Craig: The First Confirmed Case

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It’s early 2020. COVID-19 begins to spread around the globe like wildfire, and many people –– particularly in the US — are stunned. But then there are doctors like Craig Spencer, who specialize in public health and know all too well the devastation that infectious disease can cause. Having worked to combat Ebola in West Africa years before, Craig recounts what it was like to be on the frontlines of highly contagious and deadly diseases across the world. Nearly four years after COVID made its way to the United States, Craig sits down with Stephanie to reflect on where we are today — and how much further we have to go.

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To follow along with a transcript, go to shortly after the air date.



Stephanie Wittels Wachs, News 3, News 2, News, Speaker, Dr. Craig Spencer

Stephanie Wittels Wachs  00:00

Hi Last Day listeners we at Lemonada are working on a show about caregiving for elderly loved ones. If this is something you know about, we want to hear from you. Maybe you’re part of the quote, sandwich generation like me and have small kids who need everything from you all the time, and are also caring for your parents. Maybe after decades of marriage, you are now a caregiver for your spouse and feeling lonely and burned out. Or maybe caring for your dad has left you without any savings. Whatever the situation, if you’re caring for an older person in your life, we want to hear what caregiving looks like for you. All you have to do is record a voice memo and send it to uncaredfor@ That’s uncared for U N C A R E D F O R, one word Anything from just 30 seconds all the way up to five minutes works share the struggles of caregiving, the joys and everything in between. We look forward to hearing from you. Just a heads up this episode includes mention of suicide, please listen with care.


Dr. Craig Spencer  01:10

For our staff to like, go home, see their family get sick worry about getting their family sick. Do this day after day after day after day for months, trying to keep myself safe every day writing in my notebook like what are the exposures that you had today? Did you have any breaches in your personal protective equipment? Do you feel like you know that one time when your mask was really wet, something could have gone wrong. It was very clear that like the psychological trauma of what we saw what we did, and just being in that environment could have these profound physical manifestations, but everyone pushed through. And I did the same.


Stephanie Wittels Wachs  01:47

Dr. Craig Spencer is describing the harrowing experience of being in a hospital and staring down bed after bed of very sick patients fighting for their lives. Sometimes these patients make a recovery they survive. But for the very young and the very old. All Craig can really do is hold their hands, share their space, and ease their pain. Now this picture may sound and look and feel like the United States in the spring of 2020 when we saw the onset of COVID 19. Actually, it’s 2014, and Craig is in Guinea with Doctors Without Borders, treating Ebola patients. At the time, he had no idea that only six years later, he’d be facing yet another terrifying infectious disease this time, right in his own backyard.


Dr. Craig Spencer  02:47

It was March 1st that we had the first confirmed case I believe in New York City. And it was like trickle, trickle trickle. They lose, in the span of like a week. It went from trying to find that one person in the emergency room that might have COVID to trying to find one person who didn’t.


Stephanie Wittels Wachs  03:18

This is Last Day, a show about the moments that change us. I’m your host Stephanie Wittels Wachs. Today, we are telling the story of a virus, a virus that changed all of our lives overnight, told through the eyes of a doctor who had seen it happen before and tried to prepare us for when it would happen again, on a scale we never could have imagined.


Dr. Craig Spencer  03:53

So my name is Craig Spencer, I am a few things. I am a parent to two young, wonderful people. I am an emergency medicine doctor. And I’ve been working in emergency medicine for gasp it sounds like forever 15 years. And I’m now out the public health school at Brown University, where my focus is looking at basically how history informs the present of public health.


Stephanie Wittels Wachs  04:18

Craig has spent much of his career as a doctor responding to crises both here and abroad. But before he was trying to keep the world of Public Health from repeating its own mistakes. Craig was a kid in Michigan with a much simpler dream.


Dr. Craig Spencer  04:32

But initially the goal was I was going to be a shark ecologist. And I was also going to play part time I guess, apparently for the Montreal Canadiens as goalie. I don’t know how it was going to balance those two things, but I was nine and that made perfect sense.


Stephanie Wittels Wachs  04:47

Unfortunately, Craig later discovers that a psychologist is not a real thing. Also, although he does play hockey, he is no goalie and that doesn’t bode well for his sports career. So at the ripe old age of 11, Craig starts to reevaluate what he’s going to do with this life.


Dr. Craig Spencer  05:07

And I was in a social studies class one day, and we were looking at microfiche, and it said, a cardiothoracic surgeon can make like 120 or $130,000 and I was like, whoa, that is the most money of all of these things, on this microfiche, clearly, that’s what I’m gonna do. And so from that moment on, I committed myself to being a cardiothoracic surgeon. And I didn’t know exactly what a man I think it kind of like stumbled out of my mouth whenever I said it. But I became proficient enough and saying what I was gonna do. I learned everything about the heart. I knew how it worked, the electricity, all these I was like, this is what I’m going to do. So much of that, I met a cardiothoracic surgeon once and they’re like, actually, you don’t want to do this this kind of sucks. I’m like, yeah, I knew I know more than you.


