Corona onslaught in the NHS # 1

The normal operations are cancelled. Only obstetrics, babies being born, is going on. They are allowed to maintain their business in the far end of the long operation department. There, behind double closed doors, babies are coming out oblivious to the fuzz all around them. Life goes on.

But in the other theatres Corona has taken over. Three positive patients per theatre. These are the unfortunate small minority of infected people; the ones that have been hit so hard they can’t breathe. Plastic tubes stuck down their windpipes, connected to breathing machines and more often than not on strong medication that, for a while, keep their struggling hearts from failing.

As Corona came to town it didn’t take long before I was gowned up like an astronaut.

These theatres function like small improvised intensive care wards and they remind me slightly of a temporary recovery room we put up on a charity trip in Vietnam some years ago. Among the young and cute patients and their happy and forever grateful families was a clutter of boxes and plastic bags containing gear and equipment spread around in the messy room. The patients in the Corona dedicated theatres in this London hospital are not young or cute, hardly anyone is with a tube sticking out of their face, and there aren’t any happy families. Only the improvised atmosphere and the mess in the room is similar.

As Corona came to town it didn’t take long before I was gowned up like an astronaut caring for the viral victims in these temporary intensive care units. The first day I was helping out with three men who were either old, immunocompromised or both. One of them, 76 years old, had been intubated for three days already.

The show was run by a proper intensive care sister. She explained that it had been agreed to let the 76-year-old go, to die. The man was now completely dependent on various strong drugs and inputs. His heart wasn’t able to run without the boost of unsustainable amount of continues strong infusions, his lungs not able to breathe without a ventilator and his mind was somewhere far away, resting in a state of deep unconsciousness. The decision had been taken in agreement with the non-present family. In Corona-NHS you die on your own. No relatives are allowed anywhere near the premises. No ifs or buts.

In Corona-NHS you die on your own.

“Peter, I’m turning the medicine off now.” The sister placed her experienced but still sensitive hand on Peter’s shoulder. The other staff in the room, me and three other blokes – none of us proper intensive care nurses, stopped what we were doing for a minute. We watched how the numbers slowly changed on the monitor as Peter’s failing body lost its fight for life. The ventilator continued to breathe for him, but his heart had seen its days. When the heart rate came down to levels you only really see in very fit footballers it started losing it, becoming all erratic and random.

“This shit is unreal,” someone’s muffled voice could be heard behind the double masks. Just then Peter, maybe a former distinguished gentleman who himself would never had used such a foul language, lifted himself up and his heart started to beat at a normal rate again. He didn’t want to go just yet and the sister sent me out for a coffee break.

One of the many annoying things with Corona is that your break time is eaten up by taking your protective gear off and then putting it on again, a tedious process that needs to be done in specific order. As I came back Peter’s heart was on another down turn. His numbers were literally half of what they should be. Again the heart blipped and hesitated and gradually the graph on the monitor straightened out to a wave line that got continuously straighter. And as us men stood arms folded while watching the screen, the monitor let out a high pitched continues beep. Peter no longer had the sister’s sensitive hand on his shoulder, no intensive care sister has time to sit with a dying patient for an hour in the midst of a viral war. Fortunately for Peter a female junior doctor had taken the sister’s place.

As I cursed behind the hot mask and with his blood all over my triple-gloved hands, the phone rang.

Well, at least she did for a while, but there was another man, still more alive than Peter, who needed attention. As Peter’s soul already was on its way out of this seemingly godforsaken room the doctor had proceeded to start changing an arterial line on the other man, a process that requires skill, concentration and some assistance. Meanwhile I and a colleague tried to sort out the third guy. He was big, HIV positive and had just, while unconscious, vomited up lots of liquid food and as we tried to clean him up he decided to start having a rather impressive nose bleed. As I cursed behind the hot mask and with his blood all over my triple-gloved hands, the phone rang. Someone told me to take it as it might be important. The phone was just behind Peter’s head. My colleague continued trying to stem the bleeding while I took the call, making the receiver bright red from the outer gloves that I had forgotten to remove. There was a faint but worried female voice on the phone. It enquired about her brother. “How is he?” she asked nervously, “How’s my brother?” Listening, I stood only inches away from Peter’s face. The right eye was now half open. Absently it scanned the ceiling.

Peter’s soul was already on its way out of this seemingly godforsaken room.

“Y-Your brother?” I stammered, staring into the open eye and starting to panic that her brother was Peter, still with all the signs and evidence from an NHS struggle to save his life left on him. Cannulas, lines and tubes coming out of everywhere. The infiltration pumps idlily blinking on standby. The monitor had been turned off – never a good sign in intensive care.

Relieved I finally understood that the woman on the phone belonged to one of the two still alive men, the one who was now getting a new arterial line. My colleague told me he would be right there, I asked the woman to wait, put the receiver down beside Peter’s head and went back to the bleeding man.

The nosebleed had stopped but he had started to drop his 02-saturation. Why? Had the blood and vomit somehow got down his airway? It shouldn’t as he had a tube straight down there. Together me and my colleague suctioned his airway, gently adjusted the breathing tube, moved him onto his other side but when we were about to change his linen I hesitated, turned around and instead covered Peter with the new sheet. Or most of him, his feet insisted on sticking out. Still, it felt better to work with patients while having the dead one covered up. The nose bleed man seemed to agree and rewarded our efforts and professionalism with increasing his poor numbers on the screens, at least slightly.

Happy with my input I smoothened out some creases on the new sheet and then suddenly my glance fell onto the phone on the stool by Peter’s now covered head. The waiting sister! Both me and my colleague had completely forgotten about her and had simply left her waiting for a good quarter of an hour literally beside a dead man. Not nice was it? At last the sister got informed about the status of her brother and told that the NHS was doing everything it can for her brother, who the previous day, at an age of 58, had walked into A&E with a cough and shortness of breath.

Names have been changed.