February 9, 2021 • 36 mins
This week we got to interview Dr. Erik, an anesthesiologist who was deployed in the Middle East when the pandemic broke out last March. His deployment had already come to a close but he was detained for a few more weeks before he was allowed to come back to the States. He's grateful to be reunited with his family again and we spoke and mused about many different topics like healthcare accessibility, Covid bubbles, and the reliability of masks. Because of his medical background, he went into detail about how doctors go through "fit tests" to discover which masks work the best with their face - a protocol we didn't know previously existed! It left us reevaluating the efficacy of the masks we're currently wearing and wondering what we can do to create a tighter seal to prevent this pesky virus from sneaking-up on us again.
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Episode Transcript
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Unknown (00:00):
Hi, I'm Caroline Amos.
(00:00):
And I'm Raymond mcanally. And weare Fatigued (laughter)
(00:14):
Eric, thank you so much forjoining us today. How are you
doing? I'm doing very well.
Thank you for having me. Ofcourse. Could you give us a
brief summary of who you are?
Okay. I am a Swanee grad. That'show I know Raymond. But
afterwards, I went to medicalschool at the Uniformed Services
(00:35):
University, which is a D.O.D.
medical school that is kind ofthe equivalent of the academy
like the Air Force, orBut it's for medical forces of
all four services. After thatpoint, I served as a journey
(00:58):
medical officer for a couple ofyears, and then did a residency
in anesthesiology. I've deployedwith the Navy to the Middle
East, and most recently havetransferred to the reserves and
now civilian practice inanesthesia. Did you transfer
because of the pandemic? No,actually, I had completed my
(01:22):
obligated service time andfor family reasons, we thought
it was a good time to transitionover to the civilian side. I was
gonna say I was reading in yourquestionnaire that you were
deployed in the Middle East whenthe pandemic broke out last
March? Yeah, that was a veryinteresting situation. I was
(01:43):
deployed before the pandemicstarted.
I deployed with Task Force 515,which is kind of like an
emergency response action forcein the Middle East. It's a it's
a big entity. So by no meanswere we a major component of it
but we were one of theirsurgical teams to support all of
(02:07):
their different operations. Andbasically, they would fly us out
of Bahrain, where we werestationed primarily to wherever
we were needed. We went to Iraqfor a couple of months, or for
about a month or so. And thenwhen we came back, we were about
the tail end of our deployment.
When the COVID started, it hadbeen going on for a while, but
(02:28):
it started to become more andmore endemic. across the world.
When we first started, it wasjust in China, we started to
kind of see the escalation ofphases of quarantining and
limitation of life in Bahrain,which is, while it's a Western
friendly state, it's still anauthoritarian state, like the
(02:54):
the ruling party dictates whathappens. So things that they
said, went, and so we saw thisscale up from just mask and
sanitation to restaurantsclosing to pretty much
everything shutting down, andyou had to have all your food
(03:15):
delivered. And because of thenature of our deployment, we
were not on the military base,we were out in the community in
a in a hotel, because we werehighly mobile. So we would come
and go, that's where they housedus. So we were kind of isolated
from any of the militaryresources that we had available.
(03:39):
So we kind of had to rely on thecommunity has towards the the
time when these restrictionsreally hit we were actually at
the end of our deployment, ourdeployment ended, right around
March timeframe, we actually hadtickets to fly home, at least
kind of emails that we hadtickets to come home,
(04:02):
when basically all the heavyrestrictions hit. And we were
stuck there for another, I thinkthree to two to four weeks,
because the country was justlocked down.
What did it look like? beingdetained for a little bit
longer? What were the process?
What was the process likegetting back into the United
States like,well, we were basically
(04:23):
constantly on a like, well, it'sjust gonna be a little bit
longer just gonna be a littlebit longer. And then at one
point, because there the God atlarge started to halt a whole
lot of movements, even thoughour entity was due to go home at
one point they were goingconsidering extending us for an
indefinite period of time likethey had no end date, because
(04:47):
they didn't know when they weregoing to get other entities to
go out there. Oh, wow. Butultimately, that didn't go
through. Fortunately for for ourteam. He was we're ready to come
home.
Yeah. Yeah, that's gonna be abit of a shock. You've, you're
already in the headspace thatyou're going to, you're going to
see your family soon, you'regoing to be back stateside.
So that definitely wasn't wasn'tthe highlight of the deployment.
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I can imagine. Did you encounteranybody that had COVID in your
deployment?
During my deployment, we didn'tdo a whole lot of medical care,
because we were a contingencyforce. So we did set up surgical
tents in Iraq. And we were readyto receive casualties if they
were, but we mainly supportedspecial operations. So they were
(05:36):
very good at what they did. Andthey're very good at not getting
hurt. But they also want to knowthat there's a surgical team
within an hour's flight orwherever they're doing whatever
they're doing. in Bahrain, weactually don't have a hospital.
The military doesn't have ahospital, we have a clinic. So
we did have discussions as to,what would we do? If there was a
(06:01):
COVID outbreak on the actualbase? What sort of services
could our team provide? Becausewe were the only critical care
team there, which we kind of hadto tell them. We're not really
set up to do ICU level care.
We're a surgical team. So wewere designed to patch people up
and then send them to a higherechelon of
(06:24):
care, get them to the to thenext step. Yeah,
exactly. So we kind ofinternally had discussions about
Okay, well, we could intubatepeople and have them on
respirators while we get caughtthem somewhere else. But even
just the amount of medicationsthat you need for keeping
someone sedated and comfortableon a on a breathing tube for an
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extended period of time is notsomething that we were designed
for, you know, they wouldn'tbasically have to rely on the
local hospitals, which theywere, they were reasonable
hospitals, but we were not goingto be able to give them the type
of support that they would haveliked to if there was a big
outbreak in Bahrain.
(07:15):
So you get back, you backstateside sometime in in March
or early April,beginning of May. So we had like
a quarantine period. And thatwas kind of at the lower
timeframe. If you guys kind ofrecall that Coronavirus seem to
get under control.
(07:36):
I remember those.
Yeah, it was basically exactlythat just a couple of weeks. I
went back to I was stationed atthe time, and they will hospital
primary 10. And we started to docases, kind of more routine
cases and they would test peopleand we would wear all the N95
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masks.
