The anguish of not knowing what happened to her husband after she dropped him off at Detroit's Sinai-Grace Hospital on the night of March 28 brings fresh tears to Denise Chandler’s eyes three months after he died.
She couldn’t be by his side at the hospital because he got sick during a pandemic that shut loved ones out of hospitals across Michigan.
When a doctor called to tell Chandler that her 35-year-old husband, Richard, died less than 24 hours after she helped him into a wheelchair at the door of the emergency room, she couldn’t fathom how it all happened so fast.
How could he have texted her earlier that day to say that he was about to be discharged if he was on the brink of death?
How could he have had a massive blood clot in his lungs that went undetected until moments before he died?
It didn't add up.
"I knew something was wrong from the beginning," said Denise Chandler, 37, of northwest Detroit. "I want to know what happened."
She said she hasn't been able to sleep since that horrible day because her mind spins in the lonely late-night hours, thinking about whether Richard might have lived if she had taken him to a different hospital.
She'd planned to drive him to an emergency room in the suburbs that night, but Richard passed out in the front seat of their car, and Denise quickly altered her route, instead bringing him to Sinai-Grace, which was just 2 miles from their house.
She didn't know if she would ever discover the truth about what happened.
But then Denise read a June 11 Detroit Free Press report about a whistleblower lawsuit four former Sinai-Grace nurses brought against Tenet Healthcare, the for-profit parent company of the Detroit Medical Center, which runs Sinai-Grace.
The nurses allege they were fired for speaking out about unsafe conditions in late March and early April, during the peak of Michigan's coronavirus surge. They said the emergency department was so short-staffed, patients didn't get proper care, and that at various points during the crisis, they ran out of stretchers, hospital beds, ventilators, monitors, body bags and oxygen tanks, too.
The nurses allege those problems, and a policy that didn't permit them to perform CPR on patients who had coronavirus or were suspected of having COVID-19, led to the unnecessary deaths of dozens of people.
Denise wondered: Is that what happened to Richard? Could the man who doted on her and their kids, who worked so hard to support them as a site and safety manager for HydroChem PSC, who volunteered at their church and served food to the homeless, have died that way?
"It keeps me up at night to not know ... what happened to my husband," she said. "We have eight children at home from 18 down to 1 year old. And ... this has just been ... one of the hardest times in all of our lives."
Last week, Denise got some answers.
Sitting on the deck of her tidy, two-story brick home on Kentucky, blocks from Mumford High School, she spoke to Jeffrey Eichenlaub, one of the nurses who cared for Richard at Sinai-Grace.
Eichenlaub saw what she couldn’t see.
He heard what she couldn’t hear.
And he told Denise what happened to Richard — all of it — even though it hurt, even though it confirmed her worst fears.
"Do I feel like your husband's death was unnecessary? Yes, I do," Eichenlaub told her during the video-conference call. "I feel as if the chain of events that happened could have been different if it was handled better.
"We'd been crying for help with all the patients for weeks before then."
It started as a crush
Richard Chandler and Denise Lee met in high school. They both attended Detroit Community High School, but she said he didn't make much of an impression on her in those days.
"I never liked him as a kid," she said. "He was just a friend, you know? I never looked at him like that. But my husband told me, 'I've had a crush on you since you were 14.'"
By the time Denise realized that Richard was the one for her, they were in their 20s, and she already had two children, Amber and Aaron Tolson, from a previous relationship.
Richard loved Denise, and he loved her kids, too, caring for them like they were his own.
The Chandlers were married Oct. 29, 2006, and had four more kids: Kodie, who's now 12; Kaleb, 10; Kelsey, 9, and Mackenzie, 8.
When Denise's cousin lost custody of her two babies last year, Sebastian and Zoe Ontiveroz, ages 2 and 1, respectively, the Chandlers became foster parents.
Richard loved them all.
"No matter what was needed, no matter what you asked for, my husband was always willing to be there — whether it was family, friends, coworkers, church members, you know, he had an open heart."
He was a trustee at Oasis of Hope Christian Church in Detroit and ran the food ministry on Saturdays. At home, Denise said he always had something on the barbecue, eager to cook for his family, friends or anyone who happened to drop by.
And he never missed a chance to tell Denise she was beautiful.
"He told me all the time, 'I just can't believe I'm married to you,' " she said.
Even from the hospital, hours before he died, Richard sent text messages saying he wanted her to get some rest and apologizing for worrying her. He wrote: "I love u too Beautiful and im so sorry for scaring u last night."
