As COVID-19 deaths in the United States approached 200,000, the toll among health-care workers came to include a 28-year-old doctor who had gone about with a toy stethoscope as a youngster in upstate New York.
Dr. Adeline Fagan had grown up to become an OB-GYN resident at HCA Healthcare in Houston. A photo shows her in scrubs, holding a swaddled newborn. She has the incandescent smile of someone who could not think of anything better to do than to bring new life into the world.
But with the arrival of a pandemic, she sometimes delivered babies whose mothers were infected. And as the virus spiked in Texas, she was assigned to long shifts triaging and treating COVID-19 patients in the emergency room.
“On July 8th Adeline went into work for her 12 hour shift in the ER,” her younger sister, Maureen Fagan, later wrote on a GoFundMe page. “That morning she went into work feeling well and excited to see patients, but by the evening she began to feel under the weather.”
Adeline was feeling too ill to exercise with Maureen after work, as they often did. Maureen ended up taking her to the emergency room. Adeline tested positive for COVD-19 and spent the next few days quarantined in the apartment the sisters shared. Adeline’s lips then turned blue and she began having difficulty standing.
“Adeline spent the next few weeks battling COVID and was treated with several different respiratory therapies and put on dozens of drugs,” the sister wrote. “When there was no positive response to these methods of treatment, Adeline decided to begin an experimental drug trial.”
Maureen goes on, “However, before we could see if this new drug was effective, her lungs could no longer support her. On August 3rd Adeline was intubated and placed on a ventilator. That night her vitals were unstable and the doctors said that she was not responding well to the ventilator.”
The doctors said there was one last possible remedy.
“At 1 a.m. on August 4th, Adeline was placed on ECMO, extracorporeal membrane oxygenation,” Maureen wrote soon afterward. “The catheters used in the ECMO machine involved an invasive procedure to place them in her femoral artery. The ventilator opens her lungs through positive pressure, while the ECMO machine oxygenates her blood. This leaves Adeline’s lungs with the only task of healing themselves. It is projected that Adeline will be on the ventilator and ECMO for at least 6-8 weeks.”
Maureen also posted an update on Facebook, along with a message that everyone should hear and remember.
“My goal in posting this is to raise awareness,” she wrote. “Every day I see posts and tweets about how COVID is a hoax, no deadlier than the flu, and that the government telling you to wear a mask is about control and not safety. But this virus is not a joke. Adeline is twenty-eight years old. She was young, healthy, and strong. As a doctor working closely with patients, she followed every safety protocol and procedure put forth by the CDC. SHE STILL GOT SICK.”
She concluded, “Adeline’s case is a lesson for everyone. Wear a mask. Social distance. Stay home if you can. You just might be able to save someone like Adeline.”
Maureen also kept posting on the GoFundMe page she had created to help meet medical bills and expenses attendant to her parents leaving work in upstate New York to maintain a vigil in Houston.
“We want everyone to know that Adeline is a fighter,” Maureen wrote. “She is determined and has set her mind to surviving this virus. As she fights everyday for her life.”
And given her spirit and her youth, it seemed only reasonable to anticipate that Adeline would pull through and resume bringing new lives into the world.
“At this time, we do not know how long a full recovery will take or when she will be able to return to work,” Maureen wrote.
On Friday, Adeline seemed to be on the mend. The family was able to visit her in person.
“Adeline was doing wonderfully for the last few days,” Maureen wrote on Saturday. “Last night was no different. Around 10:00 we called and got a good report.”
The family had every reason to be hopeful.
“As we settled down for the night 30 minutes later, the phone rang.”
The hospital was calling. A nurse had gone to check on Adeline and found her unresponsive. A CT scan showed she had suffered a massive brain bleed.
“Everyone was crushed by the events, the nurses, the doctors, and, of course, us,” Maureen wrote. “The doctor said they have seen this type of event in COVID patients that spend time on ECMO. The vascular system is also compromised by the virus, resulting in bleeds.”
Adeline was enveloped in love at the end.
“We spent the remaining minutes hugging, comforting, and talking to Adeline. And then the world stopped…” Maureen wrote.
The father recorded the exact time of death in an online journal entry.
“September 19, 2020, 4:24 AM Central Time
The time the world stopped for a moment and will never be the same. Our beautiful daughter, sister, friend, physician, Adeline Marie Fagan, MD passed away.
We want to sincerely thank all who supported Adeline and us through this difficult time. You were all there cheering and praying and crying. The number of well wishes and caring people humbles us. Even in this darkest of times, there are good people willing to share a piece of themselves for the sake of another.”
The little girl with the toy stethoscope had died a doctor on the front line in a pandemic. GoFundMe and Facebook are filled with memories of her kindness and generosity, and that incandescent, living-a-worthy-dream smile such as can be seen in that photo of her holding a swaddled newborn. One of the fellow doctors who treated her early on expressed his surprise and grief over the loss.
“I was one of the residents on the team taking care of her when she was first admitted to the ICU,” Dr. Kendall Kiser wrote. “I don’t cry often, but I cried today. I’m not able to express how shocked and hurt I am to hear that this is how it ended.”
The COVID-19 toll in the United States when Adeline first fell ill had stood at 131,594. She was now among those bringing the count to 200,000.
Adeline was almost certainly killed by a virus that somebody brought to the hospital after getting it from somebody else, who got it from somebody. The deadly chain easily could have been broken by a mask and social distancing. Anybody who ignored the precautions after it became clear they are effective shares the blame for her death and the death of so many others.
Her death serves as a warning that none of us should have needed.
Her life leaves us with an example we should all follow in these dark, divided times when reprehensible and ultimately murderous selfishness tries to pass itself off as freedom.
“If you can do one thing, be an ‘Adeline’ in the world,” the father wrote. “Be passionate about helping others less fortunate, have a smile on your face, a laugh in your heart, and a Disney tune on your lips.”