A Message From One Of Our Own

December 1, 2020 — Ryan Padgett, MD is an Emergency Department physician at EvergreenHealth in Kirkland, Washington. Dr. Padgett was one of the first frontline healthcare workers hospitalized with COVID-19 in March 2020.

February 28^th, 2020: Sometimes my mind will flash back to that night. I see my counterpart, another physician in the Emergency Department, walk towards me, motioning for myself and the other doctors to join him. He told us what he knew: Earlier in the day, EvergreenHealth tested two patients for COVID-19. Both patients tested positive and that evening, one of the patients died – the first death from COVID-19 in the United States. Huddled together, we stood there stunned, in absolute silence. This confirmed our worst nightmare.

On my next shift, I got called in early – “We have ten patients headed here in the next couple of hours. We’ve converted half of the Emergency Department into a negative air-flow isolation unit. We need to be ready.” I remember thinking, as I drove in early for that shift, that it was going to be a day unlike any other – that I’d been in medicine for 23 years, cared for tens of thousands of patients, worked thousands of shifts and never experienced anything close to what I would see when I walked through the doors.

I would be one of the first frontline healthcare workers hospitalized with COVID-19. On March 13^th I would be intubated by my physician colleagues, and as I was brought up to my own hospital’s Intensive Care Unit, the words we exchanged felt heavy. At that point no one who had fallen significantly ill – enough to be put on a ventilator – had survived.

Over the next two weeks two different medical teams saved my life. They started from scratch, no playbook or clear path to follow. Even being in medicine for as long as I had, I couldn’t fathom the path they’d forged to save my life. It left me awestruck – their brilliance, how quickly they put the pieces of the puzzle together, and their resilience, the heroic nature with which they kept fighting for me at every turn.

With the help of the palliative care team and my then fiancé, now wife, Connie, I woke to a series of ten printed photographs, meant to reorient me to my life. A photo of my EvergreenHealth team from our ski trip that winter, a photo of my family on our boat, a photo of Connie and I together. I was 24 hours from being dead. Those ten photos could have been it. But because no one was willing to say we’re done, there will be ten more photos. And ten more after that.

When I woke up in the hospital, I faced a long road to recovery. In addition to major internal organ failure, I hadn’t been vertical in 19 days. Weak and uncoordinated, I needed to build back the body that once played Big 10 football, but right then, would settle for being able to steadily hold a glass of water. Two days later I would reach my 45^th birthday. An incredible ICU nurse, said “for your 45^th birthday, you’re going to stand for 45 seconds.” As I wobbled on my feet, exhausted, she told me, “just keep standing a little bit longer, we’re going to do this together.” And we did.

As I regained my physical strength, it became clear the most significant barrier to my return to clinical work would be the mental fog, fatigue and concentration issues I faced. As they lingered on for nearly two months, I worried that realistically I wouldn’t be able to go back to work. I knew what I was up against: I’m sure the number of people that go back to work after surviving multi-system organ failure and a prolonged hypoxic episode requiring ECMO cannot be that high of a number. More than that, I knew where I needed to get back to: my job means that 10 hours into a shift I have to be perfectly awake and mentally sharp, able to make critical decisions or perform critical procedures, even at 3:00 AM. I knew that bar was really high and that I didn’t have control over whether the fog would lift, and if I’d be able to go back to taking care of our community again.

But I hoped. And the fog lifted. In July, I stepped back into the Emergency Department at EvergreenHealth. For 10 weeks I shadowed my partners and built up my stamina each shift until I was ready to return full-time. I feel incredibly fortunate to be back, working shoulder to shoulder with my team again. 

Of course, they’re not the same team I left. We’ve all been visited by our worst nightmare. I represented all of us and the fear of what could happen. My colleagues couldn’t go home and talk about it with their kids and partners – their families know me, how do you explain to them that Ryan could die, that he nearly did? And then leave them to walk right back into the fire?

But their courage kept me alive. One of the physicians who saved my life came down to the ER after I came back to work. We’d only maybe met a handful of times so we spent several minutes on the type of straightforward small talk reserved for first time conversations. When he paused to say that he should be headed back to work, I asked him, “can I give you a hug?” That hug was all it took for us both to start crying.

How do you begin to say thank you? For my colleagues, we shared these moments. Only when they saw for themselves the full arc of my recovery, that I was truly back, did the weight on their shoulders begin to lift and the trauma they endured begin to heal. Only then could I say thank you – and they would hear it.

But how do you say thank you when you can’t look someone in the eyes and give them a hug? I struggled with this. Sometimes to the distress of my wife, I’d be restless, wondering how do I say thank you to an entire community? How do I convey that the letters, the messages, the prayers and the acts of kindness – they saved me just as much as the medicine did?

Connie would tell me to take a breath and take my time. So I did.

I’ve never spent much time on the patient side. It consumes you. There would be days where I’d try to get out of bed and the weight of it would hit me. I’d feel useless and hopeless. But then I’d read a note from someone in our community or see photos of the meals sent to Connie and my family. I’d see how our community embraced us, how much love was out there, and it would buoy my spirits. It would give me enough to keep going.

Being an emergency room physician – it’s a hard job. We see people in the worst of times, and we try to do the best we can. We try to make a connection with our patients, but the circumstances can work against us, and we’re often left wondering if we could have done more. Seeing the outreach and kindness, the effort everyone went to just to let me know they’re praying for me or thinking about me – it’s validating and heartwarming. Hearing over and over that you made a difference in people’s lives – it’s like reading your own eulogy – it’s humbling and I’m forever thankful.

Part of me didn’t think I’d tell this story. I prefer anonymity – always the offensive lineman, never the quarterback. But as I’ve experienced first-hand, there’s always a need for hope; a need to remember that absolute darkness is when you need light the most and when it shines brightest. When I woke up in the hospital in March, I couldn’t believe how we’d come together and how, universally, we’d found purpose in looking out for each other. We celebrated those on the frontlines and took pride in our own role to keep them safe. I found courage and hope in that new world.

Since then, the light has dimmed – months of fatigue, economic uncertainty and caution can do that. But we need to recapture that light if we’re going to make it through to the end.

Because I’ll tell you we’re still in this. Nine months in, healthcare workers say goodbye to their families, put community above self and go in for their 12-hour shift. Day after day. Our commitment has never wavered. It has been battered by exhaustion, loss, sickness and heartache, but it has never wavered. And right now, we need you more than ever. We need you to dig deep and stay in the fight with us. We know you’re tired – we are too. But sometimes, when you’re more exhausted than you’ve ever felt, you just need someone to say: just keep standing a little bit longer, we’re going to do this together.

With best wishes for the health of you and yours this holiday season,

Dr. Ryan Padgett | Emergency Department Physician, EvergreenHealth

Our EvergreenHealth team asks you to continue to keep our community safe: wear a mask, social distance, avoid gatherings, stay home as much as possible and follow all health and safety guidelines. If you’d like to support our community’s healthcare heroes, please do so from home and make a gift in their honor at www.evergreenhealthfoundation.com.