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September 15, 2020

HealthChannelsTV: Episode 1

Experiencing COVID-19 in a New York ED, with Dr. Lee Donner


Dr. Lee Donner joins us for our first HealthChannelsTV episode. Dr. Donner shares his experience with COVID-19 as an emergency physician in New York. He discussed the first days of the pandemic, the impact on his emergency team, and his personal brush with the virus.




Full Transcript

[00:00:00] Michael Murphy, MD: [00:00:00] Welcome to our first episode of HealthChannelsTV.  I’m really excited about this – it’s a new series that looks at all of the industry trends, stories. During this pandemic, we just, there’s so many personal things that have come to us and we just want it to be able to offer something in a very casual, relaxed environment for all of our partners, our colleagues, and our coworkers that are working with us.

[00:00:35] And, so I hope you enjoy these episodes. They’re geared to be around 10 to 15, maybe 20 minutes at tops. The first episode that we’re going to go into, and the second one is a little bit longer, but I think you’ll, you’ll really appreciate the depth and personal nature of this episode. So really excited about that.

[00:00:54] We’re having a theme of the week or month, I should say, each episode with [00:01:00] HealthChannelsTV is going to be a new drink and today’s theme is, endurance and hydration because COVID has just been an extremely long time going and the interviews that we’re doing are actually decent length interviews.

[00:01:15] So I have my favorite, lemon La Croix hydration drink here, but we’re going to change that every month. So you’ll expect something new each, each time. And hopefully we’ll have some fun with that. I’m joined today by Dr. Tony Andrulonis. For those of you who don’t  know him, he is our HealthChannels COO. He has been with us now for quite some time.

[00:01:36] We’re really excited to be here with him. He too lives in South Florida and has a lot of experience with COVID. And so, Tony, do you have any stories that you’d like to share with the team before we jump in?

[00:01:52] Tony Andrulonis, MD: [00:01:52] Sure. And thanks, Mike. I appreciate you inviting me. I got my water, so I don’t quite want to one up you, but  something to stay hydrated [00:02:00] here.

[00:02:00] So, like you, yeah, I’m down here in Southeast Florida and got a lot of close colleagues that are actually practicing down in Miami. And I think, you know, some of the things that we’re going to hear that Lee experienced, Miami really got hit with, after New York city. And so a lot of the stories that we hear coming out of New York City. I’ve heard a lot of those similar stories coming from a bunch of minds buddies down in Miami, whether it’s, you know, testing shortages and seven day turnaround times. Challenges with, PPE staff getting sick, you know, 15, 20% of the ED physicians getting sick and having, having to go out.

[00:02:39] It has really been a quite a challenge for the physicians down here. And one of my, my very, very close friends and buddies. He actually got COVID and tried to stick it at home for a few days and young guy, younger than myself, and just after a while, started getting more and more short of breath. And then it got to the point where he couldn’t even [00:03:00] drive into work. He called the paramedics and this just gives you like some of the stories that we’ve heard. When the paramedics arrived, they say, hey, you look fine. He had to keep telling them, I don’t feel good. I’m short of breath, but you don’t look short breath. And lo and behold, his pulsox was in the eighties. He ended up spending about a week in the hospital, but responded, thank God, very well to the treatment and is doing well today.

[00:03:24] But you just hear these, these stories again and again, of what our emergency medicine colleagues are going through. And it’s just really remarkable. I mean, they’re, there they’re truly heroes to me and everything that they’re doing.

[00:03:36] Michael Murphy, MD: [00:03:36] Yeah. This first episode Lee Donner, you know, he works at a basically ground zero, where COVID broke out in New York and we just kind of go through how we kind of practice medicine and how that kind of went into COVID and how they quickly had to change that. And then he has kind of a battle [00:04:00] with  probably getting COVID and at the time that the testing was really bad, and couldn’t get tested and  then how he had to deal with his kind of own personal fears and challenges of tackling COVID head-on, really at ground zero. So without further ado, let’s get into the interview with Dr. Lee Donner.

[00:04:24] Super excited to have Dr. Lee Donner with us today on our inaugural HealthChannelsTV show. Lee and I go back a long time. We met in Newark, New Jersey at UMDNJ hospital, which is now Rutgers hospital in 2009 to 2013. We spent a lot of long nights in the trauma room or in the emergency department.  We thought we saw it all during our residency period, we saw a lot and saw a lot of good things. We go sell a lot of bad things, scary things. We also felt that, you know, there were, there were long nights, but, but short [00:05:00] weeks and long months, but short years, it was, it was, it was a great time.

