Today
In the fall of 2022, Dr. William Dugal, then 32 years old, contracted COVID-19 and began experiencing unusual symptoms.
“It started with numbness in my feet, almost as if the shoes were too tight, and it progressed until I had trouble walking,” Dugal told the show. The man is now 34 years old and lives in Winston-Salem, North Carolina. He knew something was very wrong.”
Dugal, who had just finished his surgery residency, went to a local hospital, where he learned he was suffering from a rare post-viral complication called Guillain-Barré syndrome. It can cause everything from muscle weakness to complete paralysis, and very few medical interventions can stop its progression.
Soon, Dugal became completely paralyzed and could not eat or breathe without assistance. But he could still think clearly.
“I couldn't even move my eyes or blink. And while that was happening, I can't express enough the fear and uncertainty I had,” Dugal said. “Sometimes knowing about medicine is good and bad, because you are very aware of the severity of your illness.”
On Labor Day weekend 2022, Dugal and his family had a lot to celebrate. He had just finished his four-year surgical residency and was preparing to start a new job in North Carolina. Besides, his wife had just given birth to a beautiful girl.
“Things were going very well,” he recalled. “We were about to start our next chapter.”
They attended a wedding and upon returning home, all three tested positive for COVID-19. Dugal's wife and daughter had mild symptoms, but his were “strange,” such as numbness in his feet, Dugal said.
In the following days, the numbness worsened, so he asked his wife to take him to the hospital. “They had to take me in a wheelchair because I couldn't walk,” he said.
A neurologist ordered a lumbar puncture, which helped doctors diagnose Dugal with Guillain-Barré syndrome, a rare disease in which the immune system attacks the layer surrounding nerves (myelin), causing nerve damage, according to the National Institute of Neurological Disorders and Stroke.
“Unfortunately, my symptoms evolved over a month in the hospital, with complication after complication,” he explained.
In mild cases, Guillain-Barré syndrome only causes muscle weakness. In the most severe cases, it progresses to total paralysis, and patients need an artificial respirator to survive. According to Dugal, the duration of the illness can also vary.
Most people make a full recovery or have only mild symptoms, such as numbness or tingling, according to the Mayo Clinic. But recovery can take months or years. People who lose the ability to walk usually regain it within six months.
The disease can also be fatal, especially if paralysis affects the muscles used for breathing. And “sometimes nerves are damaged to a point where they are unable to recover,” Dugal explained. In these cases, patients are paralyzed.
Experts still don't know why some people develop Guillain-Barré syndrome, but it most often occurs after bacterial or viral infections. There is no definitive cure or treatment.
After receiving the diagnosis in the hospital, Dugal felt “very aware” of how serious his Guillain-Barré syndrome was.
“I knew that once I reached the diaphragm I wouldn't be able to breathe,” he said. “It was a very humbling feeling to realize that I was at the mercy of the process and had to accept whatever came.”
Little by little he experienced so much muscle weakness that he could no longer speak. He claimed that he tried to concentrate his muscles to be able to breathe on his own, but after a few days it was impossible, Dugal said.
Doctors connected him to an artificial respirator to help him breathe. At the time, Dugal worried he would never recover. “I accepted that I was probably going to die,” he said. “I looked at (my wife) and told her to take care of our daughter.”
After two weeks on the ventilator, Dugal developed pneumonia — a common side effect of being on a ventilator for an extended period — and both of his lungs collapsed. His oxygen levels dropped and he wasn't getting enough oxygen to his brain, which can be fatal if he doesn't stop quickly.
Doctors anesthetized him and hooked him up to ECMO, a machine that takes care of heart and lung function to give them time to recover. After nine days, he woke up.
“It had plastic tubes through which all the blood ran and it was completely dependent on the system working. You can imagine my anxiety was through the roof,” she recounted.
However, ECMO had allowed his lungs to heal, so he was taken off and put back on a ventilator. Still, he couldn't speak, move his fingers or toes, or even blink. But he knew exactly what was happening.
“I was completely trapped in my own body and sitting there, looking at the same spot on the wall,” he said.
Since his condition was no longer worsening, doctors recommended inpatient rehabilitation, but Dugal's family had difficulty finding a facility that would receive him while he was still on a ventilator. Finally, Houston's TIRR Memorial Hermann accepted him, so he took an air ambulance. Once there, he began working to relearn everything.
The tough rehabilitation
Rehabilitation was difficult for him. She had lost 60 pounds and was still feeding through a tube because she was too weak to eat. He couldn't sit up on his own or get out of bed, so they used cranes to transport him. Good days often included gradual changes so slight they could be difficult to see.
“It was little things, like trying to straighten your hands because your muscles literally aren't strong enough,” he said. “I remember the first time I could move my big toe. “It was the least exciting thing you’ve ever seen.”
Despite the difficulties, in rehabilitation Dugal felt that he could “take control of the situation” for the first time since he became ill.
After two months of rehabilitation in the hospital, Dugal returned home. He used a power wheelchair and still needed a lot of physical therapy, occupational therapy, and speech therapy at home to relearn everyday tasks.
“I was trying to recover my vital skills,” Dugal noted. “Being able to dress myself, eat alone, tie my shoes, take objects.”
Over time, he regained strength to the point of being able to return to work. Nine months after being diagnosed with Guillain-Barré syndrome, he could walk again.
From patient to doctor
In July 2023, almost a year after contracting COVID-19, Dugal felt strong enough to return to work. He began working in a laboratory where surgical studies were performed, “trying to figure out how to be a surgeon again,” he recalled.
Then he began an internship on ECMO, with which, for almost a year, he was “giving patients the same treatment that saved me in the same hospital.” It was like closing the circle.
“It was great to be able to work with the same people who saved me: therapists and surgeons,” he said. “I am very grateful to be able to do surgery.”
When Dugal finishes his internship, he will begin another general surgery internship. Having Guillain-Barré syndrome changed his perspective as a doctor.
“I have more empathy and a better understanding of the patient experience,” he said. “I hope to offer that same compassion and support to others in similar situations.”
