The farewell of Dr. Mario Boskis from the hotel where his isolation ended, and the oximeter, an inseparable companion during his hospitalization
I am a doctor, graduated from the UBA in 1986. For more than 30 years I have dedicated myself to Cardiology, and I am currently working as director of two outpatient cardiovascular care centers in the AMBA area, which combined serve more than 50,000 patients a year.
I go back a few months and we are now at the end of December 2019. While Argentina was preparing to receive the end of the year holidays, in Wuhan, China a group of researchers detected a relationship between patients who contracted Pneumonia of unknown origin and an animal market For human consumption. Coinciding with the last day of the year, the Chinese Agency for Disease Control and Prevention announces to the world that a new beta coronavirus has appeared, with the ability to cause a severe acute respiratory syndrome in humans, which they designate by the name of SARS-CoV-2, better known in our country as the “new Coronavirus Covid-19”, which is rapidly spreading through Asia, Europe and America, forcing the WHO to declare in mid-March that Covid-19 acquired the characteristics of a Pandemic.
Since the beginning of the Covid-19 crisis, I never doubted that our task was to keep the attention centers open, since cardiovascular disease did not stop before the new disease. We work hard in the generation of care protocols aimed at minimizing the possibility of contagion by Covid-19 and personally, I was invited to various mass media, to convey the message of not underestimating cardiovascular symptoms during the pandemic and to raise awareness among the population about the importance of epidemiological prevention measures in the fight against this new virus.
In our institutions we communicated with the most complicated health patients to ask them how they felt, and we implemented the “virtual” consultation modality. The possibility of prescribing prescriptions electronically and sending them by e-mail or WhatsApp significantly helped not to suspend treatment for chronic cardiovascular diseases. The activity was intense, but As an essential worker, he felt pride when at a checkpoint on the street, I showed my authorization to circulate or my medical credential, and received a salute with an affectionate greeting in response, to which I responded with the same affection.
I was giving my personal fight against the coronavirus, until my routine was altered on July 3, 2020. Surprisingly (for me) I started with symptoms. My own omnipotence tries to minimize them. The strong fatigue and headache could be explained by the stress of all these weeks by passing me a bill. That afternoon, after coming back from work, I lay down on the bed to rest.
Dr. Boskis, emaciated but happy. He left the Otamendi Sanatorium with 4 kilos less in just a few days
It had been a few hours before my wife woke me up, surprised that I was taking a nap. « You’re flying with a fever » he told me. It was like a blow. Fever, me? Anyway … surely a flu. But the 39 degrees and the headache were incontrovertible evidence. I had transformed into a « Suspicious case ».
Who had been my close contacts? Who had he been with in the last 48 hours? With whom did I share more than 15 minutes, less than 2 meters away, without a mask? My patients did not meet that definition, but my wife did. The only thing missing was to confirm the presumptive diagnosis.
Hours later I went to the feverish unit of the Otamendi Sanatorium, where they performed a chest X-ray and a PCR, the test that detects genetic material of SARS-CoV-2. Then a doctor came in wearing her personal protective equipment (PPE) – commonly called an « astronaut suit » – to complete the clinical checkup. A few minutes later, by phone, they informed me that my condition was « mild » and that I could isolate myself at home or in a hotel.
Since we had the infrastructure to do it, we decided with my wife to face isolation together at home. The result of the study had yet to be awaited and the 38.5 temperature was just a discomfort that receded with paracetamol. So far, I told myself, this is really just « a flu. »
The next day, July 5, I received the call from the Sanatorium informing me that it was Covid (+). The initial shock gave way to a quick self-analysis of my situation: “I have no co-morbidity, I am under 60 years old and the statistics indicate a mortality of 1%. He had to fight and he was very confident and optimistic. You beat this bug… ”.
That same day I began to write a personal diary with signs, symptoms and reflections.
It’s 8 in the morning and I have 38.1 C of temperature, headache and body, sweat and very cold. I have to take the 1 gm paracetamol, taste and smell ok.
4:00 pm: I’m with 38.4. C. It was only 6 hours after the last feeding and back with temperature. I do not like.
9:00 pm: There are 3 hours left for the next fever reducer and I have 39.1. Unstoppable.
11:10 pm: I advance the intake of paracetamol.
23:55 hs: 38.0. I feel better, a little scared. That night was very difficult. You have to isolate yourself strictly. The fever did not go down yet and it only remained to wait for the immune system to respond with antibodies. The battle was in full swing.
