Deployed
Contributed by Dr Johan Siow,
​Internal Medicine Specialist, Segamat Hospital, Johor.

MAY 3, 2020 @ 2.55PM
I step forward, facing the cabinets.
​
At the exact moment, hundreds of men and women around my country (thousands around the world) are doing the same.  The nerd inside me comes alive. I begin to hum the Iron Man theme song.
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N95. Hood cover. OT cap.  Inner gloves.  Shoe cover.  Boot cover.  Surgical gown.  Isolation gown.  Outer gloves.  White apron.
Finally, my face shield slides into place.
What is it that has brought me this far?

January. CNY day two.  Melaka
I was down with a flu, spending my CNY mostly in bed and cursing my luck. Friends joked I may have been infected with the new Wuhan virus.  Har har, bery bunny…
 
Then I received the call.  Singapore has detected its first case. Johor was preparing its borders.  Our Bilik Gerakan has been ordered to stand by for disaster.  Can you cut your holiday short and come back to Segamat as soon as possible?
I packed my bags, bid my family goodbye, and under the twinkling early morning star-lit skies, rushed back to report for duty.  To face a once-in-a-lifetime historical event.

March. Permai. 
We just survived the inrush of patients from a cluster involving a major construction company. That was during my first oncall, when we had to convert an additional ward in the middle of the night to cope with the sudden influx. The next morning, I crawled back to my hostel, and collapsed in bed without bothering to bathe.
 
Two days later, I was holding the oncall phone again.  It rang non-stop. At certain times while you’re accepting a referral, you’d hear two concurrent calls coming in.  A private GP managed to get through. 

“Boss, I have a patient here, unwell after attending a Sri Petaling mosque gathering in KL.  About a hundred attendees there, I think.  Some of them are Brunei citizens who tested positive for n-COV back in Brunei.”

I was burnt-out, fed up and sceptical.  I checked the Ministry of Health’s website and other sources online. Nothing about Sri Petaling or Brunei. 

“Can you please confirm your source?  How sure are you those Bruneians were positive?”

“Boss, you can check, it’s on Facebook.  Here, I’ll whatsapp you the link.”

It was the start of a very long day.  And the beginning of a worldwide battle.

It’s 3am.  Our beds were filling up with patients from the new Sri Petaling Tabligh cluster.  I suited up and went in to see the latest admissions.  In the hot and humid environment, sweat began sloshing about in my facemask, gloves, boots and of course, underwear.

I had barely clerked all three patients when my glasses and face shield fogged up. I was in the blind, feeling my way around the room, inserting branulas and withdrawing blood by the touch of my fingers alone.

One of the Tabligh patients was a young and friendly guy who tried to lighten the atmosphere with humour.  I laughed along as I took his vitals, bloods and swabs, inserted a line to start IV fluids and encouraged him to drink lots of water.  I then turned my attention to the other two older patients.

Ten minutes later, I noticed a sudden absence of jolliness.

My young patient had begun vomiting and sweating profusely.  He kept reassuring me he was okay.  But his smile was now a grimace.  As I handed him a yellow biohazard bag to throw up into, he let loose an explosive sneeze. 

Dead center at my face. 

I felt my face shield rattle from the shotgun-like blast. When I opened my eyes, I sucked in my breath hard.  There were droplets pockmarking the flimsy piece of plastic, barely centimetres from my eyes.

Someone once warned me the new virus seemed to behave like dengue; patients deteriorated suddenly without warning.  Borrowing another patient’s handphone (we had no clocks inside), I found the stopwatch app and began timing his respiratory rate.  Forty-four breaths per minute.

I radioed for help. Boss came immediately, personally intubating the patient herself.  It was a surreal sight when morning arrived: my big bosses in their Tyvek suits and powered respirators, our patient inside the caterpillar-like isopod preparing for ambulance transfer to the ICU.  It looked like a grim Hollywood movie.  Who’d imagine that sight would become a norm for days to come.

A week later, my young and friendly patient, whose swabs later came back positive, would return to the Almighty, leaving behind a wife and infant child.  The second Malaysian to succumb to the coronavirus.

We were at war with an enemy we couldn’t see.

It’s only been four months, but yesterday seems like so many years ago.

We brought the knowledge we learnt at Permai (and later Kluang) back to Segamat.  Like other hospitals around Malaysia, we also had our moment when a positive patient breached our walls and wrecked havoc from within.  Sixty-six hospital staff had to be temporarily quarantined, and for a crushing week, the sudden weight in workload to the remaining doctors and nurses brought us to our knees.

Many of us went home exhausted, missing the good times we had with our friends and family, dreaming of the holiday that now seems like a wisp in the distant future.  One of the biggest joys in my life comes every weekend when I travel back to KL to play music with my band. 

A damned virus has robbed me of that.

Let’s come back to Permai, for a moment.

I was taking bloods from another Tabligh patient.  As I withdrew the needle, I noticed a puddle of water forming on his arm, soaking into the bedsheets.  I looked up at the ceiling.  “Eh, bocor ke?”

“Bukan, doktor.”  My patient smiled weakly.  “You punya peluh.”

Embarrassed, I began to apologize, but my patient reached out to take my arm.  Under three layers of protection, I felt his warmth.  No, he wasn’t having a fever.

“Terima kasih doktor kerana jaga kami.  You kena minum banyak air juga ya.”

I fought back tears.

There’s also the story of a little Indian girl who got admitted in the middle of the night.  Boss found her dad sleeping on the floor during rounds the next morning.  Thinking that we were short on beds, dad didn’t want to trouble us.  He gave the only bed in the room to his daughter, wrapped himself up in a blanket, and spent the night on the cold hard floor.

How could I not stop fighting for my fellow Malaysians?

So, what is it that has brought me this far?

I’ll admit, whenever I suit up, I wish it was as cool as it was in the movies.  Unfortunately, my face shield does not come with high-tech anti-fogging technology.  It does not light up with a glowing HUD once it slides into place.  And Jarvis does not go,

" All systems online.  At your service, sir." 

Nope. It’s just a clear A4 sheet that's glued to a piece of mattress foam and elastic band.  All that is protecting me from a virus-laden cough or sneeze is the clear cover of my standard one buku projek, "Keluarga Saya".

But behind that DIY’ed face-shield is the person who’s name I’ll never know, who sat up all night to make hundreds of them for us without asking for anything in return.

Behind the isolation gowns, boots and head covers are the doctors and nurses from the surgical-based departments, who have come together to aid their medical colleagues, turning their surgical skills into tailoring prowess. 

Behind every tired front-liner is the Malaysian who has cooked their meals (oftentimes giving it away for free) and the food delivery guy who has risked his life on the road to bring it to us, come hell or high water.

We in front wouldn’t have existed without you at the back supporting us.  We know you are tired too, stuck at home under lockdown, barely surviving on your remaining savings.  Yet, you’ve reached out during this war, giving all you’ve got to continue holding us up.  Thank you for inspiring us to give our all too.

Not all heroes wear capes.  Yeah, and those cape-less heroes exist because of the unseen heroes behind the scenes. 

The air here is hot and humid, a dividing point between two worlds. I’ve come this far, and I promise, I will keep going.  Taking a deep breath, I step beyond the red border on the floor.  

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