The Otherwise Healthy Population

I was once 30 years old. Healthy. Not a care in the world. Invincible. 

I, a young physician myself, had only been to a physician’s office just a handful of times in the last ten years of my life. One time, I had battled appendicitis and had a little scar to prove it.

Completely healthy otherwise.

Invincible.

There is, however, that small percent of “healthy people” who suddenly get so sick that they require life-changing interventions— including things like ventilator support and organ transplants. 

We glance over that small percent in medical school— “healthy people, no, rarely do they get sick.”

With COVID-19 going around, infecting both the young and old, the healthy and unhealthy, and even the invincible, I’d like to tell you what it’s like from a first-person perspective ... what it’s really like to be sick. Not just “I think I have a cold” sick. This is “worst case scenario” sick. Because this might, in fact, help you realize what kind of situation we are dealing with. And how seriously you should be taking this. 

When you first get intubated, you don’t remember anything. I didn’t. The only thing you do remember is how difficult it was to breathe right before you got intubated. You remember, for the rest of your life, coming to terms with your death (peacefully), you remember the sweating, feelings of heaviness in your chest, and you remember the panic and the tension in the room— nobody was expecting it. You apparently look at your colleague and the last thing you say is, “Please don’t let me die tonight.” This will haunt them for the rest of their medical career. 

When you get extubated, you are awake for minutes before extubation. Minutes feel like hours. You gag on secretions as your visitors stare at you. Your dignity? Lost. You cry from the discomfort. But you have to wait. As soon as the endotracheal tube is pulled out, so are a lot more secretions from the orogastric tube— they were both in there together. You are immediately put on high-flow oxygen, which is perhaps even more uncomfortable, because your mouth is kept dry. You are thirstier than you’ve ever been in your life, but you can’t drink anything. You beg for ice chips. You feel nauseous. You may have laryngeal nerve paralysis from your (two) intubations. I didn’t have a voice for two months after this and had to see an ENT doctor for follow-up— apparently, this is quite common.

The ICU— one of my favorite places to be as a doctor— is the worst place to be as a patient. You are constantly being reminded of your impending death. Your vitals are being checked by the minute with your arterial line that never seems to stay in place (it needs to be replaced more than once)— and none of them are ever normal. Your blood pressure is always too low, your oxygen saturation is always too low, your heart rate is always too high. When they fix one thing, another one worsens. It’s a delicate balance— trust me, I know. 

You are taken away from your room to get procedures done every few days. It’s exhausting. Sometimes you wonder if things would have been easier if you had just died those few invincible days ago. 

You see your dad cry. A lot. In 30 years, you have never seen him cry. 

You see the stress that you are putting on him. He starts having chest pain one night but doesn’t want to go to the ER to get evaluated. He minimizes it. Your mom minimizes it. You don’t have the energy to feel guilty anymore.

You never sleep. You are tethered by wires and tubes to a stiff bed and you can’t lay down comfortably. 

You never sleep because you are afraid that if you fall asleep, you won’t wake up the following morning. Sometimes, when you’re sleeping, your heart goes into ventricular tachycardia and you don’t want to be sleeping through that. That’s how I justified it. It doesn’t make sense, but a lot of things don’t.

You finally get your life-saving heart transplant— the one you never knew you needed. The one you were told that young people likely never needed, because young, healthy people rarely get sick. If you eat right, exercise, live an active lifestyle, live a good life, become a productive member of society... why would you ever get so sick? So suddenly?

Because sometimes, things happen. 

You get that transplant in just a few days— days— and you get discharged. Your life is forever changed. You work around alarm clocks for your medications. You stay away from crowded places. People stare at you as you disinfect your plane, train seat— your new normal is understanding that you are now (officially) the opposite of invincible. Incredibly vulnerable, in fact. You know that your life won’t be as long as you once thought it was going to be. But, on a positive note, you see things in a new light— even the mundane things are more beautiful, you are more grateful for each day, and you will never take advantage of your health ever again.

Because yes, at one point in my life, this crazy thing did happen.

And I’m here to tell you that these things could happen.

So please stay safe out there. If you feel like this is nothing, and this can’t affect you, and you’re healthy and invincible...

just remember that there’s always a small chance that you’re not. 

And I hope that you never have to go through what I went through to prove this.

——

To end this:

  • The latest on heart transplant recipients and COVID-19 can be found on https://www.jhltonline.org/ — so far, low numbers, but little to no evidence to support that “healthy” (aka no other co-morbidities) heart transplant recipients are at higher risk of COVID-19 complications than the general population (YEP, I know, but read the data yourself before coming up with any conclusions). Promising! 👍

  • I’m doing fine, thank you for caring & asking. ♥️♥️♥️

  • I love all things “Alice in Wonderland” (fun fact) so here’s a good image to end this post with:

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