The cars streamed into the hospital parking lot close to midnight as the family of Hoang Dinh Nguyen rushed to say goodbye. At 72, he had survived war in Vietnam, a harrowing escape by boat, two strokes and cancer. Now, he seemed certain to succumb to the novel coronavirus.
Earlier this Thursday night, March 19, Swedish Medical Center in Issaquah had called: Nguyen’s condition was rapidly deteriorating. They said he would suffer less if taken off a ventilator and moved to comfort care, said Nguyen’s son, Vince Viet Nguyen, who got the call. “They weren’t going to do it until we were there.”
Strict protocols to prevent the spread of COVID-19 meant only two family members could go to the ICU where Nguyen lay, and no one but medical staff could enter the room. His wife, seven of his sons and daughters, and a few other relatives drove to the hospital anyway, as did a Catholic priest the family quickly called.
There in the parking lot, Father Thanh Dao led the family in prayer. Some stood in a circle, spreading out to maintain social distancing. Others, like Viet, self-isolating because his husband was showing possible coronavirus symptoms, popped their heads out of sunroofs.
And then, the priest, Nguyen’s wife, Ty Nguyen, and their daughter, Cuc Crystal Nguyen, went inside.
What happened next — like the sequence of events the week before as Nguyen fell ill — took everybody into new territory. The complications brought by this highly infectious and potentially lethal virus never seemed to stop, even after death.
“There’s always a flying piece that comes out of nowhere,” Viet said. “It’s just happening so fast and crazy.”
Amid the challenges and heartbreak came ingenuity and compassion, the latter particularly shown by a nurse Crystal describes as “fearless.”
Finding a way
“No matter what adversity he faced, he always found a way to push through it,” Viet said of a father he described as quiet and kind.
During the war in Vietnam, Nguyen used his service in the military in the North to get his wife and children to the South, according to Viet. Nguyen put them in the back of a military truck, under a blanket.
They lived in the South for a time while Nguyen had three boats built. The family set out on the South China Sea, taking along penniless strangers, after the war ended and communism took hold. As Viet heard the tale, they traveled for months, his mom pregnant with him, looking for a country that would take them. A freighter finally picked them up and brought them to an Indonesian refugee camp, where Viet was born.
Eventually, they came to the U.S., where the youngest and ninth child was born. Nguyen initially worked the berry fields of South King and Pierce counties, and later turned to manufacturing and construction. Ty also worked at times, in factories making clothing and other items.
Their father, Crystal said, was the main financial provider. “He took care of all of us.”
“We all went to college,” added the real estate broker, who lives in California. Viet, who lives in Renton, works for a company providing social work to low-income seniors. Another sister is a respiratory therapist, newly drafted by a Seattle hospital to shore up its ranks during the pandemic.
Nguyen loved growing bonsai trees and taking care of animals. Growing up, the family had koi fish, rabbits, chickens and pigeons. He could also build anything, including a deck and terrace for one daughter’s house, Crystal said.
Around a dozen years ago, Nguyen developed skin cancer on his neck. Damage from radiation treatment caused him to lose most of his eyesight. More health crises followed, including a stroke that paralyzed one side of his body.
Viet and one of his sisters tried to care for him. It proved too difficult. In 2018, the family brought Nguyen to Issaquah Nursing & Rehabilitation Center.
“They’ve treated us like family,” Viet said.
When he heard a resident tested positive for coronavirus in early March, about a week after COVID-19 deaths started to hit Life Care Center of Kirkland, Viet was concerned about both his father and the staff.
The Issaquah facility banned visitors to try to prevent an outbreak, said spokeswoman Nicole Francois. But more than a dozen cases followed. The nursing home kept residents with possible symptoms in their rooms and called local politicians and health officials asking that all roughly 80 residents be tested.
Eventually, local and federal health officials tested all residents who agreed, and some staffers. There weren’t enough tests, at least initially, to test all employees, Francois said.
When Nguyen was tested, he wasn’t showing symptoms, Viet said. But the following night, the nursing home called to say Nguyen had a slight fever. Two days later, Sunday, March 15, it spiked to over 100 and the facility sent him to Swedish Issaquah’s emergency room.
Within hours, the results came in from Nguyen’s test a couple days before: positive.
One of the coronavirus’ distinguishing characteristics is the speed with which it can kill, particularly older people with existing health conditions. Nguyen’s death was imminent, hospital staff told his family, according to Viet.
Crystal and a couple of other siblings were flying in from California. Family members here said what they thought were their last words to Nguyen through a glass door.
Unexpectedly, Nguyen got a little better. And then he got worse.
During that time, Viet said, he sensed an undertone from the hospital. As he paraphrased, “there’s just not enough resources out there for your father to be on a ventilator forever.”
That was never said directly, according to Viet. “The doctor was pausing a lot,” he said of one conversation.
Swedish spokeswoman Tiffany Moss said privacy laws prevented the hospital from commenting on an individual’s care. As for how long patients are kept on a ventilator, Moss said doctors told her “a medical decision like this is made on a case-by-case basis, and depends largely on a patient’s immediate care and treatment needs.”
