Up close and personal with death: my two weeks working in a Covid ward

I am an ear, nose and throat surgeon at Groote Schuur Hospital in Cape Town, and since specialising in 2009 I have only worked with a certain part of the body, seen little blood and even less death. I work in a tertiary hospital and, when the second wave hit the province I live in, we were asked to help out in the medical wards. I was very scared, because I was not sure if I could remember anything about normal medicine and worried that I could be more of a risk to the patients than a help. Of course, I was also concerned about getting Covid-19 myself. 

During the two weeks I spent in a Covid ward assisting the junior and senior physicians on call, this is what struck me the most: Covid-19 is a very lonely disease. As hospitals are closed for visitors, patients never see any family or friends while they are in hospital. Many of the patients I treated did not have enough data or airtime to phone their family regularly, so they had to rely on the nurses and doctors through whom messages are sent. They are also dependent on us to feed them information about the outside world. They yearn for the short messages we receive from their families.

Every morning when I walk into the ward I try to be positive, only to see two to three empty beds.

Imagine not having contact with anyone while you are not able to breathe and you are not sure if you are going to be able to fight this virus while you know people like you, that is, with comorbidities, often do not make it. Birthdays and celebrations are often forgotten while they lie there. As doctors we look at their oxygen saturation levels, not the date of birth.

I worked in the high-care unit where patients received high-flow nasal oxygen. Should they deteriorate, the next step is intubation and being put on a ventilator in ICU. However, for a patient to be able to tolerate a tube in their throat, they have to to be sedated. Of course, we would explain this to the patient and their family. We always tried our best to let them make one last video call – often with our own cellphones – just so they could say what they needed to before they were sedated and sent to ICU. The patient and their family would realise things had deteriorated badly.

Often we had to hold the phone for the patient, as they were too tired to even do that. We had to be witness, while crouching next to them, of the most personal and raw emotional conversations. I cried most of the time.

This is a disease that affects families and friends, as it spreads to the people the patient was in contact with. So often more than one member of a family would be admitted, often in different wards or even different hospitals. Imagine knowing a family member or friend is sick, but you do not know how they are doing.

Or imagine how nurses and doctors must feel when they have to break the news of a death in the family to a patient. One of my patients told me her Downs syndrome son – who was her constant companion – had died just two weeks before of Covid. How do you tell a patient like that to not to lose faith?

Every morning when I walk into the ward I try to be positive, only to see two to three empty beds. These beds are not empty because the patients got better. Some nurses and doctors like me chose certain career paths within medicine where we would seldom have to deal with death, but now we are confronted with it every day. I often wonder, how do the physicians and anaesthetists who have been at the forefront of the fight against Covid-19 since March not lose hope?

Imagine being one of the patients in our ward where you are constantly exposed to curtains suddenly being drawn around a bed and doctors running around. Then you know someone like you had just lost the fight. Thankfully, we have an amazing support structure at our hospitals and the psychiatrists check on the patients every day. But as a doctor it is difficult to remain positive.

I know those empty beds will be filled again tomorrow, but I try to remain hopeful. Perhaps tomorrow will be a better day.

Dr Estie Meyer is an ear, nose and throat doctor. She has worked at Groote Schuur hospital since 2009 specialising in ear surgery, balancing issues and salivary gland pathology.