‘Utterly tragic’: The toll of COVID, through the eyes of a Kansas City ICU doctor
Almost two years into the pandemic, the ICU doctor laughs that his hair is grayer now. The “battle fatigue” he and his colleagues are feeling, though, is no joke.
Dr. Andrew Schlachter prays that his two children, one only 3, will someday forgive him and understand why he was gone from home so much, working.
A number he read recently is stuck in his head: 150,000 U.S. children orphaned by the pandemic.
“It is utterly tragic that we’re seeing families broken,” said Schlachter, a pulmonary and critical care specialist for Saint Luke’s Health System. “We’re seeing wives widowed. We’re seeing babies who are losing their mothers at the exact time of their birth.
“We’re having families wrought with distress who aren’t nearby and not able to come to the bedside. We’re hearing pleas, we’re hearing begs … asking for any therapy that’s possible.
“And in truth, we do everything we can, we try our absolute hardest. But the best thing that we can offer is going back in time and wishing those patients had been vaccinated.”
Health care leaders across the region have sounded the alarm that this latest surge of COVID-19 has them more understaffed and busier than any time during the pandemic. Saint Luke’s Hospital of Kansas City near the Country Club Plaza invited The Star inside this week to see that play out. (University Health did the same last week.)
COVID has Kansas City in its clutches. On Wednesday alone, 4,215 new cases were reported, with 52 deaths.
Schlachter is not the kind of physician to stay silent. Last summer, he joined the governor of Kansas at a press conference to beg the public to take the COVID-19 vaccine.
He warned that intensive care units in Kansas City were in crisis, full of unvaccinated patients, many young, otherwise healthy, some pregnant.
Five months later, he’s still passionately urging vaccinations.
“I wish I had magic words that are any different than the words that I’ve used for the last (two) years,” said Schlachter — rhymes with tractor, he likes to say.
“It’s harder when you don’t see the world I live in in an ICU. But I would say as someone who is an ICU doctor, who has been here on the front lines with my partners and my care teams for the (entirety) of the pandemic, I can promise you, you do not want to be an unvaccinated critically ill patient.”
Tuesday, the day The Star was there, brought the highest number of COVID patients Saint Luke’s has had yet — 217 with active coronavirus and 80 more recovering, hospital officials said. Forty-two were in ICU.
All but 10 were unvaccinated.
Patients with severe coronavirus requiring life support measures are staying longer than other patients on the unit — some languishing weeks and months versus a more typical two- or three-day stay, Schlachter said. “And the longer we stay in bed the longer the recovery process is,” he said.
Sometimes, that road to recovery leads to a rehab center or nursing home before COVID patients can go home.
If they can.
On a ventilator and bypass
In a room across from the nurse’s station on one of Saint Luke’s COVID ICU units Tuesday, a woman lay motionless, with one end of a breathing tube down her windpipe and the other hooked into a ventilator next to the bed.
Two long tubes full of blood ran from her groin out under her hospital gown. The tubes tethered her to a second machine — an ECMO bypass, pumping and oxygenating her blood outside her body.
Humans are not made “to be comatose, laying flat, not moving around, being given medicines and having labs drawn all the time,” said Schlachter.
“If we are stuck in bed, comatose, with tubes in and out of us, paralyzed medically, it is a setup for the possibility of the next shoe to drop and the next issue to unfold.”
The virus can trigger “a lot of chronic health conditions that can all unravel a patient’s condition and stability,” he said. Pneumonia has become a frequent, sometimes deadly complication.
“We have unbelievable nursing staff and respiratory therapists and pharmacists, and all of us work together in a team-based fashion to take the best care of patients,” he said.
“But is it impossible that a patient can get a bed sore or an infection related to one of their catheters, or suffer a bacterial infection, or suffer a blood clot, or have a stroke, or have a heart attack?
“Any of these things are increased in incidence when we’re already very sick.”
Honoring health care workers
For five minutes Wednesday night, the Christmas lights on the Plaza were turned back on as part of a national event recognizing workers in health care, public safety and education during this time of global upheaval. The moment was reminiscent of similar grand gestures of thanks when the virus first infected the world.
Right now, as they battle fatigue and exhaustion and sometimes even their patients’ families, health care workers are hungry for something profound.
“We loved your cookies and we loved your food, but we don’t need sugar,” said Schlachter. “We need you to be vaccinated. We need you to understand how very real and severe this is, ongoing.”
It bothers him that some people suggest health care workers resent unvaccinated patients.
“When we hear about those who have chosen to be unvaccinated for any reason, who then suffer debilitating disease or death, I want to be very clear that there is not a group of nurses and doctors and pharmacists that are saying ‘told you so,’” he said. “We are feeling this tragic loss. It is not any solace to us. It doesn’t make us feel vindicated.
“In fact, it worsens, I think, the trauma of knowing someone who may or may not have had to suffer with death or illness.
“It’s also important to share that when you’re critically ill, no one is asking patients about why or if or anything related to their vaccine.”
He yearns for pre-pandemic days when people trusted their doctors, nurses, pharmacists and other health care providers. He believes “that the covenant in health care is changing.”
“We’ve been accused of not providing the best care, of not giving the appropriate therapies,” he said.
“Every day all of us, I can say with certainty, come to the hospital with the only plan of providing the best care that we know how. And no one has ever walked into a hospital and said, ‘I would like to give bad care’ or ‘I would like to give no care’ or ‘I would like to withhold the right therapies.’
“How we got here I don’t understand. But I would like to move back in the direction of trust in that relationship between the health care team and the patient.”
This story was originally published January 20, 2022 at 5:00 AM.
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