a close call

“Funny” was the word 68-year old Robert Calandra first used when describing the symptoms that would eventually lead to a COVID-19 diagnosis. But soon, “funny” turned to “odd,” which turned to “very, very wrong.” The Ambler resident is a talented writer whose work has appeared in books, magazines, and newspapers, but he never expected that his own life would become the story.

He felt fine while playing ice hockey one day in early March, but by the following day, his temperature began inching up, and he felt increasingly tired and listless. “I actually went into my office and pulled out my will and medical power of attorney, wrote some notes, signed them, and left them prominently on my desk. I just had a feeling that something bad was happening,” he said. “From there, it spiraled.”

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At the encouragement of his primary care physician and friend Michael Cirigliano, MD, FACP, a Penn Medicine internist, Calandra visited the drive-through coronavirus testing site in Radnor. But his longtime girlfriend Monica Hamill soon needed to call Cirigliano again — Calandra’s temperature had jumped to 102.5 degrees, and he was so weak that he could barely sit up, even with Hamill's help. They simply couldn’t wait for the results of the test. Cautioning Hamill to stay at home to contain the virus in case she was also infected, Cirigliano recommended that Calandra’s daughter, Lindsey Calandra, MSN, CRNP, a nurse practitioner at Children’s Hospital of Philadelphia, go out and purchase a pulse oximeter for her father. If it showed his oxygen level was under 90 percent, they needed to go to the emergency room immediately.

Calandra’s reading was a dangerously low 80 percent.

“I was pretty out of it, but I did tell them that Penn Presby was the only place I wanted to go,” Calandra said, explaining that he had previously received exceptional care at PPMC when he experienced septic shock. “Monica bundled me into the car, and from there, I remember flashes — parts of the car ride, being helped into a wheelchair, arriving in the isolation room,” he recalled. “My last clear memory is of the doctor telling me I needed to be intubated immediately. And then... I began my magical mystery tour.”

For Hamill and Lindsey Calandra, the next several days were harrowing. Because they could not visit the hospital due to COVID-19 precautions, Lindsey established contact with his care team and regularly received a roller coaster of updates. Calandra was initially described as “very sick,” then seemed to be pulling through, only to suddenly become unstable again.

But the experience was very different for Calandra. While he was unconscious for most of his 13 days on a ventilator, he remembers a series of incredibly vivid dreams, some of which corresponded with his condition. “I was a 19th century ship’s captain for a while, and I remember having a ponytail and wearing a short green jacket and silk stockings,” he said. But when his blood pressure dropped and his fever spiked to 103 degrees, his dream state shifted to “a devilishly hot day in Atlantic City. I just kept saying, ‘We gotta cool off.’ I think that was the night they were putting ice packs around me to bring my temperature down.”

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With an incredible care team on his side, Calandra steadily began to improve. Infectious disease expert William Short, MD, MPH, reached out to Lindsey about a clinical trial he was leading investigating the effectiveness of an antiviral drug, Remdesivir, in treating COVID-19, and she agreed to enroll her father. A few days passed, during which a foggy Calandra had FaceTime conversations with both his girlfriend and daughter that he has no memory of, mistook Short for actor James Earl Jones, and, after being extubated, reveled in the perfection of the “gourmet meals from the gods” — applesauce and pudding.

But there was one thing that Calandra was not foggy about at all, and he shared it during his next phone call with Hamill. “Monica and I have been together for eight years. As I was laying there, I kept thinking that life is the blink of an eye — and I just blinked several times over 13 days,” he said. Indeed, not only had he faced a life-threatening illness, but during his hospitalization, Hamill’s father also passed away. “It was time to move things forward. So… I asked her to marry me. She was stunned, but eventually said yes! And it had nothing to do with the ICU drugs!”

“Amidst the chaos that COVID-19 has brought into our lives, it has also forced us to reflect on what’s truly important and to find ways to connect,” recalled internist D. Rani Nandiwada, MD, MS. “When our team met with Robert in the ICU, we told him that the gossip mill said he might be engaged. He laughed and told us that after everything he’d been through, he hit the point ‘where you just gotta do it.’ He made our day and brought so much happiness just by sharing his joyful moment.”

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After transitioning to the step-down unit, Calandra was finally discharged — nearly 30 pounds lighter, but alive and on the road to recovery. For the last several weeks, he has been working with Penn Medicine at Home diligently via telemedicine, noting that he “can’t say enough good things” about occupational therapist Marisa Hart MS, OTR/L, and physical therapist Sarah Penning, PT, DPT, MDT. “They’ve been fantastic. I came home on a walker, and now I’m walking on my own — still a bit shaky, but doing better than anyone expected.” The compliments extend to everyone who cared for him during his battle against COVID-19. “I tell everybody, ‘If you’re sick, you need to go to Presby,’” he said. “I’ve received nothing but great care. They saved my life.”

Thanks to the tireless efforts of PPMC’s doctors, residents, nurses, and respiratory therapists, Calandra has been able to put his will and medical documents away. Instead, his desk will soon be piled up with manuscripts detailing his story, song lyrics about his experience to share with his bandmates, and plans for the future.

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