COVID-19 SPECIAL

Coronavirus: Success stories keep these specialists going

Their duties range from treating critically ill in ICU to reassuring patients with Covid-19

(From left) Dr Jyoti Somani, an infectious disease doctor, and Dr Kollengode Ramanathan and Dr Graeme MacLaren, who are ICU specialists. PHOTO: NUHS
(From left) Dr Jyoti Somani, an infectious disease doctor, and Dr Kollengode Ramanathan and Dr Graeme MacLaren, who are ICU specialists. PHOTO: NUHS

Dr Graeme MacLaren's heart fluttered as he thought of all that could go wrong the first time he walked into an intensive care unit (ICU) full of Covid-19 patients. But his nerves did nothing to weaken his resolve to do his best for them.

He vividly recalls one of his most memorable experiences - saving a dangerously ill patient, Mr Toh Kai Kiat, before he slowly recovered and left the hospital after a 42-day stay.

"When I heard he'd had a cardiac arrest for 16 minutes, my heart sank. I thought he would be our first fatality," he said of Mr Toh, who had been put on extracorporeal membrane oxygenation (ECMO) treatment.

"The majority of patients don't recover from that. But he did. The whole team pulled together and did their best - it worked," said Dr MacLaren, 46, director of the cardiothoracic ICU at the National University Heart Centre, Singapore (NUHCS).

He and his colleague, Dr Kollengode Ramanathan, 44, specialise in ECMO treatment - a form of life support - and each has close to 20 years of experience as ICU specialists.

They attend to some of the most critically ill coronavirus patients at the National University Hospital (NUH). Both take turns to be on call 24 hours a day for the whole week - doing daily ward rounds and attending to calls. They work with 10 ICU specialists and 16 infectious disease doctors and are roped in for very urgent cases, especially patients with heart, lung and vascular problems.

Their days are also kept busy with referrals from other hospitals on potential ECMO patients, an increasingly common request in the last few months, Dr Ramanathan said.

Only two public hospitals here have ECMO capabilities - NUH and Singapore General Hospital.

"Either of us will also cover the National Centre for Infectious Diseases' ECMO patients when we are on call. If we are not in the hospital, we are expected to be able to reach the hospital in 20 minutes," said Dr Ramanathan, a senior consultant in the department of cardiac, thoracic and vascular surgery in the NUHCS.

The doctors alternate their weeks between being on call and non-clinical work, such as research, teaching and administrative duties. It is not just the most critically ill patients that demand attention - the bulk of patients also need medical care.

Dr Jyoti Somani, 54, a senior consultant at NUH, is one of 16 infectious disease doctors who look after patients throughout their stay.

One of Covid-19's challenging aspects is that families cannot visit loved ones due to the highly contagious nature of the virus, she said.

"Luckily with technology, patients, often with the help of their nurse, can video-chat with their loved ones. I was particularly happy when our 89-year-old patient in the isolation ward was able to go home," she added, referring to one of the oldest patients in NUH.

A large part of her job is reassuring patients, especially with so much still unknown about the virus. In the earlier stages of the pandemic, Dr Somani had to reassure some pregnant patients - based on limited data from China - that they and their babies would do well. She also noted that many NUH doctors and nurses are redeployed to areas of need.

For Dr Ramanathan, the struggle to spend time with his five-year-old daughter is very real. "My daughter misses me and said that I do not come home as regularly as before now," he said. "But there is nothing more heartwarming than helping someone fight the disease and get back to normal life after narrowly escaping the jaws of death," he said, referring to two Covid-19 ECMO patients in NUH who got better, with one discharged. "These small success stories keep us going," he said.

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A version of this article appeared in the print edition of The Straits Times on May 18, 2020, with the headline Coronavirus: Success stories keep these specialists going. Subscribe