Originally published in Sanlian Lifeweek(三联生活周刊) on Jan. 27th, 2020
In March 2019, Sun Peng, Deputy Director of the Emergency Department of Wuhan Union Hospital, was appointed to take charge of the Emergency Department in its Western campus. In late December, he was also responsible for the newly opened Fever Clinic for dealing with the SARS-COV-2 outbreak from Wuhan seafood market. On the morning of Jan 26th this year Sun Peng told reporters that the hospital had just been informed that its Western campus was also recruited as a designated hospital, becoming one of the third batch of hospitals in Wuhan to receive patients diagnosed with the SARS-COV-2. Here's from what Sun Peng stated.
Verbal Statement | Sun, Peng (孙鹏)
Reporter | Bo, Jing (驳静)
Translation | Chengji Translation Team
Ten days ago I packed up some clothes from home before moving into the house I rented near the hospital to quarantine myself. Got there on New Year's Eve at nine o'clock, I cooked some dumplings to celebrate. I just swallowed before reaching my hospital because a patient suddenly got worse.
He had just been diagnosed with the SARS-COV-2 that morning before he could be sent to a designated hospital. In the morning I asked him how he was feeling. He said, "It was good", but at night, things just went down. For more than an hour rescuing him in protective clothing and masks, we clearly knew that such a close distance would largely increase the risk of being infected, but we doctors can't have a cold feet at a time like this and we won't. I hoped that miracles could happen, though the patient was not in a good state with heart and blood pressure problems, which is a frequent case among the elderly. The infection was a serious blow to him, making things worse. In fact, the elderly with basic diseases like him constitute the major part of deaths in our hospitals at present.
That night his condition exacerbated very rapidly. There was actually a rescue that worked, but for this second time it didn't. We put him in a morgue bag to get in a funeral van, which is usually done by families of the patient and the funeral home in normal cases. At this particular time, however, the family's panic of doing so made it our job as medical workers. Another death that night was also a very old patient who was permanently bedridden before the family decided not to take an active intubation treatment that led to a natural death.
It was all over in the early hours of the morning when I came out of the hospital, driving home. Maybe it was the darkness, the public transportation lockdown, or the block of my foggy glasses that I didn't see any vehicle on the road anyway. Driving alone on such a road, I was lurked back to the scenes just now. It has been raining, made the city cold and wet. I stood in the middle of the ward, with two bodies being put there. My colleagues walked by and they were all wearing protective clothing and goggles as we have always been. With the pair of glasses under my goggles that were always foggy, I witnessed the long line of patients and heard their families crying outside the door.
Later I sent a message to the Wechat group of colleagues, said "Rescuing all night and ended up with two bodies, so tired." For more than 20 years of my career, it is not unusual for me to spend the New Year's Eve in an emergency department, but there was New Year's atmosphere more or less there in the previous years. For this year, nothing. After rescuing the patient, I had only the fatigue of my whole body and mind. All I felt was the powerlessness of not making him alive. The last day of 2019 was heartbreaking.
For a month since then, I have been most worried about my colleagues. The other day Doctor Chen Dandan of our department told me after a night shift that she had a fever, which made me extremely nervous just like her: she could be easily invaded by the virus when being exhausted from a night shift. I hastened to get her checked out, praying that it's just a normal cold. This young female doctor went back home only to have one day off and texted me, "If the fever retreats later in the evening, I'll take tomorrow's shift myself as planned. Do not let others being tired out because of taking mine." Such a remark was touching indeed. Fortunately, her coronavirus nucleic acid testing turned out to be negative.
Three doctors are equipped for one ambulance to work for 24 hours. Then they take two days off and work In three shifts. Being responsible for transporting confirmed patients, they do suffer a lot. For a short trip of an hour or a longer one of more than two hours in the closed space, they are so close to patients who are might even on a ventilator. The combination of their unbreathable protective clothing and the stuffy air get them so sweaty that they have to get changed and disinfect the vehicle each round before setting off again. Once the delivery didn't end until 4:00 in the morning. How stressful do you think they are? But no one's ever complained.
