Deploying to New York City
From the Show: SolutionHealth
Summary:
Air Date: 11/5/20
Duration: 10 Minutes
Dr. James Sullivan shares his experience with being deployed to NYC during the pandemic.
Transcription:
Evo Terra: Few of us need to be reminded of the terrible toll. The pandemic has inflicted on all of us around the world and in our local community. Today, you'll hear from Dr. James Sullivan, DO, a Family Medicine and Neuromusculoskeletal Medicine, Boarded Physician about his deployment with the Army Reserves to one of America's most hardest hit areas during the peak of the COVID-19 pandemic. This is The Solution Health Podcast from Solution Health, I'm Evo Terra. Dr. Sullivan, I think our audience is going to be fascinated to hear how you spent your time in New York City when you were deployed with the army reserves during the COVID-19 pandemic. To start, can you tell me first about your military background and maybe some past deployments you've been on?
Dr. Sullivan: Doctors when they're mobilized in the military. We act as physicians. When you get to our level of education, that's all they really ever want you to do. And that is unless we are put in command of a hospital unit, and then we take more of a 30,000 foot view of things to help orchestrate the day to day. But yeah, more or less, it's the same stuff, just in a different place.
Host: So specifically, for New York City, when were you deployed? I guess is my first question. And why were you called to be deployed in New York City?
Dr. Sullivan: I got orders to report to a mobilization station within days of the President declaring a national emergency. I think it was around the end of March. It was much different than previous mobilizations for one, they usually give physicians a lot more notice. I was flat out, asked if I could be in a certain location in two days. And I said, I don't think so. I don't keep the go-bag I'm not special forces. My schedule is loaded. I got meetings. I got patients. And they were like, sir, we're really not asking. And everything goes out the window in a national emergency.
Host: Yeah. What did your family think about you being deployed in the epicenter of the well, one of the worst pandemics anybody alive can remember for sure?
Dr. Sullivan: It's a blessing that we didn't have much time to think about things. When we reported to a mobilization station, we had no idea where we were being sent. No one did. This was in fact, the largest mobilization of the army reserves in history. And frankly, almost no one knows about it. We were from the word go. We were nine days to boots on the ground, in wherever we were headed. It takes nine days for a group of generals to agree on what color the uniform is going to be. It was a staggering pace. And the fact that pretty much every single medical personnel that could be mobilized in the Army Reserves was called. A lot of things were going on in upper echelon as this whole planning process was going on. And it just such a massive amount of moving pieces at the same time.
I don't know how anybody could keep it straight and information disseminated down. We knew around 24 hours out that we were going to New York City. And honestly, my family was, they were a little upset. My wife was fearful and angry because I had just gotten home eight months beforehand. And on the ground, we were scared. We'd be stupid not to be, but you know what you need to understand about any member of the armed forces really is that we comprise about 1% of the population and we are an all volunteer army. It takes a certain kind of person. We don't run. It's not in our nature. We sold her up and we go in and it doesn't matter if it's bullets or if it's germs we're going in. And that's the oath that we all took
Host: As a son of a Colonel in the army reserves before he retired. I definitely understand that. Can you talk a little bit about the daily responsibilities you had as a member of the Reserves while you were in New York?
Dr. Sullivan: A lot of the outpatient things that family practitioners do; they tried their level best to keep us where our expertise lied and they needed family practitioners just as much in Queens Hospital as they needed doctors on the floor. So there was a lot of remote visits, of course, ran testing tents. And I also rounded on patients that were in the hospital afflicted with the virus doing OMT.
Host: How did you specifically use OMT to treat COVID-19 patients?
Dr. Sullivan: OMT or osteopathic manipulative treatment, it's a pretty good adjunct to someone hospitalized with pneumonia. There have been innumerable studies done that support better outcomes when it's used in a hospital setting on patients hospitalized with pneumonia. The techniques that I used were a little bit varied, but they were based on a protocol that was established, was a study that was done by a New York College of Osteopathic Medicine. They centered around ways to improve rib motion, respiratory mechanics, and to optimize lymphatic clearance from the lungs and the pleural cavity. This was something that was particularly effective in COVID-19 because this was an interstitial pneumonia. And that is to say that the fluid in this pneumonia was not in the airspaces, but in the tissue of the lungs, it is very much a lymphatic problem. It's like tissue swelling in the lungs.
And once the body gets overwhelmed, would that fluid in the tissue of the lungs, it starts to weep into the airspaces and starts to congeal something we've rarely ever seen in the disease. And it was for that reason that I took to the floor to see patients, and my goal was to keep these patients from the ICU. Once patients got into the ICU, one they are in a fragile condition, but not to say that manipulation can't be used there, but once they got bad enough to be intubated, survivability at that juncture really kind of dwindled. I turned my skills to those that I could try to help stay out of the ICU. And once the physician there really saw the results, the quick turnarounds, it really started to garner some attention and things got pretty busy for a while there
Host: Were you deployed, you mentioned hospitals, were you deployed in like standard hospital buildings or some of the field hospitals that they had set up?
