FIRST-HAND ACCOUNTS FROM DOCTORS WORKING IN RURAL TEXAS.

SHARED WITH KHOU 11 VIA

EMAIL.

Editor’s note: some material edited to protect doctor’s location.

#1

I was working at an ER in Tulia, a small town 45 minutes south of (near) Amarillo. I had a prisoner with
an acute GI bleed who needed to be transferred, and we had to get permission from the prison because
their contract required NWTH or UMC in Lubbock, and (hospitals in Lubbock and Amarillo ) were on
diversion. Later in the week I had a patient with rectal prolapse. We were able to reduce it, but if not the
options for surgery were Plainview or Dallas.

#2

I have been working in rural ERs in West Texas during the pandemic. The number of patients seen and
severity of patients in the ER has been significantly increasing each month since the onset of the virus.
During the last few weeks, it has been very difficult to transfer people to nearby tertiary centers. A few
of the patients I have transferred went as far as Phoenix and San Antonio.  One patient needed transfer
to the Phoenix area just for dialysis alone that was not COVID related. Some of these rural hospitals are
having to manage patients who meet ICU criteria though they lack the resources and nurses with the
proper training. Luckily, state funding has allowed rural hospitals to acquire hiflo and other COVID
related respiratory resources that are allowing patients to stay and receive adequate treatment within
their community. One of the most difficult things about floating around to different ERs in rural West
Texas is seeing the number of nurses and support staff at the hospital that have become ill. I will work in
a hospital one weekend and return to that hospital the following week to see some of the nurses,
doctors, or support staff not there. Oftentimes it’s because they are taking care of a loved one who is
sick, but recently, some of them have been hospitalized themselves with COVID or even worse are on a
ventilator due to the virus. It’s very difficult to keep your spirits up during this time! These small towns
are so connected, and it’s saddening to see the hospital staff in these communities having to take care of
their relatives, neighbors, and friends. The amount of energy and emotions that these doctors, nurses,
and support staff have poured into taking care of COVID patients is heroic. One defining characteristic of
people living in West Texas is that they are strong. This strength is derived from living and thriving in an
area where basic resources and amenities afforded to most don’t exist, and the bond you share with
your community is resilient.  

#3

So, during a very busy week working on our hospital service, in addition to all the normal medical
admissions we would handle, we were also admitting an average of 5 really sick people with COVID-19
every night shift.  With our ICU capacity overwhelmed  to the extent that many of our emergency beds
were turned into an ICU hold status (meaning they are technically admitted to the ICU, but there is no
room at the inn, so they remain in the ER), we had to transfer a patient out of town who was in
respiratory distress and needed an ICU bed in addition to urgent therapeutic hemodialysis as the patient
had known End Stage Renal Disease on top of his acute respiratory problems.  In the 3 years since I came
here, I have never seen this happen.  We treat a lot of patients with kidney failure, and normally have no
trouble whatsoever in dialyzing them, but this is just one of the many ways our system is crumbling
under the weight of COVID.  It’s not just ventilators and ICU beds.  It’s a lot of routine care, and major
staffing shortages caused by infection and quarantine concerns.  We are normally the place that outlying
hospitals call for help; now we are not only turning transfers away for lack of capacity, we are on the
phone ourselves searching for someone, somewhere that can take our patients!