The Spanish flu claimed total mortality figures of over 25-50 million people worldwide over a period of three years. It was the pivot along with World War I that shifted the balance from the ‘roaring’ 1920s to the ‘groaning’ 1930s.
And yet, I never knew it happened till COVID-19 came bursting into our lives in 2020.
As a medical intern, life is hard. It is a watershed time, between the uncertainty of what lies on the other side and the comparatively remarkably privileged years it follows. It is the year one gets their first taste of what it’s like to work in the field, when the bewildering gap between theory and practice in medicine thrusts itself in one’s face.
It was under such circumstances at the PHC in Dayalpur in Haryana that I found myself reading a notice telling me that we’d been posted to the National Cancer Institute in Jhajjar on COVID-19 duties during the second wave.
Now here’s the thing about primary health postings – they’re not exactly pleasant. Poor medical literacy, poor quality of services and an intern’s lack of expertise in general make for a dangerous cocktail. The prospect of Covid duties immediately after such a posting seemed grim, but we brushed aside our apprehensions and prepared to go.
I’ve read reports in the media about the sheer brutality of the second wave in this country. But what we saw go down in those days – day in and day out – is not easy to put into words. Philosopher Ludwig Wittgenstein famously commented on the need to restrict the use of semantics and language only to convey concepts small enough for the human mind to grasp. The devastation sweeping through the humdrum lives of Indians in the month of May 2021 was a bit too much for me to wrap my mind around.
What exacerbated the whole issue was that we were interns, moderately trained in simple procedures like Foley’s, poorly trained in procedures like arterial samplings, and untrained in procedures like inserting arterial lines. It’s remarkable because ordinarily nobody truly expects interns to go around putting arterial catheters, but such was the level of understaffing that it seemed like the only viable solution. The hospital was clearly struggling to provide enough nursing staff and orderlies, let alone doctors.
An experience that particularly stands out is taking a 64-year-old intubated patient for a CT scan with an orderly. Due to faulty equipment being in abundant circulation in those days, we didn’t realise the meter on the oxygen cylinder was showing random readings until it unexpectedly showed 0 psi, and the patient started rapidly desaturating. Some amount of screaming at the radiology personnel enabled the availability of the second emergency cylinder in the reporting room, and the patient was maintained on a rather frantic bag and mask ventilation until then.
She survived that day, only to pass away three days later due to respiratory failure. Realising at that moment, that the bag and mask were all that stood in the way of death and the woman was a defining moment of the duty for me.
Food was provided in the central cafeteria, a simple affair of vegetarian meals invariably comprising a solitary piece of paneer swimming in thin curry, watered-down raita, barely cooked wheat rotis, and an unhealthy amount of dystopian hopelessness. People sat, socially distanced, soberly and stoically discussing whatever latest tragedies they saw befalling poor patients during their shifts.
For good reason too. From my room on the campus, I got a clear view of the cremation ground designated for Covid victims. And there was a ten-day period during my one-month stay there where at any given time of the day, some poor soul was being offered to the high heavens. The cremation staff did their silent marches up to the grounds and back, not once looking up at the billowing smoke rising from the ashes.
In my mind, I believe, for a couple of days around May 10, I was prepared for anything. I distinctly remember someone telling me how a zombie apocalypse would’ve been rather more comforting than this one; we would’ve had no hope, for one, and less empathy for the victims to boot.
But just like that, within a week, cases started to go down a bit. We were posted out at the end of May. I remember packing my bags in a daze, not quite believing the worst was over, and driving back to AIIMS; leaving the place where I had felt closest to seeing an apocalypse unfold now but which also acted as a kind of salvation for my soul.
If the world was ending, I’d done my best to fight it.
It is only today, three months later, that I checked the total mortality figures for Covid. Turns out, they’re still not as much as the Spanish Flu. And it is today that I realise that it won’t take much to forget about everything that happened once it’s over. We’re inherently fickle beings.
And yet I can’t help but feel a measure of empathy and ungrudging respect for the forgotten victims and warriors of the previous pandemic, the current pandemic and the next one to come.
Sanil Garg is a medical intern at AIIMS. He is an avid writer and a drummer, who enjoys sports and music.
Featured image credit: Pariplab Chakraborty