TO COMPETE AS a college athlete, you need talent, determination, and a willingness to drive your body and mind to the edge. After the competition is over, beyond the playing fields and arenas where the games and the races and the wins and losses are tallied, lie the challenges that will transform those athletes into doctors, nurses, scientists, researchers, public health leaders -- professions often requiring long hours of pushing the mind and spirit beyond perceived limits.
For the past six months, some of these former student-athletes have been on the front lines battling the coronavirus pandemic. While much of the country is doing everything it can to avoid COVID-19, these people seek it out, risking their own health and safety and the well-being of their families and friends in the pursuit of helping those who are sick.
We knew them as football players, volleyball players, track stars; now, they are pulmonary specialists. ER nurses, hospital psychologists, researchers working on a potential vaccine. They hate the term "hero." It carries such a weight. They look at this as their job, their career and the result of the foundation of courage they began building as athletes years ago. No one planned to be on the front lines fighting a deadly virus. Yet here they are.
These are the stories of a handful of people who once played and now serve.
Dr. Michelle Tom
Occupation: Family medicine, Winslow Indian Health Care Center, Little Colorado Medical Center (Winslow, Arizona)
College career: Basketball, Arizona State (1995-99)
When I left my home on the Navajo Nation to play basketball at Phoenix College and then Arizona State, I had one dream in life: to return to my Diné, my people, to comfort and protect them as a doctor.
I realized my dream nearly a year ago, when I completed my medical training residency and returned to Winslow Indian Health Care Center and Little Colorado Medical Center, both located in Winslow, Arizona. I could have never imagined how soon my education, skills and faith would be put to the test by the coronavirus pandemic.
Starting as a child, I was always taught that community comes first, even before yourself. I think that's the beautiful thing about being a doctor: the true essence of being a physician is trying to heal others. My goal was to learn as much as I could and train as hard as I could to improve the relationship between the doctor and patient, and provide the best possible care to the Navajo people. For that, it's rewarding and amazing. I wouldn't want to practice medicine anywhere else.
Working at a hospital near the Navajo Nation comes with many challenges, even before the COVID-19 pandemic. The Navajo Nation covers 17 million acres of territory in Arizona, New Mexico and Utah. There are roughly 170,000 people living here, with only six inpatient medical centers on or near tribal land to serve them. Because of social and economic inequalities, many of my people are plagued by diabetes, obesity, and heart and lung disease, all of which make them highly susceptible to COVID-19.
Our medical facilities on the reservation are many times understaffed and underfunded. The hospital where I work, which is a nonprofit, serves about 30,000 people. We have two ventilators and 25 beds, and no intensive care unit. When I'm on duty as the hospitalist, I manage the COVID and non-COVID patients. Every Sunday, I work a 24-hour on-call shift. Most times, I don't sleep, as there are new patients to admit to the hospital, transfer to higher care or manage on the floor.
We diagnosed the first COVID-19 case in the Navajo Nation on March 16. It was two days after I was able to procure multiple hazmat suits and 3M full respirator mask. At the peak of the outbreak, we sent patients to hospitals in Flagstaff, but when beds were full, we had to transfer them to Phoenix.
The coronavirus has taken a heavy toll on my people. As of June 17, there were 322 confirmed deaths among the 170,000 residents here. (The death toll of 177 per 100,000 residents is higher than that of any U.S. state.)
"[The pandemic] has hurt our elders. Our elders are the teachers and protectors of our culture, language and belief system. They paved the way for us. As young people, we have to do everything we can to protect them." Dr. Michelle Tom
It's difficult for the Navajo to self-isolate because we live in multigenerational homes, with most homes having an elderly parent or grandparent. There are only 13 grocery stores on tribal land. Many people have to travel for hours to buy food and essential supplies. About 40% of the homes lack running water, which makes washing your hands difficult.
As a Diné and as a physician, this is the hardest time of my life because the toll of this pandemic has hit every part of my people. It has hurt our elders. Our elders are the teachers and protectors of our culture, language and belief system. They paved the way for us. As young people, we have to do everything we can to protect them. They are the key to who we are as a people. It's emotionally and physically draining to see them suffer. It's a spiritual heaviness I have never really felt before.
My strength and renewal each day comes from finding the strength that my ancestors had. They had to survive the Long Walk, smallpox and other forms of systemic genocide. They sacrificed so much for me, and because of them I was able to become a doctor.
The Navajo Nation is my home. It encompasses family, land, culture and language. Being one of the very few Navajo doctors on the reservation and being able to speak Navajo to my patients has been everything I dreamed of. My ultimate goal was coming home and helping my people. I hope I have made my ancestors and people proud even if it's in the slightest degree.
