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It’s a Family Affair…

I’ve found that the best way of managing my own problems is to hear about other peoples’. I’m not sure if that’s a healthy coping strategy or not. I won’t lie: part of it is schadenfreude. But I also like to think I can offer some damn good advice. Maybe it’s part of the reason I chose to become a medic. 

Port of call number one is always mum. My mum’s a transplant research nurse at Wythenshawe hospital. When it comes to healthcare professionals’ attitudes to illness, they fall into two camps: one is the neurotic, and the other is the indifferent. Mum’s usually in the latter – unless I’ve got a boo-boo, of course. Then it’s the end of the world. 

The coronavirus crisis had prompted some big changes at her work. She told me she was going to get some skills re-training this week, with a particular focus on intensive care and ventilation.

“Back to nursing skills training, they call it,” she told me, rather acerbically. As if she didn’t know how to be a nurse. She could nurse the shit out of any shift she’s put on. Nevertheless, as self-deprecating as always, she sighed.

“Eh… you’ll know it’s bad when I’m put back on the front line.”  

She explained to me that there are two camps in her hospital. “There are the shitting yourselves people, and the ‘oh well… it’ll all blow over eventually’ people.” No prizes for guessing her philosophy. 

“I’m not that worried, to be honest. Sure, it’s going to be like bad flu. But people are panicking a bit too much, and that leads to its own problems.” I’ve always admired my mum’s no-nonsense, common-sense approach. Maybe that skipped a generation…  but anyway, she never really panics and trudges on no matter what. 

“Camp Shitting-Themselves are miserable to be around,” she recounted. “One cardiologist ruined my lunch a couple of days ago by telling us how this is just the first COVID wave how we should expect much worse… it was kind of awkward. I didn’t feel like eating my sandwich afterwards.” What a killjoy, I thought to myself, even if he might be right. I can just imagine her sitting there after her colleague left, looking nonplussed.

Dad, a heart surgeon in Manchester, was similarly stoic (I suppose that’s a valuable trait in a heart surgeon). “It’s getting on my nerves a bit, to be honest. If it gets as bad as Italy, it gets as bad as Italy. We’ll have to deal with it.”

So far, his operations were happening as normal. “Today I did a pericardiectomy,” mentioning it in the nonchalant way only a surgeon could. He was still doing his elective bypasses, with a smattering of emergencies to keep things exciting like NSTEMIs and aortic dissections.

“People have to remember: evolution,” he announced. “The virus isn’t stupid enough to kill all of its hosts.” A valid point, I thought, until I remembered there is probably an enormous animal reservoir perfectly capable of sustaining a virus deadly to humans. But let’s keep things light-hearted, shall we?

Sometimes I wonder whether my dad’s quiet confidence conceals a more vulnerable, concerned interior. “But are you, well, worried dad,” I pressed.

“Nope. I am not worried. We’re all going to die once and at least this is unique,” he said. “I don’t care about all the numbers and all the stats. Leave that to the mathematicians. This is either going to happen to me, or it’s not.” Fair enough, I thought. What good is there in obsessing over the case numbers or death rates? It’s just miserable.

You’d have thought that my parents would be having the most, erm, dynamic time as of late. But you’d be wrong. My grandparents live together in a retirement home in Cheadle – just outside of Manchester – and a rather posh one at that. Lots of well-to-do types living in modern apartments, with regular entertainment and trips out to explore the local countryside. A positively idyllic setting.

In response to coronavirus, the management had been proactive. They had contacted every flat and provided them with advice in line with PHE’s guidance. Visitors were asked to exercise thorough hand hygiene and hand sanitisers were being installed at the doors (I was surprised they weren’t already there, to be honest). Food and medication deliveries were being dealt with for those who needed to self-isolate.

Sales staff were still working but were only showing vacant flats to potential buyers.  The furnace of the market still needs to be stoked.

Beneath the charming veneer, however, something was brewing in the retirement home – and I’m not talking about an RNA virus. The threat of COVID-19 had stirred up some internal tensions.

“We got an unofficial letter yesterday,” my Grandad said, “just slid under our door; it wasn’t signed by anyone or anything.”

It turns out, the letter was a call to action. It demanded an urgent convening of the residents. But the instigator remained anonymous – there was no sign-off. It had to be one of the other residents, my grandad surmised, because it didn’t have the official letter heading of management.

“Best of all, one the letter’s demands was to invite a GP to give a talk — about washing our hands. I think they’ve got a lot better things to be getting on with,” he said. “Part of me is thinking to send my own counter-letter.”

