Putting their lives on the line

Dr Izwan (in dark blue mask) in the midst of an operation. - DR MUHAMAD IZWAN ISMAIL

Dr Muhamad Izwan Ismail, 36, general surgeon at Hospital Sultanah Aminah, Johor Baru, father of three

As specialists dealing with acute care and cancer cases, we are not frontliners manning the Covid-19 wards but the risk of getting infected is still high, especially when patients are wheeled in for immediate surgery when the situation calls for it.

In an emergency surgery, every minute counts and there is no time to wait for the patient’s Covid-19 swab test results.

Thankfully, I haven’t gotten infected although some of my juniors have.

Most of the wards at our hospital are occupied with Covid-19 cases, so our teams at the operating theatres have had to be cut.This means we have also had to cut down on the number of elective surgeries as some of our manpower, including anaesthesiologists, has been diverted to help treat Covid-19 patients.

Despite doing fewer surgeries, our workload is not necessarily lighter.

From last year’s list, we have about 200 postponed cases. Unfortunately, many of these cases have become more serious because patients are afraid to come to the hospital. So, some cancer patients who used to be in stage one or two have now reached stage three or four.

I’m currently undergoing sub-speciality training to be a consultant trauma surgeon.Malaysia only has seven certified trauma surgeons so far, but we are planning to recruit more.

Since I’m treating more trauma patients, they actually need to be warded in the intensive care unit (ICU) for optimum care. But nowadays, there is no straightforward algorithm for who gets a bed in the ICU.

The Covid-19 ICU is always full. For non-Covid-19 patients, we discuss with the anaesthesiologists to see which patient has a good prognosis and try to find the best solution.

Yes, I do feel hopeless at times as I wish I could do more to help.

During the first movement control order last year, there were hardly any accidents and when the curbs were lifted, the numbers went back up in the emergency department. This time around, the trauma pattern seems to be mostly from elderly falls and suicide attempts.

In one case, a man in his 60s wanted to repair his leaking roof. His children, who did not live with him, told him not to climb the roof but he wouldn’t listen, probably because he couldn’t get a contractor.

He ended up falling more than two metres and sustained severe head injuries. He was rushed to the emergency ward. Despite performing cardiopulmonary resuscitation, we couldn’t save him. It was terribly sad to see his children crying.

Another incident I remember vividly is a patient in her 30s who lived alone as her family was in Singapore. She couldn’t cope with the pandemic and set herself on fire.

The pain must have been intense as she then jumped into a body of water nearby. A passer-by saw her and managed to take her to the hospital.

We thought she wouldn’t make it during the critical period after surgery because she had suffered massive burns, but her condition was better than expected.

Her mother had to sort out a lot of paperwork before she could travel here from Singapore. Then, she had to be quarantined for 14 days and couldn’t see her daughter, so she had to call us for updates.

Unfortunately, after a few weeks, the patient developed infections due to the scale of the burns and died.

On a more positive note, the pandemic has enabled healthcare workers to better understand their strengths and the resources they need or lack so that they can plan better for future disasters. Now we know what we’re capable of.

With regards to my family who live in Sungai Buloh, Selangor, I’ve been in a long-distance relationship with them for three and a half years. The last time I saw them in person was during Hari Raya Aidilfitri last year.

My request for a transfer was rejected due to the pandemic, so I don’t know when I will be able to see them again.

In our current situation, I hope we will manage to be “merdeka” from this pandemic so that all Malaysians can have a fresh start and rebuild their lives, families, communities and our beloved country.

Dr Novinth Kumar Raja Ram, 35, general surgeon at Hospital Sultanah Aminah, Johor Bahru, father of one

Not having my family here has made life challenging on the personal front. Every day, I return from work to an empty house. My wife and son are in Singapore and I used to commute there daily on my non-call days, but the border closure has made this impossible.

My wife now has to be both a mother and father to our seven-year-old son, in addition to her job as an emergency physician.

I talk to them daily but I am missing out on my son’s milestones. For example, I had to watch videos of his first day of school as I could not be there in person.

On a positive note, I have learnt how to cook.

I have been a surgeon for nine months now. I was supposed to sit for my exit exams in April 2020 but due to the movement control order, they were delayed to November. This affected our whole batch of students, but not how we serve patients.

Even if the situation remains the same, my sense of care for my patients is not compromised. I have broken down in the past but now I have to be brave, do my work and try to figure out a solution for every patient.

In a way, the Covid-19 pandemic has made things easier as I can rush to the hospital for emergency cases since my family isn’t around.

Being away from his family has been extremely challenging for Dr Novinth, seen here with his wife, Dr Sameera. - DR NOVINTH KUMAR RAJA RAM

People will always seek medical attention but in the current situation, sometimes we can only offer limited help.

Since intensive care unit (ICU) resources have been stretched, care is compromised as we have to decide who gets the ICU beds, which results in poorer outcomes. This is something that deeply affects me.

On paper, I work from 8am to 5pm but if I’m on call, I work 36 hours straight.

Even on some of my off days, I still go to the hospital to see patients I’m really worried about.

For now, specialists have yet to be pulled in to help out with Covid-19 patients as we are still needed in our own field.

When it comes to the operating theatre, it’s no fun wearing protective gear as our “spacesuits” are slightly different – we have to wear a respirator, which is hot and heavy. The resulting sweat also impairs our vision and impacts surgery.

These technical aspects are seldom spoken about outside our circle. If a patient’s Covid-19 swab test returns positive, we have to be quarantined. I’ve lost count of how many times this has happened!

To my junior colleagues who have been the true frontliners, I hope they get the recognition they deserve.

This year, Merdeka will be just another day. It was born out of the ability to celebrate our diversity – looking past minor differences to thrive as a nation.

It is not only reminiscent of the past but serves as a reminder to us Malaysians that when we are united, we can scale greater heights.