Hospital tech may lose hands during COVID-19 ordeal
Rosa Felipe, a Jackson Memorial Hospital healthcare worker who was infected with COVID-19 on the job, has been a Jackson patient since March 6, struggling with a severe case of the disease and complications that may necessitate amputation of her hands.
Rosa Felipe’s hands were never still. When she wasn’t treating patients at Jackson Memorial Hospital, she was cooking sausage dumplings for her family, keeping the peace in her corner of Allapattah, adopting stray dogs, knocking on the doors of elderly neighbors to make sure they were taking their medications or collecting clothes to deliver to an impoverished community in the Dominican Republic.
Now Felipe looks at her hands while lying in bed at the hospital where she’s worked for 20 years. She does not recognize them.
“My fingers are black. My hands are rotting,” she said. “They are going to fall off.”
Doctors she used to see in the hallways at Jackson come into a room that used to be occupied by her patients and tell her both hands will probably have to be amputated at the wrist, with a chance they can save a few fingers on her left hand.
Felipe was one of the first healthcare workers tending to the sick on the front lines of the coronavirus pandemic to contract COVID-19. That was in early March, just before she was hooked to a ventilator, when she gasped to a friend, “I’m drowning.”
After nearly five months of sinking and surfacing, flailing and floating in COVID purgatory, Felipe is on the verge of going home. She is a survivor among the 573 Jackson employees who have tested positive; three of their coworkers died.
But in her case, one of the most severe at Miami-Dade’s public hospital and the largest
medical center in the state, the bargain for beating the disease is especially cruel. She expects to lose her hands and the career she loved.
As infections, hospitalizations and deaths surge in the United States at the worst rates since the first peak in late April, Felipe is focused on recovery. She is thankful she is not a pinpoint on a graph, not among the 722,000 worldwide, 164,000 nationally and more than 8,100 in Florida who have died from COVID-19 complications.
“We were so swamped back then, and now we’re full again,” Felipe said.
Felipe, an electroencephalograph (EEG) technician who administers brain tests at Jackson, tested positive on March 9. About two weeks later, longtime Jackson nurse Araceli Buendia Ilagan was the first nurse in South Florida to die from COVID-19, a few days after she worked her final shift in the intensive care unit.
LURKING DISEASE
Felipe and other healthcare providers say the potently contagious disease was lurking at least a month prior to that time.
“In retrospect, that was a dangerous period on the cusp when COVID was here and we didn’t know it,” said Martha Baker, president of Service Employees International Union Local 1991, which represents Jackson’s doctors, nurses and healthcare providers. “I remember a press conference where Gov. Ron DeSantis said you can’t spread the virus when you have no symptoms, but it turns out the first five days is when an asymptomatic carrier is shedding the most virus.
“Rosa’s job required her to move all around the hospital, placing electrodes on patients and widening her exposure to infected co-workers as well. She got it before we were knowledgeable about the breadth and depth of COVID transmission.”
About 4,500 Jackson employees in the health system’s workforce of 12,500 have been tested since March, with 13 percent testing positive, according to spokesperson Jennifer Piedra.
“At the beginning of the crisis, the precautions and protections were activated too late,” Felipe said.
“They told us to stretch our mask use to two weeks. There was a note on the board: ‘Wear your N-95 mask until it is soiled or wet and then you can exchange it.’
“We made our own face shields with Krazy Glue. We bought the material on the internet with our own money.”
In addition to Ilagan, 63, a Jackson nurse for 32 years, two other Jackson workers have died from COVID-19: Devin Francis, 44, an emergency room radiology technician who was engaged to be married this summer, and William Vincent Murdock, 63, an MRI technologist for the University of Miami Health System.
In mid-May, state records obtained by the Miami Herald indicated anywhere from 25 to 64 healthcare workers had died from the virus. The toll has grown since, but Florida’s health department has refused to fulfill a public records request from the Herald, insisting that data set does not exist.
WORKING IN THE FACE OF RISK
Felipe described the mood at work in the early days of the pandemic as somber and fearful but resolute.
“We accepted risk as part of the job,” she said. “You show the most grace when you’re under the most pressure.”
Felipe, 41, and mother of two boys, is awaiting transfer to a rehabilitation facility. She is bracing for the next stage of a convalescence that has no clear time line.
She’s tired of being tired. The role reversal — from caregiver to dependent — does not suit her. She’s receiving treatment for a deep bedsore on her lower back that required surgery last month. Nurses change her position in bed every two hours to relieve pressure on the wound. She’s been immobile since she was admitted and has daily physical therapy on her legs and arms. She’s lost 100 pounds. The skin on her fingers has turned a dark shade of charcoal, but she can still use her left hand. Merely holding a phone is an exhausting task.
Felipe recalls her ordeal in blurry bits and pieces. While heavily sedated, she said she existed in a dream-like state. She hallucinated. She felt disembodied, as if observing herself from the ceiling.
