Joburg emergency doctor reports on Covid-19 from the front line

Saving A Stranger’s Life – The diary of an emergency room doctor, by Anne Biccard (Jacana)

Someone suggested we have “very merry little Christmas” this year. Well, I don’t know how merry it was, but it was certainly little.

A book about Covid-19 and its effect on exhausted medical staff doesn’t sound very festive for the Christmas weekend, but as this second wave is dominating all our celebrations and conversations, it seems apt.

With more than 30 years’ emergency room experience, Anne Biccard works at a private hospital in Joburg. Her book is written in diary form, spanning the period from March 5, the day South Africa’s first case was confirmed, to September 1. It has of course missed the news of the second wave and the new variant, so considering the dispiriting and gruelling nature of the first wave on medical staff, one hates to think how they’re feeling now.

We’ve been given some insight into medical staff’s struggles in the letter by Dr Andrea Mendelsohn, senior medical officer at the Retreat community health centre, which is doing the rounds. She wrote: “Yesterday my community health centre reached capacity. All five oxygen tanks were in use, five men and women saved from the strangulating effects of Covid-19. Then a sixth patient arrived…”

She added: “A tidal wave is enveloping Cape Town.”

But back to Biccard and the first wave. She writes in early March: “It feels like nature is taking revenge on the human race.” Her hospital is scrambling to try to keep up. People are queueing in the hospital carpark as staff try to separate patients with respiratory symptoms from others.

All the staff are wearing masks, gowns and gloves, but then they touch the phones and doors and countertops with their gloves “so the virus is probably everywhere already. We don’t want to throw away protective equipment because we know that the supply is limited, and we don’t know how long this crisis will last.”

At this stage only people who have travelled abroad or have had contact with a corona-positive person are being tested. An angry man appears at the hospital, demanding a test because he has a sore throat and someone at work might have been positive. Biccard refuses him a test – if everyone in the country with a sore throat has a swab for the virus, the test kits would be finished, and the labs swamped. He says he will not leave the hospital until he gets a test. She tells him he’s in for a long wait.

Eventually he storms out. She senses he’s going to complain about her, but she’s too tired to care. And that’s only March.

The next patient will be tested: he was in a hotel in China that was quarantined for six weeks. In the middle of the night he found an unlocked fire door, took his passport and wallet and caught a taxi to the airport. Now he has a high fever and a raging sore throat.

Among all this are the usual patients: a woman having a heart attack, a teenager having a miscarriage, a mechanic with a shattered leg. A man comes in with a long complicated story. He’d locked himself out of his home, had to climb in through the pantry window, but his foot slipped and in the ensuing fall a bottle of tomato sauce went up his anus.

Biccard doesn’t blink: “Why were you naked?” she asks. The man needs abdominal surgery – but what will they tell his wife?

Biccard says she jokes with her colleagues about the Grim Reaper, whom she refers to as Grim. No one, she says can work in an emergency department without forming a relationship with him. And he doesn’t always win.

Another day, another emergency. The number of injuries caused by baking have increased exponentially during lockdown – cuts, burns and in one awful case, the little string at the top of a flour bag caught in an electric mixer and wrapped around the patient’s finger. Biccard finds the finger has rotated right around, so the fingernail is facing the palm.

By July Biccard wants to quit. Only two of the six physicians in the hospital are left standing – the others have Covid. But good things happen too. One day she discovers five non-pulmonary specialists have been added to the hospital’s Covid WhatsApp group. They turn up in the emergency department, stethoscopes around their necks and announce: “We’ve come to help,” and her eyes fill with tears. They don’t have to do this – but they have.

By September the weather is warming up and Biccard is feeling more positive. Spring is virtually here. She looks at the mild evening sky and says a silent word of thanks to the universe. She will remain at her post, because there are lives to be saved.

I wonder how she’s feeling now.

This is a fascinating, sobering and occasionally funny look at one of the doctors on our front line.

 

 

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