We kind of had the luxury of nothaving a lot of the PPE
shortages that civilianhospitals faced in the military,
because we just had largerstockpiles of it in the
different supply chain, giventhe size of Naval Hospital
Bremerton being a smallerfacility. It pretty much if you
(08:21):
had COVID, you were sentelsewhere, the patient
population of that hospitalbenefits from from youth and
health, which is not the case inthe civilian world. So most of
the people who are there, theaverage military person is
usually between40s retirees, yes, that can be
(08:42):
sicker. But usually, the thingthat I've kind of
learned more as I'vetransitioned from the civilian
side, or from the military sideto the civilian side is access
to care makes a huge differencein overall health of an
(09:05):
individual. If someone has evenif they're an unhealthy
individual, they're overweight,they smoke, they kind of don't
take care of themselves, ifthey've had access to consistent
and in the military. It's freehealth care, because it's it's
all inclusive in the package.
Nice. Yeah, yeah. It's amazinghow much healthier an unhealthy
(09:28):
individual who's been able toget blood pressure medications
from the time they got theirdiagnosis, get diabetes
medications from the time theygot diagnosed, lung issues that
they get their pulmonaryfunction tests, they get their
their pulmonary meds, all ofthat stuff on a consistent
(09:48):
basis. Even as their diseaseadvances, it advances in a much
more controlled and a muchSlower way than what I've been
seeing now more in the civilianside, we have indigent
populations who, because theyuse math, they are homeless,
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they don't take care ofthemselves for financial reasons
or other reasons, other socioeconomic reasons. You've got 50
year olds whose hearts are worsethan 90 year olds, or sometimes
even younger than that, becausethey've just been kind of
ravaged by their diseases. Ididn't grow up
(10:36):
in a community like that, whereI grew up in Tennessee, people
went to the doctor to do hisreaction. You know, I'm sick,
something's horrible. I've gotcancer, and this thing is going
on. But the only time I see adoctor, and it took me quite a
long time in my adult life to tofigure out that that was not the
(10:58):
way to do it. I remember, Iremember my when my dad got
cancer. My mom who was a highlyeducated woman, and you know,
she was just speaking fromemotion, she said, and we laugh
about everything in my Irishfamily. So preface that for
anybody listening. She said,Well, your father went to the
(11:21):
doctor, and look what happenedto him. And how are you saying
that the doctor gave dad cancer?
And it hit her what she what shejust said? She's like, no, that?
Well, it is kind of I think thatis what I think we were able to
have a conversation about it,because that I mean, my that's
the way my family operated.
(11:43):
That's the way a lot of people Iknow still back home. And, and
it does have to do with access.
Even people who you wouldn'tthink they drive a nice car,
they have a nice house. Theycan't afford those medical bills
with the way they are leveragedeither. And so yeah, thank you
for bringing that up.
Yeah, I mean, speaking assomeone that does not have
(12:05):
health insurance right now, anddidn't have health insurance
throughout the duration of myCOVID experience. I'm terrified
about what's going on inside ofme. And I'm only I'm going to
turn 28 in two weeks. Like, Ishouldn't be worried about
what's going on in here. But Iam an Am I am I am I gonna go
get it checked out? No. Can Iafford it? No. So I'm just not
(12:27):
going to?
Well, you are at least one stepahead of the people who don't
worry about what's going on.
You're concerned.
Well, even Thank you.
Even my, my family's big fans ofthe Marvel Universe. But
Chadwick boseman. He recentlydied of colon cancer. He was
(12:53):
from outward appearances in thepeak of physical health. Yeah.
And just goes to show you thatyou never know kind of what sort
of symptoms he may have beenexperiencing that he may have
been disregarding, or even justhad no symptoms. And sometimes,
you're dealt crappy cards. Ifyou don't think about it, if
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health is tertiary, or furtherdown the line, you you might get
a nasty surprise one day whenyou kind of stumble break your
leg, and the X ray shows tumorsin your bones. And that's why
you broke your leg, not becauseyou fell.
(13:36):
Going back real quick, becauseyou're the first person with a
military background that we'vespoken with. Is it just in
general, from your experience,whether it be stateside or
deployed? Maybe maybe morestateside, the duty do these
bases have a natural builtbubble? And I know that there's
(14:01):
there's family interaction thatand people have jobs outside of
base. But when this when you gotback stateside, did you see
bubbles being put into place bythe military on the basis that
might have helped outbreaklevels on base.
So what they were doing withsome of these medical personnel
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was they were isolating them fortwo weeks before the workup and
usually the workups. It's acertain period of time that they
go out to sea. So maybe they'llgo out for a week at a time. So
they'll isolate them for twoweeks before they'll fly him to
the ship. Do the workup, fly himback, isolate him for another
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two weeks. And so now this oneweek, evolution became a month
long isolation period for andit's not like we have a lot of
crnas or anesthesiologists orsurgeons just kind of laying
around to do All the work, ifyou think about this guy who's
been, who's kind of slotted towork in the hospital has just
(15:07):
been kind of cut out of thehospital workload for a month,
and multiply that by every otherdeploying unit. It was a huge,
huge resource suck, that all ofthese COVID protocols have, have
caused to the militaryhealthcare system as a whole.
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And I'm not saying that it wasunwarranted, but but just to
speak to kind of your bubble.
It's like, surgeons, this iswhat they did to them. And, you
know, just kind of, and theywere faced some pretty strong
language of you will stay athome, or else type of language.
But they don't have a whole lotof leverage or control over the
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rest of the family, who stillhas to go to the store and get
food. If the kids are indaycare, or, or if the spouses
work, they're still going out.
So you've got this kind of Swisscheese bubble is Yeah, I would
say that they're trying tocreate with, with some with
(16:18):
limited efficacy, because as yousaw in the news, they were still
ships with COVID outbreaks. Andthis is why because either you
had the person decide, forwhatever reason be political or
health reasons that this COVIDstuff isn't as serious. And I'm
just getting put on house arrestfor two weeks. So I'm still
(16:41):
gonna do whatever I want. I'vejust got two weeks of free leave
from the military.
I'm curious to know if youencountered pushback for mask
wearing within the military. Didanybody push against that?
So yes, and now, the nice thingabout a military, the military
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is the guy in charge sayssomething, you do it, you don't
do it. You basically violated alawful order. And there be
consequences. Yeah. Are peoplebitching about it? Kind of half
assing? it? Yeah, there was alot of that. I think the biggest
issue that we've kind of had iswe've developed public health
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policy. During a pandemic, we'vebasically been seeing the
scientific method at work. Andpeople who don't understand how
the scientific method works.
keep on saying, well, a monthago, you told me not to do this.
