by Priya Jose, Registered Nurse in New York, written for COVID-19: Inside the Global Epicenter: Personal Accounts from NYC Frontline Healthcare Providers by Krutika Parasar Raulkar, MD
My husband was a 53-year-old man who worked full-time as a mental health aide. He was a hardworking man, with shifts from 3:30 p.m. to 12 a.m., and was very dedicated to his patients. He was on the frontline caring for COVID-19 patients. I work as a nurse at the same hospital during the day shift. Early in the pandemic, we were not provided enough personal protective equipment (PPE). On April 3, I experienced symptoms of COVID-19 and my husband was tested negative. This was possibly a false reading. He went to work as per protocol.
That week, he was working with a severely ill COVID-positive patient with whom he was with for 16 hours. Proper PPE was still unavailable at our hospital. The next day he went shopping and started shivering. He experienced a high fever that night. The next morning, he was found to be positive. He had no symptoms other than fever. The doctor said to stay home from work for 14 days. He continued to have high fever for about three to four days. While working in the hospital, we saw that a lot of people were getting pneumonia, and so we thought it was best to go to urgent care to rule out this complication. The x-ray results showed bilateral pneumonia, and he received an oral antibiotic and returned home. His fever resolved, but after three days he developed a sensation that something was stuck in the middle of his chest. He still had no shortness of breath or body pain and no longer had fever. He thought maybe it was phlegm and we tried to flush it out with hot drinks and steam inhalation.
I made soup for him but he did not have an appetite. I asked him if he wanted to return to the doctor, but he said, “No, I’m okay, I have no shortness of breath or dyspnea.” My brother-in-law brought a pulse oximeter, and he was saturating at 92 to 94%. I kept checking, and his saturations remained at these levels. At that time, we were unaware that COVID patients had increased risk of blood clots. Something continued to bother him deep inside his chest and his saturation dropped to 88 to 90%. I remember he was listening to a Christian spirituality station … I checked his saturation level and it had dropped to 84%. I said we shouldn’t wait here, we should go to the hospital. He said, “I feel a little weak, I want to lie down.” He rested in the prone position. His sat dropped to 79%. I did not call the ambulance, I quickly drove him to urgent care.
He looked like a normal person when he walked into the clinic. I told them his oxygen saturation is dropping, they called him inside and an ambulance came for him. He received 3 to 4 liters of oxygen via nasal cannula. His D-dimer level came back elevated at 7.8 and he was started on IV antibiotics for pneumonia — doxycycline, ceftriaxone, meropenem — and started on Lovenox for anticoagulation. He received one unit of plasma, five days of an anti-viral injection, and vitamin C supplementation. On his third day in the hospital, his doctor said he was doing well and I wanted to take him home. He still had a low oxygen saturation of 90%, but no other issues. However, he was started on a heparin drip and had to be monitored. His chest pain resolved, and all labs were normal except for the elevated D-dimer. It slowly trended downward — 5.8, 2.8, normal. The heparin was stopped. But he was still desaturating on high flow oxygen. He was very anxious that he saw so little of his providers in the hospital, and he felt very lonely away from his family. On May 11, the doctor called me at 4 p.m. to tell me that he was stable. I asked, “When did you see him?” He said at 9:30 a.m. I said, “He just called me and told me they are planning to intubate him.” His status had changed since that morning and the doctor was unaware. Later on, the doctor felt it was better to intubate him as he was becoming dyspneic and his oxygen saturation was dropping. During that entire time, my husband was talking to me on FaceTime. He was worried that he would be intubated and he would never come back. I tried to reassure him, saying “We don’t want ARDS to develop, we want to let your lungs rest.” He was fully alert and oriented at the time.
After intubation, he was proned, then paralyzed, because he was struggling while sedated. When transitioned from prone to supine, his breathing tube was dislodged, and from that moment his condition deteriorated. His vital signs plummeted, he became tachypneic. He went into respiratory arrest. He survived and continued on the ventilator for another two weeks. One day I called the doctor and he told me he was a stable patient and they were hoping to reduce the sedation. The next day I called and they told me he was deteriorating. I went to the hospital and he had already passed away due to cardiac arrest. The doctor never explained this to me. No one called me and I had to find out from a nurse.
The doctor had informed me he was stable and I told the doctor that if I see him, maybe he will get better. Especially during this time, my husband had no one there and he felt alone. He was very upset, anxious, and fearful when the nurse quickly informed him that he was to be intubated. I want to emphasize that it is vital for the interdisciplinary team to be kind and comforting to their patients when they are alone and sick. I am 100% sure that my husband would still be here if I was with him. This was the first time my husband was ever admitted to the hospital. If I was there, my husband would not have been ventilated. I have regret that because of me this happened. I was able to visit him, hold his hand, and talk to him for four hours. Although he was not able to talk, there were tears rolling down his cheeks and I knew he could hear me. The second and last time I went, I was only allowed to stay for 30 minutes. If only I was able to hold his hands again, I believe a difference could have been made. For one month, my husband was away from myself and our kids. Our children couldn’t see their dad and he died before they could see him again.
When I called to ask about my husband, I was asked, “Are you a physician?” I told them no, but it is my right to ask about my husband. At least they could have told me when there was no hope. I had promised him he would come out. They told me he would survive because he is healthy. I still feel that he is on vacation. I cannot even think that he is not in this world.
I know in the hospital they don’t spend much time with COVID patients. They are worried about spreading the disease and being affected by the disease themselves. As a nurse, I treated COVID patients with no PPE. One of my patients was an elderly woman — I treated her as if she was my own grandmother. I worked closely with her and that may be why I was affected by COVID, but I had to do everything I could to take care of my patients. We see the devastation in the media, but we do not actually realize what the patient and their family is going through. When it comes to your own family, you see the agony and unbearable pain.
He was a lovely husband and lovely father. My son Joel says he took care of me as if I am his daughter. He was very involved in our children’s lives, such as helping them with their homework, projects, etc. Unfortunately, he passed away a week before our son’s high school graduation. My son said he didn’t want to go to his commencement ceremony, since his father couldn’t be there. But I told him that his father would want him to go, and he will always be watching him from Heaven. I feel I have to go from this world as soon as possible so I can be with him. My family tells me not to think that way, and I have to be strong to take care of my kids. I know my husband would want me to be happy. It hurt him to see me sad or crying.
He was a God-fearing man and had a positive way of interacting with every person. If you had the privilege of meeting him, you would never forget him, his golden smile, and bubbly personality. He has touched a lot of lives and will forever live in our hearts. He loved going to church and he never failed to tell our kids about who God is and how great he is. He always made prayer a priority every single day and as a family we always prayed on our knees while holding hands. He was always one to be positive and encouraging. Even though life was challenging at times, he always kept his faith and knew that God would come through. However, God has called him home, to the place where there is no suffering.
“I have fought the good fight, I have finished the race, I have kept the faith.”
2 Timothy 4:7
In her book COVID-19: Inside the Global Epicenter: Personal Accounts from NYC Frontline Healthcare Providers, Dr. Raulkar shares insider accounts of the deadly pandemic from one of the hardest hit medical systems in the world. Packed with the most current medical information, a historical account of the discovery and political reaction to COVID-19, and inspiring accounts and photos of frontline health care workers, this book provides the knowledge you need to stay well-informed about COVID-19, and hope and optimism to get you through these challenging times.