Two years ago, we introduced you to 13 medical heroes on the front lines as COVID-19 first gripped the world. It was a time of great uncertainty. The situation was unlike anything these health care workers had dealt with, and there was no clear treatment.
These professionals layered on cumbersome personal protective equipment and put in marathon shifts. Worried about bringing the virus home, they told us about changing out of their scrubs in the garage and, in some cases, isolating for weeks from their families. Many leaned on their “work families,” who understood the shared trauma of caring for patients who were often alone at the end of life except for the staff at their bedsides.
So much has happened since our first interviews in the spring of 2020 that we wanted to return to those we profiled.
In our follow-up conversations with eight of them, we heard stories of heartache, dedication and resilience. Some sought therapy to cope with the hardship. They recount individual patients lost with clarity, and sometimes raw frustration with the unvaccinated.
Yet, most remain hopeful and committed to their profession. They talk of learning from the experience and feeling better prepared for the next crisis. They found joy when they could finally share in a celebration with their colleagues face-to-face. Many say they are finding themselves increasingly aware of the fragility of life and seizing on any downtime they can grab to re-energize for each wave.
Dr. Manu Kaushal
Dr. Manu Kaushal was so careful to protect his family in the first months of the COVID-19 pandemic that he left his scrubs in the garage and slept in the basement of his Rockville home. The only family member he would touch was Demo, their Cavalier King Charles spaniel.
As medical director of critical care and pulmonary rehabilitation at MedStar Montgomery Medical Center in Olney, Kaushal says the isolation was a necessary sacrifice because of the unknown impact the virus could have on his daughter, Reva, who was born in January 2020.
His family made it all the way to Christmas 2021 before the omicron variant hit. “We created a bubble. The weak link was [Reva], who was unvaccinated and going to day care. That’s where she got it,” says Kaushal, 42. Reva, who tested positive on Dec. 26, was sick for about a week. Then Kaushal and his wife, Dr. Vandhna Sharma, 37, and his 76-year-old mother all tested positive for COVID but had few or no symptoms—and no long-term effects.
“It was very disheartening because we had always protected ourselves,” Kaushal says. “But I had very high confidence in the vaccine. …Going through COVID and recovering and being asymptomatic throughout all this just raised my confidence in the vaccine completely.”
Most patients with COVID in hospitals are unvaccinated, Kaushal says.
One of Kaushal’s intensive care unit patients earlier this year, he recalls, was a man in his late 40s who chose not to get vaccinated and opposed his teenage children getting the shots. He said he’d done his research and was taking vitamins but then realized the severity of the situation. “You could see the remorse in his eyes,” Kaushal says.
Facing death, the patient pondered what he could do. Kaushal recalls telling him, “You’ve got to get the people around you, your kids, vaccinated. It’s very important.” But the man didn’t survive. Later, the patient’s daughter got vaccinated, but the son remained adamant. If his father didn’t do it, he wouldn’t either, Kaushal says.
ICU staff members witnessed so much loss during the pandemic that they had to get creative to process it, Kaushal says. So together, they painted pictures. In one, stars in the sky represent patients who died. In another, flowers symbolize those who survived. These works now hang in an ICU hallway at the Olney hospital.
By this past spring, Kaushal says, it was beginning to feel more normal at the hospital and with his family. His wife completed a National Institutes of Health fellowship in June and joined MedStar staff in Olney as chief of inpatient endocrinology.
The family did suffer a loss. Fourteen-year-old Demo, Kaushal’s “savior” early in the pandemic, died last year. Not only was the dog good company, but Kaushal recalls he was constantly sniffing Demo to make sure he hadn’t lost his sense of smell—a possible symptom of the virus.
After missing so many milestones with Reva as a newborn, Kaushal is trying to spend as much time with her as possible. She’s already old enough to love Pixar movies, he says.
In March, the family got a golden retriever puppy. They named the pup Wall-E in honor of Reva’s favorite movie, one they’ve watched nearly 50 times.
