Protagonist I: “I am lost, I cannot find my way”

Protagonist II: “It is the human condition”

Akira Kurosawa “Ran” (1985)

At 5.45 am on a cool morning in April, I went for my usual bicycle ride through the almost deserted streets of Lahore; this is a morning ritual that I practice religiously two to three times a week (with friends on Sundays) and there is no better time for it than at sunrise in spring. The air is cool and clear, the frequent breezes blow away the worst of Lahore’s air pollution, people are still mostly abed after their morning prayers and traffic is minimal by Lahore standards. And, I have discovered, bicycling gives you a whole new perspective on your community. It is like seeing it through new eyes, a view next to impossible from inside cars.

I came home and by the evening felt a touch of sore throat plus some aches and pains which I put down to the exercise. The next day was the first of Ramazan and we woke up at 3.30 am for our sehri and by now I felt worse: a headache and a scratchy throat. Again, I put it down to getting up in the middle of the night. The next day, I felt even worse which I attributed to keeping a roza and decided to wait one more day before pulling the alarm. I was not a whole lot better by the next morning so I called a physician friend who advised an immediate Covid test and other lab investigations.

The rest of the day is a bit of a blur. I went to the large public hospital where I work and they swabbed my throat and took some blood. Then they put me into a CT scan machine to do a high resolution chest CT scan, a standard test recommended to see any early lung involvement. This can be a predictor of later worsening of symptoms including the need for having to take oxygen or even having to be hospitalised.

Since I am also a senior faculty member at the hospital, my colleagues were extremely solicitous and I was told that my lungs looked good but there were some ‘shadows’. This, I knew, was an ominous sign which could portend disaster in a few days including having to be in an ICU or, in the worst-case scenario, on a ventilator or dead. Still, they were all encouraging. The changes were minimal, we had caught them in time and if early treatment were started, I was certain to recover completely. In addition, I was vaccinated. Having been designated a frontline healthcare worker since I worked in a Covid-referral hospital, I had received my vaccine several weeks ago and was, presumably, protected against the severe form of the illness.

But now there was another problem: the previous day, while I had been nursing what I hoped was a common cold, our family had had its first iftar, and both my elderly parents had been around the meal table along with my brother and his family. I was mindful of my symptoms and had tried to keep my distance from them. But given the infectiousness of the Covid-19 virus, especially the strain(s) of the virus circulating in this deadly Third Wave, it was by no means certain that others had not become infected. There was only one way to know. Everyone needed to be tested and while I scrambled to figure out what to do next, I sounded the alarm in my family as well.

I moved myself to a different room of the house trying to avoid the baleful glares of my wife and kids. The lab technicians came over to our house and took throat swabs of my wife, three teenage children and my two parents and I retired to my separate room to spend a restless evening and night. Dr F, my chief of medicine friend, had already instructed me sternly to begin a full complement of (unproven) Covid-19 treatments: antibiotics, steroids, an antiviral infusion and other pills. She worked on the frantic Covid wards and ICUs of our hospital and had already seen too many people die gasping for breath while their families looked on helplessly. Nothing demoralises doctors and hospital workers more than to see one of their own struggling for life. In addition, the way this Covid surge was going, we could ill-afford to lose doctors or nurses to the illness, let alone senior medics.

This had happened last year when my friend Dr F had lost a cousin, a senior surgeon and a university administrator as well as several close family members in quick succession to Covid.

The next afternoon, just as I was feeling a little better (probably from a combination of the medicines plus having had time to ‘digest’ the news) I got a message from my wife: she was Covid positive as was my elderly father, close to 80, and my two teenage sons. My mother, amazingly was Covid negative. A half hour later, my teenage daughter’s Covid test came back positive as well. Now, it was a race to get my panicky mother out of the house to avoid exposing her further to our illness. I called my brother who drove over quickly to come pick her up and she left, teary-eyed.

I was worried about both my wife, who had a history of lung problems and my father, because of his age. Dr F, as usual, advised going at the illness ‘all guns blazing’ to prevent its progression to more severe illness needing oxygen and hospitalisation. That same evening, my older son came to my room apprehensively: he had a fever and so did my younger son. By this time, I had resigned myself to all of us getting the illness so, after consulting with Dr F, I started everyone on the medicine cocktail and after trying unsuccessfully to fall asleep, took a mild sedative and passed out for the night.

I woke up the next morning to a cool and crisp sunrise, what my father likes to call “champagne weather”; the kind of day that makes you glad to be alive. The sun was shining brightly, the birds were chirping, there was just a hint of a morning breeze and all seemed to be well with the world.

After the morning temperature and oxygen saturation check for all of us, I passed around everyone’s medicines and made preparations to take my wife, children and father for their chest CT scans to make sure the infection had not gotten into their lungs. This is the number one reason people fall severely ill from Covid. The science is complicated. Suffice it to say the earlier the lung changes are detected and treated, the better the outcome of the illness. It was mid-afternoon when we were all preparing to pile into two cars to head to the hospital when the next bombshell dropped: my brother, his wife and two young children had sore throats and fever too. My mother, used to dealing with crisis as a high-powered professional woman, had already made arrangements to move to a friend’s house to try and stay a step ahead to the infection. I instructed her to leave immediately as we headed to the hospital to see what the CT scans on my family showed. By now, like the protagonist in Kurosawa’s movie Ran, I was just going along, trying to feel okay about feeling completely lost.

—To be continued—

The writer is a psychiatrist, author of Love and Revolution: Faiz Ahmed Faiz and a Trustee of the Faiz Foundation Trust. He can be reached at ahashmi39@gmail.com and tweets @Ali_Madeeh