“We are typically the last person they speak to,” says Dr Sesh Mudumbai, a professor at Stanford Medical School and anesthesiologist at the VA Hospital in Palo Alto, California. Dr Mudumbai performs the high-risk aerosol-generating procedure of intubation for COVID-19 patients suffering from respiratory distress who need to be put on a ventilator. Many of these patients do not make it.
Realising the profound significance of the moment, he always asks his patients if they have spoken to their families before anaesthetising them, “One patient spoke with his son after I asked him whether he had spoken with his family. They had a conversation about loving and missing each other. Then I put him to sleep to intubate him. Unfortunately, very sadly, later he died. There are a lot of these experiences.”
The aerosolisation that occurs during inserting a tube through the mouth into the air ways has one of the highest risks of infection as aerosols from the patient can get sprayed around. Constantly aware of the risks Dr Mudumbai follows a detailed protocol to keep himself and his family safe.
“It is stressful and scary. I do things precisely and slowly, like what astronauts do when they enter a different chamber, meticulous. I decontaminate at the hospital, then decontaminate at home. Take a second set of showers, before entering the house. We have to be very focussed. It can be distracting if you get too emotional. It is easy to make mistakes and you can’t make mistakes here. Emotional stuff comes afterward.”Dr Mudumbai.
Personal Sacrifices for Sake of Safety
The service that this Indian-American physician is providing to US veterans and their families, comes with a personal sacrifice. Dr Mudumbai has not been able to meet his elderly parents closely since March, because of the fear of carrying the virus to them.
It has been like living in a ‘defacto jail’ for his parents, especially during this holiday season of Thanksgiving leading up to Christmas.
Fortunately for him, his parents also live in the San Francisco Bay Area and he is able to see them from a distance at their courtyard or terrace, never without masks. His wife Dr Krishna Chaganti a rheumatologist at UCSF, has not been able to meet her parents Radha and Rajeswar Chagantik who live in faraway Pennsylvania, since March.
Retired academicians, the Chagantiks are facing a long, harsh, and isolating winter, as they will no longer be able to meet the only one friend they used to meet outdoors. They miss their grandkids and keep in touch with them via facetime.
“Holidays have the feeling that we can get together. We miss that very much, play games, tell stories, maybe cook a little bit, we miss that part. The grandkids call us every other day. We read stories to our grandson,” Radha Chagantik said.
Their two young grandkids are missing them too. Dr Krishna Chaganti’s parents are usually in California at this time of the year, “They would have been here earlier, especially for Thanksgiving and stayed longer. Normally they are with us every Christmas and have fun with grandkids. They are over the age of 70, so we won’t see them at least till spring next year, by which time hopefully we would have got the new vaccine. It will be the longest that I would have not seen them, as I used to meet them every 6 to 8 months. Our celebrations this year will be very subdued.”
The Elderly Miss Precious Family Time
Thanksgiving is a sacred American tradition when families gather around a table to offer gratitude. It is enjoyed by residents of all cultures and ethnicities. More than Diwali or Holi, Thanksgiving and Christmas are the occasions when desi families in US travel to celebrate together.
Every year, schools and offices are closed at this time of the year and more than 56 million Americans travel across the country to spend Thanksgiving with their families. Air travel is expected to see its largest one-year decrease on record for this Thanksgiving.
It is strange and sad to celebrate Thanksgiving and Christmas season in this time of profound separation from family and friends, to feel thankful when feeling lonely. Even more so for desi parents of medical doctors, whose children and grandchildren will not be at their Thanksgiving table.
Already isolated for many months, elderly Indian-Americans are missing that rare time in the year they get to spend with their children and grandchildren.
They are heeding advice from healthcare workers as the rate of COVID-19 infections rises sharply across the US. Many of these healthcare workers are their children, successful desi doctors, who do not want to expose their parents to the virus by travelling to be with them.
Desi Doctors at the Forefront of COVID Fight
Almost all TV networks in the US have accomplished Indian-American physicians updating viewers about COVID-19. There are hardly any newspaper articles about the pandemic without desi doctors’ interviews. Indian-Americans make up less than one percent of the US population, but 7 percent of medical doctors in the US are of Indian descent.
Apart from about 80,000 practising desi physicians fighting COVID-19, some 40,000 medical students, residents, and fellows of Indian origin are supporting many hospitals affected by the pandemic.
Desi doctors are at the forefront of the fight against COVID-19 in the US. “The pandemic has placed the Indian-American medical community at the frontlines,” said Dr Sudhakar Jonnalagudda, President of American Association of Physicians of Indian Origin, AAPIO.
