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No Barriers Podcast Episode 70: Andres S. Maldonado, MD



Dave Shurna and guest co-host, Tom Lillig, interview Dr. Andres S. Maldonado for another installment of our Alchemy Series (generously sponsored by Wells Fargo and Prudential). Andres was in his third year of residency as an emergency doctor in New York City when he tested positive for COVID-19. He was rushed to the ICU and came close to intubation. After a week, with the help of his fellow physicians and intense treatment, he was considered ready to be discharged. Andres recounts his harrowing experience and the lessons he gained in the process.

 
When Dr. Andres Maldonado started experiencing symptoms related to COVID-19, he resisted heading to the hospital. As his condition worsened, his friends and family urged him to seek help. So, after 9 days he was tested and it was positive. He was rushed to the ER and soon, the ICU. His stoicism quickly diminished when he was bed-bound and was placed on a high-flow nasal cannula to force oxygen into his lungs. For days, he struggled to breathe and was close to intubation. For a week Andres was helped by nurses and doctors (normally his coworkers) and was forced to adjust from the role of caregiver to being a patient. He fought to stay alive and was buoyed by the support of his parents, his brother, his girlfriend, and his large network of friends; many of whom sent him messages via social media. Finally, with new medication and all treatment options deployed, his lungs cleared enough to be discharged. We speak with Andres about his commitment to medicine, the strength of his Rope Team, and the importance of empathy for his patients his experience has brought him.

Additional Resources:

Dr. Maldonado New York Times Article

 

 

 


I think when you have a determination to accomplish something, and to live, or the will to do something, I think that puts you at an advantage to actually overcome whatever you’re facing at the moment


 

 

 

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Episode Transcript

Andres : I didn't want to accept the fact that I would have to let other people take care of me because I couldn't do it myself. I had done everything that I could and I think the problem I have with my ego is sometimes it's hard for me to ask for help but I had no choice at that point. Eric Weinmayer: It's easy to talk about the successes but what doesn't get talked about enough is the struggle. My name is Eric Weinmayer . I've gotten the chance to ascend Mount Everest, to climb the tallest mountain in every continent, to kayak the Grand Canyon and I happen to be blind. It's been a struggle to live what I call a no barriers life. To define it, to push the parameters of what it means and part of the equation is diving into the learning process and trying to illuminate the universal elements that exist along the way. That unexplored terrain between those dark places we find ourselves in, in the summit exists a map. That map, that way forward is what we call no barriers.

Dave : Welcome to the No Barriers Podcast. Today we go right to the heart of the fight against COVID-19 and meet a young New York City doctor named Andres Maldonado who is treating patients with COVID when he himself contracted it and nearly died. It's hard to get any closer to the fight against this thing than today's conversation. This is your co-host Dave [Shirna 00:01:44] and I'm honored to be joined by a guest host today, Tom Lillig, long time board president of No Barriers and author of the book, What's Within You? Your Roadmap to Living Life with No Barriers. A book in which Andres is profiled. Tom and Andres, welcome to the show.

Tom : Good morning.

Andres : Good morning.

Dave : Well Tom, I'd like to just start briefly with you. You have been a long time member of the No Barriers community, helped start the organization, have been our board president forever kind of and obviously we've known each other for years, since middle school.

Tom : Thanks for allowing me to co-host with you today. That's quite a privilege.

Dave : Thank you Tom for making us aware of this incredible story. Andres, I'd love to start. Have you always wanted to be a doctor?

Andres : Hi Dave. Also, thanks for having me on this podcast. This is, it's pretty awesome. No, actually I never always wanted to be a doctor. I figured it out in college.

Dave : Tell us a little bit about that. How did you figure it out in college?

Andres : Out of high school I was accepted into this seven year bachelor's of science medical degree program so I kind of went straight into kind of medical studies and science related topics. I guess three years into that seven year program the program started to introduce us to patient interactions and taking their history and getting to know them a little bit better and I think that's when it clicked. The human to human interaction about a person and they need to trust you with the most precious thing that they have, their body. That really spoke to me that I want to be able to help them in ways that no one else can.

Tom : Well, Andres I'd love to hear a little bit about your back story. Where did you grow up and tell me a little bit about where your family originally came from and when was that and a little bit about their stories and coming to America and raising you?

