There is such a profession: to save lives. Chronicle of COVID-19 in the Stories of Medical Women

March: a pandemic begins in Moscow

Yulia Andreevna Rokhmacheva, paramedic of the field brigade of the station of the ambulance and emergency medical aid. A.S. Puchkova

Ambulance medics have been at the forefront since the early days. Our heroine felt everything on herself, managed to get sick, get better and return to work.

What did your team face in March when the epidemic was just beginning?

Yu.A .: This was not a test of our professional qualities, but rather of physical and moral strength. In addition to the basic set, which we take to the challenge, there was a bag for taking biomaterials, a huge folder with new documentation and, of course, PPE. Considering the components of our work uniform and PPE on top of it, it is not very convenient to work: go up to apartments in buildings without elevators, evacuate critically ill patients, be on one call for more than an hour. After all, if someone else lives with the infected, they also need to be examined.

We forgot about the rest. I have worked in a covid brigade since the beginning of the epidemic. We only came to have lunch during the shift. The load has increased, the number of calls has also increased. Once there was a call to the barracks at the military university (a call for a special event to “sort” the sick, since there was a whole course of sick people). I got out of there only six hours later. Already in a sense, she wanted to call an ambulance for herself – it’s hot, stuffy. But such security measures. You can’t take off your suit and do some trivial things: go to the toilet, drink water. But now I can say that it was just a stage in life, and quite an interesting one.

Was there an understanding that this was for a long time? What is your opinion about the pandemic?

Yu.A .: It is difficult to draw conclusions when you fall into this funnel. In principle, I tried not to think about it and stay in the workflow. It’s easier this way, because a lot of negativity came from friends. They accused me of organizing a theater and succumbing to political manipulations and provocations. She nodded her head: well, but if you personally come across this, you will think differently.

To be honest, at first we did not worry and continued to work in the mode of the next seasonal epidemic. But when the pandemic became global, everything changed.

Then were you afraid for your family? How do ambulance doctors reduce the risks to their loved ones?

Yu.A .: I live separately from my parents, and when the situation escalated, we stopped seeing each other altogether. My colleagues and I had regular smears. I realized that mine could turn out to be positive at any moment, and stopped meeting with my parents and grandmother so as not to endanger them. I may not be sick, but be a carrier. The last time we saw them was in mid-March. From March to the present day, the family had three birthdays, we spent them remotely, online. With the hope that we will soon get together and celebrate for real.

And even when I got sick myself, I didn’t tell them anything in order to avoid unnecessary worries. Mom asked why I constantly sleep. And I answered that the shift was hard, just tired. But the mother’s heart cannot be fooled, she guessed that everything was not at all all right. I confessed only when I was discharged from the hospital and received the results about the presence of antibodies. It’s all over now. A week ago, the family was finally reunited. Like an Indian movie!

Probably the hardest thing was to find out that you were infected?

Yu.A .: Still, the hardest part is working in PPE. It’s hard to breathe and talk in a respirator, goggles fog up at the most inopportune moment. In these conditions, it is difficult to conduct an inspection. But nothing, used to.

As for the disease, I didn’t even immediately realize that it was a virus. At that time, I had been working for 2,5 months. It was hard for me to breathe that day. I thought the respirator was in the way. The fatigue was total, which is unusual for me, I am usually energetic. I wanted to lie down and not be touched by anyone. I came home, went to bed, and a call from work woke me up: the smear is suspicious, go to sick leave. It is good that colleagues and patients did not risk it, because I am always wearing a mask, we always disinfected our hands. You never know where to pick up … In my case, definitely not at work, not with our precautions. This is the specificity of the virus: you can take a ride in the subway and get sick.

Now it seems that for the doctors and especially for the ambulance, the past spring has become a real challenge. What gave you strength?

Yu.A .: Since childhood, I have been such a girl: I played toy soldiers, cars, climbed fences. Seemed to herself as a hero who would one day save the planet. When the really dark times came, I played a role that I had been preparing for my whole life. While maintaining professionalism and common sense, of course. It turned out great, I think.

It was also not without romance. When we are in PPE, nothing is visible except for the eyes. You feel like a mysterious Arab woman, the prince can find you only by looking. On one of the calls, one person just showered me with compliments. After that, flowers were delivered home and at work. From him. And he didn’t even see me! An exciting moment came when I opened my face. And our communication continues to this day.

Are you already dating?

Yu.A .: We are still … I don’t even know what it’s called. Just a pleasant conversation. Such a romantic story in the spirit of the XNUMXst century.

How do you plan to celebrate the holiday and what would you like to wish your colleagues?

Yu.A .: I have a daily shift, the holiday will turn out to be a working one. And I would like to wish all doctors not to lose heart, not to lose heart and believe that all this is temporary. We chose this profession for a reason and must go forward, work with maximum efficiency and maximum professionalism.