Dr. Craig Spencer  05:59

I walked into med school, convinced that I would be a cardiothoracic surgeon. I told everyone I was going to be a cardiothoracic surgeon. And that was the plan. until sometime in the middle, or towards the end of my first year in medical school, one of my friends was like, hey, what are you doing for the week off? And like a summer vacation as I don’t know? And said, well, I’m going down to the Dominican Republic with this World Health Student Organization group, and we’re gonna go like, help I was like, okay, I don’t know that I can help with anything but like, okay, cool, I’ll come. I’ve never really left the country all that much beforehand. And I went down to the Dominican Republic and the hospital that we were working in, as we like, walked in, like the senior doctors were leaving, because they hadn’t been paid and the residents were kind of running the place. And I remember walking in to this hospital in Dominican Republic and just kind of like being blown away that this existed, that, you know, people were being, you know, treated or not treated in such tough conditions. And to see how much both the physicians did, the nurses did, but also like families did to help their families. And they loved him massive impact on me, and I went back home and thought, alright, maybe I can be a cardiothoracic surgeon somewhere else in the world.


Stephanie Wittels Wachs  07:15

As it turns out, Craig’s still wasn’t done questioning what he was going to do with his life. And at 27 he takes a year off medical school to study abroad in China, where he meets his future wife. After returning to the States, he does his residency in emergency medicine at a hospital in Queens. And it’s while doing this work that Craig discovers his true passion, helping communities where the need is greatest, yet deeply underserved. This is what leads him to volunteer with Doctors Without Borders in 2014. At the time, Ebola is ravaging West Africa, and the organization has set up a treatment center in Guinea where the deadly disease is spreading, and conditions are getting worse.


Dr. Craig Spencer  07:57

Now shows gonna go to Guinea because that nine year old self of me that wanted to be a goalie for the Montreal Canadiens, and I started learning French. And I continue that, and Guinea was, you know, primarily French speaking, and so I was, I was sent there to be part of the response with Dr. suborders, and I was with maybe a half a dozen other folks that were working with me in the same project. And we were among the only people on this massive Air France flight into Guinea, I have pictures of, you know, an empty first class and empty business class, you know, honey, and like, seemed like a hundreds of seats, like a sea of seats that were just kind of empty, with a half a dozen of us just kind of all hold huddled in the middle, and that’s kind of when it really hit me that I was, you know, going into an area of incredible uncertainty, but also of really incredible need, and the fact that like, it was so critical to be able to get providers and supplies in as easily as possible. And so I was super grateful that I was able to get in, showed up in Guinea, and kind of started amongst the, you know, five to six, most distressing weeks of my life up until that point.


Stephanie Wittels Wachs  09:11

Craig has spent most of his career going where his patients needed the most. But now he’s dealing with a disease like Ebola, which is highly contagious. And that means there’s something else he has to consider his own life.


Dr. Craig Spencer  09:26

You know, there was this narrative at the time in 2014, really, in September of 2014. Just as I was getting on that plane, there had never been to that point, kind of an international staff working with an organization that had ever been infected with Ebola. That’s despite, you know, responding to a bunch of Ebola outbreaks, you know, for almost 20 years. And so that in itself was encouraging, like, yeah, it’s tough and it’s scary and it’s crazy. But like, honestly, there’s been so many people that have come before me a lot of people I’m working with that are training me. They’re saying like the protocols are rigorous and incredible and it It is going to be tough, but you’re going to be okay. And it was really, like right before I left that there was the first of our international staff that had been infected. And that’s kind of like tore down that wall of impenetrability. And there were people that I was training with at that time that decided to go home. And I said, you know, I kind of committed this far. And if people like myself, quite frankly, that like, feel comfortable working different places have skills to work in those different places, are willing to work in those different places. I like not doing it, then who’s going to do it? I would go in in the morning at like seven in the morning. And we would walk down the hill, we would have because it was you know, kind of like a French European mission like the need breakfast, they had like a cup of black coffee, and a little VOSH key read those little like cubes of cheese, and I was like, this ain’t a breakfast. Do you know what I’m about to go do for 12 hours come out and talk with the people that I you know, I adapted it, it was okay, because it got hot, and it was kinda humid. And we’d go down, walk down to the Ebola treatment center. And we go in, we go through the whole process, take off our clothes, put on Scrubs, walk through kind of decontaminated, make a plan for the day. And then within you know, half hour would be in one of those yellow Tyvek suits and a hood and some goggles and would be going in to really take count of the horror that had really taken place overnight. Ebola was just like, it was so mean. And you could see someone in the morning, that looked fine. And then you afternoon, come back and you know, be told that they died. And it was really, really tough. But I think we all kind of put that to the side, because it was just like more people that came in and there was not enough of us. And there was like three or four doctors for 60, 70, 80 patients. And every person that you want to do something like put in an intravenous line so you could put them on like a drip for some fluid. I was like a 10 to 15 minute activity to do to do correctly because you can’t do it incorrectly. Because the risk is if you get stuck with a needle that was you know, in someone that had Ebola in their arm and you stick yourself mistakingly like you’ll die. It was just that. So yeah, I was afraid. I was around folks that had been there for some time, the local staff were just absolutely amazing. All the Guinea and doctors and nurses that I worked with were just, I mean, heroes beyond words. And that showed up every single day and had gone home to family who had been sick and took care of them after they gone home. And I went home at the end of the day, and the day sucked and it was 12 to 14 to 16 hours, and we went in a bunch of times and it was sweaty and tiring and you know, y’all you had with some Valkyrie and some kinda crappy coffee to make it through the day sometimes. And that sucked, I can only imagine what it was like, because I got to go home and have a beer and sit and relax and for our staff to like, go home, see their family get sick worry about getting their family sick. Do this day after day after day after day for months. I just to me, it’s absolutely unimaginable, and they didn’t get enough credit for everything that they did. It was tough because at that time, there weren’t vaccines, really, there weren’t good treatments for Ebola, it was kind of just a cross your fingers and hope for the best. And if you’re younger than five and older than like 60, the likelihood that you’re going to make it is really, really, really dismal. If you’re in the middle of that range, and you’re well nourished and don’t have a bunch of health problems, the likely that you’ll make it is a lot better. But a lot of it was just kind of out of our hands, and so we did everything we could, putting an IV is giving medications, treating symptoms, giving dignity holding someone’s hand, you know, things like that, when people are in these kind of, you know, these tents, and seeing so much can have death and destruction around them again, like, despite how horrible it must seem for me, and gobsmacking It may sound like I got off easy.