Andres : I'd like to start talking about my father actually who I look up to a lot. His name is Jose Maldonado and he's from El Salvador down in Central America. Him growing up, he was just completely in poverty. He would tell me that he had one pair of shoes, two pair of underwear. He'd have to clean them every other day. Eventually his mom would work hard enough to gather some money and my father did well enough in school to get into military school there which was perceived as... The issue was that while he was in military school close to graduating the civil war started and as some people know in El Salvador primarily it was between the government and just impoverished villages and people who felt a great sense of nationalism so my father was stuck in between the two so he chose to leave his home country in order to avoid war. He traveled up to the border twice because he actually got caught the first time and the second time he was able to make it from... Take a bus from California all the way to New York.

Andres : His sister was already there and he lived in a one bedroom apartment with her, just like the New York Times article stated he started off as a dishwasher in a diner and worked his way up from there. It's kind of incredible.

Dave : Has he told you stories about those journeys from El Salvador trying to get across the border?

Andres : Oh yeah. One thing that pops up with me is as he's crossing the border he has no food. You have to cross this huge desert and the heat's excruciating and there's a group of people kind of traveling with you and just out of mercy, there were people on the way selling food but my father had no money. Out of mercy this one lady just made him a burrito and just gave it to him because he probably looked hungry and sick and tired.

Tom : He makes it to New York City and he's a dishwasher there? Is that right?

Andres : Yeah, and he starts picking up very small jobs but I definitely would want to ask my dad more about this. I know he starts just gaining a lot of money but his goal is to meet someone but also to go into school even from nothing because both my parents are pretty educated actually. I know just because of what had happened to him in El Salvador with the civil war he would attend various rallies protesting what was happening in El Salvador. That's actually where he met my mother at the time who was in Queens College and the rest is history pretty much after they met each other.

Tom : Yeah. You and your brother are born and tell me about what it was like growing up.

Andres : I had a great time growing up with my brother and my family. Throughout growing up my parents really emphasized education. Emphasized it so hard. They would use most of their money to send me and my brother to private school all the time. Now, I'm not saying that's better than public school or anything but it's just the fact that they valued it a lot more, that they thought it was worth paying for. I think that was good. It also kept me disciplined as a kid.

Tom : It sounds like they made quite a bit of sacrifice for you and your brother at least on the educational front. Did they ever share with you any sort of life philosophy that they had about what they were trying to do with their lives or what dreams they had for you?

Andres : My father would actually inspire me by just talking about himself. He would tell me how he was the fourth in his class of hundreds in his military school. They would all go through training and run miles. He'd try and be the first one. Or like another thing too that's cool about my dad, he was part of the U19 national soccer team but again, it was just everything that he would tell me in forms of stories would just be an inspiration for me or would set an example. He didn't really have to directly tell me to, "Hey, you got to study harder," just his stories alone would help me realize that I need to do better in everything that I do.

Tom : Yeah, but was there any particular moment or any anecdote that allowed you to feel driven toward this calling in medicine?

Andres : It was a collection of moments. Learning about how health affects minorities and just the whole country and that too. That struck me. I've always had a sense to help minorities, medically underserved communities. I think mostly because I come from these communities and they helped mold who I am today in a way.

Tom : Yeah, that's a great point and we join this story in the middle when I first learned about you it was reading the article in New York Times and you are a third year resident, is that right?

Andres : Yeah, that's right.

Tom : Could you tell me a little bit about the hospital that you're at and what hospital you got admitted to when you were sick?

Andres : I'm a third year emergency medicine resident and it's part of something called Jacobi Montefiore Emergency Medicine Residency Program. It's in the Bronx. There's three hospitals we primarily work at. Jacobi Medical Center, old hospital. It's been around for a long time. Montefiore Medical Center and Weiler Hospital or Einstein Hospital. Actually we mostly work at Jacobi Hospital. It's a public hospital so we see a lot of, everyone. People who don't have insurance, it doesn't matter what you have. You can come and we'll help you. I was admitted there at Jacobi Hospital which everyone knows me there so it was actually had a very good stay, very supportive stay in ICU.

Tom : Yeah, when you were there it sounds like your colleagues were incredibly scared for you. Were you also scared yourself?

Andres : Of course. I was terrified. When I first entered they had tents stationed outside of the emergency department to have people tested or at least screened or triaged for coronavirus. I was already positive but even just entering the emergency room from the tent, nurses just looking at me be like, "What are you doing here? What?" Other residents seeing that I'm short of breath, she's like, "Sit down. Why are you standing up? Sit down." Just the face of concern that I... It's shock, you know? Here I am in my casual clothes, not in my scrubs or my stethoscope and I looked bad.

