Living in an Epidemic

When I was reading about the Ebola outbreak last night, I thought of my time in Taiwan during the SARS epidemic. So I went back to the diaries I kept during this time and found couple of interesting entries. I was there as a Fellow in one of the world famous plastic surgery units during 2003. A Fellow is a young doctor who travels to another hospital unit to train for a specified period as a ‘trainee’ doctor, usually to learn from a specific doctor or a particular procedure/technique.

I have left this entry unedited, as it is a true perspective of an Australian living in Taiwan during the SARS epidemic, both as a doctor and local resident.

25th Aug 2003

It’s been more than two months already since the first wave hit Taipei. I still remember the panic that hit the city during that first week; it was when they closed down Ho-Ping Hospital in central Taipei, with all its patients and staff isolated within the hospital. It was constantly being aired on the news and the hospital exterior was being videoed 24 hours a day, a bit like reality TV. There were scenes of flying badmington cocks over the railings of the balcony, and I remembered the presenter reporting that it was great to see that the occupants of the hospitals keeping up their spirits, and exercising to keep fit. The comments from my male colleagues in the TV room at the time were less than polite. I think something was mentioned about there are better things to do when you are couped up with a whole bunch of young nurses. *eye roll*

Then there were news of individuals who were to be isolated at their own homes because they’ve been in contact with SARS suffers. After which, news of non-compliant isolated individuals venturing out of their homes were reported with the police were called to herd them back home. They have now posted guards around quarantined buildings to stop residents from ‘escaping’. Cases were on the rise, another hospital got shut down, and the mortality is starting adding up.

I have missed my chance to go home. Four weeks ago our department director gathered all the overseas Fellows in his office to let us know that if we wanted to go home and leave the country, he would still be happy to write us a certificate for our fellowship and recommend us for jobs back home. There were 7 of us, two from Harvard in the US, 2 from Italy, 1 from UK and another from Ukraine. The Ukrainian and I stayed. It was really a blessing in disguise, because now, instead of elbowing other Fellows out of the way for an opportunity to do cases, we are both operating more than 12 hours a day. I joked to my concerned parents back home that I spend so much time in the operating theatre with its filtered and uni-direction airflow, I am probably at the lowest risk of getting any respiratory virus. They weren’t amused. Wherease my boyfriend just said that if I got SARS, he wasn’t coming to visit. I’d like to believe that’s anger and frustration talking. I can understand why he’s so pissed at me. I think I would be too if our positions were reversed.

The one thing I have discovered about living in this SARS epidemic is that there seem to be more pregnant women than usual at the moment. One nurse mentioned to me that since we have to take our temperatures every day as required for all hospital staff, she has finally managed to get pregnant during her last cycle as she knew her exact ovulation date. A fellow colleague also mentioned that you can pick the pregnant nurses during this epidemic, as they are usually the ones wearing an N95-grade mask. These are heavy duck-billed masks which have viral filters and are very hot and uncomfortable. Most staff members such as myself (who want to breathe and admittedly am a bit blasé about the whole thing) just wear the regular light ones.

Oh well. You’ve gotta learn to see the bright side of life when living in an Epidemic.

Administration has been harping on about wearing the right masks, but I seriously believe that if I wash my hands (which are raw from scrubbing all day), and keep away from sniffling, slobbering people, I’ll be fine. I have been avoiding public transport as much as possible. I have blistered on my feet because it takes me one hour each way, walking to and from work. After 8pm, I just sleep in one of the spare beds in the Burns Unit. I suppose I am like every other deluded doctor at the moment, we think we are being ‘adequately’ careful and probably invincible.

A thought just occurred to me. If I die in this epidemic, I won’t be able to hear ‘I told you so.’

Well, I guess if I am not back tomorrow, you know I am being ventilated in ICU with SARS.

 

 

Two minutes

Mrs Warren* came into my practice yesterday.

Mrs Warren is the mother of Hannah*. Hannah was a 35 year old beautiful young mother of three children, who passed away from metastatic breast cancer two weeks ago. Hannah was my patient three months before she succumbed to her illness.

I heard Mrs Warren’s voice at the front desk reception.

I stayed in my office, consumed by guilt. When Hannah was dying in hospital two weeks ago, one of the nursing staff informed me about her readmission into hospital. ‘Things are not good, I don’t think it will be long.’ 

‘Maybe I should pop by and visit.’ I thought, mentally swiping at the tears that threatened to clog up behind my eyes.

‘I think they will really like that. Hannah loved you. She thought the world of you.’

I started, then realised I had thought out aloud, the nurse was just responding to my comment.

Days, then weeks passed. I couldn’t bring myself to visit her. Several times I walked towards her room – steeling myself to walk in to face her emaciated semi-conscious form on the bed, surrounded by her grieving family – then finding myself turning, striding rapidly away.

Hannah was my age. She was a lawyer, a lawyer who studied hard, worked long hours, made sacrifices and achieved. She once told me that she was the youngest associate ever to be offered partner. She told me how there was no female lawyers in her department at which we both smiled simultaneously in mutual understanding. She said she sees a reflection of herself when she looks at me. As I do, when I see her.  

I never went to see her, I never said goodbye. I never attended the funeral. AFter all, I told myself, she wasn’t a friend. She was a patient. The only thing I did, was to write a card to her family.

Now her mother is standing in my office. And I am kicking myself. I should have made more of an effort. It would have just been ten minutes of my life; After all, my ten minutes would have been nothing compared to ten minutes in her last days. My cowardice overwhelmed me,  I found myself hiding in my office, afraid to move. Or breathe.

‘Hello Mrs Warren, we are so sorry to hear about Hannah.’

‘Thank you.’ I imagined her waving her hand elegantly. Mrs Warren always reminded me of a grand matriach, she moved and spoke with such pride and grace. ‘I just wanted to come in and thank the doctor for her card.’ A sniffle. ‘It was so lovely that I had to read it to Hannah yesterday.’ A brief silence was followed by a sharp snap of a handbag. Must have been a tissue. I could almost see her in my mind, using the task as an oportunity to gather her composure.

‘You know, we had so many people at the funeral last week, the church had to leave the doors open.’ There was less wobble in her voice. ‘We got so many flowers and cards.’

‘She had so many specialists, but doctor was the only one who sent a card. Please thank her for me, we were so pleasantly suprised……’

I shut the door.

Tears were running down my face. I was humbled.

It seems the two minutes it took for me to write a card was enough for them.

 

 *All names have been changed to ensure confidentiality and protect privacy.