‘Glimmers of good’ in Covid-19

Intensive Care consultants Matthew Morgan and Peter G Brindley share their experiences of saving lives, guilt - and free sticky buns.

Dr Matthew Morgan is joined today by Dr Peter G Brindley who works at the Department of Critical Care Medicine, Department of Anesthesiology and Pain Medicine, and the Dosseter Ethics Centre, University of Alberta, Edmonton, Canada.

The last six months have been awful: for patients, for families, and for many medical staff. However, these two ICU clinicians have something we need to get off our virus-free chests. For the two of us, some aspects – okay many aspects – of Covid-19 have brought glimmers of good.

Our guess is that you’ve also had your “yeah it’s bad, but it’s not all bad,” moment. We’ll share our secrets with hopes that you will feel more comfortable sharing yours. Adversity always has something to teach.

Your two authors struggled their way up the medical hierarchy on the promise that we could make a difference. Covid has been a great chance to turn gratuitous words into noble acts: the seemingly hyperbolic claim that we could save lives – and we actually did. Never as many as we would want, but some.

We have long banged on about caring for patients even when there is no cure – this has recently been more important than ever. However, let’s be clear, that when we say ‘we’ we don’t mean the small ‘we’. Instead we mean most of healthcare, as well as large swathes of society. Well done, all. You deserve a rest. You also deserve time to reflect on what it all meant.

While pots and pans were being bashed in thanks on Thursday nights, it also felt a tad awkward. After all, were doing a job we had trained for and were being paid for. We were surrounded by public support. Governments moved barriers and funnelled money in order to help the overwhelmed NHS.

There wasn’t just a ‘can do’ attitude from layers of normally treacle-thick bureaucracy, it was ‘will do’ and ‘did do’. Not to say it all went well, or that more could and should have been done. But all of the time, despite massive challenges for patients and their families, we were appreciated and even applauded. We had gallons of free coffee and quite a few sticky buns. We even had hot food delivered from top restaurants, and got to take off our itchy masks when it arrived.

Like many people who have been through a mighty experience we feel simultaneously grateful, uneasy, and guilty.

We need to acknowledge this because many hundreds of thousands have died and many millions have suffered, staff, patients and families alike. We also need to acknowledge that we want to turn our specialty’s increased attention into future good for patients, and warn you that we will shamelessly leverage this. However, we need to accept that our current buoyancy might lead to sinking feelings in the near future. After all, regression to the mean will happen.

The clapping will stop, and the food will go cold.

Politicians may even regress to the literal ‘mean’ when it comes to future funding. How will we feel then? Will we feel worse because of the relative ‘better times’ of the past? Will we be sad because we can remember the Covid esprit de corps, where adversity and fear was beaten by kindness and cooperation? As we prepare for an uncertain second wave, we also need to ensure that we can fight that important fight. As we channel our inner Dylan Thomas, if this virus continues its rage, it will be tough raging against the dying of the light with depleted batteries.

So, what is our message, what is our point?

Firstly, our feelings are unlikely to be unique. We want to tell others that it’s OK to feel good about what you do, even while others are going through hell. Don’t feel bad, don’t feel guilty: instead get stuck in. Support others. Care but also live. However, take time to reflect and to rest up.

Part of feeling good is knowing that you cared, and that you tried your best. It’s also great to feel restored and able to take on more. It’s not a crime if you enjoyed glimmers of Covid-19, especially if it helped you become a better person and care for others. Moreover, given all that thanks that we doctors have received we’d like to take this opportunity to thank you in return. Doing so is not only right and proper, it might mean there’s enough torchlight for the long nights to come.

Photo credit: Georgina Littlejohn

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Matthew Morgan

Dr Matt Morgan is an intensive care doctor at University Hospital, Cardiff. His first book Critical (2019, Simon & Schuster) has been translated into four languages.

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