ICU Nurse on 85% Ventilator Death Rate, PPE Rationing, and Why COVID Isn't a Hoax

Vance Crowe [00:00:02] As the crow flies on the Vance Crow podcast, Luke Mulch, welcome to the podcast.

Luke Mulch [00:00:10] Hey, what's up Vance? How are you doing man?

Vance Crowe [00:00:12] So you are my juujitsu at my same gym. We are not anywhere close on the same levels. You are a brown belt. I am a white belt, but you are a good dude. You are a guy that can whip me easily. But instead what you do is you allow me to try and put you in a, in a choke or to hold you down and then you get out of it. So you, you improve by giving, making yourself the most vulnerable. I have always respected that. I like rolling with you. You're a challenge and I respect you. But in addition to that, you are a nurse and you are one of the first people that I saw out there collecting masks and getting ready for coronavirus. And so I have been very interested to hear what you have seen, how it's gone, and just talk about what your, what your perspective on Coronavirus is.

Luke Mulch [00:01:03] Sure man. Appreciate the kind juujitsu words. So I can touch on that real quick too about, you know, taking it easier, whatever. I, I, I don't see that, man. I think you guys all, you guys all come pretty hard man, so it doesn't really benefit me to just go full throttle and use all 250 pounds in my body to just crush people all the time. So like when I roll with you, for instance, man, you are getting a lot better and you're improving. Don't sell yourself short man. You guys, you guys, all that gym are, are really, really bad asses and I look forward to getting back to it at some point. But back to the nurse thing man. What's my perspective? Well, I guess first of all I could paint a picture of kind of what, what my job is. So I know you had, oh that's the other person. I did listen to a podcast with Steve Earnst, who is also an ICU nurse and also does Juujitsu with us. I thought he was awesome man. I listened to it at work actually. So basically ma'am, we're going in and taking care of the sickest of sick patients, right? And the things that we provide in the ICU that other floors can provide like a regular medical surgical floor or a telemetry floor would be, we can offer a better ratio nurse to patient ratio number one.

Luke Mulch [00:02:44] But what we really do is provide services like ventilators, I shouldn't say services. We provide ventilation with the ventilator and then we also do things with medications that other floors can't do. We do things with what we call vasopressors, which are medication drips and we titrate those basically to raise or lower blood pressure. So we have vasopressors to raise blood pressure and then we actually have medications that lower blood pressure and then we also sedate patients and put 'em on ventilators. So we're tinkering with several sedatives to try to get a patient to be relaxed and not remember anything about being on a ventilator. And then we're also dealing with their hemodynamics. Maybe their heart rate's too high, their blood pressure's too low. Those are kind of the things we encounter a lot of. So typically we have anywhere from one to three patients. So when I come in to work, typical day would be I go get kind of my supplies that I'm gonna need, stethoscope and just other various things, scissors, X, Y, Z. And then I'm gonna get a overview of what's going on in the ICU, who are our most critical patients, is there a violent patient on the floor?

Luke Mulch [00:04:17] Are we not letting family in for a particular patient? Things like that. And then,

Vance Crowe [00:04:23] Wait, wait, I mean you just threw something in there that like, I I almost started laughing. Like you actually have to worry. Are there patients that might attack the people that are trying to give them medical care?

Luke Mulch [00:04:34] Oh, a hundred percent. I came in just two weeks ago actually. And, and typically I'm the nurse that they give these patients to. Though I will say at this particular hospital I'm working at now, it's not as bad. But oftentimes we'll have patients, it's very common for a patient to be restrained. First of all what? Yeah, so so if you're ventilated, the chances of you being restrained are very high. That said, you're not gonna really remember being restrained. Okay. And and what actually happens a lot of times is, which is is actually good. A patient will, even when they're sedated, they will, the instinct is to reach up to your breathing tube, right? Your breathing tube is connected to a ventilator and then the ventilator is the machine that sustains your life. But when you wake up, 'cause sedatives are tricky, man, it is a ball game of keeping somebody down to the point where you can wake them up and and talk to them, but you don't want 'em too awake. But you also don't want 'em, what we call snowed, right? Because what will happen is they wake up and their instinct is to pull their breathing tube out. And now all of a sudden if your patient pulls their breathing tube out, they have sedatives running. You've probably heard of propofol from Michael Jackson. That's what he was getting to sleep.

Luke Mulch [00:06:06] If you have that running that suppresses your ability to breathe and now all of a sudden you just took out your lifeline. So alarms will go off and you've gotta like throw some other oxygen via like a face mask on before these people die. I mean this is something that happens a lot. We call it self extubation. So to counteract that, you tie somebody's wrist down. But to your point, you're talking about just a straight up violent patient. Absolutely. Somebody could be an alcoholic that's withdrawing or perhaps they had a stroke that's kind of altering their mental state and you have to tie not only their arms down, but their legs down. And then you have to have a nurse in there 24 7 to make sure they don't do anything stupid. And I've even gotten into several physical confrontations with patients. Probably the most recent one is a patient was standing on, on a bed, he was a younger guy, he had a full cardiac arrest and he got resuscitated and he went through this whole thing that I could tell you about, it's called hypothermic cooling, where we purposely essentially raised the bo or lower the body temperature of the patient for 24 hours, I wanna say, and then slowly rewarmed them up. So this guy went through this whole process. So physically man, he was, he was a young, strong kid. He wa you know, he was totally coordinated, but his mind, he did not know where he was at.

