UCI Medical Center’s Dr. Sebastian Schubl Volunteers at New York Hospital

Friday, May 01, 2020

Main News Photo

(Orange County Register)

The man had already spent two weeks on a ventilator at New York-Presbyterian Hospital, critically ill from COVID-19 and in a medically induced coma when he and Dr. Sebastian Schubl met.

Schubl, 43, a trauma and critical care surgeon at UCI Medical Center, saw a lot of patients during his recent week-long stint volunteering at the New York hospital — the same hospital where he started his career 15 years ago.

But that one man on the ventilator made an impression.

Maybe it was because Schubl and the man were about the same age. Maybe it was because they both have families.

Or, maybe, it’s because of what Schubl, who has a pregnant wife and a toddler, saw when the man on the ventilator finally opened his eyes.

“He just kept mouthing, ‘Call my wife. Call my wife. Please, please call my wife,’” Schubl recalls.

“That was love right there.”

For a couple of months before the COVID-19 tsunami hit New York City — where, as of April 27, more than 17,500 people have died — Schubl had been talking about the coming pandemic with his mentor, Dr. Philip S. Barie,  a longtime member of the surgery department at Weill Cornell, one of about 10 New York-Presbyterian hospital sites.

Schubl finished his surgical residency under Barie from 2005 to 2011. And he spent a few more years after that as a clinical instructor at the hospital.

He’d arrived at Weill Cornell, in August of 2005, as a result of a different kind of emergency. Schubl was in his first year of residency at Charity Hospital in New Orleans when Hurricane Katrina struck the Gulf Coast, closing the Crescent City’s public teaching institution and forcing Schubl to New York.

“It was awful,” Schubl said of the emotional wallop he felt from Katrina.

“In a different way.

On Monday of the week he left to volunteer for COVID-19 duty in New York, Schubl texted Barie to ask if he could come help. Barie’s response was definitive: “Yes.”

That, Schubl said, underscored the seriousness of the situation.

“He’s not the kind of guy to ever admit he needed help.”

Schubl arrived on Thursday evening, April 9. By 7 a.m. on Friday he was at work, the first of six straight 12-hour shifts.

Schubl saw only patients who were, he said, “incredibly sick.”

“They were in full-body shut down, with multiple organ failure.”

Each medical team consisted of about a half-dozen providers — doctors, nurses, respiratory therapists. They provided, Schubl said, “intense resource management” in an “eerie” atmosphere, void of what he’s used to seeing at a busy hospital in Orange County.

For one thing, the nature of the contagion meant no visitors.

“You never saw anyone that was a family member,” Schubl said.

“That’s an odd environment to work in.”

They lost some patients, saved others. Overall, Schubl said the outcomes were “pretty good considering what we were dealing with.”

But disease and the speed of the pandemic, which commandeered use of all 2,600 beds in the hospital, also meant there was no time to celebrate what Schubl said is “always a nice moment” — when a COVID patient is taken off a ventilator because he or she can, once again, breathe on their own. Instead, the medical team would turn their attention immediately to the next patient.

And there was always a next patient.

“You’d have to run to them,” Schubl said.

“As soon as you got somebody better, to where they were conscious again, they were almost immediately moved to another floor and somebody else was moved in.”

Schubl said his unit — and the rest of the hospital — was a constant revolving door. But it was one he said the hospital’s COVID management system ran like a well-oiled machine.

“It felt like we were a hell of a team fighting an enemy.”

Still, Schubl found himself shocked by how often and how quickly the effects of the disease could spread from a patient’s lungs to the kidneys. The hospital ran short of dialysis machines and the fluid, known as dialysate, needed to run them. That called for improvisation: Nephrologists (kidney doctors) concocted their own dialysate and doctors resorted to inserting tubes directly into a patient’s belly to exchange fluid, in and out.

“It’s not as efficient as a dialysis machine,” Schubl said. “But it works in a pinch.”

Asked what he might say to COVID-19 skeptics who insist this disease is no worse a threat than the flu is every season, Schubl couldn’t stifle a sarcastic laugh.

“It is definitely worse,” he said. “I would love to walk them into a COVID unit so they could see what it looks like.

“It’s true, you can die from the flu. But this is a totally different animal. This is not the flu.

“This is a profound whole-body shutdown.”

The man on the ventilator? His body started back up. He’s alive.


(Photo by Paul Bersebach, Orange County Register/SCNG)

Category: COVID-19