Thanks to the rotational break of the Fever Clinic, another group of colleagues will take our place in a few days. I have no wishes other than we all staying healthy by that time.
There were only 20 observation beds in the Fever Clinic of the western campus, because it never occurred to us that so many people would get infected. I remembered by late December we only had one or two patients from the seafood market. As the description of human to human transmission shifted from "no" to "limited", the number of infected patients we received reached more than 100---an alert for me. It climbed to up to over 300 cases these days. Among them are cross-district visitors who live in populated central areas, and they come to our hospital, faraway in the Economic Development Zone in Hanyang district to avoid the usually crowded hospitals there. Some are here for follow-ups. The number of people seeing a doctor here is thus accumulating.
But they are calmer than usual days. This is also shared by our nurses: patients waiting in line for such a long time to see a doctor may lose their temper and argue with healthcare personnel, yet this is not frequently seen recently. The explanation may be that people are getting more knowledgeable of the infection and more prepared to fight against it as seeing infected cases around them. Let alone the fact that the elderly suffer more from it than young ones, who are still able to walk and move freely even after being caught by the infection.
There was a man in his 30s or 40s who impressed me deeply. He brought his father to see the doctor in early January. The latter felt just a little stuffy and panting, symptoms of a potential fever. But the CT suggested an acute respiratory disease. I told him it was "not optimistic" but he thought I was just exaggerating for his father had no difficulties in moving and speaking. Unfortunately, the patient then got worse and had a trachea intubation done in our hospital before being sent to the respiratory intensive care unit. Seeing each other in the hallway, I saw him keeping silent.
His father failed to make it and died. One week later I saw him in the hospital again---this time, he came for himself. Judging from his CT, both lungs were infected. And then the same happened to his sister. Three in a family.
The second confirmed case I received was a seafood restaurant worker who regularly went to the seafood market for purchases. I was impressed by the happy face of his wife when our negative pressure ambulance tried to transfer him to Wuhan Jinyintan Hospital, and she said "I'll thank you with free range chickens!". Just a week later I ran into her again in the Fever Clinic. She coughed, no fever, while the CT result represented an infected lung that resulted most likely from looking after her husband. She was later transferred to Jinyintan Hospital as well. That was so heartbreaking.
I saw another patient's family today. Her husband was the third pneumonia patient with unknown cause that I received. He hadn't been to the seafood market then, and just attended a party with elder friends. Reassuringly, he recovered quite well. Half a month later, I met her again in the hospital, and she said, "Thank you. My husband pulled through, and I'm so grateful."
All these made us found that even when we've managed to get infected people recovered, families who took care of them started to suffer after the incubation period. As patients infected that way are increasing, I think it's getting serious and talk with peers at other hospitals, who feel the same way. One by one, we medical personnel begin to quarantine ourselves.
I'm worried about my 14-year-old daughter. My wife works as an anesthesiologist at the Hospital proper of Wuhan Union Hospital. Now that staff are all ready to take the turn, she told me the other day that it was almost her turn to be on the frontline. That way she had to be quarantined just like me, leaving our daughter whose school day has been postponed alone at home. What is she supposed to do without parents? Who will cook for her? But this is only the beginning of the challenge.
My daughter wrote me a letter several days ago in elegant Chinese, in which she expressed her care for me: " As the flu and pneumonia approaching, I wish you, my dear father, to stay healthy. I blamed you for going out early and coming back late, and thus occasionally not by my side. Now I understand why, and will not feel that way anymore." Such a letter from my daughter surprised me so much that I suddenly realized that she acted like an adult during the whole week with my absence. With this idea, I comfort my wife that there is no better time for our daughter to mature than this particular moment.
She also wrote like this: "I firmly believe that there is not a single winter that will not be far behind, and so it is for this winter when the virus is rampant. " I often meditate how fantastic it is. I've seen many patients recovered from the infection happily went out of the hospital, but there's no relief for there are still many. Such pressure and the fear of the disease is compounded by witnessing my colleagues infected and sent for treatment. Someday, maybe, I'll be one of them. But for us, there's no retreat. You just have to move ahead, with the most cautiousness of not being infected. I hope this winter passes earlier and spring comes soon.