Sorry to start a new thread, but I felt like this needed its own. So, I was doing my usual sleuthing after work this evening and came across this BOMBSHELL. Dr. Michael Bowdish (the principal investigator for the USC Keck School of Medicine arm) pens his thoughts on working in a COVID ICU and more importantly MSB's NIH clinical trial. I will not sum anything up - I encourage all to read for themselves! Sounds like news is very close!
"Glass Cages, Heroes, and A New Normal “I’ve never felt so ineffective as a doctor.” A direct quote from one of our critical care fellows as we peered into the glass cage containing a victim of the COVID-19 pandemic. “The family is asking us to do anything, but we have so little to offer, maybe your trial will help.” Seven months after this pandemic started, we still have little to offer. This was the first patient we enrolled in a therapeutic trial we are participating in at USC as a member of an NIH trial network. The patient died several days later. While two of the family members were allowed to come to see the patient, the site they saw is likely not one they want to remember. I thanked them for agreeing to enroll their loved one in the trial and offered my condolences. They were not allowed to enter the room, only to peer through the glass. The patient was “proned” (on their stomach) and had no knowledge of the presence of his family. There were no family pictures in the room, no one holding his hand, no last kiss goodbye. Ultimately, it was a lonely death in the glass cage. This how all COVID-19 patients die. Alone. I have seen much death as a heart surgeon, COVID-19 is the winner, it is horrific. If I never see it again, it will be too soon. Anyone who questions the magnitude, or existence, of the COVID-19 pandemic, should be forced to walk through a COVID ICU, experience how these patients die, and look at the body bag waiting to be picked up by the morgue. It will break the stoutest of personalities. It has made me cry. The ultimate low of the lows. Much has happened in the two months since sending out my last update. A “New Normal” has emerged. I’m not sure it is a normal any of us like, but we are trying to make the best of the situation. One glimmer of hope is that the situation in NYC has improved drastically. Dr. Smith ended his daily updates on May 12. Stating quite simply, “The ‘New Normal’, will not include Daily Updates”. He has however come back with a few “cameo” updates since – and continues to respond to my text messages. His last was a message wishing us well and hoping the surge in California is not too bad. It remains amazing to me how this pandemic has brought people together. Craig and I have arguable communicated more in the last 100 days than in three years of residency! All of Dr. Smith’s “Daily Updates” are available at https://columbiasurgery.org/news/13691. Craig, thank you again for your leadership from afar during these challenging times. The dynamic of the COVID-19 Pandemic has been vastly different in New York and Los Angeles. I’m sure these epidemiological differences will be the subject of many a Ph.D. thesis over the coming years. While several NYC area hospitals have succeeded in closing their COVID ICUs, ours at LAC+USC Medical Center are at their fullest levels since the pandemic began – COMPLETELY FULL. Texas, Florida, Arizona, North Carolina (among others) are even worse. While NYC had a very large surge, there are now clear decreases in cases, hospitalizations, and deaths. Conversely, in Los Angeles, we have had, and continue to have, a very steady number of patients that are slowly exhausting our health care system and the providers. There has been NO decrease, and a marked increase in the last two weeks. In Los Angeles, we have been running a 110 day plus ultramarathon, which as a former (and hopefully future?) triathlete, I can unequivocally state is difficult to sustain. I’ve completed six half Ironman triathlons, but no one has the endurance for this. I am privileged to be conducing a therapeutic COVID trial – my small way in trying to contribute to the eradication of COVID-19. To do this, I have rounded in the COVID ICUs everyday since May 3. We have now enrolled 30 patients – 10% of the trial target. This has been a monumental undertaking. I can’t thank the team members enough. I have admittedly seen things I never imagined. But I’ve made new friends. I have developed a tremendous appreciation for my colleagues in the fields fo pulmonary critical care, surgical critical care and infectious disease. I have new relationships with previously unknown residents and fellows. Yes, I may be a cardiac surgery attending, but in this battle, I’m just like all of them, a foot soldier doing his part. Most importantly, I’ve learned who the real heroes are – the nurses, the patient care techs, the respiratory therapists, the unit clerks, the nutrition staff, and environmental service staff. I recently thanked one of the environmental service staff coming out of a COVID room, she stopped, looked at me and said “Doc, I’m just doing my part, as long as I have my PPE, I’m safe”. Hard not to appreciate that.The last two months have been personally difficult. Never in my career has exhaustion been driven completely by what seems like endless inspiration. The exhaustion has to be ignored for the greater good. However, what I have learned is that this is not a feeling I alone share, but a feeling shared by all my colleagues in health care. That is inspiration. That is why we will succeed.Stay Safe,Mike"
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