In February 2020, when the novelist and doctor Roopa Farooki first sat down to write her latest book, coronavirus was “something that was kind of buzzing around” in the background. “Those of us going to work every day in a hospital, we weren’t really aware of it; we were just blindly doing our job, day by day, patient by patient. Knowing there was this thing happening, but it was insidious. There was a clue here or there, but we weren’t absolutely sure how far it would affect us, or how far it would change us.”
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Farooki’s sister Kiron had just died of breast cancer. Kiron was 48, a solicitor and a mother. She had previously been unwell, but the cancer had gone into remission. “We thought she had beaten this thing,” says Farooki. Her sister was straight-talking, fierce in her love, prone to doling out advice whether Farooki wanted to hear it or not. “She was super-amazing at everything she did.” To process it all, Farooki did what she has done since she was a little girl: she wrote about it. “Before she passed away, she saw that I was thinking about her and writing about it. She wasn’t angry about it. But you always worry when you write about someone that you’re twisting yourself into someone else’s tragedy.”
Weeks later, buffeted by grief, Farooki would find herself working on the frontline of the Covid-19 pandemic, covering the acute medical ward in an A&E department at a hospital in the south-east of England. At night, bone-tired, she would come home, attempt to spend a few precious minutes with her four children, aged between nine and 14, and then type late into the night, frequently waking up with her head on the keyboard. The resulting memoir, Everything Is True: A Junior Doctor’s Story of Life, Death and Grief in a Time of Pandemic, is an attempt to make sense of a bewildering and frequently terrifying period in Farooki’s life, as the grief-stricken doctor grappled with the loss of her beloved sister and the realisation that she might become one of the 850 healthcare workers thought to have died in the first wave of the pandemic.
Over Zoom, Farooki tells me she is exhausted, and possibly unwell, although she does not seem it, speaking in long, forceful bursts of high-tempo, uninterrupted speech. It is her first day off in a run of nine days, and she is worried she may be about to develop Covid symptoms: one of her colleagues recently tested positive, “so everyone on the ward is counting down to when they’re going to get symptoms again.” We speak as Britain is witnessing the start of a wave of Omicron infections: later, checking back in, Farooki tells me that her Trust is on the brink. “Bed availability for new admissions is compromised,” she says, “meaning that, in practice, there just isn’t the space, so patients who’ve been admitted may have to wait hours receiving treatment in a chair until someone else is discharged.” A disturbing number of patients have not been jabbed. “The only patients since the summer that I’ve had to admit for oxygen or treatment with Covid are the unvaccinated. Some were in their 20s and 30s and had freely passed the infection to their families.”
Before retraining as a doctor in her 30s, Farooki authored eight books, writing her first novel, the well-reviewed Bitter Sweets, while she was pregnant with her first child and renovating a house in France. Her novels, which often examine complicated and shifting family dynamics, have won her comparisons to Monica Ali and Zadie Smith. She was nominated for the Women’s prize for fiction three times. But despite the critical acclaim, the life of a novelist wasn’t enough to sate Farooki’s ambitions. “I’ve actually always wanted to be a doctor,” she says. “It was just one of those things that wasn’t possible when I was younger.” She won a scholarship to a private girls’ school, but on the condition she chose arts subjects for her A-levels, which she was strongest at. “With those A-levels,” she explains, “you don’t go into medicine.”
In 2014, she published what she thinks now might be her final novel, The Good Children. “It’s hard to think about writing novels at the moment. You need a lot of space and clarity to create and inhabit an imaginary world,” Farooki says. Her children were all in school, and suddenly medicine seemed a possibility. “I studied physics, biology and chemistry books I took out of the library for about three to six months,” she says proudly, “and I sat the graduate entry exam for medicine. And with that I could go to medical school. It was that straightforward.”
Everything Is True is written in a fragmented style, with snippets of imagined conversations with Kiron interspersed with details of the patients Farooki treats and the occasionally fraught conversations she has with her husband, who is concerned she will bring a deadly virus into their home. At times, the stoical medical professional is undone by the horror she witnesses. “Death is all around,” she writes as the toll passes 40,000. “It’s everywhere, and the air is constantly crackling with the expired electricity of it. The sound of breaking hearts is deafening.”
The memoir covers the first 40 days of lockdown. While the public sat at home, baking and Zooming, “we all marched into hospital and kept going”, says Farooki, “day after day”. She wrote Everything Is True for an imagined “future self who wouldn’t believe this had happened. I thought I was writing it for someone who would have forgotten all these terrible things, like you forget things that are tragic. Like you forget the pain of childbirth. To remind me that these terrible times happened, because it’s important to take account and to bear witness to this.”
She never intended for it to be published. “It was a cathartic outpouring,” she says. “I was writing it for me. I started writing about Kiron and it just unleashed itself, like a flood around me. And I found some comfort in trying to make sense of the insanity of the day. To try and put it in some kind of form.”
