Sorry, Not Sorry | Covid-19

“So, this next consultation will also be done via phone.” Keyboard clacking sounds ensue. Then, “Even I have a 1 in 40 chance of dying.”

I’m mid-sentence making notes: “SCLC — paraneoplastic, LEMS, 40 dying–” Wait, that’s not what I was supposed to write down and wait what did she just say?

It’s March 12th, 2020: a bizarre Thursday with flip-flop weather that switched at a simple glance and the majority of this lung cancer clinic list being done over telephone. The respiratory consultant — a short-haired lady whose mind, I observed, had a certain zippiness that can knock you out for a second — had had her iPhone propped up behind the keyboard since I walked in. She was constantly refreshing worldometer’s Covid-19 statistics, fervently attending to every blaring BBC notification sound, and relapsing into solitary moments of a sighing & head-shaking combo as she checked the respiratory doctors’ WhatsApp group chat.

It was the first thing I asked about; of course it was. I’d walked in already on edge about this Covid-19 situation. I wasn’t feeling anxious up until two weeks beforehand — not when I couldn’t find hand sanitiser in Boots for the third weekend in a row; not when there were rumours swirling around about two confirmed and one suspected case in the trust I was practicing in. Maybe I didn’t want to admit that I had my doubts about not taking this seriously, but heck, I was still scoffing with friends in car-rides about how this was “just the flu 2.0”. It stemmed from this borderline prideful thinking that as future doctors, we have a duty and responsibility to prevent the spread of panic — but in retrospect, the horrendous cost we’re dealing with now is probably caused in part by that excessive downplaying attitude.

Perhaps it hit me hard after realising this wasn’t a blip — that this situation was not wavering. It was a consistent regression from what we knew and what would happen in the form of my Mum sending Line messages everyday in our family group chat (“Buy hand gel” “Keep some in stock” “Wear mask, take from hospital” “Buy Dettol”), a simple search for antiseptic spray and alcoholics wipes for electronic devices on Amazon Prime yielding “Out of stock” messages, the empty aisles of tissue paper and dried pasta — but most importantly, it was how light-heartedly everybody around me was taking it and laughing at those who were anxious. Thus, after much internal resistance, the palatable sense of worry suddenly got through to me because clearly, I wasn’t the only one worried if there were all the stock issues going on.

My concentration fluctuated drastically in the last two weeks before being shuttled off. I still risked clerking patients in the respiratory ward despite it being closed off due to a norovirus outbreak, brilliantly left my water bottle in one of the infected bays, put a cannula dressing on the wrong way in front of a consultant, lost a page filled with haematology notes somewhere in ED. Yeah, I was a bit of a mess — so, I made it a point to get into any respiratory clinic before the weekend, so at least I could hear what an expert in the field had to say. Luckily I was on a respiratory rotation.

“How worried should I be?” I remember asking. “Because I am, but people around me aren’t. So I don’t know if I should be.”

I remember her abruptly swivelling on her chair and looking directly at me. When unquestionable resolute, she replied, “You should be”, before turning back.

The entire clinic was a lot of her abruptly stopping to check something Covid-19-related and me immediately prompting her about it. I’d ask a Covid-19 question out of the blue that would’ve probably been deemed inappropriate manners in another setting, but she always answered without hesitation. After internally battling the two ends of putting on a face for my family to not worry, to getting my own worries immediately deflected by my colleagues, talking to her was…nice. Mildly cathartic, even.

As a sort of final assessment of how serious she felt about Covid 19, I remember saying, “Well, I guess I’ll be canceling my meeting at the library this weekend, do online grocery shopping, and freeze my gym membership.” At this point I wasn’t even sure I’d do those things. But her reaction: an approving nod, and a simple “That sounds very reasonable.”

That sort of cinched it for me, and I felt oddly lighter. It was a huge, ironic relief to meet somebody who felt as anxious (albeit much more knowledgeable and sensible), even more so as a freakin’ respiratory consultant. I felt I could justifiably worry.

Besides the racist floodgates that this pandemic has outrageously opened, looking back, it was a massive conflict in attitude. Me, at the beginning of February, thinking how ridiculous it was to buy a box of masks to send back to my family in Bangkok as per my Mum’s order, embarrassed to see predominantly Asians wearing masks on the street, and healthcare professionals laughing about how this was being blown out of proportion. Then me, experiencing a sudden turn in tide at the end of February, being scoffed at for sanitising my tuff box and my stethoscope, berated at when telling colleagues to “At least wear a mask if you’re coughing”, and being told repeatedly that I’m worrying way too much as people rolled their eyes at me. “Stop contributing to the panic, I’m not going to wear a mask, they don’t even help” to “We’re gonna be fine if we get it anyway, whatever” were common things being said.

It was hard to predict what was going to happen. Fast-forward to present day, numbers have sky-rocketed unbelievably high, healthcare systems are more than exhausted worldwide, and PPE is horrifyingly running out. No one had any way of knowing.

But, why wait? It was unnerving to see my surrounding colleagues blissfully at ease with everything as if life was completely fine, because that was what I was like before my wall ‘crumbled’. It was more unnerving that even after we were told to permanently go home and an official statement was made by Boris Johnson, some people were still going to concerts, clubbing, and traveling for the weekend, like “Oh, maybe I can catch the tail-end of the last bits of freedom”. On a more personal level, I was stunned that yet again, we were all medical students — but hey, we’re all human in the end.

I wholeheartedly agree that panic is bad, and like I said, we had no way of knowing how bad it’d be — but at that point, after a couple serious official statements were made, surely it’d be a bit daft to think you could go on with life normally. Okay, so wait until you get symptoms before deciding to self-isolate. Wait and hold out against wearing a mask because they’re not even that effective until WHO officially says you must. Wait until the number of deaths creeps up until you decide social isolation is convenient for you. But why should we sit tight twiddling fingers until an official statement is released, at which point, things are usually pretty dire?

This conflict in attitude is what made me question myself in those last two weeks. That because I was acting and worrying on my own accord, I was in the wrong. Medical school hasn’t said anything. The news hasn’t said anything about a mask. ScIeNcE hasn’t told me what to do yet!11!! I was using the “but we are medical students!” reasoning both ways — a duty to not spread panic? Yeah, but a duty to prevent the worst-case scenario is just as important. A tricky balance.

That’s something I’ll remember if there is another pandemic of sorts — it’s okay to sensibly worry. You’ll know you crossed the line if you start gulping down Dettol.

©TMK