A Different Kind of Enemy: Reserve medics discuss what it's like to battle COVID-19

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Air Force Reserve medical specialists are highly trained to provide critical care to service members injured in battle; they aren’t typically trained to care for patients fighting for their lives on ventilators in crowded city hospitals. But that didn’t keep hundreds of Reserve medics from answering their nation’s call and volunteering to serve on the front lines of America’s battle against COVID-19.

We spoke with several Reserve Citizen Airmen who deployed to New York City this spring to help overburdened health systems care for thousands of people infected with the coronavirus. Here’s what we found out.

“The first thing that hits you is how very sick all of these people were,” said Col. Ari Fisher, a physician assistant from Albany, New York, who deployed for two months and was assigned to the Jacobi Medical Center in the Bronx. “We had all been watching the news and we knew it was bad, but I didn’t think it was going to be this bad. The entire hospital had basically been turned into one big intensive care unit.”

Fisher, who works at a gastroenterology practice as a civilian, said he wasn’t used to treating so many critically ill patients. “We see sick patients at our practice, but most of our patients aren’t dying. Here, everybody was on ventilators. They were critically ill with a very high fatality rate. There were patients who were intubated in the ICU when we got there and they were still there when we left. It was unlike anything any of us had ever seen before.”

As the individual mobilization augmentee for the chief physician assistant consultant at the Air Force Medical Readiness Center, Fisher said he was proud of how Reserve physician assistants responded to the coronavirus crisis.

“There are only about 40 physician assistants in the entire Air Force Reserve and there were eight PAs who were on the initial deployment of Reserve medical specialists to New York City the first weekend in April,” he said.

Fisher said he was honored to help care for the people hit hardest by COVID-19 and to provide much-needed assistance to New York’s overburdened health care workers.

“These doctors and nurses were essentially deployed inside their own hospital,” he said. “When we got there, they were in desperate need of some rest and some assistance. My only regret is that we didn’t get there earlier so we could have helped as COVID spiked. When we got there, it was actually starting to level off a little bit.”

Lt. Col. Matt Bershinsky, a physician assistant who works in orthopedic pediatric surgery at the University of Colorado as a civilian, deployed and spent nearly two months serving at Lincoln Hospital in the South Bronx.

“The hospital is in one of the poorest neighborhoods in New York,” he said. “A lot of the people who live here are very poor and there is a high rate of mental illness and disease. These were the people getting hit especially hard by COVID.”

Like the Jacobi Medical Center in the Bronx where Fisher worked, Bershinsky said Lincoln was basically turned into one big ICU.

“Interestingly, the place where we spent most of our time was the mother-baby unit, which had been turned into a makeshift ICU,” he said. “There was this crazy dichotomy of bright blue and pink painted walls and nursery windows and it was all overridden by a lot of really sick people fighting for their life.”

Bershinsky, who is assigned to the 624th Aeromedical Staging Squadron, Joint Base Pearl Harbor-Hickam, Hawaii, as a Reservist, spent 16 years as an Army medic and he said he has never seen anything to compare to this deployment.

“There’s an old saying that no matter how bad things get, at least you’re not doing it in MOPP-4 (the highest mission-oriented protective posture requiring full protective gear). This whole deployment was done in MOPP-4. We were in full gear all day.”

Bershinsky said the toughest thing about this deployment was having to watch so many sick people battle their illness without the support of friends or family members at the hospital.

“There were no visitors allowed,” he said. “For me, personally, it was exceedingly difficult to watch these people who were suffering alone. Even the people who were there taking care of them were wearing the equivalent of MOPP-4 so there was no human connection. You’re wearing masks, goggles, gowns and head coverings so you don’t even look human. There was a loss of humanity for these people. I come from a practice where it’s extremely interactive – taking care of kids who want to talk and laugh and interact. Having that complete separation was extremely difficult.

“It was even more difficult when it came to the end of life. We had an iPad and we would literally Facetime the patient’s family and let them say their goodbyes. That was really, really hard.”

Like Fisher, Bershinsky said he wished he could have deployed a little earlier. “We got there at the peak of the pandemic, which means they had been dealing with it for weeks and weeks,” he said. “We got there just in time to give them some relief. They were really hard hit and we came in and said, ‘just tell us what we need to do to help.’ They were extremely grateful to get the help.”

Capt. Heather Duggan, a physician assistant who works at a Veterans Administration outpatient urology clinic in Charleston, South Carolina, as a civilian, deployed to the Jacobi Medical Center in the Bronx, and spent most of her time working in a 10-bed ICU.

