“Death is no stranger to us; we deal with it every alternate day. But even veteran ER doctors like me would never have been mentally prepared for the huge number of patients dying from COVID and within such short deadlines. I am ready to give all my days to save the patients, but no number of days or hours are sufficient any more and the struggle of choosing people to admit in the hospital and send back home with suggestions is killing me from inside”, said Dr Ashlesha from NOIDA.
The frontline healthcare professionals have been relentlessly working for longer hours than ever before and are dealing with the fears of catching the infection or being its host and passing it on to their families. They are working relentlessly and sometimes, with the changing Health Ministry policies are not even very clear about the protocols. All the long hours, sickness and deaths from the pandemic, difficult working conditions for their staff, and team, are resulting in depression, anxiety, acute stress reactions, burnout, post-traumatic stress disorder and 'moral injury' for them; something that is experienced widely with the current spike of patients.
Moral injury is a term that originated in the military to describe the psychological distress that results from perceived injustices—and thereby has lasting harmful effects on mood and self-esteem. The frontline healthcare workers are making unimaginable triage decisions during the pandemic.
Dr Ashlesha explained it further saying, “With less number of beds and medical staff, we are forced to make medical choices like send patients with mild symptoms back home with advisories even though we know that the patients are so scared that they would rather be admitted in the hospital than stay at home.
We doctors are considered next to ‘Gods’ for saving lives, but we don’t feel any similar when we have to take these crucial decisions that can affect someone else’s happiness or life,” she said, wiping off her tears and continued, “It is painful to see how the patients’ bodies are piling up and sometimes no one comes to claim them out of fear of contacting the virus; our teams have to go to the deceased house and ask them to atleast perform the last rites of the dead person. I sometimes feel I might lose my sense of affinity, I am so tired of telling the patients they will be fine even though I am not sure myself given how little information we all have on this virus. But I am the senior-most doctor here and I can’t say all this to anyone for the fear of affecting their morale, can I?”
Just like Dr Ashlesha, most health are workers are at an increased risk of compassion fatigue and anticipatory grief during these intensified times. But what affects them the hardest is when they have to take a decision based on biases, fully aware that their decision could have a major impact on the life of the patients. Given the rapid increase in the number of patients, even the most committed of our healthcare workers, are faced with these very tough decisions..a place where none of us would want to be in.