'Remember Jay' - One family's battle with COVID-19

When nurse practitioner Gwen Eastep first met Jay Martinez, she thought he was headed for a heartbreaking outcome.

“I really thought he would not win,” Gwen says. “He was going to die.”

Gwen first met Jay, a young father of two, in the COVID unit at Cox South.

His oxygen saturation was low. He was already showing signs of confusion - an ominous symptom she sees frequently in patients who are about to descend into the depths of the worst COVID-19 has to offer.

Soon, he was intubated and on a ventilator. Even on life support, his oxygen levels were still low. His lungs were in bad shape and there were limited treatment options. Jay was among the sickest of the sick.

The team was going to do everything they could, but the situation looked grim.

They had a long-shot plan to transfer him to Kansas City for extracorporeal membrane oxygenation (ECMO), an intense procedure that oxygenates the blood outside the body.

Jay was so fragile, he might not survive the trip.

The ICU physician called Gwen to ask about end-of-life decisions and treatment. Then, Gwen had to make the call she makes all too often: A call to a family to tell them they should come see their loved one, in case it is their last chance. She called Jay’s wife, Melissa, who was on speakerphone with Jay’s father.

Almost immediately, this call was different.

“I remember Jay’s dad stopped me in the middle of the bad news. He told me they were thankful for me, and praying for me,” Gwen says. “That was just overwhelming.”

Melissa knew they were doing everything possible to save her husband. “I wanted her to hear my hope and my gratitude for her efforts,” she says.

Gratitude and prayer is not usually the response Gwen sees from families during such a difficult conversation. It definitely made an impression.

Caregivers fight for every patient, and they would fight with all they have to save Jay's life. They would fight to make Jay the exception – a patient who beat the odds and got his life back.

It’s a victory Jay and the staff would both need.

Over the next few weeks, Jay and his caregivers would offer each other a valuable gift in the dark times of COVID-19: The team’s efforts saved his life. His example gives them hope.

‘I’VE ALWAYS BEEN HEALTHY AS AN OX’

Jay remembers the day he arrived in the Emergency Department at Cox South. He couldn’t believe this was happening. A week earlier, he would never have thought he would be so afraid for his life.

He had felt mild, cold-like symptoms and some fatigue over the previous weekend. Those symptoms were not terribly surprising – he frequently works long hours and it was allergy season.

On Monday, though, he had trouble catching his breath. That was a first.

“I’ve always been healthy as an ox. I’ve been a trumpet player, and I love skiing, hiking, mountain biking, and surfing. When I couldn’t breathe, I knew something was going on.”

He had no pre-existing conditions. He had never been hospitalized. At Cox South, staff diagnosed him with COVID-19 and pneumonia in both lungs.

“Not a great combo,” Jay says with a chuckle. Still, he felt immediately better when the ED staff put him on oxygen. He was surprised when physicians wanted to admit him.

He reluctantly agreed. In his hospital room, he still had trouble catching his breath. Soon, doctors decided he needed to be in the COVID unit.

“The most bizarre experience was when they put a sheet over my whole body going up to that floor,” Jay says. “I thought, ‘Do they have to cover me like this? If this was a movie, people would think I was dead.’”

On the COVID unit, it was a different world. “It felt like I had been transferred to a warehouse. It was cold; everyone was in white hazmat suits.”

He noticed the bed across from him had a “do not resuscitate” sign posted, honoring the patient’s wishes. He texted his wife, Melissa, about the sign, noting wryly: “I guess it could be worse.”

That’s the last thing Jay remembers.

‘IT BECAME SO REAL, AND SO SERIOUS’

To know what happened in the next 4.5 weeks, you have to talk to Melissa and the caregivers who dedicated themselves to saving Jay’s life. Jay was intubated and put on a ventilator. He was in a medically induced coma.

The same weekend Jay’s symptoms originally appeared, Melissa had noticed mild symptoms herself. She was tested on Monday. By the time Jay was hospitalized on Tuesday, her test came back positive.

As Jay entered the hospital, Melissa quarantined at home with their three-year-old and their five-year old. Their youngest also tested positive.

“It was scary at first, but I thought it would be no big deal for Jay. He has a strong immune system. He will push through,” she remembers.

That all changed as his condition quickly deteriorated. Jay was intubated late Wednesday night.

“It became so real and so serious. I was quarantined with two babies. No one could come to us to help our kids, and I couldn’t go there. It was so hard to know he was by himself and there was nothing I could do. I felt helpless.”

Melissa reached out to her family and friends with a request: “Can you just pray?”

“We had people coming over, spacing themselves six feet apart on our lawn and praying,” she says. “It let us know that we were not alone. It helped us find some hope in the uncertainty.”

IT’S HARD TO KEEP MOVING FORWARD

As family and friends supported from a distance, inside the COVID unit, there were angels working to bring peace as well.

Nurse Hannah Kanai worked closely with Jay at the bedside. Jay was in critical condition and was unstable. Hannah was in regular contact with Melissa, giving her updates. The nurses offered video chats. Hannah held the phone to Jay’s ear so Melissa could communicate affirmations to him, even though he could not respond.

“I couldn’t bear to see him,” Melissa says. “I talked to him and the kids would get on the phone to say, ‘I love you, daddy.’ It was so hard.”

Melissa had sent the staff some photos of Jay and the family, which Gwen had printed out and respiratory therapists had hung near Jay’s bed.

“I wanted the staff to see who he was before all this, before he looked so bad,” Melissa says. “I wanted them to see a glimpse of his life and who he was a person.”

Melissa asked staff to play praise and worship music for Jay.

“I wanted anything to bring him some of the comfort of home. That was one of the biggest things for me,” Melissa says.