Dave : Had you been treating patients who had COVID-19.

Andres : Yeah, I'd say three weeks before I got sick just when everything was starting. Also with the problems with PPE and not enough tests, I was working with coronavirus patients.

Dave : In your particular situation, I live in Colorado, Tom's in Chicago. We've got folks on my block, the people live on the corner, he works in the ER and they don't even have the appropriate gear to protect themselves. Was that the same situation for you or not?

Andres : When it started, it was a problem. I remember using an N95 for three days in a row just because I felt bad that they're weren't enough N95 masks and obviously I had no other choice. That was the best way I could protect myself. Even face shields, you know that ones that cover your entire face, those are limited. I remember my co-resident giving me one. He's like, "Hey, I just washed it. Give it back to me next shift. I was like, "Wow, this is kind of crazy that we don't have enough materials and we're in the United States.

Dave : At that moment were you scared? Were you going into work afraid or was it no, hey this is my job. I'm doing my job. Tell me a little bit about that time before you even got sick. It seems to me as someone who isn't a doctor, I'd be afraid to go to work.

Andres : I was okay going into the ER but when I would have to go into a patient's room I was scared. I remember the first patient that I had to see that was suspected to have coronavirus, I put everything... I double gloved, I put a gown, I found everything before I would enter the room and then even inside of the room I took a couple steps back. It felt pretty impersonal the interaction I was having with the patient but I think he could understand. Yeah, I was scared to go into every room that was suspected to have COVID-19.

Tom : Then it seems that you started feeling ill. Was that a week or so later, is that right?

Andres : I had been working for two weeks when coronavirus was starting to ramp in. Yeah, two weeks and then a weekend passed and then on that Monday, March 23rd is I just really, really bad chills.

Tom : You have the chills and are you thinking this will go away or tell me about the thought process in your head before you actually went into the ER. What action did you take then?

Andres : It took nine days for me to get into the ER and I'd been reading some comments here and there. There's some misconception that I waited too long to go in but I'll just explain that a little bit better. I'm young, 27, no medical problems. I don't smoke and I had these chills. It reminded me when I was a child. I'm pretty sure most people have had some kind of cold or virus and I did have a little bit of a fever and it just goes away, you know? I thought to myself, "This can't be coronavirus. There's no way. This is probably the flu. I've never had the flu before." As the days passed, I had a fever. It would break with Tylenol which wasn't the problem. I was still eating, I was still playing video games, talking to my friends, talking to my parents, my brother. Day five, I spoke to another colleague of mine who she got tested because she wasn't feeling well so I was like, "Okay, fine. I'll go get tested. I won't just stay at home and accept that this is happening. Let me get some more information."

Andres : I went to Jacobi Hospital. They have a sort of clinic outside or conjoined with it and they tested me immediately, no problems. I got the results the next day. They called me, said I'm positive so I was like, "Okay. I don't have the flu, I have coronavirus but I'm doing okay. I'm still doing okay. This isn't that bad. At the time it still affects older people with chronic medical problems. I'll be all right." It's funny that that night on the sixth day is when I had the worst fever I've had up to that moment. 102, 103. The next day I had a fever of 104, I'm delirious on my bed in the fetal position. I remember texting my friend, his name's Dr. [Lutzer 00:15:27], Carlo for me. I asked him, "What's the data on taking NASID's or ibuprofen with coronavirus and he explains to me data isn't strong, it probably's fine. You're young. You don't have kidney problems and I'm becoming desperate. I'm looking for other modalities to help my illness.

Andres : For those three days I wasn't playing video games, I wasn't really talking on the phone. I was horrible. Most sick I've ever been until day nine where I wake up, it's like 8:00 in the morning and I have this really horrible brain fog. I didn't want to accept the fact that I would have to let other people take care of me because I couldn't do it myself. For the sake of my life I had done everything that I could in my apartment. I just needed help. I think the problem I have with my ego is sometimes it's hard for me to ask for help but I had no choice at that point.

Dave : There must be, as a doctor there must be some fear of not only this idea of letting people take care of me but I am accepting by going into the hospital that this is pretty serious and that's sort of like in my mind sort of that next level of acceptance of I can't do this alone and I need help and this is getting pretty serious.

