{"id":3736,"date":"2026-01-24T08:34:31","date_gmt":"2026-01-24T14:04:31","guid":{"rendered":"https:\/\/books.kalantri.co.in\/?page_id=3736"},"modified":"2026-03-03T16:48:23","modified_gmt":"2026-03-03T22:18:23","slug":"covid-care-planning","status":"publish","type":"page","link":"https:\/\/sp.kalantri.co.in\/gmc73\/pandemic-years\/covid-care-planning\/","title":{"rendered":"The Architecture of Care"},"content":{"rendered":"

The View from the Ward<\/strong><\/h3>\n\n\n

As the Medical Superintendent, much of my time was spent on the “macro” of the pandemic\u2014oxygen logistics, district guidelines, and drug protocols. But the true story of Sevagram\u2019s survival was written in the “micro” of the wards. To understand how we survived, one must look through the fogged goggles of a nurse or a junior resident.<\/p>\n\n\n\n

I remember speaking at length with Dr. Jwalant Waghmare, the Head of Anatomy who stepped out of the dissection hall to become a nodal officer for nearly six months. He was our eyes and ears on the ground, identifying problems that were invisible from an administrator\u2019s desk but catastrophic for a patient\u2019s experience.<\/p>\n\n\n\n

***<\/strong><\/p>\n\n\n

The Human Friction of the Red Zone<\/strong><\/h2>\n\n\n

One of the earliest difficulties was unexpectedly simple: patients stayed on. Even after recovering from COVID-19 and becoming asymptomatic, many were terrified to return to villages where they might be shunned. This “bed-blocking” frustrated new admissions and exhausted a staff that was already stretched thin.<\/p>\n\n\n\n

We also faced the rigidity of our own protocols. Early on, any surgical patient who tested positive\u2014even if they were clinically stable\u2014was transferred to the COVID ward at midnight. These transfers were chaotic and disrupted care. Dr. Waghmare and his team made a pragmatic, humane decision: we stopped the midnight transfers. We asked each surgical unit to earmark six beds in their own wards for COVID-positive patients who didn’t need oxygen. This single decision reduced unnecessary movement and eased the crushing pressure on the dedicated COVID block.<\/p>\n\n\n\n

Inside the wards, the atmosphere was a pressure cooker. Tensions occasionally surfaced between the nursing staff and newly inducted residents. These young doctors, often overwhelmed by the workload and the terrifying mortality rates, sometimes expressed their frustration poorly. Dr. Waghmare\u2019s counsel to the nurses was simple but profound: “Remember, they are still learning how to function under the weight of death.”<\/em> That empathy defused more conflicts than any official memo ever could.<\/p>\n\n\n\n

***<\/strong><\/p>\n\n\n

The View from the Nursing Station<\/strong><\/h2>\n\n\n

If the residents were the infantry, the nurses were the fortresses. I often recall my conversations with Ms. Bharti Kamble, a senior nurse who managed the COVID wards from April 2020 to August 2022. She saw the transition from a modest 10-bed unit to a massive 250-bed operation.<\/p>\n\n\n\n

In those early days, Bharti and her team were the primary instructors in the “ritual of protection.” They spent hours training everyone in the precise art of donning and doffing PPE\u2014a ritual where a single slip-up could mean bringing the virus home. She spoke of the young nurses who would cry quietly while taping their gloves, gathering the courage to step into the ward.<\/p>\n\n\n\n

The physical conditions were brutal. In the oppressive heat of Wardha, the non-breathable PPE was a sauna. I saw nurses collapse from dehydration and exhaustion. Their goggles would fog, their vision would blur, and their masks would slip under the weight of sweat. In that state, even simple tasks like setting up an infusion pump or finding a vein became monumental challenges.<\/p>\n\n\n\n

***<\/strong><\/p>\n\n\n

The “Invisible” Errors and Corrections<\/strong><\/h2>\n\n\n

Fear shaped behavior in unexpected ways. In the beginning, many were so terrified of the virus that they practiced “no-touch” medicine to an extreme. We had to rely on veterans like Benhur Premendran, our Professor of Anaesthesiology, to demonstrate that a simple gown and mask\u2014used correctly\u2014were enough. He had to show them it was safe to touch the patient.<\/p>\n\n\n\n

Errors were inevitable in a system pushed to its limits. Many faculty members from preclinical departments, who hadn’t stepped into an ICU in years, were suddenly managing ventilators and infusion pumps. I remember the story of a staff nurse\u2019s husband who developed severe diarrhea after a resident, in a moment of sheer exhaustion, mistakenly prescribed Dulcolax instead of Paracetamol. It was a stark reminder of how thin the margin for error had become when sleep was a luxury.<\/p>\n\n\n\n

***<\/strong><\/p>\n\n\n

The Priority of Protection<\/strong><\/h2>\n\n\n

As MS, I made protecting these frontline workers my absolute priority. We secured PPE and N95 masks when the rest of the country was running dry. We ensured that if a staff member fell ill, they had priority access to the best beds and ventilators we had. We couldn’t prevent them from getting sick, but we could ensure they weren’t abandoned.<\/p>\n\n\n\n

Looking back, what stands out from those ward visits isn’t a series of flawless medical interventions. It was the collective endurance. We learned while doing. We corrected course repeatedly. We stopped ordering repeat RT-PCRs before discharge once we realized it was unnecessary, freeing up beds faster. We eventually relaxed the rules to allow one relative to stay with a patient\u2014realizing that the psychological comfort of a family member was as important as any drug we could prescribe.<\/p>\n\n\n\n

In the end, it was not the protocols that sustained us, but the patience, the trust, and the unspoken understanding that while perfection was impossible, abandonment was not an option.<\/p>\n","protected":false},"excerpt":{"rendered":"

The View from the Ward As the Medical Superintendent, much of my time was spent on the “macro” of the pandemic\u2014oxygen logistics, district guidelines, and drug protocols. But the true story of Sevagram\u2019s survival was written in the “micro” of the wards. To understand how we survived, one must look through the fogged goggles of … Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1595,"menu_order":8050,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-3736","page","type-page","status-publish"],"acf":[],"yoast_head":"\nThe Architecture of Care \u2014 Stetho in Sevagram<\/title>\n<meta name=\"description\" content=\"The oxygen crisis was the macro. The nurses crying while taping their gloves, the resident who prescribed Dulcolax instead of Paracetamol, the midnight transfers that stopped \u2014 this is the micro. 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