A month ago, you said thisdidn't work. Now you say it
works. And tomorrow, you'regoing to tell me something
(17:48):
different. So I'm just not gonnado any of it.
Yeah, the amount of people whoheard for example, we we've
heard it quite a bit peoplesaying I thought they told us
this was only going to last twoweeks. And I'm like, I don't
have the soundbite with me, butI'm pretty sure they they said,
we're gonna do two weeks ofthis, and then we're gonna
reevaluate.
(18:10):
Everybody seems to haveselective hearing when it comes
to what they want to hear. Yeah,yeah. It's amazing how many
people on Facebook and Instagramthink that they are the experts
on this? The amount of timesI've heard someone say, Well, my
friend on Facebook said, I, Ifeel like that's a terrible way
to start any sentence thesedays. Well, my friend on
(18:30):
Facebook said, I mean, I feellike the second I hear that I'm
like, Well, whatever that personsaid, I'm just gonna count as a
lie. That's not true. Until I'mreading it in a factual source
of information. I'm not gonnatake anything that your friend
on Facebook said,Well, we even debate that now
that to me, that's one of thesaddest and we can agree on
what's a valid source? Yeah,what's, uh, what vetting means
(18:51):
or research? Well, there's beena, I like to call it a
democratization of facts thatyou put, you put one fact next
to another fact, quote, quote,unquote, facts. You put them in
equivalent boxes, and one box isa PhD scientists. The other box
is some Yahoo, who has a blogsomewhere, you put them on the
(19:14):
news right next to each other inequivalent sized boxes. And you
debate the issue. And you have,by all by all measures you've
equivalent, you created anequivalency between their
arguments that this is equal tothis, but that should never be
the case.
(19:41):
In your experience, because youyou had told us that even with a
higher rate of exposure in thesehospitals that you've managed to
knock on wood, remain COVID freefor you and your family because
you do have a family. What isthe stress of managing both your
job and your career? For yourfamily and and what does that
(20:02):
been like? And what, what haveyou done to be able to sit here
today with all that exposure andnot have COVID?
Well, what are the things thatI've been lucky in is that, at
least, both with my job itself,and the hospital system that
(20:24):
I've been practicing in, is thatwe've been able to maintain a
level of PvP that has allowed usto protect ourselves. Right,
they've been able to testpatients appropriately. We have
COVID operating rooms and COVIDwards and COVID protocols that I
(20:50):
have been had the luxury of kindof walking into just because of
the timeframe when I joined thepractice, like I wasn't there
for like the really bad kind oftrying to figure out what do how
do we do this sort of thing,they had already started to
figure this stuff out by thetime I started. So I've
benefited from that. The otherthing that I've benefited of is
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the lower volume of actual COVIDpositive cases that we've been
doing. Like we've been with ourgood testing, we've cancelled
elective cases that can bedelayed until the patients are
COVID, negative, like all of themore minor procedures, and it's
not just to protect us but allof these patients and to incur a
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great deal of risk by goingunder anesthesia and having
procedures done. If they haveCOVID. So it's it's both for
their benefit and ours. And thenthat just kind of reduces things
down to the cases that have togo. And in those situations, we
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do have the higher order of thepositive pressure, the peppers
and the cappers, which arepositive pressure, filtration
devices that we wear on ourheads. And most of us also like
to wear that and then 95, andthen kind of the extra gowns on
top. Andthat's the first time I've heard
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those terms of the cappers. Andso the capper is a device, it
looks like a football helmet.
And it's a, it has a faceshield, and then they have like
a plastic membrane that coversyou and seals up around here.
And it draws air from the topand blows it out the back
(22:46):
through a big hood. That's afiltration device. And then the
hopper has the added kind ofshoulder drape. So it connects
from the helmet here. And itactually drapes and it covers
you around here. And it tripsaround, and then you would wear
your mount, either on top orbelow that. I think ideally,
(23:11):
it's supposed to go on top. Buta lot of times it's just worn.
However you end up putting iton,
you're prepared to walk on themoon with that kind of gear on
you.
Yeah, so that's, that'sbasically what is the
recommended care for COVIDpositive patients. So for COVID
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unknown patients, usually it'sthe end 95, which is the the
mask. And one of the ironiesabout this whole pandemic is
back since I've been at severaldifferent hospitals in the
military beforehand. And part ofyour intake to every hospital in
the past was a respiratory fittest. So that's where they would
(24:00):
put lots of different and 95level masks on you. And they
would spray like a little sugarpacket around you. And then if
you could smell or taste thesugar packet, it wasn't making a
good seal. So like this is ahuge deal and lots of different
types of masks for us and theyhave like five or six different
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varieties of masksto help Can you find out what's
the best mask for correct foryour face? Because everyone's
face is a little bit different.
Yeah, well that's out thewindow. So like, which makes me
wonder is like so if we caredthat much to get because
everyone's face is different,that we had to go through this
(24:43):
huge process of figuring outwhich mask works for you. And
now we don't even bother likeit's like if there's one in the
corner like you make that onefit. How protective are these
masks on us? Even if it's an N95 I've never heard any other
discussion About that sense, butjust the whole. So we used to
(25:06):
fit test people. Now it's justwhichever one's available? Are
we actually getting the benefitfrom the 95? That we think we
are? And are some of thesepeople who get sick in spite of
the end? 95? Is it because theyweren't fit tested, and it was a
face mask that wasn't making agood seal?
(25:33):
I just have had a lot offrustration with the things
becoming so political over apublic health issue, that
there's so much so many peopleare upset about what the
government is doing to me. Andthere's very little of what are
(25:56):
we doing to each other? By notengaging in these Public
Safety's? That Yes, it's a it'sa infringement or, or
inconvenience to our lives to dothis, and some for some people
where their life is gettingaffected? Yeah, it's definitely
(26:17):
more so than just aninconvenience, but it seems like
we're getting lost into thismimimi culture, where it's how
is this affecting me, but how iswhat we're doing affecting all
the people that we not evennecessarily our friends, but
(26:40):
like the person down the road,who, or the, in your case, the
person who used the restroombefore you. It wasn't his
intention to give you COVID orher intention to give you COVID
it was completelyinconsequential. But the impact
that it had on on your life wasreal. If you kind of take it to
(27:06):
an a completely academicexercise. If everyone would have
just gone inside their house,and hunker down for four weeks,
and not done anything else, thepandemic would have ended in
four weeks.
