‘You walk in every day to a battlefield’: A Georgia MD on the outbreak

Dr. Enrique Lopez, in this photo at right, with his family. Lopez works in the intensive care unit at Phoebe Putney Memorial Hospital in Albany, Georgia. The hospital is in the midst of the outbreak of COVID-19, the disease caused by the novel coronavirus. Lopez runs one of the intensive care units, trying to keep uninfected patients safe from the virus. (PHOTO courtesy of Dr. Enrique Lopez)

Dr. Enrique Lopez, in this photo at right, with his family. Lopez works in the intensive care unit at Phoebe Putney Memorial Hospital in Albany, Georgia. The hospital is in the midst of the outbreak of COVID-19, the disease caused by the novel coronavirus. Lopez runs one of the intensive care units, trying to keep uninfected patients safe from the virus. (PHOTO courtesy of Dr. Enrique Lopez)

Phoebe Putney Memorial Hospital in Albany anchors healthcare in southwest Georgia, which is a center of the COVID-19 outbreak. The hospital has three intensive care units, two of which have been given over to coronavirus patients. Dr. Enrique Lopez runs the third, managing the flow of patients to try to keep one last unit safe for critically ill patients who are not infected with the virus. He also responds to COVID-19 patients elsewhere in the hospital, while his colleagues in the two coronavirus ICUs work 16-hour days. He spoke to the Atlanta Journal Constitution from work. These are his words from that conversation and text messages, edited for length and clarity. 

When we get sick COVID patients that are on the floor and I’m on call, or that are in the emergency room, then it’s my duty to respond. To gown up, to resuscitate, and to place them in one of those units.

I had gotten a report that there was a patient that had come in that was having fevers, shortness of breath. People with him had called EMS to the scene; by the time the ambulance got there the patient was unresponsive. By the time he hit the ER he had undergone cardiac arrest. Multiple rounds of CPR were able to get his heart back. We used these machines, we used catheters, we tried different modes on the ventilator.

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It was just unbelievable how difficult it was to get oxygen into this patient.

When I looked at his X-ray I knew what it was. I just remember thinking, “How did this happen so quickly?”

The patient almost passed away. Then he almost passed away a second time.

He’s fighting for his life. But we’re fighting for him, too.

This is a very interesting time that we’re living in right now. You get a sense of confidence with all your years of training that you’ve pretty much seen everything. Now you feel like a student all over again no matter how many years that you’ve been practicing.

Dr. Enrique Lopez and his coworkers at Phoebe Putney Medical Center in Albany, Georgia are treating a surge of patients with COVID-19, the disease caused by the new coronavirus. For safety’s sake, he lives, eats and sleep separately from his family, FaceTiming with them within the same house. He and his wife tell their three children he has to stay far from them because he’s sick. His daughter, 4, tries to reach for him and doesn’t understand. She is shown here in an earlier photo with Dr. Lopez. (PHOTO courtesy of Dr. Enrique Lopez)

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I mean it’s one of those things where you walk in every day to a battlefield facing an enemy that you know nothing about.

Nobody was prepared for this. Nobody was prepared for the fact that you could harbor this virus and not even know it and just continue to spread it amongst your family members, your community. So, so many people had these symptoms, and some of them got real sick, and some of them didn’t.

We’re learning to anticipate what’s going on. If their oxygen requirements change just by a little or something changes in their clinical presentation, we know what to expect. We’re very, very aggressive. We’ll intubate, we will oxygenate, we place invasive catheters sooner rather than later knowing that when we see the clouds on the horizon, that the storm is coming.

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I tell you what, the uncertainty of this disease, this virus, right? And what it’s capable of, and whether or not you have it? The health anxiety that practitioners like myself and nurses and the administration and the janitorial staff and the cafeteria staff — everybody has. Because you’re like, I have a neck ache or a fever, or I’m a little lethargic. Oh my gosh, do I have it?

You don’t know, because you know that you could harbor it for a while and not be symptomatic. Am I going to give it to my family?

Some of us go home every day and look at our kids and our wives, and usually, we come home and it’s that moment of peace that you live for at the end of the day. It’s after the match, after the game, you’re looking forward to go home and relax and be with the people that you love the most. But you don’t want to touch them. You don’t want to breathe on them.

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But the true nature of our hospital system is never more apparent than in this time of adversity. I look at everybody here every day, knowing that everybody goes home to the same kind of fear and anxiety that you’ll infect your loved ones.

There are priests taking temperatures outside in the front. We have some janitorial staff that’ll take temperatures outside that’ll play music, that are dancing and trying to mitigate the fear of everybody that’s walking in.

I have a cardiac surgeon, vascular surgeons, general surgeon walking into ICU and saying what can I do? We have intensivists at home, that’s their off week – doing research, sending out articles, constantly communicating with other intensivists across the country. I mean, the brotherhood amongst the hospital system, to me every time I walk in every day, it’s just amazing to me. Because everybody has fear. Everybody does.

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You know, we as health care workers, we want to protect ourselves too. Personal protective equipment is one of the things that allows us to come to work saying, OK. I have the tools and the weaponry necessary to go into combat every day. But the scary thing is, we’re not going to have that. In several days we won’t have any more N95 masks. So how am I going to be able to protect my family if I bring it home with me and I don’t even know it? It’s a big issue.

(At home, Dr. Lopez has decided to live in the house but in separate spaces from his wife and three young children, sleeping on a foam mattress in the living room and talking to them on FaceTime. They’ve told the children he is sick. In an incident Wednesday night his daughter, 4, realized he was there and tried to approach him.)

When she reached out for me I forgot for a second. When I told her daddy was sick, all she wanted to do was take care of me. When I kept backing away she couldn’t understand and begged to be with me. I started crying and kept telling her to stay away because daddy is sick. It’s not supposed to affect kids, but I’ve heard stories of pediatric intensive care units starting to get cases.

She starting crying, calling out for me. I cried. My wife came to comfort her, and I went back to my little mattress on the floor. Exhausted, unable to sleep, waiting to do it all over the next day…for how long…who knows. But we will find a way, whatever it takes. We do it because it’s what we were meant to do. We show up everyday, and say, “Not on my watch.”

Those poor docs that are sick, on life support, and I heard some have passed, I think about those that lost their lives fighting this. It was against this thing — not a country, not a religious group, but some thing you can’t even see.

I lay there at night thinking, “I had a good life. A life of service, a beautiful wife, three beautiful children, and I made a difference.”