Heroes of Healthcare
Heroes of Healthcare

Episode · 1 year ago

Call to Arms: One Doctor’s Courage During Crisis


When a crisis strikes, how do you react?

For many healthcare professionals, a crisis is a calling.

That was the case for Dr. Juan Cucalon, Board-Certified Anesthesiologist, when COVID-19 hit earlier this year.

In the latest episode of Heroes of Healthcare, Dr. Cucalon shares why he couldn’t just sit by and do nothing while a pandemic was raging.

We discuss:

  • How and why Dr. Cucalon stepped up to respond to COVID-19
  • The challenges in treating a new virus
  • Why a second wave didn’t surprise Dr. Cucalon

Heroes of Healthcare is hosted by Ted Weyn.

To hear this interview and more like it, subscribe to Heroes of Healthcare on Apple Podcasts, Spotify, or wherever you listen to podcasts.

You were listening the heroes of healthcare, the podcast that highlights bold, selfless professionals in the healthcare industry focused on transforming lives in their communities. Let's get into the show. Welcome to the heroes of healthcare podcast. I'm your host, Ted Wayne. I'm excited to be joined today by Dr Juan Cuclon. Dr Cuclon is a board certified anesthesiologist who resides in the Miami market. Most recently, Dr Cuclon was featured by Delta Airlines as one of the heroes of the covid nineteen fight against the pandemic. Thanks for joining us, Dr Cuclon morning. Thank you for having me. Dr Cuclon, can you please share a little bit about your background with our listeners? Where were you born? Where were you raised, where'd you do your medical education and what are you doing today? Well, I was born and Raising Kari, Columbia, South America, and after high school I went to do my med school in both that that's the capital of Colombia, and briefly five years I did primary care and he are you know, the town Coleman and sids? That's in small town new where the coffee is made and not that point I decided that I went to do something more with my life, and this when I came to the US, first to La where I start doing we get your CARDIOC. Fellowshit. That lasted about three months when I realized that I needed to really get a job in order to like. So survived. I was lucky enough to get a position at the University of Miami Department of Anesthesia, but I did my training from one thousand nine hundred and ninety nine to two thousand and three. Two Thousand and three, okay, Great. And so you've been living in Miami, I guess, since then, since since two thousand and three, and married. Yes, I'm married. I have three daughters, three daughters I have too, so I know a little bit of what that's like. So, you know, maybe you can start Dr Google. I'm with January this year and February, so we're a little bit before everything has broken out. And whyn't you tell us kind of what your world was like back then, in January, in February, when you started hearing about this pandemic? And then what did March in April look like for you? Well, like I guess, like everybody else, are on January. So hearing about this outbreak of covid nineteen corner virus in bull on. But we have have these kind of things happening during the years and kind of like don't reach US personally. So I really thought that that's what's going to be the case and it's going to be control and go away like any other virus that happened in the past. So we work doing our lives as usual, I guess, as many of the people are on the world, we're doing until we started like listening to the reality of like the spread, what's going and how deadly and fast its virus was killing people in how it was reaching places outside of China, like Europe, and then how he came here in his shell in New York. I have friends that live in New York and actually work in healthcare, so I called them and and they were really telling me this is horrible. You don't have an idea. Then it came here to like spread around the states and we reach here like South Florida, and at that point the governor, as many others, order a lockdown and see some of activities. So what was considered another essential I was working in cosmetic plastics clinic and of course that's non essential and we were forced to shut down from one day to the next. You was like Wednesday, we've been talking about like, okay, what are we going to do? How we're going to manage this? I came home and like a nine pm my boss called me say like we're closed. Wow, overnight, overnight. So you're like okay, and for how long? Nobody knew. Yeah, so the first night you really don't think much about it, but when you wake up Thursday morning and say, okay, I'm here at home, I'm supposed to go to work and I don't have really nothing to do. So the first like two three days you're like, oh well, I just take a little rest. is...

