“Geodi and I grew up together in Livingston,” comments Dr. Fiske. “Our parents were friends and our families often vacationed together. Since I was a few years younger, I was in Geodi’s sister Kelly’s class and considered Geodi to be one of the ‘cool older girls’ in high school.”
Eventually, Geodi and Josh went off to college, married their respective spouses and returned to their hometown to raise families of their own. Their children and spouses soon became friends and the family ties grew stronger. Josh had earned a medical degree and became a well-respected urologist on the Overlook Medical Staff. He is currently medical director of the Short Hills Surgery Center and chairperson of the Overlook Medical Center Urology Tumor Board. Geodi became chief financial officer of Strategic Insurance Associates, a company founded and managed by her husband, Keith.
A Life-altering Vacation
Life for both families was going along smoothly until December 26, 2017, when – at age 47 – Geodi’s world turned upside down. While vacationing in Mexico with her family, she suffered a stroke and a ruptured brain aneurysm during a run on a treadmill. Within hours, the fit, petite mother of three was in the intensive care unit of a Cancun hospital on a ventilator in a medically induced coma. As Mexican doctors struggled to pinpoint the source of the aneurysm, Keith frantically phoned Geodi’s parents and their family friend, Josh Fiske.
“I told Keith that the best available treatment for Geodi’s condition is right here at Overlook, home of the Atlantic Neuroscience Institute,” says Dr. Fiske. The flagship of Atlantic Health System’s neuroscience capabilities, the Atlantic Neuroscience Institute is ranked No. 1 for neurosurgery in NY, NJ, CT and PA, and among the top 5% of the nation’s neuroscience programs – five years in a row.
Members of the Atlantic Health System Patient Transfer Center (which coordinates patient transfers within and outside of the U.S. to any Atlantic Health System hospital) stepped in to help the Bader family with critical care air and ground transport. On December 30, Geodi was flown from Mexico to Morristown Airport, where an Atlantic Health System mobile ICU team awaited her arrival in the middle of the night. She was transported to Overlook’s Neuro ICU, where Ronald Benitez, MD, director of endovascular neurosurgery, was on call during the Christmas holiday week. He assessed her condition and implanted a drain to relieve excessive swelling and pressure surrounding her brain.
The next morning, after reviewing Geodi’s angiogram, Dr. Benitez explained that the ruptured aneurysm was in a location that required surgery. He wanted to ensure that it would not re-rupture and cause additional bleeding (an event that has a 90% mortality rate).
Acutely aware of Geodi’s dire situation, Josh arranged for her sister (and his high school friend), Kelly, to don a pair of scrubs and visit Geodi just before she was wheeled into the operating room. “It was a heart-wrenching moment,” recalls Josh, “as Kelly knew that she might be saying goodbye.”
Following surgery, Geodi remained in a medically induced coma in the Neuro ICU, while doctors, nurses, and technicians carefully monitored her condition, and her family nervously watched and waited for an outcome that was still unknown. Over the next few days, as the dedicated Neuro ICU team lessened Geodi’s sedation, she gradually regained consciousness and function.
Although Geodi doesn’t remember much of the entire ordeal, she does remember her first look in the mirror. “I walked into the bathroom of my patient room and asked Kelly, ‘What happened to my hair?’”
After several months of rehabilitation and a follow-up procedure to repair the opening in her skull from the brain surgery, Geodi recovered fully and resumed her daily routine.
“After my experience, there is no place I’d rather go for medical care than Overlook,” comments Geodi. “Dr. Benitez always gave me his full attention, as if he had all the time in the world. And I will never forget what the nurses did for me. They were the best! When I went back to visit them, they were so happy to see me. They said… ‘you’re the one who was in Mexico!’”
A Close Call with COVID-19
During his 15-year career as a urologist, 47-year-old Joshua Fiske, MD, had never been on the receiving end of treatment at Overlook…until March 23, a week after testing positive for COVID-19.
With a fever hovering near 104, Dr. Fiske drove himself to Overlook’s Emergency Department at the suggestion of his friend and Overlook colleague Meher Sultana, MD, an infectious disease specialist, as well as his father, a gastroenterologist. Both had noticed a marked deterioration in Josh’s appearance during their daily FaceTime conversations when Josh had quarantined himself in the basement of his home.
“As I stood outside of Overlook’s ED, waiting to check in, I recognized a physician’s assistant I knew. When she saw me in my weakened state, a tear rolled down her face,” recalls Josh, choking up at the memory.
Dr. Fiske was diagnosed with pneumonia in both lungs and admitted to one of Overlook’s specially equipped units dedicated for COVID-19 acute care patients.
Over the next 48 hours, his high fever raged on, his blood oxygen level fell dangerously low, and the slightest movement left him short of breath.
“I was beginning to think I wouldn’t survive,” admits Dr. Fiske who, in his darkest hour, called his wife Isabella to tell her he loved her and wrote a heartfelt message to his two sons on his phone.
Dr. Fiske’s rapidly deteriorating condition seemed inconceivable given the fact that he was an avid runner (a marathoner!) and in excellent physical health. But what was happening to him, was also happening around the world to other exceedingly fit COVID-19 patients whose immune systems were overreacting by producing proteins so powerful they risked shutting down the organs they should be protecting. At the time, early in the pandemic, there was little data about how best to treat the overreaction, known as the cytokine storm.
Hoping to circumvent placing Dr. Fiske on a ventilator in the ICU, Dr. Sultana prescribed Actemra, a powerful anti-inflammatory drug used to treat autoimmune diseases such as rheumatoid arthritis by inhibiting a particular cytokine called IL-6.
On March 26, within two hours of receiving an infusion of Actemra, Josh’s fever dropped to 99 degrees and his oxygen level returned to normal. Dr. Fiske remained in isolation for four more days, improving daily and taking his own vitals to help nurses preserve precious personal protective equipment. He returned home to his grateful family on March 30 and gradually resumed running and seeing patients again.
Dr. Fiske also made it a point to reach out to his friend and fellow survivor Geodi. “We both attribute our recovery to the outstanding care we received at Overlook,” says Josh. “If we had gone anywhere else, the outcome could have been much different.”