In 2016, Dr. David Hirsch, a maxillofacial surgeon, performed pro bono reconstructive surgery on Dustin E. Kirby, a Navy corpsman who was struck in the face by a bullet while serving in a Marine Corps infantry battalion in Iraq in 2006. In March he contracted Covid-19, the disease caused by the novel coronavirus. While recovering at home he shared the experience of his infection, and what he learned from it, by narrating to C.J. Chivers, who traced Dustin Kirby’s medical journey in a book, “The Fighters.”
When the coronavirus was spreading in China, Iran and Europe, Lenox Hill Hospital, where I’m the chief of maxillofacial surgery, was getting ready. I was impressed; they were on it. They were saying, “The disease is coming and it is coming fast.” Back then, only a few weeks ago, I would also look at the Johns Hopkins predictions about flattening the curve and how this was going to skyrocket, and say, “No way that all of this is going to happen.” I think now that every one of the predictions happened.
Elective surgery shut down on March 16. As a maxillofacial surgeon, I work on people’s mouths, jaws and faces. To treat Covid-19 patients with respiratory disease, I was going to be a backup doctor, in reserve, for whenever the hospital needed me. I expected to go to one of three places: the emergency room, intensive care or an outpatient testing facility. In the beginning it was eerily quiet. Everybody was talking about this thing happening, but it was one or two patients being admitted. The next thing you know, within a week, it was more than 100 patients and people were talking about running out of equipment.
I saw my last patient on March 13 and put myself and my family in complete lockdown in our house in Suffern, N.Y., where we live. I have three girls, 18, 15 and 12. They still had parties and bar mitzvahs to attend, but I told them early on that we were not going to see anybody. At first I told them, “You can see one person each, but I want to talk with each person’s family, to know what the risk factors are.” But pretty soon, by March 15, I said: “No, we’re shutting this down. We’re not seeing anyone else.”
We were alone at home. I felt that sitting at home I was useless, so I started to go on a crusade to find personal protective equipment for people at the hospital. It became a hustling game. I put something on social media and see if people would do good for us. I received a reply, about an exterminator who might have some protective equipment, and I followed the lead and he said, “I don’t have N95 masks, but I have hazmat suits.” And I said, “Send me those.” And then he knew another guy who had a couple of boxes of N95s, and I had them shipped to the hospital, care of the executive director.
I was ready to be called in to help. Unfortunately that hasn’t happened, because I got sick.
On Wednesday night, March 25, I woke in the middle of the night with wicked heartburn. I hadn’t overeaten. I just woke up with heartburn. I hiccupped for four hours and had bad indigestion. The next morning I woke up and was really tired, and my G.I. was a little off. I must have cleared my throat about 800 times in an hour. Then it just hit. I went upstairs, because I was very, very sick: body aches, headache, fever, off-and-on sweating and chills, and the G.I. symptoms continued. For two days all these symptoms persisted, and I also had nausea and vomiting. In the back of my mind, though, I thought, I don’t have any respiratory symptoms; I don’t have a cough or shortness of breath.
By March 28, I suspected Covid. I knew people who had it, medical colleagues who I trusted, and they were a little ahead of me in the disease. They were saying that on Day 5 I would have respiratory problems. Sure enough, on Day 5 I started having shortness of breath. Around the same time, all the flulike symptoms got a little better, and I thought, OK, I am going to get better. But then I started not being able to get deep breaths.
I’m 47. I wrestled in college; I’m still fit and consider myself strong. I know what going anaerobic is like, and this was different. I am a surgeon and speak in public. I had never had a panic attack in my life. And I was having trouble breathing. I wondered if it was a panic attack. The chest-wall rigidity would last four hours at a time. In those hours, I would not know what to do. I was scared. I was scared that I was going to die.
I had to shut off social media and stop taking calls. The bad news was too much for me; I could not take harrowing statistics and bad news, the virus had played on my mind. I wanted positivity. Here I am, supposed to be a tough guy, and I turned into a wimp. That lasted for at least a couple of days, and I only had a moderate case of this disease. There are people going through 10 or 20 times worse.
I was also scared that I was going to have to go to the hospital — and I didn’t want to go to the hospital. I knew what was going on at the hospital. I understood how lonely this disease can get. If somebody with Covid is sick enough to be dropped off at the hospital, the terror of that has to be the most isolating and lonely experience in the world, going to a hospital where you will not have visitors and where people caring for you — giving you the care that will save your life — will be scared, too, and covered in protective clothing and face shields and masks.
So I tried to bring the hospital to me. I gave myself IVs to remain hydrated. I had an oxygen-saturation meter. But you can’t tough this out. I did not see my daughters for about three weeks. I was in my room, and they had to stay away. My wife was living in the basement and bringing me food and over-the-counter medicines. She probably kept me alive.
My colleagues were helping me, too: checking in, texting, telling me what to do and what to expect. When I got in a panicky mood, I would reach out to my friends and see what they thought I should do. And my wrestling community: I am 26 years out of college, but I was getting texts from old coaches and teammates and current wrestlers. These guys are tough, tough as nails, and it helped me. When I was wrestling and I was tired and my opponent was strong, and I would say to myself, “Am I going to roll over and take this or am I going to get up and do something about it?” I channeled that.
After the wrestlers texted me, I would get up and go walk in the yard. I walked as fast as I could, which was pretty slow, and I tried to take a breath and hold it 10 seconds and maybe expand my lungs. No matter how bad I felt the whole time, I made sure I got out of bed, I put on a mask, and I went out into my yard. I walked around the yard five times. I did not let my lungs get stagnant. By that point I had figured out other strategies too. For example, if you are going to lie down, you have to lie in a prone position, on your chest. It makes it easier to breathe.
I woke up on Day 8, and I felt great. I thought this thing was over — but I was wrong. Even with moderate cases, the disease keeps circling back, with a vengeance. I probably had a good 12 hours and it just came back, the chest tightness and shortness of breath. On Day 11 I became phlegmy. It was an emotional setback, because I thought I might have turned the corner, and now it had come back again. I would feel a little better, then it would come back. On Day 16, I felt great in the morning, then, wham, I started having bronchial spasms. They got worse. In the afternoon I was acutely out of breath. I just couldn’t breathe. We started some new medicines and inhalers to open up the airway — steroids, Albuterol — to increase air flow to my lungs.
It was bad enough that the next day I went to an urgent-care clinic to see what was happening. My wife drove me in a mask and gloves. I tried two urgent-care places. They wouldn’t let me in. They want you to stay outside and tell them what is going on. I told them I was a doctor and had been dealing with Covid for more than two weeks. I told them I wanted to get a chest X-ray and that I have a cardiologist and a pulmonologist — I needed an X-ray. They flat-out refused.
At the third urgent-care center, they finally did the X-ray. It showed that I did not have pneumonia but that the bronchi in my lungs were exceptionally inflamed and just kept going into spasms. I am on a pretty hefty dose of drugs. I just hope that little by little now, I get this thing out of me.
I’ve learned a lot. As a surgeon you have to have compassion, but you also have to detach from your emotions so you can do the mechanical part of your job. This virus? It magnified for me my understanding of how patients are vulnerable. I was vulnerable, and I was scared.
