Dr. Rajany Dy is a UNLV School of Medicine Assistant Professor of Internal Medicine who’s seen COVID-19 patients die in the UMC intensive care unit that she was sure would live. She’s seen others live she just knew wouldn’t make it. To Dr. Rajany Dy, who’s right far more often than she’s wrong, COVID-19 is a coronavirus so novel that the only thing purely predictable about it is its utter unpredictability.
Yes, Dr. Dy, who was the valedictorian of her medical school class and completed her internal medicine residency through the Yale School of Medicine, admits there is no playbook for treatment of the virus -- what’s needed are clinicians with an insatiable curiosity, medical professionals devoted to finding a weakness in a virulent infection sapping the last bit of strength out of thousands of Americans.
“You may come home tired but you have to stay up and read the literature to find out if someone is doing something that is really helping patients more -- you have to keep studying,” says Dr. Dy, a UNLV attending physician in the UMC ICU who’s had several COVID patients. She’s also the UNLV School of Medicine Associate Program Director of the Critical Care Fellowship.
Her love for science and biology in high school pointed her to a career in medicine that began at De La Salle University College of Medicine in the Philippines. “Watching doctors at work when my youngest cousin had leukemia reinforced that,” says the native Filipino who completed a fellowship in pulmonary and critical care medicine through the State University of New York.
What has particularly impressed her about the medical teams attending to COVID-19 patients is the matter-of-fact courage they display as they attend to patients infected with a virus for which there is no cure. “The entire ICU staff is so brave,” she says. “They’re with the patients more than anybody and they just do all they can for them without ever hesitating. It’s who they are.”
She says antiviral treatments used to fight off other viruses may or may not work on COVID-19. Ditto for hydroxchloroquine, the anti-malarial drug President Trump promoted for awhile as a “game changer.”
“It’s really hit or miss,” says Dr. Dy, whose research has been published in several medical/scientific journals, including the American Journal of Respiratory Critical Care Medicine and the Journal of Pulmonary & Respiratory Medicine.
She remembers that her “first COVID patient was very sick with ARDS (acute respiratory distress syndrome) when she was admitted to the ICU. She stayed on the ventilator for more than a month, underwent a tracheostomy and was eventually weaned off the ventilator. I’m happy to say that she was discharged from the hospital to a rehabilitation facility.”
Another of her patients, a retired doctor, was talkative, matter of fact about having the disease. He just wanted the medical team to make sure to update his family regularly on his status. He was far more concerned, Dr. Dy says, about how his family would handle his time in the hospital than he was about his own welfare. He died. “It’s very hard to predict how patients are going to do in the ICU,” Dr. Dy says, and she says it’s “especially hard” if they’re COVID patients, for whom there is no tried and true standard of care treatment. ”It’s very disheartening to see someone die who seemed to be doing well at first.”
She says patients are well aware from news accounts that the virus is taking lives. “We’ve had patients who ask if they are going to die right before intubation and there really is no right response since it’s very hard to predict their clinical course. We reassure them that we will do the best we can to help them get better and that we will give daily updates to their family.”