...going to go away magically, like most people probably thought about it. But the news and the reality of everything that we were seeing what's like getting worse and worse, and we were not ready as a community to deal with the problem. Right. We now really how these buyers behave, and I still think that most people don't really know. Now are we going to attack all that and how we can prevent things? So there's like a lot of panic and I certainly going around a week after then I decided, okay, I cannot stay here just stumbling my tongues looking at things on fault. I need to do something. I start looking locally if there was any need of like people to help in the hospitals here. I don't think there were like still hit hard enough and they had enough people, so there was not really I need to like get supplemental people from the outside. That's why I run into the Jackson and cocker offering to like place you in different places, and I said I'm ready, because that was a pretty interesting process, because I remember that was on a Friday and the following week, Thursday night, they called me and tell me you're going to Georgia and I go like when? Tomorrow? We're starting on Saturday and I go like oh well. So I told my wife and she wasn't very happy about it. Now she was want to left at home alone with again all these fears that everybody had, and on top of that, I was going to go to the war zone and be exposed to like this virus like first hand. I told her, listen, as long as we have protection and we know we do the right thing, I don't think I'm going to be a problem in terms of getting sick right, and you think at that time, when you said that, do you think you had a full appreciation for what this was and what it was going to be? And reality, I spend the whole week really reading what's up in terms of like prevention, treatment and how the virus are supposed to work. I was supposed to in fact, and all this. So when I got to Georgia, I thought that I was like this super night going. I got this guy's I'm ready for me. Was a big surprise when I got to the hospital and up morning when they asked him. Okay, so we have this treatment that everybody's talking about, and how many of these paces I made it out a life? They told me zero. Wow, so for me that was a big step in the face. Yeah, because they's like, okay, everybody talks about the wonders of this treatment and is not working. So what do we do now? Yeah, right, yeah, so, right, exactly. You know, and it's funny, as we are starting to talk to more and more people about this time, that does seem to be the theme of that early days, the late February, early March into it, which was just a lot of uncertainty and confusion and don't know what do we do next? Where do we get equipment from? Things? People aren't responding to this thing. You know, so many of the positions we speak to just said we just didn't know what to do and we didn't even know what to do as it related to quarantining and protecting each other. So when we were done with our ship, where do we go? How do we make sure we don't touch other people? You know, a lot of that uncertainty, certainly in those early days, for sure. So, and just again for our listeners, you've mentioned Jackson Coker and Jackson Coker is a local tenance company and they place temporary positions. You said that process was very quick. So you saw a call on the Internet from them and responded. And tell me again, how long was it until you were in Georgia? A week, one week. Wow. And again for some of the listeners who don't maybe realize typical privileging and credentialing for a physician like yourself to go to another facility, it typically takes sixty to ninety days to just verify all your credentials and getting privileged at the facility. And this was one week later. There you were. Standing in the facility. So obviously unprecedented times. Well, not only does the privilege, but their licensing is also another thing. That people understand your license in one state. That doesn't mean that you just kind of cross the line and start practicing this state and neighbor...

...or like you whatever you want to go. That process takes usually about three, six months or like longer, depending on what state you're applying for. For me, what's like quickly, something really, really impressive, right the government got the licensing dawn managing by Jackson and Coker, and how fast the hospital I was able to like privilege emergently all the physicians that they require to like come and work there. Yeah, many of the states went into state of emergency and therefore they could use the governor's ruling to say these things could be suspended under the normal circumstances due to the emergencies going on. My also know that you were highlighted by Delta Airlines. Is Delta stepped up during these times and we're providing free flights for COVID emergency relief healthcare providers. Was that your initial trip was at on Delta or did that come later? That come later? The first trip I took again. My wife wasn't very happy that I was going to go, so she started thinking how to avoid like crowds, and the first thing to came in her mind was airports and airplanes. So she actually suggested that I will drive from Miami to win at and I say, okay, I'll do it. I got that there's something to like make her like little bit more peaceful with the whole idea. Sure, it was only eleven our almost twelve hour trip. And then, for me was amazing to see, because you got stuff for gas and get some food, that you're like using the laws and putting your masks and going around, and a lot of people were like nothing is going on right as the people golfing, people fishing, people gattering, and I was like wow, I don't know if these people don't see the news or don't read or like they live in a different world, but I guess it's just a different way to like live life. So that was my first trip took. I think was weak and that that I decided I'm not driving. This is far, far more dangerous than dealing with the covert. Okay, so that's what I told him. I'm flying more d think that's crazy. Yeah, yeah, Pussy. After all those hours that you're working, to then have to jump back in the car and to drive home was difficult. Let's go back when you first got into the hospital here in Georgia, you were thrown right into the working with the folks. And how did they assign you? What did they do? Want to tell the listeners a little bit about what it was like when you first walked in. I know you said earlier you got that first message, which was nobody surviving. But how did they deploy you within the hospital? And I got there, the critical care department was like run with up a group of people that are really good at doing critical care, but this aspect of critical care was very foreign to them. To and of course you're coming to a plate that no one knows who you are or how qualified you are. Right and I guess there was a little bit of fear from their side, like giving responsibilities to somebody like me that just arrived saying I want to help. HMM. So they were very welcoming, but I think in their inner thoughts were like, Oh God, what are we gonna do with this guy? So the first day actually, I was just following them, like seeing what they're doing, where they go, and that was a Saturday. Probably felt like you were back in your residency. Well, kind of like an observership, because you were not really handsome doing anything right. But someday morning did the sign up and they said do you want to take patients or like sure, so they gave me, I think, two patients of the whole senses that they had. So I went up, start looking at things, start communicating with people, start asking questions. What you guys do? Hear what you use? How we do this, and I think after they three, just drawing your own body. And it's funny because everybody has their own idea. So have to manage things and since there's no real protocol how these things should be managed, it was try up on there. So we will sit down and compare notes and see, okay, I'm doing this,...