Andres : I mean, yeah. I had been trying to be a good doctor for myself and it was time to let other doctors be good for me. I had to realize that. Even when that day when I was short of breath and I couldn't even complete sentences. I'd have to take two, three breaths in between them, I still actually, I remember I told my roommate, he's a first year resident and he's an intern in emergency medicine too. I told him, I'm just going to try and sleep this off for an hour, as if that was going to do anything. I wake up and I magically feel better. Eventually I woke up and he drove me to the emergency department thankfully. I started to accept that I need help from other people. I can't do this on my own.

Tom : Yeah, that's a pretty powerful story of accepting that and then taking action for yourself for that. During this time, are you communicating with your parents at all or tell me about your interaction with your father, someone that has inspired you and driven you most of your life?

Andres : Yeah, every day I think we would FaceTime. Also with my brother and my girlfriend but my father in particular, he's very... In times of trouble he always, he kind of has the same general message. You just got to pray to God, you have to be strong. You've got to eat well, you got to brush your teeth, basic things too. I think just that those familiar phrases and messages of inspiration, it helped me. It helped me feel like things are still normal, things are okay. Things will still be okay. Even then when I was in the hospital my father still did the same thing. He never let me know that he was worried, ever. That's huge, right? Because as you start to see other people worry you start to think, "Okay, this is a little bit more serious," but my father never, never did that. It's incredible. How can he not show me that he's worried.

Tom : You're feeling trusting. You're in the hospital admitted now and you're feeling ill. You recognize that this is now serious. Tell me about what it is that you are feeling inside? Are you feeling this sense of stress and fear? Are you actively, I guess you would call fighting this disease inside you? Tell me about what's going on in your mind during that time?

Andres : There's two phases when I were in the hospital. One when I was in the ER and getting worse and two when I was in the ICU when they finally rolled me up but I guess in the ER I still felt... I felt okay. I felt confident in my peers and everyone was coming in and out and greeting me but what struck me was when the... And I knew it, I knew when I woke up in the morning. The attending, Dr. [Corsiar 00:20:03], he comes in, arms crossed. He's this old Italian dude and with a heavy New York accent. He's like, "You know you're being admitted, right?" In a strict... I was like, "Yeah, yeah. I know." I looked down and he's just staring at me. He's watching my vitals and that's when it really hit me. This is real. I'm 27 and I'm being admitted to a hospital and we don't admit anyone. We admit the 60 year old with a heart attack or something. A 27 year old with coronavirus, this is... What the hell is going on?

Andres : I call my girlfriend and I'm terrified and I can't hide it. Now anything is possible. Now there's a real chance that I could actually die and that's insane.

Dave : Yeah, and as you're going through that Andres and then you moved into the ICU, as you're reflecting back on this now because now it's been, what is it? It's been weeks later and you think about your old self and maybe that's the self you have now become, I'm just sort of curious, you mentioned I'm strong, I'm stoic, I hide my emotions and now you're in this situation where that isn't working. Do you feel like going through that process of having to open up and experience all those emotions and perhaps even share them in different ways. Has that affected how you think you'll approach challenges in the future?

Andres : It already has. Every patient encounter that I have now, I obviously take care of them from the medical standpoint but from an emotional standpoint I want to ease them more. Sometimes I would tell myself as a joke, you don't have to be a nice doctor but you have to be a good doctor. I think some people would understand that in the medical field but if you are a nice doctor as well, that makes you a better doctor. That's something that all this... This experience was insanely humbling and vulnerable for me and I understand, I really do understand now how it is to be on that stretcher that's uncomfortable. You don't have your phone charger. You don't have clothes, you're being admitted. What do you do? You need a toothbrush. I know exactly how it feels and how distressing it can be and uncertain. I've been trying to use it with a lot of my patient interactions even when I don't have to. I tell them, "Hey, I've been sick too." I try not to give a lot of details unless they ask but I tell them, "I know how you feel. Trust me, believe me when I say this. I know how you feel." I feel like it's been helping some patients, you know in small ways but it's changed me. It's changed me forever.

Tom : That's a great revelation and so empowering to hear. When you think about this experience that you've had it clearly has changed you as your doctor and in terms of your approach. Has it changed you as a person as well?

Andres : Yeah. It's changed me as a person in the way that I appreciate the love and support more from people in general. Even people that you don't expect and know and that makes me want to get to know these people more and be able to maybe one day give that back too whenever they need it.

