On evenings when Dr. Cory Deburghgraeve reports to work at University of Illinois Hospital in Chicago, he first checks the charts of patients he treated the shift before -- people who struggled to breathe after COVID-19 caused their lungs to swell and fill with fluid.
He’s crushed when he finds those he thought would improve aren’t doing well. And they’re not who the public might think would be hit hard by the coronavirus pandemic.
“These are not what I would consider to be generally sick people,” Deburghgraeve said, describing many who are in their 30s, 40s and 50s, and though they may have an underlying condition, it’s often something that, until recently, they managed well, like mild or moderate hypertension or asthma.
“I get frustrated when people say (stay home for the elderly and more vulnerable populations). No. Stay home for yourself too; it’s unpredictable,” he said. This virus “can hit anyone, and it’s difficult to predict who will live and who will die.”
Deburghgraeve is an anesthesiologist -- a specialty many may not associate with being on the front lines of the fight against COVID-19, but he’s literally in the face of it.
Because of anesthesiologists’ expertise in intubation -- the mechanism physicians use to place a breathing tube inside a patient’s mouth and guide it into their lungs -- Deburghgraeve is paged when a patient suspected of having COVID-19 needs to go on a ventilator. An early step in that process is to intubate the patient.
Deburghgraeve normally works in the obstetrics department, specializing in high-risk pregnancies. Because that specialization often involves complicated intubations with the swollen airways of pregnant women, he was pulled from that duty and assigned to treat COVID-19 patients.
He now works 14-hour, overnight shifts five or six days a week.
So far, he said, he’s done so with adequate PPE (protective personal equipment). While he’s heard of others at his hospital and elsewhere across the country with different experiences, Deburghgraeve said he’s fully outfitted in PPE every time he treats a COVID-19 patient. Any other way would be too dangerous, he said.
Deburghgraeve said that when he intubates patients, his face hovers close to theirs. He’s right at their open mouth, and when placing the tube, the patient (who is sedated and under general anesthesia) could cough or otherwise release air or droplets containing the virus.
“As an anesthesiologist ... I think it’s important people understand what we do and that we are on the front lines,” he said.
In recent weeks, Deburghgraeve has posted videos on social media demonstrating on a medical manikin the intubation process. He’s also shown how much PPE he needs to be safe -- a gown, two pairs of gloves, a mask, a face shield and other items. Deburghgraeve said he’s been increasing the speed at which he puts it all on, getting it down to five to 10 minutes.
These videos have received thousands of views, and it’s spurred an outpouring of support from friends and strangers, he said. “It’s made me feel like I can do this for months ... that amount of support.”
When caring for COVID-19 patients, Deburghgraeve said he doesn’t think a lot about the risk he’s taking. He’s thinking more about the patients. While some of those he’s helped place on ventilators are improving, many aren’t and haven’t been able to breathe on their own in a couple of weeks. He’s also seen patients die, some of them young.
Many of his patients are unconscious before the intubation procedure, so he doesn’t get to talk to them; but those who aren’t unconscious are scared, he said. The no-visitor policies make it harder, so Deburghgraeve said he tries to offer as much support as he can.
“We are dealing with a very tragic, very terminal disease here,” he said. “The long hours ... can be challenging, but really for me what is hardest (about the job) is that young, healthy people are having such terrible outcomes.”
“It’s tragic, it’s sad, it’s everything.”
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