A Life and Death Struggle
Sixteen days into Peggy’s illness, her COVID-19 test comes back negative for the second day in a row. That is good news. Now her family can visit her in the ICU. She desperately needs to see her loved ones if she is going to rally the will to survive. The bad news is that she will likely die from COVID-19 anyway.
The 68 year-old secretary was exposed to the coronavirus three weeks ago by a coworker. That is tragically fitting: Peggy never misses work. Known for her devotion to her family and her reliability, she is quiet and kind, with short, gray hair, dark eyes, and an ever-present smile.
Despite her positive attitude, she felt some tense anticipation after learning of the exposure. Then on day six she awoke with dread. She had fever, aches, and a dry cough. At a local walk-in clinic her COVID test was positive.
Peggy self-quarantined at home, coughing violently and shaking with fever, while wracked with body aches. After another week, her breathing became short. Just walking to the bathroom left her gasping like a runner after a race. When she became too weak to walk, her family brought her to the emergency department.
The nurse dismissed Peggy’s husband, Carl, and she entered the isolation room with no visitors. She felt truly alone. In a sprawling medical center, teeming with staff, she had never been so forlorn. Her COVID test was positive again. She received supplemental oxygen. The doctor showed her the chest x-rays, revealing pneumonia, like blossoming clouds, in both lungs. Then the storm broke.
Her organs began to fail, like falling dominoes. Utterly exhausted from fighting for air, she had to be placed on a mechanical ventilator. Initially she fought the device. In response the ICU doctor administered sedation to relax her and blunt the horrors of beeping alarms, masked strangers, needles, and unrelenting air hunger.
Visitation and Trepidation
Today is the sixteenth day of her illness, and Carl is seeing her in person for the first time since admission. He trembles when entering the room. Attached to a machine with a tube in her throat and numerous lines inserted in her body, Peggy is bloated, yet gaunt looking. Dried blood cakes her cheek, while some fresh blood seeps from the corner of her mouth. Worst of all, she will not respond.
“Squeeze my hand, honey,” Carl implores over and over, as he wipes away his tears. She stirs or grimaces a little, but she will not return his grip or open her eyes. Delirium drifts through her head like tendrils of fog – a mingled mist of nitrogen waste from failing kidneys, fever dreams, and the haze of pain medications. Doctors will continue dialysis today to remove the toxins and excess fluid from her system.
Her lungs are stiffening from the progressive inflammation, sending airway pressures to alarm levels as the ventilator has to force oxygen into them, threatening to rupture the delicate structures. Even with fine tuning of the ventilator settings, her oxygen remains borderline. Her blood pressure is also tenuous, dropping so low at times that Peggy’s extremities are cold and white as a marble statue’s, tinting to blue at the fingers and toes.
Her daughter has a question for the attending physician. Perhaps you are wondering the same thing. Now that tests indicate that Peggy is no longer actively infected with the virus, why is she not getting better? How could she still have a fever? What is causing her organs to shut down?
In fact, as Peggy lies in that bed, looking so inert, there is an epic battle raging in her body. Let me help you understand what is happening to her and many others like her, as her immune system valiantly fights the coronavirus – in fact, perhaps too valiantly.
In the next posts I will introduce the combatants in this conflict, starting with the enemy, the novel coronavirus known as SARS-CoV-2, which causes COVID-19 infections. And you may be curious about the fate of Peggy.