Dr. Sullivan: Originally, we landed at the job at center where the Army Corps of engineers did a monumental job. And I really don't think they get enough credit for setting up a hospital, a field hospital inside a convention center. What a feat of engineering. That convention center was turned into a kind of a hospital on the fly that I think we had the capacity. I think, we had over a thousand bed capacity, but I think we only ever used about 400 beds of it at the hospital, it was meant to allow those patients that were over the hump with COVID to come and recover in a setting that was a little less acuity and allow the hospital to take on or take in more patients that were, that were sick. That was really, that was a problem there in New York City was the congestion and the amount of patients per capita that were served by these hospitals. The patients that you see that get really sick with this.
And obviously there's, it's a little bit of a tough thing to understand, but the facts are this 80% of the people that get this virus will barely notice, I've had plenty of friends that, that contracted that, you know, that, that work out in the city. And they thought they were dealing with some allergies that were acting up. And 20% of people are going to get truly sick with this. Maybe about 10% of the people that contract it are going to need the hospital. And now we've whittled it down to below 1%, thanks to all the therapeutics and things that we have now that we didn't have then, but about 1% of people will die. And that statistic, regardless of anything that we really did could not be changed. And it was early in the pandemic and there were a lot of theories flying around about Plaquenil or Azithromycin being effective somehow that none of it changed those percentages.
And from what I saw out there in the field, what the face of this looked like, they were some of the sickest people I've ever seen in my life, oxygen hissing out of a face mask, that was, I mean, turned up all the way as high as it would go, 15 liters coming out of the wall and patients holding it up to their face, panting like a dog. And they did this for weeks. It's frightening because when you see a patient that sick, all they have to do is get tired. And these people looked so tired.
Host: It is, it had to be a heart wrenching reality that you had to face there. So I'll return the apology that you were forced to do that. But once again, I would like to thank you for your service for providing that and being such a help to those that were able to be assisted. Ending perhaps, on an effort to end on a somewhat more positive note with that, the process, as you mentioned, it was early in the pandemic, and we have learned so much since that time about how to treat things, were you able to learn things during that deployment and then bring them back home with you in regards to protocols and how we care for patients of COVID-19 and other issues? Tell me the good news Doc.
Dr. Sullivan: I actually was in communication in real time with the Southern New Hampshire Hospital, I was on an email conversation that was ongoing, that involved the critical care specialists, the hospitalists. And I was able to report back some of the things that we were doing once I stopped in Java Center for maybe three days. And they're like, okay, we've got enough staff here. We're going to send you guys on Queen Center Hospital, which was the epicenter and some of the biggest death holes and some of the biggest need for help. And so I was able to pass on those things that we were doing in the hospital that were efficacious to report back. This is really making a difference. If even when your patients aren't really looking that poorly yet when they're just in the hospital, but on oxygen, if you turn them like 45 degrees, just essentially rolling them in the bed, like a rotisserie, that seemed to help the fluid from really settling in any one spot and help them from filling up and resulted in better outcomes.
Just little tidbits here and there, like we're using the convalescent plasma. It really doesn't seem to be making a difference in people that are this far along. You got to a certain point with this virus and it really wasn't the virus that was the issue anymore. People were past the virus, but they were succumbing in the recovery. Their body is still trying to deal with all the damage that was done, even though the attack is over. And that's where we were losing folks. And we're really still learning, just all the things that this particular bug can affect. We're talking nerve tissue, heart tissue, the kidneys, that for those people that really get hit hard by it, they get hit everywhere.
Host: No, I can only imagine that, that you did not. I'm very happy that we're learning about this disease, this insidious disease everyday, and continuing to make headway but I feel we have a long road ahead of us, but I am also confident that the physicians we have in helping out in the field as you did, as well as on the front lines in our hospitals, will continue to make progress, and we'll see the other side of it.
Dr. Sullivan: I'm actually very excited and hopeful about some of these therapeutics and things that are presently in stage three of development right now, or stage three of the FDA approval process. So far as the vaccines and the antibody combinations that are meant to neutralize this. If we can get those out to the public, we could potentially see the end of the deaths of this first, if the antibodies get out there. Because there'll be able to help those afflicted with it and see the end of the blasted pandemic, once we get the vaccine.
Host: Here's to 2021. Once again, that was Dr. James Sullivan, DO family medicine and neuromusculoskeletal medicine boarded physician. To learn more about Dr. Sullivan and our other dedicated health professionals, providing innovative models of care, please visit solutionhealth.org. And thank you for listening to this episode of Simply Healthy. I am Evo Terra.
