The COVID-19 mystery of Ben O’Donnell, a
30-somethingIronman athlete, remains as baffling
today as it did March 10— when Minnesotans
learned the state’s first coronavirus case needing
intensive care was someone in his prime.
State health investigators were perplexed,
given the virus’ historyof hitting the sick and
elderly the hardest.
Minnesotans lost hope, because being young and
healthy were not surefire shields against COVID-19.
“It made everything a lot more real,” said
Haley Kramer, an intensive care nurse who treated
O’Donnell, “because he was me,he was my husband,
he was a lot of my close friends and family.
Just a young, healthy guy.”
Odds of recovery were a coin flip after COVID-19
ravaged his lungs and forced doctors to place him
on a ventilator and an
ECMO heart-lung pump to keep oxygen-rich
blood flowingin his body.
Today, he is home in Anoka County, still recovering
but offering hope to a state awaiting the peak of this
pandemic.
“I was close as
you could be
to checking out
without checking
out, and here I
am,” O’Donnell said.
“I want to give hope
to those that are
going through it,
those that have gone
through it,
and those that are
not seeing the light
at the end of the
tunnel.”
O’Donnell, 38, remains
ananomaly in Minnesota,
which on Saturday, had
2,213COVID-19 cases and
121 deaths. The average
age of confirmed cases is 54 years old
and the average age of those
hospitalized is 64.
Even among COVID-19 cases on ECMO, O’Donnell
beat the odds. Only 21 of 65 patients globally have
survived after ECMO.
“The reason you’re putting people on it is there is
nothing left to do for them,” said Dr. Jeffrey Chipman,
a critical-care leader for
M Health Fairview and the University of Minnesota Medical
Center,
which has treated two of the world’s 21 ECMO survivors.
Chipman felt relief watching O’Donnell’s vital signs
stabilize under ECMO. It bought time for doctors to
figure out what to do next,
albeit for a disease with no proven treatment.
Didn’t look right
O’Donnell hadn’t set out to make history when
he arrived at the U emergency room March 9.
He had been worn down froma business trip and
stayed home sick for a week while his wife was on
a getaway with her sister; their 3-year-old daughter
stayed with grandparents.
O’Donnell didn’t look right when he picked up
his wife,Deanna, at the airport March 8 and asked
her to drive.
“That was weird,” she said.
They had been mindful of COVID-19 — staying
separated when O’Donnell first got back from his
work trip and keeping the house
sanitized — but figured he would just go to the
ER to receive fluids and rehydrate and then go home.
Instead, that was the last day for a month that
husband and wife were together. Isolated because
of his likely infection, O’Donnell signed “I love you”
through a window to his wife
before she left.
It was the U’s first COVID-19 case, and Minnesota’s
third. O’Donnell’s health cratered. The next morning,
doctors snaked a tube down his throat and placed him
on ventilation.
Hours later, they asked his wife by phone to OK
the ECMO because O’Donnell’s blood oxygen levels
were critically low. His lungs were packed with fluid.
He was going to die without swift action.
“His chest X-ray when he came in was abnormal,”
said Dr. Meghan Rothenberger, a U infectious-
disease specialist. “Within two days of his hospitalization,
it was terrible — the kind of terrible that when
I looked at it, I was like, ‘ohhh.’ ”
ECMO historically came with heavy sedation
to keep patients from moving and injuring themselves.
These days, doctors try to keep patients conscious and
moving so they aren’t “wet noodles”
when they come off the machine, Chipman said.
Odds are better when people are young and strong,
and O’Donnell had that going for him. He finished the
2017 Ironman in Madison, Wis.,and was training for
another one.
‘Don’t stop, don’t quit’
O’Donnell’s hallucinations
as he faded in and out of
consciousness were dark.
His masked caregivers were
evil captors to him. His vision
was not of a hospital but of a
den of human trafficking
that was grooming him. He was
in danger and needed to escape.
In hindsight, with counseling to
deal with the trauma, O’Donnell
came to see the positive
interpretation. His brain was
telling him he was in a bad place physically, and he needed to fight to get better.
