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Transcript: WellSpan Internal Medicine and U.S. Army Reserve physician shares experience treating patients at New York City field hospital

April 24, 2020

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Ryan DeCort, D.O., WellSpan Internal Medicine and U.S. Army Reserve physician is among the first in the country to be deployed to New York City where he is working at an Army field hospital at Javits Center to support overwhelmed hospitals for six weeks.

This week, Roxanna Gapstur, Ph.D., R.N., President and CEO, WellSpan Health, connected with Dr. DeCort to thank him for his service and ask him about lessons he has learned from the experience that might be helpful to share with WellSpan teams continuing the fight against COVID-19. The following is a transcription of their conversation.

Roxanna Gapstur, Ph.D., R.N.: Dr. DeCort, thank you so much for being with me today. I appreciate you taking the time to speak with us. Thank you for your service to our country and also for your work at WellSpan in Franklin County.

Ryan DeCort, D.O.: I appreciate it, thank you!

Gapstur: We’d like to hear a little bit about your role in the Army and how you got involved in New York City.

DeCort: I joined the military back in medical school. I went to Virginia College of Osteopathic Medicine. I was there for about a year and a half and I heard about this health professions scholarship program that was offered through the military. I applied for the program, and I was accepted, and I had a lot of hesitation. You know, I don’t have any military in my family, so joining the military, I was like, ‘Oh no what am I getting myself into.’ But I accepted the scholarship and I was commissioned as a Second Lieutenant my second year into medical school. Then I finished medical school and you are promoted to Captain, and I went to William Beaumont Army Medical Center where I did my Internal Medicine residency. I stayed there for a year after residency and worked as house staff and then I took a mobilization up to Fairbanks, Alaska, where I worked as an Internist for the first year. I was promoted to Major at that time, and in the military as you promote higher your clinical responsibilities go down and your administrative responsibilities go up. I was there for about four years, and when I left, I was working as the medical director for all of the outpatient medical operations for Alaska.

So, as I said, I spent four-and-a-half years there, and I came to the point where I knew I wanted to come back to the community – the community that I knew – and I really liked working in Franklin County. I worked as a tech before I went to medical school, I was in the ER. I worked in the Emergency Room and I really liked the hospital, so I knew I wanted to come back there. I got out of the military and transitioned to the Reserve Unit, and I’ve been in the Reserves for two years now, while I’ve been working at WellSpan in Franklin County.

Gapstur: So, this is a normal deployment for you then? How did you end up in New York?

DeCort: I can still remember the day. It was March 29. I was in the office working and I got a phone call from my unit saying I had 24 hours to mobilize to our Reserve Center down in Fort Meade, Md. They didn’t know any further details. They didn’t know what we were doing, but they had a packing list and I had to be prepared to pack enough military equipment and personal things for one week, and once we got to Fort Meade, they would give us further instructions. I had to report to Fort Meade on April 1, and from there, it was just a whirlwind. It was crazy. Everything happened so quickly. We came to New York on the 8th of April. We got here, but we still didn’t know where we were being mobilized or deployed to until April 7, so there were a lot of unknowns because there are so many hotspots in the United States.

Gapstur: You’ve been in New York a couple of weeks then. I’m sure safety has been top of mind for you while you are there. Could you share a little bit about what it is like to be on the front lines in New York?

DeCort: The military – in the matter of 10 days – created these urban augmentation medical task force units. They are comprised of 85 soldiers and they developed 15 of them initially designed to help augment the health care systems that were just inundated with patient care to help offset some of that and give some of their own hospital staff a break. Then they created these field hospitals, like the Javits Center, so to me, it was just crazy hearing that within just a matter of 10 to 12 days we set up a 4,000-bed medical treatment facility – something that has never been done before. So, I was kind of excited, in a way, to come and be a part of this mission.

When we first arrived in New York City it was pretty amazing how you were welcomed. Walking down the city people were hanging out of their windows, on their balconies, just cheering for us because we were there to help them. That was very touching to know they were happy that we were there, and they were welcoming us.

It’s been a challenge working in a facility that was stood up so quickly. A lot of things that you would have in a brick-and-mortar hospital, you don’t really have here. We’re trying to develop different ways to give patients optimal care with the resources that we have, so that is a little bit of a challenge. You wouldn’t think about this but working in personal protective equipment and not being able to see your colleagues and who you are working with was a challenge.

The practice of medicine doesn’t change, but there are just barriers there. I never had to document in paper in my entire medical career. It’s always been an electronic medical record. This whole mission is paper, so trying to track down the paper chart, trying to find lab results, trying to find out what happened during your shift – communication is big. Yeah, it’s a challenge, for sure.

Gapstur: It sounds like you’re making your way through those challenges one by one and providing great care to patients. I think that’s a really neat experience you had when you arrived there and people were cheering. Probably a once in a lifetime thing for you.

DeCort: Yeah, absolutely.

Gapstur: Here in Pennsylvania, we see our curve flattening a bit which is a great thing, but I’m wondering if you have any advice for us as we continue our preparations. We do think we will have some increase to our patient needs in our hospitals, so anything from the front lines of New York you think would be helpful for us here in Pennsylvania?

DeCort: We are starting to see our curve flatten as well, which is a good sign here. Continuous social distancing – honestly that is the biggest thing. For medical professionals, or when you are on the frontlines, I think the biggest thing I would say is we need to identify our resources early, and after we’ve done that, we need to continue to do daily checks on the resources we have. There’s going to be some resources that we requested and we don’t have. There are going to be some resources that we have that we never even asked for, and we want to ensure that we are using these resources appropriately. Resources to me include our personnel, our equipment, our standard practices. We want to ensure we have clear roles and responsibilities, that they are determined up front and you have great communication with your personnel -- that is key.

Gapstur: Yes, that is great advice, thank you. It will be helpful for us as we continue to prepare. I’m curious if you’ve seen any patient treatments or clinical care that you think would be helpful for us here.

DeCort: I will tell you the biggest thing that has helped our patients here. COVID-19 is affecting the respiratory system, and we’re seeing significant improvement with proning (positioning patients to lie face down). The protocols are always changing, and you just need to be flexible. Everyone’s different and every patient acts differently. You just have to support the patient.

Gapstur: Absolutely, that’s so true. Any words of advice you would impart to your colleagues here back home?

DeCort: Just be flexible. Be understanding. It’s very easy to get overwhelmed. We are all in the same situation. We are all in this together, and it is okay to ask for help.

Gapstur: That’s great. Well, Dr. DeCort, we know your time is precious and you are needed on the front lines there in New York, so I would like to thank you for being willing to speak with us today and sharing your experiences so they can help others back home in Pennsylvania. We look forward to you returning home soon. Thank you, very much.

DeCort: And thank you so much for the opportunity, I appreciate it.