. with their words. We say we will do “everything we can” as we silence them into induced comas to aid the ventilator function. They never awaken. They lie alone, for days, for weeks, sometimes months. We hold their hands, rub their shoulders, whisper encouraging nothings in their ears. We really do want them to live, wake up and breathe. But they cannot. They die, eventually, inevitably, and they are alone.

Their families are isolated, as are ours. They cannot visit. They have to make do with FaceTime calls. They hang onto our words, which are few and far between. We just cannot find the time to call them every day. We rely on nurses to provide updates to the families, the message often getting lost in translation. We turn to palliative care services. They have ramped up their staffing severalfold. They struggle as well since they are also overwhelmed with the sheer volume of the bodies in need.

We steel ourselves when the “code blue” alarm summons us to the dying bodies. We perform CPR, and we feel the crunch of bones breaking. We witness blood oozing from their mouths. We see their eyes wide open, their pupils black, dilated, soulless. We pump and zap and pray for the bodies and for ourselves. We know this is all for naught. Yet we do it anyway, to appease the family that cannot witness this gruesome charade. They cannot say goodbye. They cannot get closure. We risk our lives as the contagion is super aerosolized with our futile efforts. We pronounce the “time of death” four, five, six, sometimes more times a day.

We know this will happen again tomorrow.

We call, and we sympathize with the families who have not seen the bodies for days, weeks, months. They cannot envision, imagine, comprehend the horrors they have endured. And because they cannot see, they cannot let them go. And thus, we prolong suffering, torturing the bodies till their last breaths, breaking their bones and our own spirits with the effort.

As we console others, we try not to think about our own colleagues who have fallen in the line of duty. We cannot mourn them yet. It is too hard. If we allow ourselves to feel, we will never return from that bottomless pit of despair. We bury the pain. We will unlock that box some other day.

We hear about a “vaccine.” We are happy. We are relieved. We gather again on social media and post giddy pictures of needles in arms. We share the news with others and are shocked at the response. They don’t “trust” it. It was “rushed.” I will wait and see how it works for others.

We go on. We bear witness. We pray. We wear our armor day after day as we minister to the bodies. We watch the numbers decline, but we still hear the drumbeat, a little softer but ever-present, in the background. The danger persists. The contagion has won.

Rizwana Khan is a pulmonary and critical care physician and can be reached at DrKhanMDOnCall.

Image credit: Shutterstock.com

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