...is this working? Or why are you doing? Why you do this? So we start developing a little system that the end, like the last couple weeks later, the local tenants will take care of the covid people and their staff will take care of the rest of the things, and I think that help us understand better what we're doing good and what was doing bad, and the outcomes actually starting to improve. So it was collaboration that was really helping narrow down the best course of treatment for these patients as they were coming in. The director of the unit is a very wise guy and you will come with ideas and the guy will like look at me, like kind of when you were a little kid and you tell your father that you want to do something and they look at you like yeah, kid, I don't think that it's going to work, but you want to try it, as long as it is not harmful, right, go for it, and we were doing also in the whole Georgia system, at least Atlanta, there's three big players in health care. Here's Emory, there's north side and I think there's no star right, and they came together and there will do ground rounds once a week and they will discuss what was working and what was not working. So they certain actually help us weed out lots of things. was there anything that surprised you, like maybe you were saying, I don't think that will work, or somebody reported we're seeing this is working and you were a little surprised, but you did eventually you saw that it was working. Think one of my strengths is I'm very good at observing things and listening to other people too, and like analyzing results. I'm not very esoteric in data management, but I like to see clinic stuff and how it works and how it doesn't work. And, as I tell you, the director let us do whatever we thought was going to be good. So a little later during the course, we saw that the hydroxy Floricquin, and that's a promise and all this boodle things we're really not doing what they were supposed to. And so the whole system came to the same conclusion. So we took that out of the management and we started dealing with actually the disease in a different way. Another big lesson was to be patient, because humans, at least us as doctors, one of the see results very fast. Yeah, and we learned that if we move fast, the outcomes will be back. So it took also a lot of a leap of faith in all of us to like say, okay, we're going to do this thing here that seems very minimal and we're going to wait. Yeah, and we came to the conclusion after like once people get really sick, it takes between three to four weeks to get back if they're going to make it out. Wow, and doing those four weeks, you need to like learn how to control your anxiety, your frustration and how to like help the team that's helping the patients and nurses, respiratory text and everybody else, like being the same page and done like crumble. Don't talk a little bit more about that? That's awesome. I love the fact that, and again, same thing. We've been hearing stories in Mount Sinai up in New York and their rush, where physicicians who were inactive because of their specialty being shut down for them to move into helping with covid some of them were asked to do nursing duties, some of them were asked to do whatever needed to be done. And so talk to me a little bit about that in terms of the compassion e each group was showing for each other and how you guys supported each other. I was lucky that. I think the group that I work with is amazing and every single way their professional, but they're also very good people and looks like they are very good as a unit. Again, I went the morning rounds with the nurses and text that I was dealing with, with the patient Kire that I had, and then we'll come back around like noon w do the rounds with the pharmacy, with the runs, with physical therapist, with everybody altogether through the whole unit, and it's amazing how things that you forget or like overlooked other people can pick and then if you're open to like listen and let them do their job, I think the whole thing improved and the whole unit, like flourish, became a much stronger unit. So it was really through the power of collaboration from all...

