Tik Tok in the time of Covid:

Oonagh Hickey, Consultant Anaesthetist, Cork University Hospital

The year started on an upbeat with teambuilding activities such as the January “Coffee and Gas” pizza party and the family “ice-breaker” ice-skating trip to “Cork on Ice”, however the focus quickly turned to preparing for impending the COVID-19 pandemic. 

Workshops were run to facilitate the training of staff in donning and doffing Personal Protective Equipment (PPE), as well as intubating and proning (positioning patients on their fronts to optimise breathing) critically ill patients with suspected or confirmed COVID-19 infection. Protocols were devised, and Grab-and-Go bags for airway equipment and medications prepared. Ms Lavinia McCarthy (CNM2) and Ms Anne-Marie McCarthy (CNM2) were indispensable in these preparations. All annual leave and teaching programs were cancelled, and staff were rostered in Pods allocated to various areas of the campus. Dr Mary Walsh and Dr Damien Barry (SpR) did trojan work devising and amending these rosters as the situation evolved.

It was recognised that we would need to support each other through this uncertain time. Social distancing was introduced, travelling to visit family was restricted, staff were working in smaller discrete pods and some anaesthetists needed to self-isolate while awaiting swab results. Staff were, quite reasonably, concerned for their own wellbeing and that of their families. None of us knew what to expect or what toll it would take on us, on our families, or on our community. Showering before leaving the hospital became the norm and some of us hugged our children a little less. Caring for sick patients while wearing PPE proved to be tiring and uncomfortable, and some of the menfolk had to shave their beloved facial hair. Family life was affected by the lock-down, with schools and childcare facilities closed, and one staff member remains traumatised following an offspring’s tin-whistle lesson on Zoom. Even our beloved monthly “Coffee and a Gas” social gatherings had to be abandoned. 

The CUH anaesthesia team bore the many inconveniences and challenges with professionalism and good humour, but there was a concern that members might start to feel isolated during this uncertain time without their usual support network of friends and family. How could we look after each other in a time of pandemic and social distancing? 

Firstly, we tried to promote an on-line sense of community within the Department- a virtual “tribe”. On-line quizzes were circulated, often with a pandemic theme, covering such topics as music, literature, and James Bond movies. Dr Vincent Wall (SpR 5) and Dr Jemima “Mother of Quizzes” Nilan (Registrar) invited us to match baby photographs to the grown-up anaesthetists. Dr Pradipta Bhakta (Registrar) circulated links to old photographs of Ireland, an interesting article on the Irish Anaesthetist Dr Sarah Joyce O’Malley (1896-1959) and several articles on how to best survive self-isolation. 

We asked staff to submit photographs of their daily work, especially while wearing PPE. Dr Frank Loughnane took photographs of a combined anaesthetic and theatre nursing staff workshop, capturing some of the anxiety but also the spirit of the teamwork that went into preparing for an expected influx of critically ill patients. These photographs capture unique moments in time- and where there’s a photograph, there’s a photo shopper (AKA Dr Rob Plant). These photographs have been collated and will provide members of the team with a memento of their time in the Department and of the part that they played in the COVID-19 pandemic. 

Secondly, we took advantage of the good weather and bright mornings and made a bid for “Fittest Department in Ireland”. For six weeks we met at 7am for a socially distanced “Shake Up, Wake Up” outdoor exercise program. Dr Frank Loughnane, Dr Barry Kelly and Dr Brian O’Donnell took us through Hight-intensity Interval Training and Barry’s Bendy Bikram Yoga, much to the amusement of staff arriving for work in the near-by car park (I found that the trick was to do the sit-ups downhill). This also provided an opportunity for The Trascendent Tik Tok-ers (Dr Tim Keady, Dr Kim O’Brien, Dr Denise Gorey, Dr Claire Healy and Dr Siobhan Clarke) to practise. I fulfilled my dream of undertaking the Young Offenders Tik Tok. My children have seen the footage and are now too embarrassed to talk to me, but it was worth it. Kim has previously competed for Ireland in acrobatic gymnastics and ran handstand workshops. I can now perform an upside-down handstand without injuring myself (that is- standing with my hands in the air).   

Dr Padraig Mahon took us on a socially distanced “12 Hills of Waterfall” cycle. The elite cyclists tackled an 80Km circuit while a shorter 40Km route was undertaken by those of us wearing runners, consisting of slightly less hills. We stopped along the way for an ice-cream and a quick rhythm check. We are incredibly grateful to Padraig’s wife Doris who provided a very welcome lunch on the lawn and to his sons for guiding us. 

We also took to the high seas at Oysterhaven Activity Centre for kayaking and stand up paddle boarding. The usual piracy ensued, and heroic attempts were made to get to the end of the infamous “moon walk” with few successes and much loss of dignity. 

Some of the department are members of Irish Doctors for the Environment and they mobilised us to contribute to a tree planting fundraiser for the Covid Hero’s. They also helped to facilitate a media drive and a petition to facilitate better public infrastructure and cycle lanes between the Cork city hospitals. 

We will all have our own recollections of the COVID-19 pandemic and some days will stand out. I had a “Big Birthday” during the lockdown. My mother was cocooning so the previous weekend I had my birthday cake sitting on the wall of her front garden with my own individual birthday candle. With all leave cancelled, I was rostered in the CUMH- which was actually quite fun. It was a great talking point with the new parents and my theatre colleagues made a great fuss of me. It was a joint birthday (happy birthday again, Dr Ronan Bluett) which provided the perfect excuse for a social-distancing party- individually wrapped chocolate bars and cans of soft drinks were distributed to the various Pods and shared with our theatre colleagues. Many local businesses had donated Easter Eggs to the CUH staff and Joanne Connolly (CNM3, Main Theatre CUH) gave me a Lilly O’Brien Easter Egg as a birthday treat. It was certainly a birthday to remember.

The response from the General Public, including deliveries of food and the provision of visors and PPE from local businesses and communities, was heart-warming and very welcome. We are also very grateful to everyone who contributed to “flattening the curve” by following the recommendations for social distancing, which meant that we were better equipped to provide the best possible care for the patients who came under our care. We would also wish to offer our solidarity to all the other front line and essential workers- nationally and internationally.

It has been an absolute honour and a privilege to work with such an exceptional team who rose to the challenge posed by the ongoing COVID-19 pandemic. I know that we have all learnt valuable lessons which will serve us in the future- but I will always treasure how the members of the CUH Department of Anaesthesia rose to the occasion and supported each other during these challenging times. I hope that those who are leaving our Department shortly will carry with them the sense of comradery and community that they helped to foster during their time with us. We wish them all the very best in their future endeavours.

Many thanks to my colleagues for their contributions above and to Dr Murray Connolly for co-ordinating this.