I tested positive for COVID-19 in November 2020, and
that was when the story began. It was still quite early in
the pandemic, there were no approved vaccines, and we
were still learning how to treat the disease. I had no
obvious risk factors nor any core morbidities so was not
worried. I fully expected to be back at work within a few
days in my role as a frontline clinician (consultant
cardiovascular pharmacist) at Leeds General Infirmary
and as an Academic (Associate Professor at the Leeds
Institute of Cardiovascular & Metabolic Medicine) with
several national and international roles. The horrors I had
seen during the pandemic meant I was eager to get back
to treating patients and helping the sick recover
Quite quickly however, I sensed that it may not be
straight forward as this. My symptoms progressed from
fever and a never-ending cough to dizziness and
breathlessness. Dizziness was my mark that I needed to
visit the hospital and was the first real alarm bell. Whilst
I was very ill, I was still well enough to call for an
ambulance myself and was admitted. I thought that all I
needed was a bit of oxygen and rest. My condition
deteriorated, and I was sedated and intubated
fear. I was unconscious for more than 2 months, learning
only later that I had experienced multiple
pneumothoracies, multiorgan failure (including kidney
failurerequiring dialysis), and cardiac arrests. My
survival chances were very slim. My care team did not
think I would make it, but my body managed to rally itself: a miracle of sorts. My gratitude and gratefulness
are endless to the many good deeds performed and
prayers made to help me recover and the One who made
these prayers come true. I have definitely beaten the
odds. When I semi- “woke up” in February 2021, it was
clear that it was only the beginning, I suffered extensive
deconditioning and had multiple morbidities that
compelled me to spend many more months in hospital.
More than three years on, I am still recovering.
Currently, I am finalising a whole book about my
experiences from admission to discharge. Unfortunately
I faced many challenges after returning to work which
delayed the publishing of the book. I am sure many will
be interested in the detail.I am almost finished with the
first book, and it will most likely require a second book
to describe my return to work and the challenges I faced
since. However, in this short piece, I share some of the
lessons that I take, as a health care professional, from
being a patient for so long. I will also dedicate a few
paragraphs in this particular article for spiritual
reflections, from an Islamic angle.
Lesson 1 : The Value of Good communication
As my condition deteriorated, and I found myself in the
intensive care unit (ICU), I dreaded being sedated, not just because I knew I might never come back but also because of the praiseworthy responsibility it would place on my family. My wife is a teacher and an artist; she is
intelligent, educated, and fantastic at what she does
but has no medical training. Would she be able to make
key decisions on my behalf if I were incapacitated?
Luckily, some of my medical friends, colleagues from
cardiology and other departments rallied around and
assured me that they would support her while I was under
sedation—and, indeed, they were invaluable for
interpreting technical jargon and providing wise counsel.
At times they made suggestions and cautiously
intervened without offending the team(s) looking after
me.
Nonetheless, listening to my wife’s stories about my
period of unconsciousness was an emotional experience.
It made me realize that what we say to patients’ families
often (eventually) makes it back to the patients
themselves. Her stories also drove me to reflect more
broadly on what families go through when a loved one is
critically ill.
Good communication is so important. Some of the
consultants my wife dealt with were fantastic at
delivering what was often bad news in a way that
remained at least somewhat positive; others were overly
pessimistic and caused her significant distress.
Obviously, as responsible health care professionals, we
cannot give our patients and their relatives false hope.
However, we must keep the lines of communication
open, make time when necessary, and find compassionate
ways of having difficult conversations.
Lesson 2 : Shared Decision Making
Losing control, is another great fear that I dreaded when
sedated. Up to that point, I had been heavily involved in
the choices about my care; I even asked to review my
own blood-test results! I was desperate to avoid losing
the ability to participate. We often preach the concept of
shared decision making with our patients, and I, myself,
have written about the benefits of this approach. But how
often do we really deliver it in everyday practice? Not
enough, I suspect.
Of course, considering my background, I was a relatively
informed patient. I was fortunate enough to have the
medical knowledge that so many others in my situation
would not have. And even when my mind was barely
functioning after I first regained consciousness, I wanted
to play a role in the decision-making process. But when I
look back, it concerns me that some of my care team
seemed uncomfortable with that.
As clinical practitioners, we should allow patients a
degree of reasonable scrutiny of what we do for them. It
is not always easy in overstretched daily practice, but we
still need to make the effort to answer our patients’
questions and engage them in treatment. Their treatment
journey is a partnership after all.
The motto“No decision about me without me” is very
empowering for patients and needs to be respected and
fulfilled by us—healthcare professionals. More listening
and humbleness will make shared decision making more
a reality than an aspiration.
Lesson 3: Understanding Delirium
During my ICU admission, my wife was warned that
even if I survived, there was a big chance that I would be
a different person. Brain damage due to hypoxia, cardiac
arrests, and severe anaemia, where potential contributing
factors. This was terrifying for my family, but they had to
wait and see.
I am sure most readers will understand that facing the
possibility of death—or the daunting prospect of a
lengthy and uncertain rehabilitation – was pretty
frightening. Actually, though, the most terrifying aspect
was the delirium I suffered as I gradually regained my
mental faculties after being sedated.
