Jewish doctor describes life on the frontline

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Jewish doctor describes life on the frontline

As the pandemic sweeps the UK, we hear from Dr Michelle (Shelley) Jacobs, who is an emergency medicine consultant

Dr Michelle (Shelley) Jacobs
Dr Michelle (Shelley) Jacobs

I couldn’t imagine sitting at home and not going to work whilst everyone else is dealing with this. We are on the frontline. We have to play our part and do what we’re trained for in the best way that we know how and with the best evidence and the best advice that we’re being given.

We know the infection rates amongst hospital staff, medical or nursing staff are higher than the general population. One of my first bosses when I was a junior doctor died this week from coronavirus. These stories are coming out all the time. There is that fear, but there’s also a very strong moral obligation to go do the job we’re trained to do.

To protect my family after a shift, I change out of my scrubs before leaving the hospital. They go in a plastic bag, and I get changed into another set of scrubs that I travel home in. At the front door when I get home, I go straight upstairs, without seeing anybody or hugging the kids, take off the scrubs that I’m wearing and put them and the ones in the plastic bag in the washing machine. I go in the shower, get changed and then I can see my family.

Several doctors I know are staying in hospital accommodation or in hotels away from their families. One of my trainees, whose little girl was not well for a week or so, had to stay in hospital accommodation while his family was isolating. There’s quite a lot of that going on, which is really tough, bearing in mind that we don’t know how long this is going to last.

Recently, I was on the receiving end of a group of junior doctors, who were really upset. A patient who hadn’t come in with any symptoms of coronavirus started having a seizure. The doctors needed to do something for his airway, but because he wasn’t thought to be anything coronavirus related, they may have put themselves at risk. He later tested positive for the virus.

It’s so difficult as a senior to deal with that. What do you say to juniors who are coming up and saying how upset or stressed they are about a situation like that? We’re supposed to keep them safe, we have a responsibility to look after our junior staff. But thankfully, we are now wearing personal protective equipment for all patients presenting to our emergency department after new advice from health authorities at the weekend.

Another serious concern, publicised in a statement last week by Professor Russell Viner, the president of the Royal College of Paediatrics and Child Health, is that we are seeing very unwell children and adults, who don’t have covid-19 but have not come to medical attention because they were concerned about contracting it at hospital or bothering us when we are so busy.

I was involved in resuscitating a really sick child this week whose parents had been trying to manage his asthma at home. When he came in he was critically unwell, and we were just in time to stabilise him, get him on a ventilator and off to a paediatric intensive care unit. Thankfully he was well enough to be discharged home from there on Friday.

There is a real danger that people are not seeking medical attention when they need to. One adult recently sadly died because of something that would have been completely treatable, had he presented earlier. It’s just worrying and I think we’ve got to try and get that message across.

Obviously, with something like a twisted ankle, you can take it easy at home and not go to hospital. But if you have serious health conditions, then you shouldn’t stop coming. There are infection risks in hospital, but we are doing all we can to separate the streams of patients into those that may be covid-related and those that are not and minimise the chances of anyone becoming infected.

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