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New Doctors In India Are Starting Off Seeing The Worst. It's Taking A Toll


India this week recorded the deadliest day of the pandemic in any country in the world so far. More than 4,500 people died of COVID-19 there on Tuesday. Thousands are dying of COVID every day in India. And we have a view of that calamity as seen by Dr. Noor Dhaliwal.

NOOR DHALIWAL: In my ICU night shift, I saw that just overnight, five, six patients dying. It's really, like, a horrible and saddening sight. And in fact, the other patients who are in that cubicle, they also lose hope that - they feel like that could be them any minute.

INSKEEP: So many people are dying in India right now that Dr. Dhaliwal's experience is common. But she has a particular view of it because she is a new doctor, one of many around the world for whom the pandemic is their introduction to medicine.

DHALIWAL: I have seen young people, some just a few years older than me, not maintaining oxygen saturation. And I've seen each ward and ICU being ambushed with COVID-positive patients and frantic relatives not being able to find a single bed. And if a bed does get empty, it's usually because a patient has died.

INSKEEP: Another of India's new doctors is Prakruthi Harihar. She started her medical internship at the beginning of 2020. That spring, she was assigned to a COVID ward and immediately encountered a patient she knew.

PRAKRUTHI HARIHAR: On my first day, I was posted in COVID intensive care unit. What happened was one of my friend's father was admitted in the COVID ICU. A couple of hours into my duty, he went into cardiac arrest, and my consultant (ph) asked me to do a CPR on him. And we tried a lot of things, but we couldn't save him. It was actually a really bad and a disturbing day for me.

INSKEEP: Over time, Dr. Harihar grew accustomed to death, accustomed to the work. She finished her one-year internship and thought she would enter a specialty. Instead, her plans are delayed, and she's back in an emergency room in her city of Bangalore. The emergency room is jammed with people. And she can only sometimes transfer them to a hospital bed.

HARIHAR: The wards are completely full. And when the patient comes in, we still, like, you know, we have to tell them that there's no bed. And we see patients breaking down, crying, begging and all that. It's really difficult to decline treatment. But I mean, there's nothing much that we can do

INSKEEP: When you don't have a bed for someone, do they just keep sitting in the emergency room?

HARIHAR: No, we kind of have to tell them to go to another hospital because we cannot keep every single patient in the emergency room because they'll not be place for other people then.

INSKEEP: I find that, in its way, a little alarming. Someone shows up, maybe they've got COVID, maybe they're infectious that moment, they're in a crowded emergency room, and you're forced to send them across town in contact with who knows how many people on their way to another crowded emergency room.

HARIHAR: Yeah, it's really scary. I mean, patients are helpless too. I think the entire health care system is helpless right now. There's not much that we can do from our side. We need more hospitals. We need more beds. We need more oxygen cylinders. We need more drugs. But unfortunately, right now, we do not have all of this, and we have to tell the patients to go and search for beds in another hospital.

INSKEEP: Can I ask what this has meant to you personally? You are at this moment where you were thinking you were going to begin your career, begin a new life in a way, in a particular fashion, and it's not happening.

HARIHAR: Yeah, I mean, I did expect to write my exams and get into a post-graduation course. So personally, I am a little scared and agitated with the whole situation. But I mean, I don't mind working right now.

INSKEEP: I guess you can at least feel that you're helping in this crisis.

HARIHAR: (Laughter) Yeah.

INSKEEP: You've - you're impressively cheerful in talking of this dire situation and this desperation around you. Does it get to you, though?

HARIHAR: Yeah, it definitely does. I mean, I think now we've just got a little bit used to the situation, but especially during the first wave, it was really bad. We were so paranoid all the time and things like that. But I mean, now we've slightly got more used to this situation that we're living in right now.

INSKEEP: You must have, as a younger person, had a particular idea of what health care was and what the Indian health care system was. And now you've experienced it in such a crisis. What do you think you've learned about the job you're going into and the field you're going into?

HARIHAR: I mean, I always knew, given our population and the status of our country, that our health care system is not completely effective for the number of people like we have. But I mean, there was no situation like a pandemic that made us look at this whole health care system in this way. I mean, now that we know that there's so many people who need health care, and they're not able to get it, and now everyone's realizing that we need to up our health care system.

INSKEEP: When I think about your work in the ER, I'm realizing that you see these people for a moment or a few moments or an hour. You learn the beginning of their story, but you don't know the end. Some of those people will find a hospital bed. Some will get better. Some will not get better. Some will die. What is that like? Do you go home sometimes and wonder about the faces of different people?

HARIHAR: Yes, definitely. I mean, just yesterday there was this lady who was crying. And, like, she broke down in the ER, and she was begging for us to give her a bed. But I mean, unfortunately, everything was full. I mean, I had to send her back. But I came back home thinking, did she get a bed? Did, like, you know, did she find a hospital? Is she fine? But there's no way that we can contact the patient also. So, I mean, yeah, it does affect us.

INSKEEP: I wonder if there'll be a time when you're able to look back on this and it's hard to believe that it even happened.

HARIHAR: (Laughter) It sometimes - everything just feels so surreal.

INSKEEP: Prakruthi Harihar, thank you very much for your time.

HARIHAR: Thank you. Transcript provided by NPR, Copyright NPR.

Jeevika Verma