Doki’s COVID Story

I’ve been mostly busy all my life because of my job. Some time pre-COVID, I decided to scale down on the things I do and put more energy into my advocacy work as opposed to actually, physically being in hospital. I think I would enhance it. The pandemic showed me that while other people were struggling with being slowed down in their life, I’d already started that process maybe two or three years before the pandemic. So I’d probably enhance that – having a work-life balance.

I’d also work on being more authentic in my relationships with people. I’d already started doing that work but in the pandemic, it became clearer who my circle is and the people I was more worried about if they get COVID what would happen, and things like that. So I’d enhance that.

Something I’d keep the same from the pandemic is that I got more time to work on my hobbies, things that I’d been keeping on the back burner. Having more time on my hands showed me that I actually can. So while I was exercising before, now I’m doing more interesting things like callisthenics. I’m also playing the guitar and started DJ-ing. It’s random things that medics don’t normally do but for me being able to fit that in even post-pandemic and being clear that I’ve always wanted to do those things, that’s something I want to keep from this period. Most of the things I’m doing – the women’s advocacy and the music for example – are stuff I‘ve not yet started putting out there because It’s mostly stuff that’s in the background. But I’m hoping by the end of this year I want to start putting it out.

I wanted to prove to medics and the world that doctors can do other things. I think there’s been a perception that if you’re a doctor you’re just a doctor and you read a lot and even then you only read medicine. For many years I’ve felt that I can do other things, I just haven’t had the time or the courage to do things that are outside of medicine so for me, this is proof that you don’t have one skill, one talent, or one passion and you should be able to fit in what you like and what makes you happy as you’re doing your other things.

When COVID first started, I flew to Nairobi because I had a feeling things were going to be locked down. I normally come to Nairobi three or four times a year. I had just been there, but I went back home and told my folks “This thing is really going to change things,” but people still thought it was a Chinese problem and it won’t spread. But my gut which I really trust was very clear that something is going to happen and they’d need to shut down things and restrict movement to get a handle on it. I came back to the UK from Nairobi on March 3 and by the 4th things started locking down. That travel was purely gut-instigated; I wasn’t supposed to be in Kenya in March. I think I was in Kenya towards the end of February and then came back to the UK in March.

I felt that it was something I was seeing very clearly and no one else was seeing. Even in the UK guys were like, “ah, that’s a problem na huko far. It can’t come to us.” So my gut was very clear on that trip. I’ve always been very intentional in the conversations I have when I see people in Kenya, especially with my grandmother who is 96 now. We’ve always had a relationship where I can say, “I’m leaving and I don’t know if I’ll see you again.” Then COVID came and was teaching us to enjoy the company you’ve got now because you don’t know if you’ll have that person tomorrow.

I normally have two sorts of roles in my job. I practice in a clinic that’s sort of shielded in terms of not actively facing patients, and it was sort of easy for us to adjust to seeing patients online or not having so many patients in the clinic. We had to shut down the clinic for about three months and only see cancer patients, which was traumatic because we were only seeing very vulnerable people. If they got COVID from me or from the clinic, or from other people, they could easily die.

My other role was going to labour wards and delivering babies. That is a very patient-facing job. It was interesting for me to watch a woman in labour in a mask. You know they’re already so hot and uncomfortable then you’re straining them with all these restrictions. It was interesting that at that time life was still being brought on the earth. Everyone was thinking about death and dying, and for me, life was still coming. But this is how it was designed. Some people will be born and some people will die. Everyone was like “Oh my God, the world is going to end, we’re all going to die!” But coming from a labour ward perspective, I was seeing life every day. It didn’t reduce, people didn’t stop getting pregnant. In fact, I think because of the lockdown more babies were coming. It was very interesting from that perspective.

Labour and birth are very lonely processes. During the pandemic hospital staff were sort of required to step into those roles of being present for you. So I’m doing my job but I also have to support that lady and not make her feel like she’s alone during that process. I’m so proud of the women who gave birth during that time. Hospitals were short-staffed. At some point, roters had to change to make up for those shortages. Doctors and the staff were so overwhelmed, they were already so stretched so you couldn’t always expect that they’d fill in that role of being your doula. I give a lot of credit to women who gave birth during that time. Maybe that’s why pandemic babies are so feisty and super speedy about life. They’re a different breed of babies. Maybe it’s also because they’ve been raised by their parents at home alone. I know of babies who didn’t get to see other humans for a whole year or two, so when things started opening up it was traumatic even.

There are also people who were trying to conceive and they also struggled. If you were not living with your partner or they get stuck in another country, it was really difficult. There’s also a group of people who then realised they wanted to get a child sooner rather than later. We thought it would settle down but it’s now heading on two years and our clinic is so busy with people going, “The pandemic showed me I cannot be by myself. I wanted to have a child in five years’ time, but I’ll have one now.”

Everyone was very scared. I wasn’t particularly scared of getting COVID myself. I saw it as something that comes with the territory of the job – you can pick up diseases from the hospital – so for me, that wasn’t a concern. I was more concerned about being unwell and my people back home not being able to see me. Medicine has taught me to be very open to life and death and how that happens – I tend to be very pragmatic about death. But people I know were far and unable to be there to have that closure: that was my concern. It was interesting to have those conversations every day with my folks and my siblings. Telling them, “If anything happens, this is what you guys need to do.” They were very scared about those conversations, people are not comfortable with such conversations.

