There’s something humbling about two grown-ass doctors lost in a maze.
If we're going to use war analogies for the covid pandemic, we have to remember what happened after the war too (Poster from the Transport for London Museum.)
I met my friend A. on the tropical medicine course I did in London back in 2014. We bonded over being pre-trainees for O&G and hung on every pregnancy specific fact of the diseases we were learning about (like malaria not showing up on blood tests of pregnant woman, or at least falsely low levels, because the parasites cluster within the placenta). She has been working in StThomas and commuting from her home in Kent (90min by train) so when she agreed to meet on her only day off in the week, we agreed to meet in Kent rather than her having to come up to the city yet again.
We had delicious food in West Malling - half the menu wasn’t available- due to supply chain issues. Covid? Brexit? Who needs ginger beer anyway… and caught up.
I wish I could remember all the details, or that it wouldn’t be weird to interview and record a friend. She talked of her time before training, when she did a stint in South Africa - later mentioning that part of the rationale was to get a break from the racism of the NHS. She talked of her afrikaaner friend who went to the Netherlands to find her roots and found herself disjointed- “im not Dutch, im African, what do i do?”
She was passionate about hope despite violence and spoke of many political winds I'm completely ignorant of. “I can’t believe Swaziland's burning, can you?”
She described; pre-Covid, a driving commute that would knock out 3-4hrs of her day, everyday, of sleeping in the hospital on long days, of feeling persistently behind. And then of Covid, when at the start, the regs gathered to say goodbye to eachother before splitting into the Covid roster, because they believed that some of them were about to die. Their clinical leads and supervisors had advised them they might die.
And in late March 2020; Of popping her head in to see a pregnant woman in ICU, in full PPE, for less than 2 minutes, as she realised once in, that the woman had already been seen. She was careful, didn't linger, doffed her PPE properly. But then getting sick at home- unable to move from the lounge but for water, paracetamol and peeing, for 6 days. She lives alone. Her family is tight. Her brother would call every morning at 8 to make sure she could answer the phone. He is an engineer, and was reading about patterns of the disease online “Hey A; today you are at higher risk of developing pneumonia- do you think you have pneumonia?”She can’t really recall it all- vaguely recalls full body pain and possibly a cough? but mainly the overwhelming immovable fatigue.
At one point there were rumours flying around the whatsapp groups of other hospitals that one of them had indeed died. They hadn’t. (They’re all okay.)
She was back into full shifts after a couple of weeks. Later, when she stopped having periods; her supervisor suggested she use a mindfulness app. A. was grateful that her GP instead suggested an MRI after her blood tests were found to be wonky. (To clarify, not caused by the virus, but a common physiological response to sustained severe stress).
I asked how she felt about having 1/13 millionth of a Georges Cross. She deferred, citing a friend from Malta who was excited that she now had two; as the whole country of Malta had been awarded one for withstanding a siege from 1940 to 1942.
We recalled (stupidly) how much we had longed to be a part of some big pandemic event when we were on that 2014 course. We had all imagined, with our new knowledge, we would do better than health professionals had in the past with HIV (for example). Ebola took off just as we finished that course. We ate our words then for wishing such badness. We ate our words again now for what is here.
“It makes me so angry that it was accepted from the outset as inevitable that it was going to be so bad. It didn’t have to be so bad. Even at the start we knew things we could do: and we knew we would learn. It was like they told us to roll over and let it come.” (they, in this case, were the infectious diseases team)
“But this is our HIV”, she continued “we ignored the spread of it because it affected people that were different from us (“the gays”/China), we (the British) ignored health advice from other countries because we thought we were better (CDC/lockdown), people were reluctant to use protection because they didn’t like how it feels or we thought it didn’t do much good anyway (condoms/masks), and when finally we have a solution to it, we are slow to roll it out, prioritising rich nations get it to start with, even though it’s clear looking after poorer nations equally will resolve everything much sooner (antiretrovirals/vaccine), and when it comes back, we shame and blame the people it comes from (resistant mutation/variants)”
She described the fury she felt once when she was called to a lady bleeding to death in ED, one who was assumed to be undocumented/refugee/illegal. “They called the foreign office before they called me, a doctor. How could they do that to her?”
“Did she survive?”
“Yes”
“Was she undocumented?”
“No.
She was a resident. But even if she wasn’t, how have we got to this way of being?”
I had finished eating, but her lunch remained, cooling but still tasty, apparently, she talked at length, at some points waving her fork for emphasis.
“We were so quick to say people in the past must have known when something big and horrific was going on and should have done something. And they did know, at least some of them. but so do we.
Like the idea that RNLI are supposed to leave people to drown in the water. At the core of that is the idea that somehow some people are worth less, less deserving.
Yes there are problems, but since when have we really accepted that letting people die is the solution? We're smarter than this. We need to ask better questions.”
“But what can we actually do?”
“I wrote to my MP- I know it doesn’t seem that much but it at least holds them to account. If nothing changes, at least people in the future know we knew what was wrong, was wrong.
People try to get to the UK because they think that it’s less racist. Shouldn’t we be proud of that at some level rather than afraid of it?”
We drove from West Malling down to Leeds Castle "The Loveliest Castle in the World" and it struck me how close we were to Dover, and the tunnel to France. “The road is so quiet now”, she said. She had bought a flat where she did a couple of years ago with the hopes of popping over to France for the weekend now and again. “Maybe soon.”
We had talked so long the actual castle was shut, but we made our way around the grounds; avoiding the admittedly scary clusters of geese and scoped out the gardens: including a maze.
We ambled around it, still talking, and found ourselves in a loop, overtaken by more attentive kids and families who made it to the tower in the middle and waved down at us as we approached a familiar turning point again. I can’t tell if we were over- or under- thinking it, or just walking too slow; but we got out in the end.
She finishes her rotation in the next few weeks and will be working at a hospital within 10min drive of her house. I’m hoping this is the start of a sustained, meaningful, recovery.
(Link to divided book and blog, and borders and belonging book)
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