José Miguel Torres (61) finds it difficult not to break down when he recounts what he has experienced in the last 10 months. He does it sitting on his bed, from the room of his house, located in San Joaquín. He still cannot stand up on his own, he has not yet regained enough muscle mass to walk again. He cannot speak very loudly: the wound on his throat that is covered with a white patch is one of the consequences of the tracheostomy, and that means that his voice is still not 100% recovered. Neither are his lungs, so at times he pauses and, little by little, begins to speak again.
Behind his bed, taped to the wall, are some posters and letters that he managed to rescue from his room in the Vespucio Clinic, which the medical staff and family left him when he was discharged: “291 days,” says some of the messages.
Torres is a finishing master, an expert in repairs and painting. He has been working for Besalco real estate for almost 30 years. He says that 12 months ago his life was very different. During those days, he worked from Monday to Saturday. His routine began before six in the morning, when he took the Metro to get to the Ñuñoa building where he was working, and ended at six in the afternoon, when he returned home and shared with the three people who make up part of his family: his parents and his younger sister.
At 60, his health condition was stable, except for his overweight and hypertension that, he says, he had quite controlled. That is why in winter, when he went out to work in the morning, he was not so concerned about getting cold. In general, he was rarely ill. “Like any healthy person, with a normal life, one feels immortal. I felt that nothing could ever happen to me, ”he recalls.
With the arrival of the Covid, there were some things in that routine that changed: to avoid public transport, the first months a colleague would pick him up at his house to take him to the construction site. At the end of March, when Ñuñoa went into quarantine for the first time, he was transferred to another construction site in Florida. And in May, when La Florida went into quarantine, José Miguel Torres took a few days off.
During the first days of May he was infected. He still doesn’t know how. After eating a pot of ceviche that he bought at the fair, while accompanying his mother to do the shopping for the week, Torres says he felt stomach pains. Over the days that discomfort increased and began with a fever. The last thing he remembers is that on May 10 his brother took him to a Cesfam in San Joaquín.
That day, Torres lost consciousness. He didn’t wake up until four months later.
According to the president of the Chilean Society of Intensive Medicine (Sochimi), Darwin Acuña, the time a patient with Covid can spend in the ICU depends on many factors, ranging from severity and lung involvement, to events that may occur along the way. “The average ventilation is between 10 and 14 days and from there it lasts up to a few weeks if the situation is not compensated. The fundamental complications are muscular alterations and atrophies that decrease the mobility of the patients, because they remain in bed for a long time. But mainly there is persistent lung damage ”, he explains.
José Miguel Torres broke all records. Since he was admitted, not only did he exceed the average of 14 days in ventilation, but also, respiratory failure was not the only diagnosis with which he arrived at the Vespucio Clinic on May 12: he came with heart failure, a septic shock and kidney failure that made him require dialysis immediately. “He arrived with a 60% probability of dying, despite all the medical interventions that had been done to him before entering. He is one of the most serious patients we have received, ”says Juan Carlos Melgarejo, an internist who treated him that day.
While that was happening, Andrea Torres (37) -her eldest daughter- had a hard time finding her father’s whereabouts: after taking him to Cesfam in San Joaquín, he was taken by ambulance to Barros Luco Hospital. There, they sedated him and connected him to mechanical ventilation, but due to the saturation of beds, he was transferred again. “I went to Barros Luco for two days to ask about him, and I had no news. I spent full mornings, and it was always the same: that you stay calm because they were going to call you. At the end they informed me that my father had been referred to the Indisa Clinic. When I went to look for him there, they very kindly treated me and told me ‘your father is not here,’ ”she recalls. That same day, he called the hospital again, where they told him that there was a mistake and that, in reality, Torres was admitted to the Vespucio Clinic.
During those weeks something else happened: José Miguel Torres’s father died on May 18, at the age of 87, due to age complications. Six days after their son was admitted for Covid, who was still unconscious.
Andrea Torres had no way to tell him what had happened, there was no other option but to wait for him to wake up. The problem was, that time lasted longer than he thought. He describes it like this: “It was a long agony in which you don’t know what you are going to find the next day. One day it may be good, another day bad, another day stable. I didn’t know what to expect anymore, ”she says.
Melgarejo tries to explain how those first months were: “José Miguel had all the complications of a seriously critical patient. Although the Covid was the first two weeks, it was so intense that it left it with many sequels. He developed several infectious pictures and it was necessary to change the remedies and wait for him to respond to those treatments. ” Although there were times when he did not respond: “They called me three times to tell me that he was going to die. Those calls were from terror. You had nothing to do. But the next day he was stable again ”, remembers Andrea Torres.
