'I Felt Like Rip Van Winkle': One Of The 1st U.S. Doctors With COVID-19 Is Back Home

Apr 13, 2020
Originally published on April 14, 2020 8:43 pm

In mid-March, he was a cautionary tale for medical workers: an unnamed doctor in his 40s" with a case of COVID-19 so bad that he was near death.

Almost a month later, 45-year-old emergency physician Ryan Padgett is back in his home in Seattle, rebuilding his strength and marveling at how quickly the novel virus laid him low.

"This is very scary," he says. "That it's not only medically fragile patients, but young people can be cut at the knees and taken down by this."

Padgett works at EvergreenHealth, the hospital in suburban Seattle that saw the country's first known COVID-19 deaths at the end of February, primarily patients from the Life Care nursing home.

At first, he says, he just had a headache and some muscle soreness, but within just a few days, his health took a sharp downturn.

"It becomes a big deal when you realize you can't breathe," he says.

It took the urging of his fiancée, Connie Kinsley, to get him back to hospital. "He didn't want to," she says, "because doctors are the worst patients."

Within hours of getting to EvergreenHealth, they were putting him on a ventilator.

"I have no personal recollection, but evidently I told [Kinsley] where some important documents were, just in case," he says. "And the next memory I had was about 16 days later, waking up at Swedish Hospital."

While he was unconscious, he had been transferred to Swedish Medical Center near downtown Seattle, one of only two hospitals in the state with an extreme form of life support called extracorporeal membrane oxygenation, or ECMO. It bypasses the lungs to oxygenate a patient's blood.

"It saved my life," Padgett says of ECMO. "I'd dwindled to the point of my lungs, liver, kidneys and heart, all going into organ failure, multisystem organ failure."

"ECMO allowed us to sustain his life while we tried other therapies," says Dr. Krish Patel, an oncologist at Swedish who helped treat Padgett.

Patel thinks the drug that may have made the difference was something called tocilizumab, an immunosuppressive therapy for conditions such as rheumatoid arthritis. The hope is that it can also tame the immune system overreactions known as cytokine storms, which can ravage a COVID-19 patient's organs.

The same drug has been tried on other patients, and Swedish is now taking part in a broader trial of its effectiveness.

Padgett is impressed by how quickly medicine's understanding of COVID-19 has changed, just during the weeks he was sedated and on a ventilator.

"Not only has the understanding of the illness changed, but the world changed," he says. "I felt like Rip van Winkle, waking up ... and realizing that the world had shut down."

He also found out his May 16 wedding had been postponed. He and his fiancée don't seem too concerned about it.

"Perspective changes, I tell you," Padgett says. "When you survive something like I survived, you realize that's all window dressing. It doesn't matter."

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AILSA CHANG, HOST:

You may have heard of his case back in mid-March - the Washington state emergency room doctor who had developed a case of COVID-19 so serious he was on life support. He was only in his 40s. It was a grim warning of the dangers to American health care workers. But now some good news - Dr. Ryan Padgett beat the odds for COVID-19 patients who get that sick. NPR's Martin Kaste talked to him about his experience and joins us now.

Hey, Martin.

MARTIN KASTE, BYLINE: Hi.

CHANG: So tell us a little more about Dr. Padgett's case. Did he get sick at work?

KASTE: Most likely he did, yeah. He works for EvergreenHealth hospital in suburban Seattle. And you may recall from the early days of all this, that was the hospital that saw the first known deaths from COVID-19 right at the end of February.

CHANG: Right.

KASTE: And, you know, he - we think he was one of the first American health care workers to get this kind of serious case of this. And it was on the minds of a lot of health care workers during March when the news spread. They didn't know his name necessarily, but they'd heard of this, you know, relatively young, healthy doctor who found himself clinging to life.

But I talked to him yesterday, and he recalled that whole period, that whole cycle for him and how fast his physical decline was at first. He started out with a headache and soreness right around March 9, and within a couple of days, he's in the hospital on the phone with his fiancee trying to tie up some loose ends.

RYAN PADGETT: I have no personal recollection, but evidently, I told her where some important documents where, just in case. And the next memory I had was about 16 days later, waking up at Swedish hospital.

KASTE: That's Swedish hospital near downtown Seattle. He was transferred to a different hospital while he was unconscious.

CHANG: My goodness. Can you give us a little more detail on how bad things got for him?

KASTE: Pretty bad. He was probably a day or two away from death. During that time, he was on a ventilator. His organs were failing. That's why he was transferred to a hospital that had this extreme form of life support called ECMO. It's basically a way to oxygenate the blood, bypassing the lungs. It's a desperation measure, but the doctors there thought that that did buy them some valuable time, and he thinks it saved his life.

PADGETT: I am so thankful they recognized that there was an X-factor in my illness. I not only had this viral illness but that my immune system had caught this wildfire, this cytokine storm.

KASTE: The cytokine storm - you may have heard of that - is this overreaction by the immune system, which in some cases may cause death because the immune system is raging against the virus, damaging major organs. And especially for a younger, healthier person, it's a real factor.

CHANG: Wait - so how, in this case, did they counter that immune system storm?

KASTE: Well, the doctors at Swedish used a drug that suppresses the immune system. It's usually used for things like rheumatoid arthritis and some forms of cancer. And some hospitals have been using this - experimenting, really, with this category of drugs in some of these cases of extremely serious COVID-19.

CHANG: So could those drugs help other people who've been infected with the coronavirus?

KASTE: Well, his doctors, they used the word promising, but they also cautioned that this was just one or two cases so far where they've used it, apparently with some success. They're now part of a broader, more formal clinical study of this approach that's happening.

It should also be pointed out here that Dr. Padgett was really lucky to get some cutting-edge care. These ECMO machines, for instance, are a lot less common than ventilators. And what really struck him, he said, is how fast things seem to be changing in terms of how this disease is tackled. Just in the time he was unconscious, he says, the attitude of his colleagues changed from the time he was - he went in to when he came out.

CHANG: So how's Dr. Padgett doing now?

KASTE: Well, he's back home in Seattle recovering his strength. He may have some long-term organ damage. He doesn't know yet. But he says the whole thing changes his perspective. His wedding date was postponed. And he says that, you know, frankly, no big deal; this changes everything.

CHANG: (Laughter) That is NPR's Martin Kaste.

Thank you, Martin.

KASTE: You're welcome. Transcript provided by NPR, Copyright NPR.