SHORTCUTS – Roopa Farooki on grief, betrayal and Boris
January 21, 2022. Series 5. Episode 38
In this week’s Shortcut episode, we are joined by award-winning author and junior doctor, Roopa Farooki.
In February 2020, Roopa – who is the daughter of the celebrated Pakistani novelist, Nasim Ahmed Farooki – lost her sister Kiron to breast cancer. Then weeks later she found herself struggling to cope in an overstretched and under-resourced ITU department, caring for the critically ill Covid-19 patients who were arriving daily at an alarming rate.
Her powerful memoir Everything is True, acclaimed by the Guardian as a 2022 must read, is a story of bravery at a time of personal grief and professional crisis – written in snatched moments between 13-hour shifts. It’s both moving and at times shocking with its brutally honest account of life on the NHS frontline.
Roopa is not a woman to hold back about the challenges she and her colleagues faced, not least for her and others in the higher risk BAME demographic, but also of the betrayal she and others have felt following the No10 party revelations.
As she says: “It still makes me angry, that while we were giving up an ITU bed for our Prime Minister they were not even personally following the rules that they put in place for the population, rules which were robbing relatives of their last moments with their families.”
This is an immensely revealing and timely Crisis Shortcut episode providing a powerful perspective on the Covid crisis.
Roopa’s Crisis Cures:
1 – Routine. I think stick to what creates comfort in your routine. I always do half an hour of exercise and that includes a bit of yoga and I always feel better for doing it.
2 – Writing. I write a bit every day to try make some sense of what’s happening in my life. As opposed to reading or doom-scrolling through what everyone else has thought, I think sometimes collect your own thoughts and to put them down. I think that’s really, really helpful for me.
3 – Believe in what you’re passionate about. For me I’ve always been passionate about looking after my patients and providing care. There is nothing else that I would rather do than do what I do every day.
Everything is True: A junior doctor’s story of life, death and grief in a time of pandemic – https://amzn.to/3U6Kfrp
Stream/Buy ‘Allies’ by Some Velvet Morning: https://ampl.ink/qp6bm
Some Velvet Morning Website: www.somevelvetmorning.co.uk
Host – Andy Coulson
Producer – Louise Difford
Crisis Shortcuts is brought to you by Myndstream, music designed to help you, your loved ones and even your pets feel calmer. Check out Mydstream, that’s mind with a Y, on all the usual streaming platforms.
Welcome to Crisis Shortcuts with me, Andy Coulson. Occasional bonus episodes to sit neatly alongside the main podcast, Crisis, What Crisis? And, much like those longer conversations, in Shortcuts you’ll hear from brilliant people, who, in their own words, tell us about their crises, how they got through them and what they’ve learned. Although these episodes are brief, the insights are just as big. So, if you’re short on time but looking for inspiration or guidance, Crisis Shortcuts will offer a quick fix for, and useful lessons provided by those who’ve been there and lived to tell the tale.
And don’t forget you can still join me for our longer conversations on Crisis, What Crisis? Where we talk in greater depth and share those powerful coping strategies that will hopefully help guide you through the pitfalls of life. You can follow us on Instagram and Facebook, our handle is @crisiswhatcrisispodcast and if you like what you hear please do head over to Apple and leave us a rating and review. It really does help make sure that these stories get to the widest possible audiences. I hope you enjoy this Crisis Shortcut.
I’m Dr Roopa Farooki, I’m a junior doctor for the NHS, I specialise in internal medicine. I was born in Lahore, in Pakistan. My mum’s from Bangladesh, my dad’s from Pakistan. I’ve heard anecdotally that the reason they came to the UK was because my dad had too many girlfriends in Paris, so my mother didn’t want to put up with that.
We came over on a visitor’s visa and we stayed. I eventually got British citizenship when I was sixteen and went through all my schooling in the UK. My parents had an interesting relationship and you know, there was a lot of love for each other but my dad was a gambler which I’ve written about in the past. And he lost family money several times until we were pretty much bankrupt. And then he took the chequebooks and disappeared when I was thirteen saying he was going to the shops and never came back. When I’d gone through university and I’d finished Oxford he turned up to say how proud he was and asked for money. Which I guess was a compliment because it shows I could finally, not only support myself, but support him.