Yeah. And it would have had ahad a far less economic impact.
Yeah. But we chose not to. AndI'm not saying that that was a
(27:30):
viable option at the time, butkind of as a purely academic
argument like that would havecaused pain. And that would have
been inconvenient. But is put ithave been less painful and less
inconvenient than what we'veexperienced since I,
(27:50):
I could not agree with you more.
And that was really well said,I've been trying to articulate
versions of this myself. Mostrecently, I was trying to find a
way to encapsulate the feelingthat you know, in our cultural
narrative, as Americans, we'revery, we like to talk about
individual sacrifice for our ownpersonal gain, right. So, for
(28:13):
example, I've picked myself upby my own bootstraps and created
a company from scratch. We welove those narratives, yet.
We're not into individualsacrifice for collective gain,
apparently, yeah. And it'salways an expensive lesson to
learn when we learned it thehard way. A good example of that
(28:37):
was the fact that all thederegulation that happened in
California with the energy thatended up costing everyone in
California, tons of money,because the deregulation of the
energy market led to all ofthese private companies
profiting off of increasing,decreasing supply of energy and
(29:00):
increasing the cost per unit.
And in the end, they they hungthe governor out to dry for it,
but it was not a democraticpolicy that that they were
trying to push. It was acompromise policy. And they
learned the hard way thatperhaps sometimes regulations
(29:24):
are good.
Yeah. Well, that instinct tohang somebody something to dry.
I think we're dealing with thatright now with COVID. Like you,
like you artfully said earlier.
And then we've heard in a numberof different interviews is that
when you look at this from arational standpoint, it can be
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simultaneously horrible for theeconomy horrible for for
individual interests, and theright thing to do to shut things
down. Yet we were going to blameourselves. Politicians you said
it would have happened in theSeattle area, depending on who
you talk to the mask. And socialdistancing mandates locked down
(30:07):
mandate to be there been toosevere or not enough. We like to
point that finger. When reallywe're dealing with a non
sentient virus it is doing whatviruses do. Yeah. It doesn't
care what our intentions are, itdoesn't care what our politics
are, it's gonna do its thing.
(30:28):
And so we're combatingsomething, but trying to put
some sort of human logic to itthat does not exist. And I think
it comes from that instinct ofneeding a scapegoat.
Well, even going beyond thispandemic, the bigger question
that I think we should start tobroach as we crawl out of this
(30:52):
pandemic, is, this isn't goingto be the last pandemic, that's
going to happen. You know, we'vebeen a little lucky in Yes, this
has been kind of deadly, butit's been kind of deadly. It
could very easily if you go backto kind of the classic movies,
the medical movies, outbreak,contagion, all those movies that
(31:14):
have now started to get a littlebit more.
Yeah, they're really.
But you get a really bad flu,you get a hemorrhagic fever.
Andit'll get it'll get really ugly.
And if we don't learn thelessons of how, what has worked
(31:35):
now and what has not worked now,it's, we're not going to
Farewell, because we're notfaring great. In a slightly
pathogenetic virus. Imagine howwe're gonna fare in a very
pathogenetic vices virus.
(31:57):
I know. Yeah, we have a lot ofwork to do. And I'm thanks to
travel convenience, and, andeverything we're, we're whether
we want to admit it or not,we're global society, especially
in terms of health. This is aprime example that I really hope
we learned that from. So I knowwe're we're kind of at the end
(32:19):
and a no Caroline wants to askher off, wrap up question.
I you know, I just I loveanything on a positive note, as
positive as we can get in adeadly pandemic discussion. And
my question for you is whatgives you hope right now?
Well, the vaccines definitelygive me hope. I was lucky in
(32:41):
that I was able to get thevaccine very early on Congrats.
Yeah, you've had both doses himI've had both doses, our health
care system was very good. Andthat was in one of the top tiers
given my specialty. As morevirus vaccines, options become
available, the Johnson andJohnson one now on top of the
(33:03):
Madonna, in the other mRNA one,and I think there's one other
one that's in phase threetrials, that isn't quite there
yet. But the more that we areable to develop these, even if
there are strains that escape,it's it's definitely a starting
(33:27):
point at being able to get usback to some degree of normalcy.
Hopefully, people will take thevaccine. I know there's, that's
becoming a new issue to peopletrusting the vaccine. But if
nothing else, reducing theamount of people that will have
life threatening responses tothe vaccine, I'm sorry, to the
(33:51):
virus with the vaccine is great.
My kids just restarted school,in person or Yeah. So that's
seeing them how excited they areto interact with other kids is
giving me hope, because I knowhow much they've they've missed
having other individuals theirown age with their own with
(34:15):
similar interests available tothem aside from their sisters.
So that gives me hope, and thatat least in our district,
they're being very serious as tohow they're approaching the
reduction of density ofclassrooms and how they're
approaching cleaning andsanitation and the social
distancing. My hope is that asthe political climate hopefully
(34:40):
starts to change to a morescience based one on a national
level, that the state won't behung out to dry. And they will
get the resources that they thatthey are able to, to continue
these sort of trends because Iknow At least my school district
is is reasonably affluent. Thereare lots of other places that
(35:04):
are less so. And I imaginethey're starting out at a at a
much higher disadvantage thanour schools are. But they're
still going to have to fight thesame fight.
Yeah, my heart goes out to theadministrators who who know what
needs to be done, who see what,how the school could reopen, and
just simply are not funded wellenough to do it at all. Well, I
(35:30):
hope that I can see you sometimesoon. And, you know, hang out in
person so we can celebrate beingon the other side of this.
Yeah. Erica said it's so nice tomeet you. Thank you so much for
sharing all that you shared withus today. Yeah, thank
you for having me. It's beenfun. Yeah. Hey, this
(35:52):
is Caroline and Raymond. Wewanted to say thank you for
listening to this episode, andlet you know that there will be
more every week from now untilwe get fatigued by it.
We're building out this podcastas we go. So stay tuned for
improvements on our website, ourgraphics and video clips and
just everything else. The timewas now to tell our stories. So
we're learning as we go. Wereally do appreciate your
(36:14):
interest in support we trulyhope and the personal stories
that come out in each episodecan help build a better
understanding of COVID-19 how itspreads and how it affects us.
