On the frontlines of Mary Greeley’s COVID-19 response, Dr. Dan Fulton has been a calming, inspiring force for patients and healthcare staff.
By Steve Sullivan
Wash your hands, wear protective gear and stay home if you’re sick.
At this point, just about everyone at Mary Greeley knows these words by heart. They’ve been intoned almost daily as staff have prepared for and responded to the COVID-19 crisis.
They were prescribed early on by Dr. Dan Fulton.
An infectious disease specialist with McFarland Clinic, Fulton himself is one of the most panic-free, positive and kindest people you are likely to meet – even when he’s juggling the tsunami of issues that come with a pandemic. These traits have served him and his colleagues well during this unimaginable moment in patient care.
They also contributed to his being named the recipient of Mary Greeley’s 2020 Innovation & Excellence Award for Medical Practice.
“As an organization, we are so blessed to have Dr. Fulton,” said LeAnn Hillier, infection control coordinator with Mary Greeley. “He has a calm and can-do attitude, with just a touch of practical realism thrown in for good measure. Throughout the pandemic he has been an outspoken proponent of patient and staff safety while engaging with us in difficult policy decisions. We all rely on him for his knowledge and guidance.”
As an infectious disease specialist, there was naturally a bit of excitement early on as officials were watching the COVID-19 situation abroad and preparing for its arrival closer to home.
“It was very clear that we needed to be ready to care for really sick people in a safe way,” he said. “From the beginning this has been a team effort with the infection prevention team, nurses on the frontlines, primary care doctors, frontline doctors in the ER – all trying to find out the best way to care for people. How to sift through all the information we are getting nationally and internationally, and ultimately make some real-world decisions about how we’re going to do it here. The enormity of that work and team effort can’t be overstated.”
In times of uncertainty, someone with the right expertise and demeanor is necessary to help people to make sense of things, ease anxiety and provide good advice on what to expect and how to react to it. For many people at Mary Greeley, McFarland Clinic and the patients and communities both organizations serve, that person has been Fulton.
“Dr. Fulton has been a rock for all of us,” said Amber Deardorff, vice president for clinical and support services, who spearheaded Mary Greeley’s COVID-19 response. “We look to him for guidance and his expertise. He has such a calming effect on people and we all feel better after hearing from him. He has been a department of one through all of this, and we truly appreciate his efforts.”
Fulton is a constant presence at COVID-19 planning meetings, and regularly rounds on patients being treated for the virus at Mary Greeley. He’s done a series of videos addressing various aspects of the pandemic that have garnered tens of thousands of views.
“COVID-19 is a devastating disease with never before seen effects on society and the world, but it’s not our first pandemic. People with HIV have been understanding what a pandemic is for 40 years now, often with a sense of fear and uncertainty,” he said. “COVID-19 is a very different disease, of course, but it does remind us that what you do first is care about people, even if you don’t know what to do. In time, the science catches up.”
He adds, "My training has prepared me to at least be the person who has to or gets to make decisions during times like this. I try to make pragmatic decisions – what makes the most sense, particularly for staff and to make sure they are protected,” he said. “Protecting other patients and our healthcare workers – I felt that weight more than anything. How do we make sure our workers are as protected as they can be? We had real limitations on our protective gear early on.”
Fulton admits that it takes a lot of energy and focus to remain calm through the pandemic storm, especially during the most challenging times of the pandemic. Those have been many, from PPE shortage concerns to difficult decisions on visitor restrictions, concerns about testing availability to constant adjustments to screening protocols.
“As a physician my job is to focus on what we can do medically and what we know medically about this disease – how to take care of it, how it spreads. There are so many other questions about, for example, social distancing, that are not strictly medical,” he said. “The catastrophic downside of what had to be done to control this infection saved hundreds of thousands of lives. It’s hard to prepare for a disaster when there’s only so much you can control. But to let ourselves get angry is a dead end. You have to try to avoid that even when things are frustrating.”
Fulton already had deep connections in Ames prior to joining McFarland Clinic in 2015.
His grandfather studied forestry at Iowa State, and his father was born at Mary Greeley. The family moved to Minnesota, but Fulton’s dad returned to Iowa State as a student and a member of the Cyclone gymnastics team under legendary coach Ed Gagnier. Fulton’s mother is from Marshalltown and also an Iowa State graduate. Fulton, himself, attended Iowa State, where he met his wife, Lois, now a physical therapist at Mary Greeley. He earned his medical degree from the University of Minnesota Medical School, and did his residency at Hennepin County Medical Center, a public hospital in Minnesota. While he did an infectious disease fellowship at the University of Iowa, Ames was the college town where he and Lois dreamed of raising a family.
He remembers a day when they were driving back to Iowa City after visiting his family in Minnesota. They both talked about how great it would be if they could just head south on I-35 to Ames. The next day he got a recruitment notice for a position in a Big 12 college town. The recruiters told him it was the fastest response they’d ever seen.
Fulton took a year off after medical school, and he and Lois went to Guatemala to do volunteer work. That experience further connected Fulton to his chosen specialty.
“Infectious disease lends itself to taking care of people on the margins, whether its people with HIV, or a neglected tropical disease like malaria or tuberculosis,” he said. “It’s also a field where you really look at the whole person because infections can impact any part of the body or the entire body. You follow the disease from start to finish and I love being part of that process – meeting someone when things are at their worst and helping them through the process of resolution, or caring for them the best way possible at the end of their life.”
Following His Own Advice
At one point in April, Fulton had a cough and fever. Given that his job requires him to interact with patients with COVID-19, there was a very real chance he, like so many in healthcare, had contracted the virus. A particularly worrisome situation for a man with three young children and a wife, who at the time was pregnant with twins.
"My experience was like so many people's -- caring about who is around them and not wanting to get anyone else sick first and foremost," he said.
He had a test but then had to wait for several days. His test results came back negative, which, surprisingly, was a little disappointing. He already felt better and couldn't help but think that as a frontline healthcare professional, "maybe I already had it and maybe I'm immune."
While waiting for those results, he quarantined at home, in a guest room. His safety routine was already established -- the regular hand-washing, consistently wearing a mask, donning scrubs and protective equipment at work, showering and changing clothes the first thing when he got home. He kept up with the job, though, having Zoom meetings with patients and colleagues.
"There was still work to be done," he said.
There still is, as Fulton is so very aware.
“A hard thing for me is the realization that this is going to stick around for a while,” he said. “We may not have any patients intubated in the ICU today, but we could easily have more tonight or tomorrow.”
As we continue to see COVID-19 patients in Mary Greeley, some attached to ventilators … as we continue to monitor supplies and availability of precious PPE … as we hope for more testing … as we wait to see whether ominous predictions for COVID-19 surges in the fall come true … it seems appropriate to close this story the way it began, with Fulton’s encouraging, and slightly updated, words:
Wash your hands, wear protective gear and, as we reopen, take it slow.