Saratoga Springs

Saratoga Hospital doctor recalls isolating with medical team and patients

PHOTO COURTESY SARATOGA HOSPITALDr. Numan Rashid of Saratoga Hospital Medical Group -€“ Pulmonology unmasks for a photo on Monday, Dec. 7, 2020.
PHOTOGRAPHER:

PHOTO COURTESY SARATOGA HOSPITAL
Dr. Numan Rashid of Saratoga Hospital Medical Group -€“ Pulmonology unmasks for a photo on Monday, Dec. 7, 2020.

SARATOGA SPRINGS — “We were in our own little submarine, the ICU,” recalls Dr. Numan Rashid, a pulmonary specialist at Saratoga Hospital.

When COVID hit upstate, he became the hospital’s COVID doctor, isolating from the rest of the facility and from his family as one infected patient after another was admitted in March and April, many of them fighting for their lives.

Joining him were the people whom Rashid gives most of the credit for saving those patients’ lives: 15 critical care registered nurses; four respiratory therapists; four physical therapists and a nutritionist; plus housekeepers and other support personnel.

They arrived before him, left after he did and were hands-on with the 30 COVID-positive patients when they were at their most infectious, Rashid said.

Ultimately, 27 would go home alive, which he said was one of the best survival rates among New York hospitals. And no hospital employee contracted COVID from a patient.

Rashid discussed the early days of the crisis last week, just as it was rebounding rapidly and the COVID patient census climbed from zero to 10 at Saratoga Hospital.

“I volunteered to be the COVID doctor for Saratoga Hospital in March, April, May — when all hell was breaking loose,” he said.

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Long days at the hospital were broken up by commutes both ways in the dark, and isolation from his wife and their two children in their Clifton Park home.

“It was surreal,” Rashid said. “You’d go to work, there’d be nobody on the road. You’d come home and there’d be nobody on the road.”

Twenty of Saratoga Hospital’s 30 patients were placed in the intensive care unit with potentially life-threatening symptoms and reactions to the virus.

The problem at the time was that COVID and its effects were poorly understood, and there was no specific protocol for treatment.

“There was no standard of care, which makes a doctor very uncomfortable,” Rashid said.

Searching for insight, Rashid looked at how respiratory diseases were treated historically by his forebears, and even at how U.S. combat surgeons dealt with shock lung, a condition recognized during the Vietnam War when wounded soldiers were being taken from battlefield to operating table with a speed almost inconceivable in previous wars.

With no drugs available, treatment came down to keeping COVID patients breathing and limiting the complicating factors that came knocking: blood clots, gallbladder and digestive problems, anxiety, depression, bedsores and acute respiratory distress syndrome.

Every day, every patient had to be flipped over to prevent bedsores and ARDS, using extreme caution so as not to dislodge any of the jumble of wires and tubes protruding from them.

“That’s highly dangerous, so that took six people,” Rashid said. It took four hours to flip the entire group of COVID patients at peak census.

But not one of them developed a pressure ulcer.

At the end of the day, the team would call family members and update them on each patient’s condition; 6 to 7 p.m. was reserved for this, but often the only update was that the patient was still alive.

That was particularly hard for the families of patients transferred north from New York City, often without medical paperwork, often with a language barrier. Language-translation apps were pressed into service.

“We would get the FDNY truck bringing patients up from Brooklyn,” Rashid said. “We were talking to these families and they had to trust in us.”

There were moments that were trying for other reasons: Often, patients and their families had to be disabused of the misinformation they’d absorbed.

No, COVID can’t be treated with hydroxychloroquine or a Z-Pak. No, 80 percent of patients placed on a ventilator don’t die. (In fact, about 80 percent of ventilator patients at Saratoga Hospital survived to be discharged.)

Three of their patients never went home: Two area residents and a downstate chemotherapy patient who had planned to evacuate north to avoid infection but didn’t do it in time.

Their deaths necessitated something Rashid never thought he’d have to do, a task at once surreal and heartbreaking: telling family members waiting 30 feet away that their loved one had just died, and that they couldn’t come in to say goodbye.

All he could do was say something about them being at peace, no longer in pain.

The survivors who live locally have all followed up with Rashid in his office after their discharge.

They’ve typically shown a profound degree of muscle weakness and wasting, and have recovered their wind very slowly — the lung scarring eventually dissipates, but it is still visible on X-rays up to four months after a COVID infection, compared with about six weeks for a patient recovering from standard pneumonia.

But more than anything else, he said, his surviving patients suffer post-traumatic stress disorder from what was, in many cases, a near-death experience that lasted weeks rather than seconds.

Rashid was born in Queens 43 years ago to newly arrived Pakistani immigrants. He grew up in central New Jersey and settled in the Capital Region after attending Albany Medical College.

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He holds all three of the certifications required for his specialty — critical care, internal medicine and pulmonary medicine — and typically works out of Saratoga Hospital’s Malta campus.

In any other year, Rashid would spend about a third of his time in the intensive care unit, treating whatever ails the patients there, and two thirds providing outpatient pulmonary care for everything from cancer to asthma to COPD.

Before 2020, he felt that pulmonary medicine was a low-profile specialty, even though COPD is one of the leading killers of Americans each year.

The 2020 pandemic has raised the profile of public health experts and infectious disease specialists, but it has also highlighted the work doctors, nurses and respiratory therapists do in the field of pulmonary medicine.

The specialty has seen its profile rise in previous eras, Rashid said, such as when tuberculosis was rampant a century ago and when fungal pneumonia began killing AIDS patients in the 1980s.

“For the first time in my career, I can relate to my predecessors,” he said.

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