Madigan docs work in the heart of the pandemic

By Kirstin Grace-SimonsAugust 12, 2020

Texas Team
1 / 4 Show Caption + Hide Caption – A group of military medical personnel suited up to care for COVID-19 patients at San Antonio’s Baptist Medical Center in July 2020. Pictured from left to right are Capt. Kylie Casey, a nurse practitioner who is Army Reserve assigned to Brooke Army Medical Center at Fort Sam Houston, Texas, Capt. (Dr.) Mary Saleeby, from Tripler Army Medical Center’s Internal Medicine in Honolulu, Hawaii, who is a former Madigan Army Medical Center resident, Maj. (Dr.) Megan Mahowald from Madigan’s Family Medicine clinic and Maj. (Dr.) Leslie Jette-Kelly, a physician in Madigan’s Pulmonary and Critical Care clinics. (Photo Credit: Photo courtesy of Maj. Megan Mahowald) VIEW ORIGINAL
COVID unit
2 / 4 Show Caption + Hide Caption – A makeshift barrier hangs in a hallway at Baptist Medical Center in San Antonio, Texas. It creates an isolation unit to care for COVID-19 positive patients as the number of new cases surges. Military medicine personnel, including dozens from Madigan Army Medical Center on Joint Base Lewis-McChord, Wash., are onsite to assist in July and August 2020. (Photo Credit: Photo courtesy of Maj. Megan Mahowald) VIEW ORIGINAL
Chest X-Ray
3 / 4 Show Caption + Hide Caption – The chest X-Ray of a COVID-19 positive patient in a hospital in Texas as the cases spike. “The lungs should be black with small tapering white vessels,” explains Col. (Dr.) Eric Roberge, Madigan Army Medical Center’s chief of the Department of Radiology, of healthy lungs. Instead, in this film white patches can be seen. "This X-ray shows a pattern of lung disease that is typical of COVID-19. This X-ray along with other clinical data allows us to ensure proper care for the patient," Roberge adds. (Photo Credit: Photo courtesy of Maj. Megan Mahowald) VIEW ORIGINAL
Baptist Medical
4 / 4 Show Caption + Hide Caption – Baptist Medical Center, in the heart of San Antonio, Texas, has dozens of military medical personnel working in its intensive care unit and emergency room to support the surge in COVID-19 positive cases seen in Texas in recent weeks. On August 11, numerous service members from Madigan Army Medical Center are onsite with more expected to arrive soon. (Photo Credit: Photo courtesy of Maj. Megan Mahowald) VIEW ORIGINAL

In the space of less than a year, COVID-19 has altered operations and processes, and most every aspect of life, for workspaces large and small across the U.S. and the world. Like its civilian counterparts, military medicine has been at the forefront of efforts to combat the most impactful contagion in a century.

News outlets have flourished with stories of the mobilization of medical professionals to hotspots across the country since spring. Military medicine is uniquely poised to deploy its greatest resource – its personnel – within hours of the expression of need.

For example, the 627th Hospital Center out of Fort Carson, Colo., manages expeditionary deployments providing medical capabilities in support of combat operations. Currently, it has numerous personnel in San Antonio, Texas, providing support for the heavy spike in COVID-19 cases the area is seeing in its hospitals. Madigan currently has 21 service members in San Antonio supporting local hospitals with an additional 31 preparing to deploy there as well.

“I’m down at Baptist Medical Center in downtown San Antonio. I work with one of the hospitalists’ groups down here. Another Army Physician, Capt. (Dr.) Mary Saleeby, out of Tripler (Army Medical Center), and I cover all the admissions, transfers, and codes during the day,” reported Maj. Megan Mahowald, a family medicine hospitalist assigned to Madigan, to her team back at Joint Base Lewis-McChord, Wash. Mahowald has been in Texas since July 11 and is projected to return to Madigan in mid-September.

In a recent story with KSAT television, San Antonio’s ABC affiliate, Baptist Medical Center’s Intensive Care Unit Director Connie Thigpen commented on the current state of COVID operations.

“We are normally a 30-bed ICU. And very quickly, because of the COVID influx, we flexed up to 48 beds,” said Thigpen.

Deployments of military medical personnel into civilian hospitals are coordinated by the Federal Emergency Management Agency.

As of August 11, San Antonio/Bexar County has 725 persons hospitalized, 305 of whom are ICU patients with 216 on ventilators. In total, it has seen 42,959 cases and 455 deaths.

“I don’t know how many beds this hospital is supposed to have, but a lot of rooms have been converted to COVID units,” noted Mahowald, to include, “the PACU (post anesthesia care unit), which has been converted into a COVID ICU.”

The hospitalists’ group Mahowald works closely with includes Capt. Kylie Casey, a nurse practitioner who is Army Reserve assigned to Brooke Army Medical Center at Fort Sam Houston, Texas, Capt. (Dr.) Mary Saleeby, who is with Internal Medicine at Tripler and is a former Madigan resident and Maj. Leslie Jette-Kelly, a physician in Madigan’s Pulmonary and Critical Care clinics.

In addition, the KSAT story identified approximately 35 military nurses in five San Antonio hospitals with the expectation of another 75 nurses arriving this week.

With 176 new cases reported by the City of San Antonio's COVID-19 Open Data page on August 11 alone, all of these personnel will find plenty to keep them busy in the city’s hospitals.

“We average 10 to 15 admissions a day. Due to bed spacing, we usually end up running a mini-ICU out of the ER for a day or two until there is space for the patients to move upstairs,” confirmed Mahowald. “They play a song when a COVID+ patient is discharged home – “Celebrate Good Times;” but we don’t hear it very often, maybe once every three to five days.”

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