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Notebook Medicine

A doctor goes to New York

Ben Daxon with team members from the COVID-19 Surge ICU (Handout)

Medicine

A doctor goes to New York

One Minnesota doctor’s experience volunteering at the COVID-19 front lines for a week

On April 23, Ben Daxon, a critical care physician, donned scrubs and a scuba mask. Fitted with a 3D-printed adapter for a viral filter, the mask was “heavy, tight, suffocating,” he says. But it was necessary during Daxon’s shift working in one of six COVID-19 intensive care units at a Brooklyn, N.Y., hospital, where he volunteered for a week and where only curtains divided one critical patient from the next.

Daxon’s mask kept the coronavirus out. It also blocked his voice. By the end of his first shift, he had a sore throat from yelling through the mask. After that, he instead used an N95 mask, which rubbed his nose until it bled.

Ordinarily, Daxon, 36, works as an intensivist at Mayo Clinic in Rochester, Minn., and also logs in to satellite hospitals, communicating with patients remotely by video link. With the spread of COVID-19, especially in hot spots like New York City, Daxon wanted to do more than answer questions from his computer.

After halting elective surgeries and procedures, Daxon’s employer furloughed or cut the pay of 30,000 employees. Meanwhile, a friend who was volunteering in New York told him how bad the situation was there. Healthcare workers were making do with a lack of personal protective equipment. Some had contracted the virus themselves. Many were working overtime and outside their area of practice. “They needed help yesterday,” Daxon realized.

Of the 24 patients on his floor, almost all had multi-organ failure.

Ben and his wife, Amanda, decided Ben needed to go to the front lines. Amanda, a high-school literature teacher, would keep things running on the home front and stay with the Daxons’ three children, ages 6, 4, and 2. Before he left, Amanda asked her husband if his will was up to date. “We weren’t naïve to how serious this was,” she says.

At the Brooklyn hospital, the COVID-19 unit was “the sickest ICU I had ever seen,” Daxon says. Of the 24 patients on his floor, almost all had multi-organ failure and were “on the brink of death.” He realized many of his patients were going to die, but decided, “I was going to do everything I could to stop it.” 

During one shift, he noticed a patient’s ventilator was delivering very small breaths. An ultrasound showed that the man had a tear in his lung. His ventilator was still pumping, but the air was trapped. The air pressure could eventually crush the man’s healthy lung and heart. Daxon had to perform an emergency procedure: insert needles into the patient’s chest to let the trapped air escape. He did, and the patient improved shortly after. It was the first time Daxon had ever performed the procedure.

He had to make other difficult, urgent decisions. Two patients needed dialysis machines (some COVID-19 patients experience kidney failure), but the hospital didn’t have any to spare. Daxon decided one patient was doing well enough to take her machine and give it to the person who needed it more.

Another complication: The hospital’s ventilators were old, subpar models provided by FEMA. Though every patient at the hospital had a ventilator, the machines didn’t work well. “It’s like giving a surgeon a machete when they need a scalpel,” says Daxon.

Being able to talk medical jargon with Amanda, a former ICU nurse, helped Ben process his experiences in New York. When his night shift ended at 7 a.m. each day, he’d call his wife, walk back to his hotel, and write a journal entry.

Ordinarily Daxon doesn’t finish a week working in the ICU without questioning some of his decisions. Since returning from New York, new medical evidence (including studies suggesting ventilators might be overused on COVID-19 patients) makes him wish he had done some things differently. Would his patients have fared better with a different treatment approach? Doctors with more experience than him have wondered the same thing, he says.

Daxon recalls four or five patients died during his volunteer week, but after his return home, he heard good news about two others: Doctors extubated one and discharged the other. “It’s hard to describe to people outside of the ICU how rewarding that is,” says Daxon.

Even though he’s home now, he still thinks about the doctors and nurses on the front lines: “I’m in my kitchen. Those people are still there.”