“Sometimes I thought my kids were in the room talking with me and the nurses had to explain that they were not,” Felipe said. “Some days I was fully in my normal life, buying groceries, making dinner, doing my rounds at work. Others were just a fog. Most of the time I felt lost. I can’t tell you whether I was in or out. I couldn’t discern what was real and what was in my imagination. One time I thought my brother was pulling me out of bed by the hand,
‘Get up, girl. Rosa, we need you.’ ”
Like other critically ill COVID patients, Felipe was placed on an extracorporeal membrane oxygenation (ECMO) machine that acted as her heart and lungs, filtering and oxygenating her blood. She also underwent dialysis when her kidneys began to fail.
“She was on life support and the prognosis was very poor,” said Natasha Guzman, Felipe’s niece. “She’s spent her whole life fighting on behalf of others. This time, she had to fight for herself, despite feeling so helpless against this disease.”
Just before she was intubated, Felipe told her brother Leo, “Yerba mala nunca muere.” (Weeds can’t be killed.)
“It was touch and go for weeks and the doctors told us to prepare for the worst. But Rosa was right,” he said. “She’s a miracle.”
A VULNERABLE CAREGIVER
Felipe was overweight, asthmatic and pre-diabetic, which made her more vulnerable to a cascade of COVID complications. The combination of medications used to increase a very sick patient’s blood pressure and the low blood oxygenation caused by COVID can lead to weak circulation to extremities and necrosis of hands or feet, explained Dr. David De La Zerda, medical director of Jackson’s intensive care unit.
“For patients who spend many days and weeks in the ICU, it’s essential to put them on medications that maintain blood flow to the heart, lungs, brain and kidneys but as a side effect decrease blood supply to their fingers and toes,” he said. “Oxygen is so important to those tissues and after a certain period of time when the entire circulatory system is compromised, they are unlikely to recover.”
Extreme cases such as Felipe’s remain “the big mystery of COVID,” De La Zerda said. “You can have people in the same household with widely varying responses to infection. Underlying conditions come into play, but there may also be a genetic component involved.”
Felipe’s spirits are remarkably good despite months of isolation from loved ones, said Joyce Lopez, a friend of Felipe’s since childhood.
“Medicine is her passion. She loves helping people,” Lopez said. “She’s always been a provider — to patients, to family, to her neighborhood. She’s coming to terms with her new life and thinking about what jobs she can do in the future to continue that role.”
Felipe longs to return to the house in Allapattah where she grew up and where she lives with her sons Saiid, 12, and Ishaan, 5, and her 82-year-old mother, Asuncion, a former seamstress who raised five children on her own. Felipe’s siblings live nearby and have been taking care of the family. Her husband lives in the Dominican Republic and has been unable to travel to Miami.
Her friends say there’s a void without Felipe’s benevolent presence. They consider her the godmother of the neighborhood.
She still goes by her childhood nickname of Big Redd. As a girl, Felipe organized block vs. block street football and boxball games, arm-wrestling contests, hair-styling shows and garage sales.
“Rosa was a big girl so nobody ever messed with her,” Lopez said. “It was a tough neighborhood. She protected her friends from bullies and broke up fights. She was her mother’s keeper from a young age. She was very studious and set an example because she was always reading.”
Felipe was a diplomat on Northwest 34th Street and at Miami Jackson High School.
“Kids didn’t know what I was because I didn’t look exactly Hispanic or exactly Black. There was tension between the two groups, but I looked like I could belong anywhere,” she said. “I used that ambiguity to my advantage in a part of Miami that has notoriety for violence because it’s ugly and poor.
WE WERE SO SWAMPED BACK THEN, AND NOW WE’RE FULL AGAIN.
Rosa Felipe
But that’s not painting a true picture. It’s a pretty cool place with a genuine sense of camaraderie.
“Maybe it was fear itself that motivated me, and my mom taught me to turn the other cheek. I wanted to make sure we had a slice of peace.”
Felipe gravitated toward the needy. She’s rescued dozens of dogs over the years.
“I had a formula of
Dawn dishwashing liquid and garlic, and I’d clean them up and take them around until I could find them a new home,” said Felipe, who feeds a menagerie of chickens, turtles, squirrels and occasional peacocks in her backyard where a garrulous rooster presides over the coop she built under a mango tree.
“I miss my mom,” said Ishaan, handing an avocado to his grandmother. “We like playing different games. Sometimes she pretends to be a zombie.”
Felipe checked on her neighbors to make sure they were taking their insulin shots and hypertension pills. She took meals to those who weren’t eating properly.
She held cookouts after church. She hosted “brain bowls” for her boys and their friends. She baked pound cake for her colleagues. She created the Rise of Hope Foundation to benefit the kids of Haina, a coastal city in the Dominican Republic known for its high levels of industrial pollution, poverty and teen pregnancy.
“I want to leave you feeling better than when we first met,” said Felipe, her voice reduced to a whisper after a therapy session at Jackson. She had to stop talking and rest for 15 minutes. “In my job, I have to command trust immediately. No one is going to let you work on their head or brain if they don’t trust you.”
For now, Felipe is concentrating on getting better and getting home — not on the price she paid caring for the sick during a pandemic.
“My hands are going to be cut off. But I still have full use of my faculties.
I’m fortunate that I’ve been a Jackson patient, where I’ve received the best care in the world. God has given me a second chance,” she said. “I’m going to make the most of it.”