For instance when I was pregnant for the first time in 1974, I read obstetric textbooks (yes, bonkers, I know) which I ordered from our local library, and when India, my baby granddaughter was diagnosed with a rare chromosomal disorder, I constantly Googled scientific papers written by geneticists. Did I always understand what I was reading? Of course not! But I gleaned enough to be able to make better sense of what was happening which made me better informed and, more importantly, the knowledge I acquired helped me to feel more in control.

So, when the pandemic started to creep ever closer early last year, I searched for books about pandemics. I read Defoe’s ‘Journal of a Plague Year’ which documents the rapid and relentless spread of the disease in specific streets in London in 1665 and the powerlessness of the terrified inhabitants to halt its devastating progress. I also reread ‘The Plague’ by Camus and a beautiful and moving novel called ‘The Pull of the Stars’ by Emma Donoghue set in a Dublin hospital during the Spanish Flu pandemic a hundred years ago.

That was the best that I could find in order to make sense of our very own nascent pandemic until very recently when I read ‘Life Support’ by Dr. Jim Down, the diary of an ICU consultant at University College Hospital in London, written from March to May last year as the initial wave of the Covid 19 pandemic hit the UK.

It’s the compelling narrative of a group of clinicians and their patients who are effectively hit by a tsunami. If they are not to be totally engulfed and overwhelmed by it, they must all listen, learn, adapt, flex, experiment and cope with a virus which behaves capriciously and unpredictably. Initially it catches them all, patients and doctors alike, completely unawares. Jim Down documents how, whilst we are all going out onto our doorsteps every Thursday to applaud their heroic efforts, the doctors, nurses and managers on the front line are adapting everything they do in order to accommodate and treat the tides of sick and dying people who daily flow into their hospital. Consultants, no matter their speciality, are called into ICU, as are nurses, but little could have prepared them for the truly shocking things they are all about to experience. Down encapsulates this horror in the opening pages of ‘Life Support’ when on March 24th 2020 he encounters his first truly sick Covid patient, a young father named Adam who is otherwise fit and healthy and just twenty-eight years old.

When admitted to ICU Adam had been suffering from fevers, a persistent cough and breathlessness for four weeks at home. On admission, he had what Down describes as ‘a classic combination’ of low lymphocytes (a white blood cell for fighting infection), high temperature and shadowing on both lungs and it was no surprise that he tested positive for Covid 19. Within a day he was too breathless, exhausted and agitated to carry on breathing on his own so he was put to sleep, intubated and attached to a ventilator. Down expected that this would be sufficient to allow Adam’s youthful body to fight off the infection with the help of antibiotics and at a given point he would be well enough to be gently woken up and weaned off the ventilator. But Down and the others treating him were in for a very rude and early awakening to what Covid might mean.

We finally went into lockdown on March 23rd just as Adam’s situation deteriorated. His temperature shot up, his blood pressure dropped, his heart rate climbed and his kidneys began to fail. As Down notes, “Covid was supposed to be a single-system disease, an inflammation of the lungs, but this man was shutting down, all of him, and he wasn’t seventy with lots of chronic health problems. He was twenty-eight with none. If Covid could kill Adam, it could kill any of us.”  

Down and three other consultants and two specialist nurses used every trick in their book to save Adam’s life. They tried wrapping him in a cold wet sheet to lower his temperature, irrigating his bladder, injecting massive doses of noradrenaline to boost his blood pressure and insulin to lower the dangerously high potassium levels in his blood. Two more consultants arrived at the bedside to offer observations and suggestions. All of these top medical brains were desperately searching for something, anything that might turn the situation around. And then Dr. Down noticed an ominous patchwork of purple mottling which indicated that Adam’s tissues were dying. After hours of desperately trying to save Adam’s life, Down looked at the eight shattered faces of his colleagues and said “I think we should stop. Anyone disagree?”