Ultimately, Viet said, “it was our choice.” When the hospital called March 19 with dire news, indicating it was time to shift to comfort care, Viet, who has power of attorney, consulted with family members. They debated. Weighing heavily, Viet said, was the likelihood Nguyen had suffered lung damage and risked getting pneumonia and going into cardiac arrest.
“We just want to make sure he doesn’t have any pain,” Viet said when he called the hospital back.
Ty thought her husband had passed away when she, Crystal and Father Dao saw Nguyen through the glass in the ICU. His skin was discolored, Crystal recalled. But he was still breathing on the ventilator.
Nurse Judy, as Crystal came to know her, was with him, wearing a mask below her glasses, protective head covering, gloves, and a yellow gown covering her from neck to shins to wrists.
She was from Texas, Crystal learned. As this area became a coronavirus hot spot, Swedish brought in nurses from around the country who travel where needed, according to Moss. Nurse Judy took on an extraordinary role.
Neither Dao nor another priest called by the hospital could get into the room to deliver last rites. So Nurse Judy dipped a Q-tip into oil brought by one of the priests and made a cross on Nguyen’s forehead and hand. The priests called out instructions and recited prayers through a walkie-talkie.
Nurse Judy gestured to Ty to press her hand against the window. The nurse held up her own hand to meet it on the other side of the glass and put her other hand on one of Nguyen’s feet — connecting husband and wife.
A respiratory therapist came in to help disconnect the ventilator. Crystal used the walkie-talkie to talk to her dad. “Daddy, wake up,” she said. His eyes remained closed but she saw his chest move. Keep breathing, she urged. Ty, seemingly resigned, told her husband by walkie-talkie to call a son who had died many years before and ask him to take Nguyen to heaven.
Crystal connected to those in the parking lot by video group chat with her phone and held it so they could see Nguyen. “We love you daddy,” they called out as Crystal broadcast their voices through the walkie-talkie.
“Those images burn into your head,” Viet said.
After everyone had said goodbye, suddenly, Crystal could see her father’s chest stop moving.
In the past, Nguyen had made two requests about death, according to Crystal. One was to be buried rather than cremated. The other was not to die alone.
When death came, Crystal said, her dad knew everyone was there, “that the coronavirus that is isolating everyone was not going to stop my mom or me or my siblings from seeing him at the very end.”
A suit, a rosary, a phone
The hospital said Nguyen’s body needed to be taken away immediately, according to Crystal and Viet. It needed the name of a funeral home before Crystal and Ty left.
In the parking lot, Viet said, “we were scrambling to get them out.” It was the early hours of the morning. Columbia Funeral Home & Crematory picked up the phone and agreed to come.
Crystal later went to the Rainier Valley funeral home to drop off one of her brother’s suits, a new pair of shoes and socks, a rosary and a phone that had family members’ numbers programmed in “so he can always reach us,” Crystal said. The family had been told dressing the body was out, but a suit could be laid over the body bag in which Nguyen lay. The other items were for the casket.
Crystal said the funeral home staffer who met her in the parking lot “looked at me like I was a ghost.”
What caught funeral home director Roxanne Wright’s eye, she said, is that some of the items were in a bag from the hospital, and therefore possibly contaminated. “It was concerning,” she said.
When the funeral home picks up a body in COVID-19 cases, it uses chemicals to disinfect the bag containing the remains and then seals the body and disinfected bag in a new bag, Wright said. Similarly, Nguyen’s items and the hospital bag would have to be disinfected and put into a biohazard bag, the funeral home determined. That bag would be placed on top of the bag containing Nguyen’s body.
The burial was to take place last Tuesday without family attending, in accordance with Gov. Jay Inslee’s mid-March ban on funerals and other gatherings. (The governor over the weekend said funerals could go on if attended only by immediate family members.) As funeral home staffers were getting ready to place the body into the casket, they got word the cemetery had called to postpone.
Richard Peterson, who oversees Catholic cemeteries around the Puget Sound region, including the one where Nguyen was to be buried, said he wasn’t sure initially whether Inslee’s stay-at-home order the night before applied to cemetery employees.
“We’re trying to figure all this out,” he said, adding he was trying to keep his employees safe while touching caskets and interacting with funeral home directors who may have met with family members exposed to the coronavirus.
Peterson then learned cemeteries are considered essential businesses under Inslee’s order, their workers exempt. Burials could resume.
“We understand,” Viet kept saying at every frustrating turn.
He had taken to Facebook to let people know this virus was real and social distancing a necessity. The pandemic was affecting so many members of his family, including a sister-in-law who is a doctor taking care of COVID-19 patients at St. Joseph Medical Center in Tacoma.
While the Nguyen family waited to hear about a new burial time, Crystal, her sister Patricia Phuc Nguyen and two nieces started sewing cloth masks for health care providers and other first responders. The masks don’t offer the protection that N95 or surgical ones do, but with supplies of both running low, people around the country are making what they can.
“We have made 18 so far and have like 2,000 more to go,” Crystal said Tuesday. Some would be delivered to Swedish as a thank you to Nurse Judy.
On Wednesday, Nguyen, finally, was laid to rest.
Staff reporter Paige Cornwell contributed to this report.