Dr Rahul Mukherjee, who grew up in Kolkata, India, and arrived in the UK in 1994, works as a Consultant with Birmingham Heartlands Hospital in their Department of Respiratory Medicine & Physiology. He is a Consultant Physician and an Honorary Senior Clinical Lecturer at University Hospital Birmingham NHS Foundation Trust. He is also an examiner for MBChB at the same University and an examiner for the MRCP at the Royal College of Physicians of London and Edinburgh.
Here’s our interview with Dr Mukherjee, as the second wave of coronavirus becomes imminent.
- What inspired you to become a doctor?
My mother's inspiration, kindness towards the poor sick people that I saw during childhood and generally my love of sciences. She encouraged me to study medicine like many Indian mothers, but wasn't directly involved with any public or social work, though she inspired me to do so. I provided charitable services in free clinics in slum areas and food relief camps for five years after qualifying as a doctor in Kolkata, before I came to England.
- Why did you decide to specialise in Respiratory Medicine?
The speciality of Respiratory Medicine gives a variety and has sufficient amount of challenge in it. The overlap with critical care and the ability to help very sick people has always interested me.
- Do you think institutional racism exist in Britain, especially in NHS/your field and have you been a victim?
The racism is very subtle and mainly structural. I have been lucky not to face direct racism or abuse like in many parts of the world including pockets in the UK but there are subtle problems in career progression where a BAME person has to put in much more effort to achieve the same amount. In fact, the system now recognises it and the NHS has introduced the Workforce Race Equality Standards (WRES) which each NHS Trust has to meet. That is the best way forward to address structural racism.
- As a BAME doctor, you have suffered from Covid-19 and gone back to the job to cure others. Do you think relapses could be fatal to those who have had it before?
We don't know specifically about the fatality of relapses but have become a lot more cautious. We are now getting good supplies of PPE and hospitals have become a lot more careful. We have restricted the amount of footfall on the hospital sites by various means, like converting the bulk of follow up outpatient appointments to virtual consultations, having much stricter infection control measures for face to face appointments and increasing the ventilation in rooms with aerosol generating procedures.
- It has been found that people who recovered from Covid-19 show respiratory complications/distress later. There is also the effect of long-term ventilation on patients. What is the prognosis? How do patients avoid these effects or recover from these long-term effects?
It is too early to talk about prognosis of post-Covid lung disease. We are following up everyone hospitalised with Covid. If people feel breathless post-Covid at home, they are being advised to immediately contact their GP. We are checking oxygen saturations and chest radiographs (x-rays) on everyone coming to post-Covid clinics. If people complain of any breathlessness post-Covid, we assess them by walking them with continuous pulse oximetry and look for desaturation. Also, we do breathing tests to look for any damage to the breathing function.
- There are many people who have no idea they have existing comorbidities like heart or lung disease, because they have no physical manifestations. Now they live in fear that a second wave could be lethal for them. What is your advice for them?
Obesity is major risk factor in Covid deaths. People may not know about diabetes and high blood pressure unless checked but they do know if they are obese. The general advice would be to maintain good levels of exercise, aim for a healthy body weight and take 7 helpings (80g portions) of fresh fruit and vegetables per day.
- Do you think a 100% prevention through a vaccine is possible?
Very unlikely to have 100% protection from a virus like SARS CoV2 (the virus that causes Covid-19).
- Do you believe Obesity and Vitamin D deficiency are major reasons for Asians to be affected disproportionately?
Yes. Lack of fresh fruits and vegetables in daily diet can also be a contributing factor and there may be other factors (genetic factors like gene polymorphisms) which we don't yet know about.
- In India the recovery rates are higher, with same multigenerational households and genetic and health compositions, then why has the recovery not been the same for South Asians/Indians in this country?
There is no reliable data to give a scientific opinion on this. We have to remember that the same virus can behave differently under different environmental conditions (example: average temperature, humidity etc).
- The European commission has licensed a new, potentially life-saving drug to treat Cystic Fibrosis (CF), meaning it will be available on the NHS to many who have the condition. Do you think this otherwise non curable condition is now curable?
The new targeted therapies in CF are revolutionary in terms of changing the patient's lives. The cost is another matter. "Cure" is a word mainly used outside of healthcare but yes, the disease can be controlled to such an extent in childhood that the progression of damage is effectively stopped and in general people born with CF can lead a relatively disease-free life with minimal or no treatment.