“We were full the whole time,” she said. “And we didn’t have a lot of movement of patients. The patients we had were basically there the whole time. It was all hands on deck, doing whatever we could to help the nurses and doctors do whatever needed to be done in terms of direct patient care.”

Duggan, who is assigned to the 560th Red Horse Squadron, Joint Base Charleston, as a Reservist, said the work was extremely difficult, but also very rewarding.

“We were constantly just chipping away at anything we could to help these patients do just a little bit better,” she said. “I think everybody looks back and says, ‘I wish I would have had this training so maybe I could have done a little more,’ but I definitely think we helped out. At the end of the day, even the smallest things you could do still had a huge impact.”

Like her fellow PAs working in New York, Duggan said she was honored to be able to provide some relief to both patients and medical workers battling COVID.

“When we first got there, you could see how taxed everybody had been,” she said. “It was great to support them. You could see the excitement and relief from the medical staff knowing they were going to be able to get some assistance. To hear the gratitude from patients who came off of ventilators and from the staff was very gratifying. Those are feelings of joy that are different from anything else.”

Lt. Col. (Dr.) Pen Hou, a family medicine doctor assigned to the 446th Aeromedical Staging Squadron, Joint Base Lewis-McChord, Washington, said the two months he spent deployed to New York City would be the “the pride and memory of my life, 100% positive.”

Hou served on the internal medicine team at the Jacobi Medical Center, where on average the team saw 20 patients a day. Over the course of two months, Hou’s medical team treated 1,000 patients, mainly COVID-19-related.

He said his fondest memories are of the times when patients beat the disease.

“In the hospital's intensive care unit, whenever a patient was extubated, the hospital would play celebration music,” he said. “We knew then that a patient was likely to have recovered and could be turned to less acuity care. I heard more and more music every day, and one day, one of the ICUs had been closed because it was not needed. That was an unforgettable time.”

Jacobi Hospital showed its support for all service members who assisted there with a sendoff ceremony May 29. Christopher Mastromano, NYC Health + Hospitals/Jacobi CEO, personally thanked all the Reservists in a Facebook post.

“The sacrifices that all of you have made allow us to be here today and do what we do,” Mastromano said. “You gave up your families. You came running in a time of need. And thank you’s are not enough. You’re part of the Jacobi family. We are proud to have you. So on behalf of New York City, Health + Hospitals, and most importantly the Jacobi family, we thank you and we will fight with you any day.”

Staff Sgt. Trevor Talbert, a medical technician assigned to the 307th Medical Squadron, Barksdale Air Force Base, Louisiana, was one of nine members of his unit who deployed to New York in early April.

He said the situation was dire when the Reserve Citizen Airmen arrived.

“The civilian staff at my hospital was burned out and depleted,” he said. “There were at least 40 patients on my floor and the numbers didn’t start to go down until (right before we left).”

He explained those numbers included a broad age demographic, with patients ranging in age from twenty-somethings to octogenarians. 

“COVID-19 does not discriminate,” he said. “They all struggled.”

Reserve Citizen Airmen’s efforts helped save lives, but they had to learn to deal with losing patients as well. Talbert spoke about leaving the bedsides of patients at the end of a shift and returning the next day to find out they passed away.

“It makes you appreciate the important things in life,” said Talbert. “It never became normal, and I’m glad because I didn’t want to become lax about treating them.”

Capt. Aaron Biggio, a nurse with the 307th Medical Squadron, said hospital staff, patients and even the general public showed deep appreciation for their efforts. He said people in the neighborhood would lean out of apartment windows, cheering for them during shift changes.

“I’d get thanked in the streets by total strangers, often with tears in their eyes,” said Biggio. “There is no one in New York who doesn’t know someone affected by the disease.”

Talbert said the Airmen did their best to serve the patients beyond standard medical care. He recalled using his cellphone to set up video chats between patients and loved ones.

“We were the only family they had while they were under our care,” he said.

Throughout the deployment, Airmen worked 12-hour shifts and, in some hospitals, faced patient loads well beyond normal capacity. Biggio said he would do it all over again regardless of the hardships involved.

“I’d get back on the plane right now if they would let me,” he said.  “There’s just something beautiful about the humanity of people coming together to fight through something so gruesome.” #ReserveReady #ReserveResilient

(Bo Joyner, Maj. Candice Allen, 446th Airlift Wing public affairs office, and Master Sgt. Ted Daigle, 307th Bomb Wing public affairs office, contributed to this story.)