That swing of uncertainty also began to affect the medical team. As time passed, most of the patients were being discharged and Torres was still there, without any improvement. “If the cases that took three months to recover caused us any frustration, that of José Miguel was intensified by 10. It was the frustration of not being able to make him go back to his normal life,” says Melgarejo.
Stefany Valenzuela, an occupational therapist on the Vespucio Clinic medical team, also felt that frustration. She met him in August, in the ICU, when Torres was still unconscious and had been placed in the prone position: a body strategy of placing the patient face down to improve oxygenation. In those days he had made pressure ulcers, and Valenzuela was the one who had to take care of the positioning to prevent them from continuing to appear more than he already had. “Many times we thought that José was not going to make it, because in reality he was very bad. Their lesions could become infected at any time, ”she says.
It was only in September that Torres began to show signs of improvement. It was then that they began the process of getting him out of sedation. Stefany Valenzuela saw how, little by little, he was waking up and accompanied him at that stage.
Although the date on which he consciously woke up is not clear, since there were several days when he opened his eyes without necessarily being awake, José Miguel Torres remembers that moment. He doesn’t exactly handle the date, but it was mid-September: “After hearing several voices from afar, I felt someone squeeze my hand. It was my daughter’s hand, telling me that it was there with me. That, for me, was coming back to life ”.
Until now, there are no statistics that measure who is the patient who has spent the longest time hospitalized for Covid in the country. But if establishment by establishment is consulted, the maximum does not exceed eight months. The record at the German Clinic, for example, is eight weeks. In the Indisa and the Clinical Hospital of the UC, almost seven and four months, respectively. At the Barros Luco Hospital there was a patient who was intubated for a month and tracheotomized for seven months, and at the El Pino Hospital, the maximum was six months. José Miguel Torres surpassed them all. In total, he was hospitalized for more than nine months.
After waking up in September, he had to stay for five more months to treat his aftermath and work on his recovery. Although he never stopped being intubated: despite being disconnected from the ventilator, he remained tracheostomized until just a few weeks before leaving. It was a slow process. Stefany Valenzuela saw how he was taking some steps: “We made a video call to her with her daughter and I remember that the first muscular activity she had was blowing kisses to her. That was very exciting. “
On February 28 he was discharged. From that day on, José Miguel Torres was able to recover something of what his life had been before. Although some things had changed: her daughter had to tell her that her father was gone. “It is strong to live with this, thinking that the day will come when you will have to tell him and you don’t know what will happen. But I don’t feel guilty for not having told him before, ”says Andrea Torres. He does not feel it, precisely because it was not an impromptu decision: his daughter consulted with relatives and even with the medical team, because telling her at a bad moment could affect her recovery. That is why the chosen date was the last day, before Torres arrived at his house. “I got to the hospital early, I had the support of Stefy and Natasha, the two therapists on the team who were there in case my dad got sick. I grabbed his hand and told him that my grandfather had passed away a week later ”.
Torres did not break down, ”but it is what hurts me the most to have woken up. Not having been able to say goodbye to my daddy ”.
When he arrived at his home in San Joaquín, his family was waiting for him, and also some of his things that he left there that day he left for Cesfam. One of those was his cell phone, which he hadn’t seen since May. “I found many, many calls, also, more than 100 messages from colleagues and people that I never thought would write to me. I received a call from a friend who I had not spoken to for 20 years, who even contacted my daughter ”, Torres tells.
His full recovery is forecast for one more year. To speed up the process, there are six professionals who will see you during the week. They do kinesiology work on him, helping him regain basic actions like walking again. Stefany Valenzuela is one of them. Together with another colleague from the Vespucio Clinic, they volunteered to go to do the therapies.
However, Melgarejo explains that in terms of his state of health, Torres will never be the same again: “There is a pathology that is polyneuropathy of the critical patient, which is finally a chronic weakness that can take months, and even years, in recuperate. This makes him a chronic patient ”, explains the doctor.
Perhaps that is why Torres does not feel as immortal today as before. “My defenses are not the same, my physical condition is not the same. Today I feel more vulnerable, because if I get sick again, I don’t count it twice ”. That is why he is aware that this winter will be difficult.
Now, going out at dawn, due to the cold, implies a real risk. And that does worry him.
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