Historical Reflections: The Medical Heritage Center Blog

Voices in Humanism 

“Godzilla vs. Science”

Dr. Jeff Horowitz, Director of Pulmonary, Critical Care and Sleep Medicine, the Ohio State University Wexner Medical Center

“Our breathing ties us to each other. The atmosphere is a communal space, and lungs are an extension of it,” writes pulmonologist Michael J. Stephen in his book, “Breath Taking: The Power, Fragility, and Future of Our Extraordinary Lungs

The COVID pandemic has laid claim to its stomping ground, and like monster Godzilla, it crashed and thrashed through the world’s health. It seeks its vengeance in many ways, including merciless attacks on our lungs. The folklore nymph deity, Ondine, who has an actual breathing anomaly named for her, has definitely cast another cruel curse. Medical practitioners became part of the soldiers to battle the novel assault with the ICU as the final saving zone.

Dr. Jeffrey Horowitz M.D., a physician-scientist, started his position at Ohio State in January 2020. By March the first of the COVID patients began showing up. He has been a pulmonologist for 20 years but with the COVID treatment, “It was like learning to fly while you are landing the plane. Everything was changing so quickly,” he said, “it was an incredibly hectic time with medical decision-making, working out hypotheses, discerning opinion cases, implementing research protocols, all in a deliberate and thoughtful manner.”

Dr. Horowitz spent two hours on Sunday evenings communicating with colleagues going over the newest care guidelines and treatments which changed by the day. He said, “My approach is to remain calm, process the information and not overreact. Do things that we know work. Then apply the new approaches.”

Sporting a Chicago Cubs t-shirt, (he is from the western suburbs of Chicago), Dr. Horowitz happened to be one of the first to receive the COVID vaccine at OSU. By chance, he was in media photographs, the CNN B-role videos, and one of Governor DeWine’s videos on that historic day.

He was happy to be one of the first to receive the shot not so much for his own well-being, nor for the attention of the press, but to, as he put it, “be up front, be visible, ‘let me take the risk,’ lead from the front. That’s what leaders do though I have trusted the vaccine from the very start and I will feel good when 300 million vaccines have been given.”

He is an Avengers and Star Wars fan but when this writer brought up the heroism of Capt. America and those who treat COVID patients, Dr. Horowitz was quick to put any label of hero aside for himself, notwithstanding, the long hours, writing death certificates for 6 patients in 7 days, being separated from his family for 10 weeks in the beginning of the pandemic, and being new to the position when a pandemic struck.

“I am more like the reluctant hero. There are days when I say to myself, ‘what the hell am I doing here?’ We discover we are the right person to be doing it. There is the firefighter going into the burning building, or the police officer walking into the chaos. They are special. I am not unique, nothing special.”

Neil Armstrong was a “reluctant” real life hero. Hans Solo in “Star Wars” and Frodo Baggins in “The Lord of the Rings” are fictional reluctant heroes. We see reluctant heroes on the news speaking the same refrain as they save a child who fell through the ice or lift a car off the lifeless body. “I’m not a hero. I just did what needed to be done.”

Those called to action bear the burden of their missions selflessly. In the final comic book panel of the cling-master, Spider-Man, he says, “With great power there must also come great responsibility.”

In addition to those special people he mentioned, Dr. Horowitz offers this assessment. He holds considerable admiration for the heroics of the nurses. “They are the true heroes. They are in the rooms all the time.”

Despite many 16-hour-days, he checks his pace as one hour at a time, one day at a time. He is grateful OSU was never completely overrun like the hospitals on the east and west coasts. He does observe, however, the severity of the illness increasing and also recognizes the emotional trauma patients face post ICU interventions and a need for counseling for them.

One patient, he recalled, was “a big strong guy who had been intubated and was very scared. He panicked as we set up to intubate him. Then he went to the general med floor post intubation and he was still having shortness of breath and was so frustrated.”

A woman who had been intubated and required ECMO (extra-corporeal membrane oxygenation, in which blood is pumped through a circuit that provides oxygen, essentially serving to bypass the lungs) for several weeks. She needed a tracheostomy tube and a feeding tube, and over the course of several months, improved enough to be liberated from ventilator assistance. He met her in the outpatient clinic. She was still on oxygen and short of breath and involved in minimal activities. He said, “She will need a ton more rehabilitation and probably has scarring of the lungs. But, she just seems happy to be alive and was positive about things.”

Resilience in a pandemic is a necessary superpower for patients and medical staff alike. In Viktor Frankl’s book, “Man’s Search for Meaning,” he explains we have a freedom to choose how we will react in any situation. Frankl, a concentration camp survivor, wrote, “we cannot control what happens but we can control how we feel and what we do about what happens.”

Exercise when possible helps Dr. Horowitz, also watching movies with his 15-year-old daughter, while the other daughter is away at college. He has weekly video calls with his friends with whom he trained which helps. “This call is one of the good things we started during the pandemic,” he said.

A colleague friend of Dr. Horowitz’, from his University of Michigan days, posted a picture of a stairwell. Just a stairwell, and it was liked 60,000 times and shared 8,762 times. After two decades in the pulmonary field, Dr. Horowitz says, “We all know that stairwell. We have all had to take a moment in the stairwell.”

And then it is back to work with renewed courage and leadership. It helps to have intuitive Spider-Man “spider-sense” and in a pinch, when just hanging on is required, web shooting devices.

In his division director position, with 67 faculty looking to him for guidance, he says, “I need to keep my finger on the pulse of their morale because a big part of my job is taking care of my people. There is no respite. We’re the ones who have to do this. We were on the edge of a cliff for quite a while.”

 

Patricia Wynn Brown
Writer and Performer
Medicine and the Arts Board
Author: ESSENTIAL STORIES: Medicine During COVID-19 and the Lives of Practitioners at The OSU Wexner Center
patwynnbrown@yahoo.com