By Mary Beth Schweigert
Five days into his hospital stay with COVID-19, Daniel Wu, DO, struggled to breathe. He wasn’t surprised when his doctors decided to move him to the Intensive Care Unit.
Wu was an inpatient at Lancaster General Hospital, where he works as a trauma surgeon. As a physician, he knew exactly what the move to the ICU meant: He would likely go on a ventilator, and his odds of survival were plummeting.
He had just enough time to make five quick phone calls.
“I called my husband, my parents and my three sisters,” he said. “I told them I love them. I knew I didn’t have a lot of time to talk about anything else.”
Despite the odds, Wu, who is 44 and has no serious underlying health conditions, did survive. Three months after his nearly fatal brush with COVID-19 began, lingering effects from his illness have prevented his full return to work. When he does get back into the operating room, it will be with a new perspective on the patient experience, honed by the challenges he has faced on his own long road to recovery.
In mid-March, when LGH treated its first COVID-19 patients, Wu and his fellow trauma surgeons began working modified schedules to minimize risk of exposure. After a week on night shift, Wu, a trauma surgeon for 11 years, started feeling achy and rundown.
He figured the late hours were catching up with him, or maybe he had the flu. When he spiked a fever, he still wasn’t too concerned about COVID-19, since he didn’t have any of the other most common symptoms. But his primary-care team advised him to get tested, due to his risk of exposure as a health-care worker.
Though he doesn’t know for sure, Wu believes he contracted COVID-19 at work. Even before his test results came back positive, he began to experience night sweats and chills. His fever persisted, despite taking acetaminophen every four hours.
“About a week into my illness, my breathing became rapid and shallow, and I wasn’t able to catch my breath,” he said. “I knew it was time to go the Emergency Department.”
With treatment to help control his fever and breathing, Wu started to feel slightly better. He considered waiting out his illness at home. Then he remembered a colleague’s observation that seven days usually marked a turning point, where COVID-19 patients either got better or much worse.
Wu decided to stay at the hospital. In the early days of the pandemic, much about the virus remained unknown. A conversation with a colleague, hospitalist Jennifer Nguyen, DO, helped to ease some of Wu’s fears related to that uncertainty.
“Dr. Nguyen explained to me how much discussion, literature review and research were being done by the hospitalists, the infectious diseases team, the critical care teams and the administration in order to make sure I and the other COVID patients were getting the most up-to-date and optimal care to help recover,” he said.
The hospital turned out to be the right place for Wu. His symptoms escalated over the next few days, which he spent in isolation on LGH’s COVID unit. He grew increasingly lethargic and borderline delirious. His breathing again became rapid and shallow.
“As I physician, I had the benefit of being able to read my own chest X-rays,” he said. “One day my X-ray looked so horrible that I actually gasped. My mind was racing with all the possible risks and complications from that point forward.”
Pulmonologist Steven Khov, DO, was very concerned as he watched Wu, his friend and colleague, become increasingly sick. He knew Wu would need a ventilator to help him breathe.
“I didn’t know how long he would need to be on the ventilator, or how he would fare in the long run,” Khov said. “Seeing a friend as a patient really drove home how serious this virus can be.”
Soon after Wu made his five phone calls, he remembers the sensation of the breathing tube being placed in his throat. Then he remembers nothing until 2 ½ days later, just before he came off the ventilator.
Wu returned to the COVID unit, where his condition gradually improved. In the course of his illness, he had lost 15 pounds and grown very weak. A blood clot in his leg further complicated his recovery. He went home April 15, after 12 days in the hospital.
Lessons Learned from COVID
For many health care workers across the nation and world, the fear of exposure to COVID-19 at work was an ever-present factor this spring, especially at the height of the pandemic. The Centers for Disease Control and Prevention reports that over 83,000 health care workers have been infected to date.
Experts quickly learned what safety measures were necessary to protect health care workers and patients alike. Penn Medicine was among the first large academic health systems in the nation to adopt a universal masking requirement for all staff working in its facilities — a step which, along with other stringent personal protective equipment requirements and thermal screenings for staff, ensured the safest possible environment.
“The safety of our staff has been a chief priority ever since COVID-19 emerged because it’s so critically important that we be there and be well to care for our patients and the communities we serve,” said P.J. Brennan, MD, chief medical officer of the University of Pennsylvania Health System. “Our infectious disease physicians, occupational medicine teams, and scores of others have worked together continuously to synthesize evidence, map best practices, and manage and distribute protective equipment across the health system.”
In the weeks after leaving the hospital, Wu still tired easily and grew short of breath very quickly. Eventually he could make it up a flight of stairs, but he had to stop to catch his breath at the top. Although he slowly regained his strength, even now, two months later, he still uses oxygen to help him breathe at night. He often needs to pause to take an extra breath during a long conversation.
Wu is unsure if COVID-19 will leave any lasting effects on his health. While he was recently cleared to return to work, he has significant restrictions. His physician is concerned about the unpredictable nature of his job. He’ll need to be able to get up and go quickly, without getting short of breath. And he’ll have to manage inside an OR for long periods of time, without immediate access to oxygen.
Carla Leed, LG Health administrative director, Emergency Department & Trauma, said Wu’s fellow physicians and other colleagues throughout the hospital were thrilled to see him return to work. All were very concerned about the seriousness of his illness, particularly during his three days in the ICU, when the situation seemed dire.
“His illness had an emotional impact not just on the Trauma team but his colleagues in the many departments he worked with closely,” she said. “It hit really close to home for them on a personal level.”
Wu, reflecting on the last few months, says his personal experience as a patient will fundamentally change the way he practices medicine. He has gained a new understanding of the anxiety and isolation many patients face in the hospital, most without the benefit of a physician’s inside knowledge of all that is happening around them.
Thanks in part to his reassuring conversation with Nguyen, he notes he is more aware of the impact his words can have on easing the concerns of the patients he treats for gunshot wounds, stabbings and other traumas. His words to patients and their families also will be infused with a deep sense of gratitude for his own improbable survival.
“God has more in store for me,” he says. “I have more to do in this life.”