-- as told to Mark Schlabach
Dr. Ryan Padgett
Occupation: Emergency medicine, EvergreenHealth, Kirkland, Washington
College career: Football, Northwestern (1992-95)
When I played football at Northwestern in the 1990s, we won eight games in my first three seasons [combined]. Despite our struggles, we had faith in coach Gary Barnett, a belief without evidence. What that teaches you is that if you believe and trust that everything is going to be all right, and if you put your nose down and work hard, eventually you will get there.
When I started at Northwestern, Coach Barnett famously said, "I'm going to take the Purple to Pasadena." He proclaimed that with a microphone at a basketball game, walked off the court and muttered, "What did I just say?" Four years later, Northwestern won a Big Ten title and went nose to nose with USC in the 1996 Rose Bowl. Sometimes, just having faith and good people around you is key. Our success at Northwestern was the ultimate story of teamwork. We had only two players go to the NFL. Clearly, the sum of our team was far greater than its parts.
Having strong teammates around you is so important, and I learned that again in early March, when I became one of the first emergency physicians in the U.S. diagnosed with COVID-19. I spent 17 days in a medically induced coma, and doctors say I was 24 to 48 hours from death. I would not have survived without the tremendous care of a team of doctors and nurses at two hospitals in Washington. From my caregiving team to my friends and family, every prayer and each well-wish was important in me being here today.
The fact I am still here today, living and breathing, is a team victory.
Back in late February, I was working in the emergency department at EvergreenHealth in Kirkland, Washington. We started to see a group of elderly patients coming in, quite a few in number, and they were very sick. We got the first positive COVID-19 test back on Feb. 29, and we then knew everything had changed. We went from having only heard the name coronavirus to turning half of the ER into an isolation unit and donning our spacesuit-like personal protective equipment gear (PPE) to take care of patients. It was a stressful, scary time because we didn't know exactly what we were dealing with.
I fell ill about a week after the first positive test. At first, I had only minor symptoms like a headache and muscle aches, which wasn't typical for me but nothing that raised a red flag. Then it was the more traditional symptoms of a fever and cough; but I started to really worry when I soon started feeling short of breath.
One of my physician partners at EvergreenHealth called my fiancée and said, "You know, Ryan wasn't looking very well. Why don't you buy one of these oxygen monitors because we don't know which direction he's going to go." She was religious about it. I wasn't too concerned and didn't think I was that sick, but then we started seeing pretty consistent numbers in the 80% oxygen range, which is definitely territory where you don't want to be.
Within about eight to 10 hours, I was in the ICU on a ventilator. I remember them asking me if I wanted to say my goodbyes as they were admitting me to the hospital. Everything after that, unfortunately, is a blur. I know what happened from what other people have told me, but I only remember leaving the ER and waking up 18 days later in a different hospital. When I went to the ICU, a doctor told my fiancée that I was going to be in the hospital for two or three months and then maybe to a nursing home. She canceled our wedding scheduled for mid-May.
We knew to a certain extent that our immune system can just turn on and not turn off when our bodies are fighting COVID-19. The virus itself is significant, but in my case, as an otherwise healthy, robust ex-offensive lineman, what cut me down was that my immune system just caught fire. I suffered from an inflammatory reaction that filled my lungs with fluid and scarred them. My heart function was about a third of what it normally was, and my blood pressure was dangerously low. My kidneys and liver were failing, and I was on dialysis. It is ironic that my body's natural response to infection was what was trying to kill me.
My doctors tried a few different medications, but I was still circling the drain. In mid-March, my doctors transferred me to Swedish Medical Center in Seattle. Doctors there put me on a heart-lung machine because, even with the breathing tube and ventilator at the maximum setting, I could not get the proper levels of oxygen. Going on that heart/lung machine gave my body a rest. Another drug essentially turned off my immune system. We think that is where the turnaround occurred, and why I'm here today.
When doctors removed the breathing tube and I started waking up on March 27, I looked around and realized I wasn't in my hospital. I have been a physician at EvergreenHealth for 16 years. I looked out the window and didn't recognize anything. My body looked different, and I had a feeding tube and central line in me. I was still on a huge amount of medicine, so it was a slow understanding of the new reality. About every 12 hours or so, someone came in and explained to me what had happened. My eyes got big as I realized 17 days had passed me by. I was a happy man to wake up.
I left the hospital on April 5, and I was married two weeks later. I'm definitely a thankful man. This was a team win. It was a group of people that just refused to say "We're done" and pull the plug. I'm forever grateful to them. Slowly, my life is returning to normal. I completed physical therapy and some occupational therapy because your body forgets how to do certain things when you've been asleep for 17 days. My heart, lungs, kidneys and liver are making their way back, and I'm hoping to get back on the giving end of healing in the next month or so.