His wife is an internal medicine physician, and the doctor couple is based in Georgia. Describing the toll on personal life that desi doctors are facing while continuing to serve COVID-19 patients, Dr Jonnalagudda said, “We are proud of the community, but it comes with stress for our families.”
Averting Risk
Dr Akhil Wadhera, is a former president of AAPI, the San Francisco Bay Area chapter of AAPI and a dermatologist at Kaiser Permanente Medical Group. A Delhi College of Engineering graduate, he came to the US to complete his Masters in Engineering from the University of California, Berkeley.
His calling was medicine. He followed his heart, joined medical school, and is now an eminent Silicon Valley doctor. Examining patients who have to remove masks to show Dr Wadhera their skin problems around nose or mouth, puts him and his family at a risk of infection.
His wife Dr Rubica Wadhera is a family medicine physician. The doctor couple and their two children have only been able to meet Dr Akhil Wadhera’s mother from a distance, for the fear of bringing the virus from their clinics to her.
“Diwali was hard, Karwachauth was hard. Like other Indian families, ours is a close-knit family, with my mother being very fond of grandchildren. My two brothers’ families and we used to have potlucks, share food, now none of that is happening. We would have ideally like to have my mother stay with us during this holiday season. But because of the fear of infection, she is at my brother’s place and we speak via zoom,” he said.
Call of Duty
Desis always count themselves lucky to have doctors in their families. Now, these Indian-American doctors face the challenge of their lives as they wrestle with the dilemma of caring for their patients even though this risks exposing their loved ones to the novel virus.
Dr Ajay Lodha, former president of AAPI passed away on 21 November due to complications from COVID-19. New York-based prominent physician, entrepreneur and leader in the Indian-American community, Dr Lodha was the recipient of numerous awards for his achievements in the medical world. Dr Sudhakar Jonnalagadda, President of AAPI, called 21 November as “the darkest day in AAPI history.”
They see medical professionals around them catch the virus. Quite a number of Indian-American doctors have been infected during this public health crisis and several have succumbed.
Coronavirus infections are rising rapidly as the US heads into the winter holiday months. Forecasters predict large spikes in infections and deaths if current trends continue. Dr Krishna Chaganti and Dr Sesh Mudumbai will celebrate Thanksgiving with their nuclear family inside their home.
”We decided against inviting friends even in the back yard. In the medical field, this feels like the calm before the storm. We are very concerned the next couple of months will bring a huge surge. There is anticipatory stress that infections will be going up, winter also being the flu season. Holidays will make more people sick with increased mingling indoors. We are going with the kind of mentality of enjoying the calm during the holidays and being thankful,” Dr Mudumbai said.
The celebrity Indian-American physician, Dr Sanjay Gupta of CNN spoke virtually at India Community Center’s Silicon Valley virtual fundraiser on 20 November. He shared that he too, will not be meeting his mother this holiday season. His mother does not mind at all that her famous doctor son hasn’t had a haircut in a long time due to the pandemic, “She told me that I look like Krishna”.
Definitely, desi health care workers are having to play God during the public health crisis. One of the images that is doing the rounds in the physician circles in the US, is of a doctor wearing scrubs, drowning in water but keeping a patient afloat. Dr Sesh Mudumbai feels that the image resonates with him and his physician friends, in the current circumstances.
Thanksgiving is a time of feasting, bonding, healing and gratitude. This year the country as a whole is grateful for the medical community’s commitment. Desi doctors realise the hard work and sacrifice their parents made for the education of their children. Opportunities have taken them to live in cities far away from their parents.
As many families are starting to have tough conversations about whether or not to gather together this holiday season amidst the pandemic, desi medical workers are thankful for their parents, and hence are choosing to stay away from them. The medical community is very positive about the forthcoming vaccine, which they as healthcare workers will be among the first to receive, after which they can be reunited with their elderly parents.
It will be long awaited union.
(Savita Patel is a senior journalist and producer, who produced ‘Worldview India’, a weekly international affairs show, and produced ‘Across Seven Seas’, a diaspora show, both with World Report, aired on DD. She has also covered stories for Voice of America TV from California. She’s currently based in the San Francisco Bay Area. This is an opinion piece, and the views expressed are the author’s own. The Quint neither endorses nor is responsible for them.)
(At The Quint, we are answerable only to our audience. Play an active role in shaping our journalism by becoming a member. Because the truth is worth it.)