George

Brief Outline:

George was the first patient to survive intensive care with Covid19 at his local teaching hospital. He was mechanically ventilated for 4 weeks. He has sustained permanent damage to his lungs and continues to experience symptoms 18 months after discharge. Interviewed for the study in September 2021.

Background:

George works as a black cab driver. He lives with his three children (12, 14 and 17) from a previous marriage. Ethnicity: Black British.

More about me...

Onset

George starts his story by telling me the experience of Covid and ICU has strengthened his faith in God. When George fell ill with Covid19 little was known about the condition: public awareness of Covid was limited and there was a general lack of information and knowledge.

George’ symptoms started mildly (and included a loss of taste) but did not correspond to the symptoms that were communicated by the UK government at the time (at that time the list consisted of cough and fever; loss of taste and smell was added only in May 2020). He went about his work and life feeling not particularly well. He continued to cook for his children. When he noticed that he had not eaten for two days and asked one of his three children to go to the pharmacy for something that could kick-start his appetite. He took this medication, but it did not work.

It was not until his fourteen-year-old son got hold of an oximeter that it became evident that George’ oxygen levels were very low. Having measured George’ oxygen levels to be in the high 60s, George’s son tested the device on himself and his siblings and then called 999. They asked him a number of questions (e.g., how many people were in the house), told him an ambulance would be on the way, and told him to clear the way so that the paramedics could easily access the house and take George to hospital. The ambulance came within minutes. George was given steroids and oxygen, but as he did not improve, he was taken to hospital. At the time, the family felt that George would not make it.

Admission to hospital

Before this hospital admission, George had once suffered an anaphylactic shock after receiving a medication he was given when a bone had to be removed from his air pipe. He now carries a wristband to communicate this medication allergy to medical professionals. So, when George was admitted to hospital with Covid, this wristband was noticed by clinicians. They spoke to George about it, because they would not be able to use all the drugs commonly used for acutely ill patients, and his survival chances would be impacted. George knew that things were serious then and started praying for his survival. At this point he was not yet aware that he had Covid, something he would only learn after being transferred from ICU to the ward.

Intensive care

A doctor told George that they would base their decisions on “benefits over risks”. George was admitted to ICU, given antibiotics and mechanically ventilated. George remembers hallucinations and psychotic reactions to the medication he was given. These stopped when the antibiotics were stopped. He was told later that things had been very critical: he had suffered organ failure of most organs, and had sustained extensive kidney damage.

When George regained consciousness after about a month, he “began a gradual process of recovery”. He found this was a scary time. George became more and more aware of his surroundings and of his dependence on care, machines and oxygen. Every small thing – such as speaking, laughing or moving – could lead George “to collapse”: he would faint from exertion. As he could not speak, he received support from a speech therapist, who encouraged him to speak “one word at a time”. A physiotherapist helped him to regain his strength to first sit in a chair by the bedside, and later stand and walk. George had support with eating solid food again. The consultants and nurses encouraged him and gave him hope.

An X-ray was done to determine the cause of what George described as a vacuum in his chest that caused him to gasp for air every 5-10 minutes. The clinicians called this “breathing sensation” and determined that it was caused by severe damage to the top part of his lungs.

George remembers being proned as one of the treatment routines aimed at helping patients to breathe. He himself experienced this as extremely painful (a stabbing sensation) and he argued with his doctor about it needing to be done. Eventually the clinical team stopped doing the proning.

When George was transferred to the ward after a month, he was put onto CPAP (Continuous Positive Airway Pressure). He stayed on the ward for another 4 weeks.

Communication with family members

George was in contact with his children and other family members through the phone that his children had packed for him, and through videoconferencing, after some ‘training’ from doctors and nurses on what to do and not to do. George himself was still unable to speak, but they got by with sign language and seeing one another. Some family found it difficult to see George in the state he was in, surrounded by so many machines.

George is very grateful for what they have done for him, particularly as he was aware of the fear in their eyes, and the not-knowing what risk Covid posed to them and their families. He was born in Africa which he says means that he is familiar with infectious diseases. Now that he has been ill and has been cared for by others who risked their own lives to care for him, he appreciates even more what hospital staff do. If anything, he feels there is too much emphasis on the patient experience: all he wanted was to get better, not to get a 5-star hotel treatment.

