ACCESS Magazine Feature - Women on the Frontlines | Dr. Cynthia Crowder-Hicks

Meet Dr. Cynthia R. Crowder Hicks. In normal times she’s the medical director of the Sleep Lab at Mobile Infirmary and works in pulmonary medicine as well at the Diagnostic and Medical Clinic. Identified as a leader in caring for local COVID-19 patients, Dr. Crowder Hicks shares what the new normal looks like on the frontlines.

For most, a pandemic was unthinkable. And it was for Dr. Crowder Hicks, too. “I was the first pulmonary physician designated to cover the COVID-19 ward,” she says. “The beginning was truly an experience. With a set of scrubs and protective equipment, I changed and proceeded to my station where everyone looks the same: hair coverings, face masks, booties, and scrubs. Each patient’s door is draped in isolation dressings, I only see the eyes of my staff. They are eager and frustrated. However, in the midst of it all, they showed up willing to serve,” she shares.

Asked how a hospital could turn on a dime to quickly jump into pandemic-fighting action, Dr. Crowder Hicks says, “As the virus began to spread, it was evident we were experiencing a pandemic. Fortunately, Alabama began to see the virus later, which allowed time for preparation. A COVID critical care task force was established and meetings were held at our Diagnostic and Medical Clinic and at Mobile Infirmary,” she explains. The task force is comprised of critical care physicians, anesthesiologists, internists, surgeons, neurosurgeons, nursing administrators, pharmacists, respiratory therapists, and hospital administrators who work diligently on plans to care for patients presenting with the COVID virus. “Working on worst-case scenarios, the plan included physicians being on staff in 12-hour shifts, 24 hours a day,” Dr. Crowder Hicks says. “With Individual medical specialties eliminated, our goal is to care for patients and minimize unnecessary staff exposure and fatigue.”

As a COVID-task force leader, Dr. Crowder Hicks recalls those first steps into the COVID-19 unit. “As I rounded the hallways and made my way into the medical intensive care unit, the staff knew me, but I knew they were getting ready to know me better than ever before,” she starts. “‘Let’s huddle,’ I began. As I explained the plan, there was an immediate sense of relief. Typically, nurses are used to handling emergencies until a doctor arrives. With the new around-the-clock physicians on hand plan, there was an immediate sense of hope and appreciation. That night, my nurse practitioner joined me, and we huddled with each unit, hearing those sighs of relief each time.”

While clearly humbled, we wonder about the vibe in the COVID-19 unit and how she motivates her team. “I always try to keep a positive attitude,” she says. “There is a reason to smile and laugh every day, and I look for those openings. In general, my overall disposition remains positive, even during the frustrations. I definitely try to acknowledge concerns and offer words of encouragement to motivate them to push forward,” she shares. “So far, I think the team is coping well. For us, the loss is not unfamiliar. I think we struggle with the ‘why.’ There are so many unknowns regarding this virus and the disease process. We are constantly thinking and reading to see if we can prevent further losses. As for our emotional state, we may need to revisit this after the pandemic has ended,” she says.

Not having exhausted their ventilator capacity, their influx of patients has been steady, but not to the degree of cities like New Orleans and New York. “This virus has so many unknowns,” Dr. Crowder Hicks says. “Every patient is different. Some look chronically ill and slowly improve, and others look good and rapidly decline. You see oxygen requirements escalate in those not seemingly as ill. Temperatures rise. Blood pressures become unpredictable. Breathing appears dysfunctional and ineffective. Things move very fast. This is when the basics of medicine begin. All taught the ABCs (airway, breathing, circulation), this is where we start and work as a team to stabilize the patient.” Dr. Crowder Hicks says it’s at this point that her senses become heightened but acknowledges how important it is to keep her emotions controlled. “I think better that way,” she says. “The patient is intubated; adequate IV access obtained. Now, we work to improve oxygenation and optimize blood pressure and circulation. Each organ system is reviewed and addressed. Despite being on the ventilator, we must continue to assess and reassess. It becomes methodical. However, there is a level of anxiety in all areas. All of our personnel have had to step up in different ways to assure the safety of patients and staff as we proceed,” Dr. Crowder Hicks shares.

On the subject of patients, she says, “Each patient has a different mindset. Those who ill want help. They are grateful. Those not as sick just want to get better. Most patients assume we’re positive just as we assume they’re positive. It makes for a good working environment,” she says. “Also, despite all the medical paraphernalia, patients just want to talk. A calming voice or a soothing pat on the leg goes a long way.”
Reflecting, she adds, “Recently, I was approached by a colleague regarding a patient of mine who had been sick a few days. On the phone, the patient was audibly breathless. Concerned, she agreed to be seen at the screening tent and was immediately admitted into the hospital. She appeared weak but vocal. She has the sweetest disposition and is always helpful and kind. Unfortunately, she declined and required mechanical ventilation. In general, this portends to a worse outcome. Fortunately, after a prolonged time on a ventilator, she was able to be extubated. She continued to slowly improve, and the day of her discharge was a day of incredible celebration,” she shares.

Originally from Memphis and with a life-long long love for science and math, Dr. Crowder Hicks has always been surrounded by a family of educators and givers. “We’ve always been active participants in our church, community, and schools,” she says. “My path of service came through medicine, as it speaks to me personally and intellectually. It makes me happy.”

And how about her life with her husband Timothy, daughter Camille (3), and stepson Kendell (14)? “I completely isolated from my family,” she says. “This proved to be more stressful for all involved. After long discussions, we decided it was best for me to take the necessary precautions to return home. Fortunately, I have a detached room where I can shower and leave worn clothes before entering my home. So far, we’re all healthy,” she shares.

Grateful for her husband, Dr. Crowder Hicks beams, “He’s assumed the role of not just parent, but primary homemaker, preschool teacher, playmate, shopper, and chef. I thank him for packing my lunches and making my breakfast and dinner. I find great joy in family time and walks. These lead to great conversations and I hope to keep it up after this is over,” she shares. Both transplants, Dr. Crowder Hicks says her husband’s and her own extended family are not close by. “They’ve offered to assist, but in the spirit and order of social distancing, we try to respect all boundaries,” she shares. “This means it's just us! However, I truly appreciate their calls and texts of support. Also, my recent ZOOM meeting with college sisters was an awesome source of stress relief,” she says.

Looking forward to family dinners and attending church services once the virus passes, her No. 1 way we can help is simple: “The only consistent model of flattening the curve has been social distancing. This is how everyone helps,” she concludes. As for us? Dr. Crowder Hicks, we thank you for being in the trenches, for your sacrifices, and for your leadership¬. You may know how many lives you’ve helped save, but you will never know the number of lives you’ve touched.

Article originally printed in the May issue of ACCESS Magazine. The full publication can be viewed at: https://issuu.com/foxlitho/docs/60140_access_may_2020