“Even if we get the vaccine, it doesn’t mean that we’ll stop wearing masks, that we’re going to start congregating again. We have to stay cautious,” reminds Dr. Cabral.
Culture

Frontliner looks back: How the last 10 months changed the way doctors treat patients, themselves

Dr. Brian Cabral on the lessons of 2020
RHIA GRANA | Dec 30 2020

Nephrologist Dr. Brian Cabral was in a happier and relaxed mood when we caught up with him recently—as compared to when we first met him during the beginning of the pandemic. During that period, he shared his daily travails to ANCX as a Covid-19 frontliner, speaking in a somber tone and visibly spent from the emotional roller coaster of facing the situation in Covid floors and hospital rooms.

He spoke about the tension, the frustration, and the exhaustion then overwhelming the medical community, “the feeling of concern [for other doctor-friends] because we all know we’re unprepared.”

Dr. Cabral painted us a picture of the situation in hospitals—overcrowded with patients but understaffed with medical professionals, be it in private or public facilities. “That’s the scary part of being a healthcare provider, not knowing if there’s enough of you for everybody… you don’t know if there’s enough equipment, PPEs, rooms, ICUs…and it’s scary,” he said.

“We all signed up for this. We all signed up to take care of people. We never thought it would actually be this bad and that we would actually feel scared.”

Dr. Cabral highlighted the importance of teamwork, not only among doctors, but everyone who are part of the hospital structure.

Much better

More than nine months later, Dr. Cabral is happy to note the situation in hospitals is better. “The census is a little lower. But it’s not at its lowest. We got lower numbers before,” he tells ANCX. The doctor holds his practice at St. Luke’s Medical Center, Makati Medical Center, Asian Hospital, and PGH. 

He’s quick to add that he can only speak for that particular day (we did our interview on Dec. 28). “I can’t tell you what next week’s going to be like, or what next month is going to be like. But today, there are less patients in the hospital than there was before, when [the situation] was at its worst,” he notes.

Medical practitioners don’t want to be pessimistic, but they are expecting the number of people in the hospitals, including those in the ICU, to go up, after the holidays. “Sana hindi. I hope I’m wrong. I hope we’re all wrong.”

The pandemic proved to be a huge learning experience for the medical community, as it explored myriad options that would allow them to efficiently attend to and effectively treat patients.

With a colleague doing rounds

Dr. Cabral highlighted the importance of teamwork, not only among doctors, but everyone who are part of the hospital structure—the nurses, the respiratory technicians, the people who operate the ventilators and other machines etc. “I think we’ve all learned to work together more efficiently because of [this pandemic].”

The medical practitioners also learned to accept their own limitations. The pandemic has taught them the value of seeking help, so they can also take care of their own health. “Hindi pwedeng ikaw lang mag-isa na tuluy-tuloy. As much as you want to help everybody, maghahanap ka na lang ng backup, someone who can take your place so you can take your rest and sort of decompress.”

In recent months, Dr. Cabral says doctors have realized the importance of group practice, which was not popular before in the Philippines. “With this type of pandemic, what we found was working as a group—taking turns in caring for patients, even though we fall under the same specialty—actually benefited all of us kasi we were able to rest and come back recharged,” he says. This setup decreases their exposure to ill patients on a daily basis, as all the experts don’t need to be in the hospital every single day. “Now we’ve sort of adjusted already, not just in the way we treat the patients but also how we treat ourselves.”

With his wife, Dr. Monica Therese Cating-Cabral, and his sister, Dr. Patrica Ann Cabral-Prodigalidad

Treatment and prevention

As for the treatments, Dr. Cabral says they were essentially trying every option available in the beginning—and so far they found that steroids seemed to be helpful in most cases. Vaccine developments, trials, approvals, and procurements are underway, and that makes them even more helpful.

Telemedicine has proven to be a valuable method of practice, to lessen patients’ and doctors’ exposure to the Covid virus.

Many doctors have also learned to extend the life of their surgical and N95 face masks, by sterilizing them in UV light. Many creative local entrepreneurs are making washable, good-quality PPEs, so they are able to reuse them. “Madami ring natutunan kasi these were things we never thought of doing before,” says the doctor.

Gettng ready to get swabbed

Ligtas ang praning

Dr. Cabral says he remains as praning as he was at the start of the pandemic. “Am I still scared now? Yes. I haven’t changed any of the things that I do. May saying nga kami e—ligtas ang praning. Kung gaano ako kaingat nung day 1, baka mas maingat pa nga ako ngayon.”

He still wears complete PPE on his duty. (He brings his own PPE since it’s hard to find a size that suits him—he stands 6’4”). Aside from wearing the face mask and face shield, he also wears goggles, and “for all that it’s worth,” even that portable air purifier.

Before he walks into the house he takes off all his clothes at the garage and jumps straight into the shower and gargles Betadine. He has a steady supply of rubbing alcohol in his car. He washes his hands as often as he can and doesn’t touch anything unless necessary. He still gets a swab test as regularly as he can, whether he is symptomatic or asymptomatic. “Lahat ng maisip ko to protect myself, I do those,” he says.

Dr. Cabral, shown here in his complete PPE uniform, says he remains as praning as he was at the start of the pandemic. "Kung gaano ako kaingat nung day 1, baka mas maingat pa nga ako ngayon.”

He stresses that it’s important to recognize how serious the Covid situation actually is—this goes not only for the medical practitioners but for the ordinary individuals.

It goes without saying that he’s looking forward to the Covid vaccine in 2021, but he stresses that this doesn’t mean we can let our guard down. “Even if we get the vaccine, it doesn’t mean that we’ll stop wearing masks, that we’re going to start congregating again. We have to stay cautious.”

He hopes that we continue to find better ways to live in the new normal—“better ways to deal with school, with work, with everything.” His wish? “I hope hindi magsawa ang private sector na tumulong. And I hope the government tries to make things better for all of us.”