Learning to clap: A post-COVID19 recovery story

They clapped me out of the Intensive Care Unit (ICU). I was too weak to return the applause. At 8 pm the following Thursday, the #clapforcarers roar accentuated my hope of recovery. I tried to clap along, but the inability and incoordination were prophetic for the struggles I faced trying to navigate my ongoing recovery from critical illness. I found out my constellation of symptoms were post-intensive care syndrome. ¹ There was no care plan from the ICU nor the GP – the right and left hands failed to coordinate, and clapping was not achieved. I was freed from the healthcare institution, only to be left in the barren wilderness of fragmented care and the desert of lockdown.

When I made first contact with my GP, I told her I thought I was losing my sanity. I cried over the phone.

“I’ll send you a link for psychological support that you can refer yourself to,” she said.

“I’m unable to navigate websites,” I replied.

“That’s the only service we have to offer. Let’s catch up again in a month.”

“Will you call me?”

“No. You will have to go online to book an appointment.”

“I can’t even remember appointments.”

“Why don’t you put it in your diary? You can then request a consult via AskMyGP app.”

“Another app?!?”

I felt like I was left to navigate my own care pathway. When the ICU follow-up team called four months after my discharge, I was frustrated about slow progress and angry about the lack of communication. They set me up with physiotherapy, occupational therapy services, and a support network. All were instrumental in my recovery, but not consistently funded. ² The hundreds of thousands of pounds spent keeping me and other patients alive seemed to suddenly disappear in a sick, twisted interpretation of the popular theatrical adage, “always leave them wanting more.”

The ICUSteps support group I initially attended was out of region. So, I set up the Greater Manchester ICU support group. It soon became clear that many others also experienced similarly fragmented care. Nationally, this results in further hospital re-admissions, increased costs, and exacerbation of health inequalities. ³

After nearly 3 years, my physical weakness has reduced. The post-traumatic flashbacks took months to improve. Fatigue is a daily challenge, but muscle strength was only part of the equation. Clapping is more than putting hands together. The cerebral cortex, initiating the instruction, communicates with the cerebellum. Perfectly timed neural impulses travel to several muscle groups. The resultant sounds created by the hands land back onto the eardrums, which carry information to the brain. Rhythm, volume, and timbre are tweaked accordingly. Exquisitely intricate mechanisms for a seemingly simple skill.

I can now clap but could have done with far better joined-up care. The Integrated Care Systems put into place by the Health and Care Act 2022 is our chance to learn to clap as survivors and healthcare practitioners. ⁴ Let’s support each other, make the connections, and do it together.