[00:05:04] We – I got to go and be in part of his wedding, one of the best weddings, and funny, funny guy, this guy is, he’s a, he’s a great guy. But super happy to have you Lee. And, you know, how’s the family, how’s everybody doing?

[00:05:19] Lee Donner, MD: [00:05:19] Everyone’s doing great, you know, in the scheme of things, not much for us to complain about. I appreciate the invite and I’m very happy to share my experience with you, and your viewers. And like you said, you know, it might be months or sometimes years between seeing you, but, it’s, it’s like, it was yesterday that we were back in the trauma bay and, and doing our thing. 

[00:05:43]Michael Murphy, MD: [00:05:43] One of our amigos is not here, Dr. Hugo Razo. It was in our class, there were six people and there were three guys – it was myself, Lee and Hugo. And, Hugo was a famous actor on the New York, was it, what was the show called?

[00:05:57] Lee Donner, MD: [00:05:57] New York Med.

[00:05:59] New York Med. [00:06:00] And he was famous, people outside of the trauma bay waiting for him when he got off shift. No, not really, but he was a, he was a special guy until that go bag came into light.

[00:06:10] Michael Murphy, MD: [00:06:10] And then…

[00:06:12] Still talked about. I still talked about in the academic world.

[00:06:20] The go bag is what Hugo had to basically do intubations or trauma, but he had it in his own bag, versus, uh, some of the medications and things that should be locked up in a Pyxis and whatnot. But we love Hugo still, still talk with him. He’s out in the West coast, in Palm Springs. And yeah, for those of you don’t know Lee has twins, they’re both four years old and, and I have a little boy, a little four year old as well, so we have some common bond there.

[00:06:46] The reason why we have Lee on – and super excited again to have him and just to see him and touch base. We haven’t, we haven’t talked in a long time; we used to meet every, every year around the holidays, and get everybody together and go have some drinks. And unfortunately [00:07:00] we just, haven’t done that this past holiday. And I look forward to the day we can do that again.

[00:07:06] You know, the reason why we’re here is to talk about something that we’ve all gone through these past few months, since April, really, of COVID-19 and just how it’s just really unprecedented times – we’re sitting here meeting, over zoom, which I never thought we would do. And, you know, just how we’ve completely shut down and, and, you know, I don’t practice medicine anymore. We were joking. You know, Lee was saying that he had gotten off a string of night shifts. And do I still remember how that is? And, and, you know, my thing is that I had a lightning storm that came through Florida for a couple hours that kept me up. But I, you know, we both practiced in UMDNJ which I think, prepped us a little bit for what we went through. From the trauma perspective, we saw a lot of deaths. we saw a lot of people just in terrible situations and had to kind of cope with that and, [00:08:00] and learn an approach.

[00:08:02] I also was in the military, and got deployed overseas into Eastern Europe. And, you know, those, those kinds of feelings that you get, and I can only imagine that’s why we are here with, with Lee today – it’s to talk about some of these things. When I got deployed, I was seven- I was 18 years old and we went to Eastern Europe. You know, I had the – we’re supposed to be in dark cammo and I had this red, white, and blue flag on my back because I was the youngest guy in the military there or in the unit at that time. And that kind of fear and anxiety of having live rounds in your weapon and going into potential situations that you didn’t know what was going on. There’s a certain fear there. And, and then there’s a certain, you know, when I went to Ranger school  -and this is definitely not about me, so we’re going to turn it over to Lee – just giving some kind of feelings of my emotions that I could potentially relate to Lee. you know, Ranger school is 90 days long with, with the beginning program and there [00:09:00] was times that I just wanted to quit. I wanted to cry. I couldn’t believe that that, I was, I could put it another step forward on maybe like a 12 to 15 mile march at 3:00 AM. And you know, with, with 30, 90 minutes of sleep the day before. And so -and that stress that you have on your body, I can just relate and what that did with our, our brothers and sisters in the military at the time. And, you know, and the comradery that can potentially be there. And so there’s just a little, I think there was like a lot of similarities. I didn’t get the live COVID in the emergency department. I lived in on the corporate side, obviously. But, there were emotions that I had that I I’m sure that Lee you probably had.

[00:09:42] And, you know, I’m sure this story probably changes day in and day out for you and the emotions that you had. But, you know, when you, you know, working in an inner city hospital in New York where you’re kind of at the front lines, in the trenches with your colleagues, you know, when did you kind of first know that [00:10:00] this was like a real issue and, and, that this was not to be taken lightly?