If you have a story or aquestion that you'd like us to
address in an episode. pleaseemail us at fatigued
podcast@gmail.com that's fa tigpu ed podcast@gmail.com.
(36:36):
Thanks for listening.
Bye
Hi, I'm Caroline Amos.
(00:00):
And I'm Raymond mcanally. And weare Fatigued (laughter)
(00:14):
Eric, thank you so much forjoining us today. How are you
doing? I'm doing very well.
Thank you for having me. Ofcourse. Could you give us a
brief summary of who you are?
Okay. I am a Swanee grad. That'show I know Raymond. But
afterwards, I went to medicalschool at the Uniformed Services
(00:35):
University, which is a D.O.D.
medical school that is kind ofthe equivalent of the academy
like the Air Force, orBut it's for medical forces of
all four services. After thatpoint, I served as a journey
(00:58):
medical officer for a couple ofyears, and then did a residency
in anesthesiology. I've deployedwith the Navy to the Middle
East, and most recently havetransferred to the reserves and
now civilian practice inanesthesia. Did you transfer
because of the pandemic? No,actually, I had completed my
(01:22):
obligated service time andfor family reasons, we thought
it was a good time to transitionover to the civilian side. I was
gonna say I was reading in yourquestionnaire that you were
deployed in the Middle East whenthe pandemic broke out last
March? Yeah, that was a veryinteresting situation. I was
(01:43):
deployed before the pandemicstarted.
I deployed with Task Force 515,which is kind of like an
emergency response action forcein the Middle East. It's a it's
a big entity. So by no meanswere we a major component of it
but we were one of theirsurgical teams to support all of
(02:07):
their different operations. Andbasically, they would fly us out
of Bahrain, where we werestationed primarily to wherever
we were needed. We went to Iraqfor a couple of months, or for
about a month or so. And thenwhen we came back, we were about
the tail end of our deployment.
When the COVID started, it hadbeen going on for a while, but
(02:28):
it started to become more andmore endemic. across the world.
When we first started, it wasjust in China, we started to
kind of see the escalation ofphases of quarantining and
limitation of life in Bahrain,which is, while it's a Western
friendly state, it's still anauthoritarian state, like the
(02:54):
the ruling party dictates whathappens. So things that they
said, went, and so we saw thisscale up from just mask and
sanitation to restaurantsclosing to pretty much
everything shutting down, andyou had to have all your food
(03:15):
delivered. And because of thenature of our deployment, we
were not on the military base,we were out in the community in
a in a hotel, because we werehighly mobile. So we would come
and go, that's where they housedus. So we were kind of isolated
from any of the militaryresources that we had available.
(03:39):
So we kind of had to rely on thecommunity has towards the the
time when these restrictionsreally hit we were actually at
the end of our deployment, ourdeployment ended, right around
March timeframe, we actually hadtickets to fly home, at least
kind of emails that we hadtickets to come home,
(04:02):
when basically all the heavyrestrictions hit. And we were
stuck there for another, I thinkthree to two to four weeks,
because the country was justlocked down.
What did it look like? beingdetained for a little bit
longer? What were the process?
What was the process likegetting back into the United
States like,well, we were basically
(04:23):
constantly on a like, well, it'sjust gonna be a little bit
longer just gonna be a littlebit longer. And then at one
point, because there the God atlarge started to halt a whole
lot of movements, even thoughour entity was due to go home at
one point they were goingconsidering extending us for an
indefinite period of time likethey had no end date, because
(04:47):
they didn't know when they weregoing to get other entities to
go out there. Oh, wow. Butultimately, that didn't go
through. Fortunately for for ourteam. He was we're ready to come
home.
Yeah. Yeah, that's gonna be abit of a shock. You've, you're
already in the headspace thatyou're going to, you're going to
see your family soon, you'regoing to be back stateside.
So that definitely wasn't wasn'tthe highlight of the deployment.
(05:10):
I can imagine. Did you encounteranybody that had COVID in your
deployment?
During my deployment, we didn'tdo a whole lot of medical care,
because we were a contingencyforce. So we did set up surgical
tents in Iraq. And we were readyto receive casualties if they
were, but we mainly supportedspecial operations. So they were
(05:36):
very good at what they did. Andthey're very good at not getting
hurt. But they also want to knowthat there's a surgical team
within an hour's flight orwherever they're doing whatever
they're doing. in Bahrain, weactually don't have a hospital.
The military doesn't have ahospital, we have a clinic. So
we did have discussions as to,what would we do? If there was a
(06:01):
COVID outbreak on the actualbase? What sort of services
could our team provide? Becausewe were the only critical care
team there, which we kind of hadto tell them. We're not really
set up to do ICU level care.
We're a surgical team. So wewere designed to patch people up
and then send them to a higherechelon of
(06:24):
care, get them to the to thenext step. Yeah,
exactly. So we kind ofinternally had discussions about
Okay, well, we could intubatepeople and have them on
respirators while we get caughtthem somewhere else. But even
just the amount of medicationsthat you need for keeping
someone sedated and comfortableon a on a breathing tube for an
(06:48):
extended period of time is notsomething that we were designed
for, you know, they wouldn'tbasically have to rely on the
local hospitals, which theywere, they were reasonable
hospitals, but we were not goingto be able to give them the type
of support that they would haveliked to if there was a big
outbreak in Bahrain.
(07:15):
So you get back, you backstateside sometime in in March
or early April,beginning of May. So we had like
a quarantine period. And thatwas kind of at the lower
timeframe. If you guys kind ofrecall that Coronavirus seem to
get under control.
(07:36):
I remember those.
Yeah, it was basically exactlythat just a couple of weeks. I
went back to I was stationed atthe time, and they will hospital
primary 10. And we started to docases, kind of more routine
cases and they would test peopleand we would wear all the N95
(07:58):
masks.
We kind of had the luxury of nothaving a lot of the PPE
shortages that civilianhospitals faced in the military,
because we just had largerstockpiles of it in the
different supply chain, giventhe size of Naval Hospital
Bremerton being a smallerfacility. It pretty much if you
(08:21):
had COVID, you were sentelsewhere, the patient
population of that hospitalbenefits from from youth and
health, which is not the case inthe civilian world. So most of
the people who are there, theaverage military person is
usually between40s retirees, yes, that can be
(08:42):
sicker. But usually, the thingthat I've kind of
learned more as I'vetransitioned from the civilian
side, or from the military sideto the civilian side is access
to care makes a huge differencein overall health of an
(09:05):
individual. If someone has evenif they're an unhealthy
individual, they're overweight,they smoke, they kind of don't
take care of themselves, ifthey've had access to consistent
and in the military. It's freehealth care, because it's it's
all inclusive in the package.
