Palliating myself through the COVID -19 pandemic.

‘Physician heal thyself’.  Immeasurably harder to do in a pandemic. Dr. Sandhya Maharaj reflects on her inner world while delivering Supportive Care in a developing country.

Photo of Dr Maharaj
Dr. Sandhya Maharaj.

Living in the region of the world classed as developing during a global pandemic seemed at times quite hopeless. In fact, I’ve never related as much to the patients I’ve cared for whilst working in Palliative Care as I have during this time. I think I’ve had a greater understanding of the range of emotions that one experiences when faced with the uncertain journey of a life-limiting illness. The stages of grief with the added feeling of ‘stuckness’ seemed to permeate my being cyclically on any given day.

With our country’s borders being closed, we were literally locked into ‘Trinidad and Tobago’. Locked in the reality of infection, death and fear. Stuck on our own mainland of uncertainty, restrictions, with access only to essentials. I wondered about patients on chemotherapy, when pandemic or not, this was their daily reality. A life lived in survival mode. Or as one patient coined, ‘Doc, I’ll play the hand I was dealt in life’.

In the initial phase of the pandemic, I was very cautious in shuffling that deck. I felt incapacitated by the hand that was dealt to me. Daily trips to work seemed like preparing my mind, heart and soul to leave the comforting safe zone of my home to perform my duty. On days where my commute was longer, I was left with my ruminations. Thoughts of my family and their safety, reflections of my patients and their well-being and meditations of my colleagues on the very front-lines. The cloth mask now not only served as a respiratory protection but as an emotional armour as it caught the tears that these thoughts so unexpectedly evoked.

The human I became during the pandemic craved for pre-pandemic me. How was I to recover her? Any glimpses of her seemed to be quickly pushed back in with a new COVID-19 variant arising or vaccine hesitancy injecting into a population. As the proverb goes, ‘Physician heal thyself’. I attempted to salvage the good bits of me and tried to find hope and gratitude. The vaccine, virtual hand–holding and distractions of the mind definitely helped.

The conviction of my five-year-old nephew to ‘spray that virus away’, the written philosophical word and mostly nostalgia immensely soothed my soul. Remembering my grandparents. The food my grand mum served on coming home from school. My grandfather’s powerful voice (a Hindu priest) as he chanted Sanskrit prayers invoking the blessings and protection of the deities to our home and life. Evermore, I channelled his inner strength as I must have some parts of him within me.

Very early on in the pandemic, images of cadavers outside morgues made my dad comment on the developed world being brought to their knees. I imagine, the developing world was brought to our knees in prayer. More and more as I provide palliation to my patients, I remember to palliate myself in the process. How do you comfort yourself moving forward?

Sun going down over sea at Manzanilla
Manzanilla, Trindad & Tobago. Photo credit: Jono Hirst.

About the author

Dr Sandhya Maharaj is a physician from Trinidad and Tobago. She presently works in Community Medicine in Trinidad and Tobago and supports a home- based Palliative Care service. Twitter: @Sandhyamaharaj1.

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