On this day, she stood in front of the memorial garden she and the kids planted in Richard's memory for Father's Day. They filled Richard's heavy-duty size 12 work boots with red begonias, and surrounded them with calla lilies, geraniums, hibiscus and a host of other flowers in red and white and pink and yellow.
They placed a plaque nearby that reads: "On angel's wings you were taken away, but in our hearts you will always stay. In loving memory of Richard Chandler."
"It's been life altering, you know? It hurts more than anything. It just hurts," she said. "Truly only God is getting me through because I know I have to continue this journey for these eight beautiful kids.
"They were devastated when they learned that their father had passed. I wouldn't wish that pain on anybody."
The virus spreads through a family
Coronavirus swept through the Chandler family in mid-March, Denise said.
"Just about every last one of us was sick," she said. "Never confirmed. Never had a swab, but I know that's what it was."
It began with their son Kodie, who said he started feeling weak on March 11 — the day after Gov. Gretchen Whitmer announced Michigan's first two confirmed cases of COVID-19. A middle-age man from Wayne County and a middle-age woman from Oakland County, both of whom had a history of recent travel, tested positive.
At first, the Chandlers didn't think much of Kodie's symptoms. Public health officials had warned the public to look for fever, cough and shortness of breath, not general malaise.
So they took Kodie to choir rehearsal that night. He sings in the Detroit Youth Choir and was among the children who traveled to Los Angeles last year and competed on "America's Got Talent."
The group took second-place, and that experience, Denise said, "changed him for the better.... He used to be so shy, but it brought out the best in him." He got pictures with the show's famous producer and judge Simon Cowell and actor Idris Elba.
"We went from a very high year ... to the most extremely low year," Denise said.
She remembers that on March 12, the family went to visit Denise's father, Denver Lee, in a Novi hospital where he'd had knee-replacement surgery.
When they got home that evening, Kodie went straight to bed. He was uncharacteristically tired. His appetite was gone, and Denise realized he'd developed a low-grade fever.
Richard took the day off to bring Kodie to the doctor on March 13.
"We told them what was going on with him, but they were like, 'Oh, no. He doesn't have COVID. Don't worry about that. He just has the flu,' " she said. "But when they swabbed him for the flu, it was negative. And so they said, 'It's just a cold then.' "
But the Chandlers soon learned it was far more than a cold.
Kodie lost his sense of taste and smell.
Denise did, too. And then Richard.
"I got sick on March 16th and my husband got sick on the 17th," she said.
The other children grew feverish and lethargic, as well.
"It was terrible," Denise said. "I didn't eat, which made me more weak. I was like there's no point in eating, you can't taste it."
A few days later, text messages in a Detroit Youth Choir group chat started rolling in, alerting families that other members of the choir had confirmed cases of the virus, Denise said.
"I guess it came from choir rehearsal," she said. "They could have all been exposed. It could have been a parent. It could have been anyone."
As the days passed, most of the Chandlers began to recover.
"We were doing better. We all were doing better," she said.
On the evening of March 28, Richard and Kodie were watching a movie downstairs, but Richard was struggling to breathe. He had asthma, so he went upstairs for a breathing treatment.
He took a shower after that, but neither the shower nor the medicine made him feel better. As he sat on the edge of their bed, he texted Denise.
"Babe can you come here please," the message read. He was too weak to go find her.
"I jumped right up because it surprised me," she said of the text message. "I realized it was because he didn't want to frighten our kids. He was hunched over on the bed with the towel still wrapped around his waist and he said, 'Something's wrong.' "
The painful details of Richard's death
Denise's hands rose to touch her necklace while she talked to Eichenlaub, the nurse who treated her husband at Sinai-Grace on the day he died.
Her wedding rings hung from the chain, along with a silver angel wing that contains Richard's ashes, and it was as if she drew comfort from placing her hands on the smooth metal as she learned more details of her husband's ordeal at Sinai-Grace.
Eichenlaub, who was working as a day-shift nurse in the emergency department at the hospital March 28-29, gave this account:
His first encounter with Richard was when he was already unconscious on the afternoon of March 29. Richard's nurse had explained that he had another fainting episode.
It had happened at some point after the last text message Richard sent Denise at 3:49 p.m.
He was already on supplemental oxygen, Eichenlaub said, but it wasn't enough.