Discharge from hospital and readmission

George was the first patient to survive Covid at his local hospital. The hospital staff clapped him out when he left after 8 weeks. George kept in touch with a number of other patients on the ward, with whom he exchanged numbers.

George lives with his three children who were all under 18 at the time (12, 14 and 17). Whilst he was in hospital, their aunt from their mother’s side took them into her house in another part of town. When he returned from hospital, they came back home and helped him with everyday things.

George was happy to come home. He still had low oxygen levels (92%) and difficulties walking. When George experienced severe bleeding, he was re-admitted to hospital where an ultrasound was done to determine what was going on. After three days in hospital, he was discharged again, with the haematologist consultant saying that he had been a “second time lucky” as he had narrowly escaped a heart attack.

Recovery

George describes his recovery as “gradual” and “slow”. In the first weeks after his return home, George did maths with his younger child to test whether he himself was still able to do so. It took four months to regain his strength to walk a longer distance; at the time of the interview (a year and a half on from his initial admission to hospital), George could not run or walk fast, nor could he “argue without panting and collapsing”. His GP has told him to take one step at a time. It gets better every day, with slight improvements. His oxygen levels are now 95%, but these continue to go down quickly when George is active. George has relearned what his body can take and continues to hope and pray for further improvements to what he can do.

When asked what was most difficult in his recovery, he tells me he wondered whether he would make a full recovery. What has been most helpful were all the people around him: his children (who do most things in the house and accompany on his activities), his ex-partner (who sometimes comes to the house to help), the council (who offered food, and financial support in the form of tax suspension), doctors who did follow-up appointments (haematology, respiratory), the GP (calling regularly, following up with George after medical appointments elsewhere) and volunteer organisations. Importantly, George has also felt supported by his faith, which has been strengthened through his experience of severe Covid. George’s outlook on life has changed, he now appreciates life more than before.

George has returned to work as a cab driver, although he works fewer hours than before.

Vaccination

When George received his first vaccination, his Covid symptoms returned, he felt weakness in his muscles and had a temperature. He was so desperate about having to go through all of this again, that he felt like committing suicide. After three weeks, the symptoms subsided. After the second jab, his symptoms only lasted two days, and were very mild.

Message for others

George tells me that it is important that patients who have survived Covid tell the story of what they have endured, as so many did not survive. He feels that if others know what this was like, then they will take better care. He urges others to remind themselves that healing is gradual process, and to be each other’s keepers by protecting themselves at all times.

George had no other symptoms than a lack of appetite. His 14-year-old son called an ambulance after using an oximeter to measure George’s oxygen levels.

I realised there was something wrong with me. But because it started on the very mild, gradual…it’s like I was thinking of, yes, I am a man, I can man it up, and the government stance on the whole issue was if it’s not severe, don’t go to the A&E, I mean, just stay at home, you know? Because there are more urgent issues being adhered to or taking care of. And then with the GP as well, what they were saying was if it’s not very severe, don’t go there and bother them.

So basically, it got to a point that I’d been wondering what is going on, and all the symptoms that the government gave as regarding coughing, flu-like symptoms, et cetera, I mean, all the guidelines they gave or the symptoms that should…tell you the signs, none of them were…I wasn’t…what was happening to me, none of them was ticking the box. But it was, I think, in the second week, because I was going about my normal duties, everything was…even though I realised something was wrong with me, I was going about, you know, walking, doing everything normally. But it was, I think, in the first or second week that I realised that I’m off of food, and I’m not eating for two days.

So, then the thought now started, you know, having a look, hey, you’ve not eaten for two days, then either it’s anorexia or bulimia, something should be going wrong now for the body to be rejecting food completely. So, I went to the pharmacy to see whether probably there’s anything they could give me to probably kickstart the appetite or… So, I sent the kids to the pharmacy to do that.

But it wasn’t working, so I think in the second week, the third or fourth day, I was in the house complaining…well, I cooked for the children and then I asked them to…the third day I asked the children to, you know, feed themselves and help themselves to the [inaudible] it’s all helping me with the Zoom or whatever it is to, how do you call it, get the Zoom and change the emails for me.

