The Weekly Dose: M for Medicine, M for Morale
At the back of their minds, frontline workers have understood and accepted that sooner rather than later, due to the sheer frequency and volume of their exposure to COVID-19, every one of them will contract the infection. Their bravado has led them to be compared to soldiers; this needs to stop. Soldiers are trained for combat; none of the doctors and nurses working right now have been trained to deal with a pandemic.
The war against corona is not a war.
Wars are waged by design: for land, slaves, treasures, power, or to neutralise a threat. They end when the goal is achieved. The survival of the coronavirus is threatened when it finds itself outside a human being; it cannot help but indiscriminately attack those it needs to live and will continue to attack until we build up our defences. Enemies can size each other up and plot their assault; corona is invisible. Weapons may defend us against a blitz; in the absence of sufficient hospital beds, ventilators, a drug or a vaccine, we can bear no arms against our foe. When opposing armies are unevenly matched - as healthcare personnel and the so-far omnipotent virus are - it is a massacre, not a war.
Soldiers are not sent into the field empty-handed; doctors go to work every day without any means to beat the virus. If a patient recovers, it’s because his body fought back, and won. Deploying commandos in bullet-proof vests without guns is akin to sending toughened lambs to the slaughterhouse; making healthcare staff work in full PPE without a cure to turn the tide is a suicide mission. They are sitting ducks.
The war against corona is not a war, and we are doing frontline healthcare workers no favour by calling them corona warriors. By saddling them with this grandiose moniker, we are also burdening them with our unreasonable expectations of mindless bravery, fanatic grit and unending reserves of energy and patience. Which they - and most humans - do not possess.
And yet, thousands of doctors - some as young as twenty-two, who passed their final MBBS exams only two months ago - are showing up to work. They are at the frontlines alone - the generals directing the offensive are elsewhere in offices, far from the heat and dust. Orders are being issued in a flurry, sometimes conflicting, often senseless. Casualties are mounting. There is no end in sight.
What then motivates healthcare workers to get out of bed every morning, and willingly take themselves to places where they know they risk more exposure to the virus than anyone else?
Perhaps it is a sense of duty; if they don’t do the job, who will? Perhaps it is their response to a call to arms; they are needed, and they showed up. Perhaps they are propelled by fatalism; this is their cross to bear, and they must accept it.
But in the absence of infrastructure, manpower, medicines and hope, what keeps them at their posts?
At the back of their minds, frontline workers have understood and accepted that sooner rather than later, due to the sheer frequency and volume of their exposure to COVID-19, every one of them will contract the infection. They know the odds are against them but persist in gambling with their lives by reporting for their shifts. Their bravado has led them to be compared to soldiers; this needs to stop.
Soldiers are trained for combat; none of the doctors and nurses working right now have been trained to deal with a pandemic. For decades, India has been short of healthcare personnel; there is no reserve force, and no reinforcements will come in. And if the government has drawn up a battle plan, it hasn’t been made public.
In another vocation, everyone involved would throw up their hands, take a break, and reboot. For frontline health workers, this is not an option. What keeps them going? Morale.
This intangible - and often scoffed at quality - is what keeps hospitals staffed at great personal discomfort, patients monitored without any concrete ability to help, and emergencies attended to when it would be safer for everyone concerned - and this must be said - to let him or her die.
Morale cannot be artificially generated; it is born and lives inside a person. But it can be chipped away. By a landlord who bangs plates and spoons to applaud healthcare workers in the evening, and evicts his doctor tenant the next morning. By housing societies who switch off their lights in unison, and deny entry to a lab attendant who lives there at the end of a tiring shift. By non-frontline citizens who hog N95 masks, and deprive a frontline worker of one. By governments who delay, or cut salaries, of government doctors and nurses. By higher-ups who refuse to test symptomatic doctors; better to let them spread the infection than be short-staffed. By authorities who penalise them for speaking the truth on social media. By a media conglomerate which chooses not to report about decades of neglected public health, and blames young doctors for the disastrous consequences of this crime of omission.
Morale is what keeps them going. Morale has limits. Their morale is crumbling.
Morale is what dissuades doctors from staying put at home, staying healthy and staying safe. Morale prevents nurses from skipping one shift, then another. Morale motivates ward attendants to work despite their pitiful wages.
One day soon, this morale will be exhausted, and they will reach their breaking point. What will you and I do if they quit?
We cannot throw money at this problem and expect it to solve itself. Ventilators need doctors to calibrate them; thermometers need a nurse’s eye to read temperatures. When those who are extinguishing the patience of healthcare workers fall prey to the virus - as some of them statistically will - they will need the expertise, care and efforts of those whom they have bullied into resignation. Laws can compel doctors to come to work, but no law can force them to do their jobs.
Already, I am hearing stories of doctors who have slipped away to their COVID-free hometowns. Of nurses who are considering indefinite leave without pay. Even gods and superheroes have limits.
Like the rest of us, this frontline workforce too can afford to sit back and live off their savings. They do not need us; we need them. If you cannot help, at least don’t stand in their way. It’s your best chance at surviving this.