[A really interesting medical perspective on his own COVID experience, and at the end, a very quick loss of immunity (so he got his shot, to restore it)]
No Barriers Podcast Episode 94: Coping with COVID with Dr. Kurt Papenfus
Original link: https://nobarriersusa.org/podcast/interview-with-dr-kurt-papenfus/
Erik and Jeff speak with Dr. Kurt Papenfus, about his experience with COVID-19 and its aftermath. Dr. Papenfus talks about how he utilized his experiences in the climbing world to help him survive and recover and offers advice on how to stay safe in our changing world.
Dr. Kurt Papenfus works in family practice and emergency medicine in the rural communities of Colorado. Kurt attended school at the University Of Colorado School Of Medicine where he graduated in 1986 and began to complete his internship and residency at St. Joseph Hospital in Denver, CO. Kurt has been involved in the Center for Disease Control, National Occupational Research Agenda, Oil and Gas Sector Council, and was an Occupational Safety and Health Administration Advisory Council member. Kurt was also the doctor for the USA Climbing Team on Mt. Everest with the USA-Soviet-Chinese in 1990 and 1992 and can be remembered as the doctor on staff for the movie "Cliffhanger" in which Sylvester Stallone played an important role.
Resources:
Dr. Papenfus featured on CPR
Read Breath by James Nestor
"One thing COVID and especially bad COVID can do to you is humble you really quick."
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Episode Transcript
Dr. Kurt : One thing COVID and especially bad COVID can do to you is humble you really quick. COVID isn't like in a bar fight it just runs by and hits you over the head of the bottle and takes off. COVID's the kind of disease that's going to sit there. And if you get back up, he's going to knock you down. And if you keep moving, it'll kick you when you're down. It's a weird disease. Right when you think you're over it, it'll come back and hit you again.
Erik : It's easy to talk about the successes, but what doesn't get talked about enough is the struggle. My name is Erik Weihenmayer. I've gotten the chance to ascend Mount Everest, to climb the tallest mountain in every continent to kayak the Grand Canyon. And I happened to be blind. It's been a struggle to live what I call a no barriers life, to define it, to push the parameters of what it means. And part of the equation is diving into the learning process and trying to illuminate the universal elements that exist along the way and not unexplored terrain between those dark places we find ourselves in, in the summit exists a map. That map, that way forward is what we call No Barriers.
Jeff : Dr. Kurt Papenfus works in family practice and emergency medicine in the rural communities of Colorado. Kurt attended school at the University of Colorado School of Medicine, where he graduated in 1986 and began to complete his internship and residency at St. Joseph hospital in Denver, Colorado. Kurt has been involved in the CDC National Occupational Research Agenda, Oil & Gas Sector Council, and was an Occupational Safety and Health Administration Advisory Council member. Kurt was also the doctor for the USA climbing team on Mount Everest with the USA Soviet Chinese in 1990 and 1992. And can be remembered as the doctor on staff for the movie Cliffhanger in which Sly Stallone played an important role.
Erik : You're a unique doctor athlete Kurt, because I met you and Aspen years and years ago, you were emergency room physician there I think. So you have a lot of experience with high altitude medicine. You are also a climber. You are also the doctor for like the 1990, 1992 Everest expeditions. When I think there was a US team and a Chinese team and a Soviet team all coming together.
Dr. Kurt : Right.
Erik : So you have tons of experience. So then when this pulmonary disease happens, you're also emergency room physician and an expert in other areas, you're in a rural community on the Eastern Plains of Colorado And you're the sole doctor, right? In this and this emergency room?
Dr. Kurt : Yeah. So I'm basically the only doc that's out here full-time and everybody else just flies in and does some work and out. And I used to do a week on a week off, which as I realized now is, is way too much. I'm not going to do that again. Because maybe when I was 30, I could get away with that stuff. But you know, I turned 63 with COVID, November 2nd. And by the way, for my birthday COVID gave me COVID diarrhea at 1:00 AM. And COVID gave me the COVID headache at about 2:30 in the morning. On top of COVID pneumonia, which was really a shitty birthday.
Erik : That's excellent. That's good. Good humor.
Dr. Kurt : So yeah, it's funny, "How did you get to the hospital?" you ask a patient, they go, "Well by the ambulance." And it's like, "Well, let's rewind a little bit behind that." And then you'll get the one wise guy that goes, "Well, I was born in 1850." And, I used to hang out with Hunter Thompson and that was his doc for a while, which is another interesting story.
Erik : Dude.
Dr. Kurt : But fear and loathing in the COVID, I think it's going to, I'm going to call it Fear and Loathing in the Heart of COVID Darkness.
Erik : I love it.
Dr. Kurt : Because I'm a doc and I'm also... We started with our CDC group, started paying attention to this stuff back in November. And we found, they went back and looked at blood samples in December that were taken for other things and testing them for COVID and guess what? We had COVID in our country in December and nobody knew it because nobody was looking for it. And only when that nursing home in Washington State got hammered and people started dying, then we started paying attention to it. But up to that point, it was kind of like an academic thing. And you know, our country really wasn't revving up for what was coming because some people didn't think it was going to happen. But you know, the bottom line for that is who needs to worry about nuclear war right now?
Dr. Kurt : I mean, this stuff just talks about what we need is a really good nasty virus and set it free and you can kill a bunch of people and leave all the buildings and everything standing to take over and you don't have to worry about radiation down the road. I mean, this was a really interesting exercise just if you're into bio terrorist stuff. So our country and every country, better really be paying attention to this stuff because this was a good trial run.
Dr. Kurt : But that being said, we're paying attention to COVID, I'm at a CDC meeting talking about what we're going to do with COVID with oil and gas workers on this friend of mine literally goes in the ICU and I've always had a theory that if you're in deep shit, what do you need to do? You need to find somebody who's been in the same deep shit and got out of it and you get a hold of them and you find out how did you stick the landing?
Dr. Kurt : You know, that's with climbing that's with everything. When I was on Everest, I was hanging out with the really smart guys who'd been on Everest a bunch and just kind of did what they did. When you get sick with a lung disease it's helpful to have learned a lot about lungs at altitude. But national Jewish pulmonologists were actually pretty impressed I knew that much about lungs, because most docs maybe knew that much and forgot it. Also about hypoxia, hypoxia and altitude and you know, I could tell him exactly how I felt with O2 sats of 75%. I mean, that's not that freaky, people can live at sats that low. The freaking thing about COVID is how you can start out in the nineties and then within hours be in the seventies.
Jeff : Yeah. And there at first it sounded like a lot of folks were like, "I need to take your phone from you so we can rapid sequence and intubate you." Because they're walking and talking with the sat and the low to mid seventies and everybody freaks out, like, "We're not used to seeing this." And I've thought to myself, "I've seen, I've seen sats in the seventies at 8,000 meters with every single person and they're all walking and talking." But the evolution of how we interpret that has changed dramatically in the past 14 months, or sorry, 11 months.
Jeff : You're treating patients, you're seeing people die. You're going through these experiences. Did you, throughout the summer and early fall of 2020, feel like it was almost inevitable like that you were heading down that path and at some point it would hit you. And then when it did you weren't shocked or?
Dr. Kurt : Yeah, well kind of like everybody after months and months and months, you kind of get COVID fatigue. And at one point I just thought, "Well for as old as I am, I'm pretty in pretty good shape. I think I can handle it". Which was kind of arrogant in a way, because one thing COVID, and especially bad COVID, can do to you as humble you really quick. And if you don't get humbled really quick, it'll come back and make sure you get humbled because COVID, isn't like in a bar fight, it just runs by and hits you over the head of the bottle and takes off COVID. COVID's the kind of disease that's going to sit there. And if you get back up, he's going to knock you down. And if you keep moving, it'll kick you when you're down.
