COCOONING

THE LOCKDOWN MONOLOGUES

COCOONING

BY / JANE HARRISON

The ANAESTHETIST, mid-forties, clean-shaven, speaks directly to camera. He’s going through the steps to don PPE.

One. Wash hands thoroughly.

Two. Go into the next room. The donning and doffing room.

Three. Take off any jewellery that could puncture the suit. Wedding band is fine.

Four. Any loose hair is tied back.

Five. Latex gloves.

Six. The mask.

Seven. Put on the suit.

Eight. Tie the suit up at the back.

Nine. Suit’s secured at the wrists and neck.

Ten. Make a small tag on the zipper with duct tape so it’s easier to pull down when I’m finished.

Eleven. Boots. Non-slip.

Twelve. Make sure the pant legs are over the boots.

Thirteen. You can actually be infected through the eyes. So I went to Bunnings. Most of the population was also at Bunnings, 1.5 metres apart. And I grabbed some goggles. They’re handyman ones but they’ll do.

Thirteen. Put on the goggles.

Fourteen. Put on the mask. Curved bit at the bottom.

Fifteen. Put on the respirator. In Italy people were using snorkels

Sixteen. Pull the hood of the suit over the respirator.

Seventeen. Put on the shield over the mask and respirator. Make sure you can see.

And breathe. That’s what I do. Help people breathe. I’m an anaesthetist. It’s not about ‘knocking people out’, it’s about keeping them breathing through an op, or if they have a serious illness. Like now.

Eighteen. I put on the second pair of gloves and I’m sterile.

Eighteen steps.

It takes, maybe eleven minutes? The first time it took twenty-three.

Back in March, it was frantic. Ordering PPE. As much as we could. From wherever we could get it. Order more respirators. Daily. Hourly.

Did we have enough drugs? What drugs? Talking with colleagues overseas. Heard about the new symptom? What? Thinking. Improvising. The face always reading ‘calm’. Can’t let the mask slip. Planning. How are we going to keep our staff safe? When I read the stats on frontline health workers overseas who have died... Or passed it on to their families… How could you live with that? Briefing the staff. One of the nurses is pregnant. She’s terrified.

They were long days. Then I was up half the night. Watching the reports from Italy. Iran. Seeing the photos of New York. The makeshift hospitals. Mass graves like something from a third world genocide. In New York. Boning up on topics I hadn’t touched since my residency. Not sleeping. But I knew I’d have to be back on my toes the next day.

Clive came in yesterday for an emergency op. Severed finger. Nothing to do with COVID. We asked the usual questions – any symptoms? He had been unwell, he said, but was on the mend. Maybe the flu? No one thought he had it. But we tested. And PPEd up for the op. Even though it’s a palaver and slows everything down. Before he went under, Clive joked that he’d bought his own toilet paper and a spare roll for the doctor who saved his finger. Or his life? I said, it won’t come to that, but if it does, I’d be happy to accept.

Clive also said he loved to ten-pin bowl so that finger was really important. The surgeon said he’d have him bowling in no time. It was straightforward. Re-attached the finger with no issues.

Yesterday Clive was joking with us. Overnight he was moved to ICU. He has COVID. This morning he needed to be intubated. Urgently.

In my hazmat suit, I step into the theatre. The nurse already has the IV line in. I put an oxygen mask on him, so his lungs have a reserve.

You use intubation when the patient, like Clive, is struggling to breathe. Once they’re out cold, you don’t have much time. Which is why the residents get anxious about the procedure. You take hold of the handle of the laryngoscope. You tilt the patient’s head back slightly. You angle the blade of the laryngoscope down the throat. Making sure not to make contact with the teeth. You ease the tube past the epiglottis – that’s the flap that protects the larynx and stops food going down your windpipe – and into the trachea. That’s the tricky bit. Once the tube is in a small balloon inflates to keep it in place. You remove the laryngoscope. The nurse tapes the tube to the corner of his mouth.

Then you inflate the lungs with a hand held bag to make sure both are inflating evenly. Finally, you attach the ventilator. It forces air, with added oxygen, into the depleted lungs. You’re monitoring throughout. Checking that the levels of oxygen are not too low, and CO two is not too high. Otherwise you can damage the heart and brain.

Once intubated the ICU nurse watches over the patient for the rest of their shift, when another ICU nurse takes over. They can go down so quickly. Unexpectedly. Randomly.

I hope Clive pulls through. He’ll be in ICU for at least a week. Then in quarantine. His family won’t be allowed to see him. I’ve had to speak to a number of family members who just don’t get it. Especially if their loved one is close to death. ‘Why can’t I see my boy?’ The risk’s too great. But I’m sure Clive will survive. Will he come good with the offer of the bog roll? Not sure. I might have to face off with the surgeon, who did a very neat job on his finger.

I’ve been in a serviced apartment for two months. Eating Mee Goreng noodles like I’m back at Uni. My wife and I agreed I should isolate. Every night, no matter what kind of day I’ve had, I read The Very Hungry Caterpillar to my son Ollie. He’s three and it’s his favourite book. He holds it up to the screen and waves it about, so it’s hard to read and he corrects me if I get it wrong. But I know it off by heart.

I love the bit where the caterpillar finally emerges from its cocoon as a butterfly, but Ollie just likes all the eating it does.

So we use that – ‘eat your broccoli just like the hungry caterpillar does’.

I ordered a toy caterpillar online and had it sent here. I’m excited to give it to him. He can do some imaginative play with it.

I’m keen to go home. But… I need to be sure I’m not putting them in danger My wife agrees. Tonight I told her about the toy and she said… he’s over that. He discovered dinosaurs. Tyrannosaurus? I love them! No, she says. Triceratops. Definitely, adamantly, and very specifically, Triceratops.

He breaths out, like a release of tension.

If I could sum it up? We prepared for the worst. It didn’t happen. It’s the best anti-climax we could have had.