LEXINGTON, Ky. (March 24, 2021) – For nine days, Dr. Darren Johnson lay in a room on the 10th floor of the University of Kentucky Albert B. Chandler Hospital, watching his vital signs fluctuate on the bedside monitor. After nearly three decades of performing knee and shoulder surgeries for UK HealthCare’s orthopedic patients, he found himself on the other side of the physician-patient relationship as he battled an aggressive case of COVID-19. When one of his nurses angled the monitor away, he insisted it be turned back to face him.
“I stared at that monitor, because I knew it was my lifeline,” he said. “So each time they turned that oxygen up and the oxygen saturation got below 90, I was just smart enough to know, ‘Darren, that’s probably not great.’”
While he struggled with the disease, his mind was also on another patient just a few doors down the hall. Kelsey Johnson Latimer, his 27-year-old daughter, was also fighting COVID-19 and had just taken a turn for the worse. Housed in one of UK HealthCare’s COVID-19 ICU units, she was perilously close to being put on a ventilator.
And Kelsey wasn’t just fighting for her own life. At 19 weeks pregnant, she was also fighting for the life of her unborn daughter.
The Johnsons are a tight-knit family, their lives intertwined with health care. Darren, chief of UK HealthCare Sports Medicine and a nationally recognized orthopedic knee surgeon, serves as team physician for UK’s Football team and Women’s Soccer team. His wife, Nancy, works as a peri-operative nurse at UK HealthCare Good Samaritan Hospital and volunteers as the clinical coordinator for Surgery on Sunday.
Together, they have three children: Brandon, the oldest, lives in Chicago and works in medical sales. Older daughter Kelsey lives in Lexington and is a nurse with the UK Birthing Center, and her husband Kyle is a nurse at Eastern State Hospital. Younger daughter Lauren works as a pediatric ICU nurse in Atlanta. Every Sunday night, the Lexington Johnsons get together for a family dinner, “sort of like the TV show Blue Bloods,” Darren said.
The weekend before Thanksgiving, that short dinner – only an hour or so, according to Nancy – became COVID ground zero for the family. Despite following all the recommended precautions out in the world and in their workplaces, SARS-COV-2 found its way in. “On Tuesday, I tested positive,” Darren said. “So needless to say, that day, I’m sure I infected all of them.”
The two families quarantined immediately after, spending Thanksgiving apart. At first, it seemed they may have gotten lucky – Darren had no real symptoms other than a mild headache, and he and Nancy spent their days in isolation decorating the house for Christmas. Kelsey and Kyle also made it through the holiday with no issues.
“Darren felt pretty good,” Nancy said. “He did projects and things he’s never done in 30 years of marriage because he was confined at home with me.”
But by Friday, Nancy began to have symptoms; she tested positive for COVID-19 the next day. And when Kyle was unable to smell their two-year-old son’s dirty diaper that weekend, Kelsey said she knew her husband had been infected.
“I was like, ‘You have COVID. Get out,’” she said. “He left, was tested, and was positive. But I did not have any symptoms until later.”
When Kelsey woke up that following Tuesday – nine days after that family dinner and just a week after Darren’s positive test – she felt ill. Working in the Birthing Center – and being both pregnant and heavily asthmatic – she knew she needed to be admitted to the hospital. At UK HealthCare, pregnant women who test positive for COVID-19 are monitored very closely. Pregnant patients who exhibit symptoms, like Kelsey, are admitted as an inpatient. But each day, midwives and nurses would also call every asymptomatic pregnant patient who was quarantining at home to make sure they were still feeling okay.
“We’ve seen a lot of women who were pregnant and had COVID-19 this past year,” said Dr. Wendy Hansen, chair of the UK Department of Obstetrics and Gynecology and a specialist in high-risk pregnancies. “The thing to understand is that pregnancy itself comes with a higher risk of women getting sicker and needing hospitalization. Their disease can become more severe.”
The same day Kyle drove Kelsey to the hospital, Darren’s health began to deteriorate. After experiencing almost no symptoms in the seven days since his positive test, he and Nancy had assumed he was in the clear and they gotten lucky. But he became extremely tired and developed a headache and a cough. By the next day, his symptoms became too severe to ignore.
“I just couldn’t breathe,” Darren said. Nancy drove him to the emergency room, but due to COVID-19 protocols, was unable to stay by his side as he was evaluated.
“I’ve been a nurse for 36 years,” she said. “To walk your husband to the emergency room doors, then watch him walk through alone when he’s in respiratory distress… it’s just not a reality that as a nurse I could even put into words.”