Dr. Kurt : It's a weird disease. I mean, I've fought for 33 years. I fought all kinds of illnesses, but COVID is the only illness I can say there was a darkness about it. And what I mean by that is just having fought at hand-to-hand, you fight anything hand-to-hand, you kind of know about it more than your typical person would. So it tips its hand to you on certain tactics. So I kind of got an intimate look at how it kills people and part of it is it just, it doesn't quit. Right when you think you're over it, it'll come back and hit you again.
Dr. Kurt : You know, I've been telling all my old cowboy friends, which by the way back, I'm in cowboy country. And back in the day only bad guys and outlaws wore masks and that was the attitude.
Dr. Kurt : Well we've seen a shift in thinking about that. I mean, some guys wouldn't wear a mask no matter who flew in and told them to wear a mask, including Biden or Trump or pick your person. Some of these guys are just like, "You and who's army?" And that's the way it's going to be. But a lot of them live out in their ranch compounds and come into town once a month, kind of a thing. I mean, my county, Cheyenne County, Colorado has 1800 people basically in about 1800 square miles. So population density is roughly a person per square mile, which is really good in a pandemic. I had some CDC guys want to trade me counties. And I said, "No, I don't think so."
Erik : Kurt, how'd you go from fancy pants, Aspen as a doctor to the prairies of Colorado, right on the border of Kansas?
Dr. Kurt : That is such a good question, Erik. I get that all the time.
Erik : Yeah.
Dr. Kurt : So I was up in Aspen from God '88 to 2018. So we were up in Aspen for 30 years and I originally went from being a surgical resident. I went up to Aspen to be an ER doctor ski bum, to kind of figure out what I wanted to do with my life. And I kind of liked it. Then I met my wife up there and then I get to brag that, in my eyes, at least I married the prettiest girl in Aspen, which is pretty cool to do. So now I have that going for me and we're living up there and we have two, two sons, Andrew and Stephan. So they couldn't find a doc again. So I came out here in '89, '90, '91, two weeks on two weeks off and flew my falcons. And then I go back to Aspen and hang out.
Erik : Like true falcons, so people know that you actually have a falcon and you're into falconry.
Dr. Kurt : Yeah, yeah. I've been flying [crosstalk 00:10:14].
Erik : Saturday Night Live falconry. The real thing.
Dr. Kurt : No. And you know you're living in Aspen. When you say a fly a falcon and they say, "Oh, is it the 650 or the? You know what I mean? It's like, "No, it's the kind with feathers."
Erik : Yeah.
Dr. Kurt : Out here you don't get that. It's like, "Oh." So right now I've got a Peregrine Falcon. That's that;s a pure Rocky Mountain and Autumn Peregrine Falcon. I've always wanted to fly one. Since I saw one up on Ralston V it's up by Coal Creek, back in '64, when I was a kid. I was about seven then I think, and I did that peregrine Falcon reintroduction work, where I basically lived in a tent and watched falcons for the government back in '76, '77.
Erik : So you wind up on the prairie there and Cheyenne Wells and you decide to take a trip, right? You said you got a little lax, I guess. And you decide to take a trip and that's where you think you got COVID, right?
Dr. Kurt : So I make the strategic error, which is things look like they've died down enough. I'm going to fly to Boston. My brother-in-law just bought a new place on a Lake up in Maine. I've never been up in Maine during peak leaves. It's the second week in October. So we just decided we're going to go. Now we wear N95 masks. You fly first class because that way you get to use the first class bathroom. You're not in what I call the festival port-a-potty in the back of the plane right.
Erik : Nice.
Dr. Kurt : That's that's not a good idea. So we fly out there and no problem, fly back no problem. So I get on the train and people have been sending pictures of the packed train to DIA with complaints for months and months, I looked it up. And the DIA administrator said, "Well, nothing to worry about. You're only on the train for five minutes, six seconds at the longest." Well, one thing is if you're inches away from some young guy that doesn't even know they have COVID and they're spewing COVID out of their mask right in your face, you're probably going to get it in five minutes too. You don't need to be that CDC 15 minutes, number one.
Erik : Even with a mask?
Dr. Kurt : Yeah, even with a mask. I mean, well happened to me. I'm just counting down the minutes, going, "Okay. CDC says you have 15 minutes of close exposure time before you get it." The problem with just on the train and nobody's telling you about this, because they don't want you to know, but I put it in a letter to DIA in a formal complaint. When nothing happened, I sent out a letter to Mayor Hancock and I sent a letter to Governor Polis pointing out the problems. That's where I was really close to a lot of people. I had no clue who they were, where they came from. At any rate, so I'm pretty convinced. That's where I got it from. DIA would fight to the death saying "No, no, no, no, no."
Erik : And how long after that experience, did you start feeling symptoms and what were those symptoms?
Dr. Kurt : I'm on that flight and then exactly a week and an hour to the day of being on that train, I started getting this weird cough. And the best way to describe it is for your listeners who've ever had a kid with RSV where you just have to cough, cough, cough, cough it up, and then you're fine for a while, till you have to cough, cough, cough, cough it up. That's my symptoms exactly. And the national Jewish pulm guy says, "Yeah, that's exactly what's happening. When your immune system finally figures out, this COVID bad stuff, you basically slough your lung lining and you have to cough it up and it's like wet toilet paper." They're seeing that in intubated patients where they have all these mucus plugs and stuff and they have to go suck them out like an adult RSV.
Dr. Kurt : So I started that cough on the 27th, a week after the flight, it's a little bit late to develop symptoms, but it's well within that range. And except for that cough, not being able to sleep at night and my nighttime blood pressure is being really high. I felt really fine. I didn't feel sick at all.
Dr. Kurt : The next morning I was at Lincoln County when it started, I drive over to Cheyenne Wells. I'm a little bit tired and a little bit fatigued. I take a nap, but I don't feel bad. I don't have a fever or chills or anything like that. But that cough was weird enough where my MA who knows me well heard me cough and said, "What the hell was that?" And I said, "I don't know but I started at last night." So the nurse practitioner came out and wanted to know about it. And basically, he started with, "You have a fever? You have chills?" Going down the list. And I said, "No, it's just this weird cough, but it's really weird. I've never had it like this before. Maybe we better get a test."
Jeff : Did you feel when that process started to take over, did you sort of say, "Okay, this doesn't surprise me." Like at some point I feel like I was in the shooting range and the cross hairs were going to hit me at some point. And then I guess I'd like to hear how you felt as a patient and the vulnerability comes with that, especially with the nuance of COVID, like you said, it's so unique in the sense that not only are you sick as hell, but it's an isolated illness.
Dr. Kurt : So you're right, Jeff, it was like, "Sooner or later, I'm probably going to get this, but I think I'm pretty healthy. I think I can handle it." So I go in, and my chest x-rays normal on, on 11/3, I get a CAT scan, 11/4 and it shows COVID bilaterally in all segments of my lungs. Now that COVID was there just the chest x-rays didn't show it. But the scan, once I had the scan done that Wednesday night, the fourth, that immediately staged me into, "Wow, you're in the COVID red zone because you got it all over in your lungs." Now the people they always ask, "Well, did you lose your taste of smell or tastes?" And I said, "No, I didn't." those tend to be the people that get it in the upper airway, the sinuses and stuff.
Dr. Kurt : So it's actually a good thing. If your coffee tastes like water for a week or two, because, that's why you have sinuses and stuff to prevent that stuff from getting into your lungs. So that worked well for them.
Jeff : Right.
Dr. Kurt : You know, if you have it in your sinuses and stuff, there's only so many sinus cells and things it can divide and conquer, but once it gets into your lungs, man, there was a way more lung cells that it can do damage to. Plus, you can live with plugged sinuses for a while and you see your coffee tastes like water for even a month.
Jeff : That's anecdotally that was my process last, late February. It was exactly that it stayed, it stayed north of the neck. It felt like other than some heavy chest pressure. And the more I looked into it, the more I realized, like, "I'm one of those lucky few that sort of didn't allow it down that freeway down into the lower lobes where it wanted to sit."