Luke Mulch [00:07:40] And it got to the point he punched his mom in the room and then he punched, or minimum, 'cause I didn't quite see it, the lights were off, swung and hit a nurse to where her face was. So, oh my god, on the side. So I'm like, click the lights on, you know, I hear this ruckus because security had actually just left. 'cause the dude freaked out already and security's like, ah, everything's fine. They got the kid back in the bed, within five seconds he's back up. Blinging bombs at people. So I, this is where like my experience with jujitsu comes in handy. But I grabbed that dude, I reached across, I almost like bear hugged him 'cause he's standing on the bed, reached across, grabbed his far side arm and then switched arms and grabbed his wrist and then went cut kind of underneath his legs and almost like you're cradling like a baby. And then elevated him, slammed him, and then pinned his wrist to his body. And then he is looking at me, bro, like completely flexed like saliva coming out of his mouth, wanting to like tear my head off. And I'm like, get the restraints. And his mom's like, oh, his wrists are bruised. I don't want the restraints on. And at that point it's like, ma'am, I don't give a shit. We're, we're restraining them. You know what I'm saying? So yeah, we deal with violence, but I've geared off course a little bit, but

Vance Crowe [00:09:06] I mean I just, I it's my fault. I, I'm the one that called it off there because I gotta tell you that there's no part of my day that's going on right now where there's even the slightest chance that that would happen. Right. Because I am isolated. Right? Right. I'm coronavirus lockdown and I think about understand like you're going into work and you're dealing with, with that. That's, that's the level of people that you could be around. What is going on right now with coronavirus?

Luke Mulch [00:09:38] So right now, man, so if you look at our ICU, right, it's 20 beds, okay. And essentially on like the south side of our ICU, there's a string of 10 and on the other there, then there's a hallway in the middle and then there's 10 more beds. So just we, we have, excuse me, we have one side of the hallway that's dedicated to the COVID patients or rule out COVID patients. And I would say, you know, three, four weeks ago it was like one or two and then, you know, I guess I guess it would be about three weeks ago it was, you know, five or six. And now it's just that whole size. So the last two weeks, it's pretty much just been that one side of the hallway with either confirmed or active cases of COVID, in which case if they're in the ICU, they're in the ICU because they're either a rapidly declining, meaning they can't, they can't oxygenate with, you know, just like a face mask or a nasal cannula, which we've actually been doing both, we've been putting nasal cannulas on okay. And turning 'em to their max settings and then throwing on a, a mask as well over the top of that and then turning oxygen onto that too. That's not something I've ever seen before, man.

Luke Mulch [00:11:12] And I think the reason behind that is, is, is because the other reason that these patients come to us is they're ventilated, meaning we have to manage this ventilator, okay? But most of the patients that are positive in the ICU are all on a ventilator. And unfortunately the odds of them getting off that ventilator and surviving is very low. About 80 to 85% that decline to the point where they need a ventilator don't get off and they end up dying. And I don't want to get into too many details about my actual hospital, but there has been, there has been a good handful of people that have died already from it. So, I mean it's definitely, it's, it's definitely not a, a hoax, you know, and, and I've worked to advance, like through a really bad flu season and we don't have a whole hallway of patients lined up on ventilators just from the flu, you know what I mean? So that's kind of where we're at. But,

Vance Crowe [00:12:28] So let me ask you, how, like, is it people that you would expect to be in the hospital? Is it overweight people, people that haven't taken care of their health, people that are older? Or is it like you look around and it's just random, like, like a whole bunch of car accidents just happened?

Luke Mulch [00:12:46] That's a good question, man. So my, my brother actually asked me that same question. So I just went through and jotted the age distribution, nobody in their twenties, two in their thirties that don't really have a documented health history. And then it's just kind of like scattered throughout. I think we had 1 92, had a few in their fifties, forties, sixties, all over the board, man. But if you're gonna talk about, if I'm just visual looking at that person and look like are they healthy or not healthy? I would say overall I'm not getting like marathon runners in there. That's not to say that can't happen. I just haven't seen it, you know what I mean? I'm, I can only go off of what I've seen, but man,

Vance Crowe [00:13:48] I I, I mean just, just cutting straight to it. You and I both know a lot of guys that are working right now, they're driving trucks and they are delivering stuff and then another, a lot of guys that aren't working and you know, you're a healthcare professional that will be impacted if the disease spreads more. Do you want those guys to be able to be out there working because it doesn't look like they get sick enough to get into the hospital or does them out there participating in the economy put you at greater risk and more than you should be willing to, to have to endure?

Luke Mulch [00:14:29] I'm, I would say this, if if going back to work and kind of opening everything up without, you know, any sort of precautions and there was, you know, a large spike of infections and people kept coming in, we would, we would be stretched to the, we would get stretched to the limit, but I think we could deal with it. Obviously I would be probably exposed to more cases of COVID. I can tell you right now my hospital is already preparing for like the worst possible scenarios to where I would essentially in all the other ICU nurses would act as kind of like, almost like a manager for nurses that aren't traditionally ICU nurses. So I would have more or less like four nurses under me and then I would be responsible for managing the ventilators and just like taking care of any problem that might arise. That's kind of how it was framed to me. We haven't went over the X'S and O'S in that of that, but that's kind of,

Vance Crowe [00:15:46] And that's what the expectation that that there are so many healthcare workers that will, that have been infected by it because they've had to care for people that have it, that there could be a drastic reduction in the number of nurses that are available.

Luke Mulch [00:16:01] Say, say that one one more time.

Vance Crowe [00:16:03] So you're saying that that that you have been trained based on what happens if a whole bunch of healthcare workers get coronavirus because they've been exposed at so much higher as of a rate than the normal people that would be running the hospital would get sick. And so you'd have less people to be able to manage. So you'd have to bring in new nurses from another place or maybe that aren't normally doing this type of work?

Luke Mulch [00:16:28] So that's a good question. Sorry, I didn't really clarify that. So we have, right now, other areas of our hospital are actually low on their census. So for example, we have a whole floor that takes, you know, elective surgery type patients. And then overall I would say people are trying to stay away from the hospital as much as possible. So if you look on every given day on a hospital, there'll be a surgery schedule and there'll be, I don't even know, 30, 40 patients on that surgery schedule. Those patients aren't there anymore. So we have nurses, we just don't have ICU nurses. A lot of our nurses right now are being furloughed. Actually we've had, and I don't, I don't know if I wanna get into this, but we've had administrators let go too because I, I assume we're in the financial trouble. I mean I don't, I don't look at the books, but I mean we've let several administrators go, we're furloughing nurses, the next thing to go is probably they're gonna let some nurses go. You know, I don't know, it's kind of weird man. It's like in certain areas of the hospital, it's a ghost town. But if you go to the emergency room in the ICU, it's a completely different story.