I can't wait to be shoulder to shoulder with my colleagues again because they've been fighting a hard fight. I know it's tough for them to go in every day, leaving their families behind and putting themselves in danger, realizing what happened to me could happen to them. We know older folks are at risk for COVID-19, but when it happens to a colleague, that's an entirely different situation.
I'm looking forward to getting back into the fight. It's going to be a long, hard struggle, but there's only one thing to do, and that's to put my nose down and keep working hard. Eventually, we will defeat this together.
-- as told to Mark Schlabach
Dr. Yanique Levy
Occupation: Health psychology resident, Jackson Memorial Hospital (Miami)
College career: Track and field, University of the West Indies, Mona, Jamaica (2001-05)
Hero. It's a word we throw around all the time, especially during the pandemic. Nurses, doctors, EMTs, other medical personnel -- they are all heroes. I wear a Wonder Woman badge on my hospital uniform. It's a reminder that no matter what fears you have, you can find courage to fight through and persevere.
Before the pandemic, the majority of my health psychology residency focused on working with medical teams to assist with providing mental health support to patients. Some consults include individuals who experienced an amputation, trauma, cancer or a new diagnosis. We assess their ability to cope with their new reality and try to restore some of their confidence.
Recently, my work shifted to focus more on our medical teams. We began optional supportive meetings with nurses and staff on a COVID unit. This allowed nurses to talk about dealing with this pandemic on the front lines. The first meeting, I didn't know how many would show up, and the entire group came. I was shocked. Nothing I heard that day surprised me. They are tired and scared, and they feel isolated and expressed concern that they are outcasts, that people are staring at them. Yet they find courage. It's a tough situation.
"[Medical personnel] are seeing death and awful hardship almost every day, but there is this expectation that they are like robots. But they're not. They're human. They feel. They think. They process. And they know they are vulnerable." Yanique Levy
There was one thing that came up and stuck with me, the word "hero." Or, in this case, "superhero." For a lot of the medical personnel, it can almost be burdensome in a way. Some said it set up this expectation that they were invincible, that they couldn't catch the disease or couldn't be upset about it.
These people are seeing death and awful hardship almost every day, but there is this expectation that they are like robots. But they're not. They're human. They feel. They think. They process. And they know they are vulnerable.
They asked themselves: Is that how a superhero is supposed to feel? We talked about it, and the answer is absolutely. We validate those feelings and reframe them for our medical workers. If you fall down, mentally or emotionally, we will be there to help you get back up. It's like I say, "Even Batman bleeds." It's a reminder that we are human and it's OK to feel scared and still find a way to rise above our fear. It's healthy to process this. You need that release; when you're ready, you get back in the fight with your team.
That is a hero.
-- as told to Wayne Drehs
Dr. Michelle Prickett
Occupation: Medical director of respiratory care, Northwestern Memorial Hospital (Chicago)
College career: Volleyball, University of Illinois at Chicago (1994-98)
We all knew it was coming. We just did not know when or what, exactly, it would look like. Talk about COVID-19 started in January. When the virus first hit Washington state, we began to talk about what might happen when it hit Chicago. We knew it by name, but we had no idea the opponent we were up against or the mental, physical and emotional toll the battle would take on all of us.
I've worked as a pulmonary and critical care doctor at Northwestern Memorial Hospital for more than a decade. The human lungs, respiratory infections, mechanical ventilators and intensive care are my focus nearly every single day. I love my work because of the fast pace and our ability to make an extremely sick person -- someone teetering on the edge of not coming back -- better.
If a patient is crashing, you use your skills to make a quick assessment, do something and find out right away if your instinct was right. If it works, you keep going with that angle; if it does not, you reassess and try something else. There isn't a lot of time. That routine is usually perfect for me. But COVID-19 has been an altogether different battle.
In late February, I remember seeing patients in my clinic whose symptoms were suggestive of the flu but they tested negative for influenza. I wondered if they had COVID, but we had no ability to test them at the time. Then, one day in March, I was working when we had our first three suspected cases at the hospital and were awaiting confirmation of results when patients started to hit the ICU. With our second COVID-positive patient, we debated whether to intubate early or wait. The patient had increasing oxygen requirements, but still looked good and breathing was not that labored. However, there are risks that come with putting someone on a ventilator if you wait too long. I had an upcoming meeting, so I told my fellow to prepare the team just in case. I would be back in a half hour.
