Dr Amir Khan on the Impact of Covid-19 on the Work of GPs
In his book The Doctor Will See You Now, Dr Amir Khan shares heart-warming stories and some very funny anecdotes about his experiences as an NHS general practitioner. His book also provides a frank portrait of British healthcare in the twenty-first century, culminating in the unprecedented challenges posed to it by the Covid-19 crisis. In this exclusive piece, Dr Khan discusses the variety of ways in which the arrival of the virus has changed the day-to-day work of GPs.
The Impact of Covid-19 on the Jobs of GPs
Everybody was a bit disappointed when I chose to be a GP. They wanted to know why I wasn’t choosing to be a “proper” hospital doctor. To make matters worse, my cousin Arif was a cardiothoracic surgeon. He is the jewel in the crown that is our family tree. His mum, Aunty Zara, is always bragging about how many marriage offers he had when he passed his surgical exams. I understand, he can do a heart transplant, which is sexy. But I can test for a urine infection and swab for chlamydia – surely there is someone out there that finds that sexy?
Despite my family’s views on it, I love my job. I love the interaction with patients and getting to know families and communities over time. That is something Arif can’t compete with. It is these stories of individuals, families and communities that make up the bulk of my book, The Doctor Will See You Now.
One of the best things about general practice is that you do not know what is going to walk through the door. It is this variety that keeps it interesting. But with variety comes the highest of highs and the crushing lows.
Things changed almost overnight in March 2020 with the arrival of Covid-19. Suddenly we had to treat all of our patients, no matter what they were coming in for, as if they were harbouring a deadly virus. GP sites were set up called Red Hubs, for those patients who had symptoms of Covid-19 but were not unwell enough to need a hospital admission but were unwell enough to need a doctor to assess them. We were all to rotate into shifts at these Red Hubs.
I was used to treating patients with infectious diseases, I had done it for over 15 years. I had seen people with HIV, tuberculosis and even a case of leprosy during my volunteer work in Africa. But this was different, clinicians were dying. More specifically, clinicians from BAME backgrounds were dying at higher rates. I had never been scared of going into work before, until now.
I felt ashamed. NHS workers were being hailed as heroes and there were murals of doctors and nurses playing the roles of angels doing the rounds on social media. The day I drove to my first shift at the Red Hub I felt more like a coward than a hero. I recall the rainbows painted by children in the windows of the houses I drove past. My shame burned through me.
Seeing patients at the Red Hubs was very different to my usual surgery. For a start, the computer was covered in a thick easy-wipe plastic coating, making it very hard to type anything. We were given strict instructions on how to put on and take off our personal protective gear. It was a valuable resource that wasn’t to be wasted. My first patient at the Red Hub was seen through thick goggles, a visor and mask. The barrier created by the PPE not only protected me from the virus but also created a barrier against any of the non-verbal cues that were a vital part to every consultation I had ever done, the nuances I had spent the last decade perfecting had been taken away.
As time went on and I got used to seeing patients who could be potentially harbouring the virus, my anxiety settled down. It became second nature to me. Also the Red Hub had an endless supply of chocolate biscuits, those definitely helped with my anxiety.
But away from the Red Hubs another problem was brewing. The virus had taken hold in our nursing homes. It was hard to see patients I had spent years looking after succumb to the virus. They had been let down. One of the most difficult conversations I had was with the wife of a patient who had died alone in a care home. She wasn’t able to visit. Normally I would have such conversations in person, I would take the time to sit with them, offer them a comforting hand on their hand. But things had changed, the virus had not only robbed this lady of her husband but also the opportunity to sit down with her doctor and talk about it face to face. She too was vulnerable so couldn’t leave her home and the conversation had to be done over the phone.
These very personal encounters, both before and during the pandemic are chronicled in my new book The Doctor Will See You Now.
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