Darren says he “talked himself out of being admitted” to the hospital that night, wanting to go back home, use his nebulizer, and continue monitoring his oxygen levels with a pulse oximeter. But within hours, it was clear that he needed serious care.
“I used that darned inhaler all night,” Darren said. “At 6:30 in the morning when I asked to use it again, Nancy said, ‘Darren Johnson, get your clothes on, we’re going back.’ I went, ‘OK, yes ma’am.’”
With her husband and daughter both admitted to the hospital – and still quarantining alone at home herself, feeling helpless – Nancy said all she could do was have faith in her health care colleagues.
“There’s nothing worse than knowing the people you love are suffering and needing you, and you are not able to be there,” Nancy said. “I asked friends and family for prayers. But I had to put all my trust in UK HealthCare.”
UK HealthCare’s Birthing Center is like home for Kelsey. She was born there in 1993 and gave birth to her own son, Jack, in the Center two years ago. After experiencing some complications during Jack’s birth, she was drawn to work in labor and delivery because of the care and compassion she received from her nurses during that difficult time. Now pregnant and diagnosed with COVID-19, she was initially admitted to that floor, where she was treated by her own coworkers in one of the six negative pressure rooms on the unit.
Being there with her work family – and having assisted in treatment of other pregnant COVID patients herself – helped her stay upbeat and positive.
“Everyone who took care of me is one of my close friends… my best friend Victoria is our scrub tech,” she said. “You don’t feel as lonely when your best friend walks into the room. You just feel better.”
Like most COVID-19 patients at UK HealthCare, her father was given dexamethasone, remdesivir and oxygen. However, the protocol for pregnant women is slightly different – because dexamethasone can cross the placenta and transfer from mother to baby, Kelsey was given a substitute steroid.
“We chose a steroid that would have the same effect on moms, but not cross over to the baby,” Hansen said. “And we worked jointly with our pulmonary colleagues to figure out the equivalent dosage to dexamethasone.”
Despite her treatments, Kelsey grew sicker. As she turned up her own oxygen one day, she realized that she would need to leave the safe, familiar comforts of the labor and delivery hall.
“I ended up calling the labor and delivery desk from my cell phone,” she said. “And I was like, ‘I had to turn my oxygen up, and I know I need to go upstairs.’ I was just sobbing.”
Up on the 10th floor, Darren was still struggling, both physically and emotionally. He was wrought with guilt over exposing his family to the virus, Nancy says, and desperate with concern over his daughter and future granddaughter.
Nancy had been reluctant to share the news of Kelsey’s worsening condition with him at first. But then she got an urgent phone call from his physician: the team suspected Darren might have an acute pulmonary embolism and were prepping him for an emergency CT scan.
“At that point in time, I thought I needed to talk to him and let him know,” Nancy said. “So as they’re getting ready to move Darren down to have this CT scan, I tell him, ‘Kelsey’s really sick and she’s going to the ICU.’ Could it get any worse?”
Luckily, Darren’s CT scan was normal – “just COVID wreaking havoc in his lungs,” Nancy said. Meanwhile, Kelsey moved to an ICU on Pavilion A’s 10th floor, only two doors down from her father. While most of UK HealthCare’s COVID-positive patients are kept on this floor, the ICU rooms are reserved for the sickest of patients – those who need constant monitoring day and night. To help her breathing, Kelsey was given high-flow oxygen, a more targeted and intense delivery of oxygen through a nasal cannula. She colorfully described the experience as “having a leafblower going right up your nose.”
“I’d never heard of high-flow oxygen, I’m just a dumb bone doctor,” Darren said. “But after you get to that, do you know what the next step is? A tube down your throat. A ventilator.”
It was a fear shared pulmonologist Dr. Pete Morris, who called Nancy to make sure she was prepared for direction Kelsey’s health was going. If her condition continued to decline, a ventilator would be her only option. And if that happened, the prognosis wasn’t good – Nancy was told that if Kelsey needed that ventilator, there was a high chance that her other organ systems would also start to fail.
“He said the next 24 hours were going to be imperative to see something happen,” Nancy said. “She has to start getting better, or she’s going to start to slip.”
For patients fighting COVID-19, it’s not just the physical symptoms that are so difficult to handle. The infectious nature of the disease means that they have to be isolated during a time when they could most benefit from the presence and support of friends and family. A self-proclaimed extrovert who loves being around other people, Darren says that the isolation was the hardest part for him. With all that time alone, all he could do was stare at his monitor and speculate about might happen next.