Vance Crowe [00:17:47] Well, so a family member of mine, I'm not sure if she'd want me to talk about it, wa was going through cancer treatment and, and I was like, oh my god, you know, coronavirus, you're gonna have a weakened immune system, maybe you should talk with your doctor about not doing it. And she was like, no, I've already gone partway through this radiation. They say they can keep it clean, we're separate, we're doing everything we can, I'm gonna go forward with it. And the whole time I was super nervous, but now she's out on the other side and I'm really glad that that's

Luke Mulch [00:18:17] That's awesome.

Vance Crowe [00:18:18] Done with, you know, but what about all these people that have, that have delayed these types of treatments? Are those kinds of things happening?

Luke Mulch [00:18:25] Oh, a hundred per, I mean a hundred percent. I think they're kind of viewing things in a different way. Like if you, if you really don't need something right away, we're, we're gonna hold off. You know, so overall surgeries are down like, like I told you, like our open heart surgery area that can we reserved and half of that ICU, did I touch on that? So the area that's now the coronavirus patients usually are reserved for people that had a coronary artery bypass graft, right? A bypass surgery. So we don't have any of those now tho there are very few, unless those patients are requiring like, like an immediate type surgery, we're not touching 'em because the risk of infection is just too high. So yeah, definitely less, less surgeries overall. And it's definitely impacting those nurses as well. They're, they're like I said, not able to get a lot of work, which is kind of crazy, man.

Vance Crowe [00:19:36] What I mean, what is going on with people that are having heart attacks because it's not like people have, have changed their health such that they don't have to go to the hospital on that kinda stuff.

Luke Mulch [00:19:46] So for sure. So for, if you do have a heart attack, there's usually two different ways. The first line of treatment, if you come in with an acute heart attack, you're gonna get taken to the, you're gonna have an EKG, it's gonna say, hey, this dude's got a infarction somewhere in his heart, meaning there is a, a vessel block. So what they would do is take you to the cardiac cath lab, which what they do is stick a catheter either in your radial radial artery or into your groin and thread that through your vasculature up into your heart. And then they take a look around with a little camera on the end of this catheter and then they stent, you've heard of a cardiac stent, they put a little stent and open up that artery. Now what happens though is a lot of times these people have such bad heart disease, you just can't, you can't do anything to fix it. That's when you would have say, okay, I've gotta open up their chest and do a coronary artery bypass graft. So if that was something that was a hundred percent emergently needed, and I'm sure we would probably do it, but that doesn't happen very frequently. Typically if someone comes in with a heart attack, they will still take 'em to the cardiac cath lab that's considered kind of like an emergency. That said, we've already discussed talking about alternative treatments to the cardiac cath lab, which would be giving these patients, instead of taking 'em to the cath lab and deploying the stent and opening up the artery, we would give them a thrombolytic, which essentially is a medication that will just bust up that clot.

Luke Mulch [00:21:31] I mean that's the ideal, ideal outcome. Bust up that clot and then blood flow is restored. That works pretty well with strokes. I don't know how well it works with heart attacks because you've gotta assume for the most part, you know, a lot of times those arteries are just clogged up with plaque and then just over time slowly close up and then you don't get blood flow. So a lot of these patients, you know, that need say an open heart surgery, have experienced symptoms like shortness of breath for several months. It's not necessarily that they're coming in with, you know, elephant standing on my chest crushing chest pain and need surgery right away. They're just gonna have to sit around and, you know, be short of breath more or less. So what but Oh, go ahead. Oh, go ahead. I was gonna talk about kind of like what what's different about dealing with these coronavirus patients instead of, you know, just kind of your typical day. But yeah,

Vance Crowe [00:22:41] Tell me about that.

Luke Mulch [00:22:43] Well, so like, and I know you talked about me like collecting all those masks and whatever, so kind of crazy man. We were like, it's weird. And I, and, and I'm not saying it, it's like where I work, 'cause this was happening everywhere, but just the very like beginning, you know, before like I, maybe we had one or two of these COVID patients, man we're already like, you know, rationing like these N95 respirators. So there's a different, most people, I don't know if most people know this, when I say ventilator, I'm talking about machine that ventilates you with the breathing tube. But the respirator is just more or less a face mask. And you can see sometimes you'll see people wear these at the store. They have a van that goes back behind their neck and then one around the top of their, or back of their head rather. And then they have a little thing you can squeeze at the bridge of your nose. And the idea is you create the seal where you know, nothing can come in and affect you, infect you through the air. But so like in my nursing career bro, I've always been taught, hey, you get one mask every time you go in that room before you leave that room, there's a way you dispose of, you know, take off your gown and dispose of the mask. There's certain protocols you follow, man, this is a one time use thing.

Luke Mulch [00:24:14] So now all of a sudden they're saying, hey, you get one in the 95, you know, you're putting it in a brown bag, you're keeping it in your locker and you're breaking that bad boy back out. And we're all like, I mean there was obviously some outrage from nurses, like, this is totally, you know, not protecting us because the bacteria is just gonna live on the mask and move all over the place. Right?

Vance Crowe [00:24:44] It's a virus, right.

Luke Mulch [00:24:46] And what's that?

Vance Crowe [00:24:47] It's a virus, not bacteria, right?

Luke Mulch [00:24:49] Oh, I'm sorry, the virus rather. But yeah, and then we have other things too. So like, I think part of the problem is, and I don't know, but we didn't use a lot of N95, we used these capper air, she or face shields that sit in front of your face and then they kind of bind to your neck and then you kind of plug, plug 'em into a battery pack and they continuously produce like airflow inside the actual kind of helmet you're wearing with this face shield and those face shields, you know, you're supposed to throw those away, like, I guess it's like once every shift unless it gets soiled. So we're keeping these things, bro, like I've, I've still got one from like three weeks ago

Vance Crowe [00:25:35] Now. Is it, is it that they are rationing them so they have them in the future? Or is it that they don't have enough right now and that the, you know, the storage room is almost empty?