After university my second proper job… My first proper job was working in finance just because I really needed to pay off some student loans so I did a year in what was Arthur Andersen at the time and is now Deloitte’s, I went into advertising. I remember the job I enjoyed most was when I was handling and representing the charities and doing things where actually that were involved for medicine. So when I was at Saatchi’s I was the director on the multiple sclerosis account which is still even when I’m in medicine now and I come across someone with those kinds of neurological diseases which are just so hard to treat and look after, I think that those are the things that were really important to me.
I was a new junior doctor just starting in the August of 2019. I’d obviously been training in hospitals for four years previously, including the hospital where I was working. I started off in ITU and it was, I think it was as you’d expect. It was every kind of junior doctors kind of, you know, stressful moments that you have. But a lot of that was tempered by the knowledge that my sister was dying during that time. And it had started just when I had finished med school. I was on my elective in the Chelsea and Westminster hospital in London and my sister was having her chemotherapy, literally up the road, at the Marsden.
And I think she was actually trying to keep the fact that she’d started having weekly chemo from us until I’d actually started working at that hospital and she knew there was no way she could keep it from me because I was literally walking past her. I mean, she’d even tell me earlier in the year that she didn’t think she’d make it until Christmas. And this, I think, was the week before. And she did make it through Christmas and made it through a little bit afterwards. And when she passed away, when I came back, literally I came back the day after her funeral and I was sent home. But literally straight after that it, the pandemic, was happening. And the thing is we were all so busy working and doing our jobs, we almost didn’t notice, didn’t notice the kind of volume and the escalation of it taking over.
There were these emails and it wasn’t until, I think, the day before lockdown where it all became completely crystallised and clear that, ‘oh my god, this is what we’ve been doing, every single day, we have been working at the centre of this storm, this eye of the storm. And now we’re finally saying it out loud: this is a pandemic, this is lockdown. We are probably doing the most dangerous job in the country and we are so unprotected and so kind of ignorant of everything.’
As a doctor it’s important to try and be there for your patients to try and put what’s happening personally aside and just be as present as you can for them at this moment in time. And there are boundaries, obviously there should be boundaries. But I think, if I’m completely honest, I think boundaries were blurred during this moment of crisis. I think to kind of function as a human being, you know, we’re not automatons, we’re not machines and I’d actually, I’ll admit that when I was looking after someone who was grieving, I would say that, ‘I know, I’ve just lost someone too’.
It wasn’t to put myself in their story in any way it’s just to say that you know, I have some sense of what it is to walk in your shoes and I can’t possibly, because I’m not sitting, you know, I’m not the one who’s being excluded from my mother’s bedside at this time where she might be passing away. And I think what we owe our patients, we owe them our duty of care but we also owe them, and I feel very strongly about this, a duty of candour. We owe them the truth. I was very aware of how much I was holding back from telling my mum because she’d just lost one daughter and now she had another one working on the, working somehow, by accident flung from space into this pandemic.
We lost a nurse very early in the pandemic who had been working in the acute medical unit and who everyone knew and liked. And she got the virus from looking after patients. From looking after other people and that’s how she got it. And it was becoming quite clear that the BAME clinicians and nurses were at more risk. We didn’t quite know why and there were lots of explanations about possibly why but the first three clinician deaths were BAME. And so a lot of the young BAME junior doctors and nurses came in with fear. They came in with fear every day and so I think that we all just got on and did our jobs because frankly if we didn’t who would?
The new things that we learned, day by day, about how, you know, government leadership was actually behaving at the time, it makes it even worse because while we were going through this time and we actually thought that, you know, I mean, quite honestly during those first forty days I was wondering whether or not I would contract the virus and die. Because I was in the demographic that died and I was more at risk than anyone I knew. While we were going through that knowledge, going through that day, going through our working days trying to help people every day with that knowledge, other people were sitting having, you know, summer parties.
I mean, officially in the hospital if you don’t… say someone is deteriorating in one of the covid aerosol generating procedure rooms, you’d, technically if they’re deteriorating you don’t go in until you have the PPE. That’s the official plan. If we’re doing a cardiac arrest and someone is covid positive you’re meant to take the little sack with you on the emergency call. A patient who is deteriorating, who I had to go and look after, this patient had had two negative covid tests despite being very obviously symptomatic and with all the signs including chest X-ray. And so they were still in a regular bay.