Delirium is very common in patients in ICUs. It can
present in various ways: as agitation and restlessness or,
on the flipside, as apathy and decreased responsiveness.
For me, it lasted a couple of months, and I felt like I was
losing my mind. It was not just the side effects of the
sedating drugs used in ICUs that worried me. I had
severe hypoxia for many weeks, and the potential for
brain damage was very high. Was it just delirium? Or
was my brain damaged? It was terrifying.
Whilst unconscious, I had experienced many different
dreams, and those fed into my delirium when I woke up.
Thoughout my coma I dreamt and dreamt. In some of the
dreams, I was with my family or going about my normal
activities, such as seeing patients, giving lectures and
travelling to conferences! Some dreams were very
spiritual and related to the challenges I was going
through including when I died (cardiac arrest). There was
also a third type, which I did not understand, which later
seemed to “match” new events that occured. I might
elaborate more on this in my book. In the early days of
my recovery, I found it very difficult to distinguish the
“fiction” of these hallucinations from the fact of being
seriously unwell in hospital. Dreams and reality seemed
to be mixing themselves together and the confusion this
caused me was deeply disorienting.
Thankfully, the wonderful ICU rehabilitation nurses
recognized that seeing my family could help me to
overcome this confusion and regain a sense of
psychological wellbeing. It is well known that involving
family and friends can be important in mitigating the
impact of ICU delirium2, but getting access to them was a
big challenge during the pandemic.
I am hugely grateful to the nurses who facilitated that for
us; I am not sure that ward managers appreciated the
importance of this. We have a lot to reflect on with
regards to many decisions we made during the pandemic
Based on my experience, I do not think we are good with
addressing the psychological well being of our patients
and their families.
Unfortunately, the impact of delirium on seriously ill
patients is still too often under-recognized. I would
encourage practitioners to give greater consideration to
alleviating this very frightening manifestation.
Lesson 4: Looking after a healthcare professional patient
I would probably declare that I was not an easy patient
while in a coma and after I woke up. I asked too many
questions, I made many suggestions, but at the end of the
day I was another human being who wanted to get better
and go back to his family. There was no need to feel
intimidated that one is looking after a healthcare
professional. Yes, I did challenge the things which did
not make sense, but isn’t that a good thing if we want to
get it right?
I did worry about my privacy, as I was known to many
(not necessarily a celebrity). This was very concerning to
me. I remember the emails sent by Trust senior leaders
reminding us that when a celebrity was admitted to
hospital to respect their privacy and not to check their
records (unless you have a direct caring responsibility)
nor share their news. How many respected this aspect of
my privacy, I do not know, but I assumed that many
would have acted professionally
I have huge respect to all those who delivered on the
mottos and values that we talk about in the NHS.
However, I am not sure that we are all on the same page
when it comes to implementation. Most of the care I
received was excellent and I am very grateful for many. I
am also conscious that we are humans; we err.
Another aspect that we should be aware of is treating all
of our patients fairly. This, of course, applies to
healthcare professional patients as well. However, I
would be careful. In my experience, the attempts made
by some to not “advantage” me as a healthcare
professional, have in fact disadvantaged me. For
example, not allowing colleagues to help wheel me down
to get fresh air when staff were busy was very unfair and
caused me a lot of unnecessary distress.
I was in hospital for months; I could not walk and all other
patients were able to walk down. I felt imprisoned. It
took far too long for the healthcare team to respect and
acknowledge my need to get out of the ward “prison”. I
was disadvantaged as a healthcare professional and felt
discriminated against, as a person with “disability”
(unable to walk)—something to reflect on when we are
delivering care for patients with long hospital stays.
Lesson 5: The Importance of Family to Long Term Recovery
As I write this in Nov 2024, I count myself lucky that I
have regained much of my physical functioning. For that,
I am particularly indebted to some amazing
physiotherapists and occupational therapists.
When I began my recovery in hospital, I could not even
sit upright, let alone walk. I had to relearn these abilities
as if I were a baby. For many months, I needed assistance
with even the simplest tasks, such as eating, washing, and
going to the toilet. We take these things for granted in
normal life, and being incapable was truly humbling.
Regaining the capacity to care for myself was a cause for
celebration!
Once I was able to walk unassisted, I asked to be
discharged early. I was bored and fed up, and the
psychological burden was becoming overwhelming. I felt
imprisoned, and I felt that going back to my family would hasten my recovery. I still believe it was the right
decision. I continued my physiotherapy at home and
gradually returned to my work and other activities of
daily living.
As practitioners, we need to take a step back and not see
the illness but consider the patient too. And we must
appreciate that the hospital is not always the best place
for them to be. Many like me prefer to recuperate at
home and are fortunate enough to have loved ones to
support them there. People of faith are taught that
maintaining family ties is crucial, and in this instance,
their support can play a huge role in ensuring a complete
recovery. The healing power of a united family with
strong ties should not be forgotten or underestimated. It
is one of the biggest blessings that we should cherish and
be incredibly grateful for.