Jeff : So while I've got the mic, I really want to know where your brain was at this point about where your fear was. Were you scared when you realized like, "All right, I see my CT scan, I potentially could throw a clot any minute, fear is becoming a real issue here." Or where you always, were you calm?
Dr. Kurt : When it hit me really hard was that Thursday morning I sent my CAT scans and my labs back to my smart docs. And the one smart doc in Denver, who's a God he's a professor in toxicology of internal medicine, critical care and emergency medicine, really smart guy that I trust a lot. So Thursday morning when he calls me and he says, "You're dying in Cheyenne Wells, you better get your ass to Denver right now. You're not sick enough to be in the helicopter yet, but you need to go. Your CAT scan of your lungs is horrible. And you're going to drop your sats at some point, but nobody knows when that's going to happen. But you're at the highest risk." These guys wouldn't have told me, get your ass in the ER.
Dr. Kurt : You know, I show up at St. Joe's [inaudible 00:17:45] and that they didn't like that. I didn't like that. So here comes the Remdesivir, here comes the steroids, here comes everything that the president got except monoclonal antibodies.
Erik : Which is like hundreds of thousands of dollars, right?
Dr. Kurt : Oh, it's crazy expensive. It's super hard to get. In my case, I thought I could get away with it, Jeff. I really did. But the second week it got me and it got me. Good.
Erik : So how bad did it get when you're at St. Joe's did they intubate you then? Or no.
Dr. Kurt : No. I never, never got intubated. So they almost took me to a step-up unit, which is their high flow oxygen. Because again, you don't intubate somebody unless you absolutely have to. Because being intubated with COVID is almost like a premorbid thing that they found. Intubating a COVID patient's a bad idea, unless you absolutely, absolutely have to do it.
Dr. Kurt : So about a week out, I get admitted and got all this stuff done on Thursday. Well, the following Tuesday, they want to discharge me from the hospital because I've gone through the COVID protocols and I'm out of the algorithms. So one doc comes in and wants to send me home. And you know, it's bad when you literally tell this to your attending doc, "Look, the only way I'm going to leave this hospital today..." Quote, unquote, "The only way I'll leave this hospital today is handcuffed to a wheelchair and in security is throwing me out the front door. And that's my final answer." Unquote. So I stood them down. And then good thing, because that night I go into a full-blown [sers 00:19:10] with a fever, chills, my white count's 12,000, my chest x-ray it looks terrible. You know, that's the night I was going to die. And people said, "If you would have been sent home that night, you were dead." Which kind of worried me.
Jeff : So it was the diagnostics, it was the drop and the diagnostics that saved you because the attending there was ready to boot you out.
Erik : If you were a non-doctor, nonmedical person, they would have discharged you, you would have been able to fight back or say, "Hey, no, that's not a good idea." You would have just gone home and maybe died.
Dr. Kurt : Yeah, well you would, would've gone home and probably been septic and coming back in by ambulance, or they just would've found you dead. That's where having medical knowledge was really handy. And I did, what's called in climbing world of self rescue. And I did that a couple of times. That was a big one though, because what it was Jeff was that little red light in the back of my head that goes off when there's somebody really sick that I got to pay attention to. And that's something you get by doing years and years of this stuff, and knowing what sick is.
Dr. Kurt : There's like a sixth sense, you get like all those old climbers just have a sixth sense about stuff. You know, they look at all the numbers and all that, but then they listen to this sixth sense and it says, "Today's not a good day to go." And you'll go, "Wait a minute. It looks perfect." And then later on here comes that weird storm. How did they know that? Well that red light was going on when this doc was trying to send me home and it wasn't for anybody else this time it was on for me. And I told her that, "I said, look that my warning indicator light's going off and I pay attention to it. And right now it's telling me, 'You're not listening to me. There's something that you guys are missing and I'm still sick and I can't get home yet.'"
Jeff : You've had plenty of grand experiences. You know, I'm sure this ranks up there with those that have been a hard stop on things. What is it in I guess not just a medical perspective and not maybe how you treat patients, but almost metaphysically. Like, what did this do for you? Where did this take you, that when you came out of it, it changed you in some fashion? And I'm not talking pulmonologcally. I'm talking about from your mentation and how you're looking at things. Is there a change in the optic?
Dr. Kurt : Yeah. I just appreciate the fact that you can take a deep breath without even thinking about it now. You know, you're not tied to all... Also, it's a good idea to be a climber if you get admitted to a hospital that has all these tubes and hoses hooked onto you, because you're literally doing rope management with all these hoses, going to the bathroom and stuff. I thought of that, but you know, it hit me hard and I had an epiphany basically. And it was getting close.
Dr. Kurt : Now for some reason, I just knew I wasn't going to die, but this wasn't going to be fun. And it wasn't. And I had to do some, literally I kind of got in my COVID brain at the time I got into hand to hand combat with what I called the Rona beast. After I kind of came out of it and I started to know. Because the thing with COVID is you think you're out of it and then it comes back again and it'll hit you again, again. And I can see it's real easy, where at some point you just say, "That's it, I'm done. Go ahead and kill me. Just don't make it hurt too bad." I mean, I totally get that.
Dr. Kurt : Meaning it's easier to die. Living's the hard part. Yeah, dying's easy. It's the living that's hard. And I just I guess after that kind of time slowed down. A lot of the crazy political stuff going on. I just didn't care about. I mean, that, to me, that was just kind of trivial stuff that, "Why are you, why you're so worked up about all this stuff\? number one, half of it's boogeyman anyway." But I just appreciated lights on Christmas trees. I mean, my whole thing was like, you can't have enough Christmas trees out in the world right now. If China had a bunch and Iran had a bunch, they'd probably be a happier country.
Jeff : I love that. I think back though, Kurt on your demographic that you're working with there and the ranches and the farmers, and maybe some of them that bought in, maybe some of them think it's total bullshit. And we realize that there is a large percentage of our populace that doesn't buy into it. So I think to myself, I wonder, I do wonder if it didn't work. I wonder if being sent to our room, the ones who are really thoughtful and intuitive and listen to science are the ones who are going to come out and you're going to be changed. But the people that we need to really evolve through this process and really just learn what it means to be smacked around a little bit and sent your room and come out. I wonder if they're really learn it. So what is your take? What's your spin on that, Kurt?
Dr. Kurt : Yeah. You know, the old saw you can't fix stupid, you'd have to work around it. That's part of it. You can talk to people and if they're not willing to listen just save your breath. But for me, from where I went and came back, you just appreciate the simpler things in life.
Dr. Kurt : Now what's interesting in Cheyenne County is I come out here and I see a lot more people wearing masks than when I left. And part of it is everybody knows me. And if, if doc could get whacked like that, man, you know, maybe it could be me too. So in a way, maybe I was like a sacrificial lamb in a way so that these guys will fricken get it.
Dr. Kurt : Now they're really old cowboys that Donald Trump could fly out here in a helicopter and tell them wear a mask and they would literally tell him, "Yeah, you and who's army?" Now guys like that, you got to kind of work with them and you know it's still technically a free country. You're still allowed to be as big an idiot as you want to be within the limits, right?
Erik : Yup.
Jeff : Yup.
Dr. Kurt : The other thing is do we all just go hide in our, in our COVID pods or COVID cones or hide in our basements and just come out when it's over. And I'm thinking, "Nah, we never want a war by hiding in our basements. We need to be out doing things, but we need to be smart about it." And that's where the economic argument comes in because there's a lot of people going, "Wait a minute, we can all hide and be safe, but we won't have a country to come back to because our economy's shot." And I've never seen an infectious disease... Which is I guess what these pandemics do is they wipe out your social structure and they take your economic foundation out from underneath you. And then the question is, how are we going to come out of this?
