Big T is back.
I am over the moon to report that the Rev. Terrance Hughes, after about seven weeks on a ventilator with severe, COVID-related lung failure, is breathing on his own, out of his coma, and scheduled to be released Wednesday from the VA hospital in Aurora.
You may know Big T, as friends and family call him, as a leader in Denver’s civil rights community, co-pastor of New Covenant Christian Church/Alpha Omega Ministries Disciples of Christ, and candidate for the state House until the virus struck him in early March.
You may have read later that month the VA’s palliative care doctors told his wife, Rachel, the virus had so damaged his lungs and kidneys that, if his heart stopped, as they warned her it might, he likely would not survive. They asked if she wanted them to try resuscitating him.
“I would like for you to try it,” she told them, her voice weak from her own bout of COVID-19.
Big T, 56, was the Aurora VA’s first COVID-19 patient, admitted on March 9. In early April, doctors had been making some progress trying to wean him off more than three weeks on a ventilator until fluctuations in his heart rate and blood pressure forced them to put him back on for another three. It seemed like a devastating setback, given that most COVID-19 patients haven’t survived prolonged ventilator use, let alone two rounds of it.
Dr. Tim Amass, one of Big T’s pulmonary specialists, warned in April that a second round might be necessary.
“We anticipated setbacks,” he said Tuesday.
Dozens of readers since have been asking about Big T’s condition, prompting me to start writing this column with each step forward, then to stop with each step back. There have been too many of both to chronicle here, as indicated by piles of notes I’ve taken from audio recordings Rachel has made from her conversations with the ICU’s medical team and shared with me daily.
What Big T needed was a tracheostomy to open a new airway, but the surgery would have risked coronavirus exposure for his medical team. The VA waited until he tested negative, twice, before inserting the trach tube two weeks ago.
He has been off a ventilator, except as a bit of backup at night, for a week now. His kidneys are functioning well. He can sit up, stand and speak, even to the extent of delivering an impromptu sermon – on Romans 2 and women’s rights – to his ICU nurses on Sunday. He is scheduled to be discharged to an acute care center tomorrow, prompting his family, congregants and fellow pastors to come up with a new nickname: “Miracle T.”
“They keep calling me their miracle, like I’m some kind of miracle or something,” he told Rachel over the weekend, grinning.
I don’t know much about miracles except that in the movies, they are quick and effortless. Big T’s recovery has been neither.
His first word when waking after the tracheostomy: “Overwhelmed.”
He has been mostly lucid over the past week, with most of his memory, his signature irony and wits about him. But a combination of exhaustion, withdrawal from weeks of heavy sedatives and an inability to have Rachel and family at his bedside have led to occasional bouts of delirium he refers to as “the Twilight Zone.”
There are afternoons when he Facetimes with Rachel or chats with his nurses, mindful and fully cognizant of even the smallest details about the people he loves and things he cares about. But there are nights when he wakes to see pears growing out of the hospital walls or to yell for help, convinced he’s in a homeless shelter or somewhere in another state or South Africa, kidnapped and held hostage.
“Do I need to take an Uber home?” he asked last week, terrified in the Twilight Zone.
Dr. Amass says delirium is common after long stints in the intensive care unit, and that it can last for days, weeks or longer:
“It’s hard to say there won’t be lasting effects, but in general people – especially people as strong as Mr. Hughes – get better as they get back to their sense of normalcy.”
Rachel, for her part, says it’s painful to see her “sweetie” “so back, and so with it” most of the time, and then to lose him to the fog at night when nurses Facetime her for help calming him. She is remarkably good at doing so, reminding him to look to his left, out his window. “That’s the VA hospital, babe, see? That’s Aurora. You’re in Aurora,” she reassures him.
Rachel has at points worried the VA’s ICU staff might come to see her husband, in his bouts of delirium as an angry, black man, and give up on him. It is a fear not uncommon among black wives, mothers and daughters about the safety of black men, even in hospitals.
Some of the staff worried that it might be too soon to release him to the rehab center, which might not be able to handle his delirium bouts or keep him from getting out of bed or ripping out his trach tube.
Dr. Amass says he’s not worried: “I feel very confident that he is ready to go into that new space, where he will only get stronger.”
At the acute care center in Morrison, Big T will need to relearn how to feed himself. He managed Monday to put a cube of ice in his mouth after five unsuccessful attempts. He will need to relearn how to dress himself, stand on his own and walk.
Though he’s aware that COVID-19 almost killed him, leaving him in a coma for seven weeks, the news junkie in Big T has yet to catch up on what the rest of us have adjusted to while he was gone. Things like all sports and school and in-person church services being canceled. And that the economy has crashed, that people are protesting and that old, painful fault lines are growing deeper and more divisive. And that a prediction he posted on Facebook in early March during his first days in the hospital has played out just as he feared: “This virus is going to hit some neighborhoods and neighbors worse than others and the idea of health equity is going to be tested in the coming weeks.”
As for talking, the silver-tongued preacher already has it down, speaking in full, clear sentences even with a trach tube, which Dr. Amass expects will be removed in the coming weeks or months as Big T regains lung capacity and strength.
Rachel keeps their conversations light, like about what he wants to eat when his feeding tube is removed: One of her burritos, or her nachos, or both, he said. She has asked the VA to keep TV news off in the room as long as he’s having delusions. He has acquiesced, watching Animal Planet instead.
She hasn’t mentioned the congregants, friends and relatives who have fallen ill or died over the past two months. And she keeps herself from saying she was really scared she would lose him.
“I feel so afraid, even now, from saying anything about death. I just don’t want any talk about anyone dying.”
I asked Big T, in a very brief Facetime conversation Tuesday afternoon, what he wants people to know about what he has been — and is still going — through.
“Family and community support mean everything,” he said of the hundreds of people who’ve been praying for him, tears rolling down his cheeks.
The VA medical center in Aurora so far has had 211 COVID-19 cases, six of which have been fatal. VA staff are planning to line the sidewalk outside the hospital tomorrow afternoon to wave goodbye to their first COVID-19 patient whom several have been praying for, as well as treating.
“All of us in health care are faced with a remarkable amount of beauty and pain and challenge. And in that moment, all of us who practice at the bedside realize that not all of it is in our control,” Amass said.
I asked the doctor about the view both among some hospital staffers and many in Denver’s spiritual community that Big T’s recovery is miraculous.
“To call what happened here a miracle is well above my pay grade. We just feel lucky to bear witness to what has happened to [him],” he said.
“In the context of COVID, the fear in the community, the stress from all of it, to have someone who has been through what he has been through, to have someone come out of it like he is, to see everyone’s mood brightened by his success, well, maybe that is the miracle.”