Little did Lauren Sundergill know that volunteering to work in the intensive care unit at MedStar Montgomery Medical Center in the spring of 2020 would become an on-again, off-again gig for nearly two years. With each lull in the ICU, she returned to her position as a behavioral health nurse in the psychiatric unit of the Olney hospital—but the transition was hard.
“I felt like I didn’t really belong” back in the psychiatric ward, says Sundergill, 38. There, none of the patients were COVID-positive, and she and other staff members didn’t face the same fears about entering patient rooms for hours, clothed in protective gear. “There was so much I had seen and done that they hadn’t. I felt like a different person.”
For a while, Sundergill says, she had nightmares and anxiety bordering on panic. There was one instance she just couldn’t shake. She performed CPR on an older man, but he didn’t survive. It was particularly upsetting afterward to interact with members of his family because they hadn’t been permitted to be with him in the hospital. “I just really needed to get some help to process that and get over it so that I could go back to work and start connecting with patients again because I put up a wall, big time,” she says.
Sundergill met with a therapist online who helped her work through the trauma, and she has subsequently encouraged her fellow ICU nurses to do the same to maintain their mental health.
Another challenge has been the changing public sentiment toward health care workers.
“In the beginning, it was like, ‘Oh my goodness, you guys are so wonderful,’ ” she recalls. “Then it really did a 180.
“People got pretty nasty,” Sundergill says. “Patients, their family members, people were outright telling us that we’re lying. ‘COVID isn’t a thing.’ ‘Why won’t you give [out] this medication?’
“You name it, and people were calling, demanding that we give it to their family members. We’re talking Viagra, ivermectin, random medications that didn’t even make sense.”
Still, Sundergill says, the staff provided great care.
“It didn’t matter if they were unvaccinated. It was frustrating, especially when they were young and didn’t make it, because it hurt more,” she says. She thought, We have something that could have helped you.
While putting in long hours at the hospital, Sundergill undertook a two-year process to earn her nurse practitioner degree, which she received in December 2021. Unable to take a vacation during the most difficult days of the pandemic, she finally took two months off before starting her new position as a nurse practitioner in the MedStar psychiatric unit in late April.
During the break, Sundergill and her fiancee moved from Rockville to Ellicott City. The two had planned to wed in Hawaii on April 26, 2020, but the pandemic made that impossible. Now that grand plan doesn’t seem as important as just being married, so they are likely to have a courthouse ceremony, Sundergill says.
Sundergill says the pandemic revealed to her the fragility of life—because everyone was vulnerable.
“I have a much deeper appreciation for slowness—just watching the birds in my backyard,” she says. “With COVID, it literally could have been anybody. That kind of realization of, Wow, this really could be me at any time—it shifted my mindset to just living in the moment and being more present.”
In November 2021, staff at Holy Cross Germantown Hospital gathered for a tree planting ceremony and blessing to honor those who had died at that point in the COVID-19 pandemic. Patricia Aparicio, the nurse in charge of the intensive care unit, painted on a small stone: “For all the lives that perished in the ICU rest in peace.” She placed it at the base of the sapling, joined by other colleagues doing the same.
“I don’t know if you ever let go. You just have to think about the good things that you did and you were able to accomplish under difficult circumstances,” says the 48-year-old who lives in Boyds. “They will always have a special place in your heart.”
Two years ago, Aparicio described getting attached to her patients and the emotional toll it took, especially when family members weren’t allowed in the hospital because of COVID restrictions. Her co-workers have been her best source of support, she says, truly able to understand the experience of being at the bedside of dying patients.
Aparicio never counted the losses, she says, because she didn’t want to become like a machine—insensitive to the needs of her individual patients. It required balance to be emotionally supportive while maintaining the energy and focus needed to provide critical care, she says.
As for getting vaccinated, Aparicio says she’s come to accept that some won’t do it. Still, she tries to educate her unvaccinated patients at the hospital.
“At the end of the day, we had to respect patients’ choices,” she says. “We’re not there to judge. We’re there to take care of them.”
By the time the omicron wave hit last December, Aparicio says her team was mentally exhausted, and she wanted to get away for the first time since the pandemic began. She, her husband and their two grown children flew to Las Vegas for four days.