Lesson 6: Understanding Patients with Long Term Conditions
I was left with many chronic health conditions as a result
of COVID-19, but heart disease is not one of them
Nonetheless, as someone who spends much of his
working life interacting with patients with cardiovascular
disease (CVD), I now have a lot more empathy and can
put myself in my patient’s shoes.
Indeed, I have first-hand experience of many of the
common symptoms of heart failure, for example, such as
breathlessness, extreme fatigue, limited exercise
capacity, and peripheral oedema.
Breathlessness was, of course, a key warning sign during
the acute phase of COVID-19, and I will never forget the
distress of sitting in my hospital bed gasping for air and
relying heavily on oxygen. I had multiple pulmonary
embolisms, and breathlessness was a huge burden.
I could not even chew my food. Then later, during the
long journey to recovery, my lungs were so damaged and
my body so deconditioned that breathlessness became an
everyday challenge. Similarly, I now understand the
extreme fatigue that patients with CVD often report
Even when I regained the strength to walk, I was too
exhausted to go very far. It took a long time to get back
to work, engage fully with family and friends, and live
more normally. My quality of life was greatly damaged
Even now that I have recovered a lot of my functioning,
am still living with the aftermath. I have had to adjust my
life to chronic fatigue—pacing myself in everything I do
and rationing my energy throughout the day.
I also have to live with various chronic conditions that
many patients with CVD would recognize, such as renal
disease. My kidneys completely failed while I was
sedated, and I needed dialysis. Some of the damage is
permanent, and I have had to come to terms with that
which has not been easy emotionally, but perspective is
key here, and I am extremely fortunate to still be alive
and that I have been able to take steps towards a normal
life. I need to remain vigilant however for other issues
associated with kidney disease, for example, the
increased risk of cardiovascular events.
My experience made me better appreciate the value and
importance of the multimorbidity approach or the Cardio
Respiratory-Renal-Metabolic care.
Ultimately, though my experience suffering from Covid
in ICU with multiple complications has been difficult, I
feel that it has also helped me become a better care
provider for my own patients.
I can now see their perspectives more clearly and can
better appreciate what they go through every single day.
Patients must play a role in their treatment plan and my
experience over the past few years has only confirmed
this further.
Watch out for my book for a more detailed account of my
experience and lessons learned.
Spiritual Reflections
The ordeal I have experienced, and the outcom
thereafter, strengthened my belief that Allah is our Rab.
Rabis the one who looks after and cares for His creation.
He is indeed the one who has ultimate control of all
matters. When I woke up, and before I learnt what
happened to me in ICU, I was repeatedly made to feel
that something very “special” happened to me. “You are
a miracle” -many healthcare professionals told me. “How
many souls do you have?” – others said. “You definitely
beat the odds” – added others.
I had no idea how slim my chances of survival were
Humans reached their limit, medicine reached its limit,
but the One who is the Rab of this existence destined
something else for me. Alhamdulillah. Indeed, “And
when I am ill, it is He who cures me” (Surah Al-Shuara
Verse 80).
One of the multiple dreams I saw in my induced coma
had many people praying for me with a lot of detail. It
was a very strange dream that I did not understand.
Months later, my family started sharing with me the
videos, recordings, and messages of people who were
praying for me non-stop from all around the world. All
faiths. This was a very humbling experience, which made
me shed tears. People I knew and many I did not know
were guided by the Almighty to remember me in their
du’aa and supplications. This was astounding. I instantly
saw that this must have been a major reason for my
miraculous recovery.Didn’t the Prophet say: “Nothing
but supplication averts the decree, and nothing but
righteousness increases life.” (At-Tirmidhi)
The last part of the earlier narration fits well with another
potential reason why my destiny was changed. It is the
many good people out there who gave charity on my
behalf when I was battling. Indeed, this was the last
request I made from my family before being sedated
“Please give a lot of charity on my behalf – I sense what I
am about to face requires a divine intervention and
nothing but a lot of charity is likely to address it. These
were my private words to my family. My family were
always protective of my privacy and my request for
prayers and charity stayed only with them. However
after I woke up 2.5 months later, I was astonished by the endless charities that were given with the intention of
Allah granting me healing (shifaa).
Most were not from my family or even from people I
know. SubhanAllah and alhamdulillah who facilitated
this. I was so humbled and moved by this second gesture
by people from all around the world. Indeed, the Prophet
ﷺ says: “Cure your ill with charity” (Al-Suyuti).
I have lived experience of many spiritual encounters that
I am still learning from. I hope these spiritual experiences
and reflections can provide you, as healthcare professionals, and patients out there, hope beyond this
materialistic world.
References
- Re-engineering the post-myocardial infarction
medicines optimisation pathway: a retrospective
analysis of a joint consultant pharmacist and
cardiologist clinic model.
Open Heart. 2018; 5e000921 - Delirium in critical illness: clinical manifestations,
outcomes, and management.
Intensive Care Med. 2021; - Pumping Marvellous. Heart failure guide. Availa
at:https://pumpingmarvellous.org/heart
Accessed April 2023