When I came back, the anesthesia attending physician met me outside the room. This is a stoic, veteran clinician who was not easily shaken. I asked him how it went. He was blunt in his response: "This is so scary, nothing like I've seen before." And this is someone who doesn't get scared. The patient's oxygen levels had desaturated at a frighteningly quick pace. They intubated her immediately. And here I was worried it would be too soon.
That's the thing about COVID-19. Patients can go from having a fever and talking to you like everything is fine to complete respiratory failure in a matter of hours. And you stand there thinking to yourself, "I just talked to her." In the next instant, you worriedly say to yourself, "Am I next?"
That first week in March, we went from zero COVID-19 patients in our ICU to five in a matter of days. I tried not to panic, but deep down there was a realization that this was going to be huge. And then it just came in these massive waves, like drinking from a fire hose. I know my main priority is to protect myself and, more importantly, my staff. We need to be here to care for the patients, but seeing the devastation, we also don't want to bring this home to our families.
In the beginning, we were making decisions without a lot of concrete data and information. We went with what made sense based on physiology and the SARS and MERS data. But doing that without hard data and no systems yet in place to provide feedback was concerning. Medicine is based on historical observations, years of learning, repetition and feedback. All that goes by the wayside when facing a new disease. We try to stick with the basics and stay up to speed, but you wonder, "Am I doing the right thing?" There were a lot of sleepless nights, my mind racing as I huddled in my basement and stayed away from my family.
Northwestern is normally a busy hospital. Pre-COVID, we would have an average of 35 patients in the medical ICU under our care. At our peak in April, we had closer to 90 patients in the ICU, and about 65 of those were related to COVID-19. By mid-June, we were down to around 65 total patients. It's not untenable, but it's far from being back to normal. It is a prolonged, enduring course with no clear finish line in sight.
That day in early March when we got our first confirmed case feels like both yesterday and several years ago. What we thought we knew then was different than what we thought in April, and that's different from what we think today. A lot of medicine has the mentality of, "This is what we've always done." But that doesn't work with a novel coronavirus.
The March patients had a similar pattern. Fevers, with no other reason for having it. Shortness of breath. Low oxygen level. You knew they likely had COVID-19 even before the much-delayed test result came back. Then, we started testing more, and we would see patients test positive despite having mild-to-no fever and seemed totally fine despite lower oxygen levels. Two different personas to the same virus and thus no one-size-fits-all approach.
Treating respiratory failure is not an uncommon thing. It's what we deal with every day. We've always had patients who required prolonged intubation and ventilation, maybe one out of every three of our patients. But most of those already had medical issues. This is very different. Patients come in healthy and then some just deteriorate before your eyes. They're sick for about three weeks, and it's a rocky, rocky three weeks. Then, all of a sudden, they can be relatively healthy again. And those are the lucky ones.
Death is not foreign to me or anyone in medicine. We deal with it all the time. What is different this time is we are dealing with it alone. The ICU staff are the only ones bearing witness to the end of our patients' lives. Now, the staff is doing it with family or friends over a phone or FaceTime because they can't come in the hospital due to infection concerns. It is heartbreaking yet now the new norm.
I've always believed no one should ever die alone. Someone has to be at the bedside, and that takes an emotional toll. The patient is usually someone you've seen run the course of this virus; by then, everyone in the ICU knows them. We've taken care of them. We've called the family with updates every day. They're almost like family members. And so, when it comes down to the end of a life, we just try to have someone there, as a surrogate in a way.
We are human beings. We try to lean on each other and look for the positives. Since testing has been more prevalent, I've moved out of my self-imposed quarantine in the basement (named the "mom cave" by my family). We're still super-careful with our three boys, but I've rejoined the family and look forward to group mealtimes. I have wonderful co-workers, and we get together and have a virtual happy hour and talk about everything.
As a lifelong North Sider, I'm a big Chicago Cubs fan, and we live near Wrigley Field. Appropriately, our dog is named Addison, and my husband's name is Clark, for good measure. I take my dog for walks around the ballpark as an outlet. However, the area is unnervingly quiet this summer. Just one more sign that things are a long way from getting back to normal.
Every one of us is humbled. There are no world-renowned experts on COVID-19 with years of personal experience to lean on. Nobody even knew what it was six months ago. You have to be agile and understand you may only know part of the picture. If you try something you thought was the right thing to do and then it wasn't, that's OK. Then you look at what you should do now. You want outside-the-box thinking and adaptability, but also to continue the dedication to previously established care measures with thoughtfulness and reflective consideration. Assess, reconfigure and reengage; the patient is counting on you.
