I've never been the greatest sleeper. Insomnia has been a fairly constant companion throughout most of my life, however, I've found myself struggling to sleep even more than usual over the past few weeks, for obvious reasons. Last night looked like this for me: get into bed absolutely exhausted, find myself, as soon as I turn the lights off, inexplicably physically unable to close my eyes, worry about reasonable concerns (how we will manage on an eighth of our usual income, whether my parents will get through this pandemic safely, whether I will manage to home school my children without killing them), worry about whether I will fall asleep anytime in the near future, worry about totally unreasonable things (that I left washing on the line and whether my house will ever be clean again), try to meditate but instead breath myself into hyperventilation, worry about whether I will ever fall asleep again in my life, get up and go to the toilet, feel short of breath and wonder whether I am showing the first symptoms of corona virus, eventually fall into a restless sleep at about 4am, wake up in a flat panic at 6:45am to the horrible realisation that I have forgotten to hide the Easter eggs.
The rest of the morning followed in a similar vein. The eggs were badly hidden in a mad rush and the boys ended up fighting over them. We all ate chocolate eggs for breakfast, felt great for about ten minutes, were overcome with nausea and then hit spectacular sugar lows. I was scratchy and both boys were irritable and constantly at each other's throats. Malcolm was a little oasis of calm, but he didn't stand much chance against the three sandstorms buffeting him. I snapped at the boys for everything from the cushions lying on the lounge floor to the fact that they are inherently lazy slobs (they aren't) and Mal beat a quiet retreat to somewhere I couldn't bite his head off. Even the perfect weather irritated me, because at least if it had been miserable weather I wouldn't have missed running as much. And bloody hell, I positively despised all these super-disciplined people who were running 56km in their very tiny back gardens. I deleted the Strava app from my phone (but caved in and reinstalled it after about an hour).
This was not the Easter that I had planned at all. In fact, it was turning out to be the worst Easter I've had since the time I was knocked unconscious by a falling rock two days into a three-day hike twenty-five years ago. Easter is supposed to be a time of rebirth and hope, a time to celebrate the miracle of life. COVID was making a mockery of that. I don't know what I was expecting, whether I had thought I would wake up on Easter morning to a miraculous message that someone had found a cure or vaccine for corona virus (or at least a message that the lockdown restrictions had been relaxed a teeny bit). So I do think that some of my grumpiness was due to the gap between my expectations and my reality.
Bear with me while I change tack completely for a little while.
About two weeks ago I saw a patient- let's call her Mrs A- as an emergency consultation. She is an elderly lady with a significant medical history that includes a previous stroke, high blood pressure and uncontrolled diabetes. She had only recently become my patient so I didn't know her very well, but I did know her well enough to have developed a fairly good relationship with her. She was quite unwell and so her daughter had brought her in and sat in the consultation with her. After assessing her, I realised that she was far more unwell than I had previously thought and that she would ideally need hospital admission. Of course, during the time of COVID, this was not ideal. I had a long chat with her and her daughter and eventually we decided that, as much as Mrs A was reluctant to be admitted, the best route would be to admit her. I organised admission and sent her off to hospital with the horrible knowledge that she had about a 50% chance of making it out alive.
I didn't hear from her or her family for a few days, but when I did the news wasn't good. Although the initial infection that I had admitted her with had settled with antibiotics, she had had a bleed in her brain while in hospital and her level of consciousness was decreased. She was also in heart and kidney failure. Although I hadn't physically seen Mrs A since her admission, I chatted to her daughter and tried to break the news to her, as gently as possible, that her mother was unlikely to survive.
Against all probability, Mrs A actually improved over the next few days. I got updates from her daughter and pulled up her bloods and, incredibly, her kidney function had almost improved to normal. She was somehow bucking all the stats. A few days later she was discharged. Her discharge reminded me once again that I am only a doctor; there are complexities way beyond my understanding that I cannot ever presume to predict.
Although Mrs A was now home with a full-time nurse, she was still far from out of the woods. Good Friday was a good day. Saturday, not so much. She started to deteriorate and began hallucinating. Her nurse and I were in constant discussion and, after checking her urine, I started her on antibiotics for a bladder infection. I was fairly certain that this was the cause of her delirium, but she was becoming more and more unstable and I was unsure whether she would have the reserves to survive the infection. I suggested to her nurse that she discuss with the family whether they wanted to admit their mom again. The decision, which I supported, was not to admit her. I went to bed uncertain whether she would survive the night or not (another of my reasonable worries that I forgot to mention earlier).
Fast forward to my disastrous Easter Sunday. It was now mid-morning, by which time my whole family was avoiding me and I was questioning my own sanity, along with any sort of faith that I might have. My watch buzzed with a WhatsApp and I hesitated before looking at the message on my phone: it was from the nurse. Eventually I pulled myself together and opened my WhatsApp....and there was a picture of Mrs A sitting up and smiling. I blame my tears on the stress of almost three weeks of lockdown.
This post ended up being not entirely about the lockdown, but it was one I wanted to write because I think that at the moment, under these tenuous circumstances, we are all looking for miracles. And miracles are tricky things: they are seldom what you think you want, so you often miss them, and they have a habit of hiding in the ordinary. Yes, a cure for corona virus would have been a wonderful miracle, but you cannot put a measure on miracles, and the fact that Mrs A's family got to spend one more Easter with her and that she survived against all odds- that's as much a miracle. It's all about where you look for your miracles, kind of like an Easter egg hunt.
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