August 8, 2021 6:10:41 am
One eventful evening in mid-April 2021, after holding back for a while, I posted my contact details on a few online social platforms and circulated them widely on social-media groups, indicating my availability for COVID-19-related telephonic medical consultations. This may appear insignificant; however, it was a major personal decision. Fourteen years ago, I had made a conscious choice to practise public health and policy and stopped attending patients. However, this was not just another April in India. A ferocious second wave of COVID-19 pandemic had stormed the country and people were in frantic search of medical advice and health services.
In the days to follow, the messages and phone calls to seek health advice became routine. People had a variety of questions, including on clinical symptoms, when to get tested for SARS-CoV2, the interpretation of RT-PCR reports, Ct value, D-Dimer, CRP and HRCT. Home isolation proved difficult for many and people had multiple queries on how to make it work. Of course, there were requests for hospital beds, getting tested and for oxygen cylinders (which no one was in a position to help with). There were pressing queries regarding how to keep one’s child protected from infection when both parents had tested positive.
Many physicians rue that telephonic consultations are impersonal and lack the connection of an in-person patient consultation. Hippocrates — the father of medicine — would probably have agreed. However, this was a pandemic and unlike anything anyone alive had witnessed. The phone calls brought much-needed relief to people in distress. For a few days in late April and most of May, the trend of calls I received became my personal barometer of the pandemic situation in the country.
I had thought the calls would stop once the second wave began to decline. However, that did not happen. Instead, there was a major change in the nature of advice being sought. Now, it was much less about medical conditions but more on preventive and promotive types of health advice. A large proportion was from people who had recovered from COVID-19. A few had symptoms of post and long COVID-19 and many were worried that they may have contracted the virus without realising it. There were people who were seeking advice on whether they could go to a religious place and take a holy dip in a sacred river; a few others wanted to visit a hill station with family and friends. Someone’s father had received one shot of vaccine and was insistent on having a meal with his friends in a restaurant and his son wanted to know how to convince his father to refrain from it.
These may appear irrelevant issues but were of immediate pressing concerns to people. A mother in Lucknow got distressed as her 18-year-old daughter developed fever and rashes after vaccination; the fever continued for 11 days. A 73-year-old retired professor of ophthalmology in Kolkata developed a severe reaction after the first vaccine shot and wanted advice on what to do with the next one; a concerned husband of a 28-year-old pregnant lady, who had already had COVID-19 in the first trimester, wanted to know whether his wife should get vaccinated and when; the father of a six-year-old boy in Gonda, Uttar Pradesh, whose son was bitten by a stray dog and had level III bite, was worried about his child’s health, even though his anti-rabies vaccination had begun. There have been many other questions regarding behavioural issues in school-going children, the opening of schools, and about the selection and types of COVID-19 vaccines.
In these consultations, I prescribed medicines to a few, changed their ongoing treatment occasionally, but for nearly all I needed to counsel them on various preventive and promotive aspects. Nearly everyone needed a little better understanding of their clinical symptoms. More than physical illnesses, people were stressed due to either their own or their family members’ illness or possibility of it. Information was available from various sources, yet that online information was no alternative for a human voice or advice from a qualified medical doctor.
A few weeks ago, I received a call from an elderly lady, who had consulted me a few times and was now doing fine. She said, “Every time I consulted other doctors, they either gave me more medicine or changed the medicine. You were the one who patiently listened to me and gave me good advice. Now onwards, you are my doctor.” I am yet to take a call on whether I will continue to provide medical consultation or go back to public health and policy work. However, for me, there is one lesson from this pandemic — India needs physicians and a health system, who and which recognise that while medicines may be needed to cure some, most seeking health services need attentive listening and empathy from healthcare providers to heal.
(The writer is a physician and epidemiologist and co-author of ‘Till We Win: India’s Fight Against the COVID-19 Pandemic’)
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