Rays of sunshine warmed Ravi Turman’s skin and a spring breeze rippled over her body as she left the hospital, proving to Ravi that she was indeed alive.
Ravi’s survival had been very much in doubt at times over the 15 days she spent at UCHealth University of Colorado Hospital.
She had arrived in grave condition on the night of March 22, struggling to breathe as her lips turned blue. Then within hours, both of her lungs collapsed and a ventilator had to breathe for her. A test confirmed what her team already suspected: she had COVID-19.
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Ravi’s doctors gave her a 50% chance — at best — of ever getting off the ventilator and surviving.
She faced especially bleak odds because Ravi, 51, has some underlying health issues including diabetes and high blood pressure. Ten years ago, she had uterine cancer and had had to have dozens of lymph nodes removed. Plus, she’s African American. COVID-19 has been sickening and killing African Americans at an alarming rate across the U.S. Doctors don’t know exactly why African Americans are faring so poorly during the pandemic. One contributing factor may be that a greater percentage of African Americans have conditions like diabetes, heart problems and hypertension.
Bringing sunshine to others
Ravi’s name means sun in Sanskrit and she believes she survived her ordeal with COVID-19 to bring a little sun to others.
“There’s not a lot of hope out there for anyone getting the virus, but if I survived, anyone can survive,” Ravi said. “Don’t be dismayed by what you hear, just because we are getting it. There is hope.”
In addition to bringing comfort to African Americans and people with underlying health conditions, who are justifiably frightened about COVID-19, Ravi’s sunny attitude cheered her nurses and doctors.
Against the odds, she was the first person in her COVID-19 Intensive Care Unit (ICU) to make it off the ventilator and to once again breathe on her own.
“She surprised us,” said Dr. Josh Douin, the anesthesiologist who made the call to “extubate” Ravi, removing her breathing tube and detaching her from the ventilator.
“She’s spunky. She had a strong will to live and to leave the hospital,” Douin said.
“She was our first victory. It was really a morale boost for the team to see that we could get people through to recovery. We’ve had some losses too, so it’s been great to have victories.”
Dr. Julie Winkle cared for Ravi the day after she was extubated. Ravi was weak still and her throat was too sore to talk, but when Winkle let Ravi know she was the first person in the ICU to get her breathing tube out, Ravi flashed a beautiful smile and celebrated.
“She raised her hands over her head. She was pumping her fists in the air,” Winkle said. “Her personality came through. She just has this innate feistiness and she used it to get better.”
A newcomer to Colorado and a bout with a new virus
Ravi is a minister and loves to sing, dance and revel in life. Before moving to Colorado a couple of months ago from Indiana to be with her 29-year-old daughter, Ana Caldwell, Ravi served a small congregation at Impact Christian Church.
“My focus is just being a positive light for anyone. It doesn’t have to be about shoving the Bible down someone’s throat. It’s just being a positive light. I was in the hospital a long time. I got to see the nurses and the doctors and you could see that they were tired, but they were trying to be upbeat. I would hold their hand and look them in the eye and tell them, ‘Thank you for helping me.’”
At Ravi’s church, she and her congregants focused on helping homeless people.
“We would go out once a week and feed the homeless and try to give them clothing. They loved clean white socks, still in the plastic bag,” Ravi said.
She came to Colorado for Christmas to be with Ana, who used to work two jobs at Denver International Airport until the COVID-19 pandemic forced layoffs at both of Ana’s jobs.
Ravi didn’t plan to stay in Colorado, but she missed her flight home to Indiana after Christmas, then the idea of staying and living with her daughter grew on her.
“It’s so different from Indiana. There’s a lot more wildlife, a lot more opportunity,” Ravi said.
Ravi started working at the Colorado Department of Local Affairs. She doesn’t drive, so she took two buses and a train to get to her job. Ana believes that’s how her mom became exposed to the new coronavirus, which by early March was circulating throughout Colorado and the U.S.
A cold that never got better
At first, Ravi thought she just had a bad cold. But the cough grew worse and she had a fever that wouldn’t break. Ravi’s boss encouraged her to see a doctor, but it was the weekend and Ravi hesitated to go to the hospital.
“I had some shortness of breath, but I brushed it off because I’m still new to Colorado. I thought, ‘It’s just me.’ Indiana is below sea level and moving here was a big change,” she said.
On Sunday evening, March 22, she was Face Timing with her 81-year-old mother, Doris Davis, a former jazz singer and retired paralegal and project director for Indiana Legal Services, Inc. Davis lives in Indiana.
“I knew she didn’t feel well, but she never told me that she felt really sick,” Doris said. “But that evening, I was looking at her and I thought, ‘She doesn’t look right.’