More than anything, Everything Is True is an attempt to elude the smoothing passage of time. “I was afraid we would forget,” she says. “Forget what this felt like. And forget to hold those accountable. And [I was] holding myself accountable as well in some way. To say: ‘This was an extraordinary time and this is what I did. Did I do enough? I don’t know.’”
In the book, Farooki writes of being exposed to Covid-19 repeatedly when admitting patients to the acute medical ward. “You’ll soak it [the virus] up in your hair like a sponge,” she writes. “You’re going to get it, too. It’s inevitable.” The PPE provided is inadequate. “What was considered the appropriate PPE,” she says, “was always based on what was available … it was certainly not fully safe.” Staff secretly stashed scrubs in their lockers, as there weren’t enough to go round, and joked about whether their colleagues would save ventilators for them should they sicken.
Inevitably, Farooki fell ill with Covid-19, even discussing her funeral plans with her sons in the event of her death. “I remember being kind of annoyed and hugely relieved at how normalised it had been for them,” she says. “They could say: ‘OK, Mum, if you want to talk about your funeral, what kind of cake do you want? Let’s get it right.’ I was thinking: ‘Oh my God, you’re monsters,’ but I was also thinking: ‘This is what the pandemic has done for us – we can actually accept and talk about death.”
Farooki rejects the hackneyed battle metaphors so overused by politicians throughout the pandemic, and the corollary sentiment that the public should somehow accept doctors and nurses dying while executing their duties. “We’re not soldiers,” she says. “We signed up to care for people. This is all we signed up for. [The government] felt like they could take advantage of the fact that no one would ever not go in or not look after their patients … so the whole narrative about the bravery – we weren’t brave. We didn’t do it with any particular consent or decision-making. We were just put in that position because of the career we’ve chosen, because we’re in a caring profession, because we would never let someone deteriorate and die if we could do something about it.”
She found the weekly clap for the NHS a performative, futile gesture. “It meant nothing,” she says. “It felt like it was a way to pretend that you were doing something, without actually having to do anything concrete. It felt like someone rewearing last year’s poppy. It was symbolic just for the person doing that, but it didn’t actually mean anything for the person who was on the receiving end.”
What stands out from reading Everything Is True is how flattening the portrayal of NHS staff as heroic, willing lambs to the slaughter truly is. Farooki writes about how some doctors faked illness to avoid working on the most dangerous wards, and others contemplated leaving the profession entirely. A continual theme is the doctors’ anger at being forced to work for weeks without a day off, while their managers protect their own leave. “There was a point where it just felt that we were relentlessly being told that it had to be all hands on deck, and there wasn’t really informed consent about it,” she says. Farooki remembers one particularly strung-out colleague. “She said: ‘I didn’t even want to come in today. I just wanted to resign.’ There was this sense of unbearable fatigue.”
She is also unflinching when it comes to documenting the strain Covid puts on her relationship. “Your children’s father is scared of you … He barks: ‘You’re putting our lives at risk,’” she writes. She recounts how Kiron told her that she thought they should separate, before she died. Are they still married? “We’re still together,” she says. “We have our four children. And I will say this: it was a very, very difficult time for everyone … we’ve all had times where relationships were absolutely pushed to breaking point, going through all of this.”
Everything Is True is at its most affecting when Farooki writes about the patients she couldn’t save. Not all of them died of Covid; she is at pains to emphasise the hidden victims of the pandemic, from the person who wasn’t able to be assessed for a life-saving liver transplant to the elderly woman who stayed away from hospital for fear of burdening the NHS, until it was too late for doctors to save her. “This is how Covid was taking people from us, because of not being able to provide them the care they needed,” Farooki says.
Farooki describes herself as “not generally political”, though she expresses frustration at the mishandling of the pandemic and the government’s sluggish response to unfolding events in Italy and China. “It’s a story of poor communication and mismanagement,” she says, “and the people who did actually have information, not doing enough and not doing it in a timely way.” She is alarmed by the fact that, more than a year on, it does not appear that politicians have learned their lesson. “There are still learnings that are not being put into action,” Farooki says. “We are still not learning about how to communicate the risk, how to effectively care for each other, about something even as straightforward as acknowledging the increased risk to people of BAME origin.”
Although Farooki spent most of the first wave of the pandemic in a haze of exhaustion and overwork, one news story did cut through: that of Boris Johnson’s admission to intensive care. “I don’t want to criticise whatever decision the physicians in charge of his care made … but in my very limited experience of working in ITU, you would not have taken that bed from someone if it was just for oxygen,” she says. “You can provide that in most wards in the hospital. I felt that it was another example of something feeling unfair, I think. Of there being one rule for them and another rule for us.”
She wrote Everything Is True in the sincere belief that, by the time it was published, the pandemic would have receded from UK shores. Nearly two years on, that seems like a touchingly naive hope. “It’s quite hard to think about,” says Farooki. “But it’s not really over. I still have colleagues literally a few days ago who are PCR positive. My daughter was PCR positive. There are new variants. You don’t know whether it will ever actually be over. So we live still with the possibility of death.”