ACOG Menu

ACOG Frontline Voices |

Surviving a Viral Pandemic

Advertisement
 

This story is a mea culpa. I stumbled blindly into COVID-19. As a physician, I should have known better. 

Early on, many did not yet appreciate the seriousness of the COVID-19 pandemic. Like many, I acted without caution and put myself, my family, and others around me in danger.   

Albert Einstein opined: “Two things are infinite: the universe and human stupidity; and I’m not sure about the universe.” Surviving the COVID-19 pandemic is going to require far more intelligence and personal responsibility than I initially showed. I hope Albert is wrong and that our passionately independent society can grow up and learn the importance of the other, rather than the self.

I love college basketball, which can be a challenge when you’re an alumnus of Seton Hall University. In 2020, the Pirates were on top of the Big East and in the top 10 nationally. The faithful believed that maybe, just maybe, “next year” had finally arrived. My wife Diane, my daughter Sarah, and I purchased prime Big East Tournament tickets. While packing for our flight on March 11, Diane asked if traveling to New York was still a good idea. I brushed off her legitimate concerns dismissively, saying, “We can wear face masks if you really want to, but nothing in New York is shut down.” That was true, at least for a couple more days. 

That night, we went to see St. John’s and Georgetown play. Our section was full of St. John’s fans who can recognize an underachieving team when they see one. With six minutes to play, the Johnnies inexplicably shook off their mediocrity and closed the game with a 23-to-0 run. High fives were exchanged, beers sloshed, and hugs given as I became swept up in the St. John’s comeback. 

That was the night the dominoes started to fall. The next morning the Big East Tournament was canceled due to COVID-19 and we returned to Charleston dejected. Late Sunday night, March 15, I awoke with rigors and a temperature of 103.5 degrees Fahrenheit. 

I was already feeling much better by Thursday, when my culture returned positive. Maybe COVID-19 was no big, bad boogeyman after all, I thought. Then Sarah got sick on Friday and Diane the following Sunday. Thankfully, both Sarah and Diane had mild cases. Had anything serious happened to either of them due to my own selfish choices, the guilt and pain would have been relentless and life altering.

Each morning, I awoke anticipating that COVID-19 would finish its run. I charcoal marked my cell wall counting off the days. In the second week, a throbbing headache, diarrhea, and crippling myalgias signaled my relapse. I lost my appetite and sense of smell and taste. Grape-flavored Gatorade tasted like dishwater. My pulse oximeter drifted down each day. I didn’t feel hypoxic, but couldn’t figure out why my iPhone kept turning two-line emails into gibberish. On Friday of week two, my pulse oximeter fell below 90% and my respiratory rate was 34. The jig was up. My bags were packed, and we were off to the hospital. 

We were directed to a drive-through tent for COVID-19 positive patients in the parking lot beside the emergency room. Surprisingly, the nurse manning the COVID-19 tent was not wearing any personal protective gear. I often wonder what became of her. Any notion of a lark was dismissed when Diane and Sarah were told they couldn’t follow me into the hospital. I spent Friday evening in the E.R. behind a locked door with a pulse oximeter on my finger. 

That night, I was finally moved to a negative pressure room on the seventh floor. Nasal oxygen was started and my oxygenation improved to 94%. An exhausted nurse did my intake between midnight and 2 a.m. 

On Saturday morning, I met two new and important people. The first was the director of the new COVID-19 Unit. 

Despite increasing my oxygen overnight, my oxygenation had fallen to 87–88%. My doctor informed me that intubation was going to be necessary and I saw a tear roll down her plastic-shielded cheek. With only a one in five chance of the tube being removed before autopsy, that announcement ranked up there with being told your family couldn’t come into the ER.   

Then, I met my other new friend. My nurse, who had decided to give her middle finger to the COVID-19 virus, wearing blue scrubs with a sheer cap worn like a French beret and a paper surgical mask dangling from one ear on a tiny rubber band. 

She interjected, “He doesn’t seem so bad to me. Sometimes pulse oximeters placed in the E.R. aren’t worth a damn.” She unwrapped the tape around my fingertip and replaced the pulse oximeter on my earlobe. My oxygenation immediately rose to 93%. Her work done, she dropped the microphone, and Elvis left the building. It was the best moment of my weekend. 

My doctor was as relieved as I was. Intubating her first COVID-19 patient, especially a faculty member, was not high on her wish list. I called home and told Diane and Sarah about my brush with intubation. 

