It has been six months since the COVID-19 pandemic began in Chennai, like elsewhere in the country, and while the number of cases may have dipped in the city, the emotional trauma and sudden deaths that the frontline medical workers experience, continue to haunt them. From having patients lucid one minute and dead the next to listening to their last wishes and regrets, doctors have witnessed hundreds of dreams and hopes die before them.
In August, a 52-year-old tennis coach was beside himself with joy when Dr Ahmed, an intensivist who treated him, said that he could be discharged in five days.
"I was always after financial goals and didn't realise how important family was, doctor. When I leave the hospital, I want to spend time with my son. I understand my priorities," Dr Ahmed recounted his patient’s words.
"He was a fit man with no vices or comorbidities. He came with a fever and as his situation got worse, we put him on a ventilator. He recovered well, got off the ventilator and would talk to me about his family and regrets about not spending enough time with his teenage children," Dr Ahmed told TNM.
"He was supposed to get discharged in five days and was all set to turn his life around. Hours after we informed him about his discharge from the hospital, he became breathless, suffered a cardiac arrest and died on the same night," said the doctor, who works in a private hospital in the city.
This was among the many cases in the last few months that left Dr Ahmed weeping over a patient he knew for just a few weeks.
"I broke down completely. We did everything in our knowledge to help him, and it still wasn't enough. He died unable to even say goodbye to his children," he lamented.
Across the city, COVID-19 had brought even the hardened medical professionals to tears as they came to terms with their inability to save patients despite employing all their knowledge and resources.
For a 28-year-old doctor who works in a government hospital in the city, it was the suddenness of patients dying within minutes of coming for treatment that proved to be horrific.
"Another patient, a 39-year-old man who came with breathlessness died in 15 minutes before we could even begin the COVID-19 protocol," said Dr Ravi Kumar. "In spite of the number of months of such cases, it is still a shock to the system," he added.
But the most emotionally draining instances, he explained, is when a family gets admitted but only some of them leave the hospital alive.
"In July, a couple in their late fifties were admitted together and we had them on beds beside each other in an open ward. They were constantly talking and reassuring each other. But, one day, the woman’s health began to suddenly deteriorate. She was suffering in front of her husband. He could see us working hard to save her and watched as her heart flatlined. It would have been so traumatising for him," said Dr Ravi. "He completely broke down as we removed her body from the bed and had no one to even comfort him. Physically, he recovered from COVID-19, but the emotional toll it took on him, is indescribable," he added.
The doctors pointed out that unlike regular illnesses, patients being treated for COVID-19 are in the hospital for a week to sometimes even 50 days if they are on the ventilator.
"We are the only people they see and a bond is formed because they need the emotional strength we provide. I have hugged patients and held their hands just to get them through the day," said Dr Ahmed. "They show us pictures of their family, we share jokes with them and when things go wrong, the emotional toll is terrible," he added.
Dr Lavanya, an ICU anaesthetist at a popular private hospital in Chennai, said the trauma of watching people die doesn't fade. In the last six months, she has carried the last words of patients to their distressed families, who refuse to accept their deaths.
"A death in April, of a 23-year-old MBBS student, still haunts me and there are days I find myself thinking of him and crying," she told TNM. "He had just gone to buy groceries and had even worn a mask. Yet, he got infected. He came with a mild fever and we were confident he would make it since he was young.”
From the moment the young patient got admitted, the doctors were his point of contact for the family. “It was so difficult to tell his family when he got sicker and had to be shifted to the ICU. We told him he will get better when he asked me if he will ever leave. I gave him that confidence and we spoke every day. When he died, it made all the doctors question their own efficiency and ability to treat patients,” she said.
Informing the patient’s parents, Dr Lavanya said, was the most difficult thing she had to do.
The doctor remembered breaking down as the young man said his last words - 'Tell my parents I really love them'.
"I couldn't go back to work the next day. I was shattered," she said, adding, "Since then, the deaths have only been mounting.”
Doctors who were earlier seeing five to seven deaths a month have now been forced to deal with 17 to 20 in the same period. Informing families who were not even allowed to stay by the side of the patients, they said, has been a battle in itself.
In July, a 28-year-old patient with severe COVID-19 pneumonia was admitted to Dr Lavanya's hospital and she was among the doctors treating him. The patient had lost 75% of his lung capacity. His lower-income parents shifted him from a government hospital, hoping to get him the best treatment.
"When I told them that he had to be shifted to the ICU and that it would cost Rs 1.5 lakh per month, the shock on their faces was heartbreaking," said Dr Lavanya.
"They were doing everything to pay for the treatment, while we struggled to save him. We had prescribed remdesivir that costs Rs 3,000-4000 a vial, six of which had to be given to the patients," recalled the doctor.
"They went from pillar to post to scrounge enough money for the drug. But when they finally bought it, he was already dead," the doctor added as her voice turned heavy with emotion.
His last words to the doctors were: 'My parents did everything to save me, please help them with the cost’.
"We managed to slash the costs heavily for them but at that point, when they had lost their son, how would any of this matter? When we told them he died, they refused to accept it. After all, they had done everything they possibly could. The treatment cost the family so much but the virus still killed their son," she added.
Doctors describe that the last six months have seen deaths that stopped marriages, left children orphaned and families shattered. The trauma, they say, will stay with them.
"It has been overwhelming," said Dr Lavanya. "I find myself crying over these unknown people's deaths every day. They were not supposed to die. A virus should not have killed them. Even as doctors, we find this hard to accept."
(Names changed to protect identity)