Stephanie Wittels Wachs  14:04

After six overwhelming weeks at the Ebola treatment center, Craig flies back to New York, it’s October, and he returns home to peace and comfort. And that is when everything he’d seen hits him hard.


Dr. Craig Spencer  14:20

Having gone from, you know, a month and a half of seeing what I just just described, you know, every day saying you know, maybe half the beds in any space with someone died or you know, empty waiting for another patient because someone died overnight. I would got good at putting that off and not dealing with it then, but ended up dealing with it when I was back in New York City. And so being at home, feeling really kind of profoundly depressed. Asking questions like could I have done more? What could we have done more? What about people that are left behind? Things like that, that you just and I wasn’t working clinically I wasn’t allowed to go back to work. And so it’s kind of just like sitting around, which for an emergency doctor is probably the worst possible form of punishment. I tried to find ways to cope and adapt, and you know, would try to go for a run or try to do these other things but there was one day when a good friend of mine was like, man, you’re a hot mess. We need to get you out of the house. And I was like, I don’t want to leave the house. I’m fine here. I want to leave, but I don’t want to leave. And so he was like no, we’re gonna, like, take the train, come down here we’re gonna, like, I don’t know, go bold and do something. It’ll be fun. I was like, I don’t wanna go. I ended up going and ended up the next morning, waking up and feeling like something was a little bit off.


Stephanie Wittels Wachs  15:44

And how long did it take from feeling like something was a little bit off to figuring out that something was incredibly off.


Dr. Craig Spencer  15:52

Unofficially or officially? Well, unofficially. I knew ,yeah, it took about three minutes when I took my temperature. And I was like, oh, it’s 100.3 that is officially a fever. That was the unofficial like, like took all your malaria meds and everything else is okay so, okay, process of occlusion, not looking great. And then I think it was later that evening, maybe 12 hours later, that I you know, I’d gotten a test back after I’d gone into the hospital. The pre authorized version of the Ebola test that was done across the street at the New York City Lab was positive for Ebola.


Stephanie Wittels Wachs  16:40

We’re back after six days of being home in New York City, Craig tests positive for Ebola. The illness that brought so much horror in Guinea has followed him back home. What on earth goes through a person’s mind when you have seen the horrors that you have seen? And then you find out this test result?


Dr. Craig Spencer  17:04

I don’t know that I thought so much of my own mortality, like, okay, I know. I am at this point, you know, 33 years old, and I’m healthy and the likelihood I’m going to die is probably somewhere between 40 to 50%. I don’t think I did those numbers. I was like, wow, that really sucks. Now what do I do? Knowing of course, there was nothing really to do. But thinking one about you know, did this unpacked my family? What about my my fiancee at that time, like, what she exposed and oh my gosh, that would be the worst thing in the world. If that were the case, like, you know, my own mortality seemed more manageable than the idea of like infecting the person that I love the most.


Stephanie Wittels Wachs  17:46

Suddenly, though, this diagnosis is much larger than even that. Craig reports his symptoms to the health authorities in New York, and he’s rushed to the hospital in an ambulance. And before his Ebola diagnosis is even officially confirmed. He is headline news. Because Craig is literally the first Ebola case in New York City.


News  18:09

Breaking headline right here in New York City, a young American doctor back from Africa, a race to a New York Hospital, and tonight, it is confirmed a new case of Ebola.


Speaker  18:19

Frankly, people in the neighborhood are scared. And some of them are panicked. In fact, I had one gentleman who wouldn’t even shake my hand because he was scared.


News 2  18:28

Sensors sparked Ebola fears in New York City after health officials revealed he rode the subway, ate at a restaurant and went bowling with friends the day before he showed symptoms.


News 3  18:39

The venerable New York Times asked, Can you get a bola from a bowling ball? Experts say the simple answer is no.