One thing I’m grateful for is that because of how work changed, I got to spend time at home for a whole month. That had never happened in my career. Even since I was a child, I don’t think I’ve been appreciative of having nothing to do. I’d wake up, exercise, read my books, garden… I know people lost a lot of things, but I felt like that was my dream life. My salary was less, yes, but I didn’t need all that money. Also by some miracle, I truly believe it was

God’s work, the UK was actually hot and sunny like summer for a whole month. I think God knew because if it wasn’t good weather, we would have really struggled. This firmed up for me the idea that life is to be lived. This thing of working all the time, trying to make money to just survive everyday… no. I was very good with my boundaries and time before this, but I became even better. People were stressed with the lockdown but I was quite happy. The days would just pass and it was so nice. Other people took up things like online courses but I was just like, “Nah.” I read non-medical books, basked in the sun, and gardened. That was my silver lining. If I could do that again, I’d be very happy.

I hope I can be doing such things at least every year. Because even when I come to Nairobi, I’m busy. I still see patients, I go see my grandmother, I go to Coast for a few days, I’m really all over the place. Usually, when I get back to the UK from those trips, I feel like I need a holiday from that ‘holiday’. So that one month almost felt like being on the ocean, pure bliss, doing nothing.

By the time we went back to work, even though we were busy, the roter still worked. You’d work a week and then go home for a week, so even if you had COVID you’ve had some time to rest and recover. It was interesting to see that even medicine could be done differently. Medics would have never thought that you could work from home. I got the opportunity to work from home and see my patients from home which has really opened my mind.

Unfortunately, main hospitals have gone back to the pre-COVID way of doing things. It’s unfortunate because people are very tired. It has been mentally and physically exhausting. It’s sad to see that so many medics have dropped off the practice of medicine. Our systems are very strained. The NHS is really struggling with retaining people and the systems and managers don’t know how to address that problem. It takes nearly 15 years to train an obstetrician to full speciality level so if you’re looking at replacing that workforce, it’s going to take 15 years to replace those guys who are leaving now. It’s scary. In my position at the moment, I’m really concerned about the attrition rate – how many people are leaving to go chase their dreams and how the system is not adapted to that.

In August I’m starting a part-time role meaning I go to work a few times a week. When I talk to guys in Kenya they just don’t understand it. The Kenyan system hasn’t adapted to this. The NHS has sort of started adapting to those things, that you can be in hospital two days a week and still be satisfied with the fact that you’re a doctor and you’re helping people and giving your all in those two days but you’ve got two or three other things – go cycling, mountain climbing, or cooking. I now know two doctors who have always wanted to be chefs. While before they were waiting to turn 60 and open a restaurant, now – one is 34 and one is 40 – they’ve opened their own restaurants and are running that and have the time to do it on top of being a doctor.

In the fertility clinic, we are now giving people the option of whether they want to be seen online or have a face-to-face meeting. Nearly half the patients are keeping the online appointments because then you can do it from wherever – home, the office, in a car. And it reduces the number of times you have to come to the clinic. Those who feel that the face-to-face connection is a big deal for them can still also come in. We’re flexible in that way. Of course as the practitioners as well, there are some clinics we can run online and some we can’t. For example with the antenatal clinics, some can be done online but a lot of them need to be face-to-face because we examine. Same thing with gyna clinics. Medicine tends to stick to what is known unless something has been tried and tested. So of course we will try to keep some of the lessons learnt during COVID, but certain things may not work since it’s a very physical people job.

I felt sad for medical students because they didn’t get to touch patients, to feel and see them. I’m interested to see what crop of doctors is going to be treating us from the pandemic. Those who were medical students during this period, what kind of doctors they will make. I don’t want to say it’s worrying, just interesting to see. A lot of them may end up being comfortable seeing patients online and doing télé-medicine and looking at images and scans online, but what happens to my practice, for example, where we have to feel, we have to touch. Chest guys for example can do an x-ray and then extrapolate from symptoms and use that x-ray. But for me, I need to feel – how is the baby sat, what is the baby’s heartbeat, things like that.

I will say, though, that this new crop of doctors will be very good researchers. They had a lot of time to sit at their desks. There’s going to be a lot of desk work coming out of those guys. There may be fewer of them doing physical stuff, but a lot of them have picked up really good skills: reading, writing, editing, and coming up with questions. It’s really nice because nearly 80% of medics don’t do research. They’re very good at their jobs, but they don’t look at new things. Which could partly explain why medicine has sort of stayed the same for a long time. It would be nice for these types of people to come up and say they can do something different or look at something in a new way. They’ve had the time and they have the knowledge and the exposure and access to the internet and lots of papers.

I’ve had some friends of mine saying everything has just gone back to normal. For me, I think this was an opportunity. The next epidemic or pandemic or big thing that affects the world might be far off, or it may be near – we don’t know – but I think we should learn from this. There are some really good things to learn from. Like what did you learn?

Three weeks ago I sat in traffic for the first time in so long. When people were in lockdown doctors were allowed to travel and it was so nice. There was no one on the roads. I was so shocked by traffic. I was like, “who are all these people? Where are they going? Why are they going? I thought they were all working from home.” I was so disturbed. Even now I was reading how one of the mountains I like to climb, I went there in between our lockdowns, but I was reading how there was human traffic of people trying to get to the top. And for some reason, they haven’t opened the washrooms at the top of the mountain so people were defecating everywhere and it was littered. And I was like, “Look at these human beings. They just don’t learn, man!” I don’t like being around too many people, I don’t like having people in my space. I’m a bit of an introvert. Even in the supermarket or in banks people are just in your face. During the pandemic, it was great having people sit two meters away. The other day a patient stretched out a hand for me to greet them and I was taken aback. I said, “I’d really like to shake your hand but there’s COVID.” But in my heart, I was like, “I don’t want to shake your hand, it’s not necessary.” But such is life.