I was awakened from sleep sometime between 10 and 11 p.m. Saturday night by the COVID-19 unit director. She excitedly told me that the actual COVID-19 unit was now complete, and they’d like to move me down. Tired, comfortable, and fearful of another two-hour intake, I indicated a preference to move in the morning. This reluctance spurred a series of calls from hospital administrators insisting I move immediately. After a heated exchange with Diane and Sarah, the powers that be tapped out, but petulantly added that I’d be transferred at 6 a.m. Knowing that the night shift knocked off at 7 a.m. I figured there was no way I’d move before checkout. As expected, the nurses came for me a little after 8 a.m. the next morning. We were going to 5-Center. 

A little backstory is necessary. Just a month earlier, we had opened the brand-new Pearl Tourville Women’s and Children’s Hospital, a beautiful, glass-enclosed gem overlooking the Ashley River. The fifth floor had been the previous home of women’s services and my home for more than two decades. It was now in backfill mode. As we rolled down to the fifth floor, I got to see what that means. The hallways were dark and ominous. Flickering florescent lights hung sideways on frayed cords and the halls were cluttered with broken equipment and trash bins filled with debris. 

The 5-Center had been an intermediate neonatal nursery with rows of bassinets behind sliding glass doors. Now there were empty beds with ventilators on each side of a small nursing station—three for male COVID-19 patients to the right and three for female COVID-19 patients on the left. I had my choice. 

I got daily reassuring virtual visits from my pulmonary and infectious disease consultants. Pulmonary said my viral pneumonitis was mild and that I was holding my own with oxygen saturation. Infectious disease called me a classic case of cytokine storm and that my inflammatory markers were off the charts. He was putting me on his refrigerator.

Sunday morning brought a few changes that broke the boredom. First, I got a roomie. He was a post-op surgical patient who was in bad shape. His post-operative pain medicine had been cut back because of breathing problems. Our eyes met, but we never spoke to each other. 

The second new event on Sunday was one I’d been dreading. A unique feature of neonatal care is the lack of any requirement for adult bathrooms or call bells. They gave me a urinal, but that was insufficient for all needs. No one was around so I decided to go down the hall to the former obstetrics and gynecology call rooms. I didn’t get far, however, because the sliding glass doors were locked. A slight sense of panic arrived. 

Thankfully, my nurse arrived a few minutes later with something I’d never seen before. It looked like IKEA’s worst idea ever. It was a wobbly, rolling structure on small plastic wheels, constructed from crisscrossed erector set pieces of metal. On top there was a sheet of aluminum with a lasered oval void. She spread a sky-blue plastic trash bag over the oval void. With a “Ta-Da” flourish, she presented my throne and exited, leaving me to the most surreal moment of my weekend. I thought this might be a test of my will to live. 

My doctor visited and told me about a planned walking test on Monday. If I maintained my oxygen saturation on room air, I could go home. I spent the rest of Sunday studying for my walking test and let Diane and Sarah know I might get discharged. Late Sunday night when everyone was gone, I disconnected my oxygen and walked around the empty unit. My pulse oximeter held steady. 

Monday morning, I passed my walking test and the staff began to ponder a new conundrum: how to get a COVID-19 patient out of the hospital. The exit strategy involved taking me through the dark, deserted labor and delivery unit to a back elevator down to a side-street with loading docks and trash dumpsters. Ironically, the street had been named for a former professor, Albert Sabin, who’d invented the oral polio vaccine. Diane and Sarah were waiting. 

The quiet weekend in the COVID-19 unit forces you to consider your own mortality. The old saying about brushes with death are true. The list of things I would miss was short. At the top was the love of my wife and the delight of watching my children’s success. I thought of my brothers and sister and old friends that I don’t see or talk to enough. I thought about Ireland, Paris, Yosemite, San Francisco and all the other beautiful and fascinating places I’ve seen in my life and would like to see again. I listened to a Springsteen playlist for strength and hoped to see another concert. Surprisingly, I didn’t think once about the next cesarean or vaginal delivery I might never do again.   

I also reflected on what I had done. My choice to go to the Big East Tournament might have killed Diane and Sarah or others. I’m stupefied by arguments on television over bar closures and mandatory masks. Everyone knows that these things mitigate the spread of COVID-19. It is a virus that can hospitalize or kill you, your family, or your friends. I didn’t give it the respect it deserved and it bit both me and my family. No one should want to experience this or be the person responsible for putting family or friends in harm’s way. If that isn’t a true statement, then I fear we face an even more dangerous pandemic than COVID-19.


Dr. Roger Newman is an obstetrician-gynecologist, professor of both Obstetrics and Gynecology and Maternal-Fetal Medicine, and the Maas Endowed Chair of Reproductive Sciences at Medical University of South Carolina in Charleston, SC.

 

Disclaimer: The thoughts and opinions in the Frontline Voices initiative reflect experiences of individual ACOG members and do not represent official organizational opinions of ACOG.