...sides of health care was really helpful and getting the people the care they needed and seeing some better results. My point of views, like it's like they are. I mean, you may be the general but if you don't have good soldiers and good like Middle Commands, your tactics are not going to work. And I really have to give it to the nurses of the text, because you are going there like couple times a day and yes, you go in your dress yourself to touch the patient, Bla, blah, blah blah, but then you're out of there and the ones who actually have to execute the plan is them. Yeah, so sticking with the theme of our show here. In your view, those were certainly some of the heroes that we're running in on the front line. You, like you said, sometimes at the general you can stand back and create the strategy and go see certain things, but then you deploy the soldiers who have to run into the front lines and execute the plan. If you ask me, I really think that the heroes are the ones that are like in the front line, and I'm calling the front line inside of the rules, with the seek people. Yeah, when you're outside, protected by a glass without positive or negative pressure room and you're full peeping but you don't touch anybody, you're really not going to get exposed to it, right, and those people are like mother's wives, sisters and end that fear. You like being contamined with a deadly pathogen and then bring it to your environment at home. It's something that is very, very hard to like cope with. Yeah, and so, and I love the way you say that, because that's that's really what this podcast is about. It's about highlighting those people who are heroes. Heroes are people who are willing to put themselves in harms way in order to help other people out, out and one of the things I heard somebody else say, which I love, is there's the real reason these folks are here as also is they don't have super powers. You know, so we think about a lot of times heroes have those super powers and in this case these folks are just human doing super human things. That's the way I heard it put and I love that. And if you like talk about super powers, like the stuff that we saw, marble and that kind of thing, I a hundred percent. But I think these people have the superpower of like forgetting about themselves and caring for somebody that needs that kind of care, even that means that you may die. So that's been unselfish and for me that's even bigger than being able to do all the things that this so coheres to. Yeah, no, absolutely, and and it's amazing right it. But it ties into the calling. So ties into the calling that you have, it ties into the calling that they have. Other if I ask you the question, why did you get into medicine? When I was probably late seven eight years old, I gotta dcase called toxic plasmosis. That's a little prosite that everybody can have actually, but in my case affected my vision a little bit and I had treaten for about a year where I had to have my pupils they lated and I could into sports and take some like medicine that was very nasty. So I didn't need to. I lost weight and there was a name making lap of black. At that point I started like going every week to a different doctor of a high doctor my pedetrition and get lap word tone and I start getting really interested in how this works and what's curiosity and how the human body defends themselves. HMM. So probably by thirteen, fourteen already was decided that I wanted to become a doctor. Wow, so tell us a stray shot from there. It was that's great. Yeah, it's a that's a gift. Right, so many people. I remember getting out of college and still not knowing what I wanted to do. You know, you are fourteen. You knew what you wanted to do as a gift and you pursued it and that's that's awesome. So let's go back. So how long did you make the trip back and forth to Georgia and when did that in for you? It was two and a half months, okay, and I would have done it longer, but again the clinics here we open and actually spent two weeks more there before coming back and they called me again say Ay, if you want, we have more work. I asked my boss and the guy up in his eyes really big and kind of like got you out of your mind. That was the end of the of the going back and forth. There was the end of going back and forth. So I just love the fact that you couldn't...

...sit at home knowing that there was needs and knowing that you had this skill and this knowledge and that you could help, and you were also willing to run into the front lines to attack this thing. So tell me a little bit about when you would come home and I guess I assume you had to quarantine when you would come home. And how is that, you know, for your family, because in my view, your wife and your daughters and heroes too, because you know they were. You know, it's a sacrifice. It's a sad analogy, but a lot of what we're talking about with this pandemic and with the healthcare workers is very relative to military when people going off to battle or working in the military. And you know, one of the other unsung heroes in those stories are the families at home. You know, you talked about it even a little earlier about that frontline workers are MOMS and dad's and sons and daughters who are risking themselves there too. But your family made some sacrifices as well. In my case, I don't have like a traditional family. I'm been divorced, so my daughter's tone live with me in my life. So that sense it was fairly simple. Tell them just staying out of my contact with me for like a lot of my wife, right, and my wife to say the quarantining. I'm just coming home as you something happens with you with it right, at that point we sid seeing that this virus has a very interesting way of behaving. In that way is that you don't know what's going to do. There's no real pattern that you can follow. Yeah, so tell me a little bit also about the testing. When you know for yourself? Would they test you when you would get there, with a test you when you leave? was there frequency of testing yourself for covid actually, during the whole experience I never got tested really. Yes, take your temperature and if you're feeling fine and there's no like clinical signs, you're good to go. And did you see work people who you working with contracting it or was the PPE and measures that the facility was taking were working and keeping people pretty safe? During my stay there I knew of two physicians that had had it and they recover but from the other people, nobody got it. I tell you that the protocols that they develop and the PP that they had have to give it to their ministruation of north side. They were really prepared to handle the stuff and they were thinking also, okay, we have this amount of ventilators and they're asking me, can we use the NYSTESIAN machines, a Spenti lators in asy, as you can, and so in case that we need to have extra stuff, we can do this and we can do that. So they were like really thinking ahead, preparing to something worse that can develop. Right, that's great. I'm just great to hear that they're taking those measures and it was obviously working because if we saw the outbreaks were going. I haven't read much about I saw an article this week that supposedly nine hundred staff at the Mayo Clinic up in Rochester, Minnesota have tested positive for covid so it seems like they're having a bit of a super spreader event at that facility. So I think that problem. Well, that's just a wild gas. It's like people start to relax. Yeah, and then if you relax, you have two chances of getting effected or high. Yeah. Well, it's perfect savory, because I wanted to ask you what do you think of this new way we're going through? Are You surprised about it? Not Surprised by it? I'm not surprised whatsoever. Yeah, the one of the things about humans is that we are fairly selfish and careless as long as we don't see things affecting us directly. Right. So I hear comments that, why do I need to wear a mask? Why do I need to like not go here? Why can I have like this party with three hundred people? And and you like really, do I have to explain you this? The things I really want to slap you this is because I seen what this virus do. Yeah, and you don't care because probably you think you're immune or like, he's not going to happen to you. Right, that's for me. Is Why it's not surprising that this is going on now. With the winter approaching and things getting colder, people are going to go indoors and there they lost the fear. Everybody's talking now that, Oh, you know, this virus is only three percent deadly. So...

