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Montana Doctor Says Hospital Is 'Strapped Thin'


We have given you so many numbers about the coronavirus over the past few weeks. We know it's a lot, but we're about to throw some more at you and listen closely because they're really important. The virus is out of control in this country. There are more than 10 1/2 million cases of COVID in the U.S. That's almost 2 million more cases than in India, the country with the second-highest number of cases. India, of course, has a much, much larger population than the United States. More than 242,000 Americans are dead. There were more than 150,000 cases diagnosed on Thursday - Thursday alone. That's a record. It's one of many records that are being set all over the country. The mountain states are getting hit hard now, including Montana, where many hospitals are overwhelmed with COVID-19 patients. Dr. Jamie Riha works at Billings Clinic. That's Montana's largest health care system. She's a critical care specialist in the intensive care unit. Dr. Riha, thanks so much for taking the time for us.

JAMIE RIHA: Good morning. Thank you very much for having me on the show this morning.

KING: You've been going into the ICU every day. What is it like there?

RIHA: We are currently at a critical level of patients in our ICU. So as you mentioned, we're the largest hospital operating system in Montana. And under normal operating circumstances, we have a 24-bed ICU in our hospital. When I left last night at the end of my shift, we currently had 44 ICU patients that were under the care of our service with a very, very full emergency room and likely more ICU patients coming in.

KING: Dr. Riha, are you able to keep up with the surge? Are you simply adding beds into the ICU? How long can you keep that up?

RIHA: So our hospital has been able to come with multiple innovative sort of out-of-the-box solutions. I know many of which are being adopted around the country under hospitals facing the same level of crisis. We are doing multiple occupancy or double occupancy, having two patients within one room in our ICU. We also have expanded ICU beds outside of our normal physical ICU space. We're taking over almost all of the cardiovascular unit, which is on the floor above us. We're holding patients in the post-operative recovery room, and we're also holding patients in the emergency room.

KING: With so many more patients, it has to be hard to keep up with their needs. Are your - how are your patients doing? Are they frightened? They're obviously very sick.

RIHA: The patients are unfortunately very, very sick and they are very frightened. You know, the United States has been living with this pandemic for a long time, people know what the virus can do. And they - unfortunately, once they reach the intensive care level, they know that there's a very good chance they may unfortunately not survive. And so patients are very scared and it's one of the biggest challenges for - emotional challenges I should say, for physicians and nurses and the patients caring for these patients is that we are so strapped right now and so tight in trying to cover all of the ICU patients that we are not able to spend lengthy amounts of time with these patients, comforting them or sort of providing the emotional support that they need. And so it is very challenging for the patients. They are able to connect with their families via cellphones. And we also do have iPads so that patients can do - connect with them via FaceTime or Zoom as well, but it still is a very lonely, isolating disease for the patients in the hospital.

KING: As many patients as you have seen, is there one in particular that you have trouble getting out of your mind?

RIHA: There is one. You know, there's multiple patients that have impacted me deeply, but the one that has impacted me the most was a woman. She was just around 50 years old, otherwise healthy and was admitted to the hospital earlier this fall with low levels of oxygen due to COVID. She'd been in the hospital for only about two days and her - the condition of her lungs declined significantly, enough to the point of requiring ICU-level care. She was transferred to the ICU and I was working a night shift. And unfortunately, despite arriving to the ICU talking, approximately three or four hours later, she died very quickly due to complications from COVID. And I had to go out and tell her husband and her two teenage children who we had called in that his wife and their mother had died. And it was one of the most traumatic experiences for me, as well as multiple members of the team, because those two kids lost their mom. And it really impacted me, not just because I had to look at the grief and loss that her family and her children were experiencing, but because she was truly an otherwise healthy female.

And I think so many people believe that this disease only threatens the lives of the elderly or those with really sick chronic medical conditions. And it's not true. It can take the life of anyone. And it really highlights the need that we as health care workers, as well as the population in general, needs help from each other. I implore the public and anyone listening, if you're not wearing a mask to please wear a mask. Masks work. They will help protect your own life. They will help protect the life of your family members. They'll help protect the life of your neighbor. And hopefully, it will help get this pandemic under better control.

Our hospital is strapped thin. We've come up with great out-of-the-box solutions and we're continuing to be able to care for patients at a very high level. But if the pandemic continues accelerating at the rate it's at, things are going to be getting very, very limited and tough decisions will have to be made. And health care workers truly need the help from the general population in getting this pandemic under control so that we can save lives and prevent the death of more families, loved ones.

KING: May I ask you briefly before we have to go, I hear the strain in your voice. How are you coping with all of this?

RIHA: I will be honest, it's a challenge. I'm emotionally, mentally and physically exhausted. I try when I'm off work to separate as much as possible. I exercise. I spend time with my husband and my two young children, but it's a challenge.

KING: Dr. Jamie Riha is an ICU doctor at Billings Clinic in Montana. Doctor, thank you so much for taking the time.

RIHA: You're welcome. Thank you. Transcript provided by NPR, Copyright NPR.

Noel King is a host of Morning Edition and Up First.