Hazel McHaffie

human face

Three months and counting

Milestones are useful hinges for reflection: three months ago this week the first Covid-19 death was reported in the UK. Since then, as per the official statistics yesterday, in this country there have been a further 39,727 deaths recorded where the deceased had a positive test for the virus. Say that again slowly – THIRTY-NINE THOUSAND SEVEN HUNDRED AND TWENTY SEVEN DEATHS. Not to mention the legion of unconfirmed cases. These are indeed unprecedented and calamitous times, so it seems fitting to consider something quite different here. Not a book; not a scientific paper; not even a film. But a newspaper article.

A beautifully written article in the Review section of the Guardian on Saturday, and one of the most sobering and moving pieces I’ve read in the proliferation of writings about this devastating disease. I wasn’t surprised to find that, before going to medical school, the author, Dr Rachel Clarke, was a current affairs journalist and documentary maker.

Her usual habitat is palliative care medicine in a hospice, but during this crisis she’s been working with patients dying of coronavirus. Politicians and journalists speak ‘loftily, from afar, an Olympian perspective’, she writes, and listening to them can feel like ‘a mathematical abstraction, an intellectual exercise played out in curves and peaks and troughs and modelling‘. But where she is, in a hospital, dealing with real people caught up in this horror, ‘the pandemic is a matter of flesh and blood.‘ And she is utterly appalled by the gloss the politicians have been putting on the devastation and loss.

Used as she is to comforting, hugging, being up close and personal, the very execution of her job now cuts her to the quick.
‘In PPE, everything is sticky and stifling. Voices are muffled and smiles obscured. Sweat starts to trickle into your underwear. Even breathing takes more effort. Behind our masks, we strain to hear each other speak and are forced to second guess our colleagues’ expressions. Being protected entails being dehumanised.’
Approaching relatives of the dying is immensely painful and counter-intuitive.
‘I am a doctor with neither name nor a face. My hospital badge is hidden from view and my eyes – the only part of my face still visible – are obscured by a layer of Perspex. So much for the healing presence of the bedside physician. I scarcely look human … Everything about this is wrong.’

She illustrates her experiences poignantly with reference to a single encounter with an 89-year-old man slowing drowning in his own secretions. His sons, bewildered and afraid, enter the other-worldly scene only for the last farewell. Her own emotions plummet as she watches helplessly, unable to offer the human warmth that is her instinctive response. Neither she nor they, want this elderly gentleman to be a mere statistic – a number reported in the next day’s death toll. He is so much more than that.

Dr Clarke and her colleagues at the frontline know for sure that the soundbites trotted out at the central podium in Downing Street each day have not been borne out by the reality in the Covid wards or the care homes. Social isolation, PPE, testing, lockdown – the deficiencies and delays and shortfalls have appalled them; the article captures the discordance perfectly.  Once lockdown was established, and the quarantined population were trying to manage its fears using ‘the unconventional strategies of baking bread and stockpiling toilet rolls’, the medical staff were reeling. Fearlessly, urgently, frenetically, they threw themselves into delivering high-quality pandemic medicine. They could only look on in disbelief as staff were obliged to fashion PPE out of plastic bags, patients were sent into care homes without tests to establish their Covid status, and restrictions were being lifted in the absence of the necessary infrastructure for proper testing and tracing.

The country may be letting its collective breath out cautiously as the numbers decrease, but they are still battling this deadly enemy. They feel sick as the politicians declare the success of their strategies; they know at first hand the stupendous costs of delay and deficiency, the real tragedy of thousands upon thousands of deaths and bereavements. They were, they still are, there, ‘up close with this dreadful disease‘,  seeing ‘the way it suffocates the life from you‘. For them political judgements ‘were grotesque‘. They themselves are ‘exhausted, stunned – shellshocked, even‘. Clarke’s verdict? The loss of so many vulnerable citizens is ‘entirely and inexcusably wrong … no one is expendable‘.

I certainly don’t envy any of the people who must make these decisions, but putting a spin on the devastation, peddling untruths and half statistics, making false promises, doesn’t engender trust or confidence. And as Dr Clarke says, ‘The point of our response to corona virus is not to flatten curves, ramp up headlines, protect the NHS or invent mathematically nonsensical equations: it is to prevent unnecessary dying’. And there you have it. The heart of the matter. Summed up by someone at the very kernel of this global catastrophe.

She’s the author of Dear Life, paperback version due out in September this year. It’s top of my wish list.

NB. To be fair, First Minister Nicola Sturgeon, in her daily updates for Scotland, always stresses the tragedy of every single death.

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