Casey Naughton Dowling, DO ’89, FASA 
PCOM Heroes of the Frontline
                  Anesthesiologist, Winchester, Virginia
                  
                  “We’re nestled in the Shenandoah Valley and apparently were somewhat protected from
                     COVID at first. We have been learning ever since it hit New York. The information
                     has been a tsunami daily, and yet we still just don’t know what’s going to happen.
                     And that is so unbelievably stressful. … I get emails from the American Society of
                     Anesthesiologists, from the CDC, from the FDA. … There is no literature on this, so
                     it’s been a collaboration of physicians: ‘How did you take care of these patients?
                     How did you cover for lack of PPE?’. … Our hospital was very proactive in turning
                     to us to say, ‘Look, if we get a big surge, you’re going to be our go-to people to
                     help us cover that ICU.’ It makes perfect sense. Anesthesiologists are the experts
                     on intubation and extubation. If you’re looking to have the least amount of aerosolization,
                     you want the most practiced, the most experienced person doing that. We’re also the
                     intensivists of the ORs; we take care of everybody’s diabetes, high blood pressure.
                     We hang pressors, we do lines, we do transfusions, we do codes, we do all of that.
                     Osteopathically speaking, we take care of the whole person—that’s what anesthesiologists
                     do. … Fifteen to 20 of us have volunteered to cover intensive care. We went up, four
                     at a time, for a two-hour orientation. And then we’ve been going two at a time every
                     day to orient, do rounds and try to write a note. Again, stressful. It was like being
                     an intern again. … I can’t say enough about the people that were already taking care
                     of those respiratory patients in the unit, their grace under fire. And I can’t get
                     over my people, the anesthesiologists who have come up with so many different ways
                     to tent, to intubate and extubate and cover themselves. … Back when there was not
                     as much testing, I took care of the very first person under investigation that needed
                     to go to the operating room. Most operating rooms are the wrong pressure. They are
                     what’s called positive pressure: You want the infection to stay away from the patient,
                     so you’re blowing it all down and away. But with a patient who’s infected, you’d be
                     blowing it all over the room and giving it to everybody else. It becomes very involved.
                     … We literally created our policy of how to handle it that day, a Saturday. My chairman
                     came in, the safety officer came in—it took a village.”
                  
                  As told to Janice Fisher
April 24, 2020
                  
                   
                  
                  About Digest Magazine
                  
                  Digest, the magazine for alumni and friends of Philadelphia College of Osteopathic Medicine,
                     is published by the Office of Marketing and Communications. The magazine reports on
                     osteopathic and other professional trends of interest to alumni of the College’s Doctor of Osteopathic Medicine (DO) and graduate programs at PCOM, PCOM Georgia and PCOM South Georgia.