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This story was republished on Jan. 4, 2022 to make it free for all readers
Late at night, after the children had gone to bed, Derek Townsend would sit in a blue velvet wingback chair in his living room and write letters to his wife, who remained gravely ill with COVID-19.
Kelsey Townsend, 32, had come so close to death that doctors were forced to place her in a coma before delivering the couple's fourth child, Lucy, by emergency C-section on Nov. 4.
Kelsey's oxygen level remained low, the vital work of her lungs now dependent on two machines — a ventilator and a heart-lung machine called ECMO.
A week had passed since her delivery. She had yet to hold or even see her baby.
Unable to visit, Derek wrote his letters from their home in Poynette, describing what the children had done that day and urging her to keep fighting. The family needed her.
Derek never mailed the letters.
Each day, though, he texted her phone at University Hospital. The texts said how much he missed her. Sometimes he tried to make her smile.
"You don't by chance know where your wallet is do you?" he joked on Nov. 16.
He found it difficult to maintain the cheerful tone.
"It was a rough day for you today, but you have made some good steps tonight," the text continued. "It breaks my heart to pieces hearing what you are going through every day."
He sent each text hoping his phone would ping with a reply, but it never did.
On the night of Nov. 16, Kelsey's left lung collapsed, a life-threatening complication in which the lung ruptures and air leaks into the chest. The ICU team positioned a tube to drain the air in Kelsey's chest until the lung could heal.
Word of her struggle spread on social media, then over the airwaves. A radio listener posted a note about the Townsends on the Facebook page for the Q106 morning show.
Madison-based WWQM-FM, known as Q106, plays country music to an audience that stretches from Janesville 80 miles north to Baraboo. Many of the listeners are dairy farmers. Staff at the station pride themselves on their local focus and refer to the audience as their "Q-Munity."
After learning of the Townsends' plight, morning host Steph Peters decided to tell the family's story on air.
"So we know that COVID hits everybody differently, every family differently...but there is a family in Poynette that really needs our help right now," Peters told listeners on Nov. 17. "Let's rally around this family."
Speaking by phone, Kelsey's cousin, Janel, described the situation: Kelsey remained in critical condition in an induced coma. She had yet to hold her new baby, Lucy.
Derek then introduced listeners to two of the children.
"I miss Mommy's touch," said Payton, at 8 the oldest.
"I miss my Momma's stories," said Beau, 5.
Derek thanked the friends and neighbors who had already brought meals to the family and coloring books to keep the children occupied.
"Our family," he said, "is just kind of at a loss for words on how thankful and grateful we all are."
As November turned to December, more help poured in.
The Culver's in Cross Plains sold 1,500 orders of cheese curds to raise money for the family; the line went out the restaurant's door and down the street.
KD's Bar & Grill in Lodi held a "Meet Santa" benefit.
In January, a listener texted the morning show to say, "I'm donating my stimulus check to the Townsend family."
The family's GoFundMe page would wind up raising more than $110,000.
From time to time, the Q106 morning show returned to the Townsends, calling family members for updates. Even when the news was bad, Kelsey's relatives focused on their hope and faith.
"They kept us uplifted," said Peters, the morning show host. "I never went to a dark place when I was thinking about Kelsey."
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'Awake, staring at the ceiling fan'
Kelsey's right lung collapsed, and her left lung collapsed a second time.
Derek phoned her room and spoke to her, even as she drifted along in a coma unable to talk. Sometimes he heard voices in the background that sounded panicky, and it was hard not to feel the same.
Doctors said Kelsey was suffering from Acute Respiratory Distress Syndrome, a severe complication of COVID-19. Even with treatment, 25% to 40% of the COVID-19 patients who get the syndrome do not survive.
At times, Derek allowed himself a grim thought: "This is it."
"A lot of that information I kept to myself," he said later, "because at 1 in the morning there's no need for anyone else to be awake staring at the ceiling fan."