Dave : That's powerful. Andres, I'd like to go back to the storyline. I kind of wanted to get to the heart of some of these really profound lessons that you learned but you kind of left the storyline of your experience, you're in the ER, nervous. Your girlfriend's flying in. Tell us what happened next.

Andres : The way this virus works, we think. There's a one phase of mild illness like I had and then a second phase of something called cytokine storm, a huge inflammatory response and I had been having waves of that and finally being in the ER for so long, a wave was coming, a wave of high fevers, chills, body aches, delirium and they had been deciding where to put me. If I was stable for the medical wards where there isn't always constant monitoring or do I need the highest level of care that a hospital can offer, the intensive care unit and they saw that wave coming. Despite them giving me all these antibiotics, fluids and Tylenol I was still... Nothing mattered. None of that mattered. This virus was still just causing my body to go haywire. When Dr. [Romo 00:25:00] he's a pediatrician and the reason he's involved in my care, side note, the hospitals rearranged their units to take care of people for COVID so the PICU instead of taking care of people 20 years and younger, they did it to 30 years and younger because of the overwhelming response at the time.

Andres : That's why he was... A pediatrician was involved in my care but I also know him personally. I've been to the family parties. My girlfriend, he's there with his family. He saw this wave, he saw my respiratory rate jump up to something unsafe, my heart rate, the fever, regardless of Tylenol, 103 and I just... I looked like crap on that stretcher. That completely alarmed him so he met with the chairman, my director Mike Jones, Dr. Corsier the attending and they were talking right outside my room and I heard their conversation, bits and pieces but the most distinct one was Dr. Romo sounding extremely concerned and saying, "This guy needs to be on high flow right now. He needs to go up to the PICU right now." Hearing him worry, I'm like, "Oh man, this is bad." You can't see me but I'm holding my head right now. I was like, "If these people are worried, I'm worried," because I've worked with them side by side and I know and I've seen critically ill patients and you watch them and you know when to get worried. I have all these big shot doctors being worried about me so that just perpetuated my fear as pretty overwhelming at that point.

Tom : I know that you're a stoic guy. I know that you're this epitome of keeping it together. When you're hearing and feeling what you're feeling and what you're hearing, was there a moment where you just broke down? Was there a moment where you just let that all out?

Andres : Yeah. I don't think I've told anyone. While they were having this conversation they stopped and there was a moment of just silence. The lights were off in my room. You could hear the monitor beeping pretty fast because of my heart rate and I'm just looking outside the window and knowing I can't leave. I'm sick. This is bad. Everyone's worried. I don't know what's going to happen and I'm alone in this room too. I did cry. I honestly did to myself for a few minutes and then I kind of let that wear off. I started to think, "I'm in the right place." I tell patients all the time when they get emotional. I'm like, "You're in the right place right now. You're not home. You're in a hospital. We can help you." I gave myself that advice as well and it's true. I am in the right place. People are watching over me and yes, I don't know what's going to happen but I can trust these people with my life so I let these tears kind of just get through my system and wiped them from my eyes and tried to hide the fact that I had cried.

Andres : I got over it for that split moment. I got back, kind of back to baseline. Yeah, no one has asked me that and I haven't really shared that.

Tom : Well thank you for sharing that and telling us a little bit more about that moment. After those tears came out and you seemed to reassure yourself of that same lesson that you taught all your patients, that you're in the spot that you need to be in, you're in the right place for this care, I'm wondering did you, knowing the struggle that you're facing and are about to face is there anything as a patient that you could actively do to fight this virus? Is there something that you thought in your head, I am in a fight and I, my will can do something about this?

Andres : That's interesting, my will. I think yeah, definitely. Just having your spirits up high and that constant connection with your family and your girlfriend, you have someone you love and hearing words of optimism from every angle, I think that definitely plays a role in sort of conquering whatever you're going through. That goes beyond I guess the physical too to sound a little bit spiritual but just I think when you have a determination to accomplish something and to live or the will to do something I think that puts you at an advantage actually to overcome whatever you're facing at the moment and that's how I received it from the people that I care about the most.

Dave : That's a really profound lesson I think to remember that the power as you put it in your own words of rooting for someone and how much that having people surrounding you, rooting for you can actually potentially help the person who needs the rooting for. Not always obviously. Sometimes it can't do everything you want it to but that rooting is pretty important part of the process.