“It was a Christmas present for the whole family,” she says. Not a fan of the slots, she says she enjoyed just walking around outside. Even in December, Vegas was sunnier than Bethesda and temperatures were in the 70s. “I just needed to see a different scenario, different than home and work.”
Next, Aparicio says she’d like to go to the Caribbean, but was hesitant to book too far in advance because of the uncertainty of the virus.
“What we hope, and what is going to happen, they are two different things,” she says. “Right now, our new routine is when the [COVID infection] numbers are going down, we’re coming out. When the numbers are going up, we’re going inside. …As nurses and doctors, we adapt. We adapt to changes. It was hard and it was challenging, but we adapt.”
Dr. Rachel Vile
The low point, says Dr. Rachel Vile, came around Christmas and in January of this year, when the omicron variant was putting people with COVID back into the intensive care unit at Holy Cross Hospital in Silver Spring at an alarming rate.
“People were vaccinated and still getting COVID, which was extremely depressing because we thought we had a cure,” she says. “But we had some vaccinated people dying. They all had preexisting conditions. Healthy people who got COVID were fine.”
Vile, 53, works as the hospital’s medical director of critical care. She’s the liaison between the critical care unit and the administration. To her, it’s irrelevant whether a patient is vaccinated. One patient refused to acknowledge that they had COVID before being placed on a ventilator. That patient later died.
“By the time you come to the ICU you’re so sick that we need to do everything we can for you. Blood is the same color no matter what you do, no matter what the politics are. If you’re sick in the ICU, I just want to take care of you. I don’t care how you got there.”
Vile, who is married with three teens, has reflected a lot in the past few years. She’s increased her focus on self-care. She spends more time with friends, reading for pleasure, and exercising.
When tragedy strikes, she gives herself time to grieve. If she doesn’t, she says, the sadness will eat her alive. She spends time in one of the hospital’s newly created oasis rooms, where she can contemplate life and death. Luckily, she hasn’t been sick with COVID, and no one among her friends and family has died from it. One colleague, however, contracted the disease and has had to permanently stop working because of the long-term effects.
In the spring, the hospital had only one COVID patient in the ICU. The availability of new drugs like Paxlovid, given to patients who meet certain criteria, has helped treat mild to moderate forms of the disease. Since then, however, she has seen more patients with complications such as a blood clot or a heart attack.
Vile is quick to point out that the vaccine has made a huge difference in the severity of disease in patients.
“Over the course of two years, we’ve tried to provide all the care we can for every patient,” she says. “I try to enjoy the victories and grieve over the ones that don’t make it. Don’t try to compartmentalize the sadness; try to deal with it in the moment. I still take such pride in the patients that we helped. When I feel I’ve made a difference, it means the world to me.”
Many people are eager to put the COVID-19 pandemic behind them, but Scott Graham wants to remember all the details. His job at Holy Cross Health is to be ready for the next crisis, so that means reviewing the response to the latest one.
As director of emergency preparedness and safety, Graham ran the Incident Management Center for Holy Cross Health, Maryland Region, located in Silver Spring. Although the center closed its doors this past March, the hospital continued to monitor developments regarding the virus. But the focus has shifted to compiling an after-action report that will include interviews of those involved in every aspect of the health care system’s response to the pandemic.
“That document will serve as opportunities for us to do things differently, or opportunities for us to not have to re-create a wheel should something like this happen again,” says the 58-year-old, who has not taken a vacation day since the pandemic began.
The report will build on a July 2020 internal “pause and learn” review Graham helped conduct, co-authoring an article about the results in the Physician Leadership Journal. While Graham says the response went well in the first six months of the pandemic, there were unexpected challenges, such as a fractured supply chain, staffing shortages and fast-moving variant waves.
“Omicron really shook our trees,” Graham says of the surge in late 2021 that hit many Holy Cross health care workers and created a labor crunch. The hospital developed a staffing resource pool with job descriptions for tasks that could be done by a substitute—and the creative approach worked, he says. Graham credits members of the hospital’s executive leadership who stepped in to fulfill basic jobs, such as delivering food trays and cleaning rooms to keep the hospital running during the winter holidays.