Mixed in with the bad days were better ones, even flashes of hope.
In early December, one of the nurses showed Kelsey photographs of the children and read aloud letters Payton had written. Kelsey nodded her head, and her cousin reported the moment on CaringBridge, adding, "I asked God for a miracle, and I feel this is a small one ..."
That same day, Derek took Lucy for her one-month checkup. The infant was in the bottom 10% for weight, but otherwise fine.
In mid-December, Faith, the couple's 18-month-old daughter, and baby Lucy got to FaceTime with Kelsey, who still could not have family in her room. Janel described the moment on CaringBridge:
Kelsey smiled as a tear rolled down her cheek, as this was the very first time Kelsey has seen her newborn, Lucy, who is now six weeks old😘 (this gave me chills when I received this update!).
Needing a backup plan
On Christmas Eve, before driving to the hospital to tell Kelsey that she needed a double lung transplant, Derek texted her:
"It's been over seven weeks since I got to hold you in my arms. ... This is not the way I wanted it to go but we have a path for you to come home now. I'm really struggling with it. But if this is our option, we will adjust."
Kelsey had now been on the artificial lung for 46 days. She could not remain on the machine indefinitely.
Dan McCarthy, Kelsey's main doctor and director of the ECMO program for UW Health, was disappointed that her lungs had improved so little. He worried too that the longer she stayed on the ventilator and on the ECMO machine, the greater the risk of her developing a severe complication.
"After approximately six weeks of support, if we don't see signs of significant recovery, we have to have a backup plan," McCarthy said.
That plan was the double lung transplant, a risky operation that would require finding donor lungs just the right size. Kelsey also would have to be healthy enough to survive an operation that takes eight to 12 hours.
Preparing to tell Kelsey that this was her path home brought back difficult memories for Derek. At 15, he had stood at his mother's bedside as she died of breast cancer.
Hard as that had been, the talk with Kelsey on Christmas Eve was harder still, the most difficult thing he'd ever done. There were times when his emotions overflowed and the medical staff turned away to give the couple privacy.
The next morning, Christmas Day, Derek kept his emotions in check as best he could. He felt it was important "to wear a strong cape for the children."
So the family celebrated. It was not one of their traditional Christmas gatherings, which bring together up to 60 relatives and friends.
Still, the children opened presents. Derek videotaped them so that his wife could watch when she came home.
Other cases, other results
In December and early January, as Kelsey fought for her life, still in a coma, three eerily similar cases of pregnant women with COVID-19 were reported.
Erika Becerra, a 33-year-old Detroit woman with COVID-19, gave birth to a healthy boy in mid-November. She then declined rapidly, dying 18 days after she was placed on a ventilator.
Vanessa Cardenas Gonzalez, a 33-year-old Los Angeles woman, gave birth to a baby girl just days after testing positive for the virus; Gonzalez was placed on a ventilator and died on Dec. 14.
Ashley Gomez, a 30-year-old nurse from Northridge, Calif., was sick with COVID-19 symptoms when she delivered a baby boy on Dec. 18. She had to be placed on a ventilator the following day and died on Jan.3.
In Poynette, Kelsey's family held out hope that she would somehow come out of the coma and survive.
Preparing for a lung transplant
Derek continued texting Kelsey every day.
The texts were Hail Marys, not so different from the messages stranded sailors once stuffed inside bottles and tossed into the ocean.
Kelsey was so sick. Could she hear her cellphone? Did she ever look at it?
It didn't matter. Derek checked his phone each day in the slim hope of finding a response from her.
The doctors in Madison prepared the paperwork for the lung transplant. Although she was still quite ill, Kelsey began to receive physical therapy. She had been in bed for more than eight weeks, so long she'd lost the muscle strength to stand or sit up, let alone walk or take a shower.
The weeks had been hard on her medical team, too. McCarthy felt nervous much of the time Kelsey was in the hospital. Her condition had to be managed and monitored constantly. Often, he worried that despite their efforts, she might not survive the illness.