It was as if…complaining you’re ill, you’re ill, you’re ill, and you’re not participating, so come, let me give you a normal medical check-up in the house, you know? Because we have most of all, I would say, DIY medical…taking blood pressure, sugar monitor, diabetes monitor, oximeter test, you know, we’ve got all the medical basic whatever. So, he started putting them on, and when he put on the oximeter, that is when he realised that my oxygen level had dropped to about 67 per cent.

So, he said, oh no, definitely there’s something wrong here. But with 67 per cent, I don’t think he could make it, it’s the oximeter which is faulty, so he took the oximeter off, and put it on his finger to check the oxygen levels. So, his was over 97 per cent. So, he tried it back on my finger again, then it was the same. So, well, he then took the opportunity to try on the other siblings, so he said, look, Dad, you’re not going to make it.

George was afraid that something would happen to the machines his life depended on.

How do you look back on that time?

Number one, the electricity shouldn’t go off, because if the electricity goes off, that was one of my fears.

Oh, was it?

Yes, that the electricity shouldn’t go off. Number two, the oxygen banks shouldn’t empty out.

Yes, can you say more about that? So were you very afraid when in intensive care?

Of course! Of course. It was between life and death. Can you just imagine somebody changing the figures and pressing the button and makes a mistake? Then you hear all the alarms going off, before probably they will call for an expert or somebody who knows what they’re doing and come and change the figures again. Yes, of course. And once everything starts going off, the alarms are so sensitive, once it starts going off, you see yourself go.

Yes.

Because number one, I didn’t want…I didn’t experience a nurse or anybody to come near the machines. Two, praying that the electricity doesn’t go off. Three, the oxygen keeps running. Yes…

Yes, I can imagine with all the machines around you, and…

You’re just lying down there with everything around you like a ticking bomb not to go off.

George started praying when he heard that he may not survive.

When I was in hospital, I think when they tried and I gained consciousness a bit, because I’m allergic to penicillin and certain medications. I have whatever it is, a wristband, an allergy NHS wristband on my…you could see with my watch. So, I think one of the doctors read it and then said I can’t help you, but I’ve been warned that if I have serious conditions which those medications I cannot use them, I’m going to lose my life. So, in fact when he said it, the thought just occurred that, look, this is the time, and I’m not sure I’m going to make it, you know? So, I started praying, but I was praying when I went off. Because I was in and out of consciousness, but every time they tried, I come back, I go, I come back, I go, you know?

George is grateful for all the personal risks healthcare professional took to save his and other patients’ lives.

What would you say has been most valuable in helping you recover?

Everybody, everybody around me. Everybody around me, because what they say to me is it’s only a few who are able to cross the line and come back to tell the story, so because they know most people die if you go to that extent of… Because look, don’t tell a lie, at the hospital I was the first to recover, and when I recovered, the whole hospital lined up clapping for me, which from when I was coming out of intensive care, the whole nurses and doctors, everybody lined up and clapping, you know, for my recovery.

So, it’s like that’s when I began to wonder what had transpired, even though I was just lying down in that vegetable or cabbage state, you know? I began to appreciate if they had to do that, then their time is worth whatever it is, wow, and I thanked them all for the good work they did, and God bless them and their families. The courage as well they’ve got in that pandemic, because sometimes when they come, and you could see the fear in their eyes… And I say kudos to them, and God bless them all.

Yes, because you were one of the very, very early patients, so very little was known and also, yes… So, when you say fear in their eyes, did you get any sense of how difficult it was for professionals at that time?

Yes. It was… Look, when I was growing up, we learned about deadly diseases and like, say, for example, anthrax. You know, I grew up in Africa, so I know about deadly diseases and water-borne diseases and viruses. But never had it ever struck me in my face, in reality, my learning and reading in books and warning me about it, but for it to stare in your face, glaringly, like that, you know, it was an experience. It was an experience, I’ll say. Yes, because anthrax, when you read about it, yes, you should be expecting something of that nature, tuberculosis as well, you know, and for them to be coming near me as well with me having what you call an airborne disease which, if they breathe in, or any gaseous exchange, it will affect them directly or indirectly, and they have families, come on. I mean, who would put his life on the line to save and rescue another human being, knowing very well the consequences? So yes, I do appreciate their hard work and effort.