...if you get condemning, chances are you not going to die, and that's probably true, but they don't see besides dying, there's other things that can happen to you, like become handicap or like getting to reing a failure, like having a stroke and all the things that can happen besides dead sure. Yeah, I know. You hear the stories about, you know, the vibrus in the pulmonary and those becoming long term issues. You hear about people going into cardiac arrest while they're trying to recover from this. So yeah, no, there's no doubt that there is a bit of a cavalier. What's going on now? I have my brother list in Germany and they're like in a lockdown again. I have friends in Spain and they have like moved back because they have setbacks. So I really don't think that has to do much with the administration. I think it has to do go back to like what people believe in, what they do. Okay, probably the weakness of the trump administration was to be very relaxed and let people like do because America is the best country in the world. But here we don't want to step on other people's toe, so we kind of are afraid to mandate things because then you're like seen as a dictator, like you're pulling on my rights. Now, you taking away my freedom's right. So I think that's probably the weakness. Or don't that again. I tell you, like, I cannot complain. I got everything that I needed or wanted. And, for example, we start using Ambro, Ambrol is interlooking six inhibitor, and probably, as you read or you hear, that the damage that the virus cause is not the virus, is your own body defending yourself against the virus night and that's why your lungs get damage, your kidness get damage, and also honest or forth, so that we used to thoses of that thing each those cost twenty six hundred. And what's going to pay for it? Right, right, and it's one tell people and you say like, Oh, you know, you're getting paid to like label patients as Covid nineteen, because your hospital gets Thirteenzero, six hundred and twenty nine from Medicare every time somebody has that diagnosis. Like okay, yes, that is true actually, but it's not just for covid is, for any diagnosis of pneumonia. But if you think about the cost of and I see you bed and nurse, yeah, the medications that we were running seven and that these people spent at least two months in the hospital. You think thirteenzeros are gonna cover the cost now? So your argument combodies, like come on right. Going back, I got to a little bit of like for me was like when you are a kid and you got into a candie. You're amazed. Your amaze of all these things after like like wow, and I never seen a lot of the stuff. One of the biggest pros we had, I think, as a team, is like we run out of medication. So for Sedation, I don't know. You know there's some medication called proper file. Yeah, but that thing was back, or so we went back to use the old fashioned bents of diasse beans and narcotics to keep people under. Those two molecules create addiction. HMM. And I well, you probably hear about the narcotic crisis that this country is going on and lad or a right Baxikon and all that okay, imagine your own a drip of a narcotic seven for three weeks. Yeah, your body is probably becoming addictations. I think it's addicted as well. That's all I mean. It is. So we were like, okay, we're not trying to get this guy off the ventilator, but every time we lower the station he gets walk on. It's like, no kidding, he's asking for the drug. Wow, I go like, we need to like do something about this stuff. We cannot keep going back and forth because the guy cannot tolerate. So you had to come with a system how to replace what you were giving to the IV so the guide wouldn't go into withdrawal. It would tolerate stopping the trips. Wow, yeah, and each so you'd have to ease them off of it. Yeah, but it was not easy. No, how. And then you got tell the nurse you you at the one who's going to make this happen. Wow, these are your tools. And then you give them different medication that they can use. I don't want this drip to continue running. If the guy becomes hypertensive, you use this, if you do that, that, and you gotta believe it was funny because when I start using this kind of approach. They told me later on that...

