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“Things won are done, joy’s soul lies in the doing.”
– William Shakespeare, Troilus and Cressida
“Joy is in the doing” is not an uncommon philosophy among those who choose a career in health care. It is certainly the belief of a Kaiser Permanente Southern California physician and nurse who did what so many KP people have done during the COVID-19 crisis: go to where the need is greatest.
For Diego Covarrubias, MD, and Michael Krider, RN, the need was not just great – it was Shakespearean in scope: when it was clear that the worst of COVID-19 was descending on New York City, Covarrubias, a lieutenant commander in the US Navy Reserve, and Krider a captain in the US Air Force Reserve, did not hesitate. Both volunteered and were in the city within days.
“They called and said, ‘You’re flying out tomorrow, we don’t know where,’ though I ended up getting one additional day with my family,” reported Dr. Covarrubias, an interventional radiologist in West Los Angeles. He deployed to the Javits Center in Manhattan on April 6, in time to assist the Army in finalizing the Javits’ conversion from exhibit hall to temporary field hospital and begin treating its first patients.
Although he erects field hospitals in annual training exercises at Camp Pendleton, the reality was a completely different matter. “Our Naval Reserve unit is supposed to care for 100-200 patients at most, with minimal ICU capabilities.” Javits Center had beds for 2,500 COVID-19 positive patients. But the hard work had not even begun.
We first caught up with Captain Krider, a palliative and hospice care nurse with the Los Angeles Metro unit, arriving at Newark Airport at the peak of New York’s COVID-19 pandemic on Sunday April 16. Did he have any idea what to expect? “Only that I’ll be doing ICU or ER work, which I did earlier in my nursing career…and that it will be really busy,” he mused. “My colleagues who are already in New York report that their facilities have 80-90% COVID positive patients.”
Monday morning he reported for duty in the emergency room at Kings County Hospital, a municipal facility in Brooklyn. “It’s all hands on-deck. There’s a great group of people from all over – volunteers, civilian intensivists, new, early-graduated doctors. It’s intense but everyone’s here for the same reasons, and we’re all working our butts off.” Krider, who is also training to be a CCAT (Critical Care Air Transport nurse), clearly does not shy away from the eye of the storm.
As a public hospital, Kings County receives every variety of patients, although “COVID is so pervasive in New York that pretty much everyone who comes in tests positive. I talked to a friend in Dallas; his hospital has had fewer cases to date than this hospital has as inpatients right now.” But Krider wouldn’t want to be anywhere else. While adrenalin may keep him going through 21 straight days of 12-hour shifts, “Ultimately, it’s not the adrenalin. It’s the people. I know we’re helping. That’s the bottom line. I’ll be here as long as there’s a need.”
Back in Manhattan, Dr. Covarrubias is less exuberant, even somewhat stoic about the scene at Javits, which others have described in graphic terms. Only a casual mention of his face being chafed raw from hours on end in full PPE hints at the unending exertion. But he is no less dedicated: his service spanned Javits’ entire existence, and after caring for nearly 1,100 COVID-19 patients, he and his colleagues helped the last of them depart on May 1.
As he awaits his next deployment and reflects on the experience, he considered what he would say to the three young children he kissed goodbye so many days ago. “I’ll tell them, someday you will remember this, the whole world will remember. And I can say I was there and I did my part. I didn’t want to sit on the sidelines.
“It’s what we do that at Kaiser Permanente as well. Any group of people that comes together, puts themselves last, and makes the mission a shared objective – they can accomplish anything. This is what I want my children to know.”
“Some are born great, some achieve greatness, and some have greatness thrust upon them.”
– William Shakespeare, Twelfth Night
Few of our KP caregivers would ever admit to “greatness,” even after rising to the coronavirus challenges thrust upon them. Humility comes with the job, after all. But the rest of us know better.