The way primary care works has rapidly changed during the coronavirus pandemic, says Yorkshire GP Dr Becks Bayana, but doctors are resourcefully adapting and there is hope for the future
I’m writing this from the car, parked on the driveway. Like many others I’m working at home, alongside work in the local GP Out Of Hours (OOH) centre. Figuring out where to do your work is difficult when family are celebrating more “daddy time”. Nonetheless, the urge remains to get stuck into medical work of some kind, as the ever-present hum of the nation’s need never goes away. With video consultation capability rolling out across the country, that phone or digital device which might have been a temporary escape can now invite you to an inescapable abyss of work, more work, and yet more insatiable work.
Colleagues tell me of the constant pressure in their practices. Each day brings guideline after guideline about best ways to assess patients in the current climate, or which personal protective equipment (PPE) to use. New computer systems have to be quickly assessed to see if they will work. We are all embracing new uncertainties but I can hear the anxiety in people’s voices when we start talking about Covid-19. Some of my colleagues are pregnant or have pregnant wives at home. I worry about my brother who works in A&E and my mum who scans patients. It does mean, though, that at least we all understand each other.
The public have been incredibly supportive of the NHS. I’ve seen banners on the drive to work cheering us on; I’ve been granted the grace to quickly pop in and out of the supermarket and get back to work. It has been overwhelming. Dear public: THANK YOU. Your support keeps us going, but it also reminds us that we cannot take this lightly. People are dying.
Working as an OOH GP as I do is a challenge. Practices have struggled to see and advise patients in the daytime, so we pick up some of the unfinished work, and with less to go on as we don’t have access to every patient’s full medical information. I’m grateful that we’ve had allowance to spend a bit more time collecting information from our patients, but also making room for them to express their anxieties. Ultimately, we have to make the call: to see or not to see. Seeing the patient may mean a trip to the hospital, donning the all-consuming PPE and taking someone through a rigorous isolation pathway so that we keep a lid on this virus. To manage risk, we have to be selective. At the back of our minds we hold a part of us that is a diagnostic machine, but it sits alongside the human part which is keenly aware this is someone’s child, mum, grandpa, neighbour.
These are sad times. I’m not trying to depress everyone. But how quickly we have become numbed to the news that “758 have died from Covid-19 in the past 24 hours”. It is as though there is a plane crash every day. On top of it all, having to cancel so many important life events makes it hurt that bit more. It is a different kind of grief, but it is still there. A friend of mine was due to wed just before the rules changed – devastating, but they move on. No one is immune. We all share in this grief, so even when isolated we are not alone in our struggles.
There has, though, been a feeling of greater togetherness. I’ve spoken to my cousin for the first time in months just to check on him – he was grateful to have a chance to catch up in between his shifts at the airport. I now know more of my neighbours than at any other time in the past – and they know that they have a number to call if in trouble. Many of them are elderly and I know they have a particular battle ahead of them. But the end of this illness will surely come. There has been some progress, including in China where my in-laws live.
In my work with Medic Mentor I have come across some inspiring teenagers who want to be your doctors of tomorrow. They are fired up about academic medicine, about answering medicine’s unsolved conundrums, and they are impressive! If we can show them the light at the end of the tunnel then I think this country is going to be in great hands. They are also experiencing this dream-threatening illness season, but they are choosing to look forwards, faces beaming with positivity. They keep me going, as well as my 4-month-old, my 2-year-old, and my wife.
Hope springs – though it lingers, wait for it.
Dr Becks Bayana is a GP working in Yorkshire as well as with Medic Mentor, a non-profit organisation helping to create tomorrow’s doctors, dentists and vets.