Stephanie Wittels Wachs  18:47

With no Wi Fi or TV in his room, Craig has no idea how big his story has gotten. Instead, all he’s thinking about is how the hospital he’s in. And the care he’s getting is so vastly different compared to what he just seen in Guinea.


Dr. Craig Spencer  19:05

I was in a hospital room with one physician that could spend an hour with me. There was like 30, some people on call, you know, a pulmonologist and a nephrologist. If I needed dialysis, and then this and that, and a cardiologist and, you know, there were like 30 people on call for me. And just a few days before and I had been taking care of 30 patients by myself. And so I knew that I was going to get way better care, even if it seemed like just a few weeks ago, like no better care existed, right? Like this is all we could do. We don’t have a treatment, we don’t have a cure. Here’s all we can do. And you come face to face with the fact personally that there is something better that can be done and then I was going to receive that and I was grateful for it. But at the same time just really disturbed by that idea. That demo this is like this is what everyone should get. Like what would it what would would have been like, if just a few weeks ago, I could do the same thing for every person to get a test result back in less than half a day as opposed to three or four days sometimes where people just kind of sat in limbo, without knowing. And then we go back to him and say, hey, you forgot to tell us have malaria. You can go home now, after you’ve been in a place with other people that may have had Ebola, and maybe you’re exposed and what does that mean for your community and for your kids like, these were things we thought about every day, and I didn’t have to think about that, I’d have to think about the hospital or Verizon or the people that were taking care of me running out of their own supplies or equipment, or I didn’t have to think about that. It was reassuring and also disconcerting, at the same time to know that I was in a place where I was going to get the best, but had come from a place where I had seen the worst.


Stephanie Wittels Wachs  20:45

As Craig’s care teams swirled around him debating how best to treat him, his mind flashed to another doctor who had been infected with Ebola. Dr. Sheikh Umar Khan, Dr. Khan was at the forefront of fighting Ebola in Sierra Leone. But he wasn’t offered an experimental drug that would treat his illness, the World Health Organization, and Doctors Without Borders, debated whether it would be ethical to give Dr. Khan the one drug available in the area. He died in July, just a few months before Craig was hospitalized. But in the US, Craig’s cup was overflowing with treatment options.


Dr. Craig Spencer  21:24

We were on the phone with the FDA. By we I mean, my wonderful physician, Laura, on the phone with the FDA trying to get approval, forget one of these like medications that was just like another medication that was being used at that time to come in the country or to get access to it to get it flown up to New York. And then when she was trying to do this, they were like, well, actually, we can get you the real thing. And we’ll just come down from Canada. And so like someone was willing to like sun down, shipped down, drive down a medicine from Canada, to give to me at a point of my illness where it was clear that I was likely going to survive. And at the same time, you know, one of the best physicians in this area who put his life on the line, wasn’t able to access the same thing. And you know, people talked about it and debated it for such a long period of time. And for me, it was like, well, here, we got this thing and this thing and this thing and this thing and this thing and this other thing. And there’s this other thing. I don’t know that any of them made a difference, but just having them there, the inequities were obvious. I mean, it was it was just huge.


Stephanie Wittels Wachs  22:32

After 19 days of being confined in his little box of a hospital room, Craig is cleared to go home. And He attributes his full recovery to his amazing care team, who not only looked after his physical health, but showered him with love.


Dr. Craig Spencer  22:48

The nurses that that took care of me everyday, were just so great. When I got to the point where I was like, yeah, I’m ready to eat again. There was one of the Haitian nurses, I was like, great, I’m gonna make you the best black rice you’ve ever had, and I was like, well, I’ve never had black rice so it’s a low bar, but bring it and it was so good. And there was this nurse who had grown up in Korea, who was like, I’m gonna bring you the most amazing Bebop and sure enough, it was just, I mean, it was just so great, you know, to be sheltered from the outside and just have kind of like an internal bubble of love from those folks, was great. And so it wasn’t until I left the hospital that I interact with the media. I got to read a statement that I think was short and sweet. And basically express a lot of things I’ve already shared with you. I was like, I’m just one dude. There are 1000s of people right now in West Africa that are infected about to be infected dying. While my case has garnered international attention. It is important to remember that my infection represents but a fraction of the more than 13,000 reported cases to date in West Africa, the center of the outbreak, where families are being torn apart and communities are destroyed. Put your focus where it belongs. And I wrapped that up, got my car and said I’m never talking to the media ever again, I’m done.


Stephanie Wittels Wachs  24:14

That’s what we call dramatic irony.


Dr. Craig Spencer  24:16

Yeah, that’s what we call being dumb. And being like, I’m done with this. There’s no value in this like, what am I going to do? whose mind am I going to change who would want to hear from me in the future?


Stephanie Wittels Wachs  24:28

For now, though, Craig is eager to return to his regular life. Over the next five years, Craig is all across the world staying very busy. He flies back to West Africa to track Ebola, followed by stints in Chad and Burundi. Then he’s on a ship caring for migrants crossing by sea and later doing research in the deserts of […]. Like I said, he is a busy, busy guy. As for his family, he and his wife welcomed their daughter into the world. And in early 2019 the family moves to Paris for Craig’s teaching job, when he returns to work in New York, he’s flying high. And pretty soon it’s January 2020. Those friends Craig and his wife made while he was studying abroad in China suddenly start hitting them up. They’re on lockdown due to this new virus that’s circulating. They don’t know what the hell is going on, but they do know who to ask.