...we thought you were nuts, we thought that what were you're doing was completely crazy and really not going to benefit the patients. Right, but we have to give it to you that it works. That must have been gratifying. Is A leap of faith? Yeah, yeah, you believed in your education and your knowledge that this was the right thing to do, but you didn't know that it was going to be the right thing to do. They believed in what I was telling that that was going to work. Uh Huh. So for me that was more a leap of faith from them. Yeah, and for me that was amazing. Actually, that's awesome. And, as I they I think during crisis people bring the best from out of them. Yeah, and it's I tell you. For me it was like heartbreaking when you have to like call family members that they were not allowed to get into the hospital and tell them, listen, your husband has reached the end, so we want you to come in to say bye, and you like looking at all the stuff that has been going on and thinking what else can I do, and running it through a group of Physicians, nurses, nurse Practitioners and go like that's nothing you can offer. HMM, yeah, I'm sure that was the hardest part, is what's feeling helpless with that. Well, and then accepting the fact that you cannot do anything else. Yeah, and then having the family member come in to say bye and it's that was not pleasantly tell you that. No, and you know I talked about that tour duty and I asked you know, would you go back and you said yes, you know, you would again. Interesting in some of these conversations I'm having as we're getting into the second wave and there's a demand again, right, was seeing spike again for critical care, pulmonary care, ed all that. The response is lower than when it was in March and a lot of people are saying it's the the medical fatigue. You know they're saying. I did a tour, I came to the call, I came to the rally call that we need help and I did my tour. It was hard, it was emotionally exhausting, it was physically exhausting and I hear the call again and I don't know that I can do it again. And that's completing some of the numbers. Well, personally, my case, I to you when I was doing there. I was in a hut, a room or in the hospital. So what's a pretty like? I would like a dream. Wake up, ready, go to the hospital. Let me do it is get out. I will like by usually food in a gas station because the restaurants were not open. Right, deep and repeat, and it becomes kind of like routinary. But again, you need to have a group of people that support you morally. Yeah, if you don't have that, you're probably gonna break down. So tell me, what were some of the things that the hospital was doing for that emotional support? Where they doing things? But I think everybody, not like only the administration, but the people from and the working their workers were doing amazing stuff, and then the community per se. I think the perception of the doctors, nurses and so on from the community changed. So basically the support was shown us food and then giving us masks or like they just trap so our ears wouldn't get to love and and letters and cards, and it was very like gratifying to feel that people were grateful. Yeah, you go to a supermarket and they tell you thank you for your services, yes, like and you're like look at them like wow, and then people asking you how you feeling and being able to like open up and talk to strangers about how you feel. Right. Yeah, no, all that. That's great. Yeah, no, I think that that's obviously becoming a big part of it. The you know again, same thing. We're seeing upticks in psychology, psychiatry that need, you know, people who chat to deal with this emotionally, and a lot of them work the people like you just talked about, you folks who were on those front lines doing that and how to do that. One of the stories I heard was, you know, from Dr Nap in the previous episode, was we talked about how a lot of the healthcare workers would come to work and they didn't want to be near their family because they didn't know if they had been exposed.

