Isolated in his family's guest room, Peter D'Souza, MD, tried to sleep, but he kept waking up with coughing fits.
It was March 11, a day after he'd tested positive for COVID-19. Earlier that night, D'Souza, a clinical associate professor with the Stanford Department of Emergency Medicine, had been evaluated by colleagues at Stanford Hospital. He was well enough to be released, but his symptoms persisted.
In addition to his fever, shortness of breath and coughing, D'Souza continued to feel anxious -- particularly about his family and how they felt. What helped was a pulse oximeter that he kept in a medical equipment bag he'd used as a team physician with the San Francisco 49ers.
Before going to bed, D'Souza would check his blood oxygen saturation level and text pictures of the numbers to his wife a few rooms away. The numbers were always in a normal range, signaling that his lungs continued to function well. This meant more than any words he could say.
As a management consultant, D'Souza's wife likes data: "It would reassure both of us that we had that data," he said.
Precautions for the family
D'Souza and his wife carefully considered precautions. It was a full week before the Bay Area would enact the first shelter-in-place rule in the nation. The couple rejected the idea of setting up his wife and sons in an RV or hotel, which seemed to pose more complications than solutions. Instead they decided to strictly isolate him from the family. His wife would bring him a tray of food and leave it outside the guest bedroom. His boys would see him on FaceTime.
"With the guidelines changing so fast, you can only make the best decisions based on today's information, knowing that information might change," D'Souza told me.
He ended his isolation in the guest room when he no longer had a fever and his cough dramatically improved. At that point, a colleague advised that he could emerge from the room during the day while wearing a mask, though he continued to sleep in the guest room for two weeks after his fever had passed.
Stepping outside into a different world
D'Souza remained quarantined in his home until March 31, when he was cleared to return to work by Stanford Medicine and the San Mateo Department of Public Health.
When he finally stepped outside, the world was very different. "I stood in my driveway to watch my boys play," D'Souza said, "and there were no cars."
Returning to work three weeks after he'd tested positive for COVID-19 was an emotional experience.
"The last time I'd walked through the doors was as a patient, and I wasn't sure how bad it was going to get or if I'd see my family again," D'Souza told me. "It felt good to be recovered, and to share hope and reassurance with my colleagues."
Throughout the day, co-workers told him how pleased they were to see him. Andra Blomkalns, MD, chair of emergency medicine, had been checking in with D'Souza every day; but that did not compare to seeing him in person.
"When I rounded a corner and saw him back at work, I had this surge of relief and happiness," she said. "This was someone who had the disease, and was actually happy and confident to come back to work. He was living proof that you could get over it."
Helping others navigate COVID-19
Together, they defined a new role for D'Souza as a physician who had experienced COVID-19. He would provide guidance for his colleagues on how to navigate personal and professional concerns arising from the pandemic -- recognizing that even being tested for COVID-19 can be psychologically trying for health care workers.
"We are fortunate to have someone who understands those concerns from experience," Blomkalns told me. "That psychological support to everyone on the front lines is really important."
Back in his regular job providing emergency care, D'Souza is also determined to provide comfort and care for patients with COVID-19.
He says he's more sensitive to the isolation patients may experience, and he knows he has a special insight into their feelings and fears. He makes a point of taking time to speak with them on a personal level -- visiting them in full protective equipment to learn about their lives -- and sympathizing with family members who struggle to balance safety concerns with the desire to be by a loved one's side.
"I do share my story with some patients -- especially those who I sense are afraid of COVID," D'Souza said. "I let them know you can have it and get over it, and be back out in the world doing what you love."
Read Part 1 about how D'Souza learned that he had tested positive for COVID-19 and why he sought medical care from his colleagues.
Photo of Peter D'Souza by Susan Coppa