Dr. Craig Spencer  25:23

I’m the doctor so everyone was like, hey, hey, Craig yeah, I haven’t spoken to six months. I’m just gonna cut through the shit. What is going on? Like, what’s the deal? Like, hey, I’m in Beijing and I’m not allowed to leave my house like, what do you know about this one? Like, oh, what about what? it was at that point that I kind of jumped in, and was concerned, concerned enough to the point that like, within a couple of weeks, my wife was the one at Trader Joe’s with like, two carts full of groceries. And she was like, y’all are laughing at me now. But you won’t be soon assholes. She was that kind of person and, in retrospect.


Stephanie Wittels Wachs  25:58

I love her.


Dr. Craig Spencer  25:59

No, was laughing at her. I was like, we had toilet paper for days weeks.


Stephanie Wittels Wachs  26:06

As a non medical person, I remember I was washing the dishes. It was January, I was listening to that daily episode about Wuhan. I remember distinctly being like, fog.


Dr. Craig Spencer  26:17

Is no good.


Stephanie Wittels Wachs  26:19

Like, yeah, I mean, I really, it’s like, when how many daily episodes have I listened to and I can remember is like place in time, you know, like, where things started to feel like they shifted. Take us to that moment in your life, your career? And then at what point, you know, based on all of your expertise, did you realize that this was going to hit home and it was going to be not just bad, but really, really fucking bad?


Dr. Craig Spencer  26:41

Yeah, you know, this had been something that I’d seen and know what happens with these infectious diseases and what they look like, I know, you know, that I gotta keep myself safe and my family safe. And so I started wearing a mask in like January, because I knew that these things were already moving. And if history has taught us anything, especially with respect to infectious diseases, like, by the time you pick it up, it has already been on the move, it’s already moved around. Travel bans are probably not going to help like all these other things that we do, don’t necessarily make much of a difference. I was like, alright, well, if we can do anything, we can kind of get ourselves ready, our family ready kind of work with my colleagues and be like, hey, this is what’s coming down the pipeline, you should be prepared for this. We all should be prepared for this and how we’re going to think about it. Things that we’re going to do if we get sick, our family gets sick. And so it was kind of like in January, and February, I mean, obviously what we saw in Italy and in Iran was really just kind of like soul breaking, and concerning. And I remember like late February, just kind of waiting, like where in the hell is the saying like in New York City? Why have I not seen these? I don’t understand what is going on. Like I know, it’s definitely here. And then it was March 1st, that we had the first confirmed case, I believe in New York City. And it was like trickle trickle trickle […] in the span of like a week, from like middle to late March, it went from trying to find that one person in the emergency room that might have COVID, to trying to find one person who didn’t.


Stephanie Wittels Wachs  28:19

All of a sudden, Craig and his colleagues find themselves on the front line, trying to fight a deadly virus that is spreading so fast. The rest of us regular regular folks looked on from our television sets at home or sat on a fire escape every night and clapped, our hands are banged pots and pans together to support the first responders remember all that. But the reality is our best our heroes were sent off to battle unarmed.


Dr. Craig Spencer  28:52

In the emergency departments. Before 2020, you got to put on an n95 mask once a year. And that’s when he went in did your fit testing as part of like your hospital compliance, people didn’t really know how to use them didn’t really have to put them on maybe if you saw patients that had concern for TB, maybe you’d put it on tuberculosis, but like users weren’t wearing and so there were few few people like myself, that had gone to places like West Africa that had learned how to use personal protective equipment as if your life depended on it because it did. We had way too few of those folks here in the US because it was way too difficult for people to leave their jobs in 2014 2015 to go to West Africa, too many places made it difficult or impossible, including some of our best medical centers in this country, made it impossible to send staff to West Africa at that time. And the result was that we had so few people that had any damn idea about how to work in a place like that with an infectious disease. Things that are second nature after doing this for just a few weeks during Ebola, for example. were things that we learned the really hard way in March and in April of 2020.


Stephanie Wittels Wachs  30:05

Are you seeing as things ramp up and march and change so rapidly? Are you having like flashbacks to 2014? Are you feeling like this energy that you’ve never seen at home? What are the sort of differences in similarities that you’re sensing? Both kind of internally? And, and as you’re actually visualizing?


Dr. Craig Spencer  30:26

Yeah, what was weird for me was that I had done this in a bunch of other places, I’d gone to hepatitis outbreaks. And I’d seen, you know, Ebola outbreaks and like gone to respond to other diseases and other places, but I never expected it at home and went to like the finest medical centers in the country or in like, the wealthiest city in the world, that we were going to be, you know, not fully up to the challenge, or something that I was used to and other places, but not here, like home was where it came to for refuge from all of those things, not as a place to kind of experience that all over again. So it was definitely traumatic. And it was, you know, tough initially to try to reconcile those weird realities, with some things that even I just knew as very basic things that we could be doing. You know, one example, as a personal protective equipment, buddy, we call it a PPE, buddy, and in West Africa, during Ebola, you didn’t check your own PPE someone else was responsible for it, because you can see someone else can get underneath and take a look at all the nooks and crannies and see and make sure your your mask is covering your eyes, etc. It was called wow, why didn’t we do that initially, and that’s something that we ended up talking about, and implementing and thinking more through, but there were missteps, for everybody, myself included, and we could have been should have done a much better job. I think the the trauma of those first few weeks was because we were flat footed and short sighted and not prepared. And all of the things kind of collided, especially in New York, at the end of March 2020. Were on many days, I saw more people die in that emergency department than I did most days while working in West Africa during Ebola.