“She had gotten short of breath, and I said, ‘Put that camera up to your face.’ And I looked at her face and it was grayish and her lips were purply-blue looking. And I said, ‘You’ve got to go to the hospital. You get in the car and go to the hospital now.’”
Ravi doubted she could just show up at the hospital and get care. So, Doris had Ravi’s brother and sister call her. Her brother, a lifelong military officer, “read his sister the riot act,” Doris said. Her sister sent some Bible verses. Those efforts worked and Ana got her mom into the car and took her to the ER at University of Colorado Hospital. Ana sat with her mom as long as she could. Then, hospital workers took Ravi up to the ICU, where she soon became non-responsive as her lungs collapsed.
Ravi remembers almost nothing from the first 10 days of her hospital stay.
Her team kept Ravi’s family up to date and the outlook was pretty grim.
“They told us she had a 50-50 chance. They didn’t really know, but they were going to try some things and see if they could help her breathe better,” Doris said.
Medical providers have found that many COVID-19 patients do better in the prone position, lying face down rather than on their backs. It’s easier for the patients’ lungs to inflate and release oxygen in that position.
Doris said that made a big difference for Ravi.
“She’s a stomach sleeper. They put her in a coma, paralyzed her and put her in the prone position. That’s what made her start breathing better,” Doris said.
Both Doris and Ana said it was very difficult not to be able to be at the hospital in person, but staffers kept them informed around the clock.
“I felt so helpless as a mother. Your child is sick. You want to go be with them or hug them. But, with my age, I couldn’t come. I couldn’t do anything. That’s one of the tragedies. When someone gets the virus, you can’t be with them. You can’t hold their hand.”
Doris sometimes woke suddenly in the night and felt she had to know at that moment how Ravi was doing.
“The staff was the nicest hospital staff I have ever encountered,” Doris said. “Every time I called, no matter whether it was day or night, they were pleasant and gave me information that calmed me down a bit. I felt like I was somehow attached to her.”
‘I heard their hearts breaking’
Even deep in a coma, Ravi felt that connection too.
She has few memories from her time on the ventilator, but she distinctly remembers once feeling like she was slipping away.
“I was getting ready to leave,” Ravi said.
There was no dread about dying at first. Then, Ravi felt a powerful sensation.
“I could feel my mother’s heart breaking and I could hear my daughter’s heart breaking and that brought me back,” Ravi said. “There was a dark day when they told my daughter that it could go either way. And I guess it was that same day.”
Ravi has two sisters and one brother. Decades ago, her mom lost a baby boy, who was three years older than Ravi. He was born with a hole in his heart and died at three days old. Today, babies with those types of heart problems survive. But there was no cure then.
Even in the haze of her coma, Ravi didn’t want her mom to suffer the tragedy of losing a child a second time.
“It brought me back,” Ravi said.
A critical turning point
One of the biggest turning points for Ana came before Ravi was extubated. The nurses told Ana that her mom needed less and less oxygen, and soon she might be able to breathe on her own.
That’s when Ana started to breathe easier herself and believe her mom might get through the illness.
As for Dr. Douin, he didn’t expect Ravi to be his standout patient.
“She had very severe lung injury. It was remarkable that we were able to extubate her,” he said.
But, there were two key factors that led to the decision. Ravi’s numbers were looking good. She needed only about 30% oxygen. At the same time, Douin wanted to boost what’s known as “positive end expiratory pressure” or PEEP. Increased pressure would help open the alveoli sacs in Ravi’s lungs. At home, she was accustomed to using a C-PAP machine because she has sleep apnea, a common health condition which causes people to temporarily stop breathing multiple times as they sleep. C-PAP stands for Continuous Positive Airway Pressure.
It made sense to put Ravi on a C-PAP machine in the hospital too, but the team had to consider the decision carefully. With a C-PAP, every time Ravi would exhale, doses of the coronavirus would fill the room. Thankfully, her team was caring for her in a specially designed negative air pressure room, meaning that the infectious virus particles would not escape the room. And the air continually refreshes in negative air pressure rooms.
Douin consulted with colleagues and hospital leaders, and together, they made the gutsy call to remove Ravi from the ventilator and put her on a C-PAP machine.
Douin said it’s important to treat patients as individuals and to do what’s best for each of them. Doctors at University of Colorado Hospital also are sharing their insights in real time with colleagues at other UCHealth hospitals, while also benefiting from the wisdom of doctors elsewhere in the U.S. and around the world.
“We need to treat these patients as we normally would. She did very well,” Douin said.
He credits Ravi’s attitude as much as the medical care she received.
“She had a strong will to leave the hospital and that helped her quite a bit,” he said.
