Heroes of Healthcare
Heroes of Healthcare

Episode · 1 year ago

Unsung Heroes: Coordinating Emergency Services in New York City

ABOUT THIS EPISODE

Last year, a makeshift field hospital was built in Central Park. Did you know the last time that happened was during The Civil War?

The pandemic has stretched the healthcare system to its limits, but at every turn, healthcare workers across the country have met the challenge with compassion and creativity.

In this episode, I talk with Dr. Brendan Carr, who is the Professor & System Chair of Emergency Medicine at the Icahn School of Medicine in the Mount Sinai Health System, about the massive effort that went into fighting COVID in New York City and the many unsung heroes that led the way.

You're listening to heroes of healthcare, the podcast that highlights bold, selfless professionals in the healthcare industry focused on transforming lives in their communities. Let's get into the show. Welcome to the heroes of healthcare podcast. I'm your host, Ted Wayne. Joining me today is Dr Brendan car, Dr Cars of Professor and system chair of emergency medicine at the icon school of Medicine Mount Cy and I and the Mount Sinai Health System in New York City. Dr Cars focused on building regional systems of care for emergency care and developing innovative delivery solutions to create a more distributed and accessible acute care delivery system. He has a central role in coordinating Mount Scinis response to the recent epidemic efforts, where he recently was recognized by crane's healthcare. Dr Car earned his medical degree from Temple University School of Medicine and completed his residency and emergency medicine at the University of Pennsylvania. Dr Car also served as the director of Emergency Care Coordination Center and as a senior advisor within the US Department of Health and Human Services from two thousand and twelve to two thousand and twenty. It's our privilege to have Dr Carr join us here on the heroes of healthcare. Welcome to the show. Thanks so much, pleasure be here. You know, it's been fun. We've had several of the folks from Mount Syin I on these calls and I love having the team they're because your stories are so impactful and really so inspirational and you know, as I mentioned in the introduction, your involvement with the emergency department and all the work that you've done. I'd love the guy to go back and in our first conversation we talked about what I call the Unsung Heroes, and I'd love for you to share with the listeners how, when the first breakout of Covid came and you guys had to start mobilizing, what are all the logistics around behind it that people don't often think about that you guys had to do in order to make sure you providing the care that you needed to. Yeah, there's substantial and and thanks for refreshing my memory and and sort of taking us back to that framing all the people that are, you know, Unsung, as you said, behind the scenes but without whom you know, nothing gets done. We just can't function unless all the pieces come together in the way that they're supposed to, and we should put a name to some of them. You know, let's actually start Raud the inside of the healthcare system. It's easy to say Docs and nurses, right, but boil boy, that is very, very tip of the iceberg. But if we just even start broadly than that, and I think about getting to work during those months. You know, I live just a twenty minute walk away from the hospital, but I live in a building that has folks that support in the doorman right and said, the service guys that are making sure that people's lives go I stop at the grocery store in the way and grab some things to stick in the mini fridge in my office and on the way home, in the fridge at home. Just you know, the the and their label broadly as essential workers, and it's important just to take a minute to recognize that they never stop coming to work and it's astounding when you extend that into the hospital. You know, every everywhere you turn, everything you look at has a history behind it. So, whether it is the story of the mask that I need or the gloves that I need, or the face shield that I need, or the medications that the patient needs, or the stretcher that's been wiped down and sterilized as cleaned. All of those things have an amazingly complex journey that sort of precedes them getting into the moment. You know, where they're needed and when we put together. I know, you know, you've had other people talk about the about the command center structure and pull together the the experts within their disciplines, you come to realize that these are people who, many of them, you don't have a relationship with, because when things are working, when everything's stopped and the supplies are just there, you go to the closet and it's magic, you know, it's full of all the things that you need. Right. It's not magic, you know. It's people's lives thinking about just in time supply chains and and just...