Stephanie Wittels Wachs  32:17

Working in the ER is grueling, which is familiar to Craig in some ways and worse, and others. And as he’s treating patients and layering his PPE and coming home and cleaning off and going back and doing it all over again in the morning, he pauses and reflects on just how severe things had gotten, and how quickly Craig takes these thoughts. And he writes them out in a series of tweets. He doesn’t have many followers at the time, maybe 500. But this report from inside the walls of a hospital, it strikes a nerve.


Dr. Craig Spencer  32:58

It’s kind of the day that I think pulls it all home for me in terms of what it was actually like working in the emergency department at that time, what like the new normal had become and how normalized it had become for us what it felt walking into this kind of, you know, UV Wonderland was just like there’s this lights kind of everywhere, bouncing off of people’s goggles and what the kind of like, I call it a cacophony of coughing sounded like, you know, you just walk through these just like quarters of people coughing everywhere and hoping you don’t get sick, and what are you gonna do when you leave? And how do you stay safe and what happens when you go home? And then I think overnight, my phone just like was on a continuous seizure, and it was like a bajillion likes and retweets and I was like, what happens and I woke up in the morning and I was like, I don’t know how to engage with this, I had to go to work. People have no idea what the hell’s happening inside an emergency department, which is why when like, come home, and over the span of like, 15-20 minutes, just like, truly right what I do at work, how like, this is what I did I work today, just like anyone normally wouldn’t be talking about what they’re doing at work today. And just hit send. I had no clue that that was resonating so much with people because people had no damn idea what was happening. I had no clue, like I knew that people wanted to know, but I just, I don’t know, I just assumed people knew that things sucked inside and it was bad and people were dying. That was all I was thinking about, how could it not be? All everyone else was thinking about and knew about?


Stephanie Wittels Wachs  34:29

We]re back, so Craig tweets about his experience as an ER doctor in New York City, and for many reading an account from the inside is a harrowing wake up call. A shock to the system and a reason to be even more scared to create even more distance from other people, but Craig and every other frontline worker has to keep going back day in and day out. Was there a moment where you felt yourself starting to get fatigued, overwhelmed? Like when the fuck is this going to be over? Like, how are we going to get through this? Like? Did you hit a wall at any point? What was that experience? Like? Or maybe not? You’re a superhero, and you don’t hit walls? But let us let me know.


Dr. Craig Spencer  35:29

I mean, I certainly did, I had all those walls, you know, from West Africa, that I think that those tools have kind of better prepared me for COVID such that, like, I’d go to work, I know it’s going to be tough, we’d see people die. I would kind of put that aside. And people also I guess, people don’t understand that. I work in an emergency room, it’s still pretty rare for me to see people die like people just don’t die. People like, oh, you just go into work every day. And people are dying, left and right like, no, no, I mean, I can go for weeks working without seeing someone die. My colleagues weren’t used to going into a room and seeing somebody just talk to 20 minutes before seeing that person dead. Like, that’s just not something that we’re used to. And having that experience in my salary didn’t like didn’t make it easier for me, it just made it easier for me to like, be able to cope and think about how I’m gonna manage this later, as opposed to in that moment breakdown, you know, stop functioning for a lot of people that just like, haven’t done this, to see that day after day after day, was a lot. I remember one day working in one of the smaller kind of satellite hospitals that we had in northern Manhattan. And the concerns that we had, because all of the bad spaces that were next to the wall where the oxygen was at, were all taken by people on ventilators. And we had a space inside, closer to where kind of the doctors and everyone else sat that we wanted to put patients but we didn’t have a way to get oxygen over there. We couldn’t like string it across the ground. And there’s so we ended up doing is connecting the tubing to the wall and then stringing it all the way up along the wall, up through the ceiling. And then down in the middle of the emergency department so that these nasal cannula, these little oxygen, things would be able to go into people’s noses. So they didn’t have to rely on a tank underneath them, which often ran out and there just wasn’t enough people to know when the oxygen tank or had run out and when people were suffocating. And so we put this in place, and I remember working with a friend and colleague, Dr. Lorna Breen that day on on that. And just thinking about, like how horrible that was, and you know, kind of the the lengths to which we’re going to try to like, you know, keep people alive in the emergency department. I remember her asking me, how long is this? Like, how much longer do we have of this. And I remember saying something like, I think we have at least a couple more weeks to get through the worst. And I think it was just a couple of weeks later that Lorna died by suicide.


