HomeCoronavirusThis pandemic exposes the source of true fear – our utter powerlessness...

This pandemic exposes the source of true fear – our utter powerlessness | Melanie Cheng

As a teenager, I loved feeling scared. Horror films were my go-to. The Exorcist, Poltergeist, The Omen, even the slightly sillier ones like Friday the 13th. In my youth I mistook that manufactured titillation for real fear, but now I know better. Now I know true fear is not exhilarating. True fear cannot be easily soothed by a quick cuddle from Mum. True fear is intense, exhausting, merciless. True fear is an invisible pathogen that threatens to strip you of everything you love.

“Would you prefer to get your results on a less ominous day?” I joked as I booked patients in for their appointments on Friday the 13th of March, Some laughed and others hesitated but most seemed to eventually suppress any niggling superstition.

I can’t say it began like any other day. It was March 2020, after all. Things hadn’t been normal at the clinic for several weeks. I, like other general practitioners across Australia, had been revisiting skills I hadn’t used since my hospital residency: isolating patients, taking nasopharyngeal swabs, donning and doffing personal protective equipment. Even the terms felt awkward, antiquated, ridiculous. More like tongue twisters than descriptions for lifesaving precautions.

Just three days earlier, on 10 March, Australia had achieved the portentous milestone of its 100th case of Covid-19. About the same time, courtesy of the medical grapevine, descriptions of the situation in northern Italy were starting to sneak in. Doctors spoke in hushed tones of the impossible decisions colleagues on the other side of the world were having to make. Decisions like whether to give the last ventilator to a 40-year-old father of one or a 40-year-old father of two. Entire lives were being reduced to cold hard demographics: the number of dependants, the number of co-morbidities, the number of years a person had left to live. According to the experts, Australia was approximately two weeks behind Italy’s trajectory. For those of us on the frontline, the situation felt less like real life and more like a scene from Nevil Shute’s On the Beach – a group of survivors nervously awaiting the arrival of a deadly cloud.

We kept busy. In the absence of a proven treatment or vaccine, we went back to basics: an effective triage system, isolation of high-risk patients, mandatory mask, and a healthy dose of vigilance. Unfortunately, I overdosed on vigilance. I woke with a start at four o’clock every morning and, before my eyes had even adjusted to the dark, I hunted for my phone on the bedside table to check the latest coronavirus numbers. I listened to every podcast and tuned in to every webinar in an attempt to arm myself with knowledge. But I wasn’t a junior resident anymore, I was a GP who’d been around long enough to understand that knowledge doesn’t always translate to control. The sad truth was, medicine, with all its fancy technology and billions of dollars of research, could offer nothing more to protect me than a plastic apron and a duck-billed mask.

‘As the Victorian numbers swell once more, so too does my fear.’ Photograph: Text Publishing

I dreaded going to the clinic, which was unusual for me. Not since my internship had work filled me with such terror. Less than a week before a Melbourne GP had been named and shamed in the media for attending work with what he thought was just a cold, only to subsequently test positive for Covid-19. Whenever I stopped long enough to think about whether I, too, had viral symptoms, I felt an ache across my back and shoulders, a dryness at the back of my throat. One day, at school pick-up, after a day of testing patients for coronavirus, I startled a friendly mother who had leaned in for a chat by holding my arm out long and straight, in the manner of traffic cop, and warning her to stay away. It was still early days – apart from those of us working in healthcare, most people were still going about their usual business. Schools, cinemas, theatres, sporting venues and universities were all still open. Even I, who arguably should have known better, had plans for a chock-a-block weekend, full of soccer training, birthday parties and catch-ups with family.

On Friday the 13th of March, it seemed as though everyone was sick. Many of the patients I saw that morning had upper respiratory tract symptoms. Unfortunately, none of them met the criteria for Covid-19 testing. All I could do, in addition to the usual fluids, rest and paracetamol advice, was tell them to go home and stay away from others until they’d completely recovered.

As the morning wore on the dryness at the back of my mouth progressed to a sore throat. During a tea break I received word that the 40th birthday party scheduled for Saturday night had been cancelled. The hosts didn’t want to be responsible for an outbreak among loved ones. I felt relieved, then thankful to have such cautious friends.

At lunchtime, after I’d finished writing my notes, I checked the latest news on my phone. Nine new cases of coronavirus had been detected in Victoria, including, significantly, the state’s first case of community transmission. As I scrolled down to the list of exposure sites at the end of the article I felt a sudden churning in my belly. With disbelief I read the name of my favourite cafe, where my kids and I went for coffee and sweet treats almost every day.

This thing, this germ, which had only a month ago seemed so far away, was now circulating in my community. This fact triggered a cascade of unbidden and unhelpful thoughts. What if it wasn’t a stranger at all, but me, or a member of my family, who had brought the infection into our neighbourhood? My children had both had fevers a few weeks before. They’d recovered but now I had a sore throat. Was it possible I had been unknowingly incubating the deadly coronavirus and passing it around to my friends, my parents, my in-laws? Would I be the next doctor vilified in the press?