So they'd say, you know, what am I going to do? Go, I live by myself, I'm going to go home, stay in my apartment and with so then they were working crazy hours and they were becoming more tired and more stressed, but they didn't want to go home and sit there by themselves, so they figured let me be here and at least be able to help. But they had to finally start saying to people you have to go home. You have to rest, you have to rejuvenate yourself, you have to revitalize yourself. You know, you know, good to us if you're, you know, not a hundred percent. I think for me what the way to work is designed. At least for me, I was lucky that I could have time off between my weeks. HMM. I think that for any worker they need to have at least one day a week out of the hospital. Yeah, if you just work continuously, even if you can like be in twelve hours out two hours after like two weeks, you're like sign to like feel crazy. Yeah, and well, you probably saw that groundhot day movie. Yeah, right, kind of like the same feeling because you're dealing with the same patients in the same conditions and they're not really improving. HMM. So you start feeling, what am I doing? This really meaningful? Yeah, so they reinforcement of that concept is very important. Yeah, Oh, I can for sure, I can see. I can see how that became important, hearing those people saying thank you, thank you for your service. How are you doing? You know, that becomes it makes it all work. And again, when we were able to start like excavating people, moving them out of the unit. Yeah, you like feel like hey, buddy, you're reborn. Yeah, and everybody comes a like, Oh my God, Mr Smith has been extivated and the guy doesn't know what's going on, what happened. And there's some people that were very sick that at some point you thought they're done. HMM. But that to see them get out the unit, even in a wheelchair, yeah, to like starting their rehab was very satisfying. Yeah, Oh, and that in we've seen on on the TV and things, the celebrations and and love how they celebrate the wheelchair there wheelchairing the person out and there's all the healthcare staff lining the hallways and given them a big round applause. You know, the rocky music or something like that's playing in it. You know, were celebrating it because it is such a huge turnaround in such a huge victor. It is an accomplishment, I tell you, and again I think another on south here of these whole things, at the patients that actually have made it out. Yeah, that's true, because nobody really understands your internal fight and I haven't talked to anybody that actually lived through the ICEE. You. And then, if they remember anything, how they feel about it. You know, again, it's, like you said, the mystery of this whole thing is it's so different patient to patient. So, as you said earlier, the twenty twenty year old of the forty year old who's coming in and not making it and then the eighty year old who's coming in and surviving and there's no rhyme or reason. How it attacks the body is can be very different from patient to patient. You know, I understand, and so it makes it very challenging. So, yeah, the survivors become you know, they fought the good fight as well. Completely agree. We also one of the biggest, like personal emotional moments is when you approach the patient that's in day unit, that has gone through the High Flow Nace of candle and now you think that they need to be intubated and you come to discuss with them the intubation and they're asking, am I going to make it out of it? Yeah, you see the fear in their eyes and you well, I was very precpatic, as I like. Listen, I cannot answer you that, but I suggest grab your phone, Call Your family. Doesn't that you love them and we let's pray and see that you're going to be one of those that mix it up. Wow, and I tell you, this is very hard for you to like tell somebody this is probably your last conscious moment of your life. And let's face it, right, let's be let's you know, it's not fun, but it's reality and let's be clear about it. Yeah, wow, that's hard. That takes a lot of courage to handle that situation. But in that moment I'm sure they appreciate your honesty and for those who made it, I know they'll never forget your compassion. Well, again, thank you very much to give me the opportunity to like tell a story.

Yep, thank you. Well, hope it's helpful for you too. It is. So yeah, I still like I'm in contact with some of the people up in Georgia, but I met amazing people in every single layer, not just the hospital, but whatever I was I felt very welcome. Good. We got good people in the state. I'm biased. I would love to hear your opinion, and we were all hopeful say about vaccines. Does that cause everybody to begin to start to relax again too, because they believe hope is coming? I heard Dr Vouchi saying hope is coming but it's not here. So you need to stay vigilant with what we're doing and things like that. What are your thoughts about the vaccines that you're hearing about? Well, the problem with Covid in my view it's like it's an RNA virus and during our history, like getting vaccines against our night virus, have been very difficult because they are very unstable and they need take very fast. Right. So they're going to have a vaccine. The problem is going to be how effective that is and how long does the immunity last for and what kind of side effects you're going to get, right, and are you willing to risk it? So there's a lot of people that I talk to say, Oh, back seeing. Yeah, sure, but I'M gonna wait. Yeah, and there's the antibaxert. I think that you're going to get this and got knows what all this stuff. So they're don't want to learn, no wading to do it. Sure. So it's going to be a very interesting couple of buns ahead once the vaccine is available, see how it's going to be used and how good is going to be to protect the community against the virus. And what your thoughts, if they come knocking on your door and they say I'm ready, we're ready to you. As a frontline worker or you know, as in being in the healthcare industry. They're saying you will be one of the first to make it available to you. And what's your thought? Have you made a decision yet? I don't. You think I will probably get it. Again, if you are part of the science, quote Unquote, team, it will be kind of like ironic if you don't believe right and screech, but don't do it. That would be something that I would not do. I will probably get it and hope for the best. Right. And you for our listeners. You talked about it that the virus is an RNA. Can you just explain what that is? A little different than some of the other things? Well, there's two types of Ross. Once are DNA, this we want to plack acid, and the other ones are nice that these are different, kind of like nucleus. So I have to go back to my books and start like the rain. No problems. It's all fascinating to me, but I do know that these vaccines are using a rna sort of technology, which is a little bit different than what other vaccines have been before. Yeah, those are actually made up a minos. It's virus as actually a core of minos. It's and depending if they use that DNA chains or the RNA change, they will be a differently. So that's the problem that they're facing. That's what they're vaccine take this longer and like actually more difficult to like develop. Right, it's same thing. Another on a, if I'm not like wrong, is the common call virus, and then you can get cold and then you think of your immune and you get another cold and then I'll the colons on and so forth. Sure, yeah, well, that's the same thing where. You know, I remember when the virus was first breaking out and certain people who are saying, well, it's just another strain of the flu, which we've learned it's not, but we were saying, well, look, how many people die every year from the flu, so it's going to be a virus that's going to be out there, but nobody at that first part thought that it was going to be as deadly as it has become. But probably, and my assumption is as we get to contain it, it may never go away. We may still be dealing with it forever, just like we continue to deal with the flu or pneumonia or other types of disy, juss like that, and that sense that you think. I think the same way you do. I think covid is here and it's going to stay. Just have to learn what that and live with it. Yeah, so tell me a little bit about your back to work now, the work you're doing. How is Miami Been? Have you been seeing? They went through their way, I believe towards the...