[00:10:07] Lee Donner, MD: [00:10:07] So in the way this unfolded, you know, we have our work lives and we have our home lives and I’m subject to the same media as everyone else at home. I’m watching the same channels as everyone else. So when we saw what was going on, in Wuhan, it’s obviously on the radar, maybe a little bit sooner for us because, you know, we’re, we’re aware of the, the propensity for a pandemic. Although in my career, it hasn’t bore out. So I think that we knew that there was a huge risk. This is an assumption, but the memory of SARS-1, and having lived through all of this preparation for Ebola, which I can’t remember what year that was. And I, I can’t believe that it’s that far in the past already, but I was looking at some photos recently of my coworkers. A lot of us are still [00:11:00] there. you know, getting ready for Ebola patients. And having those threats never bore out. I think even those of us who were a little bit alarmist, tended in our consciousness or our subconscious to think, okay, we’ll prepare. And then, nothing will happen. And I think just being honest, we probably all have a little bit of that thought and probably also, that same thought probably carries through high levels of administration of, you know, we haven’t seen this when’s the last time we had such a major, a major issue – it was 1918 or with polio.

[00:11:39] Michael Murphy, MD: [00:11:39] Right.

[00:11:40] Lee Donner, MD: [00:11:40] And so at some point, we’re doing a lot more preparation. We see that it’s getting out of control and, you know, we’re getting concerned. And, there, there were a couple of patients that came through. And it, it became – maybe I have to take a step back. It became real for New [00:12:00] Yorkers when the first outbreak took place in a town called New Rochelle. If you’re not aware of it, it’s not far from the city. Most people who work in the city, living in New Rochelle and commute, back and forth, and it very quickly became a cluster in that area.

[00:12:15] And you know, it kind of spun out of control from there, but the first time, the young healthy patient had a terrible looking chest X Ray in the ER. And we knew that it was COVID even though the test at that point was hard to get, and it took a long time to resolve. The first time any of us had  a patient.

[00:12:39] There was a 29 year old guy with low oxygen saturation. Whoever was in the ED, you know, we, we were told about it. He was in an isolation room and we walked by and we all kind of took a look at him. He was, he was placed in an area where I was working, but, you know, we have more than single [00:13:00] coverage, so I wasn’t taking care of him, but I had a line of view, and pulling up his x-rayon the monitor and looking at the guy was horrifying. The look in his face was horrifying. He was scared. And, and this is early. This is, this is probably the middle of March, to the best of my memory. so this is not me speaking as a physician. This is me speaking as a young, healthy person. We saw it. I’m not the only one and it became a reality.

[00:13:34] And so there was a, there was a bit of fear there. And then from there it just, you know, one patient became two became four, and then, you know, the rest is history. But you know, the specific moment I can remember was seeing that x-ray when my coworker was like, you gotta see this guy’s x-ray and then we were like, Whoa, this is not going to be, this is not going to be fun.

[00:13:58] Michael Murphy, MD: [00:13:58] And then it just kind of – did [00:14:00] it kind of slowly build, or did it, did you kind of go from zero to a hundred miles an hour overnight? Or how did you, you know, how did that come on for you?

[00:14:11] Lee Donner, MD: [00:14:11] It seemed, it seemed to go pretty quickly. The thing is, you know, in, in preparing for this, no one had any idea of the magnitude. That it was going to affect New York. And now, you know, unfortunately like all the other clusters going around the world. Even though, you know, we, we shared a text thread where people were talking about, what’s going on in Italy. Not so much information coming out of China for whatever reason, but what was going on in Italy and Spain, we were getting for people who had contacts there.

[00:14:54] The warning was there. We had this patient, then we had a few patients and then the preparation. [00:15:00] I think, you know, I remember sitting in a meeting talking about what we needed and what we wanted as far as space, to take care of these patients as far as, flow and how we were going to bring them in and keep them separate what we were going to need in terms of PPE before the, the lay people knew what PPE was. Before there was an issue  with reserves of PBE and, you know, the, the response was, you know, we had one room and when we get it, the PUI that, that expression has gotten – PUI, if you’re not aware is person a under investigation. So that means you got a person who…

[00:15:39] Oh, by the way, the, the CDC and the department of health in the beginning wanted to declare a PUI had to come from Wuhan. So we were looking in the wrong places. and so we wanted to set up a room for a PUI where we would call the department of health and have this, you know, [00:16:00] protracted phone call, where they would say whether or not to keep the patient isolated in the hospital and issue a PCR test, for the coronavirus.

