Abstract

In lieu of an abstract, here is a brief excerpt of the content:Where the Journey BeginsJapmehr SandhuAs a fresh medical graduate in India, you are first required to go through a year of mandatory internship at your parent institute. Mine happened to start in 2021 at a government hospital in Northern India. There were a series of coincidences at that moment.To begin with, I started as a physician-in-training in the middle of the second wave of the COVID-19 pandemic whilst staying with my 70-year-old grandmother. This coincided with my hospital being declared a "COVID only" hospital and requiring the transferring of all non-COVID patients—critical or non. The country was seeing a shortage of oxygen supplies in private hospitals and even saw incidents of oxygen cylinders being looted. For my first rotation, I was coincidently allotted the COVID ward, which meant that my very first patient was a COVID patient. This start also coincided with all the second-year residents coming back after recovering from COVID—the confidence and thrill of fresh immunity translated into a shirking of any PPE equipment. With these fortuitous series of occurrences, combined with the fact that I had not seen a single clinical rotation in 2020, being 'overwhelmed' would be an understatement.This story is about my first shift. The sentinel thing that struck me upon entry was how it seemed I had automatically jumped up an imaginary level across professional hierarchies. Being offered a chair and a cup of tea seemed so surreal, but I welcomed it. It was also a subtle way of making me realise the change in my prefix and the duties that come with it. Armed with this greater power and greater responsibility, I embraced my first job of getting the whole ward's vitals down. Following this, I was told to focus on the patients on ventilators since the hospital did not have enough monitors for all the patients at the moment.Feeling like a novice doesn't even begin to describe how I felt being the only professional in the ward wearing a bright white PPE kit, resembling a half-filled balloon in the middle of the April heat, walking down the halls making "swish-swish" sounds. I had never seen a working ventilator till that point. I had never led interactions with patient families, and I had certainly not been in a position where they solely looked up to me for information about their loved ones' well-being since the ward did not allow visitors. This sense of responsibility made my tongue feel heavier than usual—like any and all sounds and words made by it would acutely affect the mood and behaviour of many. [End Page E10]One of the people accompanying a patient on a ventilator asked to have us check on their patient. I was sent for the same. The patient was in the same position as the morning, the ventilator continuing its job—obvious from the way the air was rushing through the pipes and making his chest inflate and deflate. The patient, a thin man in his 30s, was sickly and cachexic—I started with the vitals. However, the BP monitor couldn't measure the same, so I started using a manual sphygmomanometer. I couldn't locate the radial pulse and moved to the carotid, but with the tracheal movement by air being pushed in and out by the ventilator, it was hard to ascertain any other pulsation in the area. I decided to call my senior after feeling the patient's hands and feet and finding them cold. When the resident arrived, he immediately concluded the patient had passed away and turned to me and said, "Why did it take you so long"? Followed by, "He was fine this morning. What happened"? He then just went back to the resident room and continued scrolling on his phone after sending a brief message to the hospital group, which read: "One from Ward 6".My first shift of 6 hours saw 17 deaths. After each death, there was a notification in the group and a continuation of the cycle. Apparently, these patients were too far along to be saved from a disease that did not...