‘You can hear the shells are getting closer’
The diary of neurosurgery specialist registrar Dr John Duddy on working in the thick of a pandemic, as recounted to Maeve Sheehan
ICOME into Beaumont Hospital kicking doors open and using my elbows to decant sanitiser from the dispenser. My first port of call is the changing rooms beside the operating theatre where I get into scrubs. I do a double take. The operating theatre doors are sealed up and covered with two huge signs saying: “Covid-19 ICU. No Entry.”
This is new, I tell myself. In fact, I was a little shocked by this stark reminder that we are in a coronavirus world. The hospital is physically changing.
I work in the neurosurgery department, which has largely escaped the onslaught of Covid-19. Beaumont is a national referral centre for brain injury, which means cases come to us from all over the country and they don’t stop for the coronavirus.
Working the night shift last weekend, I realised we were missing the usual weekend trauma injuries. No head injuries arising from assaults on a Friday or Saturday night. No alcohol-related falls on the street. No road traffic accident patients. Tumours, haemorrhages and seizures continue regardless.
These weeks have been the strangest since I became a doctor 12 years ago.
These past few days I feel Covid-19 is invading my personal space. The virus is invisible but it is making its presence felt: it is in the huge signs, the masks and the otherworldly personal protection equipment.
We operated on Thursday on a patient who had a brain tumour. Now we have to treat every patient as being Covid-19 positive. That means gowning up in full protective gear beforehand — gown, gloves, visor. “This is worse than when HIV started,” one of the team said when we were gowning down afterwards. “Yes, but you can’t breathe in HIV,” I replied.
It dawned on me that we’re going to be doing all our operations dressed like this for a very long time.
We’ve been expecting the surge for a while. The government restrictions may have held it back for now, but the feeling on the ground is that it’s coming. We were in the phoney war period but now you can hear the shells getting closer.
A little over a week ago, there were more than 50 patients with Covid-19 in the hospital. Last Thursday, there more than 90, including 20 patients in the intensive care unit (ICU). The two big glass doors to the new unit in theatre are locked but you can still get a glimpse through the window of the staff in their masks and gowns. Someone has stuck a sign to the glass, facing inwards, which says “We love you”.
We recognise the risks they run.
One of the things we have been told by the hospital is that the majority of the staff who tested positive for Covid-19 got it through social interaction, rather than patient interaction. Doctors have been debating whether healthcare staff should wear face masks all the time on the hospital campus, regardless of Covid-19 status.
St James’s Hospital and Tallaght Hospital introduced a facemask-for-all policy. I’ve heard on the ground that if everyone at Beaumont wore a mask in hospital they would run out of them in two days.
The jury is still out on whether they are effective protection from asymptomatic individuals, but the advice is changing on a daily basis. Some clear guidance for all from the Chief Medical Officer would reassure everybody. Physical distancing and regular handwashing with soapy water or alcohol gel are still the most effective known protections against the virus.
When I finished in theatre, I went back to the ward and prepared to finish up for the day. The ward manager said: “Look out the window, John, you’ll see something you’ve never seen before.”
In the open space between the two blocks of the hospital, I saw a squad of military vehicles and soldiers erecting a tent which will be a community testing centre for the coronavirus. I never thought we would see the Irish Army outside the window in Beaumont.
It brought home to us what we are dealing with.
‘These weeks have been the strangest since I became a doctor’