Douin said he and his colleagues are seeing a number of patients of color — both African Americans and Latinos — who are becoming critically ill from COVID-19.
He doesn’t think they are more susceptible to getting the virus, but rather that patients with many underlying illnesses may have weaker immune systems than healthier patients.
“It happens that African Americans have higher rates of hypertension (high blood pressure) and diabetes. Long-standing socioeconomic discrepancies likely also are playing a role,” Douin said. “Those are our best guesses as to why we are seeing so many non-white patients.”
The faith and will to survive
Ravi vividly remembers having the breathing tube removed, and hopes she never has to re-live the experience.
While she remembered the pain of being extubated, her nurses were overjoyed and kept telling her what a big deal it was that she had gotten off the ventilator.
Ravi continued her journey of improving day by day.
“I knew I was going to make it when I woke up because there was no way I was going to give up and there was no way I was going to go on that ventilator again,” she said.
“I just had to start breathing and breathing. I’d make myself breathe deeply to keep the pneumonia from coming,” she said.
Ravi moved out of the ICU to a recovery unit for pulmonary patients. She was terribly lonely at times. She was too weak at first to talk to her family on the phone. She consoled herself, watching the sun rise and set outside her window. And a large bird, either a hawk or an eagle, soared outside her window every day, as if to say hello and remind her of all the nature shows she has loved her whole life.
Ravi consoled herself by thinking of one of her favorite passages from the Bible, the uplifting words from Psalm 96.
“We often used it in my church as a call to worship: ‘Sing to the Lord a new song…Sing unto the Lord. Bless his name….Let the heavens rejoice and let the Earth be glad. Let the sea roar…Let the field be joyful….Then shall all the trees of the wood rejoice.’”
She can’t wait to get back to another favorite activity: singing. When Ravi is well, she sings so often that Ana calls her “a human juke box.”
“I used to be the manager of a record store. I like all genres of music from Three Dog Night to classical music. It doesn’t matter,” Ravi said.
For now, she’s home in Aurora, recovering with Ana, working on breathing deeply and climbing as many steps as she can. Ana, who never got sick herself, is cooking good food for both of them while Ravi rests and watches old Disney classics and nature shows.
Ravi grew up in public housing projects in Indiana, but her mom encouraged all of her children to think big. She bought classic books for them, exposed them to educational TV shows, shared music with them and insisted they go to college.
“She is an amazing woman,” Ravi says. “She would take us to the airport and say, ‘I want you to watch those planes take off. There’s more to life than what’s right here. Look up.’”
Ravi credits the love of her family with saving her life.
Her family, of course, credits Ravi with saving herself.
“I think it’s her strong faith and her strong will. Those two things saved her,” Doris said. “She’s a determined person. If she wants something, she’ll get it.”
Not long ago, Doris remembers Ravi telling her that she was going to take up flag dancing in church.
“I couldn’t picture that, but she had me come to the graduation,” Doris said. “They were dancing and waving all the flags in church to remove the negativity in the air.”
Doris said Ravi always lived up to her name. She has always been her “sunshiny” little girl.
The family can’t wait to reunite as soon as it’s safe.
“I want to give her a hug. She needs a really good momma hug,” Doris said.
Ravi, her mom, daughter and siblings were all supposed to meet at the beach in Florida this spring. They hope to make the trip as soon as it’s safe. One of Ravi’s sisters is living in Italy, where COVID-19 also has taken a tragic toll. But, thankfully her sister has stayed well.
It is not lost on Ravi that she essentially came back to life just before Easter, the holy season when Christians celebrate resurrection and rebirth.
Someday, perhaps Ravi will have a new congregation and she will preach about the time when she came face to face with a historic plague, and for some reason that she still doesn’t fully understand, she survived.
“I really do think I’m here for a purpose. And part of it is to tell my story,” she said. “I have things yet to do. I’m a daughter. I’m a sister. I’m a mother. It just wasn’t my time.”
Full of joy after her rebirth, Ravi is ready to relish the big joys in life and the little ones too.
Someday, she hopes to visit her sister in Italy. And she hopes to see two sides of oceans around the world, like the Atlantic from the U.S. and Europe and the Mediterranean from both Europe and Africa.
For now, however, it’s enough to do what she did on April 6, the day she got to leave the hospital. On another warm April day, Ravi sat outside on a park bench.
The virus that nearly took her life is having a strange effect on the world, emptying streets, airports, churches and workplaces. But in the park, fruit trees were blossoming and nearby, tulips were blooming in a riot of red, yellow and purple.
Ravi thought of the advice her mom always gave her: “Look up.”
When she peered toward the sky, it looked perfectly normal and Ravi felt the sun kiss her face.
She breathed deeply and simply said, “That feels so good.”