My regular work usually involves consulting patients who are admitted for treatment of medical or surgical problems and then need some mental health care advice. I dont get too involved with such patients as technically they are the responsibility of the treating Specialist and I am supposed to just fine- tune their treatment with my inputs. COVID-19 was completely different.
Patients were often alone. The treatment of COVID19 was being given by a team of doctors who would hand over charge of patient as duty ended- same was with the nursing and caretaking staff. Thus patients had to deal with a high degree of impersonal healthcare. At such a time, our mental health care team filled the gap for consistency and communication to minimise the feeling of loneliness and helplessness among patients. Each mental health professional was looking after designated patients and wards and in keeping with the Government guidelines, all patients were followed up twice weekly at least. Sometimes we were the people in front of whom they let off steam- complaining about hospital, government or family members. All that ventilation was allowed and diffused to ensure patient comfort and recovery. I decided to set aside my normal reserve and allow patients to be emotionally close to me.
So AB had dementia and so many other issues, but she had no difficulty recognising me in my PPE. SB and I shared the interest in classical music and spoke about the stalwarts and different 'taals'- he actually promised to take my practice as I was not getting much time to do so at home. SS was a proud granny and it was often difficult to get her to stop her long stories- difficult because they were so lovely to listen to; but I had work to do! SN wanted to go home but she needed to be in the ICU and relatives were keen to get her treated as best as possible. So it was me- telling her all sorts of stories and consoling her like a toddler. After 2 weeks, she sees me and throws her arms open for a hug. I had to hug her- she recovered so beautifully and told me to keep her 'as long as it takes'. Mr and Mrs D arrived together for admission and later lost touch because of being in different wards. Mr D was really missing and worried about the MRs. When I found out that she was doing well and conveyed it to him, he held my hand close to his chest and eyes full of tears just chanted 'Thank you' like a 100times.
AD was not very sick but she fought against every small intervention. She spat out the oxygen mask- brother spent an entire day just standing by her and consoling her and holding the oxygen mask in place so she would not desaturate- but Madam didnt want to have anything to do with the mask- so she went down and needed invasive treatment. One FS was so posh; he held family to ransom- would cooperate with treatment only if family gave in to his demands of special food, certain way of talking to him and all. Needless to say, this temper tantrum caused the affected treatment compliance and he had to avail of intensive care. It seemed to me- there are more ways of self harm than suicide- and all not by mentally ill people. So called 'normal' people have more mental health problems and they are resistent to interventions. These made me lose sleep.
The best moment was when we were in the consultants room watching the cctv monitors. On one screen was a middle aged lady and her two teenaged daughters. On another a young lady with a basket approaching the entrance. And suddenly both screens lit up with joy and dance from these 4 females. The entrance is placed in a way that one can see right upto the entrance of wards- that's the place relatives call patients so they can actually see them from afar. The young lady placed her basket and moved back. Then one youngster picked it up- then again a series of dance moves from both sides- this time with kisses flying to and fro. This was the most beautiful moment of relatives being thrilled with seeing each other and breaking into a dance and air kissing.