"I love team sports and always knew the importance of teamwork, but this takes it to a whole new level as we work to reach a common goal against COVID-19." Dr. Michelle Prickett
And then I try to think: When we emerge on the other side of COVID-19, what innovations are going to come out of this? How are we going to be better? It's horrible and tragic and emotional and incredibly taxing, but what is the bright side? Telemedicine. Remote ventilators. A far greater sense of teamwork and empathy from the medical staff. And so much more we don't even know yet.
For me, there are two big lessons to come out of this experience. One is the importance of teamwork and everyone working together. Everyone thinks of the doctors and nurses, but it's also respiratory therapists, physical therapists, dietitians, social workers, engineers and environmental services, to name a few. I love team sports and always knew the importance of teamwork, but this takes it to a whole new level as we work to reach a common goal against COVID-19.
The second lesson is to never give up. That's how it was when I played in college, and that's how you have to be with this virus. Sometimes you look at the patients and you think, "Oh, my god, I can't imagine them getting through this." You prepare yourself for the worst. But then you know what? They come through. They win. You watch them walk out of the hospital and back to their lives. And that's when you're reminded to always dig in and fight for them to the very end.
-- as told to Wayne Drehs
Dr. Louis Falo
Occupation: Professor and chairman, Dermatology, University of Pittsburgh School of Medicine; co-inventor of the PittCoVacc vaccine
Athletic career: Three-sport athlete at Greensburg Central Catholic High School in Pennsylvania
We are working nonstop. It's a continuous effort; it's 24/7. A lot of people in this country would like to be back to work, and we're working to help them get there.
It's exciting and nerve-wracking at the same time. Every day is a surprise because you never know how the next experiment is going to work out. You could randomly run into a wall some afternoon when you get a result back that you weren't expecting and it delays you for a week. You're kind of always on the edge of your seat.
There are over 100 vaccines in various forms of development right now. That is a good thing because the more you have in development, the more likely it is you're going to find one, two, three or four vaccines that actually work. And that's what we want at the end of the day -- we want something that works. We are also collaborating a lot. We're exchanging the information. It seems like it's a race, a competition between vaccine makers, but it's actually more of a race against the virus.
Everyone wants to get back to normal and be able to do the things we used to be able to do without worrying about getting sick. So everybody's working together.
I'm a dermatologist and a skin immunologist. I've been studying how the skin works for over 20 years, and part of that is looking at the skin as a good place to target vaccines.
The idea behind PittCoVacc is to deliver the SARS virus target to the skin, which is very good at making immune responses. So we view the skin as an ideal target for vaccines because, over time, the skin has evolved important mechanisms to defend the body against invaders. If you think about it, your skin is your first line of defense. You're being attacked every day by various bacteria, viruses, fungus, etc., and you don't even know it because your skin does a great job of fending off all those attackers.
Our idea was to use a delivery strategy that would allow us to deliver the SARS target, the S1 protein in particular, directly into the skin. To accomplish that, we used something that essentially looks like a Band-Aid. On the surface of the patch are hundreds of small microneedles made out of sugar. So they're about the width of a human hair and a little less than a half of a millimeter in length. That gives you an idea of how small they really are. We use sugar because it's a safe substance that dissolves quickly when it enters the skin.
The advantages are that there is no pain at all in this process, so you're not using what we traditionally think of as a needle. It actually feels a little like Velcro. There's no bleeding, and because the antigen is incorporated into this solid matrix, it's very stable at room temperature. They can be stored and shipped at room temperature, and that makes it very useful, particularly for underdeveloped countries and global vaccination campaigns.
This is the fastest I've ever seen a vaccine in development. It's very hard to say when a vaccine will be available to everyone because we don't know if some of these leading candidates are going to be effective. We are likely going to start getting answers as we get into next spring. We may find out sooner if everything goes right for one of these vaccines. There's never been an effort like this where everyone is working together, from the level of individual labs to academic groups to large pharmaceutical companies in the U.S. and across the globe.
Our team is made up of a very diverse group of scientists from all different backgrounds and stages of career development. The age range is probably from 23 to 60. The group gets along well. There really is a feeling of camaraderie, and I think we are enjoying the quest.
-- as told to Elizabeth Merrill
Dr. Naima Stennett
Occupation: Third-year resident, family medicine, Jackson Memorial Hospital (Miami)
College career: Volleyball, North Carolina Central University (2006-10)
As an athlete, you prepare to help out with whatever your team needs. As a doctor fighting a pandemic, it's no different.
I'm a third-year resident in family medicine in South Florida. I spent most of my pre-pandemic life seeing patients in a clinic. Now those patient encounters are done through telemedicine visits through video, phone or email. In between telemedicine visits, I'm helping in a COVID-19 call center, answering questions from all over Florida about where people can get tested or what their symptoms might mean.