Dr. Kurt : And if you know your history, pretty much every great civilization kind of sort of gets taken out finally by some big pandemic and they didn't handle it right. So the jury is still out on this thing, but my point is with COVID is just... You know, I was even getting to the point where I just hope I get a little bit of it and get it over with because I'm just tired of it. I met a bunch of people like that too, including docs that they weren't wearing N95s because they just wanted to get it and get over with, and guess what? They got it. And like you, Jeff, couldn't smell things for a while and they were fine. Well, get on your knees and say, "Thank you. Thank you. Thank you. Thank you." After that one, because from my perspective, it's like, God, I could have died from this pretty easily. And I thought I was tough. So you just never know.
Jeff : Well, let's just say you are tough. You are tough. I don't think that's an indicator of tough versus not tough because if anything, we've learned, it's just such a lightning bolt of who is going to get tubed and who's going to lose their smell for a week, right? And it has really no discretion on that so.
Dr. Kurt : You don't know. The other problem they're finding out is you could have COVID like Jeff had, and three months later, all of a sudden, wind up not thinking clearly, and you can't walk a city block and they have no idea why that happens. So even when you think you're out of the woods, you're not quite out of the woods yet.
Dr. Kurt : Now I got hit hard enough where it hit my kidneys, hit my lungs, obviously, but it also hit my brain to where that really smart doc, they told me, "Get your in a Denver because you're dying now." Called me up in the hospital and said, "Normally you're such a smart guy. I trust you to haul me off the South call of Everest, put me in a Gamow bag and save my life. But now your critical thinking is so degraded. I wouldn't trust you to drive me across the street." Well, that gets your attention too. And so I'm kind of on a hard stop. I haven't practiced medicine since October 28th. Now they're thinking my reasoning and critical thinking is coming back enough to where in February, I might be able to do some clinic stuff, but they're still not sure I'm going to get back to being an ER doc again, for instance.
Erik : You know, just talk to everybody about how COVID is affecting rural communities. Because like I read just what South of you, there's 1,000 folks that came down with COVID, people are compromised. There's more diabetes, there's more challenges with people's obesity and things like that out there. So yeah. Talk about maybe people forget that COVID is affecting the rural community of the US and Canada and so forth and around the world.
Dr. Kurt : The problem with rural is, first of all, recognizing it was even a problem because you had so many deniers out here. And so many people that didn't think it was really real. Well, when some of the old ranchers and farmers and everybody knows everybody out here starts dropping dead, then that started getting people's attention. The fact that I was in the hospital for all those days, that got people's attention. And I kind of thought this too, "We're just so spread out that we're not really a sitting duck." Meaning we can't get enough COVID in people that are so close together to really get a good mini pandemic, rurally going, and rural people thought that. Well, the people that live in the medium sized towns like Cheyenne Wells, which is Cheyenne County's seat is like maybe 800 people, 900 people.
Dr. Kurt : So 900 people live in fairly close proximity and the rest are pretty much spread out on ranches except for maybe a small town called Arapaho and a small town called Kit Carson. So at first, everybody was thinking, "We're going to get up and get away with this because this is a city problem because they're all stacked up on top of each other." And initially it was, but then that dreaded second wave where COVID came out and started picking on the rural counties hit. And the problem with that is it doesn't take too many sick people to fill up your hospital and to wipe out your nursing staff, wipe out your docs. And I guess what got the press's attention was me being kind of the doc for Cheyenne County, getting sick and being gone. They kind of latched onto that before it really started to hit hard in the rural communities, which is what do you do when your caregivers are out with COVID? You're just stuck because you just can't call on help because help is literally miles away.
Dr. Kurt : Like you said, the doc that's spelled me my first week had to drive 10 hours from Fort Worth to drive up here, to work the week that I was going to work. You just have such a shallow bench. But even the cities found out like New York. I mean, they had to import docs and nurses and stuff to help them out because they just didn't have enough people. Or what I say to you, you just ran out of army guys.
Jeff : Yeah.
Dr. Kurt : So it's hit the rural area that it's kind of come and gone now. Now we're kind of down to a low boil again, which is good. What we're worried about now is that new variant that was over in Simla, which is a couple of counties east of us. If that's much more infectious, is that going to cause a problem? But like I say, I'm seeing a lot more masks here. People are a lot more aware of it than before I even got sick. You know, the old deal saw with the cowboys out here as only bad guys and outlaws where masks, which I had to remind them, "Well get the guys in the banks are actually wearing the masks now."
Erik : No shit.
Dr. Kurt : New sheriff's in town called COVID.
Jeff : Yeah. Kurt, thank you so much, man. That was really illuminating for everyone to learn about your personal story and your take on COVID and plus all your great climbing analogies of course.
Dr. Kurt : Well, thanks you guys. Every time somebody interviews and asks you things about it, they'll point out new things that even you didn't think about. So I appreciate that.
Erik : Yeah.
Jeff : It's probably therapeutic for you to go through the whole process again too.
Dr. Kurt : Yeah, it kind of is. Especially now that I'm thinking more clearly too.
Jeff : And Kurt give us some advice. Like you gave me some good advice about vitamin D and stuff like that. Just throw a little advice out to people, how they can prophylactically prevent COVID.
Dr. Kurt : Prophylaxis is good. It's like, what's the best way to treat COVID? Well, don't get it to begin with.
Jeff : Right.
Dr. Kurt : Prophylaxis is a big deal. And I keep telling people its situational awareness. It's if you go into a place where there's a bunch of people, a people herd you're going into a COVID herd too. And it's amazing when people don't have that situational awareness. Now us climbers do, because in a climbing situation, yeah you better have it or else you're probably not going to live too long because you're going to be the guy that points out the crevasse to everybody because you went in it, so that's part of it.
Dr. Kurt : You know, I think the other part is just there is some science behind wearing a mask and all that now. Now, if you're out on a combine or riding your horse out in the prairie with nobody around you, obviously you don't need to wear it. So I take a mask and when I'm in with a bunch of people or going into a closed space with a bunch of people, hell yah, I'm going to wear it.
Dr. Kurt : And technically I can't get get COVID again, although they just did my antibody titers, and they're back down to basically negative, which means I got to get the shot this week.
Jeff : Wow that was quick.
Dr. Kurt : And that kind of threw CDC through a loop, because they thought as bad as I had COVID I'd be probably immune for six months. [crosstalk 00:32:59].
Jeff : That's kind of shocking actually, because I hadn't heard that it would diminish that much, that quick.
Dr. Kurt : It got my attention.
Jeff : And I'm sure your looks from your background, like you're a pretty voracious reader. If you haven't done so already. I think this is the perfect book for you to read right now. It's called Breath by James Nestor. Have you heard of this book?
Dr. Kurt : You know, I haven't, but I'm going to write it down right now.
Jeff : Yeah, please read it. Erik and I were just talking about the last podcast, but right now I think you would really get a kick out of it because it has some really interesting historical references and some shape-shifting information on just that simple task of breathing. And because it was just such a valuable thing that you almost lost, I think you'd get a real big kick out of it. I just read it a couple months ago and I'm going to read it again. It's just that kind of book. It just came out. It's called Breath by James Nestor. Give it a read and tell other folks too to read it because I think it's a really important thing for us to take in.
Dr. Kurt : That's a good point, Jeff, because just the very simple act of breathing, which you do automatically, you don't have to think about it for most people, but when you kind of lose that just the simple act of just taking a deep breath and moving air in and out is just kind of mission critical.
Jeff : Yeah.
Dr. Kurt : When you get bad COVID you get to the point where you appreciate just that very simple act, that everybody else just takes for granted. I mean that's life is at its fundamental basics right there.
Jeff : Thanks Kurt.
Erik : No Barriers to everyone, Kurt maybe I can hold your falcon again and we can go out and you can show me how that's done.
Dr. Kurt : Yeah. I'll bring her out there. I'll actually send, if I can figure out a way to get a hold of you, Jeff, I'll send you a picture of Erik holding the falcon, which is pretty cool.
