Earlier this week, emergency medicine specialist Dr Stephen Parnis shared with a national television audience some of the issues that have been keeping him and colleagues awake at night.
These include shortages of personal protective equipment (PPE), the distress of watching health services overwhelmed in other countries, and concerns about how effectively he will respond in the face of crisis, Parnis told viewers watching ABC TV’s Q+A program on Monday night.
In the article below, published as part of Croakey’s ongoing Caring for the Frontline series, Parnis shares some of the other questions and worries on his mind.
Stephen Parnis writes:
“Steve, you’ve been identified as a close contact of confirmed COVID cases, and you have to go into isolation for two weeks.”
These words came from a trusted colleague, as I was preparing to start a shift in Emergency in late March. They hit me hard.
Was this my fault? Am I going to fall ill? How can I let my colleagues down in this way?
A torrent of thoughts and emotions confronted me as I returned to the hospital carpark. I was suddenly aware that I had to separate myself from everyone, including my beloved kids.
I felt a sudden and profound stigma, and it hurt like hell. I had lost my right to be a part of the solution. It was as if I had become part of the problem.
For weeks, if not months, I had been closely following news of the coronavirus pandemic. At first, it was just another story from faraway China – too distant for it to puncture the sense of security I have had about life in Australia, and the health system in which I have lived and worked for almost thirty years.
I have closely watched many epidemics over the years, via news services, medical journals and academic conferences. I remember SARS, because of the lives it took, and the impact it had on the countries and medical friends who lived through it. Facemasks in the streets, and fear on the faces of doctors and nurses.
But it all seemed to be a safe distance from here.
The only significant epidemics we seemed to face were the annual surges in influenza. Sure, they put increased pressure on emergency departments and hospitals, but we can reduce the risk with vaccination. Nothing we haven’t seen before, I was inclined to think.
Change of rules
But this year, COVID-19 has changed the rules, and nothing will ever be the same again.
The first few days of my isolation were tough. I was alone in my home, except for the cat. Cooking for one was unfamiliar, and I wondered who might be able to help when the cupboards ran low on food.
I shaved and dressed each morning, but wasn’t sure what the point was when I wasn’t going anywhere. I found it hard to avoid the feeling that I wasn’t useful because I couldn’t do my job – caring for the sick. These daily thoughts were a challenge I could not have anticipated.
Headaches were ever-present, and fatigue seemed to take over each afternoon. My training told me that there were many possible explanations, but my emotions reminded me that I could be incubating the coronavirus, and there was nothing I could do about it.
Friends and family were quick to assume my fortnight would be spent lazing on the couch and watching Netflix. The reality, however, was very different.
In recent weeks, my three emergency departments have gone from business as usual to a frantic scramble for pandemic readiness, for a wave that threatens to overwhelm us.
In our online world, mandatory quarantine for health care workers means videoconferencing, phone calls and writing, trying to assimilate all that can be known about the coronavirus, and how to respond as best we can.
This virus has changed everything we do in emergency medicine: triaging systems, resuscitation protocols, results tracking, equipment procurement, staff rostering. Nothing is immune.
Behind every decision we make, the unanswered question lingers, “Will this be enough when the time comes?”
We have seen the results when a health system has been overwhelmed. Northern Italy, Spain, and New York are the stuff of nightmares.
Podcasts from emergency physicians such as Roberto Cosentini in Bergamo are a reminder that being a doctor is much more than making a diagnosis and prescribing a treatment. It is about compassion to care for those whose lives are hanging by a thread, even at personal risk, and to speak the truth, no matter how painful that may be.
I used to enjoy listening to the morning radio news, as I slowly surfaced from sleep. Now my sleep is fitful, and I’m unsettled as I anticipate hearing where the pandemic is taking us.
A week after my colleague’s warning, my headaches eased, my fatigue lessened, and the COVID swab I took a few days ago returned a negative result. That’s a relief, for now.
I have now returned to my emergency departments, and it’s a relief to be able to work with my colleagues in person, care for the sick, and shoulder the responsibilities that increasingly feel like a privilege after they were taken away.
I had no idea how much I would miss the doctors, nurses, cleaners and clerks with whom I work. We have all grown closer in recent weeks, as anxiety has taken its toll, and we have all realised how much we care about each other. Emergency medicine is truly a team sport.
With trust and faith in my colleagues, and mindful of the love and support of so many, I hope I am equal to the challenge that lies ahead.
• Dr Stephen Parnis is an emergency physician in Melbourne, and was the Vice President of the Australian Medical Association from 2014 to 2016
Published previously in the Caring for the Frontline series: Amid stressful times at the COVID-19 coalface, we find glitter, gifts and hope