"Why do we have to choose?": A doctor agonizes over making hard decisions due to lack of supplies, equipment

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Metro Manila (CNN Philippines, April 6) — 12 deaths in one day.

This was the horror Dr. Katrin De la Paz had to face in a government hospital last week as COVID-19 cases surge.

Since last year, she had been on duty in two COVID referral hospitals. It's a lot worse now, she said, seeing how the virus has become more contagious and patients deteriorate faster.

At one point, De la Paz had to choose who among five critical patients would use the only available mechanical ventilator. There were three ventilators left, but two were broken.

She decided to use the ventilator on an 89-year-old female patient who had the lowest oxygen saturation level. Hours later, three of the other patients died.

De la Paz agonizes over having to make the hard decision on who gets to live and who could possibly die.

"Bakit namin kailangan mamili kung sino ang pagbibigyan? Bakit dumating sa punto na 'di namin ma-treat nang maayos or maisalba 'yung buhay ng bawat isa sa pasyente namin? Bakit kailangan namin mamili? It's very frustrating," De la Paz said.

"Nakikiusap ako sa kanila, konting pasensya. Pero at the back of my mind, ang hirap humingi ng pasensya sa isang naghihingalong pasyente. Paano kung magulang mo 'yun? Paano kung kamag-anak mo 'yun?" she added.

[Translation: Why do we have to choose? Why did it reach this point that we can no longer give the proper treatment or save our patients? Why do we have to choose? It's very frustrating. I appeal to them (families) to be patient with us. But at the back of my mind, it's so hard to ask for patience when a patient is dying. What if that was your parent or relative?]

Having to face too many deaths everyday is very traumatizing for De la Paz. Repeatedly, she said she's very tired, too. As a doctor for six years now, she is used to long hours on duty. A few hours of sleep is enough for her.

But there's another aspect that's just too hard to bear. "'Yung physical exhaustion kaya itulog, but mental and emotional exhaustion? Mahirap bumawi lalo na kung mamatayan kami kada araw. Kung 'yung mga pasyente alam namin kaya pa eh, kaya pa ilaban. Eh pero namamatay. Kasi kulang kami ng gamit, kulang kami ng tao. Sayang 'yung buhay. 'Yun 'yung nakakapagod," she said.

[Translation: The physical exhaustion, you can sleep it off. But the mental and physical exhaustion? It's so hard to recover from that especially if you lose patients every day. When you know the patient can still survive, can still fight. But they die. Because of lack of equipment, lack of medical personnel. A life is lost. That's what's exhausting.]

Frontline workers seek psycho-social help

Dr. Bernard Argamosa of the National Center for Mental Health said De la Paz's story highlights how healthcare workers' mental well-being should also be prioritized.

With many hospitals now in full capacity, healthcare workers are having mixed feelings of exhaustion, frustration, and hopelessness.

Argamosa, who serves as the program director of the NCMH Crisis Center, said since last year, more than 300 workers from government hospitals and frontline agencies like the Health and Social Welfare departments have availed of psycho-social counseling and other interventions.

"Minsan may health workers daw na natulala, nagrereklamo na 'di makatulog, pero marami sa kanila nagkakaroon ng irritability... We are bound by our duty to serve and save lives. Kung nakikita namin na 'di namin sila natutulungan dahil overwhelmed ang system, magkakaroon ng disappointment, self-doubt and blame — which eventually, if left unchecked, can lead to various degrees of mental instability," Argamosa said.

[Translation: Some health workers are distracted or absent-minded, they complain that they cannot sleep, or they show irritability... We are bound by our duty to serve and save lives. If we see we can't help them because the system is overwhelmed, we show disappointment, self-doubt and blame — which eventually, if left unchecked, can lead to various degrees of mental instability.]

De la Paz said she has cried and gotten emotional a few times while on duty. But as much as she can, she tries to avoid showing her emotions so as not to affect her patients and co-workers.

She believes counseling sessions, or simply talking to someone outside the workplace can be a big help.

The public can do their share too in easing the burden of healthcare workers to avoid the spread of the coronavirus and hospitalizations.

"'Yung feeling na parang kami na lang 'yung lumalaban, kami na lang ang naiwan. Kasi nga trabaho namin 'to. This is our sworn obligation, our oath. Ang bigat... This is all our obligation. We should follow health protocols. Tayo-tayo lang din ang magtutulungan."

[Translation: You get the feeling that you're the only one fighting, you're the only one left. Because this is our job. This is our sworn obligation, our oath. It can be a burden... This is all our obligation. We should follow health protocols. We should help each other.]

According to the Health Department, last year, some 3.6 million Filipinos suffered from mental disorders related to the pandemic.

The NCMH has a 24/7 crisis hotline. This year, they've been receiving more than a thousand calls per month from just an average of 400 calls pre-pandemic. Majority of the calls are about anxiety and depression-related concerns.

If you are in need of mental health support, please call the 24/7 NCMH Crisis Hotline at (0917) 899-8727, (0966)-351-4518, (0908)-639-2672 or 1553 (Luzon-wide landline toll-free).