My grandma chimed in on speakerphone: “I know how to wash my bloody hands. I’m more worried about the GP giving me coronavirus, rather than anything else.”

My grandad’s understanding of the behavioural psychology of the group was thoughtful if a little coarse. “There are two types of people who do this sort of thing. There are the control freaks who want to be seen as leaders, and then there are the people who are generally scared and want something to happen.” From his tone, it was clear: the former piss him off, but the latter he pities.

“I bet it’s the same fella who tries to organise group tea every afternoon at 5pm,” he said. “Me and your grandma just don’t want that regimented lifestyle.” I thought to myself that tea and a chinwag every evening sounded rather nice, but then again I hadn’t spent over 80 years on this planet suffering other human beings.

Aside from the disquiet, things were… well… normal. “We always go to the supermarket early anyway, to avoid the crowds – we’re back home before eight,” my grandma said. “We’ve ordered a few extra books in too.” Understanding that life goes on amongst the chaos is so reassuring. I found myself reflecting on my own cognitive dissonance – hearing apocalyptic tales on Twitter and on the news, but at the same time seeing things proceed pretty much as normal in my actual life. It’s worrying when you lose touch of which ‘reality’ to believe.

I find the media dynamic curious. On the one hand, newsmedia is there to inform us. But on the other, they are revenue-generating machines lusting for viewers and profit. And a sure-fire way of maximising your viewers is to spice up the truth. Talk about the worse case scenarios. Use buzzwords. Use the relative risk, not the absolute. For better or for worse, the line between real and fake can become blurred. The two objectives are certainly at odds with one another, if not (one hopes not) entirely mutually exclusive.

“I’m keeping informed by watching the TV and newspapers, but I’m well aware that they try and hype things up,” my grandma mentioned. “Some things never change.”

“The problem is, we’re in the age of communication,” my grandad went on to explain. “Everyone finds out about everything. When we were in the 1950s, people were worried about tuberculosis, about polio and iron lungs. You’d read about it in the paper, but you could get away from it. Now – it’s just everywhere you go. Your phone. Your computer. Your friends.”

Screenshot 2020-03-17 at 12.03.51

Wherever you go: coronavirus. (https://www.bbc.co.uk/news on 17/3/2020)

“You can’t escape it,” my grandad warned, drawing his astute and prescient commentary to a close. The constant barrage of news is exhausting. You lose the mental headspace to deal with life’s normal problems, let alone the threat of a microscopic bioterrorist that could f***-up your lungs at any moment.

I love my grandparents dearly, and whenever I speak to them I miss the times when I was younger, and I would sit with them for hours and listen to their stories – what life was like growing up during the war, living in the council estates and working their way up. My grandma would recount how she would spend hours in the factory in Manchester, sewing dress after dress to support my grandad during his engineering apprenticeship. She would walk outside and the air would be thick with an acrid smog. If anyone could adapt for harsher times, it was them.

But I always get irritated when they say things like this: “we are eighty-odd years old now,” my grandad declared proudly, ” and although it’d be very sad if we lose our lives this way, something has to get you one day and we’ve had fairly good innings.”

When I hear this, it stirs up a soured mix of anger and sadness. Why oh why do they say these things? It’s not just grandma and grandad, my dad’s guilty of it too.

I get that what they’re trying to do. They think that playing down their own demise, it might not hit me like a tonne of bricks when it happens. But it doesn’t help.

These next few years could be some of the best of my life – I’ll graduate, work as a doctor, maybe even make it to becoming a GP. If they go, we’ll both miss out: I want them to enjoy my achievements, and I want to be able to share what I’ve achieved with them. My work ethic is, in part, because I want so desperately to pay them back for the sacrifices they have made (although they assure me there is no debt to pay). I want them to see that their work has paid off.

“Oh… oh… don’t say that,” I mumbled, because I never really know how to respond to those sorts of comments. “You’ve got a lot of fight left in the both of you, I’m sure.” Whilst providing this superficial reassurance, in the back of my mind flashed images of my grandparents being ventilated in an ITU. I shuddered.

My grandma chuckled. “We’ll be okay, just the two of us,” she chirped. “We haven’t divorced each other yet.”

My grandparents knew what had to be done: keep calm, don’t panic, and wash your hands. In a twisted irony, the years of medical training I had received had equipped me with a huge breadth of knowledge but at the same time had left me feeling more uncertain. I felt as if there were so many variables to compute, so many nuances to consider. Sometimes you lose sight of the easy things that just have to be done.

In many ways, only time will resolve some of those uncertainties. My whole life has been built around knowing the answers. But sometimes, that’s just not possible. So, I’ll buckle up, and get ready for the ride.

 

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