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Remove my Ventilator

Como is a small scenic city at the southern tip of Lake Como in northern Italy. It is known for the Gothic Como Cathedral, a beautiful funicular railway, and a waterfront promenade. The Museo Didattico della Seta traces the history of Como’s silk industry, while the Tempio Voltiano museum is dedicated to Italian physicist Alessandro Volta. Just north are the lakeside gardens of the palatial Villa Olmo, as well as other stately villas.  Northern Italy bordering Switzerland. It is 40 kilometres away from the city of Milan having just about 37 square kilometres area and population of about 85,000.
There is a Lifeline Hospital of 150 beds capacity, which is quite old. Closer to the city of Como, there are a lot of agricultural farms and people prefer to work on farms after their retirements. Colonnello (Colonel) Dr. John Stuart has settled in Como and was staying in the outskirts of the city.
Remo was working in Alitalia Airlines till recently. Alitalia Airlines had a huge debt burden of US $ 3.3 billion and was trying to overcome the financial crisis. But with the sudden onslaught of Corona pandemic, the airline decided to ground and close all its operations. Remo was asked by Alitalia to proceed on leave till further instruction and that made him return home to spend time with family till pandemic withered away. He was married to Sofia, who was an intensivist and worked with the Lifeline Hospital in Como.
It was the first week of April, one morning when Dr. John was working in his farm, he received a phone call from the District Army Commander and the Commander told him that due to the health emergency of the pandemic of corona virus, his services will be required by the government in the nearby hospital. John quickly left the farm and entered the house. Remo was watching television and his four-year daughter Sonorita was playing nearby. Remo looked at the anxious face of John and was worried. He asked, “Dad, what is the matter? Why you look so worried?”
“Remo, I am requested by the government to offer my services to Lifeline Hospital due to the medical emergency of the pandemic. The number of doctors is inadequate.”
“Oh, I see,” Remo said. “Then???? Are you going to join?”
“Yes, of course. My country needs me.”
“But Dad, Sofia is already working there.”
“Yes, I know.” John nodded, “Still, I have to.”
John called up the hospital and told that he will be reporting the next day morning.
The next day, John reported to the hospital in the morning. He walked straight to the Medical Director, Dr. Emalio. “Hello Dr. Emalio, Good Morning”.
“Ahaaa, Good Morning Dr. John, good you honoured our request made through army district commander.”
“Tell me which area you want me to handle,” Dr. John asked very politely. Dr. Emalio was much younger than Dr. John, but John was very humble.
“Dr. John, actually looking at your age, we should not have requested help to the hospital to handle corona pandemic, but it is a question of life and death.”
“I know Dr. Emalio, I came as my national duty in such a critical time.” John replied with humility and concern.
“Ok, Dr. John, then, we wish you to take charge of the Isolation Ward of Corona. Can you?”
“Sure, Dr. Emalio.”
“Ok Dr. John, see you later.”
Dr. John was not very familiar with the whole hospital, though he had worked there as an intern many years ago. He walked through by signboards to ICU and everybody there was surprised to see Dr. John but was happy to have such a seasoned and experienced physician to guide in such a critical and challenging time.
Since the Corona virus pandemic had spread in the city of Como, the medical facilities got overloaded, which had compelled the government to request medical fraternity, whether doctors, nurses or technicians, to join back even after retirement, as a national health emergency.
Dr. Sofia had done her specialization in virology after her Master of Medicine and joined this hospital, even though there were good opportunities in bigger cities, like Rome, Milan, etc. Since her husband was in the aviation industry, he wanted her to do a job in the city hospital and stay with his parents. For the last three weeks, she had not gone home and could not see her daughter, Sonorita, as there was a risk of infection. She used to remember her many times, but could not do anything.  
John, after reaching the ICU, enquired about Sofia’s whereabouts. Senior Resident, Dr. Omar told that she was not comfortable and had a little problem in breathing. John was shocked and rushed to Sofia with Dr. Omar. Dr. Sofia was given nominal oxygen support but was looking a little frail and exhausted. Dr. Omar told that most possibly, Sofia will be discharged the next day but will be required to be quarantined for fourteen days, as a precautionary measure. He told Dr. John, Sofia was exhausted because of the infection, which may not be corona, but it was too early to say.
Dr. John spent two days attending hospital but on the third afternoon, suddenly he started feeling breathless and was taken out of service immediately to be confined to an isolation ward, due to apparent infection of corona. Natalaliee was working in ICU but could not look much at John. Her team was equally trained and concerned about all patients. John, though in a vulnerable age group, he being ex-army was quite strong and fit. His army discharged card showed him to be in good physical condition.
Sofia went to John’s isolation area. John was looking a bit down and hence, she felt worried. John’s age was not on his side. Corona, to date, has no definitive cure, though some drugs are helping, like Hydrocloroquin with others. In the same area where John was isolated, a younger man of around 40 years got admitted with many severe symptoms. In fact, he needed ventilator support, but the hospital did not have any spare ventilator now. John’s army background and medical experience were not allowing him to continue with this situation. He had worked in many army missions in alpine ranges. He had seen and handled acute pneumonia cases at a much higher altitude.
He called Sofia and asked her to remove his ventilator and provide it to that younger man.
“But papa, you need it.” Sofia was trying to convince.
“Sofia, trust me, you follow what I say. I know you are worried due to my age. We are taught in the army how to survive in an adverse situation when the help is a remote possibility. You put me oxygen support and let Dr. Omar decide the oxygen flow. Yes, you put a nurse for close observation and necessary immediate steps, in case an alarming situation arises.”
Sofia was in a dilemma and really could not decide. She contacted Dr. Omar, who personally examined John and agreed to the suggestion.  Even though Sofia was a doctor, she was worried. Since Dr. Omar had agreed, she switched John to normal oxygen support with more aggressive medicines. The higher dose was a risk but it was an unavoidable risk and was worth it. The whole night, Sofia could not relax and was alert. She was thinking about her husband, John, and Sonorita.   
“Papa, are you alright?” Sofia wondered.
Around midnight, the on-duty nurse reported to Sofia that oxygen saturation, even when it was temporarily disconnected, was 98. She went to John to see herself. It was a good sign. It meant drugs were responding well.
“Sofia, believe me, God is great and kind. He wants me to serve my country for many more years. So, he will not call me so early.”
Sofia was in constant stress throughout the night praying that God really blessed John. In wee hours, Dr. Omar examined John and surprisingly, John’s all vitals, blood pressure, sugar level, oxygen saturation, heart rate, body temperature, and respiration were found in the normal range. Tears were rolling over her cheeks. She held the hands of John and was just sobbing.  
The younger man was also showing improvement. Medical science was undoubtedly important, but in history, many doctors while treating have made many unprecedented experiments, when everything else was dark and dim.  After all, researchers also calculated risks, while making medical trials on human beings. Such trials are not totally risk-free; even though extraordinary precautions are taken, as approved by the ethical committee.
John and Dr. Omar combined their knowledge, learning, and experience and devised the plan of treatment for John. John was also aware that corona virus is a novel virus and has no sure cure available anywhere in the world, including Wuhan, China, where it originated.
Health care is always full of hazards and risks, but so are all roads, railways and aviation accidents travels. But people have not stopped walking on roads, traveling by railway or by air. Doctors are not Gods. They are also mortals. It is rigorous learning and training which makes a doctor courageous, calm and focussed on handling a critical situation, which is life-threatening, just like a soldier remains steady and unagitated while encountered by the enemy. The only difference was soldiers could see the enemy and doctors cannot see that deadly virus, yet.
Sofia thought all these and emboldened herself. She told herself that she would win and corona would vanish. Her womanhood did not make her weak, but made her more empathetic, caring and concerned, not only for John but for every patient.
John, the young man, and Sofia were just looking at each other and tears were flowing from both their eyes. 