After celebrating Christmas with his wife and two grown daughters at their farm in Comus, near Sugarloaf Mountain, Graham drove into Silver Spring about 8 p.m. to work the overnight shift at Holy Cross Hospital and allow others to spend part of their holiday at home. He had wanted to be with his mother and extended family in Cumberland but didn’t feel comfortable taking the risk with the virus still threatening. It would have been particularly comforting to be together then, he says, as his father, Dick
Graham, a Maryland state trooper for nearly 59 years, had died unexpectedly in July 2021.
“He gave me my heart for public service,” Graham says of his dad, who he didn’t see in person very often during the last year of his life. “One thing I’ve absolutely, positively hated about the pandemic was the separation.”
Graham says being able to help during the COVID-19 crisis validated his career choice in public safety, which included 27 years with the Montgomery County Fire and Rescue Service.
“So much of this successful pandemic response was based on…people willing to serve others who don’t know how sick they are, you don’t know where they are in their walk in life, you don’t know who they just lost,” Graham says. “To serve humanity is probably the greatest calling that anyone can have. And even more importantly, to lead people to be able to do what they do best.”
Dr. Atul Rohatgi
While the intensity of the COVID-19 crisis has abated, Dr. Atul Rohatgi says he’s busy in new ways at Suburban Hospital. The Bethesda hospitalist, an internal medicine physician who cares for patients exclusively in a hospital setting, is mentoring other hospitalist leaders in the region—on top of putting in more hours to cover staffing shortages.
“It’s been tough,” the 47-year-old says of the extra work for his team of 50 physicians, nurse practitioners and physician assistants. “As a hospital, you can’t be like an office and just say: ‘We’re closing our doors. We can’t see patients.’ It just means everyone has to do more—and it’s been continuing now for over two years. There has not been a chance to really just take a deep breath and sigh.”
In the early days of the pandemic, Rohatgi helped craft a manual for the care of COVID-19 patients. It was updated with each surge, he says, and became a model of sorts for other area institutions to adapt. Mentoring colleagues at Howard County General Hospital and Sibley Memorial Hospital in Northwest Washington, D.C., has been a welcome challenge, Rohatgi says, and a chance to focus more on the big picture of care. “I also get to learn a higher level of hospital medicine across the system instead of just at an institution,” he says.
At Suburban, Rohatgi’s team is finding new ways to stay connected. Instead of doing group TikTok dances at the end of shifts as they did in the spring of 2020, many are playing Wordle together, and the team’s book club has restarted after taking a hiatus.
Rohatgi refers to his colleagues as his “work family” and says they are a social group. They were eager to have a party when they all could get together unencumbered, but didn’t want to gather too early and risk holding a “super-spreader event,” he says. In early July, Rohatgi says, about 20 members of his team enjoyed dining together outdoors at a Rockville restaurant.
“COVID fatigue” was real, Rohatgi says, but the hospital staff did what was needed. “I don’t want to go through another surge, but if we had to, I would feel confident that this institution would manage it as smoothly as it could be,” he says. “Say something similar would happen in 10 years, it would be a heck of a lot easier for us to pull together and know how to approach this.”
In April, Rohatgi got on an airplane for the first time since the pandemic began for a vacation in California with his wife and two teenage children. This summer he planned to take a two-week Boy Scout backpacking trip with his son in New Mexico. “That’s probably just as scary for me as COVID because I’m not an outdoors guy. But it’s an experience I want to share.”
Laura Ventura could hardly have been greener when, eight months after graduating from nursing school, the COVID-19 pandemic hit. She worked in Suburban Hospital’s progressive care unit then—essentially one step removed from the intensive care unit—and two years later she still recalls vividly the weight of the job.
“I would get off work and sit in my car and have a breakdown after shifts,” says Ventura, 26. “There was a time when every single patient that I had was declining, and I felt like there was nothing that I could do about it. I was watching all these people not getting better, and that’s very difficult. It’s hard for nursing to feel rewarding when you’re experiencing that.”