Along with the photos, Melissa had shared a document with Gwen. It is an 11-paragraph prayer she and Jay practice daily. It was not something they would usually share outside their family, but the staff at the bedside were family now.

The piece is a spiritual mission statement they use to reaffirm their purpose. With Jay intubated in the COVID unit, its words of challenge and redemption took on new meaning.

It’s hard to keep moving forward.

It’s hard to see progress.

It’s hard to push through.

But today is the day!

The same spirit who raised the savior from the grave is alive and active in me.

Hannah and others read the prayer to Jay every day.

“Wow. I didn’t even know that,” Jay says now.

“The fact that they read every day to him – as a wife, that was incredibly valuable to me,” Melissa says. “I couldn’t be there to do that, but they did. The staff chose to do this for our family. Regardless of their faith background, they did this for us. That is a beautiful, beautiful thing.”

‘THEY FOUGHT FOR US’

Jay’s care team cycled through a variety of treatment strategies, from nitric oxide to antibiotics to Remdesivir.

Melissa was in close contact with Pam Holt, a family friend and experienced nurse who is currently working in New York.

Pam guided Melissa on what to ask and helped her understand Jay’s condition. The staff called Melissa regularly and kept her informed of the treatment plan. They were ready to answer all of her questions.

“We came prepared on the calls, and they came prepared,” Melissa says. “If we had a question, they were the first to say ‘we are on it.’

“The doctors were so good to listen. I couldn’t sit there and hold his hand and talk to the doctor about the plan. Gwen and Hannah were our biggest advocates. Gwen and Hannah fought for us.”

Melissa remembers the call with Gwen and her father-in-law. ECMO was the only option, and the closest hospital that could accept Jay was in Kansas City. Even lying in a prone position, might not be stable enough to survive the trip.

It was a Saturday evening when Gwen called. Melissa prayed all day Sunday. For hope. For another outcome.

By Sunday afternoon, the team had found a way to transfer Jay to St. Luke’s for ECMO. Monday morning, he traveled to Kansas City by ambulance.

“I can only imagine that ambulance crew. They were such a strategic team,” Melissa says. “The whole team fought. Their willingness to push through and keep advocating – despite the fact that it did not look good – made all the difference.”

‘I WAS PRAYING HE WOULD RISE UP AND BE RESTORED’

At St. Luke’s, Jay remained critically ill and unstable. He spent several days in the ICU. With supportive therapies, he began to stabilize, just enough that he would not need ECMO.

Slowly, Jay started to make progress.

“I think the Lord just had his hand on him,” Melissa says.

Jay gradually regained consciousness. One day, to Melissa’s surprise, he softly sang “Jesus Loves Me.”

“Something clicked and he started to truly wake up,” she says. “His cognitive status got better.”

Jay had been on a ventilator, paralyzed and sedated for more than four weeks. He was alive, but there were still a lot of questions.

“I didn’t know who I was going to bring home,” Melissa says. “Could he walk? Would he remember me? They warned of brain damage due to the lack of oxygen. There was a lot of uncertainty.”

When Jay returned to Springfield, he entered rehabilitation in Inpatient Rehabilitation at Meyer Orthopedic and Rehabilitation Hospital.

After weeks of rehab, Jay was ready for discharge.

“I am amazed at his progress,” Melissa says. “He is walking and talking. I am so amazed at the staff and the way they worked with him. I was praying that he would rise up and be restored. Watching him do just that is incredible.”

AN UNEXPLAINABLE MOMENT

On the day he was set to be discharged from inpatient rehab, nurses told Jay they had a surprise. Someone wanted to meet him.

“I didn’t know what they meant at first,” he says. “Then, in walked Hannah.”

He had no memory of Hannah from the COVID unit, but he had heard stories about everything she did.

“It was very emotional to see her. There are only a few people you meet who have truly impacted and changed your life,” Jay says. “When that happens, it is an unexplainable moment.”

The two embraced. Jay thanked her for everything. Not just for what she had done for him, but for becoming a nurse. For everything it takes to care for patients, day in and day out. He wanted her to know that her decision to answer the call of nursing makes a difference.

“It is only through the sacrifice of people like Hannah that people like me can survive. That’s a message that more nurses need to hear.”

Jay says the five-minute conversation with Hannah inspired him.

“I have been so fortunate. When people truly care, combined with an attitude of never giving up, it is just amazing. It was an amazing moment to leave the hospital with. It just helped me keep going.”

‘A STRONG VICTORY’

For Hannah and Gwen, seeing Jay’s recovery keeps them going as well.

“This is a strong victory in these dark times,” Gwen says. “It was such a good team. Everyone helped make it happen: EMS, nurses, respiratory therapists, fate, the universe, God. … I was just fortunate to be a part of that.”

Hannah thinks about the day she met Jay often.

“Just the boost it gave me to see him, to talk to him and hug him,” she says. “To see that we do have people making it out. That day was a lifesaver for me.”

Earlier that day, one of Hannah’s patients had died. She was preparing to meet with another family who had lost their dad when she got the call to come see Jay.

“I was at the end of my rope that day. It was overwhelming and surreal to see someone like Jay, touch them and see someone walk away. He is the only person I have ever seen come back from that point to recover.”

For the teams that work with COVID-19 patients, every positive outcome stands out – a treasured light in the darkest days of our battle with COVID-19.

“In the COVID ICU, we don’t get to see them go home. We talk to families on the phone. We hold people’s hands as they die,” Hannah says. “It’s hard not to lose hope.”

Hannah says it’s easy to wonder: “Why would we do all of this when we know the likely outcome?”

It’s in those moments – when caregivers choose to fight rather than give in – that Jay’s story is making a difference for all of our patients.

“Jay is our example. He motivates us to really fight hard for these people, even when it looks grim,” Hannah says. “He is our unicorn. He keeps us going. We say: ‘remember Jay.’”