Luke Mulch [00:25:46] So that's a good question. So the N 90 fives, they definitely, I, I think they definitely have some that they're reserving those face shields as far as I understand, man. Like we don't, we don't really have any. So we're, we're seeing a lot more nurses ditch those because their integrity has kind of been compromised and we're sticking to the face shields and then, or not face shields, but n 90 fives rather. And then what we're doing is having 'em go get sterilized and I don't even know the process for sterilizing 'em, but then they come back in another paper bag with our names on 'em and then that's our sterilized mask, man.

Vance Crowe [00:26:27] I mean it's UV light is probably the best thing you got. I mean the, I wonder it just putting out I sunlight, I think

Luke Mulch [00:26:33] What they're doing, man, and that, and I've read like articles about that and I, I've heard they kinda like damage their integrity. Like

Vance Crowe [00:26:41] Filtration

Luke Mulch [00:26:42] Two thirds

Vance Crowe [00:26:43] People don't understand. So when I lived in Africa, you would wash your dishes with whatever you could, you, I had like a lie soap. But even if you didn't, you would set the like, 'cause you're washing it oftentimes in water that you haven't like boiled, but it, the sunlight is so strong that you can even leave water on the, on the edges of the, of the plate and put it out in the sun and the sun will clean all the water out so you don't have to worry about contaminating that way. So like the sun clears all kinds of bacteria, all kinds of stuff out. But people also don't realize that like if you're talking about a fabric, like you are the mask, which is just wires that are just wound over top of each other with like some kind of polymer in between them that wears that stuff down in the same way that it wears the, the, the disease on them.

Luke Mulch [00:27:35] Right, right, right. Yeah, man, I don't know, you know, as far as what I can see on the mask, it looks okay, but obviously the studies are saying, Hey, this isn't entirely,

Vance Crowe [00:27:43] How many days are you wearing a mask for?

Luke Mulch [00:27:49] So it's hard to say because like some weeks, like last week I didn't get like COVID patients, so I was actually only wearing a regular surgical mask. And then protective goggles, that's kind of our mo if we don't have COVID patients when we're just like in the common area, we always have to have a face mask, which is great. Initially we weren't even doing that, which, you know, is not, it's not a great approach to try to not spread infection. I mean we pretty much, I'll say everybody I work with has done a great job, man. And we, we are definitely on board with preventing infection. But just thinking about like before it really popped off, if you think about the fact that, hey, you might come in contact with a COVID patient and now you as the nurse are asymptomatic and you're not wearing a mask, you're gonna go take care of the next patient without a mask and potentially get them sick. I mean, that's a reality. That's why you see like these outbreaks in nursing homes or prisons or these, you know, very dense areas that aren't taking proper precautions, man, they all get sick. Not to mention like in a nursing unit home, they're already all, you know, compromised for the most part. So,

Vance Crowe [00:29:17] So I, I worked on a cruise ship for a while, a small one, and it, it, i it was amazing how a disease could spread around a ship just, just like lightning. And you never see it when you're living in a town, right? Because you just don't see that like a disease spread through a place. So I think one of the great fears that people have is that there'll be a series of things, a bunch of nursing homes or a a couple of offices get it and then are now all need to come into the hospital. Do what do you think of that? Is that something we should be afraid of or do you think like, nah, it's not gonna come in at the, the tide didn't come in as much as we thought that it would come in.

Luke Mulch [00:29:59] I hope there's no tide, bro. Like I'm, I'm ready for it. But, but yeah, I mean, if there's something particularly like locally, like all of a sudden, like a whole nursing home has an outbreak. I mean they're, they're definitely going to be flooding my hospital, I would say. You know what I mean? That's a reality. And you're, and the other thing you touched on is like, you know, so like we don't, I don't think, you know, you've heard these people like that, that don't think this is real. And the reason they don't think this real is real is because they're not living in areas like, like New York City where they're loading up trucks full of dead bodies, man, they're living in central Illinois. The the outbreak is not as prominent here, man. So when people like try to say this is the government trying to, you know, take control of us, this and that, bro, I just try to look at this stuff logically as possible. You know what I mean? An outbreak happened in China, a bunch of freaking people died. Okay? It came to the United States we're taking steps to control the infection. A shit ton of people died and the economy is red. Now, when you look at it like that, man, you, and, and you can still sit here and tell me with a straight face that this is some government ploy. I mean, you're insane, man. And from my perspective,

Vance Crowe [00:31:25] I, I think that you could make the, the, the case that people are worried about that we thought it was going to be worse than it was. And it doesn't seem that bad. The I and like I agree

Luke Mulch [00:31:37] With that and I agree with that.

Vance Crowe [00:31:38] Okay.

Luke Mulch [00:31:40] And I agree with that. But that's the, and it's so weird, man. 'cause you get all this information thrown at you and it's hard to kind of piece through. It's kind of a weird virus. I saw one yesterday in California where it said like a large amount of their population has already been exposed because they have antibiotic antibiotics to the coronavirus. Did you see that one?

Vance Crowe [00:32:04] Yeah, yeah, yeah,

Luke Mulch [00:32:05] Yeah. I mean, so I don't even know what to make of that. It's kind of crazy. I mean, I hope, man, I hope they're saying, hey, we can go back to work and, and, and start living a normal life, man. There's nothing more I wanna do than like go back and start doing Juujitsu, bro. And I hope, man, I hope that it's not as bad. The death projections have went down drastically from a, from what I initially saw too, man, they were saying, I don't even know, 500,000 deaths in the United States. And then I just looked not too long ago and was like, which it's still high. It's like 160, 170.

