A Pandemic Year for Women: Notes on negotiating the coronavirus crisis as a healthcare worker

This essay is from our International Women’s Day 2021 series, about women who rose to the challenges of being mothers, artists, professionals, students, and above all — individuals trying to make their way through an unprecedented time — over this pandemic year.

Skanda March 08, 2021 10:05:55 IST
A Pandemic Year for Women: Notes on negotiating the coronavirus crisis as a healthcare worker

Illustration ©Adrija Ghosh for Firstpost

EDITOR’S NOTE: A UN report from September 2020 on the economic toll of COVID-19 on women, notes that “the impacts of crises are never gender-neutral”. The report delves into the many ways women have been disproportionately affected, financially, by the ongoing pandemic: For instance, industries that predominantly employ women have been worst-affected; women’s paid labour and women-run businesses are hardest hit, and the gender poverty gap is projected to widen.

The impacts of the crisis, however, go far beyond the economic. News stories and surveys have looked at how women are bearing the brunt of childcare and household chores while they work full-time remotely. Isolation and confinement have meant that cases of violence against women are on the rise.

While the coronavirus pandemic and resultant lockdowns have been especially hard on women, there are also many stories of resilience, courage and hope that have emerged in these times.

On International Women's Day 2021, we’re launching a series called ‘A Pandemic Year for Women’. These essays have been written by women with varying experiences of the past year, who rose to the challenges of being mothers, artists, healthcare workers, community outreach professionals and entrepreneurs, students, and above all — individuals trying to make their way through an unprecedented time.

These first-hand accounts do not look away from the costs of the crisis, but they look beyond too: to the future, to what is possible, to what still remains to be (and must be) done.

Read the essays here on Firstpost, in ‘A Pandemic Year for Women’.

***

When I try to think about the past year — and I try not to, unless I absolutely have to — I’m faced with a wall of blankness. This wall has been a familiar spectre in my life, having spent the entirety of my adult years in a haze of depression and antidepressants. Every time I come out of a depressive episode, I’ve forgotten who I was before — so many selves left behind, like shed carapaces whose patterns I no longer remember.

I have often wondered what could be the reason behind it: was it a protective mechanism by a brain that was drowning in a glut of negative stimuli?

I wonder if we only remember the things we form a narrative about. In the face of overwhelming odds, when thinking about your material conditions could be debilitating, you simply stop making a narrative about your present reality to your own self. You go to work, go through the motions of the day, come back home, drown out the noise in the latest distraction, hope for some sleep, get back up and keep going the next day because forming a narrative, making sense of what you are living through, isn’t a luxury you can afford at this moment. It can’t hit you, not now; you cannot take days off because you are not given the option of taking days off. I think some part of your brain senses this, and stays clear of thinking too much (or at all) about your reality that has suddenly turned incomprehensible.

The similarities between living through a depressive episode, and negotiating the pandemic as a healthcare worker, are almost laughable in their banality. But it does serve to try, remember, and set in words. So I will try to remember what I can of the seemingly endless hours in my COVID-shift, even if I unsettle myself a little in the process.

***

I remember Gopal (name changed). Gopal was 35, healthy as anyone could be. Gopal had COVID, and the day I started my first shift in a COVID ICU was his second day there. Up until then, I had been working in the COVID wards which housed relatively less sick patients, and since this was the early stage of the pandemic, even asymptomatic but high-risk ones. We had decided, in our collective exhaustion and defiance, that surgical gowns + N95 masks + goggles were sufficient protection in these wards, since we would not be performing aerosol-generating procedures here.

But someone in the roster-making machine must have decided I was qualified (?) to work in the ICUs now, and there I was, suited up in full PPE, sweating and fighting the itch to breathe, to just breathe or move normally for a second, through the layers that felt like lead. Once donned, I could not doff for another three hours at the very least. Clamour from the ventilator that was connected to Gopal was a constant presence that week in the ICU. He was not yet intubated, but needed a stronger mode of ventilatory support than what an oxygen mask could provide.

All day, it seemed, we kept dialling up the rate and concentration of oxygen that was being delivered to him, and he kept decompensating. The exhaustion was writ plainly on his face; the sheer struggle of trying to get enough air into his lungs. Bosses at the ICU were reluctant to intubate him — partly because, in that ICU, no COVID patient who had been intubated thus far had survived, and partly because intubating him would mean sedating him and rendering him unconscious, for who knew how long. Gopal wanted to fight; that much was obvious.

Again, these were still the early days of the pandemic and we were putting together treatment plans based on anecdotal evidence. These were also the glory days of Remdesivir, many months before it would go the way of Hydroxychloroquine. Sicker patients like Gopal received Remdesivir then, if they were willing. It had to be bought by the patient’s attenders — of course, pharmacies ran rackets around this — and before prescribing it, we were to tell them in no uncertain terms that this was an experimental drug that may or may not save the lives of their loved ones. It was an off chance that would cost them a minimum of Rs 30,000. Gopal wasn’t well off. He was what we’d call “not affordable” in hospital parlance. But before I could finish explaining the possibilities to his wife, she clutched at me sobbing, and told me that they would do absolutely anything if it meant giving him the slightest chance of survival. He had two young children at home, she said. Won’t I somehow save him?

This is a moment that recurs with unflinching regularity in a doctor’s life. I don’t know how it is for others, but I always dissociate a little when this happens. Faced with the pain and desperation of another human who believes in your ability to effect a magical cure, all I can think about is my powerlessness against an enemy I barely know, and the futility of my efforts against it: something that’s always running in the background, but never as acutely as in these moments.

What would I give to be able to reassure them! To just say, “Don’t worry, your husband will be fine.” But I cannot, and should not. In such moments, I try to offer them what little certainties I do have. That we all are doing our best to care for their loved one. That some patients have been on this brink and survived. Many a time, I invoke a God above that I do not believe in. But it isn’t really about what I believe in, is it? If it gives them hope and comfort and something to cling on to, how does it matter if it’s real or not?

This story has a happy ending. I do not know how Gopal’s family managed to arrange for the Remdesivir vials; they’d procured them before my shift ended. Gopal fought alongside us. After days of teetering between hope and despair, he was shifted out to the normal ward before the end of that week.

His story is remarkable because no other patient made it out of that COVID ICU that week. Every day when I arrived for my shift, there would be unfamiliar patient names on the board, the previous occupants of those beds having died in that interval. For those who were alive, it was mostly a waiting game of sorts before they died as well. I remember breaking down after my shift, on the first or second day of that ICU rotation. People dying was not something that fazed me too much — that is more or less par for the course when you’re a doctor, I think. But the level of utter hopelessness that pervaded the COVID ICU is something I cannot forget, even after all these months.

Perhaps that is why I held on to Gopal’s story, as a talisman of sorts, as I navigated being a resident doctor in a pandemic. I was Sisyphus on a hamster wheel. We still had to write a thesis and submit it. We would still have exams. We did our rotations in the COVID wards, went back and continued slogging in our regular wards. I managed to get my back broken. Heart broken. Quarantined. Isolated. Learned to bake. Gaslit constantly by the government and superiors. Put on more meds because my brain wasn’t having it.

Everything had changed, yet nothing had.

***

Author's name withheld to protect identity.

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