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.

 

 

Invisible People

BellboyMaid

When we were in medical school, we both had several jobs. At the time, M (my then boyfriend and now husband), was an overseas student, so we were paying over $30,000 in university fees. Because our relationship was not ‘sanctioned’ by either of our parents, we had no financial assistance. We slept in a $60-per-week hospital dormitory room (consisting of one bed the size of a two-seater sofa, a small cupboard, an inbuilt desk, and nothing else). There was a strict rule of one person per room, so I had to sneak into the dormitories via the service lift while the wardens weren’t watching. We lived on left-overs from restaurants and hotels we worked at. Our lounge-room was the medical library on campus, and our kitchen was the doctor’s tea room in the hospital.

M was a dish pig. The lowest in the kitchen hierarchy of a restaurant. Not just any restaurant either, it was a swanky seafood restaurant. So, apart from washing tons of dishes, pots and pans, he had to peel over 500 prawns a day, wrestle with crayfish that had woken up from their freezer-induced coma, grapple with live giant mud-crabs’ claws, and de-beard over 50kg of mussels each shift. For a boy from a land-locked central eastern European country, these were creatures he had never seen before. I remembered the first time he tried to tell me what he did at work, he said, ‘I had to peel a lot of sea-cockroaches.’ It was rather adorable in that sexy Eastern European accent….

At the end of each shift, he had to clean the kitchen, which included an hour of hosing and scrubbing down the mats in the kitchen that often had bits of seafood stuck in the its rubber grid. I still remember the stench whenever he came home from work – I knew he was in the corridor even before he knocked on the door. He would walk through the room, straight onto the outside balcony, and take off his clothes (luckily it was often past midnight by the time he arrived home, not that he had a bad physique to show off in public!). His jeans were so stiff with a mix of dirt, cleaning agent, water and salt, that the pants remained standing on its own even after he stepped out of it. He then headed straight down the corridor in his briefs to the communal bathroom. Only then, did I get my hello, kiss and hug.

I was always surprised that he took on and stayed in that job for the 4 years of medical school. M was born into a very well-off, prestigious family in his town. His mother was the superintendent of the local hospital and his father was a civil engineer, a partner of a construction company that built several towns in Russia, one of which was named after him. M grew up in privilege, and has never had to work or ask for money from his parents. He just needed to request what he wanted, and he got. After he finished school, he became the captain of their national ice-hockey team, he was quite the local celebrity with all the perks that accompanied. And yet, there he was, scrubbing the kitchen sink and grills at midnight, for $9.50 an hour. Not once during those years did I hear him whinge. To him, it was simply the means to an end.

I had several jobs myself, some were rather glamorous, some not so. My higher end jobs included modelling for cosmetic companies, teaching piano privately, and playing background live music at hotel bars, restaurants and lobbies. I also had more income-reliable menial jobs like waitressing, cleaning, hotel maid, pet-sitting, typing and shelving/photocopying medical journals in the library (yes, this was in the pre-technology days).

One thing we both learnt from those days, was that some people are invisible.

When I was a cleaner, hotel maid or even as a waitress, and while he was a dish pig, we were invisible. At work, people did not see us, or acknowledge our presence. Even though being invisible was advantageous in being able to watch and observe others freely, not to mention the lack of ‘noticeable’ responsibilities, but I, personally hated being invisible as if I didn’t exist. I often lamented about this, but M pointed out to me that we were supposed to be unseen, because those ‘higher-up’ didn’t need to be bothered with what we did, how we did it or what we thought.

Now that I work as a surgeon in hospitals, I have noticed that the catering staff, the cleaners and the orderlies are often also invisible to other staff members, or sometimes, even to the patients. This often makes me mad.  I consciously make an effort at every opportunity I have to learn everyone’s names, and to stop and talk to them. I acknowledge their presence when they are in the room, and I try my best to include them as part of my team. After all, as far as I am concerned, we are all there for the benefit of the patient. What I find even more infuriating is the fact that some people treat others depending on what they do as a job. I have very little time or patience with patients or colleagues who sweet-talk me because I am surgeon, and yet, behind my back, they are rude and insulting to other staff members.