Vance Crowe [00:32:43] What sort of precautions are you taking right now because you're working at a, at a hospital, you come home,

Luke Mulch [00:32:49] Right? So man, I work with some awesome people, man, these nurses, dude, I, I'm blown away like, like how much shit they go through and just keep showing up to work, man. Because essentially what happened, man, this one guy, so I'm living in my basement right now, but this guy I work with, Josh, he moved into a house here in O'Fallon. Like somebody just had some rental house and they said, Hey bro, you can live in it. And he asked me to come live in it. I've got a wife and two kids, you know, and I'm like, damn man, I didn't want to bring, I didn't wanna bring that virus home because I'm literally man staring this thing in the face, right? And I'm covering it when I get home from work, I strip down in the garage and go straight to the shower and then if I come upstairs or go in like the common area, I'm wearing a mask, man. But fact that Josh, he told me to, to move in and that kinda like made me think, man, maybe I really gotta start like worrying about not, you know, getting my my family sick. And even though like the risk is really low, man, being that you're younger and fairly healthy, I just think about the fact that I've taken care of people my own age, right? That have a way shorter health history than me.

Luke Mulch [00:34:23] I mentioned a, a couple that don't look healthy, but on the books, they didn't have any health history. So I thought about that man, and I just kind of did my own thing. But I think, I think that dude, because the odds of me getting sick, I mean, there's definitely a potential, I could be a, an unlucky one that could get, get sick and die. But I would hate to think that, you know, I got like either my kids or my wife sick. Is that still a possibility? Sure man. But I'm gonna do everything I can in the meantime to make sure that they don't get sick. So I moved down to my basement, bro, and I got a microwave and like a foreman grilling machine in a fridge down here. And it gets pretty lonely down here. I'm not gonna lie, but I try to stay outside most of the time. I lift a lot of weights in the garage and stuff if I'm not working. So it's not too bad, man. I got a bedroom down here, so I'm not complaining. I, I know. And

Vance Crowe [00:35:26] As you look out, as you look out on the horizon, would you do that for another two months?

Luke Mulch [00:35:34] No, and that's the thing I've talked about is like how su how sustainable is this man? Like how long can I do this for? And I probably man, if, if if more patients kept coming in and it doesn't die down, I, I could do it for, I could do it for two more months, that's not a problem. At the end of the day I would do that, man. I would, I just wanna make sure, you know, what I would love is to be able to say, Hey, you have antibodies to this virus, you know, and then I can not worry so much about it, but for the time being, man, I'm cool where I'm at and I'm not the only one doing this, man. Like, I've got a, I've got a nurse I work with, her name's Sarah, she's awesome bro. These people man can stare like in the face of death and like have a heart rate of like 50 bro and just handle it. It, man. And like, and like there's, when there's a patient crashing, bro, you, there are so many precise steps you gotta take and just be on point to do your job well. And just like seeing someone die in front of your eyes and bringing back to life is awesome, man. These people are really good at it. I include myself in that. But she lives, anyways, back to Sarah, she lives out, what do you call it, in a camper bro, out in her front yard

Vance Crowe [00:37:05] And she's

Luke Mulch [00:37:05] Got her husband inside and a lot of these people are better off than me. Like, you know, I'm, I'm fairly healthy, my wife's fairly healthy, but like not, that's not everybody's situation. A lot of people have very, you know, people that manage and deal with chronic illnesses. Yeah,

Vance Crowe [00:37:22] The nurses are people too. They, they have, oh yeah, they have illnesses and

Luke Mulch [00:37:26] Dude, nurses definitely ha have illnesses. I mean, we're stressed to the, to the guilds. Like it's, it's really common to see an unhealthy nurse, bro. I mean, I'm talking physical health, I'm talking mental health that are all, that is, that is a real reality, particularly in the ICU that we, we deal with. They say like the ICU nurses, PTSD rates are like as high as a, a veteran of, you know, like the wars in the Middle East.

Vance Crowe [00:37:58] Well, when I would come home from being a deckhand on the ship or being out in the Peace Corps, I would hang out with nurses because they partied, right? So, so like, you know, oh yeah, they're blowing off steam. They're, if they've just gotten off like four days of working 12 hour nights, oh man, and then they go out and party. Like, and that's not because they're healthy.

Luke Mulch [00:38:20] There is a reason they do that. Man, you know, with any stressful job you want to take yourself, you wanna take yourself outta that stress, bro. That's why they're drinking. That's why I know a lot of, you know, I know a lot of nurses that got into drugs and crap like that. A lot of nurses that are on anti anxie medicines. So

Vance Crowe [00:38:40] Let me ask you this man, like you are this big old hard dude. Like if, if you want, you can crack heads and you're a nurse, which people typically think of as like white dress and you know, I don't know, cute. And, but I like I said it to Steve, I'll say it to you like, I would want you to be one of my nurses. What the hell? Why did you decide to be a nurse?

Luke Mulch [00:39:06] Oh, that's such a good question, bro. Man, I can tell you the story if you want to hear it.

Vance Crowe [00:39:13] Yeah,

Luke Mulch [00:39:16] So I was, I've done a lot of different things, man. But really, like in my twenties I primarily was like dealing poker and this and that. And I was getting to the point, like anything you do for a while, I was just kind of, I was just kind of going through the motions. But what what inspired me was my wife was, she was having our, our our firstborn kid, Lydia, who's now eight years old, right? And we went to a memorial hospital in Belleville, man. And she, she had it in her head, she watched a documentary about natural birth, like she's gonna go no anesthesia bro, and just push this baby out. Okay? And dude, I was there and I remember how many, I remember I clocked it, we were at the hospital for 52 hours. Oh. And I remember because that's like my basketball number in high school, I was like, I'm gonna remember this was 52, right? So anyways, bro, I remember being in there and it was like the, the night before, it was early in the morning, I wanna say like one, two in the morning before the morning she delivered. Okay? And they actually delivered Lydia with a, it's like a suction cup.

Luke Mulch [00:40:47] And by the way, at this time I have zero medical knowledge, right? I know nothing. But they essentially like suction, cut the baby's head, pull it out, right? And they're like, Hey, we give you three tries. We don't get it out on the third try. We go do a C-section and just cut the baby out. I'm like, okay. So luckily the third time they got it out, I was like, oh, thank God, you know, 52 hours and now we're on the third time

Vance Crowe [00:41:11] Trying such this

Luke Mulch [00:41:13] Baby, I had the biggest wave of euphoria after I saw that baby take a breath.

