When their son moved out and left them empty nesters, Paul and Holly Llobet decided it was time for a change of scenery.

The couple, both from New York, did an online search and typed in "travel medicine" and connected with Global Medical.

"Guam sounds amazing!" they said, so they signed a six-month contract to work on island at Guam Regional Medical City and made the trek halfway around the globe.

Holly Llobet, a critical care and palliative care physician, and Paul Llobet, a hospitalist, planned to work every other week at GRMC and use their off weeks to travel the region.

"It was like we were on a honeymoon again," said Holly Llobet, recounting their trips to Yap and Palau and a ski trip to Niseko, Japan.

The couple had it made. Working at the same hospital, enjoying the same schedules and time off, and traveling to exotic destinations.

"We had planned to travel, and then COVID came," she said.

Suddenly, the life the couple had planned took a crazy turn. The honeymoon was over.

"When we flew back, a week or two later, the hammer fell and everything got canceled," Paul Llobet said.

For the last two months, Holly Llobet has been working in the trenches at the Guam Memorial Hospital Intensive Care Unit and Paul has been working the night shift at GRMC.

"We see each other to hand off the keys to each other. We leave food in the microwave for each other and rarely see each other," Paul Llobet said. "It's really strange. It's like we're roommates. It's been rough and tough. For us, it's always being together, communicating and destressing over dinner and breakfast. I miss that part."

Less than two weeks after they returned from a ski trip, the first few cases of COVID-19 were reported on the island.

GMH reached out to Holly Llobet for help.

"They said we're now deemed a COVID hospital and we don't have a critical care doctor, as the one they had was joining the COVID task force," Holly said.

She agreed to assist at GMH and manage the ICU.

"I ended up getting pulled over to GMH during the height of the COVID patients," she said.

She now goes back and forth between the two hospitals.

"She's the brave one of us both and has really been in the trenches," Paul Llobet said proudly of his wife.

With Holly Llobet out of rotation at GRMC to assist GMH, Paul Llobet and a handful of doctors at GRMC had to adapt.

"The rest of the crew at GRMC picked up extra shifts to kind of cover," he said. "We just had a team of seven to eight doctors that just kept working. We've been just on island working almost every week."

'We decided to stay'

As the number of cases on Guam started to increase, the couple watched the tragedy unfolding in their beloved home state. Hundreds dying, mass burial sites, overwhelmed hospitals, nurses and doctors contracting the virus.

"It's been really difficult. At first, my friends and colleagues were just telling me nightmare stories and my first thought was I need to go back to New York to help out," Holly Llobet said.

But she changed her mind when she realized her leaving would mean GMH wouldn't have someone to replace her.

"It's not like New York, where other physicians can just drive over from Connecticut to help out. We don't have any new doctors for relief," she said.

The couple reevaluated and agreed, "Guam needs us more than New York, so we decided to stay."

It was a difficult decision considering they have family and friends in New York, Michigan and Florida.

"Working through COVID, I thought: What if I get COVID and never see my family again? What if my family members have COVID and I can't get back to see them?" The questions and anxiety grew, but those fears quickly subsided as she began working with the GMH team.

"They bent over backward to give us PPE ... to do whatever was needed to take care of us," Holly Llobet said. "It's been an amazing experience, and I wouldn't change it for the world."

To date, Guam has had 154 confirmed COVID-19 cases and five deaths. The reports include 126 individuals who have recovered and been taken out of isolation.

"It sounds small, but it's actually quite significant when you look at the population," Paul Llobet said. "Statistically speaking, that's an equal share of what's happening in other parts of the world."

The couple was impressed with how quickly GMH was able to transform into a COVID-19 facility.

"They got rid of all the red tape. They said,'We need a COVID hospital,'" Holly Llobet said. "We got a COVID hospital. 'We need to cut the ICU in half and make half for COVID. We need a wall.' It was done in hours."

She said New York Gov. Andrew Cuomo deemed one hospital a COVID-19 hospital and another hospital a block away a non-COVID-19 hospital.

"They still haven't gotten that up and running. Guam did it in a day," she said. "In New York, there would have had to have been a policy. Things take weeks there. We didn't have weeks because we needed to protect ourselves."

Holly Llobet said she feels safer on Guam than she would have if she had gone back to New York.

"They shut this down and got control of it so quickly," she said. "It could have been so much worse."

Paul Llobet agreed and said having had some experience in hospital administration in New York, it's always easy in hindsight to pinpoint mistakes that are made or how something could have been done better, but he said he's been impressed with the efforts that were made on the island.

"The detractors maybe should reconsider the fact that (government officials) did an amazing job and it would be hard for anyone else to say they could do any better," he said. "I'm proud of Guam and proud to have been part of the health care here."

Community generosity

The first day the COVID-19 team at GMH didn't know how to get food or water. Once in the negative-pressure hot zone area, coming out to grab water or get food from the cafeteria isn't as easy as just walking out the door. There's an extensive decontamination process that often takes an hour. The next day, food donated from the community was delivered to the unit, including vegetarian meals for Holly Llobet.

With the constant decontamination, Holly's shoes fell apart, and she couldn't get new ones because, at the time, shoes at Kmart were deemed nonessential.

"I didn't have any extra shoes. The owner of the Flip Flop Shop heard and within a few hours delivered me a pair of Crocs that I can wear in the shower, decon and bleach the shoes and I'm still wearing them every day," she said. "Stuff like this doesn't happen in New York. It's just too big and too crazy but, on this island ... it's like, man, my shoes are falling apart and a couple hours later, I had shoes."

Paul Llobet said the kindness and generosity of the community and the CHamoru culture of being loving, open and accepting have made for an unforgettable experience.

"You don't know how powerful it is when the community all of a sudden show up with coffee or with breakfast or with cookies," he said. "You're wearing this gear. You're tired and you come out and you just want something. ... It's amazing how the nonmedical community really kind of stepped it up and motivated us."

The physicians said it was a wonderful feeling to be appreciated for the work that they're doing.

"I don't think I've ever felt that before to this extent. I almost feel like an adopted son of Guam," Paul Llobet said.

Impressed with Guam

The couple recently celebrated their 17th wedding anniversary and, as they do each year, they intended to keep their tradition of documenting the special day in their original wedding gown and tuxedo. The Llobets had planned to run the United Guam Marathon and show up in their wedding clothes for some photos at the starting line and then change to run the marathon, something neither had ever done before. But when the marathon was canceled, they donned their wedding clothes and masks and visited some scenic spots around the island to document the day.

"Marriage, family comes first before everything else," Holly Llobet said. "It's worked for us."

Having worked in top-notch hospitals and rural hospitals, the couple said their experience on Guam has been nothing short of impressive.

"Guam may not have all the specialty needs and all the latest tools and gadgets, but the bedside nursing care, the physicians, the ability to communicate, people coming together, people volunteering to help as opposed to finding excuses not to. That's just been amazing," Paul Llobet said. "My wife and I were so impressed we luckily were able to extend our contract for another year and will come back in September to work at GMH. It goes to show what a great experience we've had."

The Llobets plan to return to New York for the summer before returning to the island to start their one-year contracts.

They hope to eventually travel to Chuuk, Pohnpei and Kosrae after meeting patients from those outer islands.

"The patients have been wonderful. The people of Guam have been so nice to us. We're very happy here," they said.

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