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Credit
Sam Jerram's film - Final edited version. In copyright. Source: Wellcome Collection.
Sam Jerram, Registrar at Newham University Hospital, filmed in artist's studio in August 2020.
Dr. Sam Jerram describes how he moved into medicine after being inspired by the sense of purpose and structure he observed while visiting the Royal Free Hospital early in his career. Before the pandemic he worked part time, splitting his time between ward work and research.
He recalls how the hospital was transformed when COVID 19 began to spread, everyone was in scrubs and masks, and entering patient bays required full PPE. A&E became extremely busy, and every day felt like the busiest pre pandemic days. Patients moved wards as soon as swab results returned, meaning a constant flow of new admissions. Much of the work involved monitoring oxygen levels, which could worsen quickly and force urgent decisions about escalation of care. One major change was that relatives were barred from visiting except at the very end of life. In Newham, where family networks are strong, this absence of visitors was particularly painful. Strict rules allowed only one visitor, sometimes forcing staff to manage distressed families who wanted to be present together. Supporting relatives during end-of-life situations was among the most challenging aspects of the pandemic for Dr. Jerram.
He remarks that many people in Newham lost close family members, far more than is typical in other parts of the country due to factors such as overcrowded housing and multigenerational living, which made self isolation nearly impossible. Dr. Jarram feels lockdown should have come earlier, though no response could have entirely prevented spread of such a contagious virus. Years of underfunding also limited preparedness.
He reflects on how quickly normal standards broke down once wards were sealed, and how the environment at times resembled a field hospital, with very sick patients and a sense of fragility in societal norms. Despite the brutality of the situation, he was struck by patients’ stoicism, particularly those who were acutely aware of their own risks as others in their bay died behind drawn curtains.
Dr. Jerram concludes that the pandemic response depended on everyone in the hospital, not only doctors and nurses, but cleaners, porters, caterers, and logistics staff whose contributions were essential and deeply felt.
Keywords: High Dependency Unit (HDU), Preparedness, Difficult conversations, Impact on family, Health inequalities, Moral injury