And when they stared deteriorating we didn’t really have, like, I didn’t have time to even put on the apron and the gloves or the mask which is all we’d need for that bay. I had a mask I think, because I always had to wear one. And so I raced in to help and to stabilise that patient. And I didn’t even think about it and the patient threw up all over me and then later proved was covid positive on the third test. I don’t know any other doctor who would have done differently. Well there wasn’t actually, for that particular patient there wasn’t the PPE available because that patient, even though they were covid positive, they hadn’t been defined as such and so it wasn’t available on our ward. Any of the wards which didn’t have properly defined covid patients, we didn’t have the PPE. They were all swept off our wards and taken to the respiratory wards and… which needed them.
At the time I felt this is criminal. Isn’t it? Isn’t it criminal negligence to let someone, to let people pass away like this? To actually have it in your power to prevent this and to actually make decisions that will ensure that people will die? I felt that this government, if they’re kind of treating Britain like some kind of big corporation, in any other corporation where leadership is actually allowing its personnel to die, to actually die based on these decisions, they should be held to account. They should be held to… they shouldn’t be continuing in position. And they should be held to account, I find it stunning, I find it stunning the kind of autocracy that somehow Britain has become that allows to keep these career politicians who are making these dangerous decisions for pers-, for furthering personal career goals and personal fortunes, to actually remain in power.
At the time I, you know, we were all a little bit ignorant about the Italian trajectory, of their quarantine and what was happening there. But anyone in government had that information. They would have seen the trajectory from Italy from when it first started, from when there were maybe a dozen or two dozen dead, to two weeks later and where that would lead us. And they didn’t act. They made a decision not to act. I think that even locking down two weeks beforehand would have made an extraordinary difference to the number of lives that we lost in that early part of the pandemic.
It still makes me angry now and that was me then without the knowledge of the fact that while we were giving up an ITU bed for our prime minister that at the same time they were absolutely not leading by example, not doing what they could to stem the flow of the virus. Not even personally following the rules that they put in place for the population which were robbing relatives from their last moments with their families. They were robbing someone’s last moment with their mother, someone’s last moment with their child, while they themselves actually felt entitled. And it’s incredible, it’s just pure entitlement.
And I am, I find it astonishing, astonishing that democracy actually tolerates this. That they felt entitled to break these rules themselves. To have one set of rules for others and the other for themselves and they were actually quite happy to sit and have drinks in a private garden with each other while other people were unable to actually go and hold the hand of their relative while they were passing away. This current government, the whole kind of ‘get Brexit done’ thing, the use of the NHS potential income on the bus, they’ve been using our healthcare service as a way to kind of shore up their own political profile and gain without actually giving anything back.
And I remember when the prime minister came out of hospital and his wife was tearfully saying, ‘oh, no one can ever thank the NHS enough’. And yes, they bloody well can thank the NHS enough. They can do something, they should, frankly, do their jobs. You know, it is a matter of public record that lies have been told. You know, even a lie as simple as, ‘Oh, I didn’t know that there were any parties being held at Number Ten’ and then ‘oh yes, but I was at one’. And even little things that could have been done haven’t been done.
So, for example, the FFP2 masks that should, that actually protect the wearer as opposed to protecting the people around the wearer. The regular masks only work if everyone is collegiate and actually everyone wears them because you need to protect, you’re both wearing the mask, you’re not protecting yourself as much as protecting others. In my understanding of the evidence which, which is always changing and may change. But an FFP2, again from my understanding of the evidence from management meetings which I was sitting in over the last year with hospital leadership, actually protect the wearer. And they should have been made available to all frontline workers, to all bus drivers, to all shop keepers, to all teachers. And somehow the decision was made that they were not.
Also, in terms of the respect to the care workers in the community I have, on the geriatrics ward, I have patients that I’ve actually, that we, my team, have actually fixed, we’ve got them better. They don’t need any more medical input now. And they’re still on the wards because we can’t discharge them because there’s no one to look after them in the community. There’s no one who can actually take care of them. And Rishi Sunak, fairly recently on TV when he was being questioned about the poor pay of a care worker, said ‘well, they can retrain and do something better.’ So how, with that kind of disregard and contempt from higher levels of government, how is anyone actually expected to do the jobs which will actually get us out of this crisis? Or at least help the lot of the people doing least well in this crisis?