As they intubated Richard and connected him to a mechanical ventilator, "his heart stopped," Eichenlaub said. "We did chest compressions and we got him back."
Richard was then brought to a different part of the hospital for a CT-scan of his chest, he said.
Denise got a call from a doctor at 5:44 p.m., telling her that her husband's condition had worsened, and that they'd had to put him on a ventilator. The doctor said they weren't sure what was causing Richard's problems, and were going to get a scan of his lungs to check it out.
A chest X-ray from the previous day confirmed that Richard had pneumonia, his medical records show, but pulmonary embolisms can't be seen on an X-ray.
Levels of some markers in his bloodwork were abnormal. Denise pointed out that the level of troponin, a blood protein that can be measured to gauge whether a person has had a heart attack or may be in cardiac distress, was extremely elevated when his blood was drawn on the night of March 28.
She obtained 26 pages of medical records from Sinai-Grace and shared them with the Free Press.
And yet, at 9:42 a.m. March 29, Richard texted Denise to tell her that the staff was preparing to discharge him, even though he'd had two episodes when he lost consciousness the night before.
"They said my body was fighting a virus. They are going to send me home," he wrote.
"It was too late," she said. "Had they done what they needed to do in triage based on his symptoms when he came to the hospital, if he would have gotten that heparin (a blood thinner) the day before, it could have been lifesaving.
"Instead, they were too busy trying to send him home. They were too busy calling me to tell me they could set up his oxygen at home. They were just trying to get him out of the hospital. They didn't even consider that they should look for what was wrong, what was causing these episodes. It makes no sense."
Hours after Richard texted Denise to say he was going home, he went into cardiac arrest, and the CT scan showed that Richard had a massive blood clot in his lungs, known as a pulmonary embolism.
Although they resuscitated Richard once, Eichenlaub said shortly after his CT-scan, Richard went into cardiac arrest again.
And the second time his heart stopped, Eichenlaub said the doctor in charge refused to allow the staff to perform CPR.
"In the younger folks, the way the coronavirus affects the body is a lot different. It causes a lot of problems with your clotting cascade," Eichenlaub said. "So, younger folks were developing these large pulmonary embolism blood clots in their lungs."
Once Richard's CT-scan showed the blood clot, Eichenlaub said: "They put two and two together and they were like, 'Wait! This guy's got a huge blood clot. He's got to have the coronavirus. So the next time he codes, we're not doing CPR. We're not doing it. We're gonna let him go. We're gonna let him go.'
"We were in awe. We were like, So we're not going to do anything to help people anymore?'"
The reason the doctor told him they were not allowed to revive patients who were suspected of having coronavirus, he said, is because it could put the medical team at risk of contracting the virus.
But Eichenlaub said there were measures they could have taken to protect themselves and save Richard's life.
He said viral filters on the ventilator combined with protective equipment for the staff should have been enough to keep them from getting the contagious virus during CPR.
He couldn't understand why they weren't allowed to perform CPR on Richard when they'd already resuscitated him once earlier that day.
"We just risked it," Eichenlaub said. "You know, we just risked it for the last 30 minutes doing CPR on him. So send us in there for us to do it again because we already exposed ourselves."
Worse, Eichenlaub said, was that the staff had no way of knowing definitively whether a patient had COVID-19. At the time, it took days or weeks to get a test result back because the hospital was still using an outside lab to process its coronavirus tests.
All it took to exempt a patient from being eligible for lifesaving CPR was the suspicion of being infected, the nurse said.
"It was just a presumption that he was positive," Eichenlaub said. "They automatically assumed, and so because they assumed, they overlooked everything else."
Chandler was shocked to learn those details.
"They assumed and they used that as an excuse to not resuscitate him," she said. "He literally had been there less than 24 hours, and I think that everything should have been done in order to save and preserve his life, not to just say, 'Oh, he might be positive. Let him die.'
"They had already been exposed. They had already done CPR. The right thing to do would have been to send the same team to resuscitate him again.... If he had something, they would have been exposed to it already."
Eichenlaub said Richard's case rattled him.
"For the nurses, that was the hardest part because this is what we do. This is why we train," Eichenlaub said. "Even though we know the risks of this contagious disease, that's why we are health care professionals.
"A lot of the staff, we were kind of puzzled that we would stop, especially since he was such a young individual," Eichenlaub said.
After work that day, Eichenlaub recalled: "I went home and talked to my wife about how distraught I was, and she's like, 'I've never seen you like this. This is not you.' And I said, 'Babe, I don't know what to say. I'm lost. I'm lost.'
