The COVID-19 pandemic has caused upheaval and change all around the world. For me, it has led me on a journey from being a spine surgeon to an orthopaedic surgeon, then a doctor and finally to a potential patient under quarantine. I suppose it was inevitable that I ended up on home quarantine. My siblings and I are either doctors or have married doctors and most of us, in some way or form, had been exposed to COVID-19 patients. My sister-in-law had worked in a medical ward the past month and she developed a sore throat one Sunday morning. Before the day was over she had been swabbed and an ambulance had been dispatched to convey her to the hospital.
A tale of two cities
Prior to this, I had been serving as part of the medical team in a migrant worker dormitory. I suspect that when the history of the COVID-19 pandemic in Singapore is written, it will be one that tells of two different pandemics in the same country. We all know the story of a well-controlled outbreak in the local community and another in the migrant worker dormitories that almost spiralled out of control. There are many people who have served longer and contributed more over the past few months then I have in the short weeks that I was serving. However for me, it was one of the most chastening and humbling experiences in my medical career.
I had treated many foreign workers as an orthopaedic surgeon. I liked to think that I had been a caring doctor and that I had done my best to ensure their welfare. Working in the dormitories, however, made me reconsider my opinion of myself. Did I truly understand them as patients? Had I truly treated them as individuals or as fractures to be fixed and patients to be sent home as soon as possible? Speaking to them, I learnt something about what they liked to eat and a little about what they believed – perhaps it was time for me to learn more about these men who built my country.
As doctors we like to have answers and solutions for our patient's problems. It was extremely humbling to realise that I had none. Many of the infected migrant workers could not understand why they had to be isolated. Some had not even been told that they were COVID-19 positive. Those who knew were worried as they had been reading for months about the mounting rate of COVID-19 deaths worldwide. They did not know how long they were to be confined and when they would be able to return to work. I couldn't tell them when they would be out of isolation; I didn't know when things would be normal again. I could only hope and assure them that things would improve, and they did. A steady stream of supplies from both governmental and non-governmental organisations began to arrive and seeing the workers' morale and our rapport improve was an extremely fulfilling experience. I hoped that I would be able to serve till the end of the circuit breaker but alas, this was not to be.
In the same storm but not in the same boat
When my sister-in-law got diagnosed I could not help but wonder – was I the one who had brought the virus home with me? Had I accidently touched my face or rearranged my mask while seeing the patients? Had I breached the safety protocol in my haste to get out of the stifling heat and personal protective equipment? It was okay if I was infected; statistically I had a pretty good chance of recovering, but what about my pregnant wife, my young children and my parents? The next few days were quite stressful as both my kids had to be swabbed to make sure that they were not asymptomatic carriers. Restraining a three- and two-year-old while they are being swabbed is not a pleasant experience for the child or the parent. I couldn't help but wonder what the neighbours thought about the stream of ambulances appearing at our house. Then a mobile team was dispatched to my home and I got to experience first-hand what my patients experienced. Getting swabbed myself was an unpleasant experience, and I realised that I had not been entirely truthful when I told my patients that it would only be mildly unpleasant. Thankfully we all tested negative and it was time to settle in to life under quarantine.
I could not help but compare my life under quarantine to those of my patients. I did not have to worry about my job and I knew exactly when it would end. I did not have to deal with the uncertainties that my patients dealt with. I could work to some degree and most importantly I was together with my loved ones. I could take this opportunity to spend time with my family while I knew some of my patients had not seen their family in years. Simple things like having the space to exercise or a choice in what to eat were luxuries my patients did not have. It would have been churlish of me not to count my blessings and be thankful that all I had to deal with was the stress of trying to sing my daughter to sleep or re-enact the story of David and Goliath for the tenth time with my son.
In many ways, the hardest part of being on quarantine was the feeling that I was no longer useful. I think that one of the defining characteristics of all of us who practise medicine is a desire to be of service, to do our duty and help others. It can be a disconcerting experience when that opportunity is taken away. I still kept in contact with the rest of the medical team and I got first-hand accounts of how many patients they were treating and the issues they faced every day. It is very hard to be part of a team and not contribute, but I knew it was better to stick to the rules and complete my quarantine rather than be the potential cause of another cluster.
This quarantine experience has in some ways been a blessing in disguise; it allowed me to spend time with my children and helped me prepare them for the arrival of my third child. My sister-in-law recovered without complications and no one else in my family was infected. At the same time, it made me realise how fortunate and privileged I was to be a doctor, to be able to live in my country with my family. I hope that when this pandemic ends, we do not forget what we have learnt and make a concerted effort to improve the living and working conditions of these men who have helped build our nation.