The hidden hell of life on the NHS front line
Dr Rony Berrebi says the pandemic is putting healthcare workers at risk of developing PTSD
Ihave been an intensive care doctor for 15 years, but nothing could have prepared me for what has been happening at my major London hospital during the pandemic. It has been absolute hell.
The sheer number of patients who come to us fighting for their lives is unthinkable. It is as though there is a bomb or terrorist attack on the doorstep of the hospital twice a day, every day, for weeks on end – and with no finish in sight.
Many of the patients I treat are of a similar age to me, which is scary. I am 38 and not in an at-risk group, but I’m treating swathes of people in their 30s and 40s. I can’t imagine the pain my wife and three-year-old son would feel if I were to succumb to Covid-19. My son loves superheroes, so I tell him coronavirus is the “bad guy” and Daddy’s a superhero. He likes to act as a doctor and help Mr Potato Head recover from coronavirus.
But recently, he has been waking in the middle of the night and visibly recalling his nightmares. In them, my wife and I have left him in the middle of nowhere and he is completely alone. The mental impact on him is already huge, even though he doesn’t fully understand what is going on.
What if the worst was to happen? I try not to think about it, but it’s hard to avoid when I’m confronted with death every day at work.
One of my mentors died from Covid-19, having deteriorated very quickly. He had plans to retire and buy a boat, but having worked so hard for decades, his dreams were snatched away. The former medical director of the hospital died with coronavirus. Many of us NHS workers have had to treat colleagues – you can’t help thinking, “It could so easily be me”. It’s heart-wrenching.
We have treated two entire families, multiple generations who have been hospitalised together. These are close families where the kids, parents and grandparents all mix under one roof. An elderly member falls ill, is hospitalised and dies, only for their child to be admitted with the same disease. It’s a dark moment when you realise there is no next of kin to call, because they are themselves in ICU, fighting for their lives.
Another death that hit me hard was of a young mother who died with Covid-19 shortly after giving birth. Her family weren’t allowed to be there.
Relatives are distressed that they can’t be with their loved ones for their final hours. We have managed to get a few iPads into the wards so they can say goodbye over video, but it isn’t ideal. Even though families understand how high the risk is, they yearn to spend the final moments together.
It is at these times our job feels inhumane. As a doctor, I feel powerless. Some patients will spiral, no matter how hard you try to help them, do all you can, but you can only watch as they deteriorate: oxygen, CPAP, ventilation, death.
Our hospital has been trialling different treatments, but from what I’ve seen, there’s little we can do to relieve the symptoms, and it’s terrifying.
We are overwhelmed. A huge number of patients have been transferred to the London Nightingale and nearby hospitals. I have watched nurses burst into tears as well as doctors burn out.
Nights are particularly strained, because on top of the stress from dealing with a pandemic, you are also exhausted. At the beginning of the crisis, there was a 10-day period when I just couldn’t focus, the deluge was so intense.
I trained in France, where they
‘We’re overwhelmed. I have watched nurses burst into tears and doctors burn out’
have constant mental health support in ICUs for patients and staff. They are there when a patient is admitted to the ward, when you do a handover and during lunch breaks.
By being a part of the life of the hospital, staff find it easy to open up to them. We need the same in Britain if we are to prevent a flood of health workers from getting post-traumatic stress disorder. If you act early, you can prevent and treat it before it becomes debilitating.
Music helps me cope when I am mentally drained. I have written a song, called Superheroes, which I am using to crowdfund for a psychologist in every ICU in the country. My colleagues have found it moving and the response has been fantastic.
A psychologist from Macmillan has agreed to help on our ward twice a week. My goal in the long term is to create a charity to support doctors and nurses on the front line.
Facing death every day is overwhelming. It’s our job, but that doesn’t make it any easier.
To donate to Dr Berrebi’s campaign, visit crowdfunder.co.uk/nhsheroes. NHS Heroes: Fighting to Save Our Lives is on Channel 4 on Wed, 9pm