Vance Crowe [00:41:19] Oh man, you know that my wife is pregnant, so you're like describing a nightmare horror show for me. Thank you for this. Oh

Luke Mulch [00:41:26] Bro. So yours will be better, but let me backtrack though. So it's like one, two in the morning, man. And first of all, the whole time, man, I, the nurses there crushed it, dude, just, I was just like blown away, like essentially about situations that I perceived as being extremely stressful, right? And they were just kind of able to handle it with, with grace, dude. So, but it was like one, two in the morning, man. And my, I guess they like screw like a little thing into the baby's skull to monitor the heart. And my wife is at the point now, bro, you gotta imagine. And she had this done like the night before, okay. And she had a, a anesthesiologist or a nurse anesthetist come in and do an epidural, which is where they spread this little catheter, the spinal column and give you this medication to basically numb everything from the waist down, right? And that anesthesiologist bro, he looked like Eagle or man, like, just like some old crusty dude. He's back there, he's fixing this thing in and he's like, he's like, oh, I got some of the medicine like in somewhere where it shouldn't be. And he is like, you're gonna have a very bad headache. He warned her essentially. But she got a little relief for the time being like, dude, if you saw my wife, bro, at this point she had looked like she had run like three marathons and like had nothing left.

Luke Mulch [00:43:03] I was just like, oh my god, how is she even alive? I thought I was looking at someone that was about to die, bro. So anyways, she's gonna kill me for telling me, telling the story because anyways, she's sitting there, you know, and it's that morning and now all of a sudden, bro, she's got a headache, like the most painful headache you could ever think of. And I'm like, what the hell is going on? At the same time that heart monitor stops. Okay. And then this stuff called meconium comes out of the vaginal canal, which is essentially like stool from the baby. Now I don't know anything about this, what's going on? I thought my, I thought I was looking at my baby and it was liquified though, I dunno anything. And those two nurses dude just dealt with it. And like I'm sitting here like fumbling freaking out, sweating bullets and, and it was just no big deal. And like after that I thought to myself, man, those are some badass, those are some bad asses right there, bro. So that's kind of like got me thinking about it and then I finally took the leap. I remember I was like sitting around,

Vance Crowe [00:44:23] Wait, that's a huge jump. You, you're saying you, you watch all this happen, you're, they are the cool under pressure, they're in an intense situation. It's one thing to respect those people, but to decide that you wanna go become one of them that's different.

Luke Mulch [00:44:39] Yeah, it was. So I mean I, so that was kind of the thing that set that I idea off, but like, dude, you just have those moments in life and I don't know how many I've had, but dude, I was just sitting there like on my computer, I don't even remember what I was doing. I think I was just looking for jobs, man, because I was just tired of dealing poker and, and actually the poker, the place I was dealing poker at River City Casino, like our business was down and I could kind of see the writing on the wall that it wasn't gonna be around much longer the poker room itself, which it actually did shut down like a year after I quit. But anyways, I was looking at jobs is what I kind of remember. I haven't thought about this for a long time. I was looking at jobs, like best jobs you could have, right? It was like top a hundred best jobs you can have is like on Yahoo News or something stupid. And, and number two is like CRNA, which is basically a nurse that man deals with anesthesia, right? And you make good money and this and that. And so that was kind of like my ultimate goal. I was like, that'd be so awesome. And then it kind of like, man, maybe I should just do this nursing thing. So I looked up, the other kind of thing that really swayed me into is they have one year nursing programs to get a bachelor's. If you already have a bachelor's degree, it doesn't matter what your degree is in, you can get into kind of these fast track programs.

Luke Mulch [00:46:10] So I applied for that and fortunately because I'm a male, it's pretty easy to get into nursing. So I got accepted, man, I just went for it, bro. But,

Vance Crowe [00:46:23] And did, what is it what you thought it would be? Did you, when you imagined being a nurse, did you sign up for Coronavirus Pandemic?

Luke Mulch [00:46:33] No, but no man, I didn't. But I, if you're gonna say did I think it, I didn't know. I didn't know what to expect. I just kind of, I'm just kind of like an oddball bro. I'm like, I'm not someone that w if you would've asked me when I was younger, if I was gonna be a nurse, I, I would say no, but I would say there's no way. You know what I'm saying? But, so I'm kind of an outlier in that respect. But do what you expect in your first year of nursing as a nurse is particularly me. A lot of people get into nursing and have like what you would call a nurse tech experience or like a nurse assistant. So you at least a minimum have some level of knowledge about, hey, this person needs more oxygen or I know how to roll and maneuver patients in a bed. I didn't have any of that bro. And I got my first job in the ICU and let me tell you man, I got like five, six weeks orientation. They pulled me off early because we didn't have enough nurses. And you are scared to death, bro. It is for one, probably your first year as an ICU nurse, you were, I remember going in the bathroom bro. And just like having like little mini panic attacks before work because that, that freaking scary man. But like, I remember going in there and like, I remember the first time I went to like a overview with the night nurses I was gonna be working with and I was like, these are the freaking, these people are the craziest like I've ever met.

Luke Mulch [00:48:12] Like how they talk about things, like, it's insane. Like, you know what I mean? Like, they talk about just like being able to talk about death and oh man, did you see this and that? And I'm like, man, this stuff, I'm sitting here wide eyed, like this stuff's nuts, bro. I'm just trying to keep these people alive, you know? Know

Vance Crowe [00:48:30] What I mean? I'm mean like, I, I think there most people have never seen an animal get killed, let alone watch a human being die or, or like struggle and, and, and have as much trauma as what you see in an ICU.

