N.Y. doctor uses experience as Ebola patient to fight 'stunningly similar' COVID-19

Transcript

For Dr. Craig Spencer, the helpless feeling is all too familiar.

Spencer is the director of global health in emergency medicine at New York Presbyterian/Columbia University Medical Center. For a month now, he has been working in the thick of the COVID-19 crisis, treating patients day after day, as they struggle to survive.

It's a helplessness that recalls his own experience in 2014 as a patient in a New York City hospital when he was treated for Ebola, after he returned from fighting the virus in West Africa.

Here is part of his conversation with As It Happens guest host Piya Chattopadhyay.

What does it sound like these days when you're working inside the emergency room?

In the past few weeks, the sounds have really changed. It's gone from this cacophony of coughing, different types of coughs everywhere at all times, to more of a silence ... a displacement by the monitors, the cardiac monitors that have these sirens that go off whenever anyone's heart rate goes too fast or their blood pressure dips or their oxygen goes down.

So a lot of that coughing has been replaced by the sound of cardiac monitors.

And why has that happened? Why has that changed?

What we're doing now is we're focusing on the most severe patients. So we're trying to get everyone that's really, really sick, make sure that they're getting the care that they need. Many of them require a breathing tube, mechanical ventilation and life support.

Once you put someone on life support ... it's impossible to cough anymore because you have that breathing tube in. 

That must be quite eerie, even for someone like yourself, who's spent so many hours in emergency rooms.

Yeah. Because everything that we're seeing right now is so different than what we normally see. This is not what we're used to. Our emergency rooms have become intensive care units. We have multiple people that are intubated, waiting for a room in the ICU if they're ever able to get one.

We're just not sure if that's always going be the case for everyone. We know that the numbers are declining, thankfully, here. But you still see that the number of deaths is still continuing to remain really stubbornly high. And we expect that that will likely continue for some time.

Can you give me a sense of some of the people you've been treating? Some stories that stick with you?

I think for everyone, the hardest stories have been the fact that we see so many patients who come in alone. There's no visitors that are allowed. We don't want to get them sick. And really we don't have the personal protective equipment to share with visitors.

And so we've been having to call families on video, on FaceTime, to give them a couple of minutes to really speak to them and talk about what their wishes for care may be.

In some circumstances, families or patients have decided that they want to withdraw any life-sustaining treatment or decided not to be put on ventilators. And so it's really tough to have those conversations and those moments with people who are really sick or with family members who are at home, you know, crying over the phone or over video.

It's just something that we're really not used to and certainly not used to doing this often.

It's very dehumanizing and it makes you feel toxic. And I can only imagine that this is how my patients feel right now.- Dr. Craig Spencer

In your experience as a medical professional, you have treated another very, very deadly illness. You worked in West Africa a few years ago treating Ebola patients. Are there memories from that time that are sort of paralleled in your current experience in New York?

In comparison with Ebola in West Africa, what we're seeing here is stunningly similar. We see people reacting in many of the same ways, providers talking about how difficult it is to be in personal protective equipment for really long days. The physical exhaustion, as well as the mental exhaustion.

But we also see from a social angle that it is quite similar. We talk so much about the role of funerals and deaths in West Africa. And we're seeing here that there's a massive number of deaths every day in New York City. Morgues are full. We're having to think about new ways to honour our dead, and funerals are not being held in the same way that they used to.

So, so much of what we saw and what we heard and what we learned in West Africa, we're dealing with here again in New York City in 2020 with coronavirus.

And you not only treated Ebola patients. You, yourself, were one of them. You were treated for Ebola in New York Hospital when you returned from Guinea. So you have this unique perspective of perhaps knowing what it's like to be a patient looking up at your care providers in full ... personal protective equipment. Give me a sense of what it's like from that perspective of a patient.

It's almost impossible to describe.

It's something that I know very tangibly. I remember it very well. This feeling of looking up at someone that's almost unrecognizable through their goggles and through their masks, trying to understand what they're saying through these sick masks or through these personal protective suits.

It's very dehumanizing and it makes you feel toxic. And I can only imagine that this is how my patients feel right now. They must feel so sick and so disoriented, seeing providers that look nothing like we normally do.

For me, what I think it's done is it's given me a perspective that I try to share with my colleagues, a perspective that we need to have empathy in addition to our humanity and our tradition medical skills. 

We need to think about what it feels like for the people sitting in those chairs or sitting in those beds. It's really hard to do that if you haven't been in that place before. But I have and I try to share those skills and that feedback and those lessons with my colleagues as much as I can.

As a doctor, you have described feeling helpless right now. How is that weighing on you? How are you coping with that feeling of helplessness?

I think in the same way that so many of us dealt with that in West Africa. We didn't know at that time what exactly helped. We tried to do everything we could, but resources were limited. That was before there was a therapeutic drug, before there was a vaccine.

Right now, we don't know what works. Our traditional tools, what we normally do for really sick patients, don't seem to make much of a dent in the impact of their mortality for many people.

So we're trying to do new things. We're talking to friends all over the city, friends all over the country, in Italy and China.

But we just don't know, and that not knowing makes it so hard because we feel like a lot of time we just can't have the impact. And that's not what any of us are used to.

Written by Kate Swoger and John McGill. Produced by Kate Swoger. Q&A has been edited for length and clarity.