As cases of COVID-19 spike in some parts of the United States, we revisit our interviews with Skidmore alumni Mike Natter ’08 in New York, Diana Perry ’89 in Boston and Jonathan Brestoff Parker ’08 in St. Louis, who described their experiences on the front lines of the COVID-19 pandemic in the spring issue of Scope magazine.

Since his interview earlier this year, Natter, a medical resident with New York University Langone Health, says he is happy to report a significant decline in new hospital admissions, but the course of the disease is long and many ICU-level patients still require care. But, “we are starting to see the light at the end of the tunnel,” he said, expressing hope that the trend will continue with the gradual reopening of the city.

Perry, a neonatologist in Boston, says that since speaking to Skidmore in April, she had one of her most difficult pandemic experiences yet, separating a newborn patient from his COVID-positive mother. While she places hope in continued social distancing and work on a vaccine, she is concerned about large gatherings throughout the country, including during recent protests. “It is incredible that we have the confluence of a pandemic with the commencement of a social movement to combat the systemic racism that has been a part of the very foundation of our nation for over 400 years,” she says. “I will never lose hope for humanity and hope for a peaceful, egalitarian and healthy future for all of us.”

Parker says that because the St. Louis area fared much better than anticipated in the spring, the region started reopening in May. Research labs like his started to gradually reopen as well but are still adapting to a new “normal” that seems to change by the week. COVID cases are now on the rise again in Missouri. “We’re staying positive and adapting as needed to figure out how to stay safe and productive in this strange time we’re living in,” he says. Parker has been working remotely with Skidmore students Xinya (Sophia) Zhang and Alex Lewis on a summer research project focusing on COVID-19 outcomes in obese patients.

The battle in the epicenter

Mike Natter ’08, a third-year medical resident with New York University Langone Health who tends to patients at NYU Medical Center, Bellevue Hospital and Manhattan Veterans Affairs Medical Center, is used to treating a wide variety of maladies, from heart attacks to COPD- and diabetes-related issues to standard infections.

“Ninety percent to 95% of the patient population I've been seeing has been just COVID-19 patients, and that's very difficult,” he said in mid-April. “A, because obviously they're so sick. B, because they're so infectious. But being that this is such a new virus and we don't have many tools to fight it, it's been a feeling of helplessness from a medical standpoint.”

He and his colleagues have provided supportive care, putting patients on ventilators if they can’t breathe or giving them pain medication if they are in pain. But without a proven treatment, options are limited.

Natter had been working demanding 12-hour shifts prior to COVID-19, but the emotional component of this pandemic is unlike anything he has ever experienced.

“COVID-19 is vicious. We’re seeing a lot of death. We’re seeing people who otherwise are young and healthy become extremely sick and ventilated. And you worry about things that you didn’t worry about before, such as the volume of critically ill patients potentially overwhelming the health system in such a densely populated city.”

As the crisis evolves, Natter equates it to being in a dark cave and trying to feel your way forward. “We're all learning as we go,” he said.
Creativity has been at an all-time high as hospital staff try to mitigate the situation while limiting their exposure to the virus.
“Trying to manage patients without going into their rooms is antithetical to the training we all have as physicians,” Natter said. “We’re told you should be at the bedside. You should be doing a physical exam. You should be talking to the patients directly. You should be walking into the room every time something changes with their vital signs.”

The team has been “MacGyvering” solutions, as Natter puts it, using extra-long tubing to set up IV poles outside of rooms so nurses can manage pumps and IVs from a distance.

“Being able to think critically, but also creatively, is something that Skidmore sewed into my cerebral, allowing me to make creative decisions in my work and my art,” said Natter, who was a psychology major and art minor at the College and still uses drawing to decompress and express himself.

“Skidmore emphasizes creativity, and we're finding more need for that now, especially in medicine and science, which are otherwise historically structured and very set in certain ways. You need to have that creative mindset but still have that science foundation, and Skidmore combines the two and recognizes that things like medicine are both an art and a science.”

Amid all the suffering at the epicenter of this pandemic, he still finds reason for hope.

“I think the response from the front line, from my colleagues, from the nurses, my co-residents — especially the respiratory therapists — has been really amazing and the morale has been steady only because of them. That's been really beautiful to see.”

Fortitude against an invisible enemy

In mid-April, Diana Perry ’89 described what it is like to deliver an infant in the age of COVID-19. If she and the other attending hospital staff have no way of knowing whether a mother is carrying the virus, they prepare for the worst, as the asymptomatic carrier rate is so high.

But there is also hope in the delivery room.

“Every time a precious infant is born crying, I hear a collective sigh in the room as I am reminded that humanity has a future despite this terrible virus,” said Perry, who works as a part-time instructor in pediatrics at Harvard Medical School, an associate attending in newborn medicine at Boston Children’s Hospital and an attending neonatologist at South Shore Hospital just outside of Boston. “I know we will get a hold of this virus eventually. We must stay strong and just keep moving forward.”