Dave : Take us now, obviously you're here and you're healthy now again and so tell us the kind of the tail end of this story. You're being admitted to the highest level of care, things are not looking good. What happens?

Andres : After they had the conversation of where to put me, I hear a little bit of commotion outside. Dr. Romo's like, "Where's the portable monitor?" The thing that tells them my heart rate. He's looking for it. He's like, "Where do I get it?" Then the nurse is helping him look for it outside. I'm like, "Okay, this is good. I'm finally going up for ICU. Thank you. This is good. He comes in with it and [inaudible 00:31:29] and typically you have a transporter, someone who their job specifically is to transfer people from point A to point B or pack red blood cells from here to the ER and they just completely ignored it. The attending himself with the NP and nurse on the side, they themselves pushed me up to the ICU. They don't have to do that. He's an attending. He can tell a resident to do it or he can tell someone else to do it but he was so concerned that he felt that I had to go up immediately when he wanted.

Andres : I felt that urgency as they were rolling me up into the elevator, up to the sixth floor and even more when I got into the ICU. It's shaped like a semicircle and I'm room four and they roll me in and they're like, "Okay, we're going to transfer you to the bed." Even then I was still determined to not let this virus completely take me out and I told them, "No, no, no. I can stand up. I can stand up and get to the other bed." I did and I was really short of breath and that was probably a bad idea but they put me on the stretcher and then that's when I kind of just sat back. I'm sweating, I'm feeling pretty out of it, pretty delirious and all the nurses, they start to undress me. This happens. They undress you, they put the gown on you, they put the heart monitor stickers for the ones they have for their monitor. They placed me on oxygen, and it's funny. When the respiratory therapist, he was placing the high flow nasal canula, he stops and he looks at me. He's like, "I know you." His name's Raj.

Andres : He works down in the ER but he'd been working all over the hospital. I was like, "Yeah, how's it going?" Then he puts on the high flow nasal canula for me and I liked that. That was sort of, even he was shocked. I remember his eyes opening up a little bit saying, "I know you. You're not supposed to be here." As I have the high flow, I'm still feeling bad and I had these two pediatric residents asking me questions and they asked me about what was happening, the story, the medical history. I remember just answering yes or no. I was just too short of breath. You see there's two ICU attendings, Dr. Conway and Dr. [Berkow 00:33:44]. Dr. Romo was there too and they're just staring at me. This is something I guess people wouldn't know but like I had mentioned before, when there's a sick patient, you just stare at them for a while. You just watch them. You see how they're breathing, you see what color their skin is, if they're sweating, how they're interacting and you try making just a clinical picture. Very subjective but pretty right most of the time and you see how they're going to do. And they're watching me and I know they're doing that.

Andres : They look concerned. All of them. They're looking at the monitor and they look back at me and they look at the monitor and I know, I know what's thinking in their mind is because I've been there. Is he going to get worse? Is the high flow not enough? Is he going to need something else? I'm pretty sure that word has creeped into their mind at some point, just the word of intubation. I just closed my eyes and I started breathing with the high flow and little by little after a couple of minutes it starts working. This high flow nasal canula, it sounds straightforward but it's high flows of oxygen. 30 liters per minute into your lungs and it also creates a positive pressure to sort of open up the collapsed parts of your lungs that this virus was doing pretty horribly. Little by little, and I remember I'm feeling better even from the breathing standpoint and Dr. Romo, he's looking at the monitor and he's saying, "Look, he's breathing slower." He's from 35, he's down to 28, 25 and I stayed at 25.

Andres : Then that's when they all just took like kind of a sigh of relief. That was really close to that cliff where you fall off and then you can't come back. I think I showed up just in time to the hospital. Maybe if I had taken another two hours nap in my room to try and get better I don't know if I would've made it without being intubated.

Dave : You went from, as you said almost going off the cliff to recovery.

Andres : Yeah. Later that day too, as this New York Times article mentioned too, I had received and experimental medication called [inaudible 00:36:07] with the oxygen and the high flow and with this experimental medication it was remarkable to just feel so good in a couple of hours after being in the ICU. I felt like myself again.

Tom : It sounds like a handful of days later you were discharged, is that right?

Andres : Yeah, that's right. It took a couple days just because I still required that high oxygen. My lungs had been damaged from this. Yes, the fever was gone and my nausea, my appetite was back but my lungs still had to repair. It was a gradual process and then I had to work on it myself too with breathing exercises and trying to walk around my room but little by little these things don't happen fast overnight.

