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April 26: Envy, Relief, Thankfulness

By Shalimar Abdullah, MBBS

Today is 26th April 2020.

Kuala Lumpur, Malaysia.

University Hospital (Universiti Kebangsaan Malaysia). 

It has been 6 weeks since we first became worried about the COVID pandemic. I was scheduled to attend the Asia Pacific Hand meeting (APFSSH) in Melbourne, Australia on March 10th. But 6 days before my flight my colleagues started to back out one by one. Fears of sitting in the plane with someone unknown for 8 hours, using the cramped airplane toilet, possibility of not being allowed into the country–all those made me cancel my trip.

I took a keen interest in the goings-on in China and Italy but that made me very fearful. Four days after examining a patient from Indonesia I felt unwell, lethargic. But I had no fever. For 2 days I was very worried then finally decided to take the Covid test. Thank goodness it was negative but the 24-hour wait was extremely stressful. I still felt unwell though there was nothing I could put my finger on. Every morning I woke up wondering whether I was having a sore throat. After 3 weeks, I felt normal. I am not sure if I had the Covid disease at all or was I just having a psychosomatic attack?

My hospital began preparing for the onslaught. All elective cases were cancelled. Clinics were drastically reduced. Ward rounds were reduced to just 1 hand fellow and 2 orthopaedic residents. Consultations were over the phone unless the case was ambiguous. I had to go to the ward only once to decide if a case really needed surgery (a 55-year-old lady with lymphoma and extravasation of chemo drugs resulting in a possible abscess at the elbow).

Our country had a large COVID cluster of 10,000 people from a religious meeting attended by migrant workers. We had a migrant worker presenting with a two finger amputation, which we spent 5 hours doing a replant. We had asked him numerous times for any possible contact and signs and symptoms of Covid which he denied. At that point, Covid tests were not mandatory and we were not wearing full PPE. In retrospect, we were quite foolhardy but that was still at the beginning of the wave.

I had fluctuating feelings of envy and relief – envious of those who were really on the front lines – the anaesthetists, emergency physicians, respiratory physicians, nurses, paramedics whilst we hand surgeons were somewhat useless but also relief that we were not at the front lines. I consoled myself telling myself that I must stay at home first, conserve my energy, perhaps we will get called once the other specialties are overwhelmed, but we were never called. I was preparing myself for an Italian worst-case scenario, but the wave never came.

Having my 75-year old parents staying with me tempered my decision to not join a voluntary sampling team and to not be too reckless. To always be careful of where I went. Thankfully, Malaysia is doing quite well so far (fingers crossed) with about 5800 cases and 98 deaths in a country of 30 million people. In the last 3 weeks, I ended up doing much more work volunteering for my humanitarian NGO where we helped to sew PPE, supply PPE /medical equipments, deliver food packs and support COVID screening services. 

Dr. Shalimar Abdullah

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