It was the worst of times, it was the best of times. It was a time for grieving, it was a time for rebirth. A time we’d never want repeated, a time we’d later yearn for. 

People were dying. But, people were living. Not in an affirming or exhilarating sense; rather, in a slow, mindful, present sense. Between the fear and anxiety and stress, there was generosity and creativity and hope. A feeling that things could be different; a belief that they must be different; and that this was the opportunity to change.

And we did all change. Not necessarily in ways others could see, nor even in ways we could articulate, but in ways that we carried with us afterward.

But before that, before any of it, before I was even a doctor, I was an idealistic young student who wanted to do good and help desperate, needy people and save lives. By the time I was 30, I knew I was hardly ever saving lives, only making them slightly more comfortable, and mostly for people whose lives really weren’t especially uncomfortable. That had become gratifying enough, though, and I was making good money and living in a renovated house and eating at good restaurants and seeing different parts of the world, and a few years after that paying for expensive medical aid and generous life insurance and private school fees. A few years after that it had all stopped being gratifying and had become routine, and then dull, and then, at times, imprisoning.

So when the call came for people to put themselves forward and on the front lines, I knew I would volunteer. I discussed it with Julia, but I’d made my mind up, and she didn’t stand in my way; she knew I needed something. We, I, didn’t really consider the details and all the possibilities of what it might mean. And if I knew what was coming, I put it out of my mind.

The first weeks were quiet. My practice pretty much came to a standstill and effectively closed. In the hospital, there was barely a trickle of patients. One, then no one. Then another, then none. It was like a waiting game. We thought, maybe we’ll be lucky, maybe it won’t be like they said, the same way children believe that they can will something into being; that if they hope for it hard enough, it’ll come true.

When it happened, it happened fast. Intensive care went from being almost empty to half full in a week; the week after that it was almost at capacity. Julia and I decided I would stay in the flatlet behind the garage. It was usually rented out but our tenant had left suddenly to be with her family before we were locked down. I said goodbye to Rose and Cole knowing that I might see them across the garden but that I wouldn’t be with them for a while. They asked me what “a while” meant but I couldn’t give them an answer. “It might be weeks,” I said, knowing it would probably be longer. I hugged them, aware that I probably shouldn’t, but with no certainty of when the next time might be. With very little certainty about anything. We agreed that I’d cook for myself in the kitchenette. In any case, I didn’t know when I’d be coming or going.

There turned out to be very little of either. The hospital shifts were extended, sometimes running into each other, sometimes lasting days. When I did come home to the flatlet, it was usually just for a few hours, to shower and get some sleep. It reminded me what it was like to have a baby in the house, and to survive on a few hours of sleep every night, and I was again surprised at how we manage to cope. Except, of course, coping isn’t much more than surviving. We’re not at our best; not physically, not intellectually and not emotionally. At the hospital, we were all just fuelled by the pauseless attention that one patient after another needed and the decisions, the life or death decisions, that we needed to make. There were seldom lunch or tea breaks; sandwiches and bad hospital coffees were consumed in the passages.

Sometimes, arriving at the flatlet in the early hours, I’d be too wired to fall asleep; sometimes I fell asleep so quickly I didn’t remember lying down; a few times I sobbed on the bed and fell asleep more from the exhaustion of crying than working. I’d set the alarm but usually woke up in the early hours, before it went off, and couldn’t get back to sleep.

We were quickly short on doctors and nurses; some had tested positive. Patient numbers grew, staff numbers shrank. That was likely to be the pattern. None of us knew how we would cope, or if we would. The hospital, the patients, the disease, consumed everything. While some people on the outside complained they had too much time on their hands, I didn’t have enough to read the news or watch TV. I didn’t make small talk with the staff; there was nothing else happening in our lives, nothing else to talk about.

It became unsafe and impractical for me to leave the hospital. I told Julia that I wouldn’t be able to come back until the worst was over. In effect very little changed; I hadn’t been at the flatlet for days anyway, and my decision just put some clarity and formality to what was already happening. 

In my younger naivety, I used to think that people became addicts only in their 20s or 30s. That’s when they experiment, I believed. That’s when they’re unconcerned with their mortality. And that’s when they’re likely to get sucked down the sinkhole of abuse. Not in their 40s. In any case, I’d never felt drawn to heavy use. I’d also never felt this degree of exhaustion, and under the circumstances, a mild stimulant would serve me and my patients. So I took one. Then I took one a day. And then two a day became two twice a day.

But then I stopped being able to sleep altogether. I’d lie there, with thoughts and scenarios and decisions and prescriptions and diagnoses and information and graphs swirling through my head all night long. I developed a twitch and my vision became blurred. I was restless and agitated, I was drinking more coffee, I was doing everything faster.

I tried to speak with Julia and the kids every day but often it was only in the early hours of the morning that I could find five minutes so I missed them. One night I got Julia just after nine, as she was going to sleep. She sounded calm, started telling me how she’d sat in the garden for an hour earlier in the evening, just sat, listening to the quiet, not looking at her phone or thinking about emails. She couldn’t remember the last time she’d done that; maybe it was 20 years ago, she said. Why don’t we do that, she asked. But, still speeding and beckoned by the endless rush hour of the hospital and the ward, I was as impatient as she was content. I cut her short and said I had to go.