Dave : Andres, I understand you are better now and you're actually, I think back at work. Is that right?

Andres : Yeah, I worked a shift yesterday. 12 hour shift on the adult side. I feel good. There are some residual things like I get a little short of breath when I talk a lot and pretty fast and if I go up the stairs, more than usual but it just feels like something I can improve on. It just feels like I took a big hit on my endurance. If I were to exercise one day, I'll get better and I feel good.

Tom : After living through this experience obviously there's a lot of pain that you endured, a lot of fear that you endured and that people close to you endured. Is there anything that you would say was a gift that came out of this experience for you and if so could you tell us a little bit about that?

Andres : I think a gift I received from all of this was not only empathy but sympathy for those who are ill we're always taught empathy in medical school. We have a definition and we try and apply it in these simulations but with people it's a little different. Everyone's different. It's hard to give empathy sometimes. This taught me another level of deeper... Sympathy for someone. Someone who's in pain, someone who just needs a urinal to pee in because they can't get up. Maybe they had an amputation. It his something deeper inside of me that maybe at some point I had forgotten. This willingness to not only understand where a patient is coming from but to whatever that entails as well. The emotions, social implications, the fears, the worries, everything. That's a gift. I don't feel like people always feel that or they forget it at some point. I hope I can hold onto this for the rest of my life.

Dave : That's great. Andres, do you have any token or I guess you'd say a memento of your time being a patient, of your time having lived through this? Do you keep your wristband somewhere or do you have any sort of reminder of this extraordinary experience that you had?

Andres : I have the discharge paperwork just on top of my dresser. It doesn't have to be there but I kind of, I just leave it there. It's in my line of sight and I see it and I just think about, "Yeah. I was a patient. I was a patient one time."

Dave : Yeah. One of the things that we teach at No Barriers is our slogan of what's within you is stronger than what's in your way as a way to offer people in some ways that little bit of optimism or trust that they can get through it, whatever that struggle is that they're going through. I just wondered if you had any reflection on that? What's within you is stronger than what's in your way?

Andres : I think it's something like you mentioned before, just that innate determination, work ethic and will to overcome whatever you're facing can push you to accomplish things that you would never expect. Can push you to even defy death at some point and it's something inexplicable that I think everyone has just the way they find it is in different ways. I found mind through this horrible virus. Like I said, I think everyone has that, they just need to find it or discover it in some way.

Tom : That's great. I can't think of a better way to end.

Dave : Andres, it's been a real honor to have you on the show. I feel happy and proud knowing that there are physicians like you out there treating those who are the most ill. Andres, it's been a real honor. Thank you so much for all that you are doing and thanks for sharing your story.

Andres : Thank you for hearing my story as well and having me on the show.

Dave : Tom, great conversation. Thank you for bringing Andres to us. What was something that really stood out for you in the conversation today?

Tom : Well, I think that the acknowledgements and the transformation that Andres shared with us was probably the most powerful thing and it's a reminder to me that when those transformations happen that we can allow ourselves to be vulnerable, we can allow ourselves to lean into whatever those feelings are that we're having. The fear, the fight and ultimately depend on that team around us to help us get through it.

Dave : Yeah, and for me I'll go back to that segment where Andres talked about the power of the people rooting for you. I think that's something we all have the opportunity in our lives to root for others and that act of rooting for others can have tremendous impact not only on the person you're rooting for, but it can bring a lot of fulfillment to your own life so I think it's something we should all to more of, root for others.

Dave : With that, we are going to end our show today. As always you can find our show notes at NoBarriersPodcast.com. Thank you Tom, thank you Andres.

Tom : Thanks.

Andres : Thank you.

Dave : The production team behind this podcast includes senior producer Pauline Schaffer, executive producer Dedric [Jonk 00:42:57], sound design, editing and mixing by Tyler [Kautman 00:43:00]. Graphics by Sam Davis and marketing support by Megan Lee and Carly Sansmark. Special thanks to the Dan Ryan Band for our intro song, Guidance and thanks to all of you for listening. We know that you've got a lot of choices about how you can spend your time and we appreciate you spending it with us. If you enjoy this podcast, we encourage you to subscribe to it, share it and give us a review. Show notes can be found at NoBarriersPodcast.com.

Dave : (singing)


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