A Doctor’s Sacrifice- Tribute to our Saviours on National Doctors’ Day
In conversation with Lt. Col. (Dr.) Sunita B.S. and Lt. Col. (Dr.) Virender Singh
By Naisha Khanna
This piece is intended as a tribute to those who have found themselves inextricably entwined with suffering, devastation, and illness for the past one and a half years, with no respite. To those who were entrusted with the responsibility of not just their own life, but multiple lives unknown to them, whose grief became theirs.
The onset of the pandemic transformed life for all of us. But if there is one group of people whose lives were more drastically impacted than the rest, it is Doctors and Healthcare workers. Their experiences since the spread of covid-19 have been marked by unfathomable physical exertion and mental turmoil. Their daily lives were consumed by a constant battle against death and despair. Helplessness often pervaded the space they occupied due to the sheer overwhelming numbers of patients combined with a severe dearth of necessary resources. It is lamentable that their efforts go unrecognized at times, and in the most unfortunate cases, grieving families overcome by guilt feel a misguided sense of anger which manifests itself in cases of violence and brutality. Combating the ravages of Covid-19 has been an unending war of attrition and trying to restore health and normalcy has been an exercise in peacemaking.
Since March of 2021, India has reported more than 2 lakh deaths. During the second wave, the countries health infrastructure was rendered incapacitated. According to The Indian Medical Association (IMA), among the lives lost during the second wave were 776 doctors, who succumbed in the line of defence against the virus. Their sacrifice shall not be forgotten. Their journey and struggles are the defining tales of our times. To honour our veritable saviours and give them a platform, I sought to search for doctors who have been at the Frontline and would be willing to speak with me candidly about all they have endured, and the aspirations it has left them with. I had the privilege to interview two doctors who have been at the intersection of two essential services- they are both army doctors. Lt. Col. (Dr.) Sunita B.S. is an army pathologist and her husband, Lt. Col. (Dr.) Virender Suhag is an army radiation oncologist. They are a married couple based in Pune who have both been on the Covid frontline and I had the privilege to interview them regarding the plight of our medical infrastructure in the fight against the ongoing pandemic.
Both Dr. Sunita and Dr. Virender emphasized how doctors had to essentially forgo their field of expertise and as Dr. Sunita explained, “go back to the basics”. She had to abandon the usual job description of a pathologist and revisit the fundamentals known to any MBBS graduate. “All the specialists had to pool in as normal physicians and had to work to combat this disease,” she said, “otherwise it would have been impossible with the number of physicians that we have. So, I had to relearn all the basics. I had to leave my speciality and do the clinical side of the job.” There was a complete overhaul of the preexisting system. Dr. Virender, a radiation oncologist, described how there was a shift in infrastructure and human resources. They only treated emergency cases concerning their specialities, devoting almost all their time and energy to those with Covid-19.
There was an expansion in the duties of doctors. Dr. Virender explained how doctors had to fulfil administrative duties too, such as “managing flu clinics, controlling crowds, arranging PPE kits, arranging oxygen and procuring lifesaving kits”. “I used to see 5-7 deaths per day at the peak of the Pandemic,” he recalled. The physical toll on doctors increased unprecedentedly, so did the extent of suffering they had to witness. He shared instances as distressing as patients being abandoned in the emergency room by panic-stricken families. Dr. Sunita experienced a complete halt in the previous active lifestyle she had. She adds with mirth that despite this, she has lost weight, a result of the obvious strenuosity of her work. The “mental agony” she had to endure due to constantly witnessing suffering, being virtually helpless when there was a paucity of resources required to save someone and grappling with the threat of contagion from such proximity to patients paints the severity of the situation that doctors were forced to deal with daily. “When you’re seeing patients dying in front of you when you’re not able to do much” that is the amount of mental stress that doctors have been going through this pandemic. She was also among those doctors who were required to shift to a different city for a prolonged period, where the distance from her own family combined with the turmoil ensuing around her played on her mind. The fear in her mind has been persistent, and is still potent, due to the anticipated third wave. “Things might be getting better but we’re aware that the third wave is about to come so we are still really scared.” The experiences of both the doctors clearly state the unimaginable mental and physical distress that our medical infrastructure has dealt with. Despite this, their efforts often go unrecognized, a sentiment she expressed. “When we think about the fact that we don’t get the recognition that we deserve it hurts.”
