When he unexpectedly did not die, and they weren’t quite sure why, some of his nurses took to calling Michael Flor “the miracle child.”
It was part joke, as he’s actually 70 years old. But it was partly in reverence. Because by a quirk Flor was born in 1950 in the same Seattle hospital system, Swedish, that he ended up in for the past two months struggling to fight off COVID-19.
He’s Swedish’s longest-hospitalized coronavirus patient, by far. When he went into the hospital March 4 there were only 149 confirmed cases in the entire country. Now there have been 1.2 million.
He was on one of those dreaded ventilators for more than four weeks.
“He was as sick as you can get, with basically every organ system shutting down,” says Dr. Anne Lipke, a Swedish pulmonary and critical-care physician.
At one bleak point Flor was so close to death the doctors told his wife and two kids that it was probably over. No visits were allowed to the quarantined patients’ rooms, so a night-shift nurse held a phone to his ear while they choked out their final goodbyes.
But on Tuesday, 50 or so doctors and nurses — most of whom had helped on his case because he had been there so long — clapped him out of the hospital in a boisterous sendoff.
“Sunshine!” Flor yelled when he got outside. He was wearing a Superman T-shirt.
He hadn’t heard those wrenching goodbyes from his family anyway, he says. He doesn’t remember much beyond eerie figures in hazmat gear looming at his bedside. Probably better that way — a nurse told him, “you don’t want to know what we did to you.”
“It’s all news to me,” an ebullient Flor told me. “It’s like I’ve missed the whole pandemic. There’s five or six weeks of just nothing.”
He’s like a Rip Van Winkle for the coronavirus era. When he finally started getting his senses back, last week, he was astonished at the new world around him. That a quarter-million have died worldwide. That all the schools are closed. That there are no traffic jams in Seattle.
He was especially startled to see a pitched political fight going on about whether COVID-19 is really a serious illness.
“I’m back from the dead, and I can tell you,” he said. “This will kick your ass.”
Most patients with severe cases either get better or die within a couple of weeks. Flor stubbornly did neither.
When he came home early from work in March with a bad cough, the first known COVID-19 death in the U.S. had occurred only three days earlier. Nothing was shut down yet. He didn’t think his cough was a big deal, but his wife, Elisa Del Rosario, insisted on driving him to the emergency room.
He tested positive for the new coronavirus and was transferred to the intensive care unit at Swedish Issaquah. Within a few days his lungs deteriorated, so he was intubated and put on a ventilator, an intensive-care breathing machine.
What followed was six weeks during which doctors threw everything at him they could think of. His lungs filled with fluid, his heart weakened, his kidneys shut down. As happens to lots of COVID-19 patients, he developed blood clots. His immune system had what Lipke called an “over-exuberant inflammatory response” in fighting the virus. It crashed the rest of his body.
They gave him blood transfusions, super doses of vitamin C and multiple trials of the experimental drug remdesivir. It isn’t clear what, if anything, worked.
“I don’t know if I’m really supposed to say this,” Lipke said, but a heart doctor at Swedish came in to work one Monday and confided to her that “he really couldn’t believe Michael had lived through the weekend.”
“I’ve never been through such a difficult life experience,” Del Rosario says. “My breast cancer was one thousand percent easier than this. There was a textbook for that, but this was a roller coaster.”
Lipke also went old-school, as she put it, by inserting a catheter through Flor’s heart and into his lungs. It’s a technique for analyzing heart function that she said isn’t much used anymore. But it allowed them to hyper-tune his care, just as his heart was failing.
The night of the final goodbyes, Del Rosario was told the hospital would call her when he had died. She slept clutching her phone. The call never came.
“His stubbornness finally served him well,” she jokes.
Still, he was on a ventilator for two more weeks after that.
Flor’s only memory is rotating shifts of nurses and doctors, following a ritual of donning plastic protective suits and headgear whenever they came into his room. Some of the nurses had flown in from Tennessee and Texas to help. He started weeping when he told me about that. He can’t stop thinking: Who flies across the country to risk their own lives for you?
Lipke says that unlike in New York and Italy, the hospital system here never got overwhelmed. Maybe it was because Seattle got so much attention as the first hot spot, or because of early efforts here to “flatten the curve.” Even at the peak, in late March when there were nearly a hundred hospitalizations a day locally from COVID-19, the hospitals had the bandwidth to handle it.
“It doesn’t make for sexy headlines, but I think the lesson here is that being able to do really meticulous critical care works,” she said. “That’s care on a consistent basis overseeing multiple organ systems at once, and we were able to keep doing that with him. But if you get overwhelmed, and both patients and practitioners think this is becoming an insurmountable disease, then it becomes an insurmountable disease.”
In other words: The miracle child’s survival wasn’t so much of a miracle, after all. Which is the most hopeful news for the rest of us I’ve heard yet.