Evo Terra: Few of us need to be reminded of the terrible toll. The pandemic has inflicted on all of us around the world and in our local community. Today, you'll hear from Dr. James Sullivan, DO, a Family Medicine and Neuromusculoskeletal Medicine, Boarded Physician about his deployment with the Army Reserves to one of America's most hardest hit areas during the peak of the COVID-19 pandemic. This is The Solution Health Podcast from Solution Health, I'm Evo Terra. Dr. Sullivan, I think our audience is going to be fascinated to hear how you spent your time in New York City when you were deployed with the army reserves during the COVID-19 pandemic. To start, can you tell me first about your military background and maybe some past deployments you've been on?
Dr. Sullivan: Doctors when they're mobilized in the military. We act as physicians. When you get to our level of education, that's all they really ever want you to do. And that is unless we are put in command of a hospital unit, and then we take more of a 30,000 foot view of things to help orchestrate the day to day. But yeah, more or less, it's the same stuff, just in a different place.
Host: So specifically, for New York City, when were you deployed? I guess is my first question. And why were you called to be deployed in New York City?
Dr. Sullivan: I got orders to report to a mobilization station within days of the President declaring a national emergency. I think it was around the end of March. It was much different than previous mobilizations for one, they usually give physicians a lot more notice. I was flat out, asked if I could be in a certain location in two days. And I said, I don't think so. I don't keep the go-bag I'm not special forces. My schedule is loaded. I got meetings. I got patients. And they were like, sir, we're really not asking. And everything goes out the window in a national emergency.
Host: Yeah. What did your family think about you being deployed in the epicenter of the well, one of the worst pandemics anybody alive can remember for sure?
Dr. Sullivan: It's a blessing that we didn't have much time to think about things. When we reported to a mobilization station, we had no idea where we were being sent. No one did. This was in fact, the largest mobilization of the army reserves in history. And frankly, almost no one knows about it. We were from the word go. We were nine days to boots on the ground, in wherever we were headed. It takes nine days for a group of generals to agree on what color the uniform is going to be. It was a staggering pace. And the fact that pretty much every single medical personnel that could be mobilized in the Army Reserves was called. A lot of things were going on in upper echelon as this whole planning process was going on. And it just such a massive amount of moving pieces at the same time.
I don't know how anybody could keep it straight and information disseminated down. We knew around 24 hours out that we were going to New York City. And honestly, my family was, they were a little upset. My wife was fearful and angry because I had just gotten home eight months beforehand. And on the ground, we were scared. We'd be stupid not to be, but you know what you need to understand about any member of the armed forces really is that we comprise about 1% of the population and we are an all volunteer army. It takes a certain kind of person. We don't run. It's not in our nature. We sold her up and we go in and it doesn't matter if it's bullets or if it's germs we're going in. And that's the oath that we all took
Host: As a son of a Colonel in the army reserves before he retired. I definitely understand that. Can you talk a little bit about the daily responsibilities you had as a member of the Reserves while you were in New York?
Dr. Sullivan: A lot of the outpatient things that family practitioners do; they tried their level best to keep us where our expertise lied and they needed family practitioners just as much in Queens Hospital as they needed doctors on the floor. So there was a lot of remote visits, of course, ran testing tents. And I also rounded on patients that were in the hospital afflicted with the virus doing OMT.
Host: How did you specifically use OMT to treat COVID-19 patients?
Dr. Sullivan: OMT or osteopathic manipulative treatment, it's a pretty good adjunct to someone hospitalized with pneumonia. There have been innumerable studies done that support better outcomes when it's used in a hospital setting on patients hospitalized with pneumonia. The techniques that I used were a little bit varied, but they were based on a protocol that was established, was a study that was done by a New York College of Osteopathic Medicine. They centered around ways to improve rib motion, respiratory mechanics, and to optimize lymphatic clearance from the lungs and the pleural cavity. This was something that was particularly effective in COVID-19 because this was an interstitial pneumonia. And that is to say that the fluid in this pneumonia was not in the airspaces, but in the tissue of the lungs, it is very much a lymphatic problem. It's like tissue swelling in the lungs.
And once the body gets overwhelmed, would that fluid in the tissue of the lungs, it starts to weep into the airspaces and starts to congeal something we've rarely ever seen in the disease. And it was for that reason that I took to the floor to see patients, and my goal was to keep these patients from the ICU. Once patients got into the ICU, one they are in a fragile condition, but not to say that manipulation can't be used there, but once they got bad enough to be intubated, survivability at that juncture really kind of dwindled. I turned my skills to those that I could try to help stay out of the ICU. And once the physician there really saw the results, the quick turnarounds, it really started to garner some attention and things got pretty busy for a while there
Host: Were you deployed, you mentioned hospitals, were you deployed in like standard hospital buildings or some of the field hospitals that they had set up?