Nice. Yeah, yeah. It's amazinghow much healthier an unhealthy
(09:28):
individual who's been able toget blood pressure medications
from the time they got theirdiagnosis, get diabetes
medications from the time theygot diagnosed, lung issues that
they get their pulmonaryfunction tests, they get their
their pulmonary meds, all ofthat stuff on a consistent
(09:48):
basis. Even as their diseaseadvances, it advances in a much
more controlled and a muchSlower way than what I've been
seeing now more in the civilianside, we have indigent
populations who, because theyuse math, they are homeless,
(10:13):
they don't take care ofthemselves for financial reasons
or other reasons, other socioeconomic reasons. You've got 50
year olds whose hearts are worsethan 90 year olds, or sometimes
even younger than that, becausethey've just been kind of
ravaged by their diseases. Ididn't grow up
(10:36):
in a community like that, whereI grew up in Tennessee, people
went to the doctor to do hisreaction. You know, I'm sick,
something's horrible. I've gotcancer, and this thing is going
on. But the only time I see adoctor, and it took me quite a
long time in my adult life to tofigure out that that was not the
(10:58):
way to do it. I remember, Iremember my when my dad got
cancer. My mom who was a highlyeducated woman, and you know,
she was just speaking fromemotion, she said, and we laugh
about everything in my Irishfamily. So preface that for
anybody listening. She said,Well, your father went to the
(11:21):
doctor, and look what happenedto him. And how are you saying
that the doctor gave dad cancer?
And it hit her what she what shejust said? She's like, no, that?
Well, it is kind of I think thatis what I think we were able to
have a conversation about it,because that I mean, my that's
the way my family operated.
(11:43):
That's the way a lot of people Iknow still back home. And, and
it does have to do with access.
Even people who you wouldn'tthink they drive a nice car,
they have a nice house. Theycan't afford those medical bills
with the way they are leveragedeither. And so yeah, thank you
for bringing that up.
Yeah, I mean, speaking assomeone that does not have
(12:05):
health insurance right now, anddidn't have health insurance
throughout the duration of myCOVID experience. I'm terrified
about what's going on inside ofme. And I'm only I'm going to
turn 28 in two weeks. Like, Ishouldn't be worried about
what's going on in here. But Iam an Am I am I am I gonna go
get it checked out? No. Can Iafford it? No. So I'm just not
(12:27):
going to?
Well, you are at least one stepahead of the people who don't
worry about what's going on.
You're concerned.
Well, even Thank you.
Even my, my family's big fans ofthe Marvel Universe. But
Chadwick boseman. He recentlydied of colon cancer. He was
(12:53):
from outward appearances in thepeak of physical health. Yeah.
And just goes to show you thatyou never know kind of what sort
of symptoms he may have beenexperiencing that he may have
been disregarding, or even justhad no symptoms. And sometimes,
you're dealt crappy cards. Ifyou don't think about it, if
(13:14):
health is tertiary, or furtherdown the line, you you might get
a nasty surprise one day whenyou kind of stumble break your
leg, and the X ray shows tumorsin your bones. And that's why
you broke your leg, not becauseyou fell.
(13:36):
Going back real quick, becauseyou're the first person with a
military background that we'vespoken with. Is it just in
general, from your experience,whether it be stateside or
deployed? Maybe maybe morestateside, the duty do these
bases have a natural builtbubble? And I know that there's
(14:01):
there's family interaction thatand people have jobs outside of
base. But when this when you gotback stateside, did you see
bubbles being put into place bythe military on the basis that
might have helped outbreaklevels on base.
So what they were doing withsome of these medical personnel
(14:22):
was they were isolating them fortwo weeks before the workup and
usually the workups. It's acertain period of time that they
go out to sea. So maybe they'llgo out for a week at a time. So
they'll isolate them for twoweeks before they'll fly him to
the ship. Do the workup, fly himback, isolate him for another
(14:44):
two weeks. And so now this oneweek, evolution became a month
long isolation period for andit's not like we have a lot of
crnas or anesthesiologists orsurgeons just kind of laying
around to do All the work, ifyou think about this guy who's
been, who's kind of slotted towork in the hospital has just
(15:07):
been kind of cut out of thehospital workload for a month,
and multiply that by every otherdeploying unit. It was a huge,
huge resource suck, that all ofthese COVID protocols have, have
caused to the militaryhealthcare system as a whole.
(15:28):
And I'm not saying that it wasunwarranted, but but just to
speak to kind of your bubble.
It's like, surgeons, this iswhat they did to them. And, you
know, just kind of, and theywere faced some pretty strong
language of you will stay athome, or else type of language.
But they don't have a whole lotof leverage or control over the
(15:54):
rest of the family, who stillhas to go to the store and get
food. If the kids are indaycare, or, or if the spouses
work, they're still going out.
So you've got this kind of Swisscheese bubble is Yeah, I would
say that they're trying tocreate with, with some with
(16:18):
limited efficacy, because as yousaw in the news, they were still
ships with COVID outbreaks. Andthis is why because either you
had the person decide, forwhatever reason be political or
health reasons that this COVIDstuff isn't as serious. And I'm
just getting put on house arrestfor two weeks. So I'm still
(16:41):
gonna do whatever I want. I'vejust got two weeks of free leave
from the military.
I'm curious to know if youencountered pushback for mask
wearing within the military. Didanybody push against that?
So yes, and now, the nice thingabout a military, the military
(17:06):
is the guy in charge sayssomething, you do it, you don't
do it. You basically violated alawful order. And there be
consequences. Yeah. Are peoplebitching about it? Kind of half
assing? it? Yeah, there was alot of that. I think the biggest
issue that we've kind of had iswe've developed public health
(17:27):
policy. During a pandemic, we'vebasically been seeing the
scientific method at work. Andpeople who don't understand how
the scientific method works.
keep on saying, well, a monthago, you told me not to do this.
A month ago, you said thisdidn't work. Now you say it
works. And tomorrow, you'regoing to tell me something
(17:48):
different. So I'm just not gonnado any of it.
