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'This man knows he's dying as surely as I do': a doctor's dispatches from intensive care

As lockdown is relaxed, many in the NHS are left reeling. Palliative care doctor Rachel Clarke shares her experience working with coronavirus patients, and her fears of a second wave

It is mid-April. Death has been headline news for so long now, I am beginning to feel like a plague doctor. My next patient, an 89-year-old from a care home, is perilously ill. Despite the highest flow of oxygen we can deliver through his face mask, he is gasping for air at a rate of 40 breaths per minute, two or three times the norm. Swiftly, I search his hospital record for a glimpse of the man he used to be before coronavirus so violently reduced him.

In my mind, the voices from this morning’s car radio linger. Listening to the politicians and journalists talk – loftily, from afar, an Olympian perspective – coronavirus can feel like a mathematical abstraction, an intellectual exercise played out in curves and peaks and troughs and modelling. But here in the hospital, the pandemic is a matter of flesh and blood. It unfolds one human being at a time. And when the statistics threaten to throw me off balance – the unprecedented number of deaths for peacetime – I try to keep things as small as I can. Winston used to work in the local glass factory. His wife died three years ago. He has two sons called Michael and Robert.

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