Copyright © 2020 Albuquerque Journal
Editor’s note: This story has been updated with the correct first name of Dr. Pierce.
After 37 years as a practicing physician, Stephen Hightower of Rio Rancho retired a year ago. But he never gave up public service.
He co-wrote a book about universal health care and teamed up with a nonprofit organization trying to find ways to clean the dirty water produced from oil exploration.
Then COVID-19 hit.
“When we saw this last surge, where all of a sudden there were 800 and 900 and 1,000 people a day being diagnosed, I called my old boss (in the Presbyterian Health Care System),” Hightower said last Friday. “And I said, ‘If there’s a place that you need some help, I would like to volunteer.’ ”
So beginning Monday morning, Hightower plans to get up before dawn to beat the traffic and drive across Albuquerque to suit up for his new job at Presbyterian Kaseman Infusion Clinic, which will treat COVID-19 outpatients referred by doctors.
He’ll be helping one of the first-of-its-kind clinics in New Mexico deliver two new emergency-authorized medications aimed at keeping at-risk COVID-19 patients from getting seriously ill.
The added bonus: The outpatient treatments potentially could free up space at New Mexico hospitals suffering shortages of bed capacity and medical staff.
A week ago, state health officials said major hospitals in the state were at capacity or over, with more than 100 people being treated in converted outpatient areas and hallways. Hightower said he hopes the new infusion clinic can help reduce that strain.
But the protocol requires patients first obtain a doctor’s orders before receiving intravenous doses of either Remdesivir or the monoclonal antibody Bamlanivimab.
Upon arrival, qualified patients are to telephone from their vehicles in the parking lot outside the clinic, which is located off Wyoming and Constitution.
Then someone in personal protective equipment will escort the patient into one of about 17 negative-pressure isolation rooms and hand the persson an iPad computer tablet. The will use the device to communicate with staff while they receive their IV treatment, which could take an hour or longer.
“We have to try to limit the individual interactions to protect those of us who are doing this,” Hightower said. “But at the same time, this still allows us to, yes, go into the room, yes, to talk to people (receiving treatments), and be part of their recovery. Because sometimes, it’s just a matter of talking to folks, letting them express concerns that allows them to recover more quickly, more easily.”
In his Rio Rancho practice where his subspecialty was geriatrics, Hightower said he “did a lot of listening. I do some talking, yes. But listening helps. I found that early on, that works best: ‘Tell me how you’re feeling. Tell me what you’re experiencing?'”
During the clinic’s first four days of operation last week, four patients received Remdesivir, while antibody infusions were limited to patients at Presbyterian’s emergency rooms. That treatment will be available at the infusion center when more doses arrive.
In one case, a person received Remdesivir at the clinic but had to be admitted to the hospital.
Hightower said he learned that patients who have received Remdesivir treatments “are very happy. They’re so happy to be out of the hospital.”
In one reported case, a patient received Remdesivir at the clinic but had to be admitted to the hospital.
At 67, Hightower isn’t afraid of the risks involved in treating contagious patients afflicted by a disease that has taken the lives of more than 1,700 people in New Mexico.
“For this I have no fear. Everything is positive. I’m positive about everybody who is going to get the therapy. And if they show up at this door and they are very sick, we will know that. We will help get them back to the hospital, where they need to be. We’ve got all these safety processes already embedded in the system … so we won’t make mistakes. We want to do it right.”
The clinic team includes two other physicians, including another doctor who had been retired, clinical pharmacists and nurses. Aside from caring for patients, the team will also gather data to determine the efficacy of the treatments, Hightower said.
Remdesivir, an antiviral medication, is typically administered in a hospital, but eligible patients could receive an initial IV dose in the hospital’s emergency room, and if stable, they will be directed to follow up at the Presbyterian infusion clinic for each of the four other required doses.
The antibody, Bamlanivimab, is for people newly diagnosed with COVID who exhibit symptoms and are considered to be at high risk because of an underlying condition.
President Donald Trump took both medicines during his bout with the virus in October.
“We are trying to keep them out of the hospital or get them out after one day,” Hightower said, “so it makes the patient feel a lot safer. … For any of us, going into the hospital nowadays … that’s pretty frightening.”
The start-up was headed by Presbyterian Infusion Services director Dr. Arand Pierce, who said it took 26 days to convert what had been a former skilled nursing facility into the infusion center.
Because the two COVID-19 drugs have been approved for emergency use by the FDA, there’s been national interest in Presbyterian’s clinic rollout in Albuquerque and another in Lincoln County.
For instance, Hightower said, he recently spoke with the head of ICU care at Walter Reed Medical Center, who wanted to know about Presbyterian’s quick rollout of the clinic.
“He said, ‘I think everybody is going to go to this (outpatient infusion), but you guys are beating them by three to four weeks.’ He said, ‘The need is definitely there, and I’m glad you are doing these two drugs. I think they give us our best chance.’ ”
On the home front, Hightower said he and his wife have devised ways to protect themselves against the virus.
For instance, the PPE he will don for work will stay at the clinic. But upon returning home after a shift, Hightower said, “I’ve got to come in through the garage, not the front door. I’ve got to shower and clean up, and clothes go into the washing machine, and the clean clothes go on. And we’re good unless I’ve had some atypical exposure. So I think we’ve got a good plan to try and mitigate all the major risks.”
Hightower said retirement has been comfortable over the last year as he found ways to branch out from his medical career. He and a colleague have written an online book on affordable health care to be available at www.thehealthcarepapers.com.
And he is continuing to work with the New Mexico Produced Water Research Consortium to find ways to treat toxic water created during drilling for oil.
“We want to make it useful in multiple ways that will allow us to save fresh water … and protect the water supply in this drought-ridden area of New Mexico.”
“My other hobby” he added, “is I’m a rockhound. I love to collect rocks. I’m just fascinated by rocks.”
His day job now will entail working one week out of every three, trading off with the other two physicians.
“The other two weeks I’m going to be out walking the dogs, collecting rocks, and seeing if I can make dirty water better and all that stuff.