Erik : All right.
Jeff : Right on.
https://nobarriersusa.org/podcast/interview-with-dr-kurt-papenfus/
Original link: https://nobarriersusa.org/podcast/interview-with-dr-kurt-papenfus/
Erik and Jeff speak with Dr. Kurt Papenfus, about his experience with COVID-19 and its aftermath. Dr. Papenfus talks about how he utilized his experiences in the climbing world to help him survive and recover and offers advice on how to stay safe in our changing world.
Dr. Kurt Papenfus works in family practice and emergency medicine in the rural communities of Colorado. Kurt attended school at the University Of Colorado School Of Medicine where he graduated in 1986 and began to complete his internship and residency at St. Joseph Hospital in Denver, CO. Kurt has been involved in the Center for Disease Control, National Occupational Research Agenda, Oil and Gas Sector Council, and was an Occupational Safety and Health Administration Advisory Council member. Kurt was also the doctor for the USA Climbing Team on Mt. Everest with the USA-Soviet-Chinese in 1990 and 1992 and can be remembered as the doctor on staff for the movie "Cliffhanger" in which Sylvester Stallone played an important role.
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Dr. Papenfus featured on CPR
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"One thing COVID and especially bad COVID can do to you is humble you really quick."
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Episode Transcript
Dr. Kurt : One thing COVID and especially bad COVID can do to you is humble you really quick. COVID isn't like in a bar fight it just runs by and hits you over the head of the bottle and takes off. COVID's the kind of disease that's going to sit there. And if you get back up, he's going to knock you down. And if you keep moving, it'll kick you when you're down. It's a weird disease. Right when you think you're over it, it'll come back and hit you again.
Erik : It's easy to talk about the successes, but what doesn't get talked about enough is the struggle. My name is Erik Weihenmayer. I've gotten the chance to ascend Mount Everest, to climb the tallest mountain in every continent to kayak the Grand Canyon. And I happened to be blind. It's been a struggle to live what I call a no barriers life, to define it, to push the parameters of what it means. And part of the equation is diving into the learning process and trying to illuminate the universal elements that exist along the way and not unexplored terrain between those dark places we find ourselves in, in the summit exists a map. That map, that way forward is what we call No Barriers.
Jeff : Dr. Kurt Papenfus works in family practice and emergency medicine in the rural communities of Colorado. Kurt attended school at the University of Colorado School of Medicine, where he graduated in 1986 and began to complete his internship and residency at St. Joseph hospital in Denver, Colorado. Kurt has been involved in the CDC National Occupational Research Agenda, Oil & Gas Sector Council, and was an Occupational Safety and Health Administration Advisory Council member. Kurt was also the doctor for the USA climbing team on Mount Everest with the USA Soviet Chinese in 1990 and 1992. And can be remembered as the doctor on staff for the movie Cliffhanger in which Sly Stallone played an important role.
Erik : You're a unique doctor athlete Kurt, because I met you and Aspen years and years ago, you were emergency room physician there I think. So you have a lot of experience with high altitude medicine. You are also a climber. You are also the doctor for like the 1990, 1992 Everest expeditions. When I think there was a US team and a Chinese team and a Soviet team all coming together.
Dr. Kurt : Right.
Erik : So you have tons of experience. So then when this pulmonary disease happens, you're also emergency room physician and an expert in other areas, you're in a rural community on the Eastern Plains of Colorado And you're the sole doctor, right? In this and this emergency room?
Dr. Kurt : Yeah. So I'm basically the only doc that's out here full-time and everybody else just flies in and does some work and out. And I used to do a week on a week off, which as I realized now is, is way too much. I'm not going to do that again. Because maybe when I was 30, I could get away with that stuff. But you know, I turned 63 with COVID, November 2nd. And by the way, for my birthday COVID gave me COVID diarrhea at 1:00 AM. And COVID gave me the COVID headache at about 2:30 in the morning. On top of COVID pneumonia, which was really a shitty birthday.
Erik : That's excellent. That's good. Good humor.
Dr. Kurt : So yeah, it's funny, "How did you get to the hospital?" you ask a patient, they go, "Well by the ambulance." And it's like, "Well, let's rewind a little bit behind that." And then you'll get the one wise guy that goes, "Well, I was born in 1850." And, I used to hang out with Hunter Thompson and that was his doc for a while, which is another interesting story.
Erik : Dude.
Dr. Kurt : But fear and loathing in the COVID, I think it's going to, I'm going to call it Fear and Loathing in the Heart of COVID Darkness.
Erik : I love it.
Dr. Kurt : Because I'm a doc and I'm also... We started with our CDC group, started paying attention to this stuff back in November. And we found, they went back and looked at blood samples in December that were taken for other things and testing them for COVID and guess what? We had COVID in our country in December and nobody knew it because nobody was looking for it. And only when that nursing home in Washington State got hammered and people started dying, then we started paying attention to it. But up to that point, it was kind of like an academic thing. And you know, our country really wasn't revving up for what was coming because some people didn't think it was going to happen. But you know, the bottom line for that is who needs to worry about nuclear war right now?
Dr. Kurt : I mean, this stuff just talks about what we need is a really good nasty virus and set it free and you can kill a bunch of people and leave all the buildings and everything standing to take over and you don't have to worry about radiation down the road. I mean, this was a really interesting exercise just if you're into bio terrorist stuff. So our country and every country, better really be paying attention to this stuff because this was a good trial run.
Dr. Kurt : But that being said, we're paying attention to COVID, I'm at a CDC meeting talking about what we're going to do with COVID with oil and gas workers on this friend of mine literally goes in the ICU and I've always had a theory that if you're in deep shit, what do you need to do? You need to find somebody who's been in the same deep shit and got out of it and you get a hold of them and you find out how did you stick the landing?
Dr. Kurt : You know, that's with climbing that's with everything. When I was on Everest, I was hanging out with the really smart guys who'd been on Everest a bunch and just kind of did what they did. When you get sick with a lung disease it's helpful to have learned a lot about lungs at altitude. But national Jewish pulmonologists were actually pretty impressed I knew that much about lungs, because most docs maybe knew that much and forgot it. Also about hypoxia, hypoxia and altitude and you know, I could tell him exactly how I felt with O2 sats of 75%. I mean, that's not that freaky, people can live at sats that low. The freaking thing about COVID is how you can start out in the nineties and then within hours be in the seventies.
Jeff : Yeah. And there at first it sounded like a lot of folks were like, "I need to take your phone from you so we can rapid sequence and intubate you." Because they're walking and talking with the sat and the low to mid seventies and everybody freaks out, like, "We're not used to seeing this." And I've thought to myself, "I've seen, I've seen sats in the seventies at 8,000 meters with every single person and they're all walking and talking." But the evolution of how we interpret that has changed dramatically in the past 14 months, or sorry, 11 months.
Jeff : You're treating patients, you're seeing people die. You're going through these experiences. Did you, throughout the summer and early fall of 2020, feel like it was almost inevitable like that you were heading down that path and at some point it would hit you. And then when it did you weren't shocked or?
Dr. Kurt : Yeah, well kind of like everybody after months and months and months, you kind of get COVID fatigue. And at one point I just thought, "Well for as old as I am, I'm pretty in pretty good shape. I think I can handle it". Which was kind of arrogant in a way, because one thing COVID, and especially bad COVID, can do to you as humble you really quick. And if you don't get humbled really quick, it'll come back and make sure you get humbled because COVID, isn't like in a bar fight, it just runs by and hits you over the head of the bottle and takes off COVID. COVID's the kind of disease that's going to sit there. And if you get back up, he's going to knock you down. And if you keep moving, it'll kick you when you're down.
Dr. Kurt : It's a weird disease. I mean, I've fought for 33 years. I fought all kinds of illnesses, but COVID is the only illness I can say there was a darkness about it. And what I mean by that is just having fought at hand-to-hand, you fight anything hand-to-hand, you kind of know about it more than your typical person would. So it tips its hand to you on certain tactics. So I kind of got an intimate look at how it kills people and part of it is it just, it doesn't quit. Right when you think you're over it, it'll come back and hit you again.