March 3: opening of the hospital complex in Kommunarka

Yulia Andreevna Salkova, anesthesiologist-resuscitator of the City Clinical Hospital No. 40 in Kommunarka

Yulia Andreevna came to Kommunarka from the GKB im. S.S. Yudin, when the complex had just opened and needed specialists.

Remember your emotions in the first working days? What was a new experience for you?

Yu.A .: Personal protective equipment was the only thing you had to get used to. They are uncomfortable, hot, and sweating. Then it became habitual. And, of course, it is psychologically difficult to help seriously ill people. It is far from always possible to see this in ordinary intensive care. There are always relatively stable patients, but here, when the intensive care unit was opened, the patients began to be admitted immediately. Otherwise, everything is familiar, there was no need to learn any new manipulations, we knew our job and knew how to do it. Everyone came with some experience.

During what period during the epidemic was it especially difficult for the doctors in Kommunarka?

Yu.A .: At the beginning. We did not come all at once, and as soon as the intensive care unit opened, there were literally three of us. We were on duty one at a time. This is now a team, and in this regard it is already easier. And at first it was emotionally difficult to do everything at once, to devote time to each patient. But we had to and did it.

But there were also bright moments?

Yu.A .: Every time the patient recovers. It is with this infection that many patients have experienced this: you expect a negative prognosis, but at some point they respond to therapy. They get better in one day.

And personally, I appreciate my colleagues, it is easier with them. We will continue to work here. Even if someone leaves, this experience will not go unnoticed. For me personally, this is so.

Will Kommunarka continue to work when the virus is no longer dangerous?

Yu.A .: Yes. I think this will be the most advanced infectious diseases department in Russia with worthy workers, since it began with a big problem that brought us closer together. There is new modern equipment here, but a lot, of course, depends not only on some technical issues. Much depends on people. We came here with a common goal, it united us.

What would you like to wish your colleagues?

Yu.A .: Many of them, like me, have not seen their parents, their families and their children for a long time. And first of all, I would like to wish to quickly reunite with them. And health.

April: testing for coronavirus

Svetlana Alekseevna Polevshchikova, Head of the Central Laboratory Department of the Centralized Clinical Diagnostic Laboratory of the Moscow Scientific and Practical Center for Dermatovenerology and Cosmetology of the Moscow Department of Health

Under the leadership of Svetlana Alekseevna, PCR testing for COVID-19 is still being carried out.

What does your department do?

S.A .: Laboratory diagnostics. Nine Moscow PCR laboratories have connected to the isolation of the virus from samples, ours is just one of them.

A sample is delivered to us – a swab from the oropharynx and nasopharynx. We examine it and give out the result of the analysis. Samples are collected from city and federal medical institutions: from polyclinics created for the treatment of patients with coronavirus infection, hospitals. Our Center has its own sampling points, samples from there are also sent to our laboratory.

How were patients diagnosed with suspected COVID-19 at the beginning of the epidemic, and how has it changed over time?

S.A .: When we first started working on COVID-19, it was difficult. We did everything by hand. Manual selection, manual digestion of PCR analysis. Over time, the Moscow City Health Department equipped us with modern automatic analyzers for the isolation and digestion of PCR studies for COVID-19. And it made the work much easier and faster. For example, in the beginning we did fifteen hundred samples, then two thousand, and each time our capabilities grew. Now the capacity of our laboratory is designed for about 4,5 thousand analyzes per day.

How is your work changing now that the peak of the epidemic has passed?

S.A .: We noticed that the number of studies remains at a very high level. People went to work and are being checked right now. So I cannot say that the number of samples has decreased, it remains at the same level. But the number of positive samples begins to decline.

In the laboratory, there is no feeling that the main events are taking place outside of you?

S.A .: Of course, we do not see patients, and yet we feel like a part of something larger. Like other doctors, we had a hard time. No laboratory has done such a large number of PCR studies before. This is an RNA virus and is very difficult to isolate. The research itself takes about five hours. The reagent kit is designed for 96 studies, and these 96 samples require about 5 hours, and in total, at least 1,5 thousand samples per day. Imagine how difficult it was to work with your hands at first. I was so worried about my team, about the girls. Because everyone is in suits, respirators, there is nothing to breathe … The girls are persistent, strong, but it is very difficult for them. Without straightening your back, you work directly with the biomaterial, and so on without stopping.

Did you have enough people?

S.A .: Actually, our state at the beginning of the epidemic was not designed for such a volume of work. That was also why it was not easy. But very soon, clinical laboratory diagnostics doctors and medical laboratory technicians from other institutions came. They called themselves and asked if they could come and help. Thanks to them, we have more hands, thank you very much! We have such a close-knit, friendly team that now everyone wants to stay in our laboratory.