I think the, the term front line and all the metaphor and imagery of battle in the beginning of the pandemic, I felt it was overused and misused. I think it’s the comparison of us as kind of warriors in blue scrubs going out. I think it did us a disservice actually as healthcare professionals. Because it implied somehow that this is what we’d chosen. It implied a kind of foolhardy courage. And it implied that you know we didn’t have the right to complain because this was our job wasn’t it? You know, this is what you do, you go into battle, you know, for your patients.
And no one actually went into healthcare thinking ‘oh yes, I’m going to work at the forefront of pandemic’. No one did that but somehow there was the expectation that, you know, you’re a doctor, you’re a nurse, you made it your decision, stop whining and put up with it. That comparison of us to being on a battlefield and as though we are soldiers who have made a decision and taken a contract. No one made that decision. And particularly, I think, the overseas workers. No one thought that they were going to come across to Britain to hopefully to get their qualifications and hopefully create a good life for themselves and their families. No one thought that they were going to actually just lay down their life for the NHS.
I still talk to my sister, [Kian?]. I think people are only really lost when they’re lost in memory. And I think that’s really important for me to kind of keep, keep her there. It can sometimes seem a bit pathological, can’t it, to be talking to someone who isn’t there, to be having these conversations. And I’ll argue with myself, say no it’s not, it’s normal. I know it’s perfectly normal to have these conversations and to want someone to be there to try and keep them. Because you know, they, you know, your loved ones are still part of you. And you can carry on, have these conversations and have them still there. But you don’t really want to say it out loud. You don’t want to say that you know, I’m having conversations about watching Bake Off or this because it sounds like… you know, I guess it sounds like the truth. It sounds like you haven’t let go.
If grief, is the long shadow of left by love then I think it’s alright to keep it there. I’m not sure, frankly, whether she’d be annoyed with me thinking oh my god, it’s all about you again isn’t it? But, but there you go. I try to think about whether writing the book was helpful actually. I think it wasn’t so much something that I wanted to do. I think maybe like all kind of, writing, it’s just something that I just had to do. You know, I think I wrote it because I think sometimes as writers we just write because we must. Not because it’s good for us. Not because it’s even helpful and not because we’re thinking of any kind of end game. I think it was just something I had to do. I had to just try and unwind this sense of the day.
I persisted in it. I persisted in writing it and eventually I thought it might be helpful to share. If it’s helpful for anyone to actually have a sense of what it is like to grieve through everything that was going through, to understand that they weren’t alone, then maybe it’s worth sharing. It’s not about me. It’s about us. I think for that reason I’m kind of taking one for the team and putting out my kind of embarrassing personal musings and my sense of what it was to go through this pandemic, this crisis, day by day in the hope that it’s useful for others. And maybe, maybe it will be useful for a future self, for a future me who will look back on this time from a place of wisdom.
My first crisis cure is your routine. I think stick to your routine and what creates comfort in your routine. So for me it’s always, whatever time I’m getting up, I always do half an hour of exercise and that includes a bit of yoga. And I’ve done that for years even when I was getting a 4.00am train to London to do a placement which involved me having to clerk everyone in before surgery. I always do that and I always feel better for doing it. So that’s my first crisis cure: stick to your routine and whatever comforts you in that routine. So for me it would be that exercise.
My second crisis cure, for me, I guess this is a personal one, would be to write. I always write a little bit, write every day and try and just make some little sense of what’s happening in my life and sometimes it can be a little or it could be a lot. But I think that time, as opposed to reading or scrolling through what everyone else has thought, I think sometimes collect your own thoughts and to put them down. I think that’s really, really helpful for me.
My third crisis cure is believe in what you love. Believe in what you’re passionate about. And so for me I’ve always been passionate about looking after my patients and providing care. And even now, going through all of this, I still think, would I do anything else? It’s like no, there is nothing else that I would rather do than do what I do every day. To go in and actually look after people and get them better day by day. So believe in what you’re passionate about and pursue it.
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