Pulmonologist Finds Himself in Epicenter of COVID-19 Pandemic

After more than 30 years working in the medical field, Dr. Howard Sklarek faced the biggest challenge of his career in early 2020.

The unexpected arrival of the COVID-19 pandemic was an earth-shattering event for everyone working in health care, but for some, it had an even bigger impact on their lives and work.

That was the care for Sklarek, particularly because the virus was centered around his area of expertise.

Sklarek is a pulmonologist with Stony Brook, working out of Meetinghouse Lane Medical Practice in Southampton, across the street from Southampton Hospital. He grew up on Long Island, in Commack, and earned his undergraduate degree and medical degree from SUNY-Buffalo before doing his residency at Winthrop, which is now NYU. Sklarek is board certified in internal medicine, critical care medicine, pulmonary medicine, and hospice and palliative care medicine.

For the past ten years, Sklarek has been the director of the ICU at Eastern Long Island Hospital in Greenport, and he does rounds nearly every morning at Stony Brook Southampton Hospital when he’s at work. He also spends a significant amount of time teaching residents.

Being a doctor who specializes in the care of patients’ lungs meant that Sklarek was in the thick of the battle against COVID, and he describes how it was like nothing he’d experienced in his nearly 40 years in practice in the area.

He treated the first COVID-19 patient that arrived at Stony Brook Southampton in early March 2020.

“He was a healthy guy, and he got better,” Sklarek said. “After that, we had multitudes of patients, and we only had seven ICU beds in Southampton.”

Sklarek spoke about the “excellent” work done by hospital staff to quickly increase the number of ICU beds at that critical time. Despite the hard work everyone put in, it was of course an enormously difficult experience on many different levels.

“The challenge was the large number of patients who died, and those who just got worse and worse,” he said. “We’re respiratory doctors, and a lot of the parameters we used for many years didn’t work.”

When faced with a novel disease that seemed to have no respect for many of the standard procedures and parameters that typically informed the care decision making process, Sklarek said the importance of leaning on each other became key.

“Our colleagues became much more important,” Sklarek said. “We worked together, doing something all day, and then someone else would take over at night. We really had to rely on each other.”

There was only one other event during the course of his long career that shared similarities with what Sklarek found himself facing in spring 2020.

“The only thing like this, when I was in medical school, going into my internship was HIV,” he said. “It was this thing we hadn’t heard of before and all of a sudden it was here. But that didn’t kill people as fast.”

It was an exhausting and scary time for doctors, especially those who specialized in treating patients with breathing and lung issues, which was the main focal point of COVID-19.

Sklarek said he and his fellow pulmonary doctors would take turns doing one overnight shift each week, which he said he liked but also admitted was nerve-wracking at times.

“There were doctors in other hospitals who died,” he said, adding that he was grateful to Stony Brook Southampton for always providing high quality PPE. He added that he was proud of the work he and the rest of the hospital staff did at that time, pointing out that he’d read a JAMA article that said at one point in the early months of the pandemic, one hospital had only a 20 percent survival rate for patients who had to go on ventilators, while at Stony Brook Southampton, less than 40 percent of patients who had to go on ventilators at that time did not survive.

Sklarek said it was emotional when patients who had been on respirators and had been hospitalized for 20, 30 or even 40 days would finally become well enough to go home, and would get a send-off from him and other hospital staff.

“It was like a party when the ambulance would come to bring them to rehab,” he said. “As opposed to the sad times when people didn’t make it.

“I got my vaccines the day they came out,” he added.

Being a small hospital with a close-knit staff was hugely beneficial at that time, Sklarek said.

“I think we learned more as it went on, and we got better at it by doing it. It was a great challenge, but our small hospital is like a family. The ICU nurses and respiratory therapists stay for years and years, and everybody was so great.”

Dr. Peter Michalos is a prominent ophthalmologist in Southampton who has been friends with Dr. Sklarek for years. He said it’s hard to understate the impact Sklarek has had on the community, particularly during the pandemic.

Michalos credited Sklarek for recognizing early on that COVID-19 was a clotting disease, and using innovative treatment solutions to help patients.

“He’s an amazing physician and he saved many lives,” Michalos said. “We were very lucky out here to have such a seasoned pulmonologist who is board certified in four area and is well respected by all the nurses and the staff.”

The support of his co-workers was key in keeping it all together during that time, Sklarek said. He also continued to rely on the activity that he says has helped him stay physically and mentally fit and well for years-running. Sklarek, who has completed 16 marathons, kept up his running routine even during the exhausting months of working longer shifts and occasionally nights at the hospital treating COVID patients, often with a companion; his rescued greyhound/chihuahua mix, Rosie, who he adopted from Puerto Rico. They would traverse the roads of his East Quogue home together frequently during that time, he said.

It is unlikely that Sklarek will be around for the next big moment when it comes to a global health care challenge like the pandemic. He is tentatively planning to semi-retire around summer 2024, which would mark 38 years in the field.

His main motivation for cutting down his hours can be boiled down to one word, he said: grandchildren. He has three, ages 5, 3 and less than a year, and would like to spend more time with them, especially after the years of COVID-19 where, because of his line of work, his time with them was extremely limited.

Sklarek added that he and his wife are also looking forward to spending more time traveling.