Dr. Thomas Ardiles likes to joke that when he arrived in Arizona from his native Peru on July 4, 2000, he was greeted with fireworks and celebrations everywhere.
But what Ardiles, a pulmonary and critical care physician at Banner-University Medical Center in Phoenix, is dealing with these days is no laughing matter. With more than 20 years of experience, Ardiles is one of the leading physicians helping to treat COVID-19 patients, particularly those who are hospitalized because of the severity of their cases.
Even for someone with his expertise in respiratory issues, the coronavirus is like nothing he's ever seen before, Ardiles said.
"It's been a very difficult time for all of us. At least we understand the flu. We know the course it takes. We didn't know anything about this. Nobody was prepared for the magnitude of this," he said.
It's particularly difficult to have to isolate patients from their loved ones to avoid further spread.
"It is a very humbling and emotional experience. The relationship with the families has been real important," Ardiles said. "They see us every day, and we speak with them, and they know us and develop a trust."
There are some cases he'll never forget, like that of a young man with the coronavirus.
"I remember a very difficult conversation with a family. The patient's lungs were completely gone, and the heart was giving out. We talked with the family and said, 'We don't know if he's going to recover and have a normal life.' And the family said, 'He's young, let's hope for the best, let's see what happens.' He managed to recover."
Ardiles considers his ability to speak Spanish with the families — and, in some cases, the patients themselves — a big advantage.
"Those hard conversations, to be able to speak in Spanish means we can make sure that nothing is lost in translation," he said. "Latinos are particularly affected because of issues related to access to health care and because many tend to live in close proximity, even among generations."
Communities of color nationwide have been hit hard, and those in Arizona are no different. According to state health officials, in July alone, Latinos in Maricopa County comprised half of coronavirus cases. Maricopa County includes the state's largest city, Phoenix, where 42 percent of the population is Latino.
Earlier in the summer, officials in Phoenix and other localities mandated masks, which Ardiles said is a very simple way to help stop the spread and bring the pandemic under control. He said he doesn't understand those who refuse to wear masks or follow social distancing directives.
"Think of a war. If the country doesn't stay united, it wouldn't do very well," he said. "If we were, for instance, to make wearing seat belts optional because I don't want to infringe on your freedom or you don't want to wear it because you feel restrained, you can't move around, you can imagine what would happen in car accidents. And it's no different now to tell people to do their part to help stop the pandemic.
"For those who aren't heeding the warnings of social distancing and wearing a mask, the fact that you cannot empathize with the suffering of your neighbor and just do one little thing that we ask you to do is really shocking to me," he said. "They don't want to comply. They don't think about others. It's like the golden rule, love your neighbor."
Ardiles likes to unwind by spending time at home with his family, taking walks and listening to a variety of podcasts. "We're a churchgoing family, and we haven't been able to go to church, so we do different things," he said.
When NBC News spoke with him, Ardiles had just finished some yard work at home. At the hospital, he takes the extra precaution of showering and leaving his scrubs behind before heading home, and "as always" he is frequently washing his hands.
Ardiles, 47, graduated from the Universidad Peruana Cayetano Heredia medical school in Lima, Peru. In addition to his hospital work, he is also a clinical assistant professor of internal medicine at that University of Arizona College of Medicine-Phoenix.
Ardiles said he wouldn't be able to treat any of his patients without all the health care professionals who work with him.
"I don't want to take any credit for myself without crediting my whole team. We can't do this without our nurses working hard, without all the people that help."