Trigger Warning-Important: This article is written about life working at the frontline of the NHS. It describes some aspects of treatment for Covid-19 which may be difficult to read for you.

I step in to the cavity between ignorance and apprehension, the Covid-19 inflicted victims on the other side of the wall. Here is where we ‘don’ up- a process where we layer disposable items onto ourselves in a bid to protect us. A gown, an FFP3 mask, an elasticated hat, a pair of surgical gloves and a visor. There is a mixture of appreciation and guilt at the amount of PPE (personal protective equipment) we’ve been given, knowing full well the scarcity of supplies elsewhere. I can already feel the metal strip dig into my cheeks. I don’t deserve to complain. The mirror within the donning station displays four other people dressed the same. It’s difficult to know who’s who.

Approximately 30 patients are on the ward. Each one of them is attached to a ventilator, a tube put down their throat while oxygenated air is forced into their lungs. The bilateral expansion of their chest looks involuntarily challenging. They’re all deeply sedated to preserve as much energy to fight the disease. They’re unable to eat or drink, and so nutritional support is given via a tube from their nose into their stomach. If it weren’t for their chest rising up and down, and the confirmatory ECG trace on the monitor, you’d think they were dead.

The day shifts and night shifts were indistinct. A constant sound of buttons and bleeps echo through to the high ceilings. We do approximately 25K steps in one 12.5 hr shift, making going to bed the day’s most anticipated experience. I struggle to sleep after the shift, as the day’s memories follow me into the present. Luckily the hotel room has blackout curtains, but even then, darkness is not dark enough here.

The work here is so different to my usual job. In my usual job, the majority of patients were unconscious artists of their own misery, and what they call their symptom is, in fact, their life. Here, on the other hand, patients were made unconscious in an attempt to manage their symptoms. This indiscriminate disease attacks with the intention to kill. In some people, they are completely asymptomatic, in others it can take a few hours to a few weeks to either recover or pass away.

I felt a profound sense of powerlessness, that I, like every other being on the planet were at the mercy of God.

Lots of professions make up an ICU unit: nurses, ICU doctors, anaesthetists, radiologists, healthcare assistants, radiographers, clinical scientists, biomedical scientists, physiotherapists, pharmacists, operating department practitioners, porters, clinical engineers to name a few. Very few people here know someone from their previous jobs. We’ve come to work at this hospital alone. This brings about an unusual kindness and friendliness among Londoners, feeling for common ground as we speak. We initiate conversations of life before Covid-19, of our pregnant wives we’ve left at home, at the husband and children we haven’t seen for weeks, at how lovely it would be to taste fresh, ground coffee amongst friends again.

As days went on, I became annoyed at my own clumsiness. The way I allowed the patients to drag me into the vortex of their passion, spume and irruption of their unconscious. Notes left from their friends and family telling them they love them. Paragraphs of their lives, their likes, religion, hobbies, occupation, family. Humans are machines of interpretation and explanation; all these fragments are displayed around the patient and we can’t help but try and piece their lives together. Some of us will go a step further, and relate to the patient as one of their family members, neighbours, friends. The distressing thing about the spread of this disease is that nearly all of the patients on the wards were key workers: ward clerks; bus drivers; teachers; nurses; engineers etc. It shows us the disproportionate impact this virus has on the people that keep our society going.

It could have been any one of us attached to that machine.

The thick filter layers in masks make our breathing difficult, and so I often find myself breathing harder and deeper. Assessing the patients during the ward round, only emphasises the discrepancy between the movement of air in my lungs, and the stillness of theirs. I know that most people in there coped with it by pretending suffering didn’t exist. ‘It’s best to detach yourself. You need to look after your mental health’, I often heard people say. I wouldn’t be surprised if there was some sort of psychological impact that follows through after the pandemic.

There were several patients who had recovered. These were the stories we shared with our friends and families. Of how one patient remembered how we held their hand when they were at their most sick. Of how another patient remembered how we played their favourite music station, whilst they were recovering.

It was nice to see the colour return to their cheeks and for the warmth to return to their hands.

It’s easy to lose track of time in there, with the lack of clocks and windows.

Luckily my colleagues encouraged us to take frequent breaks. In the lounge, there were lots of donated food, teas and coffees that we’re all grateful for. Acts of kindness and generosity are abundant nowadays, but maybe that’s because it’s the most powerful form of distraction. If anything, what this pandemic has taught us is that as humans we appreciate that life, communities and society is sewn together by the needle of exchange. The impact of this virus is international. The checking in on our elderly, the reduction in our air pollution, the liberated wildlife, the extra time spent with our children, the weekly recognition of some of the lowest paid but vital workers, and the list goes on. This deadly virus has shown us how much better we can be together.

Working on the frontline taught me what it means to be human. To be vulnerable and finite. Suddenly, the contemplation of death, and life for that matter, plants within the soul elevation and peace. Hopefully, once this whole Covid-19 pandemic is over, it will allow us to see the world in its true light.

Humayra Abdul Razakq

Diary of Working on the Front Line: “It’s Easy to Lose Track of Time in There, With the Lack of Clocks and Windows. ”

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