A colleague of mine once pursued me relentlessly to join his practice. I asked him why he wanted me to share his business so much. He said that it was because I treated everyone equally, that my demeanor and attitude to the cleaner was the same as that to the professor of surgery. It was a good thing for business he said, because I would be courteous to the staff, and respected by patients. Then he said, that I must have had a good upbringing.

Looking back, he hit the nail right on the head.

When we were little, we had a maid and a driver. The maid was an elderly woman, who was a generation older than my mother. We were to call her ‘ma’am’ because we had to respect our elders, and we were not allowed to give her cheek. Ma’am had a shoulder problem, and I remembered that mum used to empty the top cupboards for her to clean, and bought her light ladder so that she didn’t have to reach up too much. Once Ma’am dropped a plastic jar full of biscuits, it cracked on impact and the biscuits spilled all over the floor. She was about to bend down to the floor to pick up the crumbs when mum stopped her. ‘Oh no, Ma’am, you have only just recovered from your back surgery, don’t get down on the floor.’ She turned to us children and said, ‘kids, show your respect, there’s no need for someone older than you to squat down to the floor when you can do it for them.’ My brothers and I dutifully dropped to the floor and started sweeping and picking up biscuit crumbs.

Once when we were home early from school, Ma’am was on her hands and knees polishing the wooden floor, my bothers and I were aghast at this sight. We picked up our own polishing clothes and started to do our own rooms, because we couldn’t possibly have her clean up after us, on her hands and knees! Couple of weeks later, as we were in the supermarket with mum, we tried to sneak a polishing mop into her shopping trolley. Considering the fact that the mop and its handle was twice our size, it was hard to hide it from mum. She asked why we wanted to buy one, so we told her that we were going to give it to Ma’am so that she didn’t have to get down on the floor anymore. Mum didn’t say anything, but I was sure I caught a smile when she turned to pay for it at the cashier. We were so excited when we got home, my older brother raced up the stair with the mop to the bathroom where we could hear Ma’am tinkering away. When we told her that we bought a mop for her, she gathered us in a hug so tight and long that we started to whimper. When she released us, tears were running down her face, so hard and fast that we were all alarmed. My brothers and I started crying because we thought she was upset with us. It took a lot of hot chocolate and cake before my mother could pacify both Ma’am and us children from turning into a big slobbering mess.

Mr Lee was our driver. He was a gentleman who, despite being the same age as our parents, looked twice as old. He was often seen, leaning against the car, dragging anxiously on a cigarette, waiting but would quickly put out his smoke as soon as we approach. Mum used to lecture him from the backseat about looking after his health, to stop smoking and spending his money on gambling. He used to drive us to and from school, piano lessons, dance classes, to visit grandparents and looked after Dad on his business trips. One night, I was woken up by noises from the lounge, so I climbed out of my bed, headed down the corridor and quietly looked through the glass sliding doors. Mr Lee was sitting with his head in his hands, slouched on the edge of the sofa. Both mum and dad were sitting on each side of him and talking quietly to him. Dad had a thick wad of cash in his hand, and he gently pried Mr Lee’s hand from his face, and placed it in his hand. Mr Lee tried to give the money back, but Dad refused. I couldn’t hear what mum was saying, but the words ‘your wife and children’, ‘gambling’, ‘debt’, ‘must stop’, filtered through the frosted glass door. Mr Lee put the money into his jacket, collapsed onto the floor on his knees in front of mum and dad, and started bowing to them. Mum and Dad got up quickly, and tried to help him up from the floor.

