As a conventionally-educated and trained physician, I always believed that the power of science and modern medicine was key to survival. Now that I am a COVID-19 survivor—one who barely escaped from the clutches of death—I now ardently believe that technological prowess as well as the power of love and prayers paves the way to healing and recovery.

At the height of the COVID-19 pandemic I was adamant that as doctors, we can fend off any disease or pandemic. The essential vulnerabilities of life became obvious to me on Oct 8th, 2020. I finished my rounds at a local Skilled Nursing Facility and boarded a plane for San Francisco to help my son move to his new abode in the Bay Area for his first job. Prior to that, I attended the funeral of one of my best friends, a young and brilliant psychiatrist in our group. I began feeling strange, however; I had hiccups and couldn’t complete a full sentence while trying to express myself. My spouse, Molly, rushed me back to San Diego—we visited an Urgent Care center and were presented with a worrisome CXR. We went straight to Scripps Hospital in La Jolla and everything shut down like a veil shut—I had a total memory blackout.

As Molly told me later, I had to be intubated and placed on life support within 24 hours of admission. As my oxygenation saturation plummeted to dangerously low levels, I was placed on a life saving device called Extra Corporeal Membrane Oxygenation (ECMO) that took over my lung function. As the disease process alters the coagulation profile, I started to form clots erratically and simultaneously started bleeding profusely in my lungs. My spouse who was not too satisfied with the level of care exercised at Scripps got me transferred to the nearby academic center UCSD. UCSD muscled their fullest research potential and infused novel, out-of-the box treatment approaches. Considering me contracting the disease while in its incipiency stage in terms of research there was lots of ambiguities in the treatment process. I was blessed with the most competent and compassionate group of physicians who worked relentlessly to succor me during this crisis. Molly—being a physician for the VA systems—worked in close conjunction with with these physicians, carefully monitoring my care with the multiple specialists on board.

After being on ECMO Life support and eventually coming back to my senses, I felt as if I woke up from a deep slumber. Despite this, I remember being in intractable pain, especially in my legs. I was told that I broke the UCSD record of being the longest living survivor on ECMO for 59 days: previously, there was a pediatrician who survived 56 days on ECMO. I’ve never met this pediatrician, but he was nonetheless our glimmer of hope.

Every day I faced a new challenge and my doctors tried to find innovative ways to counter the challenges. Despite the relief I felt being off ECMO, I was facing one crisis after another: I had a fungal infection in my blood that comes with being on Total Parenteral Nutrition (TPN). Additionally, I became extremely hypotensive and suffered from profuse bleeding in my lungs. It was Dr. George Chang who washed my lungs with tranexamic acid and used Surgiseal to arrest my bleeding, a game changer for my respiratory health. I was on Dialysis for CKD. At times I remember sordidly that I used to have violent cough and the respiratory therapist used to come by the hour to administer breathing treatments through my Trach. However, all was not dour: one day the rounding team was debating on a drug regimen for me and I barely responded with the correct dosage—out of humor, they responded that the good news was that my cognition was intact.

As my medical condition became stable, I had to face another big hurdle. I was 94 lbs skin and bones, extremely cachectic, and had a condition called ICU Myopathy. I couldn’t move my extremities and required two person assist just to stand for a few seconds. I required extensive rehabilitation for my functional limitations. I craved for water and juices but had to settle for ice chips to quench my thirst. I had multiple CXR and imaging studies and eventually set for a LTAC facility called Select Rehab and then Sharp Acute Rehab.

What I learned from enduring my hospital stay was the power of love, the strength of spiritual resolve, and the value of human touch and presence. Every single day, my spouse used to come and spend the whole day with me. The love, devotion, and comforting words she had for me not only gave me the will to fight to live but also strengthen my resolve to get better. Once in the acute rehab setting, they had imposed strict restrictions against visitation—Molly had to come by the window. After I developed an acute stage of delirium, I required transfer and readmission to the hospital. As an accommodation, the hospital made special provisions for Molly to spend with me day and night, which was profoundly healing and therapeutic on me. After learning that my sleep cycle was altered by staying indoors and a lack of sunshine, I insisted on a quick return home where Molly set me up for home dialysis, necessary DME, oxygen, and home rehabilitation through an agency called Rehab without Walls. My road to recovery started and still it was a perilous journey. I gradually weaned myself off dialysis, oxygen, and other ancillary aids—all meted by excellent therapy and caregiving. After surviving my protracted life-threatening illness, I’ve learned to never underestimate the value of life and of human relationships. God’s grace and the power of prayer goes hand in hand with all the technological prowess modern medicine has to offer.

The most important thing I learned, though, is to maintain an attitude to gratitude. I was so blessed to receive kindness and compassion from others. I am profoundly grateful to physicians like ECMO Chief Robert Owens, Intervention Pulmonary Dr. George Chang, Dr. Joe Ix, and the nephrologist who arranged for Home Dialysis who even came to visit me at home to monitor my progress. Also scores of nursing staff, physical therapists, ancillary providers, and my caregivers. I am profoundly blessed that God has given me life to enjoy my dear family, friends, co-workers, and my patients. This pandemic has definitely changed my life; it has given me different perspectives, profound values, and a deep appreciation for life.

Aboo Nasar, M.D.