The worst part was over and she was in the hotel, finishing the isolation period until final discharge.
It’s 10:14 am, I’m very sweaty, less headache, 36.8 (incredible), to enjoy feeling better. Take a paracetamol a few hours ago. Hopefully I arrive at noon without fever.
1:00 p.m. 39.2. Every episode of fever is a challenge. You do not know if it will go down again, or when, you cannot relax, you have to be alert and attentive. My whole body hurts like never before.
3:00 pm: 38.2, better
18:15: Feverish. A luxury.
21:10 39.4: This is not a common flu. My whole body aches and the fever looks like a jet engine at takeoff. Always on the rise, it squeezes, it is intense, you have to fight against it, Paracetamol is no longer enough for me. Another difficult night. I don’t like this topic, we’re not doing well.
9:00 am: Very tired, fever rises and falls. Now 37.8. Throughout the day the headache and fever come and go, wear down, attack and retreat, as in a war, the powers of both sides are measured. At times I feel like the virus is winning.
17:20: 38.4. How much longer for paracetamol? My follow-up doctor, a friend of life, calls me every day and follows my progress. He’s busy. He talks about taking me to the Sanitarium to take some pictures of my lungs and complete some tests. My wife, in her multiple role as nurse, psychologist, and counselor, supports this theory. The doctor inside me knows that this patient is not doing wellIt is already night and the fever continues, the pains throughout the body, the cold and heat, the lack of appetite, are all signs that speak for themselves.
On July 9 the « astronauts » come to look for me by ambulance, bound for Otamendi, where he stayed. The tomography shows Bilateral Pneumonia, blood gases show desaturation with hypoxemia. They start with corticosteroids, anticoagulants, anti-thermic, oxygen. Covid-19 wants to win, the picture is already severe. Doctors and nurses do their thing. Excellent professional and human group. Despite the isolation, the message comes through clearly; « Dr. he has to fight it « , » Give him that we’re doing well. » The watchword is not to loosen.
The doctor inside me knows the statistics, he knows that the saturation is not good, and that it has to rise, that the fever has to go, he knows that this bug is fought and won.
My wife accompanies me via WhatsApp at all times. My brother, cardiologist, colleague and friend is another unconditional support, my children are present. I am convinced that love also helps to heal and the virtuality makes the treatment amplify. The fight is more even.
And suddenly, all the parameters improve. After almost a week, I no longer need oxygen, the appetite returns timidly, one thinks about discharge, Intensive Therapy is moving away and the respirator. Recovery begins.
I completed the two weeks of isolation in a hotel and was discharged to my home, where I continued my recovery. I had lost 4 kilos in a few days, and the body had to regain its normal rhythm and metabolism.
After a few days, a negative PCR showed that there is no virus in my body and that I could go back to work. IgG antibodies showed a good immune response.
Dr. Mario Boskis
Today, I am back in my office, seeing patients. I share my experience with them and ask them to take care of themselves. This is not one more flu.
We went for a walk with my wife, to do some shopping, and I see that there are groups of people at the door of a cafe, with the wrong mask placed and without taking care of the distance, I grab my head. I mark the mistake and they look at me crookedly and suspiciously. I can’t believe the news in the media, when I find out that families and friends are getting together to celebrate a birthday or mass barbecues are organized. Teenagers in a bowling alley defy the basic rules of contagion, Europe with outbreaks. The world upside down.
Surely we will end up defeating the coronavirus in the long run or in the short run. The vaccine is close, and there are dozens of treatments in various phases of clinical research that are showing promising results for safety and efficacy. But let’s not trust ourselves, today the bug is there around the corner, in the community. Personally Thank God I did not have any sequels and my wife never caught it. Life returned to its usual speed and rhythm. An old and well-known phrase haunts my head: what does not kill you, strengthens you.
Mario Boskis (MN 74002) is a clinical researcher and expert in the prevention and treatment of heart diseases, Titular Member of the Argentine Society of Cardiology (MTSAC), Fellow of the American College of Cardiology (FACC) and directs his own medical center (Boskis Grupo Cardiológico) created by his father (an eminence in cardiovascular medicine) 65 years ago. Boskis is also the one who introduced the famous study called Eco Estres in Argentina.
I kept reading:
The moving message of a Brazilian doctor who died of COVID-19: « I got infected doing what I love, I would do it again »
24 hours in the life of an intensive care physician: 61 COVID-19 patients and the dramatic struggle between life and death