Like Riding a Roller Coaster in the Dark: Dr. Sanjay Gupta’s coronavirus podcast for June 1

When a family member is hospitalized with Covid-19, often a single relative is chosen to be the primary line of communication between doctors and the rest of the family. CNN Producer Lou Foglia took on this role when his father was hospitalized. CNN Chief Medical Correspondent Dr. Sanjay Gupta invites Lou to share excerpts from the essay he wrote about that experience.

You can listen on your favorite podcast app or read the transcript below.

Dr. Sanjay Gupta: I’m Dr. Sanjay Gupta and this is “Coronavirus: Fact vs. Fiction.”

As you now know, an astounding number of people have died of Covid-19. And for every one of those people, there are also family and friends who have navigated the hospital system, the rapidly changing information on this virus and who are now grieving their loss.

My colleague Lou Foglia is, unfortunately, one of those people. Lou lost his father to Covid-19, and he recently wrote an essay for CNN about what it was like just coping with the logistics, the reality, the things that we don’t often talk about but certainly do arise when your family member is in the hospital.

Lou was the one in charge of all the communication with doctors about his father’s condition, which meant he was also the one who had to figure out how then to relay that information, as tragic as it would be, to his family and friends.

Lou’s words are powerful, and they reflect the experience of so many people right now, so today I wanted to have Lou share his story.

Lou Foglia, CNN Producer: I decided to write this piece in as much vivid detail as possible, even though they’re very painful memories for me, because Covid-19 I know is a very new virus. And people who haven’t experienced it, who haven’t had a family member go through this ordeal, I don’t think they appreciate the sort of roller-coaster ride it is in the dark. It’s like riding a roller coaster in the dark. There’s no game plan. There’s no protocol. There’s very few resources.

And I wanted to make that tangible for people to let them know what families who’ve been afflicted by this are going through and maybe to reconsider how they communicate with those families.

I hope it has some impact.

……

My father had been on a ventilator for 11 days when the attending physician at the intensive care unit called and asked whether they should include a do-not-resuscitate order in his chart. They had asked before. I had been indecisive. A successful resuscitation would extend his life. But it might also lead to brain damage.

Now multiple organ systems were failing. They needed an answer.

“What are the odds he survives?” It was the first time I allowed myself that question.

“If it continues in this direction,” the doctor told me, “we’re talking about a single-digit chance of survival.”

I was in the backyard of my mother’s house in the Bronx, New York. She had rushed him to the hospital after his mild Covid-19 symptoms quickly developed into breathing problems.

Since then she was in quarantine with her own mild symptoms. My brother, uncle and I sat on her back porch every day and kept her company through the window. We avoided contact, wore masks and went through bottles of hand sanitizer. No one had entered the house since her quarantine began.

I suspected that my father had a will and a health care directive inside. I put on my mask and gloves and entered my childhood home for the first time in weeks. My mother barely registered my presence. She was crying on the couch.

I entered my father’s home office and opened his filing cabinet. It was alphabetized. I found a file labeled “Will.” There were several documents inside. I learned that my father was planning to bequeath me his law school ring. I had steeled myself for this grim search — for this whole weeks-long nightmare — but that revelation blew away my composure. I kept searching. I found the health care directive. It was clear. Do not resuscitate.

I was relieved — we wouldn’t have to make what felt like an impossible decision — but then I kept reading. My father had noted that he did not want to be supported by a ventilator or hooked up to a feeding tube for any length of time.

He had been connected to both for nearly two weeks. I had been the point of contact with the hospital and approved each element of his medical care. I was overcome with guilt. I started sobbing.

My outburst drew my mother into the home office. There was grief on her face, but also curiosity. What had finally gotten to her younger son? She began crying. I couldn’t form the words. We couldn’t touch each other. We couldn’t embrace.

I took a deep breath and continued flipping through the file. There was a copy of my dad’s resume and a five-page summary of his career. I laughed. Just like my dad. He wanted me to have the correct materials to write his obituary.

My phone rang at 11. My mother pressed her face against the window screen. My brother took a deep breath. I opened my laptop and picked up the phone.

The doctor updated me on the salient changes in my father’s condition. I transcribed as much of the conversation as possible. My notes from that day read, “baseline bad, trend lines good. Life or death still possible.”

……

I sent a daily email to a group of 20-some people with the latest details on my father’s status. These were the people closest to him; they deserved to be kept in the loop. My intention was also to preempt any questions that might be directed to my mother. “At this point, all communication should go through me,” I emailed the group on March 21. “I’ll let you know when it is OK to reach out to her.”

