The X-ray of his lungs resembled “an exploded fireworks factory that had gone up in smoke”.

Hooked up to a ventilator in the hospital’s intensive care unit, family doctor Joseph Ferriggi knew he might never wake up again.

It was extreme lethargy on the morning of October 22, following a couple of days of tiredness, that had led him to call an ambulance and go directly to the hospital’s emergency department.

Despite having none of the typical symptoms, he was not himself. He suspected he had contracted COVID-19.

His fatigue that morning meant two nurses had to help the normally active and energetic 63-year-old down the stairs and a stretcher was needed to wheel him along the driveway to the ambulance.

A chest X-ray revealed 60 per cent of his lungs had been infected with the virus and his oxygen level was down to 50 per cent.

A doctor for 39 years, it meant the patient was able to analyse and understand the enormity of his own results. But it also meant he felt “serene” in a familiar environment, with his family of colleagues and under the best care.

Part of that calmness, he jests in the aftermath, could have been due to the lack of oxygen in his brain, which gets foggy in these conditions.

Ferriggi also recalls he was probably hyperventilating when the consultants decided he should be admitted to intensive care, where he would remain for 17 days.

“The layman looks at the ITU as pre-death; where you go when you have reached the end,” he said.

“As a doctor, I knew it was the place for the best treatment, under the constant monitoring of specialised doctors and nurses.”

60 per cent mortality

It has been established that COVID-19 pneumonia patients on a ventilator in the ITU have a 60 per cent mortality rate, which rises to 70 among those who develop kidney failure.

“But I knew I was in good hands. I knew the capabilities of some of the best medical minds. I knew the unit was equipped with state-of-the-art technology. I knew it was my best chance,” Ferriggi says.

That evening, following a thorough investigation, the ITU consultant suggested Ferriggi be put on a ventilator.

While his was a bad case, the infection was still localised in the lungs, but his clinical profile painted another picture of a strong man with a real fighting chance.

The lucid patient instantly accepted the option, despite knowing the complications associated with ventilators.

“They could give rise to infections that are resistant to antibiotics, and it meant being put to sleep and not knowing whether I would ever wake up again. It was a crucial but obvious decision,” he says.

“I was moribund.”

The widower called his daughters, both in the medical field, who also gave their go-ahead.

It has confirmed my belief that we are not taking anything with us. One minute, I was at home; the next, I was in emergency ITU and out cold

He was knocked out and intubated, starting off under total ventilation.

On around the ninth day, in his unconscious state, the patient pulled out the pipe in his main airway and it was impossible to intubate him again due to the swelling.

He, therefore, underwent surgery for a tracheostomy, when a tube is passed directly into the windpipe through a hole in the neck.

This is a procedure that would normally have happened later to avoid damage to the vocal cords.

“Of course, I was not aware of any of this. But I did know that I was subsequently strapped down to stop me from pulling it out again.

'I felt I was packed into a washing machine and could not get out'

“For days, I felt I was packed into a washing machine and could not get out,” he says, managing a chuckle from the comfort of his study six weeks later.

Ferriggi was on a cocktail of three drugs to keep him deeply sedated – but they also caused hallucinations, and he recalls these vividly.

“Physically, I was in another place where everything was in order – the total opposite of what is going on in the world.

“Then I was in Africa, where I tried to fight for the rights of an oppressed tribe but could not because I was actually tied down,” he says.

When Ferriggi came to, he asked his doctor whether he had been transported through airports on a plane for treatment and was told it was the sound of the ventilators and dialysis machines.

The weaning off is a critical time, when sedation is reduced and the lungs may not respond. Fortunately, his did.

Semi-conscious, Ferriggi could only see the eyes of the COVID-19 ITU staff through their PPEs and was convinced they were aliens that had abducted him and were carrying out experiments on him.

“It was like being trapped in a scary movie. I felt helpless and could not communicate. I was frightened we would be used and binned by these kidnappers. I was truly scared.”

One thing the doctor learned is not to talk in front of a semi-conscious person.

“As I was being weaned off, I was aware of what was going on but interpreted it according to my own state of mind.”

When the hallucinations stopped, he was relieved to return to this chaotic world, recalling the moment someone in PPEs gave him the thumbs-up and told him: “You made it, dott!”

Urged to get out of bed and start tending to his own patients, Ferriggi admits he was so weak. His muscles wasted and his weight went down 14 kilos in 17 days, he was unable to stand and walk by himself.

He was discharged on November 20, following a stint in the Infectious Disease Unit for observation and oxygen inhalation. He stepped out with a walking frame, “like a man who had suffered a stroke”.

But after a week, he could let go and venture down the stairs.

“I feel myself and fully recovered,” Ferriggi acknowledges.

'Miracle recovery'

For the medics, his is a success story, but for the spiritual man it is more than that. It was a “miracle recovery” he struggles to explain.

A public figure in his hometown, he believes it was the community prayers that helped as much as the medicine.

Since then, his own mother and sister have moved into his Rabat home to assist him and he is still housebound, holds virtual clinics and is even more cautious, despite seeing his patients in his PPEs since March.

He plans to check his immunity levels, and when the time comes, he will be vaccinated.

Meanwhile, he admits the whole experience has affected him and his way of thinking.

“It has confirmed my belief that we are not taking anything with us. One minute, I was at home; the next, I was in emergency ITU and out cold. All that you have achieved in life comes to nothing at that point,” he said.

“COVID is more than your personal life and health. It will change the world socially, economically and politically,” Ferriggi maintains as he warns about the unpredictability of the virus and correctly predicts daily cases will surpass 200.