Covid-19 is teaching everyone in medicine lessons about health care and public health. Mine have been up close, personal, and frightening.
One day I was a healthy 44-year-old doctor, CEO of a health care company, and a triathlete who was prepared to do another triathlon. Then I was a Covid-19 patient a few shallow breaths away from being put on a ventilator. A nurse saved me from that fate.
A journey that made me ponder new questions and opened my eyes to a new sense of purpose and perspective started innocuously enough. The soreness and aches began on a Monday night; a fever followed. I woke up Tuesday morning feeling awful. I got tested and it was official — I was one of the thousands of new Covid-19 patients that day.
By Friday, I was having trouble taking deep breaths. My pulse oximeter showed 95%. Not bad, but not normal for me — that would have been 99% to 100%. Over the next two days, things got worse.
Sunday morning, six days after first feeling sick, I walked to the bathroom and felt a new sensation: I was winded and light-headed. My oxygen level was still 97%, but I was breathing much faster. As I sat on the edge of the bathtub, my respiratory rate was 18 breaths per minute (50% higher than usual) and my heart rate was 85 beats per minute (up from my baseline of 50).
When you come from a family of doctors and lead a company of doctors, getting a second, third, and fourth opinion is easy. Everyone I reached had the same advice: Go to the hospital. Before we left, my wife, Stephanie, called family members, friends, and my colleagues at ChenMed and asked everyone to pray for me. We weren’t sure how things would turn out, and we needed as many people as possible appealing to a higher power on my behalf.
At the hospital, a CT scan showed Covid-19-related pneumonia in all parts of my lungs. I was given a dose of steroids (dexamethasone) to decrease Covid-19-related inflammation in my lungs, a shot of a blood thinner to prevent blood clots, and was then admitted.
The hospital was fantastic. I knew many of the doctors, including the chief medical officer and the chief of cardiology. They would walk by the window of my room, knock on the glass, then call my cell and reassure me I was in good hands.
Even so, I began feeling despondent. It didn’t help that I kept feeling worse and worse. I felt like I was staring into a dark tunnel — standing alone and worrying about myself, my wife and children, my parents, and my company. Sure, nurses would come in frequently, but only fully gowned for two minutes or less. Doctors would review my numbers and then call my phone to speak with me. I was alone, and I was lonely.
Nights were the worst. That’s when the fevers were highest and my breathing was most labored. I felt like I was wasting away: covered in sweat, unable to bathe or shower, tied down by a web of wires, lines, and tubes and trying desperately to breathe. I got an inkling of what my heart failure patients experience when they cannot breathe due to fluid buildup in their lungs and feel like they are drowning from the inside out.
I prayed for hope but feared the worst. I knew I was getting sicker, and had just heard that remdesivir, a promising antiviral drug, was in short supply. I was enrolled in a study to receive convalescent plasma — the liquid portion of blood from someone who had recovered from Covid-19 which is filled with antibodies against the virus — but was on the waiting list.
I knew that everyone was working tirelessly to stop my Covid-19 from progressing, but I was losing ground. Without a firm date for treatment, I felt sad and hopeless.
On Tuesday night, my ICU nurse was a 6-foot-tall woman from Jamaica named Helen, though I’m pretty sure she had been a drill instructor in another life. If she wanted me to sit on the edge of the bed and I said “no,” we reached an understanding: I sat on the edge of the bed. Helen started her shift by changing my gown and sheets, then helped me take a chlorhexidine towel bath. Those small acts of kindness felt wonderful.
Despite having trouble breathing, I sometimes fell asleep. Then my breathing would slow and my blood oxygen level would drop to unsafe levels. Helen would open the door to my room and yell, “Chris, c’mon. You’ve got to breathe. Breathe for me.” I knew what she was doing: waking me up so I would breathe faster. When I took faster breaths, my blood oxygen would rise and the alarm attached to my pulse oximeter would stop chirping.
If I couldn’t breathe on my own, I would be put on a ventilator and, if that happened, my chance of dying would skyrocket. I believe that Helen saved my life that night.
Around 3 a.m. she came into my room again. When I heard her voice, I immediately started to breathe faster. But this time she had a different message: “Chris, your plasma has arrived,” she told me. “I’m going to get it.”
“Are you sure?” I asked, since the plasma wasn’t supposed to get to the hospital for a few more days.
“The blood bank just called,” she replied.
All I could say was, “Praise God.” It was my first glimmer of hope.
I received the plasma as the shift was changing in the morning. I wanted to give Helen a hug or at least shake her hand, but the best I could do in the time of coronavirus was to say an emotional “Thank you for getting me through last night” as she headed home.
The following morning, my brother, who is a cardiologist, called and said remdesivir had been secured for me and I would get my first dose at 11 a.m. That afternoon, I began feeling better. I was able to sit in the chair next to my bed. I wondered if the plasma and remdesivir were working, or whether my body was finally fighting its way back.
I remained fever-free. When Saturday morning rolled around, my light-headedness had cleared. My breathing felt less labored and I was able to take deeper breaths. My aches were subsiding, and I felt stronger and more alert. I walked around my room without becoming short of breath. I was ready to go home.
As I was wheeled out of the ICU room, I looked around. When I arrived, half of the rooms — all reserved for Covid-19 patients — were empty. As I left, all of them were full and many of the occupants were on ventilators. I asked to stop for a moment so I could say a prayer for my brothers and sisters with Covid-19.
Stephanie and my oldest son were waiting outside the hospital in a carport reserved for Covid-19 patients. I was overcome with emotion. We hugged and held each other tight. For the first time since entering the ICU, I realized I would still get to be a husband, father, brother, and son, and would continue to lead ChenMed. I was overwhelmed.
As I write this, it’s been 20 days since I first started feeling sick, and I am still recovering. I still have questions, but they are far different than the ones I thought about when I was in the hospital.
I’ve realized how naïve I was about what it is like to be a patient. Coming out of medical training, critical care was one of my strongest skills. I conducted countless blood gasses, which means drawing blood from an artery to test for oxygen and carbon dioxide levels, but never had one done to me. I’ve heard the constant din of hospital bells and alarms, but never from a hospital bed. I’ve poked and prodded patients every few hours never knowing what it felt like. I knew that the jumble of cords and wires attached to my patients made it hard for them to move, and now feel foolish for suggesting that they “Try and get some sleep.” And I never could have imagined the feeling of being weighed down and immobilized by sensors and intravenous lines and other tubes.
The experience of being in an intensive care unit for Covid-19 is making me ponder a whole new set of issues: How can I be a better husband and father? How do I show appreciation for the amazing care that saved my life? How can I convince others of the severity of Covid-19? How can I help health care workers empathize with the pain and anguish of being hospitalized — and alone — so we all rise to the challenges caring for the patients we serve? How can I better lead ChenMed? And how does God want me to use what I learned?
Before this experience, I thought I knew a lot about Covid-19. I was wrong. But here’s one thing I know for sure: If you haven’t been taking the risk of this pandemic seriously, you should start now.
When you’re an ICU patient with Covid-19, it is like dying in solitary confinement.
Christopher Chen is a cardiologist and CEO of ChenMed, which focuses on providing primary care for seniors.