that’s really good news

Lila and Tibs… The silent bastions on whom it all has been resting for the past month. Ever since the second wave broke, they have been at it. Day in and day out, sleeping, living, eating, breathing COVID.

Lila is the elder one… by some one year or so, and would never let Tibs forget that. Tibs is a little younger, considers himself a little stronger. She is bubbly, charming, enthusiastic, easy to smile and vivacious. Tibs on the other hand is the silent, quiet type. They are both efficient, knowledgeable, concerned and above all caring.

They are the two doctors at the Station Medicare Centre (SMC), at an Air Force Station, somewhere in the heartland. There are others, but one has got COVID, while the other was, well, out for some time. So just Lila and Tibs. Usually, its not that tough. Oh, they do have a clientele of 8000 or so, but they manage. What tipped the balance was April.

In the month of April, the SMC has had 230 cases of COVID, positive on Rapid Antigen Test (RAT). This means that there would be another 1000 lurking around here and there, some asymptomatic, some scared to come over lest they are quarantined, some missed by the RAT, whatever. But 230 is a lot.

Lila is newly married, her naval officer (Sudhir) posted far away. She could barely squeeze in a honeymoon before the China virus played spoilsport. Tibs managed a brief trip to his steady girl and came back with COVID a few months back. Hasn’t managed to meet her since. They still remain cheerful.

So let’s see what it means, looking after 230 COVID patients, by two doctors. 15 min to 30 min of questions by relatives for 230 patients… CHECK. Getting basic protocol tests ie Blood counts, Renal Function, Liver function for 230 people, regularly, sifting through results, ensuring you don’t miss anything… CHECK. Monitoring SpO2 levels for 230 patients four times a day, keeping track, making sure none are missed… CHECK. Rechecking after a six minute walk test… that’s eight times a day… CHECK.

Then the first person starts showing a little low SpO2 and the next struggle starts. The overloaded local hospital’s first reaction is, we can’t. You manage. Give oxygen in the SMC. So then that is a sudden huge demand on the limited number of people available. But they manage. Running from patient to patient, attending some meetings on hygiene or sanitation or sewage or water, all the time worried about the patient on an oxygen concentrator at the SMC.

Lila develops a cough. Fever is 102 deg. She has been double masking, hand sanitizing, social distancing, covering herself. But she knew this was coming… someday, somehow. She walks up to Tibs, to find him coughing, bodyache, fever is 100 deg. They sit down. Now what? What happens to the 230? They sit silent for two hours. Drink nimbu-paani after nimbu-pani, trying to figure out what to do. Obviously, there is no logical answer. If they see patients, they could be super-spreaders. If they don’t, who does?

Lila resolves. Pops two tablets of Paracetamol, asks Tibs to go home and relax. She stays, does her work. Her RAT test is negative. She will get an RT-PCR tomorrow. She wades through the day. It was horrible, high fever, outside temperature 42 deg Celsius, cough, bodyache.

The next day both Lila and Tibs undergo an RT PCR. Buzzed with Paracetamol, wade into the day, like they have over the past month. Fever varies between 99 and 102 deg for both. The bodyache is killing. The cough is bad. Exhausted they go back home.

Lila is in bed hugging Sudhir’s photograph, waiting for sleep to come. Tibs calls… RTPCR results came back. It is NOT COVID. It is just exhaustion, he says.

Oh… that’s really good news, she says. She hugs Sudhir’s photographs tighter and goes to sleep.

 

Lona’s Ordeal

It started simply enough. I had been double vaccinated, second dose on the 18^th of Feb and felt confident. A cough and fever started on 9^th Apr, so I quietly told the wife that I will shift to the next room, just in case. You see, she was not yet immunized.

12^th Apr was Monday, and got a RAT test, which was positive. Sangeeta and Tintin remained negative. The fever subsided by the 13^th as did the cough. Sangeeta tested positive on the 14^th, so I managed to get back into the bedroom, with the attendant Netflix and so on… Settled in for a ‘break’. Maze karenge.

The fever recurred by the 15^th, as did the cough. Felt it was time to get an x-ray done, which was absolutely fine. However, still decided to get a CT and inflammatory markers done. CT showed 7/25 involvement, bilaterally. Inflammatory markers were marginal. Spoke to the medical specialist who advised admission. Was admitted on 17^th Apr to the local hospital.

At the time of admission, I was running 102-103 deg fever, severe cough. SpO2 was maintained. Was placed in a far-flung ward with a medical assistant peeping in twice a day to check SpO2 and BP. Getting a cup of tea took 48 h and water 6 h. The nurse would come once in two days. The Med Spl would pop in daily and have a conversation. Over the next two days, my appetite disappeared, and I remained nil orally for the next 48 h. The fever was unrelenting and though my SpO2 appeared to be holding, the cough was awful. I didn’t realize it then, but I was getting slightly breathless going to the loo and was avoiding it. I would brush, but find it difficult to rinse my mouth, breathlessness. The hospital stay was yielding little, other than sapping my spirits and giving me an occasional paracetamol. So when the Med Spl suggested discharge on 20^th Apr, I jumped at it. This, even though I was running fever now for ten days, had cough, breathlessness, and according to Sangeeta, was barely coherent… Dull, listless and sort of oblivious of surroundings.

After reaching home, the fever, cough and breathlessness persisted. Since I could now monitor and assess myself, I realized that even slight activity was causing my SpO2 to drop to 88-89, though it would recover spontaneously. That is when Sangeeta took charge and rang up my brother, a Gen Surgeon but dealing with a lot of COVID cases as any other general practitioner in India. He was categorical… Start injectable steroids and Injectable LMWH, IMMEDIATELY.

Well, took the first dose of steroids and found that within the next six hours, my fever of almost ten days relented. Inflammatory markers sent the next day had gone through the roof. I got an oxygen concentrator home and settled in to brave the Cytokine storm at home, having lost faith in the hospital completely. Every day was an improvement, as it was a challenge. It took two days for the appetite to come back, the cough still persists. The inflammatory markers settled within the next three days. Netflix (sadly absent at the hospital) aided an early recovery, even though news channels tried their best to dampen the spirits.

To cut a long story short, today is the eighth day on injectable steroids and LMWH. My SpO2 levels are holding. Did a half hour walk today without losing SpO2. I feel that the worst is over, though one can never say for sure. It has been an ordeal like few others and is testimony to the healing power of love and affection of loved ones as much as it is that of medicines. Saved by my wife and brother as much as by modern medicine. Phew….

The Desi Traveler

I suppose travelers from all countries have a distinct sort of identity, some peculiarities, which identify them to others, more specifically their own countrymen. Over years, I have found that the Americans would find everyone other than an American inefficient, rude, unhelpful and generally nuts. Europeans, and I shall differentiate between different countries in Europe at some other time, find others uncouth, uncultured, flashy and so on...

So what about the Desi Traveler? For my readers from outside India, Desi is a part endearing, part pejorative term for a person of Indian origin - stemming perhaps from the fact that Columbus  and his cronies usurped the term Indian for the original inhabitants of the New World, leaving us kind of identity-less, till we found Desi. 'Desi' (देसी) comes from 'desh' (देश) meaning country, and literally means a country person, or a country bumpkin.