Pandemic Diary #2: Doctor, USA

Second entry in the series

Could you tell us how COVID19 started in America?

From the news, it started from the city of Wuhan in China and was reported back in December 2019. We did not get the information here in the United States until the end of February. Although our government knew about it, they did nothing. The first case in my hospital was discovered the first week of March; the patient I admitted from the emergency room.

How does it feel to face the risk attached to COVID19 every day?

The risk is there and it is very scary. Right from the moment I admitted the patient who had had symptoms for about ten days. He was a school teacher who taught in two schools. He had pains, difficulty breathing and dry cough. I admitted him the third day when his fever didn’t subside, one of my colleagues decided to test him for COVID19.  Thank God I had my mask and my gloves on when I saw him at the emergency room. 

It was very scary because this was the first patient at my hospital. Due to this, I was told to stay home. That day, everyone kept on calling, my children were frightened.  I eventually didn’t develop symptoms. Regardless, we still have to see the patients and protect ourselves. However, the background anxiety and the reality of the situation is there. 

How does this affect your mental health?

Right. The first week when we had a lot of cases in my hospital, it wasn’t easy. I’m in a group of physicians and we are about ten in my group. Everyone kind of broke down in tears. People were crying all around, the day I actually cried was the day I had about 11 patients. Having to constantly change, this and that, about ten times. My head was hurting, I came down to my office and broke down in tears. My colleagues were all there and at this point, we all agreed this had to stop. Unfortunately, it has not.

To help ourselves, one of my colleagues brought in a 10-minute meditation tool to relax. We all sat in the office, put the lights off and listened; we did that continuously for three days. At this point, we just joke about it in the office because we can’t avoid the situation. So, I honestly don’t think I am affected now. I have a lot of friends who I open up to and who pray for me. I release a lot of tension by talking to my friends. That kind of helps.

What’s the typical day like working with a COVID19 Patient?

Hmm. Firstly, we have designed a protocol at my hospital. Instead of going into the room with the patient, we use a telephone. I call their room, introduce myself and give them their results.  If positive, I ask about their current symptoms. If the patient has had any CT scan done, I explain what their oxygen levels are like. I then give them the opportunity to ask any questions on the forum. After, I inform the patient that I will be coming into their room to examine them and that I would not be asking any questions in the room, as it is highly infectious.  When I go into the room, I do all the necessary examinations and between a minute or two, I’m out. That’s for a typical patient.      

How has your personal life been affected?

Well as a physician, I’m passionate about the wellbeing of my patients. It is my priority most of the time. It really affects me when I see my patients not getting better and still having to transfer them to the ICU, especially the young ones. When I come home, I think about it and I follow them on the computer to see how they are doing. Like I said, because I have so many friends that are doctors, I kind of let out my anxiety through my medical school forum and I have a lot of friendsand relatives that keep on praying and calling me to make sure that I keep safe. At the same time, I pray for my patients, just to make sure that they are okay. So far, I have not had any deaths on my list.

Do you think America has done a good job so far?

The news that you guys see over there is the international news. Over here, we get first-hand information from other news channels asides CNN.  The President originally made it political rather than listen to the scientists. Due to this, it took the government a while to believe that this was real. Initially, the government promised that the number of cases will be very low, about 15 cases and after two weeks, it should go away. The President actually mocked the Governor of Washington state, which was where the first case was recorded. 

The Governor acted swiftly on the case, as a result, he was mocked by the President of America. The President said that he was trying to gain the attention of the media and referred to him as a snake. Due to these, the government was not prepared for the tsunami attack of the virus. When it started spreading to other states, nothing was done about it till about the middle of March or something. Many people had died at this point in New York. 

The government’s response caused the majority of the lives that were lost. The President didn’t call a national shutdown, but it was done state by state. Most of the republican states did not call for a lockdown, this was because they were following the President. News stations like Fox news are largely republican and the President and other republicans speak through Fox News. Hence, most of their listeners are old, Caucasian men who do not listen to any other news besides Fox News. The result of this was a large exposure because they initially assumed it was fake news.

Many were affected because they did not stay home. As we can see, they’re getting the aftereffect of not staying home. In the next two weeks, the President will most likely call off the lock-down. There are a lot of asymptomatic patients moving around who will be the next wave of people that will be seen in America if the lockdown is called off. 

