Lifting seldom-heard voices in order to re-examine traditional social constructs and to cultivate love and empathy

Voices of Covid-19 Part Three: Denver

Denver Patient Voice

Michael Cho, 55, was on his way out the door for work on Monday, March 30, 2020. This morning he was feeling unusually exhausted however, and so he sat on the couch for a minute before leaving. That is the last thing he remembers from that day.

His son attempted to rouse Michael from the couch. With no response, Michael’s son called 911. Instead of driving himself to work that Monday, an ambulance took Michael to St Anthony’s Hospital.

Michael has abstract memories of his first three weeks in the ICU. He remembers getting an MRI. And he was intubated and placed into a medically induced coma. Although in a coma, Michael says he has bits and pieces of memories from those three weeks. “It was torture. No one told me why I was there. My mind couldn’t track time. The doctors, nurses, everyone were in hazmat-looking suits. And I was tied to the bed.” I asked Michael if he had been combative or difficult. He said he doesn’t know; he can’t remember. But he does remember being on the floor at one point.

Things looked pretty bleak. Michael believes he died temporarily. His near-death memory was, not of family and light like most people have but, of being covered in roaches. Not a place he wanted to stay. He remembers one of the doctors giving up on him. He heard that doctor say at one point that it was “a waste of time” to help Michael anymore. The medical staff enacted a “do not resuscitate” order. They called a priest through a Zoom connection to give Michael his last rites.

But suddenly, and miraculously, he began to improve.

Michael still had a long way to go. It all was like a nightmarish dream. He remembers his toes being black and that they gave him medication to circulate blood to his ear tips and feet. He remembers being flipped onto his stomach. There were so many tubes and wires that he was connected to that the flip was complex. Besides being intubated, he also had a feeding tube, dialysis, and a catheter along with the standard hospital monitors connected to his body. Along with flipping, they also moved his head from left to right. Still in a medically induced coma, he remembers the TV being on. Or maybe he was imagining the TV on? He was not sure. “It was like a dream state. Like not real. I couldn’t tell if what was on TV was happening or if it was just on TV. Some things were so detailed. Others were abstract. It felt like I was in The Wizard of Oz.”

After three weeks in the ICU Michael was finally extubated. At this point he was moved to the Covid unit of the hospital. That is when he finally learned why he was in the hospital. “They waited to tell me because they didn’t want me to freak out.”

No one was allowed to visit Michael, except his daughter-in-law, who is a nurse at another facility. She also had to suit up into the hazmat-looking garb to visit him. The priest who had given his last rites “visited” him a second time via Zoom.

Michael was released on May 11, six weeks after his ambulance ride. Although he tested negative for the virus twice before they released him, he has been advised to stay away from others for a month after his release. Because he is still recovering and weak, the doctors do not want him to pick up anything else.

Each of Michael’s sons tested positive for the virus, but they were out only a day or two. Michael does not know how the virus got to him or to his household. He knows that it came suddenly and dropped him fast. “Keep your phone close,” he admonishes.

As I spoke with Michael on the phone, he sounded tired. His voice sounded breathy. He says that as a result of being on the ventilator for three weeks he sometimes now will stop breathing. “I forget to breathe because the ventilator was doing it for me. I have to do breathing exercises, like hyperventilate, to bring my oxygen back up.”

He does not think he will have any lasting effects at this point. He no longer needs dialysis. His heart and lungs seem to have returned to normal functioning. He says that he might be moving slower until he can get his strength back but that cognitively he expects to be fine. They administered three MRIs total while he was hospitalized. He has physical therapy now which consists of reflexology stretching, and massage. He says, “I feel like a rusty car. My joints need oiled.”

Michael says he is not sure what his future holds after this experience. “I think I’ll go through my bucket list again and decide what is really important. I also wasn’t as healthy as I should have been before this. But now I know how fragile life is. It puts my health into perspective.”

He also feels as if he is more open to listening to other points of view. “A lot of people make binary decisions. It’s either/or. Self-interest or humanity. It should be both or none. We can’t live like everyone is an island anymore.”

He knows when he gets more strength that he wants to donate plasma. “I have antibodies. I want to help people, considering how close I was…I want to help.”

Denver Hospital Staff Voice

On the other side of town, Paula (not her real name) has been an RN at a major hospital in Denver for 32 years. She also would like to keep her hospital anonymous so we will call it Quality Health Services, or QHS, for short. I chatted with her in mid-April about how QHS has been handling the Covid-19 situation.

