[Read about this story from the perspective of Jacqui, the patient, here.]
It was April 2020 and we were now into the second month of COVID-19 hitting the United States in force, specifically in NY and NJ. Practicing primary care physicians were challenged by limited testing in the face of over 50 daily calls from patients fearful that their symptoms could be COVID-19. In addition to my daily load of nearly 30 patients for routine visits by either telemedicine or in person, I was remotely caring for about 20 people diagnosed with COVID-19, all of whom were calling me every 1–2 days and were given instructions [for self care and monitoring]. At night, I had been pouring over every NEJM [New England Journal of Medicine] article as soon it was published to ascertain what I could understand about the virus. As a Molecular, Cellular and Developmental Biology major from Yale University, I was starting to see the difficulty of this disease: pre-symptomatic patients could spread this disease through viral shedding for 14 days before their symptoms started. I was watching my COVID-19 patients carefully as I did not want to lose anyone on my watch. There were daily news reports about deaths happening at home when patients had been turned away from the ER because they were not sick enough for admission.
My staff and I were all working tirelessly for at least a month now under these heightened conditions. We knew sometimes we all needed a break so we could recharge to come back to fight another day. My staff really tries to not call me on my day off and let my other colleagues cover. While I generally have no clinical hours on Wednesdays, because of the coronavirus, I instructed my staff that if there were anything acute going on with one of my positive COVID-19 patients of if they were unsure of any particular situation, PLEASE CALL ME!
It was a Wednesday. I was sitting on my porch — breathing in a breath when I heard my phone ring, it was a call from one of my nurses, “Dr. Green, I don’t know but I wanted to call — and I’m sorry to bother you, but Ms. Canter didn’t sound so good.” [I said,] “Amanda, you know I wanted you all to call me for these exact things — thank you for letting me know.”
I called Ms. Canter — and as soon as I heard her talking, I knew. “Dr. Green” — labored breath — “I am here” — labored breath — “I am here.” As soon as I heard her voice, the years of medical training kicked in and I could actually visualize her based on how her voice sounded. Even though she was not in front of me, I could see her. She was in severe respiratory distress. “Call 9-1-1 immediately,” I said. I could hear it in her voice, she needed emergent medical attention. “Really, Dr. Green? You want me to call? Am I really that sick?” [she asked me.] “Yes, you are. I do not like how you sound, call 9-1-1 immediately!” “Ok, Dr. Green, ok I will I do it.” I added, “Please keep me posted.”
Later that evening, Ms. Canter called me from the hospital. “I breathed a sigh of relief- knowing that she had gotten there safely. I was worried for her and didn’t think she sounded good. I told her, please keep me posted on your care while you are there. I told her I am praying for you and rooting for you.
During this time of COVID-19, things had been non-stop. Sometimes, you would wake up at night or have a thought during your time away from the office — did I make the right call? Testing, quarantine, hospital — repeat. Testing, quarantine, hospital — repeat. Did I clean everything well before I came home? Is there any possible point of contamination to my family?
When after over a week I had not heard from Ms. Canter, between patients, I called and left a message. I looked through her chart and watched the harrowing account of her ICU stay including intubation, altered mental status, and pneumothorax (a collapsed lung). I asked my staff to reach out and then I got a call from Jacqui directly from the hospital. “Dr. Green”— I was so glad to hear her voice. “I ended up in ICU intubated for days, it was horrible. I am now on a regular medical floor — but the doctors say my lungs are not strong enough for me to be able to be discharged. Dr. Green, you saved my life…” She started crying on the phone, and the tears formed in my eyes as well. “I live alone, there was no one else that would have been there. Thank you, you saved my life.” This echoed in my head I didn’t know what to say. The very reason I went into medicine was to save lives — her words hit me in my heart, “That is why I am here. That is why I am here. All glory to God and you are a miracle.” To see what had happened — her survival was a medical miracle. And she was a miracle — the timing — the changing of my practice —asking patients to call every 1 to 2 days, and the amazing nurses and staff that are the team at the [the health center where I work]. It was a team effort to save Jacqui and then our neighbors at the hospital cared for her moving forward. I told Jacqui, “I am here for you, call me when you need me, and make a follow up visit when you are out of the hospital so we can talk. You have gone through so much.” This virus had almost taken my patient’s life. As I have taken care of many patients with COVID-19, I have seen the variability and randomness of those that it hits very hard — and those that have mild to moderate symptoms. This is a novel virus — and it cannot be emphasized enough the need to wear a mask and wash hands and take this seriously. Because it is serious. What I have seen, is that we can only defeat it together. Humans relying on each other and those with medical training doing their best for every patient, and then Almighty God to step in when we have no more strength. That should be our creed for now — we have to protect and take care of each other.
Jacqui had a lot of cognitive involvement in her battle with COVID-19. In some patients, with loss of smell we also see cognitive issues because the virus has also affected their brain. In the case of Jacqui, because she was intubated for so long, she had to regain her strength through physical therapy. And she also struggles with the mental scars of the trauma that sometimes come after a long ICU stay that was also complicated by COVID-19 cognitive involvement. I am honored to be able to take care of her, and to continue on this journey to recovery with her as her primary care physician.