Dr. Kurt : You know, I've been telling all my old cowboy friends, which by the way back, I'm in cowboy country. And back in the day only bad guys and outlaws wore masks and that was the attitude.
Dr. Kurt : Well we've seen a shift in thinking about that. I mean, some guys wouldn't wear a mask no matter who flew in and told them to wear a mask, including Biden or Trump or pick your person. Some of these guys are just like, "You and who's army?" And that's the way it's going to be. But a lot of them live out in their ranch compounds and come into town once a month, kind of a thing. I mean, my county, Cheyenne County, Colorado has 1800 people basically in about 1800 square miles. So population density is roughly a person per square mile, which is really good in a pandemic. I had some CDC guys want to trade me counties. And I said, "No, I don't think so."
Erik : Kurt, how'd you go from fancy pants, Aspen as a doctor to the prairies of Colorado, right on the border of Kansas?
Dr. Kurt : That is such a good question, Erik. I get that all the time.
Erik : Yeah.
Dr. Kurt : So I was up in Aspen from God '88 to 2018. So we were up in Aspen for 30 years and I originally went from being a surgical resident. I went up to Aspen to be an ER doctor ski bum, to kind of figure out what I wanted to do with my life. And I kind of liked it. Then I met my wife up there and then I get to brag that, in my eyes, at least I married the prettiest girl in Aspen, which is pretty cool to do. So now I have that going for me and we're living up there and we have two, two sons, Andrew and Stephan. So they couldn't find a doc again. So I came out here in '89, '90, '91, two weeks on two weeks off and flew my falcons. And then I go back to Aspen and hang out.
Erik : Like true falcons, so people know that you actually have a falcon and you're into falconry.
Dr. Kurt : Yeah, yeah. I've been flying [crosstalk 00:10:14].
Erik : Saturday Night Live falconry. The real thing.
Dr. Kurt : No. And you know you're living in Aspen. When you say a fly a falcon and they say, "Oh, is it the 650 or the? You know what I mean? It's like, "No, it's the kind with feathers."
Erik : Yeah.
Dr. Kurt : Out here you don't get that. It's like, "Oh." So right now I've got a Peregrine Falcon. That's that;s a pure Rocky Mountain and Autumn Peregrine Falcon. I've always wanted to fly one. Since I saw one up on Ralston V it's up by Coal Creek, back in '64, when I was a kid. I was about seven then I think, and I did that peregrine Falcon reintroduction work, where I basically lived in a tent and watched falcons for the government back in '76, '77.
Erik : So you wind up on the prairie there and Cheyenne Wells and you decide to take a trip, right? You said you got a little lax, I guess. And you decide to take a trip and that's where you think you got COVID, right?
Dr. Kurt : So I make the strategic error, which is things look like they've died down enough. I'm going to fly to Boston. My brother-in-law just bought a new place on a Lake up in Maine. I've never been up in Maine during peak leaves. It's the second week in October. So we just decided we're going to go. Now we wear N95 masks. You fly first class because that way you get to use the first class bathroom. You're not in what I call the festival port-a-potty in the back of the plane right.
Erik : Nice.
Dr. Kurt : That's that's not a good idea. So we fly out there and no problem, fly back no problem. So I get on the train and people have been sending pictures of the packed train to DIA with complaints for months and months, I looked it up. And the DIA administrator said, "Well, nothing to worry about. You're only on the train for five minutes, six seconds at the longest." Well, one thing is if you're inches away from some young guy that doesn't even know they have COVID and they're spewing COVID out of their mask right in your face, you're probably going to get it in five minutes too. You don't need to be that CDC 15 minutes, number one.
Erik : Even with a mask?
Dr. Kurt : Yeah, even with a mask. I mean, well happened to me. I'm just counting down the minutes, going, "Okay. CDC says you have 15 minutes of close exposure time before you get it." The problem with just on the train and nobody's telling you about this, because they don't want you to know, but I put it in a letter to DIA in a formal complaint. When nothing happened, I sent out a letter to Mayor Hancock and I sent a letter to Governor Polis pointing out the problems. That's where I was really close to a lot of people. I had no clue who they were, where they came from. At any rate, so I'm pretty convinced. That's where I got it from. DIA would fight to the death saying "No, no, no, no, no."
Erik : And how long after that experience, did you start feeling symptoms and what were those symptoms?
Dr. Kurt : I'm on that flight and then exactly a week and an hour to the day of being on that train, I started getting this weird cough. And the best way to describe it is for your listeners who've ever had a kid with RSV where you just have to cough, cough, cough, cough it up, and then you're fine for a while, till you have to cough, cough, cough, cough it up. That's my symptoms exactly. And the national Jewish pulm guy says, "Yeah, that's exactly what's happening. When your immune system finally figures out, this COVID bad stuff, you basically slough your lung lining and you have to cough it up and it's like wet toilet paper." They're seeing that in intubated patients where they have all these mucus plugs and stuff and they have to go suck them out like an adult RSV.
Dr. Kurt : So I started that cough on the 27th, a week after the flight, it's a little bit late to develop symptoms, but it's well within that range. And except for that cough, not being able to sleep at night and my nighttime blood pressure is being really high. I felt really fine. I didn't feel sick at all.
Dr. Kurt : The next morning I was at Lincoln County when it started, I drive over to Cheyenne Wells. I'm a little bit tired and a little bit fatigued. I take a nap, but I don't feel bad. I don't have a fever or chills or anything like that. But that cough was weird enough where my MA who knows me well heard me cough and said, "What the hell was that?" And I said, "I don't know but I started at last night." So the nurse practitioner came out and wanted to know about it. And basically, he started with, "You have a fever? You have chills?" Going down the list. And I said, "No, it's just this weird cough, but it's really weird. I've never had it like this before. Maybe we better get a test."
Jeff : Did you feel when that process started to take over, did you sort of say, "Okay, this doesn't surprise me." Like at some point I feel like I was in the shooting range and the cross hairs were going to hit me at some point. And then I guess I'd like to hear how you felt as a patient and the vulnerability comes with that, especially with the nuance of COVID, like you said, it's so unique in the sense that not only are you sick as hell, but it's an isolated illness.
Dr. Kurt : So you're right, Jeff, it was like, "Sooner or later, I'm probably going to get this, but I think I'm pretty healthy. I think I can handle it." So I go in, and my chest x-rays normal on, on 11/3, I get a CAT scan, 11/4 and it shows COVID bilaterally in all segments of my lungs. Now that COVID was there just the chest x-rays didn't show it. But the scan, once I had the scan done that Wednesday night, the fourth, that immediately staged me into, "Wow, you're in the COVID red zone because you got it all over in your lungs." Now the people they always ask, "Well, did you lose your taste of smell or tastes?" And I said, "No, I didn't." those tend to be the people that get it in the upper airway, the sinuses and stuff.
Dr. Kurt : So it's actually a good thing. If your coffee tastes like water for a week or two, because, that's why you have sinuses and stuff to prevent that stuff from getting into your lungs. So that worked well for them.
Jeff : Right.
Dr. Kurt : You know, if you have it in your sinuses and stuff, there's only so many sinus cells and things it can divide and conquer, but once it gets into your lungs, man, there was a way more lung cells that it can do damage to. Plus, you can live with plugged sinuses for a while and you see your coffee tastes like water for even a month.
Jeff : That's anecdotally that was my process last, late February. It was exactly that it stayed, it stayed north of the neck. It felt like other than some heavy chest pressure. And the more I looked into it, the more I realized, like, "I'm one of those lucky few that sort of didn't allow it down that freeway down into the lower lobes where it wanted to sit."
