Doctor pulls back ER curtain during pandemic

Marlena Sloss/The Herald
Emergency Physician Stephen Sample sets up a webcam system before his video interview on MSNBC at his home in Jasper on Thursday. Dr. Sample was also interviewed last week on air with MSNBC about COVID-19 in Dubois County to speak from a rural area perspective. Social distancing guidelines were followed in the making of this photograph.

By ALLEN LAMAN
alaman@dcherald.com

In the age of COVID-19, emergency rooms across the United States are becoming one of two things.

Some ERs are bustling as those working inside struggle to keep up with the drastic increase in patients fighting for their lives on limited resources. At the same time, however, other life-saving facilities are sitting largely empty.

Dr. Stephen Sample, an emergency physician at Memorial Hospital and Health Care Center in Jasper who is also the Dubois County Emergency Services medical director, explained that Memorial currently falls into that quieter camp.

“Right now, our ER is pretty much a ghost town,” Sample said Thursday. “Because we haven’t seen a wave yet. So we’re all sitting. We’re waiting.”

Draining the tub

Sample believes Memorial leadership is using this time wisely to prepare and plan for such a surge, if it were to come to Dubois County.

New policies have been put in place. Beds have been freed up. Supplies have been stockpiled.

“If we’d have gone down in a huge wave six weeks ago, there’s no way we would have had enough,” Sample said of the amount of personal protective equipment that was on hand at the time. “Because everybody was fighting for it. But now that we’ve had time and we’ve developed policies, I’m very optimistic.”

He compared the hospital’s patient capacity to a bathtub filled with water. In recent weeks, the hospital has bailed water out of its tub to preemptively increase its capacity by canceling elective surgeries and other unnecessary procedures. This is all done, in a sense, to keep the water level down.

“But at some point, when and if we get the wave, we’re gonna start lowering our body into that bath tub, and that water level is gonna start to rise,” Sample explained. “And then when it gets to the very, very tippy-top, when you can’t add one more drop, if anything moves an inch in the water, or you add one more thing, then our capacity’s gonna overflow. And that’s when things start getting really dangerous for communities.”

This, he said, is what has happened in hotspots like New York City. For now, Memorial has breathing room.

Sample noted that the PPE supply chain is loosening. But does Memorial currently have enough protective equipment to get through a horrible coronavirus wave?

“I don’t know,” Sample said. “I don’t think anybody really knows. I know that they are working tirelessly to secure our piece of the pie.”



‘I don’t want to die’

COVID-19 has wreaked psychological havoc on Sample.

“This feels scarier to me and more uncertain than it did when I was in Iraq and Afghanistan,” said Sample, who was deployed to those countries during times of war to serve as an emergency physician.

He took rocket and mortar fire every day while he was on bases in the Middle East. The chance of those rounds actually landing on his sector and doing real damage, though, was statistically slim.

“But I have a statistically very high chance of contracting this,” Sample said of the coronavirus. “As do most of us, but health care workers more than anybody. Because we’re just gonna be right down in people’s faces all day. And it only takes one slip-up.”

He flips between panic and resignation for things outside of his control. The Jasper man continues to study the latest information regarding relevant medical practices and regularly tunes in to a news cycle that steadily churns out grim information.

Being incredibly informed has become a big part of his life. And his life has become incredibly exhausting.

Sleeping is hard. Sitting still and waiting for that serious wave to hit Dubois County, if it ever does, is challenging. A former smoker who used electronic cigarettes to kick the habit, the 45-year-old doctor also lives with concerns of how his body would react if it became infected with the virus.

“Can my lungs tolerate this if I get it?” he said of a concern that has run through his mind. “Because I don’t want to be on a ventilator for three weeks. I don’t want to die. I’ve got a wife and two kids to take care of.”

Other physicians, nurses and support staffers are “just as uncertain and fearful about this as our population,” Sample said. “And so we’ve really just gotta team up and kind of do it together.”

He spoke highly of the crew he works with in the Memorial emergency department that shows up every day to work together with a shared purpose.

Sample is taking a long list of precautions to ensure to protect himself and his family and allow himself to continue fighting with his team. His work day is now filled with masks, goggles, gloves, bleach wipes, hand sanitizer, gowns, hand washing and a consistent, repetitive disinfecting of anything he touches.

When he gets home, he strips down to his underwear and immediately throws his clothes and scrubs in the washer before ducking straight to the family’s shower. Even tiny mistakes are not an option for him — or anyone on the frontlines.

‘Where are our patients?’

When speaking about the nationwide ghost town effect, Sample said that fewer patients with chronic conditions are visiting emergency rooms, as are fewer people who would previously use the facilities as a convenience and not a necessity.

In any given 24-hour period, Memorial’s emergency department typically sees between 80 and 90 patients, he explained. On a recent day, the hospital saw just 35 patients in that same stretch of time.

Another reason that number has plummeted — fewer people experiencing heart attacks and strokes are coming to the emergency department. Sample believes that could signal an issue.

“There’s kind of this feeling like, ‘Where are our patients?’” he said. “Where are these people? And I think that a large part of it is that people are sitting on these conditions that probably should be seen quickly. And they’re either fearful to come in [or] not sure whether they should come in.”

He wants readers to understand that the local ER is still open to those who are experiencing non-coronavirus symptoms and who are in need of urgent care. The medical professionals still want to see you, and you still need to be seen before your symptoms deteriorate into a more severe stage of illness, he said.



Help them, help you

Sample stressed to readers that they need to take seriously the threat that COVID-19 presents.

“If everybody does what they’re supposed to do, we can really minimize this,” he said. “If we do not, we are in a small hospital ... it does not take as much to overwhelm a small, regional hospital, as it does a massive, academic center in New York City.”

Memorial has less equipment and fewer physicians than those bigger facilities, Sample explained. Cutting down on the spread of the virus will help everyone through to the other side.

Sharing his perspective with the nation

Sample has recently become a national face of small town medicine. MSNBC anchor Katy Tur opened her direct message inbox on Twitter about a week and a half ago to health care professionals wanting to share their COVID-19 perspectives — leading to Sample’s big break.

“I just said, ‘Hey, [I] thought you might want to have a little different perspective,” Sample recalled of his DM. “I know you’re hearing about nightmares and you’re hearing about PPE and you’re hearing about all this other stuff. And I was like, ‘Here’s what it feels like to be in a small town who waits. We’re watching the world kind of burn around us and we’re just waiting, and we’re anticipating and we’re wondering.’"

Tur liked the perspective, and Sample beamed from the sunroom of his Jasper home to TV screens across the country for the first time on April 3. He made another appearance on April 9, and he will be a guest on The 11th Hour with Brian Williams, which airs at 11 p.m. on MSNBC on Wednesday night.




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