ORLANDO, Fla. – On Halloween night 2020, Dr. Anthony Tucker woke up in a Palm Coast intensive care unit with the blurry figures of his wife and two teenage sons across the room. They wore what looked like spacesuits.
“Am I hallucinating?” he wondered, trying to piece together the few facts he could recall of the preceding days.
He blinked and stared. One of his sons began to cry.
“And then it struck me that they were actually there, that the hospital had wrapped them up in these hazmat suits and brought them in to say goodbye.”
Tucker, a 46-year-old ear, nose and throat specialist — a man whose only previous health problem was mild acid reflux — was losing his battle with COVID-19.
The virus had attacked his lungs, filling them with fluid and pus, and forced his heart to work to the brink of failure.
After seeing his family, Tucker would have no memories of the following two weeks. The next thing he knew, he was waking up in another ICU bed, this one in Orlando.
“We don’t know why some people make it and some people don’t,” said Dr. Gilles Chemtob, the critical care director at AdventHealth Palm Coast and Tucker’s main physician for those first two weeks. “I know he had an incredible spirit to fight. But he got everything he could throw at him, and he was still deteriorating rapidly.”
‘He never gets sick’
It began with what he thought was a bad cold. The kids had had it. Then his wife. But when he couldn’t make his oldest son’s Friday night football game, Kristin Tucker knew something more serious was wrong with her husband.
They’d known each other since they were both 16-year-old baggers at a grocery store in Georgia. Their first date was their high school prom.
Sure, her husband had put on a few pounds over the years, but he was healthy and active. He played golf almost daily. They went boating. He even surfed and took up scuba diving. Every winter they would go skiing somewhere out west, and he always opted for the most difficult runs.
“He never gets sick,” she said. “And he never misses a game.”
A week and a half earlier, while on call, Tucker had been summoned to the emergency department to treat a homeless man with an abscess on his tonsils. The procedure is a common one, if sometimes messy, and although Tucker wore a medical-grade mask, he had to remove his protective goggles to see clearly. The patient had no outward signs of COVID.
As always, when he got home, Tucker stripped off his work clothes in the laundry room and went directly to the shower.
But by that Friday night, Oct. 16, he had begun running a fever and was feeling winded. He asked Kristin to drive to his office to pick up an oxygen tank. He wasn’t convinced he had COVID — he still thought it was a bad cold or, at worst, the flu — but supplemental oxygen would make him feel better, he reasoned.
And at first, it did.
But by 4 a.m. Sunday, as Kristin lay awake, listening to the shrill rasp of her husband’s breathing, she began to plan: “We can go to the ER now,” she finally told him. “Or we can wait a couple of hours until the boys are up and we can explain what’s going on.”
Two hours later, she called the hospital and alerted them to a possible COVID patient. Then she drove him to the emergency room parking lot, made another call, and waited for the nurses to take him away. She was not allowed inside.
Tucker was immediately admitted to intensive care.
Like all critical COVID patients, he would get an arsenal of medications: the anti-viral drug remdesivir, two rounds of antibody-rich convalescent plasma, a high-dose steroid to counter inflammation, blood thinners to prevent clots. He had supplemental oxygen. He was turned onto his stomach to relieve pressure on his lungs.
“Initially, he had some good days,” Chemtob said. “I was praying that he was going to turn the corner. And then I was off for two days, and when I came back, he was severely, severely ill.”
Though Tucker sometimes did surgeries at the Palm Coast hospital, he and Chemtob had never met until Tucker was his patient.
But they had a long, blunt talk about options.
“His saturations were doing poorly. The amount of oxygen in his blood was very low,” Chemtob said. “But he was still trying to resist getting on the ventilator.”
At that time, most studies had shown disturbingly dismal outcomes for mechanically ventilated patients, though studies since then — including one by AdventHealth physicians — have refuted those findings.
Chemtob made arrangements to transfer his patient to AdventHealth Orlando, which had an ECMO unit that his Palm Coast hospital did not. ECMO, for extracorporeal membrane oxygenation, allows a patient’s blood to be diverted, infused with oxygen and filtered for carbon dioxide and then pumped back into the body. In short, it does what the lungs usually do, allowing the lungs to rest.
Lastly, Chemtob called Tucker’s wife. She and the kids should come to the hospital quickly. If there was anything they needed to say, now was the time.
A series of turning points
For six weeks that he largely doesn’t remember, Tucker and his body fought for survival. He would seem to do better, then worse, then better, then much worse. When he was lucid, he would think back to the night of the football game and wonder if he should have gone to the hospital then. He wondered if, by waiting, he had sealed his fate.
Only one family member could visit at a time. Kristin would visit each weekday. On weekends, the boys — then 15 and 13 — would take turns.
Kristin had always been a relentless optimist. And in front of the kids, she worked to hide her fear.
On her first visit to the hospital in Orlando, she grabbed a book at random for the long hours she was likely to spend waiting. She doesn’t even recall the title now, but one of the lines stayed with her.
“I’d never been through anything like this. I had never had to be the person taking charge and making all the decisions,” she said. “And this line from the book, it said, ‘They didn’t know how strong she could be.’ And I just kept thinking that over and over. ‘They didn’t know how strong she could be.’ It became my mantra.”
It got her through the ECMO and the ventilator and the tracheostomy — the hole doctors cut in her husband’s throat so a tube could connect him to the ventilator. And it got her through Thanksgiving when family members insisted she join them.
“I wasn’t having a lot of contact with people outside the hospital, you know,” she said. “So I hadn’t really had to see that sad face — when the people you love look at you, when they’re feeling bad for you, and you can see it on their faces.”
Yet Thanksgiving night was a turning point. Tucker again began to improve, but this time it was steady progress forward. Finally, with his lungs able to rest, his inflammation eased and his blood oxygen levels climbed. Soon, he was off the ventilator.
And on Dec. 18, two months after he’d gone to the Palm Coast emergency room, he went home. He had lost 50 pounds.
His wife and sons never got the virus.
Uphill battle
By Jan. 18, Tucker returned to his practice, working a limited schedule. By March, he could finally climb the stairs to the second floor of his home without stopping. By April, he could lift more than 5-pound weights. By May, he could ride his Peloton stationary bicycle for a 20-minute simulated hill ride.
He got vaccinated as soon as he could. So did his wife and 16-year-old son.
Some days, his energy still lags, especially if he doesn’t sleep well, and several oxygen tanks still stand sentry in the corners of his home.
“My pulmonologist doesn’t want to have me remove them yet,” he said. “I know they saved my life, but it’s a reminder I’m ready to get rid of.”
But of all the battles he has faced, the most baffling, he said, is the one he sees raging around the nation today.
“We’re fighting ignorance and misinformation,” he said. “I hear people say they don’t ‘believe’ in the virus or they don’t ‘believe’ in the vaccine. Let me tell you — this virus doesn’t care if you believe in it. It doesn’t care if you’re a Republican or Democrat, a conservative or a liberal. This virus can kill you just as easily either way.”
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