Last month, I volunteered with the Surveillance Program Assessing Risk and Knowledge of Coronavirus (SPARK-C), a collaboration with the University of Miami Leonard M. Miller School of Medicine and Miami-Dade County, to conduct random antibody tests in the community. It was myself, some medical school volunteers, a few research scientists and local firefighters. By the end of the day, covered in protective gear, we were drenched in sweat.
The test involved a small pinprick on the finger, and then a drop of blood falls into this device. A serology blood test identifies the presence of antibodies that would indicate if a person is positive or negative. The preliminary results showed about 6% of participants tested positive for COVID-19 antibodies. That might not seem like many, but it equates to around 165,000 Miami-Dade County residents. It shows the virus is far more prevalent in the community than the 10,000 positive cases that had shown up at the time through testing.
Just as important, more than half of the participants had no symptoms seven to 14 days prior to their screening. The thing that stuck with me was how important it was for people from these different backgrounds to come together to help the community. People were so appreciative. They kept saying, "Thank you." And you begin to realize: We're actually making a difference.
-- as told to Wayne Drehs
Dr. Ali Aserlind
Occupation: Third-year OB-GYN resident, Jackson Memorial Hospital (Miami)
College career: Swimming, University of Connecticut (2008-12)
When a mother goes into labor, emotions run high. There is excitement, fear, anxiety and, often, surprises. The pandemic has only amplified all that.
Each mother coming into labor and delivery is tested for COVID-19. For some, this is how they find out they have the coronavirus. There is shock, tears. Some insist the test is wrong. But, at one point during this pandemic, we had seven moms on our labor and delivery floor with COVID-19.
In the beginning, before universal testing, we didn't always know if a mother was COVID-positive. There were a couple of times we pushed for three, four hours with the patient screaming, crying and yelling as they do in labor, only to find out later the moms were COVID-positive. There was one case in particular where I know I didn't wear a mask. At first, I was distraught. I'm a new mom myself, and thinking about going home to my baby was scary. But I never had any symptoms or issues.
Now, when a mother tests positive, everything changes. She is put into a negative pressure room. The mom chooses one person to stay with her throughout her hospital visit, and that individual can't leave the delivery room for any reason until discharge. When the birthing process begins and the mother starts to push, we wear full PPE. It's quite a workout. Usually by the end we are drenched in sweat.
As soon as the baby is born, it is taken from the mother. They don't get those first few minutes together, that skin-to-skin bonding. Instead, the babies go to the Neonatal Intensive Care Unit, where they are tested for COVID and kept under close observation. It's sad and hard to see, but so far, all the COVID-positive mothers have given birth to healthy, COVID-negative babies.
The mother doesn't reunite with her newborn until discharge. Until then, their only connection is through a telemedicine system similar to FaceTime.
When I think about my transition from captain of the University of Connecticut swim team to this, I'm just so proud. There is this stigma that college athletes are stereotypically "dumb jocks," and that's not the case. You learn time management, teamwork, prioritization. Athletics teaches you to trust yourself, and no matter how hard classes or practices get, you made a commitment. This is the same scenario. When you take that oath to help patients, you vow to stand on the front lines and be a team player -- and that's exactly what I'm trying to do.
-- as told to Wayne Drehs
Dr. Barbie Gutshall
Occupation: Internal medicine, Avera St. Anthony's Hospital (O'Neill, Nebraska)
College career: Volleyball, Nebraska (1985-88)
O'Neill is a town of about 3,800. You see your patients at the grocery store and church, and sometimes when they pass away, you bake a cake for their funeral dinner. That's just life in a small town.
It was probably in early January when we first heard about the coronavirus. When it was so bad in Italy, we were trying to think ahead with our PPE. We were having people make cloth masks and gowns and scrub caps knowing it could come at any time.
We still haven't had any cases. It's stressful because you don't know when it will come. Initially, all the talk was about the surge, and we were very ready to be overwhelmed. That's what we were preparing for. Now it's been two months and we haven't had an active case that we're treating. We're thankful for that, but it's mentally exhausting to always be "on." You're always wearing your PPE, and people get a little lax and complacent. Wearing the gear is uncomfortable, it's hot, it fogs your glasses. When we haven't had a case here and it's been this long, it's really hard to maintain that degree of awareness and alertness that this could be it.
I feel like people are becoming more complacent in our community and not wearing masks at the grocery store and other public places. I don't know if they feel as if it's not coming or because the issue is becoming more politically charged. I'm concerned that if people don't wear masks we are going to have an asymptomatic exposure that hits a lot of people in our community. I've put up Facebook posts that say "Wear a mask" or "Mask it or casket." But it's kind of preaching to the choir.