Luke Mulch [00:48:46] Oh yeah, for sure. I mean I, yeah, and I mean I've look, I've pressed buttons on, on pumps and stopped them, bro. And then within seconds the patient dies. Like that's crazy too. You know what I'm saying? Like everything, a lot of times we'll get, it's kind of interesting. We'll get families that say, Hey, I'm gonna leave it to God's will if they're in the ICU and they've got all these medications going and this ventilator, it's ceases a lot of times it's not, it's not in god's will. Okay. That, that's crazy. What what unfortunately happens is a lot of times these patients, at least from how I perceive it, is they're being tortured, man, just to keep 'em alive, just to keep our going. It's actually really sad sometimes. And that's another thing a lot of, and I'm trying not to get all my, my wife told me, don't get too dark and dreary, man. But that's a lot of times like what we have to put up with when you talk about like, you know, like you never want to do things that you're like morally conflicted with, you know, just because they say cool hand Luke, man, just because it's your job doesn't make it make it right. So I feel like I do that a lot. Unfortunately I'm veering off track from

Vance Crowe [00:50:21] No, this is, this is amazing. I mean I think it applies to every person.

Luke Mulch [00:50:26] Yeah, man, it, it, it, it is crazy. So if I could give like anybody advice bro out there about like end of life, right? Because I see a lot of end of life and everybody that's alive right now is gonna die. And what happens is when someone declines and they're in say in ICU is that person in that bed is no longer gonna be able to make decisions for themselves, right? Because they either have a breathing tube down or they had a stroke and they can't process things normally. So somebody's gonna have to make that decision, you know, in terms of their treatment, how to go forward. And usually nobody's not usually, oftentimes no one's been designated. So all of a sudden it became, becomes a fight between family members, Hey, I don't want to put in a feeding tube or do a tracheostomy. Well, I do what, what doctors are gonna do is they're never gonna, if somebody, if not on, if somebody wants a tracheostomy like the white, but all the kids don't want a tracheostomy, a tracheostomy is cutting a hole right here and now all of a sudden you have a trach inserted and that's how you're gonna breed potentially for the rest of your life.

Luke Mulch [00:51:56] It's not always the case, but a lot of these people are end of their life anyways, bro. And at the end of your life, do you want a feeding tube? And do you want something in your neck when you don't even know, bro? You don't even know your name. Okay? You don't know where you're at, okay? You don't know what year it's, you can't eat anymore because all, everything you eat goes down to your lungs. What are we trying to accomplish with sustaining life? The person in that bed doesn't want all this shit done. And unfortunately they're no longer able to make those decisions. It's crazy, bro. So what I would recommend anybody man, is to have a power of an attorney that is somebody that's not even in your family, that's someone that knows Medicine man and can kind of interpret information from a doctor or a nurse and make a good decision. But that's just my 2 cents on that. No,

Vance Crowe [00:52:56] I'm a hundred percent with you on that. And I think people, so you know, when you start to, when you start a family and you start thinking about like, hey, I'm gonna have a responsibility here. What am I, how am I going to want things to work if I can no longer earn or provide for my family? Like how do I want all this to work out? And all of a sudden you start answering questions and saying, who's going to be the person to make that call when I'm not around? And like, I can't believe it. 'cause 'cause I have a, I'm the middle child of seven, but I would absolutely never have imagined when I was growing up that I would want my older brother and my younger sister to be sitting there giving my wife advice. But my older brother knows like me really deeply and and really like knows what's up with me and my little sister, Alicia is a nurse and she is realistic on like what the cost of doing CPR is, like what, what it looks like if you've cracked open ribs. And I want her to be able to say that to my wife. Like those are the two polls of of, but I want, ultimately I want my wife to make the decisions,

Luke Mulch [00:54:02] Right? Yeah, man. Once you get to CPR, that's,

Vance Crowe [00:54:08] That is a universal juujitsu at BJJ Lifestyle Academy where we all, where we train, there are a bunch of nurses, almost all of you, ICU and everybody has rib cracking stories from CPR. Oh yeah. It's like a regular thing that they talk about.

Luke Mulch [00:54:23] They, they say I have, I shouldn't say they say it, but I had a doctor. We have a, we have a device, so it's called an Emma and you can attach it to the end of the endotracheal tube and it reads and then you attach past that, you attach the bag that ventilates the patient, that's what you would do before you hook 'em up to the machine or if they needed like a little extra pump of oxygen, but it reads the CO2 level and the better your chest compressions, the higher that number will go. And they say a good good CPR you get like around 20, I was hitting 42 and the doctor's like, no way this patient has to be alive if his CO2 level's that high, it's like, stop compression sure is enough, no pulse. He comes up to me afterwards and he's like, he's like, I just wanna say those are the best chest compressions I've ever seen. I was like, thanks doc.

Vance Crowe [00:55:25] Wow,

Luke Mulch [00:55:26] What do you say?

Vance Crowe [00:55:27] I think people have a skewed perspective because they've watched on tv like do pull out all the stops to, to make it to save me. And it's like, what they don't show is that it's not pretty

Luke Mulch [00:55:38] Ugly, bro. You're gonna get, you're gonna get your ribs crack. I mean, look, I've seen some really quick good outcomes. Usually like a quick defibrillation or defi where you're only like doing CPR for like 30 seconds. Those are best case scenarios. If you do have CPR done man, and it's something we can fix, you can have a good outcome. The best, the people that do the best are the ones that get CPR right when they arrest though, you know, so we'll call it like a witness arrest. If you've been down for like 10 minutes and now all of a sudden we get your pulse back, your brain is never gonna be the same, more than likely. So CP R's got its place where I don't think it has its place as someone that's 93 years old and can can't even eat food anymore. You know what I'm saying? It's kind of, it's kind of crazy how we approach that sometimes.

Vance Crowe [00:56:35] So I am I'm really grateful that you were willing to come on and share like what is going on with coronavirus because as a nurse, somebody that has been in in the hospital has seen it to me it's, it's a, it's a big thing to hear, you know? Exactly. From you. And so, but before we go, I, I'm wondering right now, I'm was just trying to look up the date. What is today's date? It is April 22nd. It's Wednesday.

Luke Mulch [00:57:04] Correct.

Vance Crowe [00:57:05] What do you think the world will look like two weeks from today?

Luke Mulch [00:57:12] Probably about the same to be honest with you.

Vance Crowe [00:57:19] Will you be living in your basement?