...end of the summer. Think, if I remember right, Miami was getting hit pretty hard. But I guess we in your current work you're not as involved with the covid part of it right now. Well, as I tell you, I work in a plastics clinic and there's really healthy people that, when I look better and interesting enough, since we reopened, the amount of people that want to look better has increase probably fifty percent. Okay, test everybody before having surgery and that's all we can do. We also protect ourselves, but it's not as strict. Everybody wears a mass we wash our hands, but there's no ninety five involved. I told my intubations just regular. I don't run, I don't have a popper or like. I don't have any extra stuff. To protect myself. We test ourselves like once every two weeks, okay, and if somebody tells positive, you're out of here until your back negative. So it can take two weeks to a month to go back to work. Sure. So we have couple of those cases happen and so far, so good. Everywhere has recover and we're back in business. So let me ask you another question. So it situation at your clinic where to shut down again and you had the free time again, would you go back? Would you you volunteer? Not Volunteer, but you know I mean, would you see what would be available and where you could help again? Or was one tour duty enough? No, actually, in sent and the sense of like personal challenge, it was very satisfying. So I will do it like ice close. Wow, that's also the situation with non essential clinic closing and going back to like be useful and challenged in terms of like doing stuff that you have to think and analyze. Yeah, caught me back to willing to go back to the hospital. Wow. So an April I apply to a new job in California and I think by February I am going to move there. Oh great, that's exciting and will it be doing? Are you going to continue with anestysiology or you moving into more the critical care? Now? I'm going to continue doing a nice seizure, but it's going to be fullblown now with every sort of case. Is Not just doing like routine things that, yeah, I'd say he's been good to pay the bills, but it's not like very satisfying right, like in terms of your profession. Yeah, well, and that's what I love about medical profession people. They feel that calling right and and it's about serving patients, it's about making people better, it's about providing care. So, yeah, I love that. Well, good luck with that, good luck with that opportunity. Will Continue to stay in touch and we want to hear how that goes. I guess the last piece that I like to kind of end all of the episodes with. First off, want to thank you for your time again. You continue to be very gracious and giving us your time and telling us your story and we love continuing to tell it. So thanks again for your time. I like to end the episodes here with heros of healthcare and ask the question, as you were either growing up or now, who is your hero? Well, for me that's an easy answer to give you, and I think my hero is hoping been my parents. They have been great. They have been great role models in terms of person in terms of relationship among them and among other people. They're kind, they're hard workers, they have good morals and always being there to like, help me with my doubts and provide me with good like advice and guidance. That's awesome. But episode one for this podcast is my father, who was my hero, and my father worked in a pharmacy from when he was fourteen years old until he retired. Wow. Well, again, thank you for your time, thank you for being part of this and thanks for all you do. Oh, thank you very much for having me as a tell you again, and I will continue to tell I don't feel that I did anything that anyone in my position would have not done. Well, that's what makes you a hero. Well, thank you very much. Thanks, Dr Google. On you've been listening the heroes of healthcare. For more, subscribe to the show in your favorite podcast player or visit...

...us at heroes of healthcare podcastcom.

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