The Covid-19 pandemic has influenced lives in many aspects. Doctors from every stream have come to the same platform irrespective of their specialization and has been involved in Covid management from prevention, mitigation, awareness, treatment and management of complications. I would like to share my experiences of how plastic surgery training helped me in moulding myself and emerging as a confident Covid Specialist.
On 22nd March 2020 after nationwide lockdown orders were issued in India, all outpatient and elective services were cancelled at our centre (Dedicated Covid Hospital) to utilise the available manpower and conservation of resources and also to minimise the exposure of healthcare workers. Areas like Flu clinic, Covid ward and ICU were made functional and surgeons were posted in wards similar to physicians. On the first day of duty, I was having a mixed feeling of apprehensions and excitement about entering inside the Covid ward and seeing my first patient. After donning personal protective equipment (PPE), I simply found myself looking like an alien and emotions got converted into thrill and adventure (Figure 1). Initially, I tried my best to memorize the battery of investigations and medications as per protocol and was also braining a flow pattern for my first medical rounds (after internship) so that I don't miss on relevant things. It was the same feeling as before performing a new surgery in residency days, trying to memorize the steps and doing virtual surgery in my thought process. I used to scan through the CBC, LFT, KFT, LDH, CRP, Procalcitonin, ferritin, PT/APTT/INR trying my best not to miss any derangement and prescribed medications as mentioned in the SOP especially their doses. Once these steps were followed, I used to scrutinize the general status of the patient whether sick, oxygen saturation, if requiring oxygen, at what flow rate, whether improving or deteriorating, requirement of ICU. Then there were other decisions like when to prescribe Tamiflu, remdesivir, toclizumab, plasma therapy.
Within only 2 to 3 days, I became fluent like mastering a surgical technique after operating few cases by own. I also learnt not only how to manage the Covid presentations but took care of the comorbidities like diabetes, hypertension, chronic kidney disease which were commonly seen in these patients. Then I also took the responsibility of making two 500 bedded Covid care facility functional at two other districts of the State. There, I got the opportunity of working with doctors from armed forces, understanding their work culture and extending all the support which provided an entirely new experience outside my own institute. Every day, after the rounds with Covid patients was over I used to feel like a conqueror. With time, my all fears got suppressed and I started returning to my normal enthusiasm and courage with which I worked in operation theatres before Covid streamed in and the same was displayed. In the words of Mr. Nelson Mandela - "The brave man is not he who does not feel afraid, but he who conquers that fear." 1