Battling COVID-19: Stories from an ER Doctor - Part 1 (Transcript)

Dr. Dobson: Well, hello everyone. I'm Dr. James Dobson and you're listening to Family Talk, which is a division of the James Dobson Family Institute. Shirley and I continue to be sequestered at this time, but we're being kept informed hour by hour about the pandemic and the other aspects of what's going on that plague our land today.

We're praying for the American people and for the human family around the world. We don't want to forget them because they're suffering too, and of course that includes all of our listeners today. I know that the tensions are very high for families during this crisis and our hearts go out to those of you who have lost a loved one perhaps or a close friend. And you're quarantined, that's also terribly difficult for families, especially those with children.

I'm hearing about that. Kids are designed to run and play and they really don't do very well when they're boxed in. Their parents are also stressed enormously. In fact, I don't think there's been an upheaval quite like this one since World War II. At least, I'm not aware of one. It's just turned everything upside down. Now, maybe that's an overstatement. Every generation has its challenges, but I don't believe there's been anything quite like this.

Nevertheless, we know God is in control and that He hears our plaintiff cries. Our Family Talk team is monitoring issues related to the virus, and we're going to talk with our listeners today about one of the most urgent. I have great concerns for the medical people who are literally risking their lives to minister to suffering patients. They are national heroes in my mind, I'm sure you agree.

These men and women include physicians and nurses and dentists and PAs, and medical students and technicians and phlebotomist and orderlies, and all the people who are in direct contact with sick and dying people every day. We must be in daily prayer for these exhausted caregivers, and I want to talk to one of them today who has become a very good friend of mine.

He's Dr. Erik Axene. He's a medical director for several municipalities in the Dallas area. He's also a physician for the NFL and for the Dallas Cowboys, in specific. Dr Axene was designated physician of the year by the largest physicians group in the United States. This is just a short summary of a very impressive bio. He's married to Deborah and they have two young children. Dr. Axene, thank you for joining us today amidst the enormous responsibilities that you're carrying.

Dr. Erik Axene: It's a pleasure to be here. Thank you very much.

Dr. Dobson: I understand that you were up most of the night last night, is that right?

Dr. Erik Axene: Yes, I did sleep today and I did work last night all through the night, and I'm very happy to be sitting in my home talking to you today.

Dr. Dobson: Are you separated from your family?

Dr. Erik Axene: I am. I miss them very much. I miss hugging my children. I miss sleeping with my wife. I miss petting the dog. I have just quarantined myself in an area of our home, where I can be separate from the family.

Dr. Dobson: Well, tell us about the pressures you and the hospital staff are under during this pandemic. Are you all absolutely exhausted today? I rather think that's true.

Dr. Erik Axene: I can't remember the last day off I've had, it was probably back in February. It's just been very busy with my responsibilities as medical director for other municipalities, cities and counties out here in the Dallas area. They keep me very busy, serving my firefighters. I also work as medical director for our emergency department and an assistant medical director for another ER. So I'm very busy with administrative responsibilities. In fact, after I get off this call, I got to drive to the hospital and put some finishing touches on our triage tent that we have set up in our parking lot.

Dr. Dobson: Tell me what it's like to be in a big hospital now, one that is being overrun by sick and dying patients.

Dr. Erik Axene: It's different in different areas of the hospital. One of my colleagues is in New York right now and his experience is different than my colleagues in the Los Angeles area, which is different from my experience here in the Dallas area. It's just the chaos, and we are doing things medically that really we've never done before. It's unheard of to discharge certain types of people, but there's just no room to put them in the hospital, so they're being sent home. It's a very scary time.

Dr. Dobson: Are you actually discharging sick people who need to be hospitalized?

Dr. Erik Axene: Yeah, that's correct. What I mean by that is yeah, sometimes we will discharge these COVID patients home to quarantine themselves at home and hope that they get better. But I'm also speaking of people with medical conditions who come in, who would classically be admitted to the hospital for even an extended period of time, but there's just no room to keep them in the hospital. We have to send them home.

