Experiencing COVID-19 as a doctor and patient
 Matthew R. Shahan, West River Health Services CEO |
 Karl Viddal, MD, West River Health Services hospitalist and family medicine doctor |
As a rural doctor on the front lines of the COVID-19 pandemic, Karl Viddal, MD, recognizes the overwhelming stress health care workers are under. He also understands what it’s like to be a patient with COVID-19 fighting for his life. Viddal survived his own battle with COVID-19 last spring. The 46-year-old spent 55 days in the hospital, including 28 days in a medically induced coma, and 34 days on a ventilator.
He was one of the most severely ill patients early in the pandemic to recover with the help of a last-resort, lifesaving intervention. When he was at risk for organ failure, he was placed on extracorporeal membrane oxygenation, a life-support machine that sustains the heart and lungs during recovery from respiratory distress. “The doctors and nurses risked exposure to this virus on a daily basis,”
Viddal says. “They literally navigated through uncharted waters to treat the virus. I’m so grateful to the medical team that cared for me. If it wasn’t for this team of incredible physicians — their early interventions and their heroic efforts — I would not be here today. They gave me a second chance to be a father and a husband.”
Having dealt with the heart-wrenching decisions that arise with critically ill COVID-19 patients and their families, Viddal is grateful for the compassionate care he received as a patient at Dignity Health hospital system in Gilbert, Ariz.
“In retrospect, it is still hard to believe this happened to me, how drastically this virus can affect different individuals. Prior to COVID, I was healthy and without any past medical issues, and this virus nearly ended my life,” Viddal says.
After recovering from his illness and going through rehabilitation in Arizona, Viddal decided to return to the setting where he could continue to help others. He now works as a hospitalist caring for some of the sickest patients at West River Health Services (WRHS), a 25-bed critical access hospital in Hettinger, N.D.
Viddal completed his residency through the rural training track at WRHS in 2019 and has since returned to work part-time to help with COVID-19 surges.
Fighting COVID-19 in North Dakota
WRHS has six physicians based out of Hettinger who staff the hospital and five rural health clinics ranging from 26 to 60 miles outside of town. “The closest tertiary facility is two to two and a half hours away, and we try to do as much as we can locally, but our providers are stretched thin,” says Matthew Shahan, West River Health Services CEO. “Bringing in Dr. Viddal as a hospitalist allowed us to relieve the burden on primary physicians who are covering the hospital and driving out to clinics serving five local communities.”
“It was definitely interesting being on the other side of medicine,” says Viddal, who has been able to lean on his personal experience as a patient with the coronavirus, as well as his relationships with physicians in Arizona.
“Viddal did his residency training at WRHS, so we’re all familiar with him, and many patients know him too. We’re fortunate enough to have that relationship and bring someone in to help during our greatest time of need,” Shahan says.
A critical shortage of health care workers
Rural hospitals needed strategic plans for managing staffing levels in the wake of COVID-19 surges. Critical shortages of health care workers pushed hospitals to their limits, with burnout and exhaustion taking a devastating toll on doctors, nurses, and staff.
“Rural hospitals across America were already in a staffing shortage before COVID, and now we’re deep into a staffing crisis,” Shahan says. With COVID-19 cases rising quickly in North Dakota last fall, WRHS had to focus additional resources on caring for extremely sick COVID-19 patients.
“When COVID cases started surging in our state, it became clear that the tertiary centers don’t have the capacity to take on transfers from surrounding areas. We’ve been able to quickly adapt to meet the needs of our community, but the surge in COVID cases was a strain on our facility and staff,” Shahan explains.
"In retrospect, it is still hard to believe this happened to me, how drastically this virus can affect different individuals. Prior to COVID, I was healthy and without any past medical issues, and this virus nearly ended my life."
Having a hospitalist on staff is a new strategy for WRHS, and it helps alleviate the additional workload for on-call primary physicians. “We are acutely aware that our doctors, nurses, and staff on the front lines are facing risks to their own health every day, and we’re doing everything we can to keep them safe,” Shahan says.
Stronger together
“We’re finding solutions through collaboration with other hospitals. Working with other CAHs and tertiary facilities has led to discussions that help our community and our neighbors. We’ve been in constant contact with hospital administrators across the state on meeting the challenges of COVID-19, how to handle COVID-positive staff, and providing moral support. Through collaboration, we’re building efficiencies and learning from each other,” Shahan says.
In many cases, WRHS staff members are caring for people in their community who they’ve known throughout their lives, which Shahan says makes the losses even harder on health care workers who are already overwhelmed.
“I’m in awe of what our teams are able to accomplish under such stressful and dire circumstances,” Shahan adds. “The care they provide for patients is amazing. I couldn’t be more proud of what our front-line health care workers are doing.”
Viddal echoes that sentiment and offers a sobering message on the severe unpredictability of the virus: “Some people are lucky and only develop cold- or flu-like symptoms at worst. However, if this virus has your number, it will hospitalize you and potentially cause multi-organ system failure or death regardless of your age or health status. To date we can only speculate who will be adversely affected. Being infected by and treating this virus has been a humbling experience.”