When I was 9, Mr Lee picked me up from school to take me to my ballet lesson. I had a fight with my best friend – and for a 9-year-old, it was considered a very bad day at school. When we arrived at the dance school, I refused to get out the car. There was no amount bribery or cajoling from Mr Lee that could make me leave the car. I was behaving like a spoilt little rich princess. Mr Lee gave up after twenty minutes, and drove me to the nearest park, where we went for a little walk and he bought us some ice cream. He took me to the playground, and pushed my swing for me. When we went home an hour later, my mother was anxiously waiting at the front door.  Apparently she received a phone call an hour ago from my dance teacher to say I didn’t turn up to class. She was furious and demanded to know where we had been. I was terrified because I knew I was in big trouble. Mr Lee bundled me out the car and ushered me toward the door. He apologised profusely to mum, he told her that he was late picking me up from school, and by the time we got to the dance lesson, it was so late, he didn’t think there was any point dropping me off. He said that I was very upset that I had to miss my class, so to make up for his sloppiness, he took me for ice-cream. Mum berated Mr Lee angrily and told him that next time he should just bring me straight home. He apologised again and asked for Mum’s forgiveness. Mum was so mad, she threatened to fire him as she turned away, marching towards our front door. I was alarmed and cried out, trying to catch mum’s attention. Mr Lee turned to me and put his finger to his lips. ‘Go on, little girl, go inside with your mama.’  I did what I was told but when I looked back at him with my sad face, he winked at me with a great big smile, displaying all his crooked yellow tobacco-stained teeth, and gave me a thumbs-up sign like he didn’t have a care in the world. I was so relieved to see him waiting to take me to school outside our front door the next morning that I ran to give him a hug before he could put out his cigarette.

Recently, I realised, that despite the fact we live very comfortably after scraping and saving through medical school, we haven’t changed. Neither has my parents. We stayed at the very swish Peninsula Hotel in Hong Kong for Chinese New Year earlier this year. We had my parents along for the trip. It was stinky humidly hot when we landed, but luckily we were transported in fully air-conditioned private car. When we arrived in the driveway of the hotel, Dad was concerned for the bell boys in their full uniform carting luggage in the heat. My 68-year-old Dad insisted on taking his own luggage out of the boot. It was only when I told him that he will get the bell boys and drivers in trouble with management by doing their job, that he backed down. Dad was so distressed that he didn’t have any Hong Kong dollars on him for a tip, I had to ask the bell boys if they accepted Australian dollars. Mum then wanted to buy bottled drinks for the bell boys standing outside so they didn’t get dehydrated. She gave me money to pop down to the local seven-eleven to get some soft drinks. My husband jokingly said that we should just give the bell boys the money so that they can go and get themselves something to drink. He got a jab in the chest from me and a command from Mum to go and get some drinks from the supermarket. It was a hilarious sight to see my 5-foot-grey-haired mum, handing out bottles of Coke to the bell boys. A couple of days later, Dad was at the morning fruit market buying lots of mangos. I asked him why he needed to buy so many, since we couldn’t take it back with us, he told me to mind my own business. That afternoon, when I was coming back to the hotel from a shopping trip, there was Dad, at the front door of the hotel, handing out his mangos from a plastic bag and telling each one of the bell boys how they must refrigerate it first, so that it would be more delicious and sweet. He repeated the whole exercise at the concierge desk.

My husband and I are not much better ourselves. When we arrived in St Moritz for our ski-trip last year, we had a butler with our suite at the hotel. We didn’t know what to do with him. He offered to unpack for us, but the thought of him handling my underwear made me hurriedly decline his services. He then kept hovering around the room which made us feel very self-conscious. I realised that it was because he wasn’t invisible to us. We had to send him away, even if it was just so that we could take the itchy woolly winter layers off and walk around in our underwear. Our butler got the hint for the rest of our stay and really became invisible. He made sure that all our laundry and ironing were picked up and put away while we were out, and our pyjamas, and delicious nightcap-treats were laid out while we were at dinner. The fire was always on in case we came back early from skiing. At one stage, we caught the front door bell boy whispering into his walkie-talkie as we strode through the front door – no doubt to give our butler warning. The one time we actually saw him was when we locked ourselves out of the room. He appeared out of thin air and apologised profusely for the 50-second-wait we had to endure.

Although we have become very accustomed to having just about everything done for us, not just in our travels but in our everyday life, I am so glad these people have not become invisible to us. I hope that our natural curiosity about people and respect for their lives will keep it this way, because after all, they are here to make our lives easier and they are simply fellow human beings, just like everyone of us.

So Thank you, Mum and Dad, for showing me that no one is invisible.