“I was somewhere else mentally,” he said. “It was a
pretty terrible place, but I now know the entire time my mind was looking for a
way for me to be able to escape.”
O’Donnell woke one day to see his sister, Dawn Inman, a
Mayo Clinic nurse, who was permitted to visit. Confused, he wrote
her a note: “human tr?”
“No,” he recalled her replying. “You’ve been here the entire time.
You were really, really sick. You’ve started to get a little bit better.”
It was March 17, the last day she was allowed in the hospital
under new visitor prohibitions. The state now had
60 COVID-19 cases, and epidemiologists were two days f
rom acknowledging that the virus had reached broad, community-transmission levels.
Inman ducked into the room one last time to hug her brother.
Reality became clearer after that, O’Donnell said, and he
believed he was going to be OK.
“Don’t stop, don’t quit, keep moving forward,” he thought, r
epeating the mantra that fueled his Ironman finish.
The hospital had prepared for COVID-19 but was not expecting
a first case so bad in someone so young. Rothenberger said
some people feared walking by his room, but his nurses
never hesitated to don protective gear and treat him.
Brain damage is a concern for ECMO patients, but O’Donnell’s
pupil responses and reflexes were good during initial sedation.
Later, he amused caregivers with a middle-finger gesture when
a nurse tried to put mitts that he didn’t want over his hands.
O’Donnell was still in there.
“It was amazing how much he remembered,” Kramer said.
The dilemma was what to do with the time ECMO bought.
Doctors tried an anti-malaria drug, hydroxychloroquine, based on
reports that it worked against COVID-19.
Hospitals worldwide reported immune-system overreactions in
some bad cases, and O’Donnell showed signs of a cytokine storm
— an excessive release of cytokine proteins to fight the virus.
Hematologists at the U have treated that problem in cancer
patients with tocilizumab, a drug that blocks the Il-6 cytokine,
so the doctors tried it. Coincidentally, O’Donnell, a chemical
company executive, had worked earlier in his career on a
blood test for Il-6.
“We saw him really turn around,” Rothenberger said, though
the drug is only one possible reason.
O’Donnell was strong enough to stand while on ECMO, which
was removed March 22, and he continued in therapy exercises
until his discharge April 6.
O’Donnell wasn’t the first U.S. COVID-19 case on ECMO, but he
was the first survivor to get off it. Doctors flooded the U with questions
about what worked. The case will soon be featured in a medical journal.
‘Tiger germs’ are gone
Back home, Deanna and their daughter grew hopeful. They had
been quarantined for two weeks because of their potential exposure
to the virus but never tested positive.
Daily video chats were limited to waves and hand signs at first,
but soon O’Donnell was talking. To make the infection understandable,
Deanna told their daughter that her father had “tiger germs” clawing him.
Some of the talks stung. O’Donnell recalled his daughter saying,
“ ‘Daddy, I wish you never went to work to get those tiger germs.’ ”
Over time, the girl could see her father’s progress — first his
intubation was gone, then a large nasal cannula, and the feeding tube.
After discharge, O’Donnell’s sister drove him home. Father, mother
and daughter embraced for the first time in a long time on their driveway.
The tiger germs were gone.
Treatment had been frightening and complicated. Twice, O’Donnell
had to be reintubated — the first time when his breathing tube clogged,
and the second when he coughed so hard he forced it out of his throat.
He needed periodic dialysis for his kidneys, and suffered internal
bleeding because of anti-clotting medication.
Full recovery remains possible, with patience. The Ironman
lasted .4 miles on a treadmill this week, and needed supplemental
oxygen for only half of a 15-minute walk.
Now, O’Donnell is looking to help. Researchers are studying
his blood and genetics, trying to figure out what made him vulnerable
to such an attack. He hopes to donate blood plasma to treat others
with COVID-19.
“As terrible as it was,” he said, “I would do it again if I could
stop someone else from being sick.”
jeremy.olson@startribune.com 612-673-7744
