None of us has previously experienced anything like that which we have collectively shared over the last few weeks. The Covid Pandemic has shown the worst a pathogen can do- the indiscriminate speed and severity of its attack, its ability to prey on the more vulnerable and those who work so hard to defeat it to protect others.
It has also shown us the best in people and in what we can achieve.
As Dean, a response to the Global Pandemic is almost certainly not in the job description, but like so many colleagues, friends, neighbours we all find ourselves with new responsibilities and challenges.
I, like many of us, have been so proud of the response from all the St. Mark’s family. I cannot single out individuals but suffice to say, everyone has been affected and had to change their normal day to day working, almost on a day to day basis. The flexibility and commitment shown by so many has been overwhelming.
Fear, trepidation and anxiety affected many of us, myself included, when faced with working in unfamiliar territory but the rewards have been plenty. Working alongside new colleagues as well as familiar faces in different roles has helped bring a different kind of team spirit that many of us haven’t seen before. We have welcomed and been welcomed into new teams within the trust. So many of the St Mark’s family- from the most junior to the most senior- have stepped up and gone above and beyond what they have been asked to do and with good grace, bravery and professionalism. Redeployed junior doctors, specialist nurses, gastroenterologists, colorectal and orthopaedic consultants working seamlessly alongside our intensivists and respiratory specialists are all learning a new language of medical protocols. I have seen this with good humour, kindness and support for one-another in what is arguably the most uncertain, upsetting and stressful time of our careers.
For some, notably our research fellows, their professional lives are on hold as they willingly returned to clinical and other supportive roles, pausing their research careers. Many of them have contributed to tremendous fund raising activities and selfless acts of much needed but ‘menial’ tasks. Our clinical trainees have been re-deployed to less familiar clinical settings working on new rotas, sacrificing their specialty training opportunities. Our nurses and healthcare assistants have been pillars of strength many showing outstanding leadership creating new ways of working, returning to wards and intensive care after many years and of course holding up the key emergency services we have had to continue to provide.
We have had the pleasure of working more closely with so many of our colleagues in the wider LNWUH Trust community. I have seen many cleaners, pharmacists, porters, physios, dieticians, caterers, decontamination technicians, dentists, clerical, IT, secretarial and management staff, amongst others, pulling together in supporting the response. Many colleagues have been unwell but have returned, to push on and work harder. Those who have been unable to work in the frontline have provided very welcome support from further afield. The concept of a ‘weekend’ has been on hold whilst many holidays have been cancelled or postponed. All this whilst still managing complex domestic issues of social isolation at home.
The staff in the Academic Institute and the St Mark’s Foundation have, from the very first day it became apparent that our lives were changing, turned their attention to supporting the St Mark’s family in delivering care, not just to our own patient population but to all those we have been looking after. The commitment and drive to help and make a difference in every way has been astonishing, again way beyond the job-description.
The three key ingredients that make St. Mark’s special are excellence in clinical care, research and teaching. Clinical excellence, leadership and flexibility has been seen in spades, albeit not always in specialist bowel diseases but right from the start we have had our eye on keeping our current and future patients safe. New ways of delivering care have been promptly adopted and no-doubt we will have a lot of catch up to do but safe in the knowledge that plans will be in place.
Research has largely been on hold but collaborators, sponsors and academic partners are all focussed on a shared goal for now; clinical care in the pandemic must come first. The Academic Institute has supported our fellows and supervisors through the process of pausing projects. Our wide and varied teaching programme has also gone on hold. Sadly several events have had to be cancelled, talks unwritten, presentations not given, conferences unattended. We are cautiously optimistic that by November we will be able to deliver our flagship Frontiers course and that we will all be able to come together to reflect on the challenges of 2020. The programme is written with a first class faculty all waiting in the wings for what we hope will be a remarkable conference.
With every challenge there comes opportunity. We have seen new ways of communicating with each other, with patients and with colleagues further afield. Best practise has been shared in this evolving field. These new opportunities will, I am certain, change the way we work, interact with patients and even how we teach in the long term.
We are so grateful to the charitable supporters of the St. Mark’s Foundation who have been tremendous. Generous donations including scrubs, PPE, food, chocolate and perhaps most importantly confidential 24/7 professional counselling for our staff demonstrate how much our supporters want to help and be part of St. Mark’s response to the pandemic. One of the very best innovations has been the profoundly important use of i-pads for patients on our wards. Being in hospital, alone, without the ability to see and speak to loved ones has been one of the most distressing aspects of this pandemic. Very generous charitable donations have funded i-pads, which were very quickly distributed to the wards. Our research fellows have lead the implementation of this complex scheme which we hope will be followed by a long lasting trust lead programme. I have personally seen how important this is for patients at the most difficult time of their lives. Enabling a patient to see and speak with their family for what was their final conversation has affected me deeply. So many of our staff have come together to make this happen and I am sure this will be a positive long term legacy of which we can be very proud.
In the last month, two of our most longstanding colleagues have left our organisation. Neither wanted a fuss or a big send off but neither would have chosen to go when all of our attention was, necessarily, elsewhere. These two people, who I am going to name, are the epitome of what it is to be part of St. Mark’s- hard working, loyal and committed. Janice Ferrari and Judith Landgrebe have both left us after a combined career of almost 60 years working for St. Mark’s. They both contributed to the enormous efforts I have described right until their last days at work and we will of course invite them back for a special ‘post-Covid’ send off.
As I write, we are beginning to see a glimmer of hope that we may soon be able to think of returning to a new-normal practice. We need to be cautious and ready to return to the frontline as needed but we have many colorectal and gastroenterology patients needing our help and care both now and in the future. Although strange, deeply challenging and sad, I am sure this period will have made us all stronger. St. Mark’s can be enormously proud of the response we continue to deliver to this worldwide emergency.
Please continue to look after yourselves physically and mentally.
Dr Siwan Thomas-Gibson
Dean, St Mark’s Academic Institute
Consultant Gastroenterologist
St Mark’s Hospital, LNWUH NHS Trust