Even though many people are dying, he’s still saying that it’s better for 240,000 people to die than 2 million. If any of them were to be affected, they would be given utmost care whereas the majority of people who are affected here are really the African Americans. Those who their socio-economic class is low. They live in poverty, are uneducated, obese and usually have diabetes, hypertension, cholesterol, heart problems, etc.  They really do not have the right kind of immunity. They are dying in thousands every day. The government has obviously not done a good job.

From another angle, the so-called African-Americans who are born here usually don’t have access to good health care due to educational status. Although the republican government has tried to remove so many subsidies away that makes life easier, they still largely depend on the government for assistance. This is one of the reasons it spreads fast among them. 

For example, an African American died of Corona so a funeral was organised in honour of the deceased. More than a quarter of the people that attended the funeral tested positive to COVID19. The funeral director and about four siblings of the deceased died.  I picked up one of the family members that attended this funeral and he informed me that he was still being tested.  By the time I arrived home that day, he had been moved into ICU.

Your advice to the common man 

We should listen to all the scientists talking on the radio and on the television. One, hand washing is very important. We must wash our hands for about 20 seconds, the back of the hands, in between the fingers and the nails should be caught short. This is not the time to have fake nails. Take out the fake nails and wash underneath the nails and all that. 

We should avoid putting our hands on our faces, mouth or the nose because that’s the source of the infection.  If you have to scratch your nose or eyes, you should find a cloth or tissue.

If you can wash your hands like hundred times a day, even if you had any contact with the virus, it would have been washed out. Also, if you have the virus or you develop symptoms like aches and pains, dry cough, runny nose, bad taste in the mouth that progresses to breathing difficulty, then it’s time to go to the health department in your local community. That’s not the time to go to your doctor’s office as this may lead to a wider spread of the virus. 

If tested positive, they can be isolated. However,  it’s going to be difficult for the Nigerian government to quarantine all patients in their homes. This is because people usually live in the face-me-I-face you apartments where there are a lot of people in a home. Hence, it’s better to go where the government is isolating the patients. 

What do you have to say concerning the use of various drugs to ‘cure’ Coronavirus? 

Yeah, these drugs are just being used as a clinical trial.

From the clinical trial being done with some medications, the analysis showed that nearly 14% of recipients were unable to complete the full 14-day experiment primarily due to adverse effects like anorexia, nausea, abdominal discomfort as well as diarrhoea. Some of these drugs have a lot of side effects. It can also prolong the QT level and if not monitored, the patient can develop cardiac arrest. In conclusion, the guideline I recommend is to use these only in the context of a clinical trial; additional clinical trials or prospective outcome registry are needed to conduct research.  There’s no guideline to practice for this new virus. We isolate them, tell them to hydrate themselves and manage their temperature. without giving out medication, the majority of patients will recover and go home. 

Wow. Thank you for your time and this information.

Thank you.

Interviewed by Faridah Bakare, 17th April 2020

Braveheart – for our heroes on World Health Day

This poem celebrates all health care workers on World Health Day 2020, as they put their lives and time with loved ones on the line to keep us healthy. It is hoped that we all recognize the sacrifice and appreciate it by working together with them, following their guidelines, supporting them and help them to help us.

Braveheart

Sacrifice and duty

Passion and diligence

Are the traits that 

Drew me closer 

In an abstract way 

I knew you would face 

Battles and be at great risk

And you would love it

It is intense to support

as you head straight

Into harm’s way

Every day a close shave

Not afraid to catch it as 

You drag back lives from

The hands of death on the wards

and hallway, you give your all

What we have is more

Than gold and strong 

Enough to weather this

Yet I can’t stop the chills

I can not hold you

This space is for my safety

Yet all I want to do 

Is hug you tight

Armed with bravery and the oath

You set forth into danger each day

Leaving me at the window

Dying inside from the terror

  • Oumissa

This poem was recently published in a collection Love Stories in a Pandemic by Folábòmí Àmòó

Download a free copy here.

Trust Your Journey

Mental health is coming into the limelight as a major threat to overall wellbeing for many people. When a celebrity is lost to suicide, it is easy to detach oneself from it. But when it affects someone close to you, it takes the shape of a more vivid reality.

It results in a rollercoaster of emotions. You feel sad about losing them, you feel helpless for not being able to help them.. you may even feel guilty in the terrible case that you may have contributed to their trauma.

Being a young doctor in Nigeria of today is an existence that is tough. The system is not suited to latest standards of care, your career prospects may look bleak, you grapple with exams, and you see your friends moving ahead in life. The mirages of good pay and prestige fritter away before your eyes as you run for cover (in both literal and figurative ways).