From that first encounter with the havoc which could be wrought by Covid on a healthy young body like Adam’s, Down details the ups and downs of working on the front line of Covid care during that first wave of the disease. He loses colleagues to Covid, and also existing patients whose illnesses make them particularly vulnerable to the virus, and occasionally there is the surprise and satisfaction of seeing people suddenly and unexpectedly turn a corner and begin to recover. 

His book conveys the initial confusion and fear, the exhaustion, the ghastliness of wearing PPE which is hot and uncomfortable whilst also creating a physical barrier to communication, and the sheer horror of grappling with a new, complex and unpredictable disease which tests every ounce of his medical knowledge and skill. And yet in many ways Down is lucky. He’s an experienced and highly competent consultant in one of the best equipped hospitals in the world.  He is surrounded by knowledgeable and supportive people at work and at home he is happily married to Tish, a sculptor, so he can return after a gruelling shift to his wife and 11 year old twins who all keep his feet very firmly on the ground.

So, would I have wanted to read Down’s account in ‘Life Support’ as the pandemic struck in order to help me to make better sense of what was happening, help me to be better informed and feel more in control? Absolutely! The book brings home very eloquently a number of important lessons. The first is that we should always take the threat of a pandemic very seriously indeed, and in fact should have done so much sooner than we did. The second is that as a system the NHS proved to be remarkably robust and able to flex to accommodate the demands made of it. As the first wave diminishes, Down notes: “an incredible transformation has taken place in UCH… almost everyone in the hospital was working a new rota, with over 100 staff arriving on ICU alone for every shift.” The third lesson is that our death toll was higher than it should have been, mostly because of a reluctance to lockdown, but once within the hospital system, everything humanly possible was done to mitigate the impact of the disease.

We seem to be In a period of partial limbo currently, hoping against hope that vaccinations will prove to be the panacea we all crave, whilst worrying that new variants may lock us all up again. Eventually this too shall pass and when (rather than if) at some future time another pandemic strikes, then books like this one will remind us just how important it is not to ignore the potential threat, just how much we rely on a robust health care system and just how much we owe to health care professionals like Jim Down who are prepared to give their all to save our lives.

A Chance to Meet Dr. Jim Down:

I am delighted to tell you that I will be interviewing Jim Down on Tuesday March 25th in a live zoom session at 4pm (see details below), so if you’d like to hear his story and also ask him your own questions, then please do join us.

Tricia x

You can purchase 'Life Support' here: https://www.waterstones.com/book/life-support/dr-jim-down/9780241506318 

Upcoming Event Information:

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Teatime with Tricia - Dr Jim Down

Dr Down is head of the ICU at University College London. He is also author of the book 'Life Support: Diary of an ICU Doctor on the Frontline of the Covid Crisis'

Day: Tuesday 25th May

Time: 4pm

Link: https://us02web.zoom.us/j/81052104919?pwd=NU9vVDg1QThoQzR6UFU0UTBXUURYZz09

Meeting ID (if needed): 810 5210 4919

Password (if needed): LOOKFAB

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Tricia Talk - Jodie Filogomo, Fashion Blogger 

Jodie believes it's never too late to look great, no matter your age, size or budget. Along with her mother and close friend, she showcases weekly clothing style inspiration, with lots of tips and tricks on how to add fun to your clothes. 

Day: Tuesday 1st June 

Time: 4pm

Link: https://us02web.zoom.us/j/87999908540?pwd=WVJkREZUTkdsTi91dlFlWEFmUVBVZz09

Meeting ID (if needed): 879 9990 8540

Password (if needed): LOOKFAB

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Film Club - Some Kind of Heaven

Available on Curzon Home Cinema or Amazon Prime

Day: Friday 4th June

Time: 4pm

Link: https://us02web.zoom.us/j/88921017357?pwd=WnhLcG5BaG1lWDJCaDFNVXVLanBPZz09

Meeting ID (if needed): 889 2101 7357

Password (if needed): LOOKFAB

You can also keep an eye on the weekly schedule of Events which will be updated every Friday at 5pm (GMT) here: https://www.lookfabulousforever.com/a-bright-spot-for-your-day