Battling daily on the Covid-19 front line

Spending years at medical school prepares doctors to deal with the worst situations – but nothing compares to Covid-19.

With cases continuing to surge, for Steve Biko Academic Hospital specialist emergency physician Dr Vidya Lalloo,
taking care of patients likely to die has become a traumatic daily routine.

Having graduated from the University of Pretoria (UP) in 2006, Lalloo, who has passion for emergency medicine, teaching and point-of-care ultrasound, found life at medical school different to real life.

“You come to the hospital environment definitely unprepared. When I was at medical school, I imagined myself
calmly sitting in a [general practitioner’s] office, seeing one patient at a time and not being in this high-pressure environment.

“Going into emergency medicine, where you are always under pressure with many patients to deal with at the same time, is very different.

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“Here, you have to multitask – facing challenges of dealing with trauma and medical patients – all needing your attention. Emergency medicine teaches you to learn adaptability and to deal with many things at one time.

“In the context of the pandemic, emergency medicine is dealing with it a lot better than the other specialties, because we are used to this chaotic and changing environment. We are used to a quick change and adapting to new protocols.”

Steve Biko Academic Hospital has, since December, been among the country’s medical facilities battling to cope with the influx of Covid-19 patients, with some referred from neighbouring provinces due to lack of space.

Dr Vidya Lalloo at the Steve Biko Academic hospital in Pretoria, 26 January 2021. Picture: Neil McCartney

Being an emergency specialist puts Lalloo at the coalface of the pandemic. She described her experience as “quite
traumatic”.

“People who are usually very happy coming to work are daily reduced to tears because of the exhaustion and emotion.

“Within a short period of time we have seen so many deaths – traumatic for patients’ families and healthcare workers,” said Lalloo.

Doctors at the hospital have had to “do a lot to compensate for each other by doing extra shifts and working longer hours”.

“Every time somebody is off with Covid-19, we’ve had to come in,” said Lalloo.

Despite the pressure, emergency doctors have shown resilience and perseverance. “They have come to the party by putting in that extra effort, but it is taking a toll on us.

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“We normally do longer hours on weekends – a 10-hour shift on weekends. It used to be eight hours during the week, but because we are short-staffed, we are increasing hours.

“What we are doing is more than 12 hours, staying later than what we should and coming in earlier.”

Among her many traumatic experiences, Lalloo related the story of a 42-year-old man who was put on oxygen in the hospital’s waiting area, while awaiting his Covid-19 results.

“This happened to a friend of mine, who was attending to a patient under investigation – not yet diagnosed with Covid-19. The patient grabbed her arm and looked at her, telling the doctor he needed a ventilator and was going to die.

“Before she could find a ventilator, he died. Imagine a young man pleading with you and dying – oxygen not being enough.

“Before you can do anything about it, he dies and resuscitation is not helping. Although you do not know him much as a new patient, you think about the impact on his family. Imagine a life disrupted.”

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She also recalled the day a colleague called to say her granny was on the way.

“It did not sound like a Covid-19 case because she had different complications.

“When my colleague’s granny got to us, she was already dead in the car. There are a few that already arrived a the hospital dead – something not uncommon because we see about five a week.

“For me, this was the worst because I know the family and the colleague. It was crazy, because it sounded like she had a problem with a hip and the next thing she dies of Covid-19. Two days later we got the results, which confirmed it was Covid-19.”

Dr Vidya Lalloo at the Steve Biko Academic hospital in Pretoria, 26 January 2021. Picture: Neil McCartney

How does she deal with harrowing incidents on a daily basis?

“As a front-line doctor you get used not to personalising things because there are many patients and many people dying.

“You create that barrier and treat patients as numbers. The only way to cope with the trauma is to be distant in treating patients.”

Working at Steve Biko has had its challenges.

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“We have had to ventilate people with oxygen cylinders taller than I am, which is not ideal. Ideally, we want wards to have wall oxygen, but there are many patients and all the points have been used up.

“Those ventilators run out so quickly – within an hour or two you have to change cylinders. Suddenly, the tank is empty without giving you a warning and the patient is struggling to breathe and you have to run.”

Being a medical doctor and married mother of two has also meant being extra careful at home.

“If they get sick, you are definitely to blame – something you have to live with.”

– brians@citizen.co.za

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