After frantic phone calls to my husband, my manager and Victoria’s Department of Health and Human Services, I elected to get tested. With a tremulous hand, I inserted a swab so far back into my nose it could have been a party trick, if anyone had been around to witness it. As it was, I was alone in my consulting room. It was quiet and anticlimactic. But the significance of the moment was not lost on me – I had the sense that I was about to launch an unstoppable chain reaction. There was no going back. I sealed the swab in a small zip-locked bag, dumped it in the bin for the courier and went home to wait for my results.

That afternoon the prime minister announced a ban on public gatherings of more than 500 people. He encouraged us not to panic. Keep calm and carry on, he said. But, as someone who has treated patients for anxiety, I knew that simply telling people not to panic wouldn’t be enough. It certainly didn’t do much to relieve my anxiety. The forced isolation, however, did offer some respite – at least if I was at home I couldn’t infect anyone else.

My next hurdle was telling the kids. Coronavirus may have surpassed Voldemort and Darth Vader as the supreme baddie in their schoolyard games, but they had not yet come to expect the disease to impact their lives in any meaningful way. My daughter took it the hardest. “It’s true what they say about Friday the 13th!” she yelled when I told her she wouldn’t be able to go to her friend’s birthday party that weekend. “It’s the worst day ever!”

My test results came back on the Monday. Coronavirus was not detected. It was a relief. But my relief quickly turned to despair. In the week that followed, the number of confirmed cases in Australia doubled every three days. Our curve started tracking dangerously close to those of Italy and the US. Despite the PM’s entreaties, people panicked. Supermarket shelves were stripped of everything from flour to cans of tuna. As neighbourhoods prepared for lockdown, sales of televisions, iPads and laptops soared. At work, masks, hand sanitiser and even thermometers started disappearing from our trolleys. More patients than ever before presented to the clinic for testing. My email inbox was bombarded with updates from medical organisations – all the usual ones and some I’d never heard of before. I felt as though I was being buried alive by an avalanche of information.

Perhaps the most confronting experience of all was performing nasopharyngeal swabs on suspected cases. As I stood in the isolation room, taking as brief a history as I could to minimise my exposure time, my sympathies lay heavily with the patients. How must they feel, being tested for a potentially fatal disease by a human being wrapped in plastic? I tried to comfort them by being as expressive as I could through my masked mouth and goggled eyes but I knew it was hopeless. I took the swab and got out.

At the end of the week my husband called me as I was driving to work. He’d just received word that three anaesthetists in the UK were in intensive care. Only days before, as a consultant anaesthetist himself, he had “opted in” to intubate Covid-positive patients. Neither of us mentioned the kids during that conversation but we didn’t have to. They were there, in every pause, in every weighty silence. When I arrived at the clinic and a colleague asked me how I was, I dissolved into a mess of hot, ugly tears.

The Royal Melbourne hospital intensive care unit

The Royal Melbourne hospital’s intensive care unit. Photograph: Christopher Hopkins/The Guardian

In the months of lockdown that followed, I, like everyone else, watched the daily coronavirus numbers. My anxiety rose and fell like flotsam on the wave of that ominous graph. Finally, sometime in late April, I reached a point where I could sleep, laugh, read again. But the reprieve was short-lived. Now, as the Victorian numbers swell once more, so too does my fear. Only this time the source of my terror is less nebulous than before. Now the bogeyman has a vague form and features – he takes shape in the empty streets, the shuttered shops, the panicked voices of patients.

When I was a kid watching horror movies all those years ago, I confused the exhilaration I felt with true fear. But really it was just a watered-down version of it – as close an approximation to true fear as fruit punch is to absinthe. I always knew the ghosts in the films weren’t real and couldn’t hurt me, just as I knew my parents were in the next room, at hand to reassure and protect me.

The pandemic has shown me that true fear arises when we feel that someone or something has taken control of our fate. It comes when we contemplate our nonexistence; when we acknowledge our fragility, our insignificance. We’ve all had experiences like this. A friend goes to work and doesn’t return home. A family member is told a cluster of cells has gone rogue. In these watershed moments, our little world is turned upside down. But usually the wider world carries on. And while we may find this fact incomprehensible, even offensive, in times of personal tragedy, there is also some comfort – and hope for our own recovery – in seeing everyone else keep going.

What is so exceptional about a global pandemic is that the wider world does not carry on. When we stop, the wider world stops too. And in the chance moments we meet – at a safe social distance, wearing masks – and catch each other’s gaze, we see nothing but our own fear reflected in a stranger’s eyes. It is then that the illusion we have all worked so hard to maintain for so long – that we are supreme and all-powerful and important – finally falters. The jig is up. We were never in control. And there is nothing quite so terrifying and transformative as that.

• This essay will be part of the anthology Fire, Flood and Plague, edited by Sophie Cunningham and published by Penguin Random House in December

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