Don Emery was inching close to 30 when he got into medical school in the 1970s. The work was daunting, and he seemed a good bit older than everyone else in his classes at Thomas Jefferson University, but he was struck by a comforting thought: He knew what he’d be doing with the rest of his life. Other people might have to change careers like pairs of shoes. He was going to be a doctor.
Emery is 70 now, and has spent the last 14 years at Chester County Hospital, working for much of that time as the medical director of the intensive care unit. At this point, he could probably make the 20-minute drive, from his house in Malvern to the hospital’s parking lot, in his sleep.
But that’s where the predictability ends.
The coronavirus pandemic has disrupted nearly every aspect of daily life, down to the steps Emery must complete before he can set foot inside the ICU. First, he has to slip a mask over his closely cropped white beard, and then an employee takes Emery’s temperature to ensure he’s not feverish.
The ICU looks like a regular ICU — 24 single-bed rooms, a team of floor nurses and nurse practitioners — but the beds on the second floor are occupied only by the sickest of coronavirus patients. Doctors initially thought it did its greatest harm to victims’ lungs, but have since discovered it can cause blood clots and strokes in even young patients.
Something else is different, too.
“It’s quiet,” Emery said.
No family members are allowed to visit COVID-19 patients in the ICU, to whisper words of encouragement or quiz doctors and nurses in the hallway. Those conversations now play out over the phone, emotionally devastating exchanges that can last hours.
“I just can’t imagine being on the other side of that call,” Emery said. “I always thought I couldn’t imagine being a patient. But now I can’t imagine being someone who hasn’t seen their spouse in 10 days.”
Emery is uniquely qualified to be in the thick of such a fraught moment, when everyone is desperate to understand and overcome a lethal new virus. He’s still clocking 100-hour weeks at the hospital, even though he belongs to an age group that is especially vulnerable.
But then he found his footing as a physician under the cloud of another unsettling public health crisis, a generation ago.
From Salem County to San Francisco
Emery laughs at the image he has of himself as a boy, growing up in Salem County, N.J., which felt a time zone away from Philadelphia.
“I was really a rural, backward kid,” he said. “All my friends were farmers. I spent a lot of time on farms. ... My parents didn’t have much money, and I didn’t think I’d go to college.”
Villanova University gave him an engineering scholarship, and an introduction to the wider world. But after graduating in 1971, Emery realized he didn’t have much interest in an engineering career. Becoming a doctor, getting a chance to help people? That had allure.
Emery landed a job in Wilmington as a respiratory therapist, and started taking pre-med courses at night. He got into medical school in 1977, when he was 27, and started dating a fellow student, Christine, who would later become his wife.
A post-medical school training program took the couple to Boston, and then the Bay Area, where Emery began a pulmonary fellowship in 1984 with the University of California, San Francisco.
AIDS, which had started appearing on the medical community’s radar just a few years earlier in small numbers, was coming into sharp focus as an epidemic; the number of reported deaths in the United States would grow to nearly 6,000 by the end of 1984.
Emery worked at San Francisco General Hospital, where he found a mentor in John F. Murray, a pioneering pulmonary physician known for his work diagnosing a lung disease known as acute respiratory distress syndrome. Emery was tasked with performing bronchoscopies on patients who were displaying some AIDS symptoms — weight loss, skin lesions.
“For a four-month period, I was personally diagnosing every case of AIDS in San Francisco,” he said. “I was giving 10 to 12 people a death sentence every day.”
Christine Emery, who works as a radiologist at Christiana Hospital in Delaware, recalls the darkness of that era. “I lost many people that I knew, as did Don,” she said.
There have been plenty of echoes from the early days of the AIDS epidemic during the first few months of the coronavirus pandemic — the race for a cure, the creeping sense of paranoia, the challenge medical professionals face in trying to persuade the public to avoid spreading the virus.
“The reason it feels similar is that [COVID-19] was something that came out of the blue, and we don’t really know all of what we’re dealing with,” Don Emery said. “We see different manifestations every day.”
His wife worries about the risk he takes each time he ventures into the ICU to care for coronavirus patients, but Emery sounds unfazed. “I think we know how to protect ourselves,” he said.
A phone call in late March offered Emery a somber reminder that physicians are mortal, too. A friend told Emery that Murray, his former mentor, had died in France at age 92.
Murray’s death was attributed to the same respiratory illness he’d once diagnosed — brought on by COVID-19.
A song before I go
Emery felt a sense of dread shared by many other doctors and nurses when early forecasts suggested as many as 2.2 million people in the U.S. could die from the coronavirus.
Now there is talk of states gradually reopening, of some areas taking tentative steps back toward some semblance of normalcy, because hospitals aren’t overrun everywhere, and the curve of new cases is flattening.
“We think we have a much better handle on what’s coming,” Emery said.
The ICU at Chester County Hospital has had, at most, nine coronavirus patients at once. While some of those patients might need to remain on ventilators for three weeks — instead of, say, five days, like patients with other illnesses — Emery said the hospital has 100 ventilators, and is prepared for the possibility of another surge in cases.
He finds it difficult to tear himself away from his patients and their perilous recoveries. Several times a day he finds himself peering at his computer, checking his patients’ vital signs and lab results, even when he’s off.
“When I started out in medicine, one of my mentors said, ‘Don, medicine is a jealous mistress,’ ” Emery recalled.
“I bring a crossword puzzle when we go out to dinner,” his wife said, “because I know I’m going to be eating alone.”
But nothing lasts forever. He plans to retire at the end of June, just before he turns 71, and focus more on his hobby: playing the guitar.
Emery has a dozen of them, and when he gets home from a particularly draining shift at the hospital, he pours himself a nice Scotch, picks up one of his acoustic guitars, and picks his way through some jazz or blues.
Lately, he’s been learning a new song, something from Metallica.
“It’s called ‘Nothing Else Matters,’ ” Emery said. “It feels appropriate.”