Kathmandu: Dr Santa Kumar Das, a thoracologist (chest physician) at Tribhuvan University Teaching Hospital in Kathmandu, found himself in a dilemma earlier this month. Dr Das has been at the frontline in the fight against the coronavirus pandemic since its spread in Nepal. At 44, Dr Das has been on the job for 14 years, but the challenge the pandemic has posed has been unprecedented and daunting, both physically and mentally, he said.
That day, which Dr Das recalls as “one of the saddest” in his professional life, two heavily pregnant women came to the hospital–both with coronavirus positive showing severe symptoms. Both patients required intensive care, but the hospital had only one ICU bed left; Dr Das told Nepal Live Today recently over the phone while he was in between shifts. “There was no option for us but to admit only one,” he said.
Only one of them could make it out alive.
“Another one was looking at us with hope, probably with hope of her life and her baby’s life,” Dr Das said. “But we could not save her and her unborn baby.”
A brutal second wave of the coronavirus pandemic has coursed through Nepal for the past couple of months. The country has been recording fresh cases north of 7000 daily. Nearly 200 people succumb to the viral disease every day. The country’s already rudimentary healthcare infrastructure has been overburdened. Physicians such as Dr Das have had a difficult time, both physically and mentally, and are forced to make hard moral choices like in the aforementioned case.
The aforementioned case is just one of the many tough decisions Dr Das has to make in his line of duty. “I became a doctor to save lives, but now I am forced to choose between patients,” he said. “This has left me appalled.”
Faced with this daunting situation, Dr Das admits to feeling “helpless” at times, but he is careful not to let his emotions get in between his responsibilities, he said. However bad the situation may be, “I can’t get flustered,” he added. “People depend on me to save their lives.”
According to Das, around 70 Covid patients come to his hospital every day, most of them are in critical condition. He wants to treat them all, but he is forced to make difficult choices due to limited infrastructure.
“Often I cannot admit a patient due to unavailability of beds,” he said. “I can’t help but think that I could have saved a life, but my hands are tied. I feel helpless.”
These circumstances have taken a toll on his mental health, Dr Das admits. But by this point in the pandemic, he has trained himself to be resilient enough to do his job without letting his emotions get the best of him.
About 70 patients are under his observation daily. “The patients that come here are usually in a critical condition,” said Dr Das. “Some get better and go home to their loved ones but others lose their lives without even getting a chance to say their last goodbye.”
The good doctor has some words of advice so others wouldn’t have to go through similar fates. “The second wave is much deadlier than the first one,” he said. “It is in one’s best interest to maintain Covid protocol and get checked immediately even if the symptoms are minor. This virus is determined to severely damage the body, especially lungs. The more one waits, the riskier it gets.”
Because of the risk of being infected that he faces in his work, he has refrained from any physical contact with his family. He is vaccinated, but even the inoculated are reported to have been infected, so he needs to maintain safety, he said. “After seeing all those patients in the hospital, it terrifies me to imagine my family in that position. So, I try to maintain as much distance as possible,” he said.
Dr Das’s battle against the pandemic has three aspects to it–physical, emotional and, with a shortage of beds, moral
Similarly, his family members are also constantly worried about him working on a frontline during this pandemic. He says that his family, especially his mother, is always worried about his well-being.
“Even though they understand that this is my duty, the constant worry for my health never leaves them. My family will always be worried about me like the way I am for them, but I continue to provide my service nonetheless,” he said.
Indeed, even if technically he is supposed to look after the patients and be present at the hospital for specific hours, he has to be alert 24 hours a day.
“I might get a call from the hospital at any hour of the day, and it might require me to reach there immediately,” Dr Das said. “My duty never stops.”