Holmdel HS Graduate Shares Pandemic Front-Line Experience

HOLMDEL, NJ — Dr. Krutika Parasar Raulkar remembers the first time she heard there was a case of COVID-19 in her hospital. During the height of the pandemic in the United States, Raulkar was a resident at New York-Presbyterian Hospital in Manhattan, where she worked in the rehabilitation unit. In March, as officials from the hospital disclosed that a case of COVID-19 had been confirmed in the hospital — the second confirmed case in New York state at the time — Raulkar recalled a “lot of fear” in the meeting room.

Related: 2nd Coronavirus Case Confirmed In NY; Family In Quarantine

“When the chair of our department told us that the first case had reached our hospital, we were all shocked,” said Raulkar, a 2008 graduate of Holmdel High School. “He told us that this could really change things and that it could reach pandemic status. There was a lot of fear in the room; everyone was scared for themselves as well as their families.”

One month after the March meeting, during New York City’s peak on April 9, Raulkar witnessed over 700 patients on ventilators at the hospital, with resources stretching and hospital beds nearly filled to the brim. Raulkar’s rehabilitation unit tried to limit coronavirus patient intake, but the task soon proved an “impossible” feat. The resident’s section of the hospital steadily began flooding with COVID-19 positive patients as well.

In her latest book, “COVID-19: Inside the Global Epicenter,” Raulkar paints a sobering reality of life at the heart of an epidemic. Through interviews with hospital staff, vignettes of fatigue, burnout and loss become astonishingly real. Like so many other health care professionals, staff from New York-Presbyterian had to stand in for many patients’ families during their last moments.

‘We really had to step up to be their family’

While the streets of New York City changed overnight — with shops quickly shuttering, restaurants closing and residents leaving in the middle of the night — Raulkar’s hospital changed too, but in a different manner.

Many doctors had to take over new roles. One contributor to Raulkar’s book described that, during the peak of the pandemic, his job instantaneously became to call for when patients would become “comfort measures only” — stating there is nothing more doctors can medically do except to keep patients comfortable in their last moments.

“He was kind of desensitized to the process because he was saying that so often per day. It just struck him that it was so different than what he usually had to do.”

Other health care workers began to take over the roles of family members for patients, as visitors (even next of kin) were barred from seeing infected loved ones. Raulkar recalls instances of hospital staff using iPads to communicate patients’ last minutes of life with their families.

“I think that family is such an important part of being in the hospital. The only time I have been in the hospital was to give birth to my kids. I am a completely healthy person, but having my husband there was so important to me,” Raulkar said.

“Our patients are significantly debilitated in the rehab unit — they can’t care for themselves. They completely rely on their family members. The fact that family was not [allowed to be] there was really a very difficult aspect for our patients. We really had to step up to be their family.”

'It could be anyone'

While scores of interviews from Raulkar’s book detail heart-wrenching stories of lost patients and family members during the height of the pandemic, the Holmdel-raised doctor describes a somewhat different experience.

“From the rehab perspective, it was very interesting to see the patients who survived but had lasting morbidities,” said Raulkar, who detailed that a number of surviving severe patients showed weakness and nerve injury after proning (intubation). “Although proning appears to be one of the most beneficial maneuvers that could be done for these patients, it caused significant problems with muscle weakness and nerve injury after they were proned and intubated for so long.”

Raulkar also described that some patients experienced cognitive difficulties, confusion and delusions after going through intensive treatments for an extended period.

The doctor detailed a wide array of symptoms and ailments seen in her unit, affecting both young and old. However, it was the severe (if not rare) cases in young people that touched the former resident the most: “Those were the cases that really affected me, because it could be anyone and cause significant morbidity.”

“Seeing those types of patients was very difficult for me because it’s really a huge change of their life. They’re not going to go back to their normal life,” Raulkar said. “But I’m lucky to be part of the rehab side that we do get to see a lot of people improve and go home from us. Others that I interviewed saw a lot more constant death.”

'This is what I was meant to do'

Raulkar has since wrapped up her residency and relocated to Chapel Hill, North Carolina, with her family and continues to practice medicine.

Amid the release of her book Aug. 9, the doctor recalled several small moments of joy throughout the darkest days at the New York City hospital, namely the outpouring of support for front-line health care workers and the unbreakable bond she felt among the rest of the staff.

“I do think we are going to experience some benefits from the pandemic, especially with the technological revolution,” Raulkar said. “I think telemedicine is an incredible option that has finally gotten funding. The silver linings were just the camaraderie and seeing people work together.”

It was only during an hourslong conversation about life in the hospital with a neighbor that Raulkar came up with an idea to write down her experiences.

“It started out as an information guide on what we know so far about COVID in a readable format; I love to read, and I would love to read something like that,” Raulkar told Patch of her decision to write about her front-line experience. “When I sent it to an agent, she said ‘I’d love to hear more about the physician experience,’ so that’s when I went back and interviewed all of my colleagues.”

“Everyone was so eager to participate and share their stories, and also so thankful for sharing the stories,” Raulkar said.

“Overall, there was a huge sense of camaraderie, and a lot of people felt like 'this is what I was meant to do.' They felt honored to serve in the pandemic.”

Raulkar’s book is currently No. 1 on Amazon.com in New Releases in Public Health. Click here to learn more.

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