In all of this, it is important to have a good support system of both colleagues and mentors who can help navigate the treacherous waters and work together with you to find your way.

A colleague who is an epitome of excellence in her work, studies, leadership, friendship and helping others wrote this message on a forum for colleagues. In the hopes of reaching more people with this lifeline, I asked to share it here. Now, it was directed at a group of young doctors but it’s words can apply to anyone feeling like they are underachieving.

Hi guys, good afternoon. This is random but I thought I should put it out here. I know it might seem like everyone is out on a path, figuring their lives out, getting married, getting fantastic jobs, writing and acing exams and stuff.

I just want to leave a word of encouragement to folks who feel their life is a mess or they have no idea what to do, say post housejob or post NYSC. Somehow, the government planned our lives from primary school to NYSC level and there might be someone here confused about what next.

Please guys, there are always folks around to help. We are a family here and I really like what Leo did some weeks back about appreciating everyone. Perhaps you’ve written IELTS again and again and keep failing, say Writing tasks, or you’re studying for USMLE and you keep forgetting what you’ve read or you lowkey did Primaries and didn’t pass.

Don’t worry, keep pushing, try again and again and again. Weird but I have this belief that if anyone who can pass 300Level Pharmac exam can pass any exam in the world. Perhaps you’re the one person that your whole family looks up to, you hardly saved anything during housejob because of responsibilities here and there and you don’t even have money for exams right now, always remember God’s got you and there’s a time for everything.

I honestly don’t know why this came to my mind this afternoon but please guys, SUICIDE IS NOT AN OPTION.

Have a nice day, fam.”

– Dr. Akudo Umeh

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I really hope this helps someone at least to trust their journey and believe they will surmount all obstacles.

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OumissaInspire

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Lagos, Nigeria

First Do No Harm – by Dr Lawal Abisoye

In work environment bedevilled with heightened stress and sometimes difficult conditions, it is imperative to remind doctors to pay attention to their physical and mental well-being. Dr Lawal Abisoye wrote a piece doing just that below.

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Good morning colleagues, a quick reminder.

We have a noble call, which is the servitude of mankind. Alleviation of sufferings and restoration of health is what we do. This takes a lot from us, physically, mentally, emotionally, morally and even spiritually.

I want to remind us that we are humans, however “super”. Our bodies, spirits and souls need to be looked after.

Eat adequately; have your breakfast, take adequate water, let your kidneys rejoice, take fruits in any and every form, even smoothies, exercise, pace yourself. Don’t stay on a liquid diet, don’t console yourself overtly with junk.

Take time off to rest, our activities call for sacrifices and stretching, not at the expense of your good health; recognize and embrace your limits; after all, you are also human.

We make a lot of withdrawals from our emotional bank. We aren’t numb to the sufferings of our patients, every death takes a piece of us. Give yourself time to grief, talk about it at least to colleagues that understand. Get a psychologist if need be; there’s a limit to bottling up, we all need sanity. Cry if you must, weep in your closet if you have to, you’ve earned it.

Don’t let anyone guilt-trip you into doing beyond what you can; you owe yourself a responsibility to be healthy. The funny thing is that you owe this responsibility to your patients as well.

Have a connection with God our Maker and in whatever belief you ascribe to if you don’t believe there’s a God. Spiritual health is as important and physical.

First do no harm.
Do not run yourself down.
Have a wonderful day and week ahead.

Ecstacy

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Visit Dr Lawal’s Twitter thread

Ace Your Pros – For Syncytium’17

It is close yet it feels like there is so much to read. So much more information to memorize.Some of you are more than ready, confident in the distinctions you will get. Others might still be very jittery.

Whether you are in the former group or the latter, please face this exam with all the valour you have. It is a battle and you are ready. Know that you can win this. Remember that worry ends where faith begins.

The pressure of every year spent in formal education weighs down on all of you right now. But you can overcome it and get that prestigious MB;BS/BDS degree.

Trust your choices, your work and your potential. You can and will succeed. Don’t doubt yourself or your answers starting from tomorrow. If you need last minute help, go get it.

Rest if you can because your predecessors know only too well how every second of sleep suddenly seems like a luxury. The next two weeks will be grueling but think of them as the furnace your ore must be refined by to become gold.

Bear it, endure it and come out the other side victorious. You will be medical doctors, dentists and surgeons of distinction.

I wish you all the very best and can’t wait for your induction into this profession.

Congratulations in advance to the doctors-to-be.

BarakAllah fikum!

OumissaInspire

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