It seems that a dream team has gathered under your leadership.

S.A .: I have one of the best, strongest teams, maybe in all of Moscow. Strong-willed. Nobody has ever refused help. When I think about them now, even tears come to my eyes. All endure difficulties. And they treat their work with such trepidation. The virus opened my eyes to those employees, from whom I did not even expect that they would come and say: here, Svetlana Alekseevna, we are ready to help you. In my laboratory, no one was touched by the virus, we took great care of ourselves, observed all precautions. And now I just want to wish my colleagues and their families great, great health. I wish us many more years to work together and appreciate what we went through together.

How do you plan to celebrate the holiday?

S.A .: I had a birthday just recently, so my colleagues said: take two days off, finally get some rest. I’ll go fishing tomorrow. Honestly, for the first time in three months I will get out into nature to get some distraction.

April: outreach services of polyclinics were strengthened

Svetlana Maksimovna Mikeshkina, general practitioner, polyclinic department No. 3, GKB im. M.P. Konchalovsky

Before the epidemic, Svetlana Maksimovna was at the reception. When the situation became threatening, along with other doctors, she came to the aid of the field services.

Why did you need the support of the field service of your clinic?

CM.: Typically, home calls are served by several specialists. Given the current situation with the COVID-19 epidemic, in April the field service was reinforced with a special team that worked with this group of patients. At first it was two doctors per shift, then three, several nurses.

As far as I remember, our field services coped with the peak incidence of, for example, influenza on their own. After the reception, there were also house calls, but this, in general, passed imperceptibly, evenly. In the context of the coronavirus epidemic, since patients could not visit the clinic, we threw all our efforts into serving patients at home. Two physicians remained in the clinic, the rest were mobilized. Doctors visited the patients at home, and a specially equipped covid team monitored another category of patients.

How do such teams differ from the ambulance?

CM.: An ambulance leaves for a significant deterioration in the patient’s condition. And our team worked in epidemiological centers. Doctors monitored the patients, the contact persons, work was carried out to draw up sanitary service regulations, and determine the terms of quarantine. The patients were under the dynamic supervision of doctors, if necessary, they were sent for computed tomography of the chest organs, and received the necessary medications. The nurses of our teams were responsible for examining patients, taking smears for COVID infection, testing and conducting electrocardiograms at home. All this is our work. When it got worse, we called the ambulance team ourselves, without waiting for serious consequences.

Many doctors note that they have never worked so intensively before. For them, this epidemic was a test of their strength. Do you agree?

CM.: Yes, and we turned out to be strong. Mobilized and helped each other every day. We worked following the recommendations for the management of patients with COVID infection, where the criteria for assessing the severity of the patient’s condition and treatment regimens are clearly stated. Despite the fact that situations were often non-standard, we always knew how to proceed. There were no problems with medicines, with the equipment of the employees.

What turned out to be the most difficult for you?

CM.: Physically, it is very difficult to wear special clothes. We are not used to wearing gloves, masks, overalls for hours. But somehow they still adapted. 

It was more difficult psychologically, especially in the beginning. People were suddenly and unexpectedly isolated. Unsurprisingly, they did not handle mood and anxiety well. At first, the 14-day quarantine was taken hard by them. But gradually people began to understand the need for two weeks of isolation. And it is much more difficult to see how the state of health of patients, often young ones, is deteriorating, when they need intensive therapy in a hospital setting.

Has your family helped you in any way?

CM.: During the epidemic, my daughter brought me ready-made food – she understood that there was no time to cook. It was not easy for the relatives themselves, but they helped in word and deed. Colleagues became the second family. We rallied, everyone gave their best. In this difficult time, we became like-minded people.

This is probably an invaluable experience?

CM.: Yes, we realized that we can do a lot. For this, we had effective leadership and an understanding of the team of the importance of the tasks before us. We believed in ourselves – this is the most important thing.

Do you also meet the Medic’s Day together?

CM.: Precisely, this is a working day for us. Do you mind if I wish my colleagues health in advance? So that they remain optimistic, good spirits, positive mood, wisdom in solving difficult problems. I wish all colleagues that such a difficult situation does not happen again. And I would like to separately thank the doctors of the hospitals. Because, you know, there was another psychologically difficult moment – to observe statistics in the news, where they gave the number of deaths, showed resuscitation. Doctors in hospitals, I know for sure, did everything for the sake of the recovery of their patients. They are real heroes. To them we owe the salvation of many, many lives. 

Written by Alla Astana.

Photos are provided by heroes from personal archives.

Cover photo

Photographer Alex Lumier

Makeup artist-stylist Ksyusha Elizarova