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Author : Mukund Bhalerao

Mukund Bhalerao hails from a family of a high school teacher, brought up in a small town of Eastern Maharashtra. He has four siblings. His basic degree is in humanities, followed by two law degrees, Masters in Political Science & History, and a couple of post-graduate diplomas in Production and Labour. In a corporate career spanning for more than three decades, he was responsible for legal matters form the lowest court to Supreme Court.

He has been fortunate to get trained for Organization & Human Resources Development at the Indian Institute of Management. He is a Practitioner of Neuro-Linguistic Programming certified by its inventor, Dr. Richard Bandler, USA. 

National Institute of Personnel Management, Kolkata conferred on him its Honorary Fellowship of the institute. He is a Life Member of the Indian Society for Training & Development, New Delhi. 

He is the Certified Implementor of Quality in Healthcare by National Accreditation Board for Hospital & Healthcare, New Delhi and is also an accredited Lead Auditor for ISO-9001:2015 Quality Management System & ISO-14001 Environment Management System.    

He is actively involved with the national work of Rashtriya Swayamsevak Sangh from childhood and currently serves Sanskrit Bharati. He is conversant in Marathi, Hindi, English, Sanskrit, Guajarati and Urdu. He composes poems, traveled to various countries, reads photography, has a taste for Indian Classical Music, Instrumental Music, Jazz and Gazals. Literature and Mythology are other areas of interest. These days he is actively involved in healthcare facilities.

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