Yeah, the amount of people whoheard for example, we we've
heard it quite a bit peoplesaying I thought they told us
this was only going to last twoweeks. And I'm like, I don't
have the soundbite with me, butI'm pretty sure they they said,
we're gonna do two weeks ofthis, and then we're gonna
reevaluate.
(18:10):
Everybody seems to haveselective hearing when it comes
to what they want to hear. Yeah,yeah. It's amazing how many
people on Facebook and Instagramthink that they are the experts
on this? The amount of timesI've heard someone say, Well, my
friend on Facebook said, I, Ifeel like that's a terrible way
to start any sentence thesedays. Well, my friend on
(18:30):
Facebook said, I mean, I feellike the second I hear that I'm
like, Well, whatever that personsaid, I'm just gonna count as a
lie. That's not true. Until I'mreading it in a factual source
of information. I'm not gonnatake anything that your friend
on Facebook said,Well, we even debate that now
that to me, that's one of thesaddest and we can agree on
what's a valid source? Yeah,what's, uh, what vetting means
(18:51):
or research? Well, there's beena, I like to call it a
democratization of facts thatyou put, you put one fact next
to another fact, quote, quote,unquote, facts. You put them in
equivalent boxes, and one box isa PhD scientists. The other box
is some Yahoo, who has a blogsomewhere, you put them on the
(19:14):
news right next to each other inequivalent sized boxes. And you
debate the issue. And you have,by all by all measures you've
equivalent, you created anequivalency between their
arguments that this is equal tothis, but that should never be
the case.
(19:41):
In your experience, because youyou had told us that even with a
higher rate of exposure in thesehospitals that you've managed to
knock on wood, remain COVID freefor you and your family because
you do have a family. What isthe stress of managing both your
job and your career? For yourfamily and and what does that
(20:02):
been like? And what, what haveyou done to be able to sit here
today with all that exposure andnot have COVID?
Well, what are the things thatI've been lucky in is that, at
least, both with my job itself,and the hospital system that
(20:24):
I've been practicing in, is thatwe've been able to maintain a
level of PvP that has allowed usto protect ourselves. Right,
they've been able to testpatients appropriately. We have
COVID operating rooms and COVIDwards and COVID protocols that I
(20:50):
have been had the luxury of kindof walking into just because of
the timeframe when I joined thepractice, like I wasn't there
for like the really bad kind oftrying to figure out what do how
do we do this sort of thing,they had already started to
figure this stuff out by thetime I started. So I've
benefited from that. The otherthing that I've benefited of is
(21:16):
the lower volume of actual COVIDpositive cases that we've been
doing. Like we've been with ourgood testing, we've cancelled
elective cases that can bedelayed until the patients are
COVID, negative, like all of themore minor procedures, and it's
not just to protect us but allof these patients and to incur a
(21:41):
great deal of risk by goingunder anesthesia and having
procedures done. If they haveCOVID. So it's it's both for
their benefit and ours. And thenthat just kind of reduces things
down to the cases that have togo. And in those situations, we
(22:03):
do have the higher order of thepositive pressure, the peppers
and the cappers, which arepositive pressure, filtration
devices that we wear on ourheads. And most of us also like
to wear that and then 95, andthen kind of the extra gowns on
top. Andthat's the first time I've heard
(22:24):
those terms of the cappers. Andso the capper is a device, it
looks like a football helmet.
And it's a, it has a faceshield, and then they have like
a plastic membrane that coversyou and seals up around here.
And it draws air from the topand blows it out the back
(22:46):
through a big hood. That's afiltration device. And then the
hopper has the added kind ofshoulder drape. So it connects
from the helmet here. And itactually drapes and it covers
you around here. And it tripsaround, and then you would wear
your mount, either on top orbelow that. I think ideally,
(23:11):
it's supposed to go on top. Buta lot of times it's just worn.
However you end up putting iton,
you're prepared to walk on themoon with that kind of gear on
you.
Yeah, so that's, that'sbasically what is the
recommended care for COVIDpositive patients. So for COVID
(23:35):
unknown patients, usually it'sthe end 95, which is the the
mask. And one of the ironiesabout this whole pandemic is
back since I've been at severaldifferent hospitals in the
military beforehand. And part ofyour intake to every hospital in
the past was a respiratory fittest. So that's where they would
(24:00):
put lots of different and 95level masks on you. And they
would spray like a little sugarpacket around you. And then if
you could smell or taste thesugar packet, it wasn't making a
good seal. So like this is ahuge deal and lots of different
types of masks for us and theyhave like five or six different
(24:20):
varieties of masksto help Can you find out what's
the best mask for correct foryour face? Because everyone's
face is a little bit different.
Yeah, well that's out thewindow. So like, which makes me
wonder is like so if we caredthat much to get because
everyone's face is different,that we had to go through this
(24:43):
huge process of figuring outwhich mask works for you. And
now we don't even bother likeit's like if there's one in the
corner like you make that onefit. How protective are these
masks on us? Even if it's an N95 I've never heard any other
discussion About that sense, butjust the whole. So we used to
(25:06):
fit test people. Now it's justwhichever one's available? Are
we actually getting the benefitfrom the 95? That we think we
are? And are some of thesepeople who get sick in spite of
the end? 95? Is it because theyweren't fit tested, and it was a
face mask that wasn't making agood seal?
(25:33):
I just have had a lot offrustration with the things
becoming so political over apublic health issue, that
there's so much so many peopleare upset about what the
government is doing to me. Andthere's very little of what are
(25:56):
we doing to each other? By notengaging in these Public
Safety's? That Yes, it's a it'sa infringement or, or
inconvenience to our lives to dothis, and some for some people
where their life is gettingaffected? Yeah, it's definitely
(26:17):
more so than just aninconvenience, but it seems like
we're getting lost into thismimimi culture, where it's how
is this affecting me, but how iswhat we're doing affecting all
the people that we not evennecessarily our friends, but
(26:40):
like the person down the road,who, or the, in your case, the
person who used the restroombefore you. It wasn't his
intention to give you COVID orher intention to give you COVID
it was completelyinconsequential. But the impact
that it had on on your life wasreal. If you kind of take it to
(27:06):
an a completely academicexercise. If everyone would have
just gone inside their house,and hunker down for four weeks,
and not done anything else, thepandemic would have ended in
four weeks.
Yeah. And it would have had ahad a far less economic impact.
