This is part of our occasional series called Portraits in Healthcare to capture the changes happening in healthcare due to COVID-19 as experienced by providers.
Michele Loor, M.D., typically splits her time between surgery and critical care at Baylor St. Luke's Medical Center, part of CommonSpirit Health. But in recent weeks, her shifts have been solely in the ICU as severe cases threatened to overwhelm the hospital. She said it now feels like new admissions have stabilized and providers are now working to refocus on ramping up to allow elective surgeries. But they're also very cognizant of the threat of another wave. This is her story as told to FierceHealthcare and edited for length and clarity.
Thinking back to February before everything started, we were hearing reports about COVID and how bad it was. I think it was something we all knew was eventually going to come here.
But I don’t think that it was clear or that me and my colleagues really quite understood the magnitude of it in terms of how sick patients get.
You know, we have in our minds the flu or patients who have bad influenza and how sick they get. I think that’s what was stuck in my head, if I think back to where I was in February. It wasn’t that I thought everything was going to be OK ... But I certainly didn’t realize how sick patients get, how individual patients just get a lot sicker than what we were really expecting.
As intensivists, we treat patients all the time who have trouble breathing. However, the progression of how fast these patients got sick and how their systems kind of shut down very rapidly was something that was more pronounced than what we thought we were going to be seeing. In retrospect, I guess we should’ve taken the reports that were coming out of other countries a little more seriously. But you know, even when I pull those reports now, it doesn’t really describe what actually happened to them.
They could come in and go from just having a mild cold to being really sick and on maximal life support within a few hours. That’s really what we were seeing. It’s not just the older patients who have other medical issues. We were seeing it in younger healthy patients as well.
When we were first ramping up, it was very eye-opening for everyone because not only was this a disease we didn’t know how to take care of and we were learning every day from what was going on. But it was always: "This could happen to any of us. Any of us could be the next person in that bed." It was really psychologically and mentally straining.
I still feel like we don’t have a very good grasp on who gets really sick and who doesn’t. Working in the ICU, I’m always seeing the really sick patients. So my view is definitely a little bit skewed in terms of how bad I think the disease is. I definitely think there’s a lot about this we don’t understand yet. We all kind of went into this as it was coming over here and affecting the U.S. like it was going to be a really bad flu season. And I really don’t feel like that’s the way it’s been. The patients behave completely differently from a medical perspective. It’s nothing we’ve ever had to take care of or deal with before.
I think because we understand so little of it, it leaves this black box of stuff we don’t really know how to take care of or how to handle. Not just for the patients to get better, but also to keep ourselves safe and to keep people outside of the hospital safe around us.
One of my partners who recently had a baby and has her older patients that are taking care of the baby. She didn’t want to bring it to her house. So she essentially came to work here for a week and then she went into quarantine by herself for two weeks. Then she came back here to work for a week. That was on quarantine from her family. From a new baby, she’s been away for six weeks. Similarly, I have another partner who has not been going home and staying away from his family.
My husband is a physician. He also comes to the hospital, so I didn’t feel like I needed to quarantine away from him. We don’t have any other extended family in the area or anyone else who is coming into our home. I’m comfortable going home, but it's a process. I change into clothes before I leave. I change my shoes. I go home and take a shower before I even go into my house …
Now that we’re at the phase where we don’t feel as overwhelmed, things are trying to go back to normal. I think the biggest thing is that we’re shifting our attention from ramping up for COVID care to ramping up for procedures and other diagnostic testing. So elective cases are going to start at the end of this week and early next week. It’s a little bit of a shift in attention. We’re all very cognizant there could be another wave of it and that it’s not going to go away. There are still sick patients that are here in the hospital and I think that’s important to remember. As things open up, it’s not as if the virus has left the planet. We all have to be really careful about what happens next in terms of another surge of patients.
I feel from reading the news and social media and the response in the community that everyone really does get it. That we are putting our lives on the line and really working hard for patients. I guess we really do appreciate it and we appreciate all the donations. It’s interesting because it’s recognition—I’m not saying I deserve, but—everyone I work with definitely deserves. We get food donations every day which has been fantastic. But I also think about the people who are making the food and their families and hoping they are getting the attention they need too. It’s hard for everyone … I do want everyone to know we’re very grateful for everything.
My clinical interest has always been more on the surgery side. I do critical care because I like those kinds of patients and I like getting to take care of them and I like getting them better. Since this happened, it really made me think about critical care and the importance of it and how I can really make a difference doing this.
When I think about how this is going to change the world, it’s been a very humbling experience. We do not know everything. And I never thought we did. But taking care of these patients has really shown me how little we know about things and how little control we have over some situations.
But it’s also taught me the power of teamwork. It brought together a lot of people from a lot of different disciplines thinking about how to best treat patients and how to get them better. Colleagues I’ve never worked with before I had the opportunity to work with and really brainstorm on how to make improvements in what we were doing. It’s really changed how I look at healthcare.
Are you a provider with a story about COVID-19 you'd like to share for our Portraits in Healthcare series, we'd love to hear it. Please email [email protected]. Please include a photo that can be used with your story and a telephone number where you can be reached if your story is selected.