Something strange was afoot. Soon you could feel it in the streets, and in the hospital coridors, but it was apparent, at first, in the questions I was asking my patients. There was a new question now, an outlying question; one of those questions that muscle into medical histories from time to time, a question of the moment, pressing up against the same old questions doctors have been asking their patients for centuries. Do you have a fever? Are you coughing? And then, adjusting my mask, my tone acutely serious, I’d hone in: And have you travelled to Wuhan?
It’s been more than six months now since my A&E department turned, in effect, into a covid-19 ward. The virus chased out my usual mix of patients, the fractured hips and mucky coughs, the bumps and bleeds and mental suffering. Staff were redeployed to areas of greatest need, and our working lives were reconfigured — specialty training scratched, rotas upturned. We embraced the earthquake, mostly with pride and a sense of duty. This was what we’d been trained for.
Did you dream, during those early days of the pandemic? My dreams were unsettling and vivid, the mind’s revolt in a world so new, and upset. Writing, I found, was cathartic, a useful tool to settle my thoughts, to bring order and sense to things. Writing corralled those fears that run wild otherwise, rampaging through the quiet hours. Writing lent life a sense of reality too, during what was, and perhaps will always be, the most surreal time that I’ve been alive.
The A&E waiting room has been changed by covid-19, like so much else. I used to wonder if what I cherish most about the NHS could be found here. To me, the waiting room was Britain, in microcosm, though blessedly free of the usual hierarchies. In the waiting room, we attend to your clinical need, but your money and status don’t help you jump the queue. Here’s the cancer patient, hunched over a carboard bowl, the anti-sickness drugs not breaking though the violence of chemotherapy. Here are diabetics (who are also dads, sisters, solicitors, labourers, immigrants and Rotarians, film buffs and amateur ballroom dancers…) Here’s the drunk, the septic, the bruised and the hopeful. Relatives are on hand to comfort patients and occasionally, patients chat to one another too. There are often small, funny moments here, in contrast to the pain and sadness, yet somehow a sense of harmony reigns.
Often, it was too full. Some days it spilled into corridors and the paramedics got backed up, delivering more patients into a relentless swish of medics in vivid scrubs. But even so, it’s a reminder — the best I can imagine, in fact — of a value that feels so much under threat. Togetherness, beyond the hospital walls, can feel anomalous, fantastic, even, amid signs of ever greater anxiety, entrenchment and division. So I like to dwell on the togetherness of the A&E waiting room, even when it’s a gloomy place, or when we, the staff, feel overwhelmed and mad.
Yet now, Covid-19, some scrap of protein, on the very edge of life, has transformed my place of work. Relatives have been exiled to carparks. These partners and sons and mums and cousins and sisters… they were a window into the lives of my patients, a handy source of information as I pondered their loved one’s pathology. They could be an ally, an aide-mémoire, a hand to hold as a needle punctures skin, a tea giver. I miss having them around.
We’ve been trying to get patients into cubicles sooner, out of the chairs and away from others, it’s safer that way. And as the A&E department has adjusted, I’ve lost this messy reminder of what the NHS is for, which is people — every single one of them. It’s been compelled to change, along with everything else. I just hope that the values sustaining our health service never do.
(A version of this article was originally published in NB Magazine, Issue 105, Autumn 2020, and again in The Griffen)