Weeks before Eid in May, surgeon Owais Makhdoomi received a distress call from his sister Mursaleen Asim, who was pregnant with her first child. She had developed symptoms of the Covid-19 disease and was worried for her unborn baby.
Asim’s pregnancy had elated the entire family who began preparing to welcome her “precious baby”, said Makhdoomi, an otolaryngologist. The 42-year-old had conceived after eighteen years of trying — what is called in medicine as a “precious pregnancy”. The baby was due in August.
Makhdoomi immediately rushed to his home in Srinagar from the District Hospital in central Kashmir’s Ganderbal, along with a testing kit to carry out a rapid test on Asim at home. She had tested positive.
In isolation at home for a few days, Asim was shifted to the SMHS hospital in Srinagar after her oxygen saturation levels dipped below normal. But her condition deteriorated and she was put on a ventilator the same evening. Meanwhile, Makhdoomi’s other sister and his brother-in-law also tested positive for Covid-19.
For the next two weeks that she was in the ICU, Makhdoomi stayed by her side. “Her condition was not what one would expect when someone is on ventilators for thirteen days,” he said. “I looked after her along with my batchmates from medical college and a couple of my close friends who were posted there.”
On 13 May, Makhdoomi took a break from caring for his sister when suddenly doctors rushed to her bed. He waited outside the ICU, frozen, while the doctors, he was later told by a friend, were attempting to resuscitate his sister.
Asim passed away shortly thereafter. Outside Kashmir’s hospitals flooded with Covid patients, the occasion of Eid was being celebrated. She was buried in the afternoon. Makhdoomi isn’t the only health worker, on the frontlines of the fight against the Covid-19 pandemic, to lose family members and still work under immense stress.
According to the Resident Doctors Association, more than a hundred doctors, “and [an] even higher number of their family members”, of the Government Medical College Srinagar alone had contracted Covid-19 during the ongoing second wave. Across India, according to the Indian Medical Association, as many as 513 doctors have died due to Covid-19, three of them from Jammu and Kashmir.
‘Not on my watch’
Makhdhoomi regrets not being able to hug his sister one last time before she went into a coma. “She could have seen me and hugged me back,” he sighed. As a doctor himself, he had a privilege of receiving priority care at the hospital and knowing when to call a senior doctor. “I knew where to take the tests and when to bring a consultant and they had the courtesy to help me,” he said, admitting: “For attendants of other patients, things are different.”
But there was a drawback as well. Unlike other attendants, Makhdhoomi understood each moment and the manner in which his sister’s condition deteriorated — the entire process unfolded before his own eyes. “I knew that her lungs were gone and it was the ventilator that was pushing her,” Makhdhoomi added. “You lose a patient, you wash your hands and face and move on to another patient but losing your sister is like losing a part of your soul.”
For doctors treating Covid-19 patients, it isn’t just the risk of contracting the virus but also endangering their family members as well. The only solution to this has created another challenge of itself — staying away from their families for prolonged periods.
At home, Makhdoomi hasn’t met his parents or his sister, who was at his home for days before contracting the virus. “I stay aloof, even have kept separate utensils to eat food from,” he said. “I even trained my [domestic worker] to administer insulin to my mother.”
“I never imagined that I would one day lose my own sister to the virus,” he said.
Doctors have not just tested positive or lost their family members but have had their mental health impacted as well. “One thing that I know for sure is that once the pandemic is over, there will be many doctors with depression, Post Traumatic Stress Disorder (PTSD) and sleeplessness,” said Makhdhoomi. “I am a surgeon, lots of patients have died in front of me on the table. But Covid deaths hit differently.”
Makhdhoomi worked without a break since the outbreak of the pandemic, conducting surgeries during the decline of cases after the first wave. But after his sister’s death, he finally felt the need to take a break. “I lost my sister who was more like my mother and a friend,” he said. “But I have to start working again because someone else’s mother or sister is waiting for my help.”
Now, Makhdoomi is more determined to face the uphill task of keeping his patients from dying. “Not on my watch,” he said. “I remember her [Asim] telling me that I am good at what I do so I should keep doing it… So I will do that.”
Mir Mushtaq, Spokesperson of the Directorate of Health Services, Kashmir, said that losing a loved one leaves a terrible impact on the doctors specifically while working in a stressful environment caused due to the pandemic.
“A doctor has to try to be mentally very strong,” he said, adding that if a doctor loses a family member due to Covid or if they are themselves infected, they should be given adequate breaks and possibly reassigned to non-covid duties. “Doctors need to regain [their] mental strength and come back with more vigour.”
There are measures that Mir suggested for the government to ease the pressure on doctors: by reducing individual doctor’s workload by employing more doctors and by providing mental health counselling on priority. “Psychologists should be made available for doctors because they need it right now for speaking out and relaxing a bit.”
Additionally, small improvements in their working environment would go a long way too, said Mir. “Proper food and transport arrangements should be made for doctors. We have to basically aim at reducing the stress levels of doctors anyhow,” he said.
Meer Zafar Iqbal, Director of the Rehabilitation Psychology Composite Regional Centre said that there was a need to empathise with doctors as individuals with feelings and families. “As far as doctors are concerned they are suffering from different psychological problems including PTSD,” he said, noting that doctors witness people suffer and die.
The stress caused due to the pandemic can be dangerous for the doctors and other healthcare workers who are at the forefront, said Iqbal. “In the coming times, our healthcare workers will be psychologically distressed,” he said.
Many of the anonymous callers on the centre’s helpline to help deal with stress, Meer suspected, were doctors. “There is a need for counselling doctors because they are more impacted than us,” he added. “A doctor is not made of stone.”