How does one remain resilient under extreme duress? “That comes with the job,” Dr. Sunita remarked as though it was no extraordinary feat. For her, it is simply a matter of routine, after 25 years of experience in the field. This level of distress is handled with no special remedies. Listening to music, speaking with her husband, thinking of her family, and of her role in society, are how she draws strength to go on. Ordinary remedies we all resort to, for an extraordinary burden we shall never experience. It is indeed a marvel, how they manage their grief and continue to serve our nation. Dr. Virender mentioned the mental and emotional support provided by a cohesive team. “We used to look out for each other, we used to provide each other mental and emotional support, hearing each other’s concerns, holding each other’s hands”. He also spoke about how he is still in touch with his peers from 27 years ago, and how they shared their experiences regularly. It gave them an outlet and a community in whose stories they found a sense of resonance. Religion, for him, was another source of mental peace. He recollects how he found solace in prayer. “I used to pray to God every day to end this Pandemic. Why is humanity suffering so much?” he would ask. Dr. Virender explained the precautions doctors had to take at home to ensure they do not infect their families. They would often cordon off a room or an area at home where they would self-quarantine. “They can’t hug their children. They can’t go close to their elderly parents at all” he lamented. The constantly looming threat of contagion necessitated physical distance- “the fear was always there”. A recovered patient can resort to the comfort of their family’s physical affection, for a doctor, there is no such moment of relief. As long as they work, irrespective of whether they are infected or not, they must practice physical separation. I wonder about the insurmountable mental gulf created by this physical space. To forgo comforting touch and intimacy for that long is bound to be transformative- I use the word devoid of any positive connotation. Dr. Sunita shared how she spent only a month with her daughter in a period of one year. “I can’t shirk the job during these times,” she says. However painful the price may be, she knows it is unavoidable now.
The second wave drove home an unshakeable feeling of defeat, said Dr. Sunita. At times she was made to stop and ask herself “Are you of any use to society? Are you doing your job?”. She shares the vulnerability she felt, and it was heartbreaking to hear. The small triumphs though, where she managed to rescue someone when it seemed they were in the clutches of death, were what gave her a sense of fulfilment and gratification. During the second wave, she says, she has seen very few people going back. Every victory made a massive difference in those times. Dr. Virender shared a heartwarming anecdote about one such moment. A 92-year-old was transferred to his tertiary care unit from a peripheral hospital. Upon making a full recovery and returning home, she made a video thanking all the doctors and healthcare workers who treated her. That was extremely motivational for them, he shares.
Concerning the unfortunate scourge of violence which has erupted against doctors in some parts of the country, Dr. Virender said that working in an army hospital has shielded him from facing any such events, but he has heard about the experiences of his friends who have faced this. He attributes this violence to families being unable to adjust to loss or being in a sense of denial, and their outburst against doctors is a coping mechanism, he explains. “Doctors can’t generate health overnight. Doctors can’t create oxygen facilities overnight,” he poignantly expressed, “It is for the administrators; it is for the ministers and other bureaucrats to ensure.” The blame for who is responsible for these shortcomings is often misplaced and doctors are held accountable for factors outside their realm of control. Dr. Virender stressed the need for a robust security system in all hospitals. He asks for stringent action to be taken by the government against perpetrators of such violence. The public must be sensitized to the plight of doctors so that they may form a rational opinion rather than a visceral one. Dr. Sunita added that the public does not realize the extent of the time and effort a doctor must devote to earning their credentials and practicing their profession. The hardships faced by doctors and healthcare workers often go unconsidered by the public. She did emphasize that she understands that families may be overcome by grief, but she urges people to understand the conditions doctors have to endure. “When life matters, people do become emotional. There must be empathy from the side of the doctors. But people must also understand that if you are overworked, you are bound to lose it sometimes. Can you imagine somebody working 48 hours and still not losing it?”. “If we are seeing 300-400 patients a day, how do you expect us to give that quality.” She emphasized the need for reasonable working hours while affirming her commitment to being empathetic towards patients and their families. She reminds us of the urgent need for change in short-staffed Government hospitals. The working conditions of doctors must be drastically improved so that the likelihood of slip-ups is reduced, and people do not have a reason for outrage.
Dr. Sunita, while recognizing that the very meaning of a Pandemic is that the existing medical facilities are overwhelmed, stressed that there should be infrastructural changes that can improve the preparedness of the country. Even though hospital facilities are available in urban areas, rural areas significantly lack such facilities, and many cases go untreated and unaccounted for in society. There should be a hospital in every district in India, she said. She believes all doctors, not only those with a speciality but even those at an MBBS level, should be given an increase in their pay. Their efforts must be adequately compensated. Dr. Virender reiterated the necessity of increasing manpower. “There is a shortage of doctors. We should have more colleges; we should increase the number of seats. More courses should be recognized so that we can increase the doctor to patient ratio.” He too stressed the need to bridge the gap between the healthcare facilities in urban and rural areas. He added that insurance facilities and government policies must accommodate the healthcare needs of the poor who often cannot afford treatment. The red-tapism which slows down the procurement of essential equipment must be done away with, “Procuring a particular facility in a government hospital- it’s a herculean task,” he said. The process of upgrading technology is elaborate and arduous, to the detriment of patients. “Medicine is an ever-changing field. So, the process of modernization of government hospitals must be expedited”. Lastly, the public must be sensitized and educated about how they can take care of their health. In addition, public opinion must be made to empathize with doctors. “The opinion of the public and the media which may be against doctors must change,” said Dr. Virender, “The government needs to act faster. It needs to plan in a more coordinated manner, more scientifically. More research activities need to be undertaken.”
“We may be in different boats, but we are all in the same storm,” said Dr. Virender in conclusion. I must object to this statement, for I feel that doctors are entrusted with the task of guiding all these boats ashore. They aren’t in the same storm as us. They face a tempest that is undeniably more formidable- a storm beyond our reckoning.
Edited by- Jyot Shikhar Singh