Covid-19 diaries from the respiratory unit: Entry #3 | #TeamBartsHealth blogs

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Covid-19 diaries from the respiratory unit: Entry #3

Royal London Hospital skyline

In this diary entry, Brinni Selvarajah and Richard Toshner reflect on the amount of upheaval to the department formerly known as respiratory medicine, now known as covidology. 

'May you live in interesting times' is an old saying that has felt appropriate lately. Like it or not, we are definitely living in interesting times.​

Recent weeks have brought an astonishing amount of upheaval to the department formerly known as respiratory medicine, now known as covidology. Rotas have had to be written and re-written on a regular basis and whole teams of doctors (from juniors through to consultants) have been mobilised in other departments. We have all become used to spending our working days clad in the ubiquitous PPE and to the attendant sheen of sweat and mask pressure sores that inevitably accompany​.​

As juniors and middle grades we have had a more straightforward job than the consultants - no regular departmental re-structures or cancelled clinics to worry about.  We have been able to focus simply on trying to quickly assimilate the daily burgeoning experience of a disease which none of us knew existed in 2019 (how long ago 2019 feels now) and doing the best we can to give good care to the patients on floor covid. 

But we all now feel well into the swing of our new now normal.  We have become more attuned to the patterns of how covid 19 affects our patients, more acclimatised to managing HDU level patients on a ward setting and sadly more used to the regular and distressing conversations we are having to have with family members - explaining over the phone events that they cannot be here to see. Answering the questions we would be asking if it were our mum or dad. Reassuring when possible, consoling when required.  

With events moving fast, many of us are now also discussing with patients the possibility of being involved in the RECOVERY clinical drug trial, set up at bewildering and unprecedented speed, designed to look at a number of different potential drug treatments.  Although in its infancy we are all excited about the possibility of some concrete evidence on which to base our practice and - fingers crossed - maybe even an effective treatment option, something more to offer our patients when conventional therapy fails them.

The challenges are acute, but from the Thursday night applause ringing out, to the generosity of the local businesses who have been providing sustenance and treats to the staff on an almost daily basis - the support we have all felt has been uplifting and morale has remained high.

For the RLH team 2020 has so far brought hard work and big changes, widespread support and even wider spread weight gain, moments of despair and moments of hope.  And on the good days, a reminder of the words of Abraham Lincoln;

'This too shall pass away

how chastening in the hour of pride

how consoling in the depths of affliction

This too shall pass away'


This week's recipe is chocolate brownie, an exceptional version of which was brought to the ward by Hannah, one of the doctors on the team. Her secret tip - add white chocolate.

Take care and stay safe. 

Love Team Resp xx 

Brinni Selvarajah and Richard Toshner 

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