“I’m a 58-year-old male with no pre-existing conditions,” he said. “I never thought about my own mortality – never. And all of a sudden, you think, ‘I might not make it out of this hospital.’”
“Surgeons like to be in control; they command the room,” Nancy said. “They want to put their hands on a problem and fix it. With COVID, there’s a lot of ‘wait and see.’”
Nancy and Darren both credit his nurses for helping him get through his hospital stay, calling out one nurse in particular – Alexis Zody, a young woman who graduated in May 2020 and had just started her career working on the COVID floor. After talking to Nancy over the phone, Alexis helped him shower, wash his hair and brush his teeth: simple things that helped make him feel human again.
“She was upbeat, and she kept saying, ‘You’re going to be fine; you’re going to get through this,’” he said. “Thank God for her.”
“That was really a turning point,” Nancy said. “I think at that point in time, he finally believed it. He was really starting to wonder.”
In the ICU, Kelsey maintained a forcefully optimistic perspective even as she noticed her cannula was maxed out on the high-flow oxygen. She was driven by the thought of her husband and young son at home in isolation without her, and she longed to be there making Christmas memories with them – baking cookies, building gingerbread houses, moving the Elf on the Shelf. She even placed Kroger ClickList orders for her family from her ICU bed.
“Kelsey is a true caregiver,” Nancy said. “She spent more time in the hospital worrying about everyone else – her dad, her husband and son, and me. She is a force to be reckoned with.”
“My dad and I had very different perspectives,” Kelsey said. “He was sitting in his hospital bed thinking, ‘Am I going to survive this?’ Whereas I was sitting in bed, thinking, ‘When the heck am I going to go home?’”
After nine long days as an inpatient, Darren had recovered enough to be discharged. As he was wheeled past his daughter’s room, his nurse asked if he would like to be taken inside to see her in person.
“I couldn’t do it. I couldn’t go in her room,” he said. “I would have broken down. So I stayed outside and waved to her. She saw me, she waved, and she looked like a million bucks because she’s way tougher than her father.”
And then, he says, something remarkable happened. Kelsey had thankfully begun to improve in those critical 24 hours after maxing out on her high-flow oxygen. Just a day after her father left the hospital, she made it out of the ICU. And just two days later – with a little pleading to her physicians – she made it home.
“How does that happen?” Darren said. “This is a true story; this is the power of prayer and the human connection that we sometimes miss in medicine.”
“I had my two-year-old at home, I have a baby in this belly, and I had a lot more fight to keep going,” Kelsey said. “I couldn’t let myself get down, because if I had, I would have just sat in that bed and probably never gotten up or moved. I could have gotten a lot worse than I did.”
Roughly three months after their ordeal, both Darren and Kelsey are still dealing with the lingering aftereffects of COVID-19: weakness, shortness of breath, bouts of unusually high heart rates. Both were discharged with supplemental oxygen, which they needed frequently for a month after. Simple tasks – like walking up the stairs – became monumental efforts. Both are back to work at UK HealthCare, though Kelsey’s time is limited. In less than five weeks, she’s due to give birth to her baby girl.
Reflecting back on the experience, Nancy says that despite working in healthcare and following all CDC guidelines, she doesn’t feel the family “fully respected” how catastrophic COVID-19 could be in otherwise young, healthy people.
“We’ve always followed the rules, but I do think we all felt that we were wearing masks to help somebody else, not to help ourselves,” Nancy said. “And I see that a lot differently now, because we went through the worst of the worst and we could have lost two family members. They’re not patients in nursing homes, and they’re not people who have had a lot of health problems. They’re people who should not have been affected by it, but were.”
“The power of advanced medicine is wonderful, but it’s nothing without the people.”
It’s a point to which Darren gives extra emphasis – for all the technology and complex care UK HealthCare offers, what makes this place special are the employees doing the work. Earlier this year, he spoke openly about his family’s experience during one of UK HealthCare’s Town Hall Sessions, broadcast live from the Karpf auditorium inside Pavilion A.
Voice cracking with emotion, he offered perspective, lessons learned and gratitude to all his fellow health care workers who took care of his family. He’s a better doctor for having gone through this experience, he says, because it’s shown him that patients need more than just technical expertise – they also need a healthcare provider who slows down and takes the time to show how much they care.
“It’s those interactions with [people on the 10th floor] that I am forever and eternally grateful for. I cannot thank those people enough… because to me, they saved my life,” he said. “In this country, we’ve thrown around the term ‘heroes.’ Let me tell you something: there’s no bigger heroes than the people who work on that damn floor.”