My parents’ closest friends understood why I was keeping my mother out of reach. So did she. “Tell people they could text me,” she said a few days into my dad’s illness. She flinched anytime the phone rang.

Several people asked when we would be able to visit my father in the hospital. Were these people not watching the news? One family friend told my mom that we should inquire about a kidney transplant. Another quizzed her on the type of dialysis being used. My mother called me, flustered, asking for the specifics.

We were asked over and over again if the hospital had tried hydroxychloroquine. Or rather, “that malaria drug”; no one was able to pronounce it properly. Yes, they tried it. It seems not to have worked. What about remdesivir? The doctors don’t think it will be helpful this late in the hospitalization, and besides it’s not available right now. What about huge doses of vitamin C? What about this YouTube video from South Korea? What about this thing I read on Facebook? Did you see the newspaper this morning?

I did not handle these inquires well. I lost my temper more than once. My brother would cool me down.

……

About three weeks into my father’s hospitalization, I made my normal 8:30 p.m. phone call. The familiar nurse picked up. “Oh Lou, I’ve been waiting for you to call. I have such good news. They are planning to extubate him tomorrow. They are going to take your dad off the ventilator!” She was practically screaming with excitement. I was speechless.

My father’s breathing was labored on the morning they were planning to extubate. They delayed the procedure a day. That next morning, April 16, a doctor called. I was in the shower and rushed out to answer my cell.

He said they were doing the extubation within the hour.

“What do we want to do if the extubation fails?” the doctor asked.

“What do you mean?”

“Should we reintubate him?”

“Is the alternative death?”

He hesitated. While he searched for the right words, I asked, “Will he be conscious after you extubate him? Can you ask him?”

The doctor explained that while my father was awake, he was still extremely groggy from weeks of powerful sedation. He might not be fully capable of making a life-and-death decision.

……

I called my brother. The two of us conferenced with the doctor. We agreed that we wanted to reintubate if necessary. I wished the doctor luck. He said he’d call when they finished the extubation.

It was another false start. My father’s heart rate was too high, they’d try again tomorrow.

It had been four days since the hospital extubated my father. They had transferred him out of the ICU. By then I was staying with my mother in the Bronx.

“Go home,” she implored me. “Be with your wife.”

I packed my duffel bag and called my brother. He was on his way to the Bronx. My uncle was with my mom. I left the house.

I turned on a podcast about European history and started driving home. Ten minutes into the ride the podcast cut out. My phone — via my car’s Bluetooth — rang.

It was my dad’s doctor.

“Sounds like he’s doing better today,” I said.

“Lou, I’m so sorry. Your dad passed away about 10 minutes ago.”

……

I remember pulling off the highway and stopping at a red light. I was frustrated that I didn’t have it in me to drive through the red light. I remember honking at the red light. No one was around.

I drove back to my mom’s house. My brother’s car turned the corner. I reached for my cell phone and pretended to be in the middle of a conversation. My brother and I made eye contact. He pulled up alongside me and lowered his window. I gestured to the phone. He waved. I watched him park and enter the house through the rearview mirror.

I gave him exactly two minutes before following him inside. I timed it on my phone’s stopwatch. He was washing his hands at the kitchen sink when I came in. My mother and uncle were sitting in the family room.

“Why did you come back?” he asked.

“Come inside,” I said.

“What is it?” my mom said. “Why are you back so soon?”

“I just spoke to the doctor,” I said. “Pop is … he’s gone. He died.” I broke down. So did everyone else.

The rest of the scene played out how you’d expect it to.

I called my wife. I called my dad’s best friends. I called the guys he grew up with. I called his former colleagues. I began every conversation the same way, “This is that call.” I listened to each of them yell and cry and ask if I was serious. Then I said I had to make another phone call.

I went upstairs to my childhood bedroom and started writing my father’s obituary.

……

Gupta: Philip Foglia died on April 21, 2020. Lou wrote that “Philip Foglia was a husband for 44 years, a father for 40, a loyal friend his entire life. He was a skilled and compassionate attorney for four decades.”

And Lou, I’m quite certain Philip was also proud of you.

You can read more about Philip and find Lou’s full essay, “Life or death still possible: 31 days at my dad’s virtual bedside.” You can find that at cnn.com/opinions.

We’ll be back tomorrow. Thanks for listening.