My youngest daughter is going to be a senior in high school, and part of me thinks that if people all wore masks, maybe things would get back to normal sooner and maybe she'd be able to have a normal senior year. We don't know. We still don't have a way to get a rapid test done.
Our game plan is just to be ready so we can keep our community, particularly our elderly members, healthy. That's our goal. We have a large elderly population, and they are doing a good job of staying isolated. But it's taking a toll on them mentally; they can't see their kids and grandkids and friends, or even get together to play bingo or cards.
We're all doing telemedicine visits at nursing homes and long-term care facilities. I'd much rather be able to sit there and visit with them and examine them, but you have to weigh the risk versus the benefit.
There's also a degree of guilt. I see colleagues of mine, people really working hard and taking care of people across the country, and I feel guilty on a certain level that we're not able to help them out. I don't know ... it's just a strange sense of what you're doing. I shouldn't feel guilty about that. I don't think I'm alone. You just want to help. That's why I'm here.
-- as told to Elizabeth Merrill
Dr. Milt McColl
Occupation: Primary care physician, Santa Clara Valley Medical Center (San Jose, California)
College career, and beyond: Football, Stanford (1977-80), San Francisco 49ers (1981-87), Oakland Raiders (1988)
When we first started seeing patients back in February, we would ask, "Have you been to China? Have you been traveling? You have all the symptoms." We had heard a little bit about COVID-19, but we didn't really know. We didn't even have any testing capabilities. The first couple of patients, I don't even remember if I had a mask on. We weren't cavalier about it. We just didn't think it was here yet. We didn't realize it was probably in the community by then.
At that point, most of what we were doing as primary care providers was screening a lot of the patients over the phone. We basically closed our clinic down and started just having phone calls with patients. You can still develop a relationship. I am finding that I prefer to do it over video instead of the phone if I can.
It's really hard to practice medicine when you can't examine somebody in person. The benefit of physical diagnosis is you get to listen to people's hearts and put your hands on their belly and feel around. We can do a lot through lab tests and other stuff where we still get most of the information. If we really have to, we tell them to come in.
I realize that's part of my job. I am going to take my risks. I wash my hands a lot and all that. But I think my threshold is a lot lower than a lot of the patients. I realize every day I see any patient, that could be an exposure. You hope they don't have it. I take extra precautions. Some of the patients are more worried because they just don't want to take that risk at all. I had one patient the other day, I said, "Your potassium's really high. If your potassium goes too high, your heart could stop. That's really dangerous. I need you to go get a lab test."
He said, "Well, I'm afraid of COVID."
I said, "Don't be worried about COVID. Your heart may kill you before COVID kills you if you don't do it right." If you have a stroke or a heart attack, you better get to the hospital. You might worry about COVID, but you've got to worry about other things, too.
-- as told to Ivan Maisel
Dr. Chris Colasanti
Occupation: First-year orthopedic resident, NYU Langone Health; member of a proning team at NYC Health + Hospitals/Bellevue during the height of the COVID-19 crisis in New York City.
College career: Football, Penn State (2007-10)
"Proning" is the process of flipping a patient to lie on his or her stomach. Doctors discovered that in the most severe COVID-19 patients, proning can help get oxygen to lungs stressed by the virus. The movements must be accurate and synchronized since you are dealing with some intubated patients -- those who have a breathing tube inserted down the throat.
When you get fully dressed with your PPE, you are wearing an impervious gown, an N-95 mask, a face shield, and a bouffant [cap] on top. Wearing it makes you feel almost like a wrestler trying to cut weight, with the amount of sweating going on. I didn't weigh myself, but I should have. Every day, I was pretty much drenched from head to toe.
There were eight of us on the proning team at Bellevue. Each day we would prone around 20 to 25 people, flipping them at 10 a.m. and at 3 p.m. We broke up into two teams, four per team. Early on in the month, proning 20 to 25 patients would probably take us three and a half hours. Later on in the month, it was such a close-knit team, everybody working together, we would get done with each session in an hour and a half.
"To see you can dramatically change someone's life is an honor. It's so different from football, but at the same time, it's just as fulfilling." Chris Colasanti
Proning a patient, while it might sound simple, requires precision and great care. The people we were helping were intubated and very ill. Everybody on the proning team has their specific jobs to make sure we are maintaining the patient's health and safety as we take the necessary steps as quickly as possible.
We would use two flat sheets, one on top and one on bottom, and roll the patient tight -- essentially like a burrito. We would flip toward what side their [breathing] tube was facing. I would always be on the opposite side, tucking the sheet underneath the patient as we carefully turned them. The individual on the opposite side would be grabbing that rolled sheet so we could flip them over onto their belly or from their belly onto their back.