Luke Mulch [00:57:24] Oh man, I hope not, bro. It's, it is, it is a little boring down here. This, that said though, I'll say that ever since I can't do Jiujitsu, I have been doing stuff around the house, bro, that you, I mean, power washing, landscaping, all sorts of stuff, man. It's amazing how much time I have when like my hobby doesn't like encompass like every waking moment and thought, you

Vance Crowe [00:57:56] Know what

Luke Mulch [00:57:56] I mean? So that part's kind of, in a way it's kind of cool because I can get some stuff done, but

Vance Crowe [00:58:02] It's great to have a balance, like, right, like there are a lot of downsides to this thing, but it's good to say, all right, what do I value? Why do I value it? Like, and

Luke Mulch [00:58:11] I

Vance Crowe [00:58:11] Tell you what, like the comradery is what I miss. Like the

Luke Mulch [00:58:15] Oh yeah,

Vance Crowe [00:58:16] The whole bunch of stuff that got cut out for me that I don't really care about. But Saturday open mats at the Jiujitsu where you don't know who's showing up, but you're just gonna roll. You get to a lesson in with coach and you're like, my whole week is better because of that.

Luke Mulch [00:58:31] There's nothing better. Oh God, I feel so much better after I do that, man. I, I miss that stuff so much and I, I hope it gets back to normal soon, man. I, I feel for coach. I know he's, he's wanting to, he's wanting to start it back up. And I do not blame him, bro, because I'm right there with him. I get, I get the best release, man. It is like, jujitsu is almost spiritual for me. Like a good role. Like I feel like a million bucks man

Vance Crowe [00:59:04] Afterwards. So I, I have a friend named Dave, and Dave does training of special forces. He teaches the martial arts. So like if you wanted to know who knows how to do combative arts, Dave is your guy, right? And that's how we found Coach. It turns out, I don't know if you know about coach, but I get to hear all these background things and so Mike Remi and it BJJ Lifestyle Academy is an old school. G is what he said. He's like, he's from the old country now, comes to the United States and knows the secret, magic like way to maneuver your body to, to dominate other people. And on top of that, he's a mountain of a man. And so you've taken this guy and you've pulled him out of doing the one thing, his art, which is the crushing of other human beings. And I can't, I can't wait to get back

Luke Mulch [01:00:00] There. Well, I'll tell you like, and you're right man. And I know it's hard on him, but, but I know he had those hip surgeries. So I know he kind of knows already how to live, like, and all those hip issues. He is, had he, he knows how to live through not doing juujitsu. And I kind of dealt with the same thing, man. I had a, I have, I kind of have like this clotting disorder. I've had a few blood clots and things, and then I tore my Achilles too, so I understand what it's like not to do jujitsu, but at the same time, I've had periods of time where I wasn't able to. It sucks, but, but hopefully we just gotta hope for the best man hopeful. Be back doing it. I mean, I don't really see a future in my life, bro, where I'm not doing jujitsu. I mean, already I'm essentially non-compliant with taking blood thinners just so I can go do jujitsu. Like I'm essentially already putting my, my life at risk to do something I love. And I don't know if it's the smartest thing, bro, but that's, that's how I, that's how I roll, man. I,

Vance Crowe [01:01:20] I mean I think that that's maybe like this silver lining is everybody should be looking at the things they were doing in life pre coronavirus and saying all the things that you don't feel are like actually connected to who you are. The things that, like, you a like I can hear how you ache for Juujitsu, right? But all the other stuff that you were doing that you did out of obligation or because you thought you were supposed to or you thought you were having fun. Just all that doesn't matter. Get rid of that shit. Doesn't

Luke Mulch [01:01:48] Matter, bro. Doesn't matter. That's what I want to get back to. I don't want to sit here and watch the news in my basement all day. Like, it's toxic, bro, to me. Like, like I just want to get back, like I do my best, bro. When I stay busy, I go to work, you know, I'm lifting weights, I do juujitsu, I make some food, I go to bed and I just repeat that over and over and over and over, man. And like, my wellbeing and my mentality is elevated to, you know, I kind of tripped up over that. But,

Vance Crowe [01:02:22] Well, I mean, I'm with you, man. Like, I, I took Coronavirus as like a, a weekend getaway or something where I don't have to get up on the same time and I can stay up late. And it has taken me a long time to be like, Hey, the reason you were sane and productive before Coronavirus was 'cause you were getting sleep, you were exercising, you were, you know, doing these things. You had a pattern. And now I'm treating, or I was treating my days without a pattern. Now I have one and I'm sticking to it. Bang, bang, bang, get things done in the day. Because it's that productivity that progress forward that makes me feel like good to be alive.

Luke Mulch [01:02:58] Right, right, right. A hundred percent bro. A hundred percent.

Vance Crowe [01:03:03] Well man, I have loved this conversation. Thank you so much for giving up part of your time off from work. I, I hope you stay safe and anytime something changes with what's going on with you, let me know and we'll hop on and record something else.

Luke Mulch [01:03:17] Cool, man. Hey, can I give a shout out?

Vance Crowe [01:03:20] Sure, of course.

Luke Mulch [01:03:21] Okay. Shout out to, to all my boys at BJJ Lifestyle Academy. Love y'all. I know you want it. I I know you want your names called by name.

Vance Crowe [01:03:33] I

Luke Mulch [01:03:33] Throw a few out. Tony Bird Morgan Free. Who else? J Jarod. Lance,

Vance Crowe [01:03:44] I've seen Lance doing a whole bunch of stuff on Instagram,

Luke Mulch [01:03:47] Meone. Oh, for real. All you guys. I know I'm missing you. Oh, Bart, AKA house. Bart, the builder. Sheriff Bart man, trying to off your,

Vance Crowe [01:04:00] You, your time is up. I

Luke Mulch [01:04:02] Didn't. Okay. I love you guys. All right. Hey

Vance Crowe [01:04:05] All. Thanks man. I appreciate it talking

Luke Mulch [01:04:07] To you, bro. We'll

Vance Crowe [01:04:07] See you later.