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Stranded in Mumbai by COVID-19, local doctor takes practice global

I find myself hunkered down with my wife in an Airbnb in the heart of India’s financial capitol, Mumbai, far from the family medicine I have practiced in New London County for the past 35 years.

With COVID-19 disrupting normal medical care, colleagues work bravely on the frontlines at Lawrence + Memorial Hospital or by telemedicine from their homes.

I too work remotely in this, the seventh most populated city in the world with some 20 million souls living in close proximity. The privileged reside in posh apartment buildings while millions are packed like sardines in filthy slums reminiscent of those depicted in the award-winning film, “Slum Dog Millionaire.” The homeless and migrant workers are countless.

We arrived in India on March 9 for what was to be a short visit with my father-in-law, a 92-year-old retired pediatrician. COVID-19 was rampant in China, Europe and elsewhere, but not in India. The only hint of what was to come was a temperature check and health screening form to fill out on arrival at the airport. The State Department had not yet advised against U.S. citizens traveling here or to many other countries.

As we prepared to fly home on March 24, Indian Prime Minister Narendra Modi addressed the nation on prime-time television, announcing a lockdown of the entire country for 21 days. He gave four-hours notice. All international commercial flights were grounded, stranding us. COVID-19 had arrived in India, an inevitable unwelcome guest in a nation of 1.3 billion, second only to China in population.

Fortunately, our Airbnb has a good internet connection and I am traveling with my laptop. My U.S. cell phone company has a travel plan that essentially keeps me connected with the same data and unlimited texts and calls that I have back home.

I’ve been able to maintain continuous contact via voice, text, email and videoconferencing with the various clinics, health care agencies and schools I work with, as well as patients. The only somewhat limiting factor has been the time difference: I’m 9½ hours ahead of Eastern Standard Time, so most of my communication with Connecticut takes place before early afternoon or I reply by email when folks back home are sleeping.

I also signed up to volunteer for an online platform for physicians and patients around the world seeking medical advice while unable to go out and see their usual health care providers. Besides their anxiety about COVID-19, the full array of symptoms and concerns, minor and severe, acute and chronic, real or imagined, stream across the computer screen around the clock. Depending on their specialty, physicians choose which ones to answer. There’s even peer review so colleagues can comment on each other’s answers.

On a recent morning I fielded questions from a mom in Zambia worried about her infant’s irritability and constipation. Another parent’s son in Johannesburg ran into a table with his front teeth and wouldn’t bite an apple. A Canadian woman had a missed period and was concerned about exposure to chlamydia. A Nigerian wife asked how long it would take before the pain from her husband strangling her subsided. Of course this is the tip of the iceberg of primary care anywhere in the world. COVID-19 has vividly brought it out into the open on the internet as much of the world’s population remains confined in their homes.

Am I worried? You bet! Our son is a cardiologist treating COVID-19 patients in an ICU in Connecticut. My brother, a pulmonologist, is caring for patients in Michigan. My daughter-in-law’s sisters are risking their lives reporting to work every day in hospitals in New York City.

My wife and I are on a U.S. Embassy list of citizens stranded in India waiting for an evacuation flight to return home. That airplane journey, if and when it materializes, will have its own perils. Like millions of Americans, we, our loved ones, friends, neighbors and coworkers are affected but doing our best to pitch in to control this health care crisis and put it into our rear-view mirrors.

Writing from the subcontinent where Mahatma Gandhi lived and influenced generations around the world, COVID-19 has helped me understand like never before in my entire medical career two of his precious sayings: “It is health that is real wealth and not pieces of gold or silver,” and “The best way to find yourself is to lose yourself in the service of others.” Amen.

Dr. Vijay Sikand lives in East Lyme. On Thursday the American Consulate said he and his wife should get seats on the first evacuation flights out of Mumbai this weekend.

 

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