Jeff : So while I've got the mic, I really want to know where your brain was at this point about where your fear was. Were you scared when you realized like, "All right, I see my CT scan, I potentially could throw a clot any minute, fear is becoming a real issue here." Or where you always, were you calm?
Dr. Kurt : When it hit me really hard was that Thursday morning I sent my CAT scans and my labs back to my smart docs. And the one smart doc in Denver, who's a God he's a professor in toxicology of internal medicine, critical care and emergency medicine, really smart guy that I trust a lot. So Thursday morning when he calls me and he says, "You're dying in Cheyenne Wells, you better get your ass to Denver right now. You're not sick enough to be in the helicopter yet, but you need to go. Your CAT scan of your lungs is horrible. And you're going to drop your sats at some point, but nobody knows when that's going to happen. But you're at the highest risk." These guys wouldn't have told me, get your ass in the ER.
Dr. Kurt : You know, I show up at St. Joe's [inaudible 00:17:45] and that they didn't like that. I didn't like that. So here comes the Remdesivir, here comes the steroids, here comes everything that the president got except monoclonal antibodies.
Erik : Which is like hundreds of thousands of dollars, right?
Dr. Kurt : Oh, it's crazy expensive. It's super hard to get. In my case, I thought I could get away with it, Jeff. I really did. But the second week it got me and it got me. Good.
Erik : So how bad did it get when you're at St. Joe's did they intubate you then? Or no.
Dr. Kurt : No. I never, never got intubated. So they almost took me to a step-up unit, which is their high flow oxygen. Because again, you don't intubate somebody unless you absolutely have to. Because being intubated with COVID is almost like a premorbid thing that they found. Intubating a COVID patient's a bad idea, unless you absolutely, absolutely have to do it.
Dr. Kurt : So about a week out, I get admitted and got all this stuff done on Thursday. Well, the following Tuesday, they want to discharge me from the hospital because I've gone through the COVID protocols and I'm out of the algorithms. So one doc comes in and wants to send me home. And you know, it's bad when you literally tell this to your attending doc, "Look, the only way I'm going to leave this hospital today..." Quote, unquote, "The only way I'll leave this hospital today is handcuffed to a wheelchair and in security is throwing me out the front door. And that's my final answer." Unquote. So I stood them down. And then good thing, because that night I go into a full-blown [sers 00:19:10] with a fever, chills, my white count's 12,000, my chest x-ray it looks terrible. You know, that's the night I was going to die. And people said, "If you would have been sent home that night, you were dead." Which kind of worried me.
Jeff : So it was the diagnostics, it was the drop and the diagnostics that saved you because the attending there was ready to boot you out.
Erik : If you were a non-doctor, nonmedical person, they would have discharged you, you would have been able to fight back or say, "Hey, no, that's not a good idea." You would have just gone home and maybe died.
Dr. Kurt : Yeah, well you would, would've gone home and probably been septic and coming back in by ambulance, or they just would've found you dead. That's where having medical knowledge was really handy. And I did, what's called in climbing world of self rescue. And I did that a couple of times. That was a big one though, because what it was Jeff was that little red light in the back of my head that goes off when there's somebody really sick that I got to pay attention to. And that's something you get by doing years and years of this stuff, and knowing what sick is.
Dr. Kurt : There's like a sixth sense, you get like all those old climbers just have a sixth sense about stuff. You know, they look at all the numbers and all that, but then they listen to this sixth sense and it says, "Today's not a good day to go." And you'll go, "Wait a minute. It looks perfect." And then later on here comes that weird storm. How did they know that? Well that red light was going on when this doc was trying to send me home and it wasn't for anybody else this time it was on for me. And I told her that, "I said, look that my warning indicator light's going off and I pay attention to it. And right now it's telling me, 'You're not listening to me. There's something that you guys are missing and I'm still sick and I can't get home yet.'"
Jeff : You've had plenty of grand experiences. You know, I'm sure this ranks up there with those that have been a hard stop on things. What is it in I guess not just a medical perspective and not maybe how you treat patients, but almost metaphysically. Like, what did this do for you? Where did this take you, that when you came out of it, it changed you in some fashion? And I'm not talking pulmonologcally. I'm talking about from your mentation and how you're looking at things. Is there a change in the optic?
Dr. Kurt : Yeah. I just appreciate the fact that you can take a deep breath without even thinking about it now. You know, you're not tied to all... Also, it's a good idea to be a climber if you get admitted to a hospital that has all these tubes and hoses hooked onto you, because you're literally doing rope management with all these hoses, going to the bathroom and stuff. I thought of that, but you know, it hit me hard and I had an epiphany basically. And it was getting close.
Dr. Kurt : Now for some reason, I just knew I wasn't going to die, but this wasn't going to be fun. And it wasn't. And I had to do some, literally I kind of got in my COVID brain at the time I got into hand to hand combat with what I called the Rona beast. After I kind of came out of it and I started to know. Because the thing with COVID is you think you're out of it and then it comes back again and it'll hit you again, again. And I can see it's real easy, where at some point you just say, "That's it, I'm done. Go ahead and kill me. Just don't make it hurt too bad." I mean, I totally get that.
Dr. Kurt : Meaning it's easier to die. Living's the hard part. Yeah, dying's easy. It's the living that's hard. And I just I guess after that kind of time slowed down. A lot of the crazy political stuff going on. I just didn't care about. I mean, that, to me, that was just kind of trivial stuff that, "Why are you, why you're so worked up about all this stuff\? number one, half of it's boogeyman anyway." But I just appreciated lights on Christmas trees. I mean, my whole thing was like, you can't have enough Christmas trees out in the world right now. If China had a bunch and Iran had a bunch, they'd probably be a happier country.
Jeff : I love that. I think back though, Kurt on your demographic that you're working with there and the ranches and the farmers, and maybe some of them that bought in, maybe some of them think it's total bullshit. And we realize that there is a large percentage of our populace that doesn't buy into it. So I think to myself, I wonder, I do wonder if it didn't work. I wonder if being sent to our room, the ones who are really thoughtful and intuitive and listen to science are the ones who are going to come out and you're going to be changed. But the people that we need to really evolve through this process and really just learn what it means to be smacked around a little bit and sent your room and come out. I wonder if they're really learn it. So what is your take? What's your spin on that, Kurt?
Dr. Kurt : Yeah. You know, the old saw you can't fix stupid, you'd have to work around it. That's part of it. You can talk to people and if they're not willing to listen just save your breath. But for me, from where I went and came back, you just appreciate the simpler things in life.
Dr. Kurt : Now what's interesting in Cheyenne County is I come out here and I see a lot more people wearing masks than when I left. And part of it is everybody knows me. And if, if doc could get whacked like that, man, you know, maybe it could be me too. So in a way, maybe I was like a sacrificial lamb in a way so that these guys will fricken get it.
Dr. Kurt : Now they're really old cowboys that Donald Trump could fly out here in a helicopter and tell them wear a mask and they would literally tell him, "Yeah, you and who's army?" Now guys like that, you got to kind of work with them and you know it's still technically a free country. You're still allowed to be as big an idiot as you want to be within the limits, right?
Erik : Yup.
Jeff : Yup.
Dr. Kurt : The other thing is do we all just go hide in our, in our COVID pods or COVID cones or hide in our basements and just come out when it's over. And I'm thinking, "Nah, we never want a war by hiding in our basements. We need to be out doing things, but we need to be smart about it." And that's where the economic argument comes in because there's a lot of people going, "Wait a minute, we can all hide and be safe, but we won't have a country to come back to because our economy's shot." And I've never seen an infectious disease... Which is I guess what these pandemics do is they wipe out your social structure and they take your economic foundation out from underneath you. And then the question is, how are we going to come out of this?
