'It will get better, the end will come': Palliative care doctor describes working amid 'exhausting' pandemic

·6-min read
doctor man taking a break, looking tired, exhausted or sad. Wearing protective gloves, mask and stethoscope. coronavirus covid-19 concept
A palliative care doctor insists the pandemic is 'what he signed up for' when he became a medic. (Posed by a model, Getty Images)

A palliative care doctor has opened up about working amid the coronavirus pandemic.

The unnamed medic, 53, who works at a hospital in England, has at times felt “exhausted” by the “desperate situation”.

With visitor numbers restricted, he has been forced to hold phones over dying patients, while their loved ones say goodbye via FaceTime.

Rising patient numbers and porter shortages even saw the doctor taking dying patients on “trolleys” to a palliative care unit, where they could die with “dignity”.

While hospital admissions are at the highest level of any point in the pandemic, the doctor claims the first coronavirus wave was more challenging, when medics were somewhat in the dark about how to best treat patients.

Read more: Website calculates coronavirus transmission risk for given room

With healthcare workers now more “confident”, the medic insists “this is what he signed up for as a doctor”.

Having received his first coronavirus vaccine dose, the doctor reassures the pandemic “will get better, the end will come”.

Hospital emergency, medical staff pushing patient on gurney.
Terminally-ill patients have reportedly been run down to palliative care units where they can die with 'dignity'. (Posed by models, Getty Images)

‘This is what I signed up for as a doctor’

The doctor initially cared for both hospital and community patients, despite the transmission risk of entering people’s houses.

“We made a positive decision to keep visiting people at home,” he told Yahoo UK. “It was quite a bonding moment.”

The pandemic quickly caused the number of beds on his ward to rise from 10 to 38. While demanding, the medic has long had to contend with terminally-ill patients.

“For palliative care, death and dying is our bag,” he said. “It’s [the pandemic] been our moment.”

That is not to say he has not found it challenging, however.

Read more: COVID death risk nearly doubles when ICU capacity exceeds 75%

“The first wave was a real learning curve; all these very sick, very ill people dying very quickly,” he said.

“There weren’t enough porters so we would put them [a patient] on a trolley and run with them down to our unit so nurses could look after them and give them a dignified death.

“You’d think ‘I can’t do this’. I was working seven days a week, but it felt like really worthwhile work.

“This is what I signed up for as a doctor.

“It isn’t about me, it’s about helping patients.”

While UK hospital admissions are high, expert understanding of the coronavirus has come a long way, with drugs like steroids now known to cut the risk of death among patients on ventilators.

“People [medics] have learnt and are managing symptoms much much better now,” said the doctor. “There are guidelines out there.”

Initially, the coronavirus reminded the medic of working during the 1980s HIV scare.

“People [healthcare workers] were terrified to go near these dying [Aids] patients,” he said. “This [pandemic] has similar feelings.

“In the first wave people were really frightened; didn’t want to go near these [coronavirus] patients.

“Now people aren’t blasé, but a bit more confident.”

Watch: Can you catch coronavirus twice?

While the doctor is well versed in treating terminally-ill individuals, the pandemic has put strict restrictions on visitors, with the regulations varying between hospitals and at different stages of the outbreak.

“Often we’d be holding our phones up over patients,” he said. “The chaplain would be giving the last rites and we’d be trying to FaceTime three or four different people.”

The medic has cared for patients who are terminally ill as a result of COVID alone, as well as those who caught the infection while being treated for another condition, with the coronavirus ultimately causing their death.

Others were already dying of a terminal disease like cancer or kidney failure, only for COVID to accelerate their decline.

The doctor is currently caring for a coronavirus patient whose legs have turned gangrenous, likely due to the infection making his blood “stickier”.

“He’s delirious, he’s in pain,” said the medic.

Read more: 10% rise in mask-wearing triples chance of coronavirus’ R being below one

Another man is battling both oesophageal cancer and the coronavirus, with the latter set to end his life.

The man had a stent put in his oesophagus to open up the blocked area, enabling him to swallow.

“It ruptured so everything he swallows goes into his COVID-infected lungs,” said the doctor.

“He’s alone in a bay with no windows, just looking through plastic, with five demented old ladies around him.

“That’s where he’s going to be for the rest of his days.”

‘I was resigned to getting it’

Personal protective equipment (PPE) has helped protect healthcare workers throughout the pandemic, however, masks add a new challenge to communicating with patients.

“It’s exhausting,” said the doctor. “Some patients can’t tolerate it and take the mask off; they’d rather die than wear a mask.

“[Imagine] you’re elderly and hard of hearing, and then isolated in a room where you can’t hear people properly, then we wonder why they get scared and muddled.”

The doctor therefore tries to connect with his patients by talking about “non-medical things”.

“Sometimes just sitting with them – ‘tell me about your dog, what did you used to do as a girl?’,” he said.

“Trying to anchor them to something that has meaning to them.”

While news of PPE shortages have repeatedly hit the headlines, this was never an issue for the medic, who instead noticed some staff were stockpiling masks and gloves, much like the public did with toilet paper.

“In the first wave we were all so fed up with staff found with big boxes of gloves going home on the bus, but that’s all stopped,” he said. “Staff were terrified so were taking stuff.

“There was enough PPE as long as people played the game.”

Read more: Scientists get a grasp on long COVID’s cause

Despite wearing the protective equipment, the doctor caught the coronavirus.

“I felt fluey for a few days,” he said.

“We [medics] were face to face with patients coughing all over us, so I was fairly resigned to getting it.

“However well you wash, it’s in your hair, it’s on your feet.”

While the doctor appears to have made a full recovery, he has seen colleagues endure lingering complications, with “young nurses” even developing kidney and heart failure as a result of the infection.

While 2021 may be off to a rather bleak start, the doctor has stressed the pandemic will pass.

“It will get better, the end will come,” he said.

In order to get back to life as we once knew it, however, people must take up invitations to be vaccinated.

“If you want to die gasping in A&E that’s your decision, but you’re expecting me to look after you and it’s avoidable if you have the flipping vaccine,” said the medic.

“Whatever you’re scared of, it can’t equate to dying gasping on ventilation.

“Just roll your sleeve up.”

Watch: What is long COVID?