From vaccines to definitions, life trundles on
Illustration Eoin Coveney
Lockdown status: level 5. Government movement restriction: 5km. Hospital activities: urgent or emergency care only.
Sprawled out on the carpet with Duplo and wooden blocks scattered all around, Michael and I were busy. I was occupied building an elaborate tower of blocks, and he was engrossed in pulling pieces of Lego apart, holding aloft the shapes that he liked most, exclaiming at them, and at 14 months old, chewing on them too. When my phone rang out with the hospital’s number flashing up on screen, I was surprised. During my free evening time – when I was not on call – why would they be looking for me?
“Clare?” It was Aideen, one of the ward managers. “The vaccine has arrived, we’re going to start vaccinating tomorrow. Do you want it?”
“Yes please,” I sat up.
Around this time Ireland had the worst COVID numbers in Europe, recording a seven-day rolling average of 1,267 cases per million in early January. This was after we had excellent numbers at 50 cases per million in early December. It seemed that as a nation we had relaxed and mixed too much over the Christmas break.
Getting vaccinated would be a relief. For my family, I am definitely the riskiest contact. My husband is working from home, not seeing people. Our child-minding system for Michael includes a shared nanny, a Brazilian woman who minds Michael together with his cousins in my brother’s house. I am careful at work, but I know that I am the most likely to get exposed, and go on to bring COVID home, and from there spread it on to my brother’s family and their two children. Getting vaccinated should reduce that risk by 95%, going by the Pfizer/BioNTech data.
Excited, even giddy, we waited for our shots the next day. The cataract unit, a dedicated theatre to allow for a higher volume of patients, had been repurposed as the vaccination centre for the hospital. That first day of vaccinating, there were about 60 doses arriving. Not enough for everyone, so some doctors and nurses would not get it straight away. People were anxious, enquiring about their place on the priority list. Clerical and admin staff wanted it, and needed it, as their work takes them in and out of the clinical areas of the hospital, but there were not enough doses to cover everyone just yet.
That morning the jab was quick, almost painless. As synthetic messenger RNA was being translated into COVID spike protein in my shoulder, I went back upstairs to the main operating theatres. There was one urgent case that needed to go ahead – a tarsorrhaphy for a man admitted with a nasty Stenotrophomonas keratitis, who had a dangerously thinned cornea. It was a short procedure for me to suture the lids together, after excising a thin strip off the surface of the posterior lamella, with bolsters in place.
In January changeover happened, and I moved to the cornea team. The theatre lists, which were previously filled with cataracts, grafts, pterygiums and other anterior segment procedures, are empty now. Emergencies only. We have to cut down the clinic numbers as much as possible too. Some patients, though, still need to be seen. I work in a cornea clinic for the first time since my senior house officer years; I am a specialist registrar now, not so far from finishing training. After five years or so in ophthalmology, rotating through different units and specialist clinics, I feel confident that I have seen most common things. Day one in clinic the Consultant Barry Quill asked me to look at a patient and describe what I saw.
“There is vascularisation of the cornea…”
“What else? What level are those opacities at?” Mr Quill asked.
“Superficial stroma… With clear cornea in between.” The patient sat patiently as I puzzled at her eye.
I paused, unable to recall the eponym.
“Salzmann’s,” Mr Quill said.
I knew then that I would need to get back into my books. I had treated myself to the updated version of Kanski last year, but most of its pages still had that suspiciously fresh smell, despite my aims to have re-read the whole thing by now. Studying while being a parent and working full time must be possible. Lockdown at least adds time for reading, if only I can manage to overcome ennui and focus.
At the end of the working day I cycle back home. Arriving at the small square we live on, I wave at the neighbours. They are another family of three; the father is a professional actor, who has acted in plays in Dublin’s national theatre, and in film. Ten months and counting for closure of his industry here. I am reminded that everyone faces their own problems, directly or indirectly, because of this virus.
Clare Quigley is a resident at the Royal Victoria Eye and Ear Hospital, Dublin, Ireland