Dr. Sullivan: Originally, we landed at the job at center where the Army Corps of engineers did a monumental job. And I really don't think they get enough credit for setting up a hospital, a field hospital inside a convention center. What a feat of engineering. That convention center was turned into a kind of a hospital on the fly that I think we had the capacity. I think, we had over a thousand bed capacity, but I think we only ever used about 400 beds of it at the hospital, it was meant to allow those patients that were over the hump with COVID to come and recover in a setting that was a little less acuity and allow the hospital to take on or take in more patients that were, that were sick. That was really, that was a problem there in New York City was the congestion and the amount of patients per capita that were served by these hospitals. The patients that you see that get really sick with this.
And obviously there's, it's a little bit of a tough thing to understand, but the facts are this 80% of the people that get this virus will barely notice, I've had plenty of friends that, that contracted that, you know, that, that work out in the city. And they thought they were dealing with some allergies that were acting up. And 20% of people are going to get truly sick with this. Maybe about 10% of the people that contract it are going to need the hospital. And now we've whittled it down to below 1%, thanks to all the therapeutics and things that we have now that we didn't have then, but about 1% of people will die. And that statistic, regardless of anything that we really did could not be changed. And it was early in the pandemic and there were a lot of theories flying around about Plaquenil or Azithromycin being effective somehow that none of it changed those percentages.
And from what I saw out there in the field, what the face of this looked like, they were some of the sickest people I've ever seen in my life, oxygen hissing out of a face mask, that was, I mean, turned up all the way as high as it would go, 15 liters coming out of the wall and patients holding it up to their face, panting like a dog. And they did this for weeks. It's frightening because when you see a patient that sick, all they have to do is get tired. And these people looked so tired.
Host: It is, it had to be a heart wrenching reality that you had to face there. So I'll return the apology that you were forced to do that. But once again, I would like to thank you for your service for providing that and being such a help to those that were able to be assisted. Ending perhaps, on an effort to end on a somewhat more positive note with that, the process, as you mentioned, it was early in the pandemic, and we have learned so much since that time about how to treat things, were you able to learn things during that deployment and then bring them back home with you in regards to protocols and how we care for patients of COVID-19 and other issues? Tell me the good news Doc.
Dr. Sullivan: I actually was in communication in real time with the Southern New Hampshire Hospital, I was on an email conversation that was ongoing, that involved the critical care specialists, the hospitalists. And I was able to report back some of the things that we were doing once I stopped in Java Center for maybe three days. And they're like, okay, we've got enough staff here. We're going to send you guys on Queen Center Hospital, which was the epicenter and some of the biggest death holes and some of the biggest need for help. And so I was able to pass on those things that we were doing in the hospital that were efficacious to report back. This is really making a difference. If even when your patients aren't really looking that poorly yet when they're just in the hospital, but on oxygen, if you turn them like 45 degrees, just essentially rolling them in the bed, like a rotisserie, that seemed to help the fluid from really settling in any one spot and help them from filling up and resulted in better outcomes.
Just little tidbits here and there, like we're using the convalescent plasma. It really doesn't seem to be making a difference in people that are this far along. You got to a certain point with this virus and it really wasn't the virus that was the issue anymore. People were past the virus, but they were succumbing in the recovery. Their body is still trying to deal with all the damage that was done, even though the attack is over. And that's where we were losing folks. And we're really still learning, just all the things that this particular bug can affect. We're talking nerve tissue, heart tissue, the kidneys, that for those people that really get hit hard by it, they get hit everywhere.
Host: No, I can only imagine that, that you did not. I'm very happy that we're learning about this disease, this insidious disease everyday, and continuing to make headway but I feel we have a long road ahead of us, but I am also confident that the physicians we have in helping out in the field as you did, as well as on the front lines in our hospitals, will continue to make progress, and we'll see the other side of it.
Dr. Sullivan: I'm actually very excited and hopeful about some of these therapeutics and things that are presently in stage three of development right now, or stage three of the FDA approval process. So far as the vaccines and the antibody combinations that are meant to neutralize this. If we can get those out to the public, we could potentially see the end of the deaths of this first, if the antibodies get out there. Because there'll be able to help those afflicted with it and see the end of the blasted pandemic, once we get the vaccine.
Host: Here's to 2021. Once again, that was Dr. James Sullivan, DO family medicine and neuromusculoskeletal medicine boarded physician. To learn more about Dr. Sullivan and our other dedicated health professionals, providing innovative models of care, please visit solutionhealth.org. And thank you for listening to this episode of Simply Healthy. I am Evo Terra.