She begins every morning with a meditative prayer for all the patients in intensive care units fighting for their lives on ventilators, and she relies on her strong Catholic faith to keep her mind calm. In September, she plans to run her ninth Boston Marathon, this time to raise funds for substance abuse programs at South Shore Hospital that have been cut back due to the pandemic. Running also helps her to de-stress and stay focused.

Her greatest fear is bringing the virus home to her two children, one of whom has asthma, so she is vigilant in every aspect of her daily routine and her cleaning habits have become obsessive.
“As a physician who has cared for other people’s critically ill infants for 26 years, I previously have never been afraid to enter the hospital. Never. What frightens me now is something so small and completely invisible to the naked eye yet so very powerful.”

Upon reporting to the hospital, she already has an N95 and surgical mask in place before lining up in the entryway, where 10 staff members at a time stand on strips of blue tape placed 6 feet apart. Friendly greetings and chit chat are sidelined as anxious physicians and nurses are screened for coronavirus symptoms before being permitted to enter.

“Pre-COVID-19, I used to float into the hospital each day, smiling and greeting multiple people,” Perry said. “Now, no one can see my smiles beneath my mask.”

This pandemic is unlike anything she or her parents, who have been physicians for 60 years, have ever seen. To deal with the immense psychological toll, Perry relies on her education as a sociology major at Skidmore.

“The big part of this COVID-19 nightmare is its effect on society and how our day-to-day lives have changed,” she said. “I have patients, parents of my patients, some of whom are sick with this virus, some of whom need to learn about different resources. My background in sociology has given me the wherewithal to help them.”

In serving on the College’s special coronavirus committee, Perry, who is also a Skidmore Board of Trustees member, was able to provide a realistic view of what the virus is like on the front lines.
“I think President (Emeritus) Glotzbach and his cabinet have done a phenomenal job of making sure students are being well cared for in this crisis,” she said. “I remember stating to the president on our very first conference call that this will be a long journey and we must focus on ‘facts over fear.’"

This is a very scary virus, but we will figure out how to beat it if we keep our fears in check.

Diana Perry ’89

For now, she counts herself fortunate to be able to help others in their time of need.

“I do love taking care of others and I know I risk my life everyday doing so during this pandemic,” Perry said. “I have no regrets. It is my calling.”

An arsenal of innovative research

As Jonathan Brestoff Parker ’08, medical director of one of the hospital laboratories at Washington University in St. Louis, Missouri, reflected on the magnitude of the COVID-19 crisis in early April, the physician-scientist trained in pathology was preparing to be called upon to care for patients directly, bracing for the disease to potentially hit St. Louis as hard as it has hit New York, Seattle and Boston.

“I have not experienced anything remotely comparable to this pandemic,” said Parker, who studied biochemistry at Skidmore. “The scale and pace of the COVID-19 pandemic are frightening.”

Hospital labs like Parker’s adapted quickly to support the COVID-19 response and to protect the health and safety of laboratory staff. His research laboratory, which typically focuses on understanding how the immune system affects metabolic diseases such as obesity and Type 2 diabetes, was forced to suspend that mission until normal university operations could resume.

Struck by data suggesting that patients with obesity and Type 2 diabetes may have much worse outcomes than metabolically healthy people, Parker shifted gears to perform clinical studies comparing immune cell responses and COVID-19 outcomes in patients with or without chronic metabolic disorders — research that could have an immediate impact on patient care.

There is a real sense of urgency because any solutions will come from science, research and innovation. I am now having to find creative ways to contribute to our health care efforts and am leveraging my skillsets in research to make a difference where possible.

Jonathan Brestoff Parker ’08

Employing creative solutions to confront and adapt to challenging situations is one of the many skills Parker says he learned at Skidmore. So, when he was asked to serve on the College’s special committee on the coronavirus crisis, he was eager to help navigate the unprecedented situation. “I was honored to participate because Skidmore made such a difference to me in my own personal journey,” he said.

As a member of the COVID-19 committee, Parker summarized new research, as well as the relative impact of travel restrictions and reducing local transmission on viral spread. As he listened and provided feedback, he was impressed by how holistically the committee approached the situation, with the primary goal of protecting the health and well-being of the Skidmore community.
“Skidmore’s leadership had to make some very difficult decisions to reduce community spread, and students, families, faculty and staff have made real sacrifices to contribute to that effort,” Parker said. “In the end, those sacrifices quite literally prevented illness and saved lives.”

While Parker says it is more important than ever for citizens to increase their scientific literacy, he also emphasizes the value that liberal arts disciplines bring to our lives and our ability to navigate crises.

“We are all affected by an overwhelming health problem that is being tackled largely using medicine and science, and it’s empowering to be able to understand the problems better,” he said. “But we need the arts, social sciences and humanities, too. I hope those who are able will blend these fields with science to help us all understand the enormity of what we are facing today and its impact on our lives and culture.”

---

This article appeared in the spring 2020 issue of Scope magazine.