A nurse struggled with COVID-19 trauma. He was found dead in his car

Healthcare workers with histories of substance abuse may have more difficulty coping with fear

(Reuters) - Becoming a nurse in 2018 was a dream come true for William Coddington. He loved helping people and feeling needed at his West Palm Beach, Florida hospital. The 32-year-old was on the upswing of a decade-long battle with opioid addiction and other substance abuse, according to friends and family, who said he was committed to his recovery.

It all started to unravel in March, as fatally ill COVID-19 patients showed up in his intensive care unit. It rattled Coddington to see patients his age die, his mother Carolyn said. He could no longer attend his 12-step recovery meetings in person. He was scared about how little personal protective equipment he had. He had nightmares about alarms going off on ventilators in the ICU.

On the night of April 24, he spoke by phone to his best friend Robert Marks and sounded distraught, Marks said. Coddington was caught between the war zone at work and his confinement at home. “Don’t take unnecessary risks but hang in there,” Marks texted him.

The next morning, Coddington was found dead in his car in a hotel parking lot in Deerfield Beach, Florida.

His family suspects a drug overdose. A spokeswoman for the Broward County Medical Examiner s office said the case is pending. The Broward County Sheriff s Office said it is still investigating but does not suspect foul play.

Reuters reconstructed Coddington s last weeks through some of his text messages, Facebook posts and interviews with his parents, brother and two close friends. Reuters could not independently verify Coddington s cause of death.

Frontline healthcare workers are trying to cope with the trauma of treating the novel coronavirus, which has inundated U.S. hospitals with desperately ill patients and killed more than 90,000 Americans in less than three months.

Healthcare workers with histories of substance abuse may have more difficulty coping with fear, isolation and witnessing so much death during the pandemic, psychiatrists told Reuters. Those factors could provoke relapses in workers recovering from addiction, they said.

“Patients who are being treated for opioid use disorder have reported increased stress and opioid craving since this pandemic began," said Kelly Dunn, a psychiatrist at Johns Hopkins University who researches opioid use.

SCARED, BUT COMMITTED

Coddington grew up living with his mother, an executive assistant at a healthcare company, in Deerfield Beach, after his parents got divorced in 2001.

Coddington s family said he was addicted to opioids from a young age. It started with painkillers he received after a leg surgery, Coddington told his friend Skye Alexander, whom he met in nursing school.

Coddington entered inpatient rehabilitation at age 21, his mother said. When he emerged, he joined 12-step fellowships, self-help healing groups and therapy.

“He was always trying different things to find the stability to interact with the world,” said Marks, a resident of Miami Beach who knew Coddington for 10 years.

When COVID-19 patients in March started arriving at JFK Medical Center s North campus, where Coddington worked for 3 months, he volunteered for the coronavirus unit.

He did it because he was younger than some of his colleagues, and so potentially less likely to become severely ill, and because he was not a parent, said his friend Alexander.

“That was the type of person Will was,” she said.

Still, Coddington was scared, his friends said. He risked exposure and infecting his 65-year-old mother, with whom he still lived.

Palm Beach County ranks third in Florida behind Miami-Dade and Broward counties for confirmed coronavirus cases; nearly 300 people have died of COVID-19 there.

Coddington said in an April 13 Facebook post that his hospital had a shortage of protective equipment, especially crucial N95 respirator masks. He said he didn t blame his employer because the issue was widespread.

“In my hospital we are rationing 1 n95 mask for my whole shift,” Coddington wrote. “We are running out of gowns. We are having people make makeshift face shields that end up snapping."

Days before he died, his face shield fell off while he was helping with an intubation, which involves putting tubes into patients’ airways to assist breathing, said his father Ronald, a port engineer in Palm Beach.

“He literally felt things splash on his face,” Ronald recalled his son telling him.

Kathryn Walton, a spokeswoman for JFK Medical Center, part of the hospital group HCA Healthcare, declined to comment on Coddington s death except to extend condolences to his family. She said the hospital’s goal was always to protect employees.

The hospital has “adequate supplies of PPE” and is “taking steps to conserve PPE because we do not know what our future needs will be," Walton said.

She said the hospital offers mental health counseling by phone and video. Coddington’s friends and family say they don t know if he used those services.

 BRACING FOR IMPACT 

Coddington suffered from the social isolation imposed by the pandemic, his family and friends said.

He loved being around people, said Marks, who first met Coddington at a diner. Coddington’s “wacky” impersonations of TV characters endeared him to Marks right away.

“He was like a character all on his own,” Marks said.

Coddington relied on 12-step meetings to stay sober, but after one virtual video gathering, he told his mother it was not as helpful.

“He couldn’t meet with his sponsor,” she said. “And his friends, nobody wanted to see him because he worked in a hospital, not even to sit 6 feet apart.”

In his last weeks, Coddington came home from work, spoke little and played video games in his room, Carolyn said. His impersonations - including one of her Southern accent that always made them laugh – stopped.

His friend Alexander, of Sunrise, Florida, said she noticed the change too: "It was despair ... creeping in."

Coddington had relapsed before. In 2017, while on a break from nursing school, he had ended up on a ventilator, according to Alexander, who said she visited him in the hospital. She said Coddington told her he had overdosed on the club drug Gamma-Hydroxybutyrate (GHb).

With the pandemic weighing on Coddington, his loved ones were “bracing for impact,” Marks said. Carolyn checked on him constantly. His father and friends called and texted.

“You are so needed right now by others. You can be great," Ronald Coddington said to his son in text messages on April 1. “Please please bury me some day. Don’t make me bury you ... I love you.”

"I love you too," Coddington replied.

CRAVING RELIEF

The night of April 24, Coddington argued with his mother, who feared a relapse was coming. They made up, but he announced he was heading to a hotel for a good night s sleep.

Coddington kissed Carolyn and assured her she could track his location on her phone. He called Marks that evening, expressing how trapped he felt between the chaos at work and being cooped up at home.

“I couldn’t stop thinking about him because of how upset he sounded,” Marks said. Sleepless at 1:24 a.m., Marks sent his friend $20 on Apple Pay to buy himself coffee before his shift.

Coddington never responded. Carolyn checked his location the morning of April 25. He wasn t at the hospital. She drove to the hotel and found him dead in his car.

Ronald Coddington said police told him they obtained a video, likely hotel security footage, showing his son sitting in his car in the parking lot that night when another car briefly pulled alongside. Ronald said there was "some kind of exchange" between his son and the other vehicle s driver that he suspects was a drug deal.

The Broward County Sheriff’s office did not respond to Reuters  request for the video.

Family members think the toxicology report, expected in a few weeks, will confirm an overdose - a temporary escape gone wrong.

“Do I think he wanted to die that night? 100% no,” said his friend Marks. “I would bet every dollar I have that it was in an effort to have some relief.