While we are still trying to understand how best to treat COVID patients, I believe proning did have a positive effect. You could see it on the monitor; patients' oxygen levels just picked up right away when we changed their position. In that sense, it was particularly rewarding.
When you're in the moment, both on the field and in the hospital, you're doing your job and you just want to do it as efficiently as possible. You don't really appreciate it until afterward, and you're thinking about how much effect you've had on patients. I had the pleasure of seeing a good percentage of our COVID-19 patients sent home. To see you can dramatically change someone's life is an honor. It's so different from football, but at the same time, it's just as fulfilling.
-- as told to Ivan Maisel
Occupation: Emergency room nurse, Level I Trauma Department (South Florida)
College career: Softball, Auburn (2013-16)
I didn't grow up with dreams of working in medicine. I wanted to be an athlete. I wanted to inspire young athletes to know that hard work and trusting the process will take you to where you're meant in life.
In the fall of my senior year at Auburn, I blew out my right knee. I rehabbed and returned for my senior game that season. It was my first start after all the rehab and recovery. In that game, I ended up tearing my ACL on my left knee, ending my senior season just as it was beginning. My athlete days were over. But Auburn's motto is hard work and family. That was instilled in me to get into the role of nursing. The daily grind. Meeting new faces every hour, every minute. The chaos. The commotion. That's what ER nurses live for. The challenging moments under pressure. It was just like being an athlete. You want to be competitive. You want to be great.
To be a great nurse, you need a unique ability to adapt -- and, in tough times, thick skin. Throughout the COVID-19 pandemic, we've had so many of those tough times. While most of the world runs away from the virus, we run straight to it. It's emotional. It's exhausting. It's scary.
I didn't think twice about the virus when talks of preparing for its arrival first started. But then we started putting up tents outside of the hospital to prevent the spread of the virus into the ER and pretty quickly it became real. Are we really going to treat patients in tents? The answer was yes.
The ER is different than the ICU. Our job is to stabilize patients when they first arrive and either admit them to another department or send them back home if they are stable. The COVID ICU nurses build more of relationship with patients because they are with them so long. But I had one patient who I will never forget. We were the same age. She had a lot of health issues, and we suspected she had COVID-19. We asked her if she wanted to call any family, and she told me she didn't want to call her mom and worry her.
The doctor had to intubate her because she was in respiratory distress. Five minutes later, her heart was giving out. We pounded on her chest and pushed lifesaving medications for 30 minutes, an hour, trying to save this girl's life. Ultimately, there was nothing we could do. When the doctor announced the time of death, it all just sort of hit me. It just didn't sit right how young she was.
I took a couple of minutes to take it in. Did we do enough? I had other patients I needed to stay strong for. Other staff asked me if I was OK. No, I wasn't OK, but that's part of being an ER nurse. You must continue on to save others after losing one. I wanted to focus on my work, finish my shift and deal with everything when I clocked out. So I pressed on until my shift was finished. When I got to my car, I just broke down.
I live with my parents, and I'm always worried about exposing them. That day, when I got home, I headed straight to the shower like I always do. When I got out of my room, my mom could see my eyes were swollen from crying. She asked if I was OK. I told her I had a bad shift. I told her about the girl. My mom and dad wanted to hug me, hold me, but I didn't want to risk exposing them after that case. My mom, being a total mom, didn't care. She hugged me anyway.
For a good week, that girl stayed on my mind. I would have nightmares when I went to sleep. What is her family thinking? What are they doing now? Did we do all we could? What if that was my brother or sister or family member? What if it was me and they had to call my parents? It was all just so heartbreaking.
I haven't been diagnosed with the virus. At least not yet. But on the days when I wake up and my throat is itchy, I wonder, "Is today the day?" Usually I'm just tired from work, run-down, have a bad headache. Then you start playing games in your head. "Do I have corona, or am I just paranoid?" It's easy to freak yourself out and mentally exhaust yourself.
To deal with all of it, you just have to escape. For me, it's the ocean. It's a place I can clear my mind, take a step back from reality. Nothing helps me forget about work more than sports -- that's always been my escape, as well. I miss Auburn every single day and look forward to visiting for football season. What am I going to do if Auburn doesn't have a football season? Usually I'd go back for a softball game, but that was obviously ruined due to the season ending for corona precautions.
My world has always revolved around sports. So hopefully we get more of it back soon. Until then, I'm going to keep using all the lessons I learned as an athlete to help anyone who walks through the doors of our hospital.
-- as told to Wayne Drehs