Rajani Surendar Bhat is tired of saying “no.”
She wakes up with dozens of requests.
Requests for a bed, for care, for medication.
Requests from family, from friends, from acquaintances.
Her phone has been buzzing continuously for weeks.
“You can’t complete a single conversation without a new request or a message coming in,” says Bhat, as her phone lets out a shrill beep, as if on cue.
“I feel ashamed to open their message in the morning and have to answer ‘no.’ As soon as I wake up in the morning, the first thing that I do is I say ‘no’ to a whole bunch of people who I know if I could have in the hospital, I would be able to help.”
Bhat is an interventional pulmonologist in Bengaluru, India. For the past year, she has been among the country’s health-care workers battling the pandemic and among those who, in the past couple of months, have been responding to India’s second viral wave – now culminating in the massive surge in cases and thousands of deaths per day.
Bhat has been seeing patients online for the past few weeks, staying home to care for her mother, who is recovering from COVID-19. She notes the past two weeks have been particularly difficult for her, on a personal level, with her family losing her uncle to the virus. Not only is Bhat deeply saddened, having cared for her uncle for five years, but she initially blamed herself for his outcome.
“I couldn’t even speak to his brothers and sisters for a week because I felt I failed them completely,” says Bhat.
When her uncle required medical attention, Bhat says she hunted down a hospital bed, a difficult feat during what has become a national bed-shortage crisis. Despite her efforts, she says he did not get the right treatment at the right time in hospital.
“I couldn’t get him the procedures that he needed. I couldn’t get him that higher level of care that he needed to make it out of there,” says Bhat of her uncle, who died last week. “It’s only now that I started to reach out to (my family), one by one, and had a long chat with them over the weekend. I’m coming to some degree of acceptance that these were circumstances that were beyond my control.”
Bhat says despite her persistence in advocating for her uncle and his medical needs, the proper course of action was delayed for days because specialists in the overwhelmed hospital system could not assess him
She says the random nature of who lives and dies, who gets treatment and who gets turned away is incredibly frustrating. She says she hears about someone in her family’s circle dying every day and feels an intensifying sense of shame at not being able to help everyone.
Just days before her uncle needed a bed, her friend, who waited 10 hours to get a spot, received access to a hospital. Bhat says the beds, while free, are given through city allotment, and she notes it is either privilege or a “stroke of luck” that gets a person hospital care.
“(My friend) was saying ‘What separates me from someone else who did not get this bed?’ She knew how lucky she was, that she reached a place, at the right moment when she needed the help,” says Bhat. “But it wasn’t without that sense of ‘Oh my God, there are others who also needed this who won’t be getting it’… There’s so many we’re not able to help.”
Back in March 2020, the buzz among her tight-knit network of doctors and colleagues around the world alerted her that it was only a matter of time until India would be hit with seismic outbreaks like those seen in New York and parts of Italy.
“I remember spending sleepless nights sobbing on the sofa,” says Bhat. “I (was) listening to my friends and colleagues describing what can only be called horror in countries which have far better medical infrastructure, healthcare infrastructure than us.”
This past January, she recalls hearing about Brazil’s COVID-19 crisis and oxygen shortages, knowing they were most likely unprepared for a similar outbreak in India. When India opened up in the spring to allow for travel and events, Bhat says she was “just hoping it would not be the same. We watched with absolute dismay as large gatherings happened,” says Bhat. “People seemed to let their guard down… now (COVID-19) is pretty much everywhere.”
This tragedy has also taken a major toll on frontline workers’ mental health, says Bhat. Her own experience with burnout and depression made her, at one point, want to quit medicine.
“There is this trauma that comes from feeling helpless and feeling like ‘What’s the point of everything that I do if I’m failing?’” says Bhat. “Even in the midst of madness I can say that this is the only thing I would be doing, but it took a while to get there.”