Dr. Dobson: if all the beds are occupied by people suffering from COVID-19, what does happen to those who are suffering from heart attacks or cancer, or other chronic illnesses? How are you dealing with them?

Dr. Erik Axene: That's a great question. In certain areas where there's just no place to put people and no ICU beds to house them, we aren't able to treat these heart attacks that would typically get care going to the cath lab. We have protocols in place at our hospital that a COVID patient will not go to the cath lab, as they have classically done.

Dr. Erik Axene: Instead they'll receive medication in the ER, we call it TPA, a clot busting medication, and we will hope for the best. Then we have obviously our protocols for treatment for these patients, but this is not the way we normally do business and it's really a very unique time, unprecedented.

Dr. Dobson: Are you implying that, you have seriously ill patients who will die because there's no way to treat them? Could that actually be happening in America?

Dr. Erik Axene: No, that's correct. We're seeing that happen now. There's not the bandwidth at some of these hospitals who are overrun with COVID patients. There's just, like I said, not the bandwidth to be able to care for them in the way that we have done in the past.

Dr. Dobson: Well, you said hospitals vary in what they're experiencing. Talk about what's going on at your hospital. Are there people whose beds are in the hall? Are they being maintained or treated in places where they wouldn't ordinarily be?

Dr. Erik Axene: Well, it's interesting you ask, I'll tell you some stories. I just got a call before our call here today from a colleague of mine asking me, "Hey, have you ever intubated anybody on the floor before?" He got called to a room in the hospital today. A patient had collapsed in cardiac arrest in the bathroom, a COVID positive patient, and they coded him, chest compressions, intubated him on the floor of his bathroom. It was just chaos.

Last night, one of my first patients I saw was a COVID patient and I was preparing to put this patient on a ventilator as well in a very small room. Really what we're forced to do as ER doctors is use what we've got and do the best we can with the resources that we have. And last night, this very sick cancer patient on chemotherapy with COVID, needed lifesaving care in a room half the size I'm used to dealing with. It was a very unique situation.

Dr. Dobson: Did you get her through the night?

Dr. Erik Axene: I did, yes. She got into her room. We got her admitted up in the ICU and obviously I know her family is praying for her. I am praying for her, I hope she does well. This is a very peculiar disease, it rapidly worsens. It's a real unpredictable disease from my experience.

Dr. Dobson: What do you anticipate in the next few weeks, especially there in Dallas?

Dr. Erik Axene: Based on estimates, I think we're about two and a half weeks behind New York. We have not yet seen our peak. We're going to probably see that sometime at the end of the month, maybe early May.

Dr. Dobson: I know that you and your colleagues are putting your own lives at risk during this crisis. Honestly, I really do think you're all heroes.

Dr. Erik Axene: Well, it sure is an honor to hear that. I don't know that any of my colleagues and I would call ourselves heroes, but we love what we do. We really are honored to be able to help people, that's why we do what we do. And I know that, as a Christian, to me it's a form of worship, and I think the real hero here is Christ for me as a Christian. To me, I feel as though I'm worshiping Him and bringing Him glory by doing what I do and I have a hard time calling myself a hero. I just feel honored to be able to use my gifts and abilities to serve Him.

Dr. Dobson: Well, are you able to share your faith with people?

Dr. Erik Axene: Absolutely. These patients that are coming in are so scared. They really are so scared. Last night a young lady came into the ER, she started to cough and have some flu like illnesses, and she was rattled to the core crying in the hospital bed as I treated her. It was a blessing for me to be able to share Christ's love with her through my hands treating her, but I think that's a microcosm of what's going on. I mean, everybody's just so scared in our community right now of getting this coronavirus.

Dr. Dobson: Well, tell us how you and the medical team are holding up under this pressure.

Dr. Erik Axene: You know what? The tensions are high and there's a shortage of PPE, it's Personal Protective Equipment, to defend ourselves against this virus. And when people come to work, they're doing the opposite of what they know is safest. The safest thing is to stay at home and to stay away, and my colleagues and I are called to walk towards it. And when we're walking towards these things with a lack of PPE ... I mean we are wearing PPE, but there's a shortage and like I said earlier, the tensions are high.