Dr. Craig Spencer  38:20

And it was really, it’s impossible to describe just how tough it was. For everyone that like you know, came to work as much as they could, many people couldn’t anymore because they got sick. We lost especially a lot of our nurses very early on because they are at the bedside, the most. We lost one of our nurses who got sick with COVID after coming out of retirement. And I mean came back to the frontline to try to help and got sick himself and died a few weeks later. So that I mean that seeing your friends, get sick, seeing your friends die, the people that you work with, like it was all really really tough and really hard but that was by far the hardest part of it. And still hurts.


Stephanie Wittels Wachs  39:12

So sorry.


Stephanie Wittels Wachs  39:18

So here we are, we’re in 2024. It’s four years after the pandemic first struck. And, you know, my little person who was toddling is now a full blown kindergartener with opinions and thoughts and feelings of his own. You know time has passed, and I think for a lot of us who may not be immunocompromised or have other pre existing conditions, it feels like things have returned to quote unquote normal or in a lot of ways the new normal where you know, a stuffy nose means swabbing and testing right my nine year olds that get the COVID test, you know, I have a pickle, you know, yeah. Which is just wild, and so I guess my question is, you’re an expert? How would you describe the stage that we find ourselves in today? Like, is it actually normal? Or is it not normal? What’s the actual reality?


Dr. Craig Spencer  40:17

Confused. You know, so as of just, you know, a few months ago, you have 1000 people dying per week of COVID. So you’re talking to 50,000 people per year, which still puts it like in the top, in terms of killers in this country, do we think about it like that in the same? Same way as we did a year ago? Two years ago, three years ago? No. Do we take the same precautions? The majority of us including myself, as we did a couple years before? No, even when I see patients in the hospital, I’m not wearing a mask for every patient if I think it’s someone that is sick, or as immunocompromised I do but like, if it’s something that someone that like, you know, maybe broke their ankle, you know, maybe I’m not. And so even for us, you know, providers that were so diligent a few years before, things have changed, so it’s a confused time. Because, yeah, lots of people are still dying of COVID. are they dying of the same COVID of March 2020? When I saw people coming in struggling to breathe with their lungs, you know, whited out on the chest X ray? No, almost never, like never see that anymore. Are they dying because COVID does things to your body, like makes you more dehydrated? Or makes it more likely for older people to fall and hit their head and bleed? And? Yeah, yeah, absolutely. So COVID is continuing to have an impact. It’s still taking the lives of many people and still remains, again for what will be the fourth year in the row was one of the top killers of Americans. Which is, again, incredible, given the fact that it’s been nearly 100 years since an infectious disease was amongst the top three killers in this country. And so is it normal? No, that’s not normal. No one should make an argument that’s normal, if they do, they’re absolutely silly. But have we reached a place in which most people have gone back to some sense of normal, where we’re sending our kids back to school? And knowing that, like, if they’re sick, it’s probably something other than COVID, and right most of the time, yeah. Are we better prepared than we were four years ago, three years ago, two years ago, like, sure, like we have vaccines, and we have therapeutics, like we’re in a much better place. That doesn’t mean that we’re in a perfect place so I know, it’s really, really tricky for a lot of folks to think about what this moment means for them. Because four years ago, what it meant for everybody was the same thing. It was scary, it could potentially impact you, your family, your loved ones, we’ve had over a million people die in this country. So many people have lost a family member in the past four years and continue losing family members. It’s really hard to reconcile those kind of Dr. Jacqueline Hyde sides of this virus where people are just like, we’re ready to move on in for the majority of people. And like, that’s okay, you know, we’ve done this, we’ve been vaccinated, we’ve nearly everyone has got, has been infected, like, yeah, like it feels safe to move on but at the same time, we can overlook the fact that like, it’s, it’s not, it’s not normal, there are so many things that we can take from this moment, to think about how we prevent a similar moment, in the future. We saw, I remember in April of 2020, looking at the maps of who was being infected with COVID, in New York City and who was dying. And I, you know, I feel convinced that I could show this to, you know, a teenager and say, you know, look at these maps and show me where the wealthy people live and where the, you know, the people that are less well off live, and, you know, have that correlate to infection rates and death rates, like the inequities that we saw, had been built in. And we have so many of the same problems, we still have a bunch of states have not expanded Medicaid, we still have millions and millions of uninsured people in this country, we still have a health care system that spends trillions of dollars a year, and where you are lucky if you’re lucky enough to get the best health care in the world, you can, but you still have neonatal and maternal mortality, especially in communities of color higher than like, you know, developing countries around the world. We have so many other like massive health threats that might make COVID at this moment, look less dramatic and horrible than it is. But that’s only because those are like really bad. Not because COVID necessarily isn’t.


Stephanie Wittels Wachs  44:55

I mean, when you put it in those terms, it seems like. It’s so it’s so demoralizing because what what that suggests is that when we look into the future, we are still in great danger. I mean, it’s until we fix those systemic inequities, and so many other things that are broken, like, if it’s not COVID, it has to be something else. I mean, I don’t know, how do you? How do you get out of bed every day? Why?


