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August 9, 2021 30 min
Franciscan Spirituality Center
920 Market Street
La Crosse, WI 54601

Steve Spilde: Joan Filla is a friend of the Franciscan Spirituality Center, and also a personal friend. She has attended many events at the FSC, and she has done presentations for us on the healing of trauma. Joan is a physician at Gundersen Health System in La Crosse, and she has been on the front lines in the battle with COVID since the pandemic arrived in our community. Today, it is my honor to invite Joan to share her unique perspective in this traumatic period in all of our lives. Welcome, Joan.

Doctor Joan Filla: Thanks, Steve. I’m happy to be here.

Steve: You work as a physician for Gundersen Health System. What’s your medical specialty?

Doctor Filla: I am an Internal Medicine Hospitalist, which basically translates to I take care of sick adults who require hospitalization. I describe myself as the quarterback. I’m kind of the one that organizes things and needs to call in the specialist, when needed, to take care of a patient’s needs.

Steve: Take us back 18 months ago prior to the pandemic’s arrival. What were your thoughts about what might be coming? And when did you know that we would be affected here in La Crosse?

Doctor Filla: I have to admit that my first response and reaction was based out of naivety. I remember having conversations with my colleagues saying, ‘I just want to get this infection, get it over with, and be able to move on with my life and deal with other patients that have it.’ I quickly realized I did not want this infection. I was not caring for the first patient that we had at Gundersen; that was one of my colleagues who has gone on to become as what I would refer to as our local hospitalist expert on COVID. It was with that patient, even though it was one patient, that I realized just a little bit of what the magnitude of this could be. That one patient where we really had no … there was really no guidance. We had no idea how to treat this other than to be supportive. We couldn’t ask any specialist because nobody really knew a whole lot more than we did. I’m speaking for him and feeling what my colleague talked about, [and that] was it felt very lonely [and] very fearful. And then the family is afraid, [and] the patient is afraid. Patient and loved ones are separated. That patient changed me. It made me afraid to go down there, to go into the unit.

Steve: That was the first patient you encountered, and then talk about, when was that, timewise?

Doctor Filla: April of 2020. I don’t remember the exact date. I was hearing about COVID kind of secondhand from my colleagues. I didn’t work in the unit, I don’t think until May when I actually took care of my first COVID-positive patient. At that point, we had a few hospitalists, docs, and physician assistants who had sort of gravitated there and become as much as we could the local experts. It’s hard to say ‘experts,’ but when you don’t know a lot, that’s literally what you are. I walked in as the physician leader for that team being one of the least experienced ones, which is also interesting. It’s relying on a lot of past history [and] past knowledge of working with patients, and book learning, which it’s been a long time since I’ve had to rely on book learning. It’s been more based on experience and knowledge and actually taking care of people with issues. The first week of encountering patients, I wish I could say was the hardest, but it wasn’t. If anything, it was a … there was some professional excitement because it was new. It was different, it was challenging. In some ways it was freeing, but it was also terrifying.

During that week, I cared for the first COVID patient that I took care of that died. He’s there, delirious [and] dying alone. [He] had already lost another family member to COVID. His other loved ones can’t be there. I remember a phone conversation with one of the family members who wanted to talk to him, but he was not even in a state to be able to talk to his loved ones. The request came to me to tell him that I love him. To be the messenger in a situation of this gravity where the family has already lost another loved one, and now they’re losing somebody else and they can’t be there to be able to go into the room [and] tell him, ‘So-and-so says I love you.’ His response was, he moved – that was as much as he could respond and to be able to share that. It was a moving moment. It was a moment that made me say, ‘As hard as this is, I want to keep doing it.’

Steve: In that regard, this disease is unique in terms of, people are sick [and] people are dying, and yet you need to keep them isolated. And so family members were not in the room with them.

Doctor Filla: Correct.

Steve: And also, as physicians you have to have a level of – or even any healthcare workers [such as] nurses, therapists [or] whatever – you have to have a level of separation from the person that’s not typical.

Doctor Filla: It’s an interesting dynamic because you need to keep a level of separation while you are there as their surrogate family. The largest burden of that fell onto the nursing staff – the registered nurses, the nursing assistants who spent the most time at the bedside. The respiratory therapists spent a lot of time at the bedside. I think it was easier as a physician to walk away because I had other people [and] other responsibilities. I’m not the bedside caretaker. But the nursing staff were phenomenal in being there to hold patients’ hands, pass messages on from the family, coordinate and be present for the video conferences when we could get them, [and] the phone conversations. All of the times that they heard loved ones saying their last goodbyes, they were part of it. [They were] giving hugs when they could. It was very emotional. How do you keep separate, but yet still do that feeling and be present? That is a big challenge, and I think that’s one of the traumas of healthcare in general: the art of keeping distance while being present and compassionate. But it was amplified with COVID.
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