[00:16:10] And so in, in those plans, you know, I think from what we already knew was going on in Italy, we were ready for, you know, it’s not one person that’s gonna walk in. It’s going to be 80 people in a day with the same complaint and statement. Not that we weren’t ready or betting that it was going to happen, but this was the fear.

[00:16:32] And so the preparation was a little, a little lagging and maybe there was a failure to believe that it was going to happen. And then it really did just explode. You know, it might not have been three or four days, but it was, it was less than two weeks where we went from, like, we can handle this with what we have in place, and with who we have, to this is unchartered territory, completely uncharted territory. And we’re in over our heads.

[00:17:00] [00:17:00] Michael Murphy, MD: [00:17:00] Yeah. I remember when – I can only imagine what you guys are going through and you’re right. The thread we were on, and that kind of fear. We were on a thread – a WhatsApp thread with 50 of our colleagues from the Northeast, and really around the country too, ’cause they kind of all spread out, and so it was Texas and Colorado and Florida and just everywhere. And,  obviously the Northeast had it the hardest during, you know, during the March, April may really. And, it was almost pandemonium . It was fear – just a bunch of  anxiety and ‘what are we going to do?’

[00:17:35] And everybody was trying to share best practices, whether it’s looking at different, Podcasts  or other evidence-based literature out there. Just whatever it was because we didn’t know. One thing that I remembered – when you gave a story  on that chat, you know, you had that patient and he went through a box of PPE on like one patient.

[00:18:00] [00:18:00] I remember what we did at Newark, you know – at Newark, the patients we saw sometimes would be, we’d have a lot of HIV population, Hep C population, and, you know, they come in really CD four counts of four and viral loads of greater than a thousand. And they, you know, we’d have to intubate them. They probably have TB. And we would blow through our N-95 masks, our PPE to intubate them. You know, take it off, go do stuff, come back. You have to do a central line, come back – you know, whatever it was. And you know, you weren’t, you weren’t thinking of that precious, life saving N-95, you just kind of went through it.

[00:18:42] So I’m sure you guys did the same thing, not, not putting blame on anybody. We just that’s what we did. You know, we didn’t, we didn’t think there was going to be a bus full of TB positive patients to give an analogy coming in, you know, day after day after, day after day, [00:19:00] where you need to start preserving things. So I’m sure you know, that that kind of caught you guys off guard too with the PPE.

[00:19:06] Lee Donner, MD: [00:19:06] Oh man. The PPE thing is, is one of the, one of the terrible memories that we’ll take away from is our relationship with N-95s and PPEs entirely changed. That patient, we used gowns and, and N-95s, the way that you and I trained the way you’re describing, we would go – a nurse went in for a blood draw, would come out of the room -everything’s garbage. We didn’t know that three weeks later it would be a different scenario. And, and the other thing was – such precious little information was available about transmission. Nobody knew how it’s transmitted. We still don’t really know. But we’re all very happy to take the precautions now. And, you know,  I’ll wear an N-95 for 12 hours, even if it leaves these marks on my face.

[00:19:56] But, you know, [00:20:00] I had a medicine resident rotating in the ER yesterday. Just yesterday, who brought this up, he was talking about with another one of my EM residents getting mad at him for, “do you remember back in March, you know, you yelled at me for taking it an N-95 when I came into the ED?” And because what was going on at the time, you know, we had no idea what was the right thing to wear and when, and there was bad information and changing information on a daily basis coming from administration, which is, you know, essentially it was all coming from the department of health and from the CDC. And so at some point there was this only for aerosolizing procedures. You’re doing an intubation, you’re doing a sputum induction – you’re wearing N-95. So anybody else just wear a surgical mask, we need to preserve the N-95s and you don’t need it in those scenarios.

[00:20:53] So when we saw, essentially a consultant come to the ED, and take [00:21:00] an N-95- which now is crazy to me. You can’t just walk into an ED and take an N-95. You have to like put your social security card down. So when that happened, people in the department were, you know, territorial and would say, “Hey, you can’t do that. Where are we going to be come May?” And I don’t think we realized how true that was.

[00:21:22] So that guy wasn’t wrong for trying to protect himself. We weren’t wrong for trying to follow the guidelines. It was just a lot of confusion and, we’re still in a state of confusion about it. But, nobody looks at an  N-95 the way we did in February all the way through whenever it was invented.