Dr. Craig Spencer  45:28

Well, because I’m encouraged, I’m encouraged by the fact that you know that we have those maps for April 2020, to say, look at the experience of Hispanic and black New Yorkers, and what happened, we have people who are committed to making sure that this is highlighted at each and every stage that make sure that data reflects the realities not just for wealthy white Americans but for everyone in this country. We have people and communities and centers and schools and universities, and labs focused on highlighting these inequities. Has there been a change undoubtedly. I’m optimistic about the recognition of the things that are wrong, the people who are committing their whole life and all of their energies to reversing and addressing those, the changes that have been made and the challenges ahead, like, Yes, there’ll be another COVID or there’ll be another something else that’s going to take disproportionately the lives of people who are poor, or communities who are more vulnerable or marginalized. But there will now always be a light on those communities, there will be people focused on fixing those inequities. And I am confident that there will be change, that we will continue to make progress in addressing this issues and other issues that have plagued medicine and public health and really our society in general so that’s how I get out of bed. I work with, like, awesome students that are so fixated on, on this, I work with people at local levels, or at the federal level in government in nonprofits that are like this cannot stand and work their ass off every single day, to make that change a reality. And we are a far way away from being able to like scoff, the next time a new respiratory virus comes to our shores and say, ah, you can’t, you know, you won’t kill any of us like, we’re going to make mistakes. And we’re going to see other threats, whether chronic diseases or infectious diseases, we should be humble enough to admit that we’re not perfect, but damn it, we need to work all of our asses off to addressing those inequities and to fixing those issues that have plagued health, public health for quite some time and do our part to to reverse those trends.


Stephanie Wittels Wachs  47:55

Craig, and all of us really exist now in this strange space, where we are holding two mind bending ideas at the same time. One, that we have experienced incredible loss and crisis over the past few years. And two, that we have come out the other side, which means we can hope, and we can plan for a better, more equitable future. Now, if you’ve been listening to this show for a while, you know that we call a space like this, the happy sad. And after everything Craig has witnessed and experienced, I wanted to hear about his.


Dr. Craig Spencer  48:40

My sad is pretty clear. And that spending 19 days in a tiny little box on the eighth floor of a hospital in New York City, where it wasn’t clear that I was going to make it out to the other side was definitely a low point, definitely a sad. I’m glad that I did. I’m super glad that I had access to like unbelievable care and great people and great food from the nurses like all that stuff was so great. But it was still really, really sad. It was sad to think about the care that I received and how was so different from the care that I was able to give like that. That’s what hurts me, I think the most to this day. So maybe like, well, how in the hell do you turn that around, drag and make that into something happy? You know, that experience showed me a lot. It showed me that one, I could use a platform like when I got out of the hospital and was able to say, hey, I’m ready for my book deal. Instead say something like, hey, stop focusing on me, I’m not important what’s important is that people that are continuing to die today that represent an ongoing loss of life to something that should not happen in that should get access to the exact same care as myself. And so I think that instilled in me this sense of purpose. The ability to kind of share other people’s stories and played that, like the podcast mic, or the camera or the radio was not necessarily focused on. So that was one thing, and the other thing is that in the ensuing time, I have recognized that, oh my gosh, there are so many unbelievable people just like those doctors I worked with in Guinea, that worked their ass off every single day, not knowing if they were gonna get paid, not knowing if they were gonna get sick, or what was going to happen to them if they got sick, or if one of their family members got sick, like showed up every day taught me everything that I ever knew about Ebola, who did it the next time that I went and worked in some other place where they were there and their family was there, or did it here over the past few years, when I saw so many people sacrifice so much, to put themselves on the line, to fight for better things, to raise their voice for better things. And my sad moment was sad, the happy moment of seeing how many freaking incredible people are out there committed to doing the right thing, despite the risks to themselves, despite the risks of their reputation, and their politics of their followers on social media. Like damn if that is not so cool. And something that I’m just like, elated to be part of, to talk with students that can hear my story that can be like that’s not okay. And to say, yeah, you’re right, it’s not okay and they’ll have them get fired up to go do something about it and to be committed to a career in public health where they focus on these things. I don’t know that I would have had a similar platform had in 2014 I not been infected. That’s sad moments sucked. But like so many of the people that I’ve worked with that have found a way of translating their sad into something impactful. I hope that’s what the last, I guess decade has been for me. And that makes me that makes me happy.


CREDITS  52:10

There’s even more LAST DAY with Apple premium subscribers get exclusive access to content like behind the scenes chats with the producers of the show, diving deeper into episodes. Sign up now on Apple podcasts. LAST DAY is a production of Lemonada Media. The show is produced by Kegan Zema, Aria Bracci, and Tiffany Bui. Our engineer is Brian Castillo. Music is by Hannis Brown. Steve Nelson is our Vice President of weekly content and production and Jackie Danziger is our Vice President of narrative content and production. Executive Producers are Jessica Cordova Kramer and me Stephanie Wittels Wachs. If you’d like what you heard today, we have three other seasons that you can check out. Have a story you’d like to share, head to, or click the link in the show notes to fill out our confidential Google Form. follow and subscribe wherever you get your podcasts or listen ad free on Amazon music with your Prime membership. You can find us online at @LemonadaMedia and you can find me at @WittelStephanie. Thank you for listening, we will see you next week.

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