When Pigs did Fly...

Bang in the middle of it. That's where I am now.

When I'd first heard of a new disease, swine flu, hitting Mexico and how they'd responded by going into a curfew, I wondered how a whole nation could come to a standstill for a cough. Then again, Mexico's population barely covers a few few Indian states at best. Of course, I also recall listening to my mom tell me how those 'damn USA people and their neighbours' should have expected it with their porky habits. I spent a good few minutes of that conversation trying to convince her that the disease was not contracted by eating pork or for that matter, hugging pigs, sleeping besides pigs or if a pig sneezes around you. Mom listened carefully while I explained it all to her. She always listens when I speak on medical matters. Cause I know best.

Since then, I've watched the pigs fly across oceans and continents, waxing and waning wherever they stopped by, taking a few lives and leaving many a runny nose along the way. And just like that, one fine day, I woke up and found myself bang in the middle of it. From out of nowhere, Pune became the hub of the disease in India with a present score of 15 out of 23 registered deaths across the nation and over 180 people diagnosed to be infected in less than a week.

On Saturday, I'd struggled to get elbow space while walking through the busy malls of Pune, waiting in line for my ice cream cone(s). On Monday, the mall was all mine. The 1000 strong Saturday crowd had dwindled down to a brave ( uninformed ) 25 of us on Monday, even before the official call to shut down colleges, schools, malls and theatres had occured.

Of course, even then, we were all wearing the statutory masks. Of course, back then it was the basic one. Since then, calls for the more impermeable N95 masks have reverberated across the city. It felt weird walking down the streets and staring at all the different types of masks available... I couldn't help but imagine how, like a bikini, soon, there'd be more varieties available in shapes ( a two piece for my nose and mouth ? ), G- string ( covering just my nostrils ? ), the see-throughs ( for the daring girls of the city.. oooh yeah ) and of course, my all time favourite - the itsy bitsy teeny weeny yellow polka dot maskini !! I wouldn't be surprised if before this is all over, this would actually come true.

On a more serious note, I've been reading a lot of articles on how people feel the disease is hyped. How it's just a flu and this is some sort of gimmick by the medical / pharmaceutical ganglords to cash in on just a simple running nose. Being in the medical field for nearly a decade now and having a front row seat here in one of Pune's hospitals which has decided not to turn away symptomatic patients, unlike some of the major hospitals, I have to say that I disagree.

The symptoms have usually started with a simply runny nose and sore throat, fever and headaches ; just as in each and every case of flu you and I have encountered over the years. But then it turns bad... and turns bad real fast. Respiratory distress sets in acutely and in hours, your lungs need external mechanical support in the form of ventilators just to keep you alive. Amongst those who've progressed to needing ventilatory support, only 30 % have been weaned off it.. i.e. have come out alive.

As scoffers say, it is true that most of the patients dying have underlying diseases as well... but there are two questions I'd like to ask you in this regard.

Firstly, How many of your loved ones are truly free of any disease ? And given the choice, would you want your parents or spouse walking around in the midst of a disease that spreads by breathing ? Would you be willing to risk their health for your beliefs, citing the high odds ? Would you be willing to let them sit besides someone with a runny nose if another seat were available ?

And secondly, while most of those who died had underlying diseases, what about the healthy youngsters who died ? They were just walking around like you and me minding their own business and 48 hours after sneezing for the first time, they were taken off ventilatory support and declared dead. They were not necessarily of a lower social strata either.

My heart goes out to the medical residents stuck in between all this. On the one hand, you have a shortage of protective mechanisms ( acute shortage of even the basic masks and Tamiflu pills ) while on the other hand, you find yourselves literally staring into the mouths of possibly infected patients for as many as 24 hour straight shifts. You examine patient after patient, enduring their coughs and sneezes, knowing that even the cough droplets which lands on the table in front of you, can potentially be fatal. I know we would all have loved to be decked in Z-kits ( the protective kind which covers us from head to toe usually seen in disaster movies ) with our fancy N-95 masks and literally swimming in antiviral tablets, but the fact is - we're at the wrong end of the barrel of a deadly gun. We're risking our lives and praying a single flimsy mask will save us , when we ourselves know it won't work. I've been getting calls from medical staff and friends in other states advising me to wear upto 6 regular masks to get the effect of an N95... they maybe right, but they're also being impractical.

In fact, unlike public opinion on the streets, I'm totally supporting the stand of those doctors who, having being denied these protective measures, have refused to treat flu patients. Sure, our aim is to heal but that doesn't mean that we have to die for lack of protective gear simply 'because we're doctors and it's expected of us.' Just as getting HIV or Hepatitis B from your patients is not part of the job description, dying for a patient isn't a doctor's job. Atleast the last time I checked. If the city cannot provide adequate protective measures and preventive medication to the attending doctors, who are easily the highest risk group presently, I see no reason to blame them for their indifference and concerns.

My two cents ? Stay at home and enjoy a long weekend. India was always gonna be a boiling pot once it all started thanks to our population density. Since even city wide curfews are impossible here, the best you can do is take adequate hygenic precautions and avoid large crowds and closed ventilation halls or malls. Because respiratory diseases hitting a nation as crowded as ours - well, it's gonna take awhile to get rid of it. Other than that, pray to the Swine God ( surely, we must have one of those amongst our One crore Gods , right ? ) and offer sweetmeats to every pig you see to keep him happy. And save a prayer for us white coats too... we're gonna need it, now that all the regular patients have disappeared and only the sneezers are pouring in.

Of course, my Mom just called again and told me that now that the disease is in Pune, I should wear my mask properly, even while eating ( guess I'll have to get the two piece mask for that ) and to stop walking around pigs. I thought of explaining it to her once more, but then I figured I was better off just agreeing to whatever she said. So I did what I do best.

I listened carefully while she explained it all to me. I always listen when she speaks on medical matters. Cause Mommy know best.