People are very anxious, but you know what? I have to tell you though, that there's a comradery and a teamwork and a fellowship amongst healthcare workers. Whether you're a person cleaning a room or a physician or a nurse or a PA, there's a special bond there between us in the ER. That really helps to comfort each other and one another, and I think that also comforts our patients as well.

Dr. Dobson: It brings tears to my eyes to think about what the medical team is experiencing in hospitals across the country. There are thousands of them and some of them have brought home the virus themselves. It's just a terrible situation.

Dr. Erik Axene: You know, there is a lot of bravery and a lot of courage there, and it is such a pleasure for me as a Christian to face these risks. The mortality rates are higher for healthcare workers. We're just inundated by the virus and this tiny little 120 nanometer virus is really wreaking havoc on our workers here in the hospital.

I will tell you that when I think about that, I'm reminded of Philippians, "Be anxious for nothing, in everything by prayer and supplication with thanksgiving, let the requests be known to God and then the peace of God, which surpasses all understanding, will guard our hearts." And I really feel that way, Dr. Dobson.

Dr. Erik Axene: When I walk to the ER, it's my common practice. I sing, "How Great Though Art" in my mind, in my heart as I walk into the ER. And then when I'm in the ER, I have found a deeper dependence upon Christ, and I have found that I have a tendency for self-sufficiency, and that's kind of a common, I think, trait for ER doctors around the world. Whether you're in Italy or Spain or New York or Dallas, we tend to pride ourselves, and wrongly, pride ourselves in our self-sufficiency.

We, as ER doctors, say, we can handle anything that comes in the door, and I think we're seeing something right now where we really can't. And in fact it's really stressing our healthcare systems. But you know what, as a Christian, I just found a deeper, deeper walk with my savior, and it has been such a joy in the midst of this battle. You know, Ken Hutchison, who used to be my pastor, and he-

Dr. Dobson: You know, I knew Hutch personally and he was just one of my respected friends, and he was doing a great heart for the Lord when he died several years ago.

Dr. Erik Axene: I know, I miss him. He taught me how to play dodge ball back when he used to live in Seattle. I love that man. And he was my pastor at Antioch for a short time. But I remember a story he told once about teakettle Christians. A tea kettle Christian, is somebody you put them on the burner, and then that stress causes him to sing like a tea kettle.

I remember that story. In fact, we were having dinner the other night, and we don't do dinner at the same table anymore. They set up an iPad at the table with the FaceTime with me, and I told my kiddos that story, because I want us to be tea kettle Christians as a family. When we feel that pressure and that anxiety, instead of being afraid, I want people to sing. And I want my kiddos to sing to their friends. We don't have to be afraid.

Dr. Dobson: Well, that testimony really touches me Erik, because sooner or later all of us are going to encounter challenges that we can't handle on our own, and some deal with that nearly every day. We just need divine intervention to make it through.

Dr. Erik Axene: That's right.

Dr. Dobson: Have you lost any of your friends and colleagues to COVID-19?

Dr. Erik Axene: No, fortunately I have not had any colleagues pass away. I have had some that were sick and quarantined in a hotel for a short time, and boy that was a real eye opening experience and a time of prayer for my colleagues as they were in the hotel room with high fevers. You know, we're all on edge. I'll be honest with you, every time I have to clear my throat I wonder, "Uh-oh, am I getting it?"

Dr. Dobson: Tell me about the equipment situation there. Do you have enough ventilators to go around?

Dr. Erik Axene: Well, the projections say that we don't, and our hospital's been very proactive in expanding our ICU, and we're preparing for an increase influx of COVID patients. So right now, we are not short on ventilators in our hospital, but based on actuarial projections, we are short on ventilators, we're very short on ventilators for the surge that is being predicted.

Dr. Dobson: Erik that means that people who are dying are not going to be able to get the help they need to breathe.

