PILOT KNOB, Mo. — One night in January, Dr. Ralph Leigh awoke with severe shortness of breath.
Leigh, who is 76 years old, went to the nearby, 15-bed Iron County Medical Center in Pilot Knob, where he was treated for COVID-19 and discharged. But his condition worsened, and in March he was transferred to the 450-bed BJC HealthCare Missouri Baptist Medical Center.
He spent the next six weeks at the hospital. His doctors said he was severely ill.
Then, in late April, Leigh asked to return to Iron County Medical Center, a hospital where he had worked for years. He was immediately surrounded by family, friends and co-workers.
And they watched as his condition began to steadily improve.
Leigh is still recovering and thinks it may be years before he is fully better. He is one of many COVID-19 patients who will continue to battle symptoms of the virus for weeks or months after the first infection. Leigh, who has rheumatoid arthritis, is also one of many Americans who are either immunocompromised or rely on medications that suppress their immune systems, and therefore may not receive the same benefit from the vaccines.
But more than anything, health care workers who treated Leigh at both hospitals said the experience underscored a common challenge of the pandemic: COVID-19 patients have to spend more time in isolation, away from family and friends who are normally some of the most positive motivators during critical illnesses.
Dr. Nitin Anand, an ICU physician who treated Leigh at Missouri Baptist Medical Center in Town and Country, said it’s not unprecedented, for seriously ill patients to improve when they are surrounded by family and friends. The visitor restrictions for COVID-19 patients have been as challenging as they have been unavoidable.
“When they’re taken care of in the ICU, they’re at their sickest, and most critically ill,” Anand said. “But … at that time their disease is the most transmissible, too.”
Family, friends, co-workers
Leigh is an immigrant from Peru and veteran of the U.S. Army Special Forces. Though he technically retired at 65, he’s been working part time at different hospitals ever since. It’s been “11 years of retirement, working,” he joked.
He lives in St. Francois County, not far from the hospital, and has a small garden, 24 chickens and a cat.
Before he got sick, Leigh had been picking up part-time shifts at Iron County Medical Center for years, said CEO Joshua Gilmore. Leigh was an instant favorite among staff and became known for his warm, open demeanor with patients.
“If you went to the ER yourself for something, you would be really happy that you had an ER doc like him there,” Gilmore said.
In March, when Leigh was transferred to Missouri Baptist, he spent about two weeks in intensive care, said Anand, the ICU physician there.
He then moved for a few days to the medical floor, and then for three weeks to rehabilitation.
Anand noted that, to his knowledge, Leigh is the only COVID-19 patient who has been admitted to the hospital’s ICU who was fully vaccinated. His medication for rheumatoid arthritis likely weakened his reaction to the vaccine.
“He just wasn’t able to mount an immune response to the vaccine,” Anand said.
Leigh said he didn’t want to stay in the city. He wanted to be surrounded by his friends. He requested that he be transferred back to Iron County, and in April that wish was granted. His son immediately flew in from Maine to see him. Friends and co-workers began to cycle through his hospital room, and his condition began to improve.
“It was like a revolving door,” said Leigh’s son, Heinz Leigh. “As soon as he started getting visitors, and had to start using his brain to think and come up with conversations … he turned around immediately.”
By the time his son returned for a visit three weeks later, Leigh could hold a conversation without getting winded. He could stand up without help. By late May, he was using one to three liters of supplemental oxygen, down from 15 liters in April.
On the afternoon of May 25, respiratory therapist Chris Conway walked from his office at Iron County Medical Center to Leigh’s hospital room. Leigh was sitting in his chair in a Hawaiian shirt, his preferred uniform when he practiced as a doctor. Next to him, a massive elk skin blanket was draped over the bed — a keepsake from a hunting trip to Montana.
Conway put a stethoscope on Leigh’s back, and listened to his lungs.
“Getting clearer,” Conway said.
Leigh put on a filtered mask that pumps oxygen and medication. As part of his respiratory therapy he also used an incentive spirometer, a clear device with a piston inside that rose as he exhaled, showing the volume of his breath. Conway, the respiratory therapist, said Leigh sometimes turned the incentive spirometer upside down, to trick the device into showing a stronger readout. The first time he did, Conway said, he knew Leigh was getting better.
Leigh knows the ins and outs of the hospital where he used to work. When he wanted to check how much oxygen he was using, he rose from his chair and read the levels on the equipment behind him.
“When he got down here, he just had visitors every day,” Conway said. “He had a lot of friends that were coming in here and encouraging him to get better. I think that’s what really made the difference.”
Despite all of his progress, COVID-19 will largely define the next period of Leigh’s life.
He’s one of an unknown number of COVID-19 patients who continue to battle the long-term symptoms for weeks or months — often referred to as COVID “long-haulers.” He still gets short of breath, and his conversations are punctuated by coughs.
He suffers from brain fog. When he tells stories about his life, and his recovery from the disease, he has trouble recalling certain words, and the names of friends. He thinks his recovery may take two years or more.
He urges everyone to get vaccinated.
“You don’t want to go through what I have gone through,” Leigh said.
On May 26, Leigh was transferred about 70 miles away, to a long-term care facility for veterans, in Cape Girardeau.
But the facility wasn’t what he expected. He said he had less interaction with staff and other residents than he had hoped for, and his health started to regress.
A week later, Iron County Medical Center nurse Steven Creek drove to Cape Girardeau and brought Leigh back to the hospital.
In early June, Leigh was there, wearing a different Hawaiian shirt. A friend, a fellow veteran, had just stopped by to visit.
“It’s a very, very, very virulent disease,” Leigh said. But, he added, “I’m recovering.”
Leigh’s health has continued to improve.
On Monday, he moved back to his home in St. Francois County.