Since then, things have improved personally and professionally for Ventura, who now splits her time between Suburban’s intermediate care unit and Sibley Memorial Hospital’s ICU. She cares for COVID patients much less often these days, but that doesn’t erase the memories of those she knew who didn’t make it.
Before June 2020, Ventura hadn’t lost a patient under the age of 50, a situation that sadly didn’t last. A year later, her unit moved to the floor at Suburban that once housed the hospital’s COVID ICU. The shift triggered memories of seeing patient after patient intubated, each one seemingly doing worse than the last.
“We experienced a lot of people crashing and having emergencies at the same time, dying on the same shift,” she says. “I have a memory bank of patients who touched me. I think about the patients who I have connections with, who tell me their stories. I tell them my story, and we make that connection. That stuff doesn’t leave me.”
Ventura occasionally sees a therapist to help her process what she’s gone through. She says reacquainting herself with her friends post-quarantine and practicing daily yoga and meditation have improved her mental health. But nothing has been more important than adding a furry friend to her household. Her cat, Lucifer Hellfire—Lucy, for short—usually greets her at the door of her Silver Spring home after she returns from one of her three weekly 12-hour shifts.
“I work nights, so I come home and all my roommates are at work, so it’s just me and the cat,” she says. “He’ll come and snuggle up next to me in bed and it’s just the absolute best.”
There was plenty of cuddle time in March when Ventura contracted COVID. It was a mild case, she says, that felt like a cold. She missed just two days of work.
Nearly three years into her nursing career, she says she can’t imagine doing anything else for a living.
“I already knew that it was hard when I started, but I learned that you have to come in there each day with all this energy to give to people,” she says. “You need to fill your tank to make sure that you have enough for yourself and for all of the people you’re taking care of.”
At the beginning of the pandemic, Nimeet Kapoor was the newly hired nursing manager of the intensive care unit at Adventist HealthCare Shady Grove Medical Center in Rockville. It was a stressful time for everyone in the health care industry, but particularly for Kapoor, who was 31 at the time and tasked with adding two ICUs to treat COVID patients.
He didn’t realize the toll the job was taking on him until he posted a photo of himself on social media in May 2020.
“Somebody said, ‘Nimeet, you look good. Thin,’ ” he recalls. “I weighed myself, and I didn’t realize that I’d lost 30 pounds in like six months.”
He wasn’t dieting, so over the next year he made an effort to eat a healthy breakfast and lunch, two meals he had often skipped because he was so busy at work. He joined a gym and started going on regular walks with his two dogs and wife, whom he married in October 2020.
Kapoor has a new role at Adventist HealthCare now, as the system’s program director for staffing management services.
“When I was in the ICU as a manager, one of the things I had a passion for was ensuring that we can get the right processes in place to get the right staff in the right places,” he says.
Kapoor worked as a nurse for eight years before shifting to administrative roles, so he knows how exhausting the profession can be. He remembers walking through Shady Grove’s ICUs after the first surge and noticing how drained the nurses looked. He arranged for therapists and chaplains to be available for the staff, and he set up meditation sessions for those who were interested.
Kapoor himself wasn’t immune to the emotional strain the disease caused. He recalls a patient with seven children whom doctors determined was terminal. When they went to remove the patient’s breathing tube, only two of the kids could be there.
“The family had to decide which two kids to have bedside when it happened,” he says. “There are a lot of decisions that have to be made about end-of-life care. At the time, there was a week when we were seeing one death a day, which is not typical in the ICU. That was extremely challenging not just for family members, but for our staff, too, because they’re the ones who are trying to empathize with the families.”
The experience profoundly changed the way he looks at life.
“When I saw people my own age come to the hospital with COVID and become seriously ill, it made me appreciate what I have,” says Kapoor, 33, of Gaithersburg. “I was fortunate enough to have a good family and nobody around me got severely ill. It made me appreciate life a lot more.”
This story appears in the September/October 2022 issue of Bethesda Magazine.