Some of the nurses seemed to notice my edginess and showed some compassion. Katy tried. She ask if everything was okay, but I snapped at her. 

“Obviously everything isn’t okay.” 

I apologised. I knew her intentions were good. But instead of laying off the pills, I found others. The anti-anxieties made me floaty. I was a calmer version of manic. Or a manic version of calm. At any rate, I felt I was doing better with both self-medications than I would be without either.

For the first time in days, I started getting a couple of hours of sleep at night. I became less emotionally attached and affected. I wasn’t panicked anymore. Not like the nurses. They were scared. And I felt relieved not to be. On that level, at least, I believed I was being a better doctor.

Medically, I probably wasn’t. I started to drift off and daydream, the way you do on a long drive when you suddenly refocus on the road ahead of you and wonder how you got there, or you try to remember what the landscape was for last few minutes and can’t. In the hospital, it felt like it was just for moments at a time, but one day I was standing over a patient in cardiac arrest.

I heard a concerned and urgent voice ask, “are you with me, Doctor Wu?” But I just kept staring somewhere distant. “Alex!” the same voice shouted. It was Katy, breaking my daze and the unspoken convention of nurses addressing doctors by their title. 

Later that night I told myself that the patient would almost certainly not have survived anyway. It wasn’t a thought that the young, hopeful, idealistic me would have entertained. It was the thought of a shadow of the man that I once knew, half a lifetime ago.

My judgement as a doctor had become clouded. But, worse, it had become objective. Decisions were made according to a process of weighing up who was more likely to live and who was more likely to die based on the information and data I had. In one way that is as it should be; nothing much wrong with it, other than that sympathy was absent from it. There was no getting to know the patient; no effort to, no intent to, no desire to. It was all utility, no humanity.

I laid off the stimulants for the next few days, but doubled down on the sedatives. It could have gone the other way. It was one decision that was not objective. A gamble taken for no reason that I could or cared to fathom. 

I can’t recall much about those next few days. I can’t recall if I gave better care or made better decisions. Even now I don’t know what “better” was or how it would have been measured in those times. I do recall another doctor telling me that Katy, previously my ally, perhaps at that point even more my ally, had spoken with my superior out of concern for the patients. I believe she was concerned for me, too.

But nothing came of her conversation. Before it could, I started getting symptoms and tested positive. Saved by the virus, I thought, indifferent to the irony. I left the hospital with enough meds to last me through 14 days of quarantine.

My symptoms were mild. At least, those from the virus were. But those from my time at the hospital and my ongoing abuse were more severe. I hadn’t been to the flatlet in a month. I hadn’t seen Rose or Cole in nearly two. Still, I could hardly get myself out of bed or to the door. I told them it was because I was sick and weak, and that was how I felt, though not in the way they understood. I slept for 10 or 11 hours every night and for much of the day. Julia left food at the door like I was incarcerated. I usually ate a few mouthfuls and left the rest.

When I moved back into the house, Rose and Cole had made cards and posters for me. They said “Welcome home daddy!” and “We missed you!” They gave me tight, prolonged hugs; I hugged them back, tighter and longer. They patiently let each other take turns to catch me up on the highlights of their lives that I’d missed. Julia made the lasagne I love so much and we ate as a family. It felt so foreign, and so familiar. We let the kids stay up late and I read them three stories. Held them close. Kissed them good night. Wiped tears from my cheeks.

Julia made me a cup of tea and we sat outside together. We listened to the quiet, didn’t say anything. She put her hand on mine. And then I sobbed, like I had at the hospital in those early weeks, scared and sad, but unlike those early weeks, now also sorry and shameful. She let me cry, didn’t ask any questions or expect any explanation. 

I don’t think she knew and I didn’t tell her about the drugs. I stopped taking them, abruptly and, to my surprise, easily.

I had to make a decision about returning to the hospital. Even though the staff who’d got sick before me had returned, more had got ill since. They still needed doctors. But I didn’t want to go back. Saving lives wasn’t the experience I imagined as a student, or as a professional. Maybe that’s true for everyone who worked at any hospital in those times.

“Perhaps it’s for the best,” the senior doctor said. He thanked me graciously and wished me well. I asked him to tell Katy that I said thank you and sorry.

I stayed home for a month after that. I spent a lot of time with Rose and Cole, and just watching them. Julia told me about friends who were volunteering for charities and starting new ones, businesses that were helping, ideas people were having, optimism they were feeling. I caught up with news and the stupidity and sincerity of leaders. I caught up with friends and family. Vacuumed floors and washed dishes. Cooked dinners. Read books. Went to bed early and woke up late. Slept deeply and dreamed vividly. 

My practice started up again slowly. Rose and Cole eventually went back to school. And in time things looked, from the outside, much as they must have before. If you’d asked me, the only visible difference to our lives that I might have been able to identify was that Julia and I sat outside most nights, even the cold ones, even just for a few minutes, listening to the not quite quiet that she described the night I called her before she went to bed.

But we’d lived through the worst and best of times, and shown the worst and best of ourselves. We’d been selfish and kind, felt fear and hope, seen grief and rebirth. And things were different; they couldn’t not be different. And we did all change. Not in ways others could see, not even in ways we could articulate, but in ways that we carried with us afterward.