FALL RIVER — For weeks, Dr. Daniel Sousa slept in the “she shed.” Then he moved into the sunroom. But now the physician who has been on the front lines of treating COVID-19 patients is back in the house and ready to enjoy Father’s Day with his family.
The father of three children, daughter Scarlet, 8; sons Skiler, 12, and Sidney, 14, said his wife, Theresa, a stay-at-home mom, has been doing double duty as teacher since the schools closed, while he’s been focused on treating COVID-19 patients.
Though it’s been a challenge he never imagined when he decided to become a pulmonologist — and it’s far from over — the first couple months were filled with uncertainty, recalled Sousa.
As one of the partners with Southcoast Health Pulmonary, Sousa and the other pulmonologists in the practice have been taking turns rotating shifts covering the ICU unit at Charlton Memorial Hospital, Tobey Hospital in Wareham and occasionally at St. Luke’s Hospital in New Bedford.
Sousa said they had been watching what was going on in China and then it came on in this country at an exponential rate, well before the medical field was prepared for it. Suddenly their nerves were up as they saw the rates rising and then the closings started to happen mid-March. They started to realize they didn’t have good therapy for it, as it was truly a novel coronavirus that was also extremely contagious, he recalled. “We all started to think we’re going to be at risk to our families. Potentially we’re going to spread it to our loved ones: wives, children. And then a lot of us thought, OK, we’re in the thick of it, we signed up for this but it’s probably a matter of if not, when we get it, but please don’t let me get it now because I’m needed. So we kind of had that mentality,” said Sousa.
Then their colleagues — nurses and doctors — started getting sick and Sousa said they had to intubate a doctor who contracted it. “That really hyped up your perception of this,” he recalled.
That’s when his thoughts turned to staying in the "she shed” in the backyard as a way of keeping his family safe during those uncertain early days of COVID-19. Sousa moved into the shed, which also doubles as a mini pool house, outfitted with a futon, cable television, a refrigerator and an electric fireplace. “I would eat dinner away from them and then when it was time to go to bed I would go hit the shed. After about three weeks I got sick of it, it was getting pretty lonely so then I started sleeping in the sunroom on an air mattress and I did that for about a week and then that got old,” he recalled.
After a while he started going back into the house when he was five days clear of potentially dangerous situations, like his shifts covering the ICU.
In talking to his kids about the virus, he said statistically speaking, the risk to children is small and most children who get it have symptoms that are so mild they don’t even know they have it. “I said, you’re going to be OK. If you get it, you’ll be fine it’s just your dad has to do this. I could get sick, but I’ll be alright,” he said. “And then I said, you know what I do for a living, I take care of sick people.”
Eight of the doctors at Southcoast Health Pulmonary rotate through the ICU at Charton Memorial Hospital, meaning they do one week every eight weeks. They also do one of 16 weeks at Tobey Hospital and a smattering at St. Luke’s Hospital when they need help. Additionally each partner covers the COVID-19 ward every eight weeks at Charlton. “When you’re in the hospital, every day is different — you don’t know what you’re going to see,” he said.
Sousa joined the practice in 2004. A native of Lisbon, he immigrated to Providence when he 7 seven years old. Even as a kid he said he knew he wanted to be a doctor and having asthma as a child made him empathetic to people with breathing problems leading to his specialty as a pulmonologist. He moved to Fall River in 2004, when he joined Southcoast Health Pulmonary. Being fluent in Portuguese has been extremely handy in caring for patients, especially in this area of the state, he said.
Dealing with COVID-19 has been by far the toughest part of his career. “I never want to go through this again. It’s not just the medical part, it’s like one eye is closed and one hand is tied behind your back. The eye closed is that early on we couldn’t get the testing done and when we did it took forever to get it back. And the hand behind your back is you’re running as you go. You don’t have a good attack plan. It takes a lot of supportive care to get people through but we’ve been through this to a lesser extent before in 2008/2009 when we had H1N1,” he said. “And during my residency training, AIDS was a terminal illness and we were taking care of AIDS patients and even then, you put yourself at risk, but that’s the job. You signed up for it.”
As a support system, the doctors at Southcoast Health Pulmonary have been texting each other, bouncing ideas back and forth as the set out to treat patients with COVID-19. First they tried hydroxychloroquinine because they were desperate, though they found it out didn’t work. Then they turned to convalescent plasma, which was somewhat effective and now remdesivir is the latest treatment, he said.
Adding time to patient care, they have to do what’s called “donning and doffing,” gowning up and putting on a vented hood for each patient visit. But the toughest part, he said, is the fact that families can’t be there. “It’s hard that you’re trying to express everything by a telephone call and you just don’t have that face-to-face. It’s hard to tell people that your loved one isn’t doing well. Only when they’re dying are they allowed to come in the hospital to spend their last moments with them,” said Sousa.
The most heartbreaking, he said, is seeing loved ones FaceTiming each other before the patient is put on a ventilator. “At that moment they’re looking at each other and they know, that could be the last time I see you alive. That’s hard, probably the hardest part,” he added.
But at the same, he said they’ve had some great moments when they’ve had a patient pull through after weeks of being in the ICU. One of those patients was Somerset resident Robert Ledo, who Sousa met a couple weeks into Ledo's lengthy stay in the ICU with an extreme case of COVID-19. “I did a telehealth visit with him afterward and here he is sitting at his table at home and I said, I can’t believe how good you look; you look amazing. That gives you the push that this is what you want to do for a living,” said Sousa.
Though cases seem to be slowing down a bit locally, Sousa said he thinks COVID-19 going to be around for a while. Being a corona class virus it rears up in the winter so it will behave in that pattern, said Sousa, adding a lot it will depend on human behavior and the risk of spreading it increases as people get complacent and let their guard down. While he understands the cause behind the recent Black Lives Matter demonstrations, for instance, Sousa said he worries about the crowds spreading the coronavirus. “It’s going to be with us through the winter season and it will rotate around the planet, so until we get a good therapeutic or a good vaccine, we’ve got to hunker down.”