Because ... as comfortable as I've been in this environment, this is where I don't know what to do ... They were telling us that we shouldn't be doing stuff to help people now because ... the COVID risk is too high. But yet, we're still dealing with the young person."
A person Richard's age, he said, often is able to bounce back after CPR, and has much better survival odds than older people.
About 25 minutes after Denise got the initial call from the doctor telling her Richard had taken a turn for the worse, her phone rang again.
At 6:09 p.m., she was told her husband was dead.
The death certificate says Richard Chandler died at 6:06 p.m., and that his death was attributed to "cardiopulmonary arrest secondary to pneumonia and COVID-19."
Eichenlaub told Denise that he was sorry for what happened to Richard.
"I wish I had more answers," he said, "but I understand that empty feeling that you have because it was such an atrocity that he was taken from you so quickly."
As the Chandlers mourned a husband and a father, another tragedy struck.
Denise's dad, Denver Lee, also succumbed to the coronavirus.
"I feel like we gave it to him," she said, "like we got my dad sick."
He died April 16 of COVID-19, 18 days after Richard. He was 75.
"When when my husband passed, I said, 'At least my kids still have my dad, a male figure for them.' And then, like, five days later, after my husband passed, I got the call that they were rushing my dad to the hospital and I'm like, 'No! No! No!' I can't do this again."
An uncertain, scary future
While he could not comment on pending litigation or the allegations Eichenlaub and the other nurses made about hospital conditions during the height of the coronavirus surge, Brian Taylor, a spokesman for Sinai-Grace and the Detroit Medical Center, said there is no hospital-wide do-not-resuscitate policy.
"As for decisions on whether a patient receives CPR, these decisions are made on a case-by-case basis by physicians and the medical care team in accordance with the patient’s advance directive," Taylor said. "If a patient requires CPR, of course the patient will receive CPR."
But Denise is not convinced that's true.
"I wish that I could have gotten him somewhere else," she said. "I really feel like it would have made the difference in my husband surviving or not surviving."
She's considering litigation, but said she knows nothing that happens in a courtroom will bring her husband back to her.
"We went from middle class to poverty overnight," she said. "My husband was the breadwinner."
Before he died, she worked as a foster care case manager at Bethany Christian Services, but she hasn't been able to go back to work.
"I just couldn't focus on it," she said. "I really couldn't focus."
There was too much grief — for her and for the kids.
"My youngest told me, 'Mom, I just want to die,' and I'm like, 'No! Mommy needs you. You can't die. Don't say that.'
"My 10-year-old, he was like, 'Mommy, promise me you won't leave me early.' And I was like, 'I can't. I don't want to tell you that, but I promise you I will talk to God about it, and I will ask him to please keep me here until I am so old, I can watch your kids.'
"I can barely go to the bathroom without them checking on me. I literally can't be away from them."
The Chandlers are eking out a living on Richard's Social Security check and the money Denise gets from the commercial cleaning business she and her sister inherited from their father. The kids have medical insurance through Medicaid. She's uninsured right now.
On Saturday morning, Denise was out on a cleaning job. When the staff needs a day off or calls in sick, she has to do the work.
"It is making our ends meet. It is what is allowing us to survive," she said.
"Everyone says, 'Oh, you're so strong. Your strength is amazing.' But I don't have the option to lose it. I have eight kids here that are depending on me to stay strong."
As coronavirus case numbers in Michigan begin to rise once again after weeks of near-steady decline, she said she never wants another family to suffer as hers is now.
"Please social distance, wear your mask, wash your hands and sanitize your home," she said. "If they hate wearing a mask, being put on a ventilator is so much worse. Life can change in an instant. Don't let poor choices put you in a situation like mine."
Contact Kristen Jordan Shamus: 313-222-5997 or email@example.com. Follow her on Twitter @kristenshamus.
Michigan Radio, Bridge Magazine, and The Detroit Free Press are teaming up to report on Michigan hospitals during the coronavirus pandemic. We will be sharing accounts of the challenges doctors, nurses and other hospital personnel face as they work to treat patients and save lives. If you work in a Michigan hospital, we would love to hear from you. You can contact reporters Robin Erb firstname.lastname@example.org at Bridge, Kristen Jordan Shamus email@example.com at the Free Press and Kate Wells firstname.lastname@example.org at Michigan Radio.