Dr. Erik Axene: That's the fear, that's correct. So we have a protocol in place, which is very sad but true, where there may come a time, and I hope this does not happen, but there may come a time when a patient will present to the emergency department and there won't be the ventilator for them, where classically I would have put them on a ventilator and admitted them to the ICU. I may have to tell the family to go home with a home palliative care plan, and that's a protocol that we have not enacted but that is something that we may need to do, where we will be delivering care to the healthier people. And we have a very strict protocol that we will enact, which we will follow as physicians and only deliver the care to the people who will likely improve.

Dr. Dobson: If I understand you, there may come a time when a physician will have to decide who lives and who dies. I can't imagine that. I just pray that that will not occur, because it's too heavy a burden for anyone to carry.

Dr. Erik Axene: It really is. I was just reading an article last night about moral injury, and that's a real issue amongst physicians, nurses and PAs. Everybody, all these healthcare workers, firefighters, our first responders, is being able to understand and grasp the magnitude of these decisions, when you know what needs to be done, you know what's right and you can't do it. And it's this concept of moral injury is something that we're being faced with right now with this coronavirus, and it's really devastating to the healthcare workers that have to make these decisions. It's awful.

Dr. Dobson: Well, I can't imagine the emotional strain that occurs when a doctor is already at the point of exhaustion like you are now, but can't rest because of the demands placed on him or her. Then there's the anxiety about their own families at home and what's going on there.

Dr. Erik Axene: Yeah, it's stressful. Every day I go to the ER and I don't know what I'm going to have. I don't know what's going to be presented, what challenges will be presented to me, but I've got the best team of nurses and doctors and PAs, my intensivists, my cardiologists, my infectious disease doctors. I have seen a coming together, a unity amongst different departments in the hospital like nothing I've ever seen before. I think it's actually been a beautiful thing to see all of my colleagues coming together in this crisis. I really feel very fortunate to have the team that I have. So when I go to the ER, I almost feel like I'm walking into a football game, like I've got the best team on the field and I feel really good about that.

Roger Marsh: A truly remarkable insight into what doctors and nurses are facing in the midst of this current crisis. I'm Roger Marsh and you've been listening to part one of Dr. James Dobson's conversation with Dr. Erik Axene here on Family Talk. These are truly unprecedented times and we ask that you pray for all those in the medical community. As you heard today, they are sacrificing their time and jeopardizing their livelihoods to help those infected.

I hope you've been touched by today's edition of Dr. James Dobson's Family Talk, and in the midst of this crisis, please know we have a great and encouraging resource for you. Go now to and request your copy of Dr. Dobson's book, When God Doesn't Make Sense. Now, this is one of his bestselling titles ever and it's so relevant for what we're experiencing right now. Throughout this timeless work, Dr. Dobson unpacks why we must hold onto our faith during difficult times, especially when it seems like God isn't even listening to our prayers.

You'll receive your copy of When God Doesn't Make Sense, as our way of thanking you for a gift of $20 or more to Family Talk and the James Dobson Family Institute. So you can learn more about how you can support this ministry and receive this resource when you go to That's

Thanks so much for tuning into today's program and be sure to join us again tomorrow as we continue Dr. Dobson's recent conversation with Dr. Erik Axene. You won't want to miss what he has to share coming up on the next edition of Family Talk. I hope you'll join us then.

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Dr. Dobson: I've often tried to stress how important it is for parents to watch for those teachable moments with their children, but if you really want to try to make an impact, try creating special times together as well. Bob Welch recently awoke his 16 year old son early in the morning hours and headed toward the ocean. They buried a small can in the sand and then they walked seven miles away along the beach, each carrying only a pocket full of golf balls, a handful of tees and a driver.

At 6:00 AM, they teed up their first shots of the game, 12,320 yards from the hole, a par 72 they figured. For the better part of the day, they walked and hit and they talked and they laughed together, often about nothing and sometimes about everything. The game ended 68 strokes later in a tie and a promise for a rematch. Listen to what Bob writes about that experience.

He said, "I realized that we've come a long way, father and son, much farther than seven miles. We've made a memory that may be told around beach fires for years to come." It's impossible to overstate the impact these kinds of memories have on the lives of our children. When parents go out of their way to create special times together, they send their kids a very clear message. I care deeply for you and I want more than anything just to be with you, and that's a message every kid needs to hear.

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