The doctor made himself available at all times. Once, after working a 30-hour shift, McCarthy received word that Derek was trying to reach him. It was late at night, but the doctor phoned Derek, then spent an hour patiently answering his questions.
In early January, Kelsey's cousin wrote on CaringBridge:
Kelsey's medical team continues to wean her off a lot of her medications which she is tolerating well.
Physical therapy is a work in progress — yesterday, she was able to sit up at the edge of her bed and dangle her feet, and today, with a lot of assistance, they had Kelsey out of bed and standing!
It was around this time that Kelsey remembers waking from her coma. She remembers thinking of her husband and the children. She remembers praying.
Then her eyes fixed on the window in her room, on a flash of bright red. As she stared, she realized what it was. A cardinal had perched outside on the window ledge.
In Christianity, the cardinal is considered a symbol of hope. The bird also reminded Kelsey of her grandmother, Sally, who had been blessed with the most vivid red hair.
"It was a sign to me," Kelsey would recall much later. "I have so much to live for. I have to fight."
On the morning of Jan. 5, Derek woke in Poynette and checked his phone, as he always did. This time the screen wasn't blank.
At 3:39 a.m., Kelsey had texted:
"What I wouldn't give to be next to you.
What is Lucy's DOB? I don't remember having her."
Derek had grown accustomed to the one-way conversation on his phone. Now, he stared at his wife's first words to him in two months.
He typed back:
"Oh my goodness baby I've sent you over 100 text messages.
"To see you reply brought me to tears this morning. I'm sorry!"
An astonishing development
The day after texting her husband, Kelsey was placed on the national lung transplant list. Her case was considered so urgent that she was near the top of the list.
The hospital in Madison began receiving offers of lungs. The organs were not ideally suited to Kelsey, so doctors held out, hoping for a better match.
There was discussion within the medical team. Should Kelsey be given time off the machines to find out what her lungs could do on their own?
The elation Derek felt seeing Kelsey's text did not drive away his doubts. He never felt certain she would come home.
Then, on Jan. 10, a Sunday, he answered a call from McCarthy.
"Derek," the doctor said. "Something miraculous has happened."
The images of Kelsey's lungs had begun to look much better. McCarthy could see more air filling the lungs. Air now made it through areas damaged by scars and inflammation. It was possible, McCarthy said, that Kelsey might not require a transplant, that she might take a different path home.
The following day the phone rang again. Derek picked it up and heard the doctor say: "I don't know why this is happening, but her lungs are significantly better than yesterday. They look like a set of lungs. There's a good chance that she comes home with her own lungs."
Kelsey's cousin wrote a new entry on CaringBridge:
Divine intervention! A miracle or an act of God! Her lungs have regenerated and the scar tissue is subsided.
In retrospect, McCarthy believes Kelsey's lungs must have been improving steadily in January, a trend that began subtly. But he cannot fully explain the change. The irreversible had reversed.
"I'll have to reconsider," McCarthy said later. "If we have a similar patient, at what point do we say recovery is no longer possible?"
Asking to remove the machines
Kelsey's doctors stopped considering offers for her lung transplant.
Usually patients as sick as she had been transition from the hospital and then spend many weeks in rehabilitation.
Kelsey began physical therapy sessions in the hospital and never required transfer to a rehabilitation facility.
Early on, she was so weak she could only wiggle her toes and fingers. She could not lift her hand to wave. But knowing that she might be able to come home with her own lungs inspired Kelsey, and she began to push herself.
Eventually, she would work through 60 minutes of in-person physical therapy, then ask for 30 minutes more. She grew weary of her dependence on the machines to help her breathe.
The medical team asked, "Are you more nervous about having ECMO taken off, or about having it stay in?"
"If it's safe," she said, "I want to be off it."
On Jan. 13, after nearly 65 days on the artificial lung — the longest of any COVID-19 patient at University Hospital — Kelsey was disconnected from the machine.
