Love in the time of SARS

We’ve seen them all. A mayor barring the evacuation of a suspected SARS patient from a remote barrio to his city’s modern hospital. Another mayor stopping the hometown burial of an overseas worker cremated in Hong Kong after dying of severe acute respiratory syndrome. Half a dozen hospitals in Cagayan Valley turning away a Canadian tourist downed by ordinary flu. An entire barrio defying quarantine orders if only to prove themselves uninfected. Barangay heads, egged on by radio commentators, petitioning health authorities to stop admitting SARS patients at the San Lazaro Hospital and the Regional Institute for Tropical Medicine. Doctors no less spreading rumors by text about nonexistent SARS patients dying in their hospital wards. All this, amply sensationalized in the local press and prompting foreign governments to ban the entry of Filipinos.

The SARS crisis brings out the worst in people. It also brings out the best – especially among health workers.

President Gloria Arroyo beamed with pride at the SARS summit in Bangkok when leaders of Malaysia and Singapore told her how Filipino doctors and nurses in their hospitals readily volunteer for duty on patients afflicted with the dreaded disease. In Manila, health workers are no less heroic. Young doctors with promising careers ahead of them also brave the risks for the call of duty. Despite reports that most of the first victims of the sudden spread of SARS in Asia were doctors, they man the quarantine desks at airports and ICUs of specialized centers with intrepid spirit. Some work 36 hours straight since there simply aren’t enough doctors and aides to detect and combat the disease. They do not know each other, but they are in common battle to prevent a pandemic and keep the coronavirus at bay until a medicine is invented to kill it.

The medical profession recognizes no nationality, perhaps. When the Italian doctor who first detected SARS in Hanoi post-humously was awarded for his dedication, health workers all over the world rejoiced. His was a story of greatness. Despite the danger, he alleviated the pain of his patients before himself contracting – and succumbing to – the disease.

Another story worth retelling is that of Dr. Yu Cheuk-man of Hong Kong’s Prince of Wales Hospital.

A professor of cardiology at Chinese University where the hospital is, Dr. Yu was one of the first to fall ill. It was Thursday, March 6. Along with other professors, he was testing a group of students on clinical skills when he visited one of the wards. In it was a 26-year-old pneumonia patient. Engrossed with inmates with heart ailments, Dr. Yu paid the man little attention. Unknown to him, the patient was already down with atypical pneumonia that only a week later would be called SARS.

What happened is a testimony to how contagious the disease is, but that it can be licked too. Dr. Yu came very close to death, and to this day has not completely recovered his athletic strength. During his confinement, he provided doctors with first-hand clinical experience on SARS. At one point, when all the cardiologists lay sick, he had to be lifted from sickbed to attend to a fellow-patient who needed emergency heart treatment.

Three nights after the hospital rounds Dr. Yu was struck with severe headache. He felt he was coming down with the flu. The next morning, he awoke dizzy, but forced himself to the hospital at noon. Upon arriving, he was told that a dozen fellow-professors and their 18 students had reported symptoms similar to his. All were relieved of their medical duties. Since he wasn’t running a fever, Dr. Yu worked on lectures till late afternoon.

Tuesday, fever set in at 102 degrees. Dr. Yu’s wife, an eye doctor, felt his body was hot but he felt icy inside. He could hardly walk. Rushed to hospital, his x-ray showed negative for the pneumonia that had hit his colleagues. But his kidneys and liver were malfunctioning, unusual for a 37-year-old who kept himself fit through exercise bike and badminton.

Wednesday, another x-ray showed the beginnings of pneumonia. Dr. Yu was admitted to the Prince of Wales, the first time he ever entered a hospital as a patient. His white blood cells counted low, a sign of impaired clotting, but his muscle enzymes were unusually high, which meant these too were under viral attack. He would later recount that throughout his ordeal, almost all blood tests were abnormal; the virus was so toxic.

That day, too, Dr. Yu’s younger of two sons started running a fever as high as his. The two-year-old was admitted to the hospital, becoming the first child to be listed as a suspected SARS victim. Fortunately, the boy did not develop pneumonia and was discharged 11 days later. He is one of the reasons scientists conclude that old folks are more prone to SARS.

With no known cure for SARS, doctors orally administered steroids to reduce Dr. Yu’s lung inflam-mation. Plus ribavarin, which the World Health Organization says is not effective although Hong Kong doctors insist otherwise. Weeks later, both sides would investigate if the steroids and ribavarin caused the high incidence of SARS deaths. At the time of Dr. Yu’s sickness, they didn’t have a choice.

A week after entering hospital, Dr. Yu’s pneumonia became graver. It followed the pattern elsewhere in which SARS patients entered a critical stage on the second week. More powerful doses of steroids were given to protect his lungs. Still, he was feeling worse by Sunday.

He was lying exhausted after breakfast that morning when doctors ran to him for help. A SARS-infected colleague had gone unconscious and they suspected a mild stroke. All the other cardiologists were in intensive care. They took Dr. Yu on a wheelchair to minister to the patient and operate the echo machine. He just loves his work.

Days later, he and a few colleagues began to recover. To help the undermanned staff, they took each other’s blood samples and did other work at the SARS ward.

Eighteen days after entering hospital and 10 pounds lighter, Dr. Yu was discharged. He rested at home for four more weeks, trying to regain his strength through his stationary bike. He was among the lucky ones.

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Catch Sapol ni Jarius Bondoc, Saturday, 8 a.m., on DWIZ (882-AM).

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