Up Close and Personal with Covid-19

By Charles McKenzie, November 24, 2020

Physical therapists take on the duty of "proning" patients

Victoria Rainaud ’13, DPT ’15, walked into a patient’s room as part of a team that does the “heavy lifting” of COVID-19 treatment. Millimeters away from infected, unconscious patients, Rainaud and the team work to “prone” patients, a labor-intensive job that involves manually turning them onto their stomachs to get more oxygen into their lungs and bloodstream.

After proning a man, Rainaud noticed his wristband. Staring back at her was the name of a former patient. The global pandemic that had once crept slowly into Rainaud’s life was now hurtling quickly and recklessly, becoming the sole focus of her new, modified job and reaching her in deeply personal ways.

Victoria Rainaud ’13, DPT ’15, volunteered to work with COVID patients.

“That was a really crazy moment,” Rainaud said. “I guess I knew it was a possibility that I would see one of my former patients there, but I didn’t expect it to be so soon.”

He died that Sunday.

“That hit hard. It’s difficult stuff,” she said, still trying to process the moment.

Sometimes out of horror stories, good memories can grow. One of the epicenters of COVID-19 on the East Coast, CentraState Medical Center in Freehold, New Jersey, saw its first suspected coronavirus case on March 6 and was quickly overrun to the point that it closed satellite services, such as the outpatient physical therapy practice where Rainaud usually worked.

“We were required to show up at the hospital, but we weren’t required to be in direct patient care,” she said. Some colleagues worked in the warehouse and delivered meals, but Rainaud thought about her coworkers and their family members who have medical conditions, and her decision was easy.

“I volunteered to work inpatient right away,” she said. “This is just so contagious. I’d want to take the hit before my other coworkers with families. I don’t have those issues when I go home. I won’t be around other people, and I guess that can be good and bad at times like these.”

“I wasn’t sure he was going to survive, and there he was walking out of the rehab facility — walking,” she said. “He was probably one of the patients who was the most ill whom I was able to see make that much improvement. Seeing that video, that was really a good day.”

Victoria Rainaud ’13, DPT ’15

The need for isolation became more apparent than ever when Rainaud worked with one patient who lost several family members to coronavirus. But he was one of the lucky ones. She celebrated his discharge to a rehab facility, and then, days later, a colleague showed her a Facebook video.

“I wasn’t sure he was going to survive, and there he was walking out of the rehab facility — walking,” she said. “He was probably one of the patients who was the most ill whom I was able to see make that much improvement. Seeing that video, that was really a good day.”

Madeline Arena ’13, DPT ’15, works as an inpatient physical therapist at another epicenter, New York Presbyterian Hospital/Columbia Medical Center.

Sixty miles north, in New York City, Madeline Arena ’13, DPT ’15, remembered a similar moment, which also stemmed from one of her earliest patients. An inpatient physical therapist at another epicenter, New York Presbyterian Hospital/Columbia Medical Center, Arena worked with a woman who had been surprised to regain consciousness in a place where patients aren’t usually awake to see: an operating room. Additional Intensive Care Unit rooms were built in order to accommodate the increase in numbers of critically ill patients.

“Just to kind of paint a picture, the OR looks like a room out of a sci-fi movie — metal everywhere with tons of machines, and everything’s beeping. There are two or three other patients in that room, and everybody’s on ventilators.”

The woman had been taken off a ventilator once but had to be put back on it the same day. When she came to after a week, she could follow simple commands.

Arena later asked the patient what her first reaction was to waking up after being under for so long: “She said she looked around at all of the other patients in this OR who were asleep, so to speak, and she just bawled. She was afraid, and she cried because she was worried this was how she was going to have to live the rest of her life.”

Arena describes the scenes that unfolded over the following weeks with this patient in the same way a proud parent might record a child’s milestones. And, similarly, the patient’s family proudly oohed and aahed at her over FaceTime: “That kind of gave her hope to continue and fight on. She felt like she was going to be able to get better.”

Arena recalls first seeing her. “She was scared, but I asked her if she wanted to try to get up to see how her strength was. She was so motivated, so very willing, and I won’t ever forget that.”

“I helped her sit at the edge of the bed by herself. I helped her stand by herself. I helped her take her first steps. It’s also going to give me hope for the other patients that they can end up walking out of the hospital, too. I think that had a lot to do with her mentality — her personality, her motivation, and her willingness to just give it her all every time.”

Madeline Arena ’13, DPT ’15

Arena carefully helped sit the patient up for the first time. Poor trunk, neck, and head control left her slumped more than sitting, and she had to be held up. But soon the patient was surpassing milestone after COVID-recovery milestone. Within two days she could sit up by herself. “I will never forget her sitting at the side of the bed, and I asked her, ‘Do you want to take a picture on the iPad, so you can show them you’re getting up and able to sit up?’ and I will never forget her smile in that picture.”

“That was the most she’d done in over a month,” Arena said. “Two days after that she walked five feet with a walker and two therapists helping her. Two weeks after that, she was discharged, walking around without a walker, her tracheostomy taken out, breathing on her own without supplemental oxygen.”

All told, she was on a ventilator for a month and worked with Arena for more than three weeks before she was able to go home.

“This is a very fast recovery, and many of the patients I’m seeing now are not recovering nearly as quickly as she did,” said Arena.

“I wish I could give her a hug, but I really don’t think I can. It’s going to be a great send-off. Everybody is going to be clapping. She’s going to be cheering and very excited to see her family. It’s going to be emotional,” Arena said.

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