Dr. Kurt : And if you know your history, pretty much every great civilization kind of sort of gets taken out finally by some big pandemic and they didn't handle it right. So the jury is still out on this thing, but my point is with COVID is just... You know, I was even getting to the point where I just hope I get a little bit of it and get it over with because I'm just tired of it. I met a bunch of people like that too, including docs that they weren't wearing N95s because they just wanted to get it and get over with, and guess what? They got it. And like you, Jeff, couldn't smell things for a while and they were fine. Well, get on your knees and say, "Thank you. Thank you. Thank you. Thank you." After that one, because from my perspective, it's like, God, I could have died from this pretty easily. And I thought I was tough. So you just never know.
Jeff : Well, let's just say you are tough. You are tough. I don't think that's an indicator of tough versus not tough because if anything, we've learned, it's just such a lightning bolt of who is going to get tubed and who's going to lose their smell for a week, right? And it has really no discretion on that so.
Dr. Kurt : You don't know. The other problem they're finding out is you could have COVID like Jeff had, and three months later, all of a sudden, wind up not thinking clearly, and you can't walk a city block and they have no idea why that happens. So even when you think you're out of the woods, you're not quite out of the woods yet.
Dr. Kurt : Now I got hit hard enough where it hit my kidneys, hit my lungs, obviously, but it also hit my brain to where that really smart doc, they told me, "Get your in a Denver because you're dying now." Called me up in the hospital and said, "Normally you're such a smart guy. I trust you to haul me off the South call of Everest, put me in a Gamow bag and save my life. But now your critical thinking is so degraded. I wouldn't trust you to drive me across the street." Well, that gets your attention too. And so I'm kind of on a hard stop. I haven't practiced medicine since October 28th. Now they're thinking my reasoning and critical thinking is coming back enough to where in February, I might be able to do some clinic stuff, but they're still not sure I'm going to get back to being an ER doc again, for instance.
Erik : You know, just talk to everybody about how COVID is affecting rural communities. Because like I read just what South of you, there's 1,000 folks that came down with COVID, people are compromised. There's more diabetes, there's more challenges with people's obesity and things like that out there. So yeah. Talk about maybe people forget that COVID is affecting the rural community of the US and Canada and so forth and around the world.
Dr. Kurt : The problem with rural is, first of all, recognizing it was even a problem because you had so many deniers out here. And so many people that didn't think it was really real. Well, when some of the old ranchers and farmers and everybody knows everybody out here starts dropping dead, then that started getting people's attention. The fact that I was in the hospital for all those days, that got people's attention. And I kind of thought this too, "We're just so spread out that we're not really a sitting duck." Meaning we can't get enough COVID in people that are so close together to really get a good mini pandemic, rurally going, and rural people thought that. Well, the people that live in the medium sized towns like Cheyenne Wells, which is Cheyenne County's seat is like maybe 800 people, 900 people.
Dr. Kurt : So 900 people live in fairly close proximity and the rest are pretty much spread out on ranches except for maybe a small town called Arapaho and a small town called Kit Carson. So at first, everybody was thinking, "We're going to get up and get away with this because this is a city problem because they're all stacked up on top of each other." And initially it was, but then that dreaded second wave where COVID came out and started picking on the rural counties hit. And the problem with that is it doesn't take too many sick people to fill up your hospital and to wipe out your nursing staff, wipe out your docs. And I guess what got the press's attention was me being kind of the doc for Cheyenne County, getting sick and being gone. They kind of latched onto that before it really started to hit hard in the rural communities, which is what do you do when your caregivers are out with COVID? You're just stuck because you just can't call on help because help is literally miles away.
Dr. Kurt : Like you said, the doc that's spelled me my first week had to drive 10 hours from Fort Worth to drive up here, to work the week that I was going to work. You just have such a shallow bench. But even the cities found out like New York. I mean, they had to import docs and nurses and stuff to help them out because they just didn't have enough people. Or what I say to you, you just ran out of army guys.
Jeff : Yeah.
Dr. Kurt : So it's hit the rural area that it's kind of come and gone now. Now we're kind of down to a low boil again, which is good. What we're worried about now is that new variant that was over in Simla, which is a couple of counties east of us. If that's much more infectious, is that going to cause a problem? But like I say, I'm seeing a lot more masks here. People are a lot more aware of it than before I even got sick. You know, the old deal saw with the cowboys out here as only bad guys and outlaws where masks, which I had to remind them, "Well get the guys in the banks are actually wearing the masks now."
Erik : No shit.
Dr. Kurt : New sheriff's in town called COVID.
Jeff : Yeah. Kurt, thank you so much, man. That was really illuminating for everyone to learn about your personal story and your take on COVID and plus all your great climbing analogies of course.
Dr. Kurt : Well, thanks you guys. Every time somebody interviews and asks you things about it, they'll point out new things that even you didn't think about. So I appreciate that.
Erik : Yeah.
Jeff : It's probably therapeutic for you to go through the whole process again too.
Dr. Kurt : Yeah, it kind of is. Especially now that I'm thinking more clearly too.
Jeff : And Kurt give us some advice. Like you gave me some good advice about vitamin D and stuff like that. Just throw a little advice out to people, how they can prophylactically prevent COVID.
Dr. Kurt : Prophylaxis is good. It's like, what's the best way to treat COVID? Well, don't get it to begin with.
Jeff : Right.
Dr. Kurt : Prophylaxis is a big deal. And I keep telling people its situational awareness. It's if you go into a place where there's a bunch of people, a people herd you're going into a COVID herd too. And it's amazing when people don't have that situational awareness. Now us climbers do, because in a climbing situation, yeah you better have it or else you're probably not going to live too long because you're going to be the guy that points out the crevasse to everybody because you went in it, so that's part of it.
Dr. Kurt : You know, I think the other part is just there is some science behind wearing a mask and all that now. Now, if you're out on a combine or riding your horse out in the prairie with nobody around you, obviously you don't need to wear it. So I take a mask and when I'm in with a bunch of people or going into a closed space with a bunch of people, hell yah, I'm going to wear it.
Dr. Kurt : And technically I can't get get COVID again, although they just did my antibody titers, and they're back down to basically negative, which means I got to get the shot this week.
Jeff : Wow that was quick.
Dr. Kurt : And that kind of threw CDC through a loop, because they thought as bad as I had COVID I'd be probably immune for six months. [crosstalk 00:32:59].
Jeff : That's kind of shocking actually, because I hadn't heard that it would diminish that much, that quick.
Dr. Kurt : It got my attention.
Jeff : And I'm sure your looks from your background, like you're a pretty voracious reader. If you haven't done so already. I think this is the perfect book for you to read right now. It's called Breath by James Nestor. Have you heard of this book?
Dr. Kurt : You know, I haven't, but I'm going to write it down right now.
Jeff : Yeah, please read it. Erik and I were just talking about the last podcast, but right now I think you would really get a kick out of it because it has some really interesting historical references and some shape-shifting information on just that simple task of breathing. And because it was just such a valuable thing that you almost lost, I think you'd get a real big kick out of it. I just read it a couple months ago and I'm going to read it again. It's just that kind of book. It just came out. It's called Breath by James Nestor. Give it a read and tell other folks too to read it because I think it's a really important thing for us to take in.
Dr. Kurt : That's a good point, Jeff, because just the very simple act of breathing, which you do automatically, you don't have to think about it for most people, but when you kind of lose that just the simple act of just taking a deep breath and moving air in and out is just kind of mission critical.
Jeff : Yeah.
Dr. Kurt : When you get bad COVID you get to the point where you appreciate just that very simple act, that everybody else just takes for granted. I mean that's life is at its fundamental basics right there.
Jeff : Thanks Kurt.
Erik : No Barriers to everyone, Kurt maybe I can hold your falcon again and we can go out and you can show me how that's done.
Dr. Kurt : Yeah. I'll bring her out there. I'll actually send, if I can figure out a way to get a hold of you, Jeff, I'll send you a picture of Erik holding the falcon, which is pretty cool.
Erik : All right.
Jeff : Right on.
https://nobarriersusa.org/podcast/interview-with-dr-kurt-papenfus/
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