Yeah. But we chose not to. AndI'm not saying that that was a
(27:30):
viable option at the time, butkind of as a purely academic
argument like that would havecaused pain. And that would have
been inconvenient. But is put ithave been less painful and less
inconvenient than what we'veexperienced since I,
(27:50):
I could not agree with you more.
And that was really well said,I've been trying to articulate
versions of this myself. Mostrecently, I was trying to find a
way to encapsulate the feelingthat you know, in our cultural
narrative, as Americans, we'revery, we like to talk about
individual sacrifice for our ownpersonal gain, right. So, for
(28:13):
example, I've picked myself upby my own bootstraps and created
a company from scratch. We welove those narratives, yet.
We're not into individualsacrifice for collective gain,
apparently, yeah. And it'salways an expensive lesson to
learn when we learned it thehard way. A good example of that
(28:37):
was the fact that all thederegulation that happened in
California with the energy thatended up costing everyone in
California, tons of money,because the deregulation of the
energy market led to all ofthese private companies
profiting off of increasing,decreasing supply of energy and
(29:00):
increasing the cost per unit.
And in the end, they they hungthe governor out to dry for it,
but it was not a democraticpolicy that that they were
trying to push. It was acompromise policy. And they
learned the hard way thatperhaps sometimes regulations
(29:24):
are good.
Yeah. Well, that instinct tohang somebody something to dry.
I think we're dealing with thatright now with COVID. Like you,
like you artfully said earlier.
And then we've heard in a numberof different interviews is that
when you look at this from arational standpoint, it can be
(29:45):
simultaneously horrible for theeconomy horrible for for
individual interests, and theright thing to do to shut things
down. Yet we were going to blameourselves. Politicians you said
it would have happened in theSeattle area, depending on who
you talk to the mask. And socialdistancing mandates locked down
(30:07):
mandate to be there been toosevere or not enough. We like to
point that finger. When reallywe're dealing with a non
sentient virus it is doing whatviruses do. Yeah. It doesn't
care what our intentions are, itdoesn't care what our politics
are, it's gonna do its thing.
(30:28):
And so we're combatingsomething, but trying to put
some sort of human logic to itthat does not exist. And I think
it comes from that instinct ofneeding a scapegoat.
Well, even going beyond thispandemic, the bigger question
that I think we should start tobroach as we crawl out of this
(30:52):
pandemic, is, this isn't goingto be the last pandemic, that's
going to happen. You know, we'vebeen a little lucky in Yes, this
has been kind of deadly, butit's been kind of deadly. It
could very easily if you go backto kind of the classic movies,
the medical movies, outbreak,contagion, all those movies that
(31:14):
have now started to get a littlebit more.
Yeah, they're really.
But you get a really bad flu,you get a hemorrhagic fever.
Andit'll get it'll get really ugly.
And if we don't learn thelessons of how, what has worked
(31:35):
now and what has not worked now,it's, we're not going to
Farewell, because we're notfaring great. In a slightly
pathogenetic virus. Imagine howwe're gonna fare in a very
pathogenetic vices virus.
(31:57):
I know. Yeah, we have a lot ofwork to do. And I'm thanks to
travel convenience, and, andeverything we're, we're whether
we want to admit it or not,we're global society, especially
in terms of health. This is aprime example that I really hope
we learned that from. So I knowwe're we're kind of at the end
(32:19):
and a no Caroline wants to askher off, wrap up question.
I you know, I just I loveanything on a positive note, as
positive as we can get in adeadly pandemic discussion. And
my question for you is whatgives you hope right now?
Well, the vaccines definitelygive me hope. I was lucky in
(32:41):
that I was able to get thevaccine very early on Congrats.
Yeah, you've had both doses himI've had both doses, our health
care system was very good. Andthat was in one of the top tiers
given my specialty. As morevirus vaccines, options become
available, the Johnson andJohnson one now on top of the
(33:03):
Madonna, in the other mRNA one,and I think there's one other
one that's in phase threetrials, that isn't quite there
yet. But the more that we areable to develop these, even if
there are strains that escape,it's it's definitely a starting
(33:27):
point at being able to get usback to some degree of normalcy.
Hopefully, people will take thevaccine. I know there's, that's
becoming a new issue to peopletrusting the vaccine. But if
nothing else, reducing theamount of people that will have
life threatening responses tothe vaccine, I'm sorry, to the
(33:51):
virus with the vaccine is great.
My kids just restarted school,in person or Yeah. So that's
seeing them how excited they areto interact with other kids is
giving me hope, because I knowhow much they've they've missed
having other individuals theirown age with their own with
(34:15):
similar interests available tothem aside from their sisters.
So that gives me hope, and thatat least in our district,
they're being very serious as tohow they're approaching the
reduction of density ofclassrooms and how they're
approaching cleaning andsanitation and the social
distancing. My hope is that asthe political climate hopefully
(34:40):
starts to change to a morescience based one on a national
level, that the state won't behung out to dry. And they will
get the resources that they thatthey are able to, to continue
these sort of trends because Iknow At least my school district
is is reasonably affluent. Thereare lots of other places that
(35:04):
are less so. And I imaginethey're starting out at a at a
much higher disadvantage thanour schools are. But they're
still going to have to fight thesame fight.
Yeah, my heart goes out to theadministrators who who know what
needs to be done, who see what,how the school could reopen, and
just simply are not funded wellenough to do it at all. Well, I
(35:30):
hope that I can see you sometimesoon. And, you know, hang out in
person so we can celebrate beingon the other side of this.
Yeah. Erica said it's so nice tomeet you. Thank you so much for
sharing all that you shared withus today. Yeah, thank
you for having me. It's beenfun. Yeah. Hey, this
(35:52):
is Caroline and Raymond. Wewanted to say thank you for
listening to this episode, andlet you know that there will be
more every week from now untilwe get fatigued by it.
We're building out this podcastas we go. So stay tuned for
improvements on our website, ourgraphics and video clips and
just everything else. The timewas now to tell our stories. So
we're learning as we go. Wereally do appreciate your
(36:14):
interest in support we trulyhope and the personal stories
that come out in each episodecan help build a better
understanding of COVID-19 how itspreads and how it affects us.
If you have a story or aquestion that you'd like us to
address in an episode. pleaseemail us at fatigued
podcast@gmail.com that's fa tigpu ed podcast@gmail.com.
(36:36):
Thanks for listening.
Bye
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