Sometimes we help just by being there

Lockdown is a dark time for some patients, and this is where GPs can shine like no other doctor.

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Flight 780. 3pm, Western standard time. Perth to Melbourne. March 2021.

The plane announcement crackles: “All aboard, please, seats 15 to 30. Don’t obstruct the aisle.”

The uniforms of the female flight attendants on our national carrier look fresh. This is not unexpected as they probably haven’t flown anywhere in the past 14 months. Nor have most of Australia.

Spending five days in Perth visiting an ill relative earlier this year,  I felt I was in a place that covid forgot. Apart from a brief early lockdown, Western Australia had almost entirely escaped the ravages of covid-19. Hundreds of aged care residents did not perish here in the dark winter of 2020 as they did on the eastern seaboard. No deathly quiet streets, nor rows of locked-up deserted shops and queues of unemployed for the West Aussies.

Back in the present, the hot WA sun was slanting through the plane window. With a shudder, I think back to the contrasting dimness of Melbourne in August last year, where in the midst of lockdown 2 (or was it 3?) I gazed at my booking screen and saw a sea of red telehealth appointments. Everyone was bunkering down in their homes, afraid of not only the virus but also of the restriction-enforcing police. I’d packed away my stethoscope, as who knew when I’d actually listen to a real-life chest again. And as for throats, forget it.

I clicked on the next patient’s name. “Hi Jude, how are things going?”

I could picture her sitting at her cobbled-together plywood desk. Her blind would be up, facing another blank apartment building. The digital clock would be telling her I was 15 minutes late, as usual. She had another eight hours of staring at her screen to go as her employer expected her to work through her usual commute time, with 15 minutes of lunch somewhere in the middle.

It was a good thing her new lunch bar was now a mere three steps away from her work station, just around the corner of her queen-size mattress. No point in making the bed. After her allowed one hour of exercise outside, she would fall, mentally but not physically exhausted, into her rumpled sheets, where she would stare at the ceiling, wishing she had a balcony, something.

“Doc, I’m not sure how I feel. Sometimes I think I’m going mad.” I felt as if I’d had this conversation 20 times before that week. Because I had. And it was only Tuesday.

“Jude, I know it’s tough. Hang in there. This will end.”

She was unconvinced. “At least you get to go out to work and see other people,” she said. I nodded guiltily then remembered she couldn’t see me over the phone.

“Jude, have you thought about getting a dog or some kind of pet?”

“They’re really hard to get and really expensive. Everyone wants one as they need someone or something to love during lockdown.”

“Think about it – beats talking to the walls all day. Anyhow, shall we talk about your asthma?”

“Yep, it’s really bad at the moment. Odd, as I’m not outside much.”

“I’ll send you out your scripts electronically. That’s a silver lining to covid.”

“Thanks, Doc. I really appreciate it.”

As the phone clicks, I rub my ears. My AirPods are not built for six hours’ straight of phone calls.

As I walked my naughty, gambolling dogs that night in the gloom of the park, I felt lucky. And guilty. I had retained my job. My husband had retained his work, albeit working from home. My children had the technology they needed –  and even too much –  to complete their studies in their rooms. Their headphones were filled with the chatter of their teenage friends, themselves confined in their own untidy bedrooms, in suburbs scattered around us.

In my one hour of freedom dog-walking, I felt Melbourne breathe. Like a huge resentful, restrained animal: heaving, shifting restlessly, just waiting for a word from its master to be released again, once the invisible contagion had passed.

Meanwhile, Jude and all my other lonely patients sat and waited. Alone in their 50 square metre, one-bedroom apartments, watching the tiny numbers in the corner of their screens flick over to the liberation time of closing their laptops, but then to watch yet another screen of artificial hilarity on their TVs, to manufacture some simulacrum of joy on their bedrock of loneliness.

The next time I spoke to Jude, the rays of a late Melbourne summer 2021 glimmered through my still-glued-shut window.

“Doc, I took your advice and got a dog! Her name is Jinny. She’s a cavoodle and I don’t have time now to think about anything else. I’m still training her and she pulls on the leash like your dogs. I don’t even care if I lose my job if they don’t think I’m working hard enough. Thank you so much for suggesting I get a dog. It took a while but it’s worth it. I even survived the last snap lockdown with no worries. Jinny just sat on my lap and we watched TV together.”

Sometimes the prescriptions we give patients are not of the medication kind. Through the long, grim months of lockdown in 2020, we GPs supported our patients. Not just through supplying scripts, but by being there.

The friendly reliable voice in their ear. The reassurance that there was still hope; that sometime in the future there would be life again. Our humanity and our humanness bound us. My patients have become my friends through shared difficult experience.

Now, in the winter of 2021, we are all travelling again together, even though the current round of lockdowns has as a backdrop the minefield of the covid vaccination rollout. Again, the goalposts change. Confusion reigns. Now, as ever, the importance of communication with our practice staff, our patients, our peers and also our commanders is paramount. We face a new challenge but we know we can do it.

As I write these words, I feel limpid eyes on my back. I turn and pat my dog.

For all the social distancing, hand sanitising, zoom conferencing and government support payments, it has been our emotional connections that have sustained us during the hardest trials of this pandemic, especially here in Melbourne. Covid, for all its many negatives, has certainly helped us value what is truly important … and to be grateful.