[00:21:45] Michael Murphy, MD: [00:21:45] So love to get into, you know, one of the things we saw – I think you actually got COVID. I don’t think you got tested, but I remember you were in isolation.

[00:21:54] Lee Donner, MD: [00:21:54] I’ll give you an update on that. I still don’t know – I was [00:22:00] sick. I tested negative and I tested ultimately for virus, which causes common colds. There’s a lot of questions about test power and sensitivity, but, I got sick and I got either a lot of very typical symptoms or a lot of psychosomatic things that were very strong power of suggestion. And I no longer think I’m as headstrong as I used to.

[00:22:29] Michael Murphy, MD: [00:22:29] Got it, but

[00:22:30] Lee Donner, MD: [00:22:30] sorry to interrupt you.

[00:22:31] Michael Murphy, MD: [00:22:31] No, no, no. So. At the time you thought you were positive with COVID, you know, there was, I mean, you were you’re, you know, you have your two twins at home. You’re starting to see that exponential rise of cases, you know, and pretty much like if you, if you’re going to survive, COVID you, you survive pretty quick, you know, 14 days.

[00:22:54] But if you’re going to succumb to COVID, it happens in almost clockwork. I mean, our treatments have gotten a lot [00:23:00] better, but at the time you were basically seeing – you get infected and 14, 15 days later people are dying, you know, the most death I saw when I was training was, I saw 10 people die in a shift. And, you know, you just, I used to, I used to be so numb to death, but what got me every single time was when the families, would cry and get emotional. It wasn’t the fact that somebody died, but when the family members got emotional and you had to tell the news to them that that tore me apart. And especially when younger people died as well, it didn’t really matter. It just, there was, that was the thing that hold on my strings.

[00:23:46] How did you – know a couple things here: how did you deal with that with the death? How did you deal with the anxiety of – multiple questions here – but going out, you know, potentially being sick at the same time and [00:24:00] knowing you had to go back to the hospital and deal with it, how’d you just keep going? And then, you know, one of the things that you know, in the military, and I thought even at UMDNJ, you know, we’re doing those night shifts and you and I, and, and Hugo and the rest of the team, Yon and a bunch of other people, we, we became close. You know, we just, there was this like comradery you’re in the trenches together. You’re grinding it out. You know, how did the department – are you guys a stronger department now? Or, you know, what’s going on there?

[00:24:35] Lee Donner, MD: [00:24:35] All right. So let me try to dissect some of that. You put a lot on the table. 

[00:24:39] Michael Murphy, MD: [00:24:39] We can go piecemeal.

[00:24:41]Lee Donner, MD: [00:24:41] For all intents and purposes. When I got a URI with a fever during the surge of COVID in New York, in which I’m working in, you know, if, if not the busiest, one of the busiest COVID EDs in New York, I thought I had it, [00:25:00] right?

[00:25:00] I didn’t get tested right away. and that, that was really scary. You know, I don’t, I think now, talking to people who are not in healthcare, there’s a lot more known and there’s, there’s a little bit less doom and gloom on the TV and people are, would expect to do fine. But at that point, my thoughts were I’m only seeing sick of the sick, right.

[00:25:30] Everybody who’s, you know, on the verge of intubation and or dying. So, you know, a fear of my own mortality was there, but leading into it during, during those weeks of like, is this going to become a problem in theU.S. or not? I, I had several conversations with my wife about, you know, this is, this is going to be a big deal if it happens. And I might have to – you know, the way I said it, probably a little harsh, but I was like, I might have [00:26:00] to disappear for, for two to three months. I don’t know where it came up with that time course. But I figured if things were going to get that bad, I’m going to move into, you know, luckily we have a guest bedroom, and I’ll just stay there while I work.

[00:26:16] And when all this settles I’ll come back and I’ll reemerge into our family. And I thought it would be hard and think it would be a big deal. And I, and I never pulled the trigger on that. So then one day – Remember what it’s like to prepare for a night shift, take a bit of a drill because it was my first night and it helps me fall asleep. And I laid down to try to get a nap to try to get a few hours in the middle of the day before you start your first night. And you get this like chill and you don’t, you know – as a young adult, I haven’t been sick that many times, but when you get that first [00:27:00] inclination that you might be getting a fever, maybe for like five minutes, you’re like, Oh, it’s just cold or something. I don’t know. And then you get them, you know, the hair on the back of your neck, your neck feels weird. And I, you know, to myself said – I don’t want to curse on your show – but I, you know, I said, f***. This is it? What else is it going to be? I’m not dealing with flu. I’m not dealing with anything else at work.

