At first, he thought he’d caught a cold.
Joshua Wortman had just returned home from a West Coast business trip in early March. As the early reports of the coronavirus outbreak in New York began to make the news, Wortman and his wife, the journalist Rachel Dodes, decided to take their 6-year-old son A.J. and their dog Coco from their Long Island City home to Dodes’ parents house in Westhampton.
The couple wanted to get out of the congested urban environment and were unaware they’d be fleeing the epicenter of the pandemic in the United States.
“It seemed like the perfect place to be quarantined,” he recalls.
In retrospect, Wortman thinks it may have been a decision that saved his life.
By mid-month, Wortman recalls, he felt feverish and had developed a cough. They’d just settled into his in-laws’ place — they winter in Florida, so the Westhampton house was available — when he began to feel significantly worse.
Several days later, he said, “it was like, all right, this is to the point of ambulance time.”
Up until then, Wortman figured even if he did have the coronavirus, he would recover on his own. At 45, he is healthy and fit. It would be like just the flu, he said.
“No big deal, right?”
Wrong, as it turns out.
Wortman was coughing so much and so hard, it hurt. “I think I pulled every muscle in my back from coughing,” he says.
He began to have serious difficulty breathing, so his wife called 911 for an ambulance. The ride to the hospital in Riverhead, tended to by EMTs in hazmat suits and gear, was the beginning of an odyssey he’ll never forget — even the parts of it he can’t quite remember.
Not long after his arrival at Peconic Bay Medical Center, Wortman was in the intensive care unit on a ventilator. He doesn’t remember much from that first week, he says.
“I’m a little hazy,” Wortman explains. He was heavily sedated, as is standard with patients on ventilators. The sedation is needed to keep them calm.
“It’s really hard to relax with a tube down your throat,” he says. “You’re in restraints. You’ve got a million needles and tubes in your body. And you need to relax and just breathe,” he says. “That is not easy.”
Wortman credits the doctors and nurses with helping him through it.
“It’s not like I’m just this vegetable in a room with a tube down my throat,” he says. “There were times of semi-clarity. And those were the most challenging moments.”
He remembers nurses holding an iPad in front of his face so he could have a visit with his wife. The hospital had stopped all visitors to curtail the spread of the virus. Someone donated 100 iPads to the hospital and that iPad provided him with a link to his family that meant a lot to him, Wortman says.
The ICU staff would walk back the sedation and the respirator, to gauge how the patient could do on his own.
“Patience was a big part of it,” he recalls. On “day seven or so,” his patience ran out.
“I couldn’t take it any more.”
Focused on getting the tube out, Wortman worked his way out of the restraints and pulled out the tube.
“I’m pretty sure I did it,” he recalls, a hint of mischievous pride in his voice. “There were alarms going off and 20 people in the room. I couldn’t have done that day two and lived. I had already turned the corner. I just did not want to be on that respirator any more. It’s not a pleasant — it’s just like, when you’re conscious of it, you feel like you’re choking.”
Patients pulling the tubes out is more common than you’d imagine in an ICU, Peconic Bay Medical Center deputy executive director Amy Loeb said.
“Before we can take them off the ventilator, we have to remove the sedation — lighten it up and pull it back till they can reliably breathe on their own.”
Once the tube was out and he was breathing on his own, Wortman was moved out of ICU, where he spent the next week being nursed back to health.
“One thing that is clear is that the level of care was not just this clinical thing,” Wortman says. “It was a pretty powerful combination of — frankly, people in a kind of situation they’ve never been in before, innovating as they went along with rules changing every day — and caring for me as a person. I had really great care. I wasn’t just like a data point about COVID,” he says.
“Even if I couldn’t talk or I was out of it and wouldn’t even be able to look at the iPad, I would get a communication from the nurse. ‘I spoke to your wife. She loves you and AJ is going great.’ Every day they were having meaningful conversations with my family, and that meant a lot to me.”
The hospital has posted personal information about each patient on the door to their ICU room, Loeb said.
“We have asked the family for information about them, who they are, what’s important to them. That’s an interaction we normally have face-to-face with a patient that you can’t have when he’s on a ventilator. We need to have that kind of interaction,” she said.
Wortman says it meant the world to him, boosted his morale and kept him going.
“They are the real heroes,” he says.
Members of the staff who could get away for a few minutes went outside to give Wortman a sendoff with a “clap out” Wednesday afternoon when he was discharged.
Wortman was PBMC’s first seriously ill COVID patient, the first to be put on life support, Loeb said.
“For him to feel wind and be discharged from the hospital,” she said today. “It was such a source of hope and optimism for all of us. I can’t even describe the power of that right now.”
There have been other patients whose stories have not had happy endings. Many remain on life support. The hospital’s 16-bed ICU is full, and Loeb said PBMC expects its second, 12-bed ICU to follow suit before long.
Some patients have died.
“As I said to the team up on the ICU, this was one we really needed,” Loeb said.
Wortman is a healthy adult with no pre-existing conditions that foreshadowed his case becoming critical.
“When we first heard about this,” he says, “it was like most cases — quote, unquote — feels like a bad cold or a flu. But it’s nothing like the flu. Symptoms that are mild are suddenly not mild at all,” he says. “That’s why testing is so important, so they can understand how the data matches.”
His wife tested positive, he says, and her case was completely different —more like the flu.
The range of illness severity is puzzling to doctors and scientists, who are trying to piece together information about how the disease behaves and progresses.
Being reunited with his family, Wortman says, is “really the best feeling ever. Nothing can compare. Words fail to describe how amazing it is being back together.”
He urges everyone to maintain social distance as the health authorities advise.
“Take care of yourself, your family and your loved ones. Take this really seriously, as seriously as you can, because it is a very serious thing.”
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