While Paula does not work directly with Covid-19 patients, she does have occasional contact. Paula is a charge nurse. A charge nurse manages the shift: she is in charge of the CNAs, coordinates with doctors, assigns nurses to patients, trains and helps with procedures that other nurses might not be familiar with, has staffings twice a day with other charge nurses, and up to five other meetings a day. Often these meetings will include discussions about how to handle a patient who might be dying and their family who might be disruptive. These days family do not want to or cannot visit because of the Covid situation, which can be hard on patients who are not at the hospital for that reason. On Paula’s floor she works with stroke patients and so has many types of patients: asthmatics to alcoholics.

At QHS the surgical floors are shut down. One floor has been designated the Covid floor and is considered the command center. She sometimes has to help transfer some of her patients to this floor and sometimes has to go to administer medications to the patients who are on the Covid floor. One of her patients was recently featured on a Denver news program for being released as an elder who beat Covid. Notable because the virus has a reputation of being fatal to the elderly.

One of the things that Paula trains her staff on is reverse isolation. This is a method where medical staff cover themselves in order to prohibit bringing new micro-organisms to an already compromised patient. She says everyone on her floor knows the methods associated with this technique.

Like my brother-in-law Jeff, featured in a previous Mulling it Over article, Paula has to wear the cumbersome PAPR respirator mask in order to go in to the Covid patients. She shared that the apparatus has lights inside and that it self-filters and recirculates oxygen.

An essential activity for safety is mask-fitting. Paula says this is a part of her job. Medical staff try on a N95 mask and has to wear the mask for 20 minutes in a domed hood. They are submitted to various odors and tastes, asked to make certain movements, and are asked to read five sentences. If the staff can smell or taste the odor at any time under the mask, they fail the fit test. They are given the test a total of three times. If they cannot pass a fit test on the N95 they will have to use a PAPR. This becomes problematic if the medical staff is claustrophobic, which can be difficult for someone who is wearing a PAPR which covers the entire head.

Paula says that some of the support staff at her hospital have had to quit, retire, or look for work elsewhere. People like secretaries and receptionists who are elderly or have other health issues have either been offered work in other locations or they have been furloughed.

Sometimes Paula has to go to the Covid floor of her hospital to administer an NIH scale test. This is a test that measures the severity of the lingering effects of a stroke. Many Covid patients experience strokes and so she frequently has to go to the Covid floor to administer these tests as well as taking care of the patients on her own floor.

Paula enjoys working at her hospital as well as working with the people on her team. However, since Covid has started Paula says that her staff are closer than ever. She says they have great managers and that the hospital chaplains have come to check in on staff more often. The hospital cafeteria stopped charging nurses and because there are fewer people in the building overall, the extra groceries have been going to nurses for a nominal fee. Paula says this is especially helpful so that an extra stop in a grocery store is not needed on the way home. She does not want to infect anyone if she can prevent it.

Paula goes home to her husband and adult daughter at the end of her shift. In order to protect them when she goes home, she takes her shoes off outside the house. She wipes the shoes down then puts them in a bag. Other nurses she knows have a closet by the front door where they take off their clothing and put it into a bag. They have a robe in the closet, and they make sure everything is put in the proper places at their houses to avoid infecting anyone living with them.

Because I am friends with Paula, I mentioned that I noticed pictures on FB of her and a new grandchild with other family members. I asked about the picture. She said, “if you look, none of us are touching each other and we all held our breath as we stood next to each other.”

I asked if Paula is scared. She says she is holding her own. “Having the chaplains stop in to check on us more frequently helps. They will pray with us if we need it. And when we have staff meetings we check in on everyone’s mental health. If someone needs a mental health day, we recommend they take it. We’re going by comfort level. If someone else wants to work more, we let them.”

“The outpouring of love from the community is humbling. It seems like there’s appreciation almost daily. We have been brought food, masks, and the ear protectors that hold the masks on your head instead of ears. Those are handmade!” Paula shared. She has never seen such appreciation. “One day as I drove off to work a lot of neighbors were standing outside holding love signs and cheering for me!”

Paula and her staff really want to say thank-you to everyone who has been so kind and to let you all know that it has been so helpful as they work through these difficult circumstances. Your kindness has helped many of them continue on while they battle for our patients to recover. “For some of my staff, the public appreciation has been a huge motivation and helps to keep going. Thank-you!”





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