[00:27:27] Yeah, I’m on I’m in the middle. Like the expression we use at work because we were swimming in COVID patients. We really were. So I freaked out, you know? I don’t freak out too much. I didn’t want anyone near me. I get out of our, our bedroom upstairs. I ripped all the sheets off, I ripped our comforter off. I brought everything down to the washing machine.

[00:27:48] And I ran to the room that I’m in now, which is our extra bedroom. And I closed the door and, you know, Sarah was freaking out and she’s like, what’s wrong? What’s wrong. What’s wrong. I took my [00:28:00] temperature and I had like 101, which is when I really thought that I had it. and so at that point I moved into the room and, there was guidance at that point that you had to stay out of work.

[00:28:14] For seven days, three days of no fever, seven days without symptoms. So I was, you know, I had already, contacted my chair and the scheduler, and just said it is what it is. And you know, for the first time, probably in the history of emergency medicine, we’re all proactive in staying home from work instead of to just march on through. So I’m prepared to spend a week, at least in the room and have my meals delivered to me in the morning.

[00:28:42] But, that was the hardest time when I thought that I had it and I had to hear my family, going through, you know, their just day to day issues and I couldn’t help. And hearing Sarah have some struggle with the kids and not being able to go help [00:29:00] out and knowing that everything depended on her,  made that phase really, really difficult for me.

[00:29:09] Then a lot of other symptoms came on and I did get short of breath. And in retrospect, maybe that was an anxiety or maybe I had it, I don’t know, but I ultimately got tested and it was negative. And I recovered. The other thing, that, you know, you kind of brought up this 14 day thing, you know, on my text thread that I have with colleagues, we’re all, you know, maybe two or three of us at a time had febrile illness. During this span. So we we’re losing workers, you know, luckily, maybe one or two people fell kind of sick. No one fell seriously ill. But on this text thread, it’s always like, Oh, what day? What day are you at? What day are you at? And everyone’s expecting, you know, Oh, day five, maybe it’ll get worse in the next couple of days. And if you made it to the eighth day, [00:30:00] you’re probably okay. You know, the 14 day thing was like, Probably where people were getting intubated at about 10 to 14. That’s when people got really sick. So, there was also this fear of like a lot of people saying they got better at, around the fifth day. And then on the seventh day they were like, fell terrible.

[00:30:19] So there’s this whole like, anxiety anticipation. Of like, Oh,tomorrow am I going to wake up feeling like I can’t walk across the room? And what day am I going to decide – like, I can’t just ride this out of my house. What have I been telling patients for the last three weeks? You know, how many people we had to send home and just said, you know, normally in a normal scenario, I would have been very hesitant to keep a lot of those people at home. I would have wanted to admit a good chunk of them for a host of reasons we can talk about later. We sent a lot of people home. And so now I’m like, you know, I don’t know if it was guilt, but another thought of like, what did I do – did I [00:31:00] send like tens of people back to their houses and apartments in fear like this without any strong guidance I gave them?

[00:31:07] What I thought was good information where I thought was good instructions, but what does it mean to tell someone who’s never really been sick in their lives? You’re fine. You’re not sick enough to stay in this war zone right now. Go home and come back if you think you’re dying or you think you can’t catch your breath. Like, it seemed appropriate.

[00:31:28] And we were all doing what we thought was best and what everyone else was doing. There’s no great guidance on a new disease. but I’ve had a lot of, I guess, I’ll just go with guilt. Like what did I, what did I do? I mean, not that I could have admitted them, but I thought a lot about that.

[00:31:47] Michael Murphy, MD: [00:31:47] And we’re going to pause right there and just take a second to reminisce about what just  happened, what just occurred over those last 20, 30 minutes with Dr. Lee Donner. I mean, if we could go back in time and look at things, [00:32:00] you know – he started to express those fears and those emotions, that I think all physicians, or having, especially in the Northeast at that time, but little did, did anyone know, the magnitude of the tragedy and the lives that were going to be lost that were occurring.

[00:32:18] And in this next episode, that’s going to occur. We get into the kind of that night and day difference of when he left, when he was sick and when he came back into the emergency department and the magnitude there. So I hope you’ll join us. Thank you.