She was still supported by the ventilator, but the amount of support diminished. She kept pushing harder in physical therapy.
One day she told Derek that she wished she could be moved to the intermediate care section, or even the hallway, so that her ICU bed could be freed up for another patient.
The embrace of family
The morning of Jan. 27, Kelsey rushed through everything: breakfast, brushing her teeth, showering.
She was going home to Poynette.
Derek would be picking her up. As he drove to the hospital, he felt more nervous than he had on his wedding day. The children stayed at home with their grandparents.
The four-bedroom white ranch looked to Kelsey unchanged. It looked "like home," she remembers thinking as they pulled into the driveway. The couple went inside and Kelsey sat down on a chair in the living room so the children could come up and hug her.
Then Derek brought over Lucy. The baby was almost three months old. Kelsey had never held her.
"We both locked eyes," she said. The baby's eyes are hazel; Kelsey's brown.
"I love you," Kelsey said. And then she thought about all of the time she had missed with her baby.
Twice during Kelsey's long coma, priests visited her hospital bed to anoint her, one of the seven sacraments in the Catholic Church.
In daily prayers, the Townsends now ask, not for things they seek, but for "strength in the process."
They pray, also, for all of the doctors and nurses, and the COVID-19 patients struggling in intensive care.
As Kelsey reads bedtime stories to the children, they sometimes ask about the scars on her neck. She tells them about the trouble she had breathing and the machines that had to do it for her.
She and Derek are determined to be transparent with them about her illness.
Recently, the doctor told Kelsey that her lungs are now up to 50% of their capacity, she says, "which is awesome because when I was at the hospital they were at zero."
McCarthy, her UW Health doctor, describes Kelsey's prognosis as "guarded." Medicine has only been dealing with the new coronavirus for a little more than a year; doctors have not seen what happens to survivors five years, 10 years or 20 years out.
"We are optimistic for a complete or near-complete recovery," McCarthy said, "but there is simply not enough data yet for us to accurately predict long-term prognosis after a patient suffers severe COVID pneumonia."
Kelsey enjoys the small things: folding laundry, cleaning the countertops, loading the children's backpacks in the morning.
Recovery is work, and she still has a ways to go. She labors through hour-long sessions of physical and occupational therapy, twice a week for each.
But she can sit and stand without assistance, and no longer uses a walker to get around.
She sees the recovery process transporting her back to some of the same developmental markers that her baby, Lucy Kyu, is now approaching.
They are learning together.
Mark Johnson has written in-depth stories about health, science and research for the Journal Sentinel since 2000. He is a three-time Pulitzer Prize finalist and, in addition, was part of a team that won the 2011 Pulitzer Prize in Explanatory Reporting for a series of reports on the groundbreaking use of genetic technology to save a 4-year-old boy.
Email him at firstname.lastname@example.org; follow him on Twitter: @majohnso.
How we reported this story
To report this story, the Milwaukee Journal Sentinel conducted extensive interviews with Derek and Kelsey Townsend and with Kelsey Townsend's doctors at St. Mary's Hospital and at University Hospital, both in Madison.
The Townsends allowed the Journal Sentinel access to the family's online CaringBridge journal, a detailed account of Kelsey's 84 days in the hospital, Those days included the birth of the couple's fourth child, Lucy Kyu, and Kelsey's struggle to survive COVID-19.
In addition, Derek and Kelsey Townsend provided copies of text messages sent during her days in the hospital. Many scenes in the story were reconstructed and verified based on the memories of the participants and on the texts and journal entries.
The newspaper also read multiple scientific papers on COVID-19 and pregnancy, spoke to doctors who have studied the subject and examined published reports of other pregnant women who suffered severe cases of COVID-19.
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This article originally appeared on Milwaukee Journal Sentinel: Wisconsin mom nearly died of COVID-19, but had 'miraculous' recovery