...in time logistics and delivering on it so frequently that it feels like magic. HMM. We just come to expect and we just come to expect it. Yeah, you know, means people think the same way the public health. Frankly, you know, neither of US woke up today and thought, thank goodness I don't have a waterborne die real illness. You know, we didn't wake up and think that today, and yet it turns out right, very intentional. Right, that has happened over years and years and years and years and years, because we are careful about our water and our food and our sanitation. We have learned all these things anyway. So, yes, those are the unsung folks. And when they say, when you sit around the table and are on the list and everybody points to the to the doctor or the emergency doctor who stands at the entrance of the hospital, it's really easy to celebrate. And don't get me wrong, those guys are heroes, those women are heroes and we are grateful in mental lot, a lot to have people recognize. You know, New York City was everyone has talked about it, but but you can't really understand it. And until it was you at seven o'clock, when people would just go out on their balconies, are stick their heads out there, windows are stopped their car and start honking just to sort of say hey, we see you and we know it's scary in there. Yeah, now that those are some of the most moving things I saw on the media. But then my daughter lives up on a hundred and seventy five and Broadway and she's right next to Presbyterian and her only refuge, which I've talked about another episodes, was up on the roof. Was a way to get out of her room and get at get some outside time during the heyday. And she would send me the video clips of the shift changes at Presbyterian then. It was so moving you'd get chills, you know, see hearing everybody just appreciating all that work. For sure. Yeah, it's I'm going to still get just thinking about it, right and thinking about what it meant to you know, the Fire Department pulls up. Yeah, and then are is go outside and and they applaud each other. It's just I mean, you know, I think if you weren't in it, maybe it seems a little staged in, a little silly. Right, boy, these were dark days. These were really, really scary dark days and it's Nice, as it's nice just to think about them again, but again, but circling back right. So, but you know, we're talking about one of them, one of the one of the folks that I mentioned to you when we were talking casually. There's two people that I think about a lot. I think about, and I'll name them just first names only. Is Carlos and Tom Right, you know, and I think about Carlos runs the supply chain for everything that we need, that we bring into the system, and Tom runs real estate. And you know, who would have ever thought that real estate had something to do with the response in New York City? UN To you realize that these are tens of thousands of employees that were afraid to go home. But you got a right. It's a different disease. Now we understand some things about this disease that we just didn't have to. I remember back picking up, I think it was a new and Journal of Medicine Article That talked about airsolized virus being alive on surfaces for four days, hours to day's, you know. And so how did you coat something that lives and, as you know, as viable on a surface for days? Right? He wipe down everything, all right. How do you wipe down your body? Right, and we all wipe down our groceries, but we also sort of showered the second we came home. We all change their clothes, you know, in the garage, if you have one. Those of us who live in apartments in New York. That's not really a thing. So you have an anti room. You know, it starts to get everybody had their their routine around it anyway. You know, it just we knew so little about it and people needed a place to sleep and all the sudden there's thousands and thousands and thousands of hotel rooms that Tom's coordinating every day at the same time that the other real estate piece bridging him to Carlos was we all functional with just in time supply chains. Right, it arrives as we're running out of it, until we don't trust that anymore, in which case they say to Tom, Hey, we know it's New York and no one's got space, but can you find a lot of space for us to put a lot of stuff for the biggest health system in Manhattan so that we can stockpile, you know, ourselves, hoping that the supply chains open up beyond our internal stock pile? Right, there's just not big warehouse is laying around open.

There's just a big warehouse. That's exactly right. Yeah, it's a little bit of a thing, man, and you know, people may have noticed when they so anyway. So you know the I mean these guys, I think about them all the time and I think about what they overcame and I think about how stressful it was. You know, in order for them to do their jobs, you know, they needed they need a mathematic modeler, they needed people to tell us what our these words are, these are words people think about, but what our burn rate was. Yeah, right, so that you can tell us how many days out we are for everything, right, all the time. How many days we have a gloves? How many days do we have left the masks? How many gowns, etc. Everything to medicator the moment. There's uncertainty there, there's panic. Yeah, and the you know, the clinical facing, even the nonclinical facing leadership have to be able to say to their folks, we're three weeks, three weeks solid of masks, right, and we have a million orders out there and we're sourcing it from all over the place. It's okay, right, we're okay, yeah, don't panic and eat. And it needs to be true, because if it's not true, number one, most people don't want to say it and give false red assurance. But anyway, so, you know, add the mathematic modelers onto the list of heroes that the logistics experts whose names most of us don't know and who probably didn't hear that seven PM applause. As for them as much, even though they were also working twenty two hour days. Yeah, so, and let's talk about it bit Tom a little bit, and you talked about the thing the room. So just to make sure the listeners understand. So he was having to coordinate places for the medical staff and other staff to stay. Is that correct? Yeah, that's right. People are afraid to go home. We didn't really know much about the disease and it wasn't clear how it was spread. We knew that there was a symptomatic the ability to carry it and being symptomatic, and during those days you know if you're contaminating your your kids or your partner, your grandparents, whoever it might be. That introduces a sort of a level of stress beyond the normal level of stress. It's one thing watching people get critically ill and die during the day and then working the extra shift or stay in for a couple hours to help out and then being able to go home, take a shower, see your family and recharge a little bit. It's another whole thing to go home you lock yourself in a room and be afraider you're going to contaminate your family or go home and interact with them normally and worry that you're that you're going to contaminate them. So a lot of people chose to stay in hotel rooms. By the way, the hotel industry was pretty extraordinary and what they gave us for free of discountant. I don't actually know the details, but lots of lots of people sort of rose to the UK. Yeah, I even heard there were some pools where you could call if you were evacuating the city because you didn't want to be in the city and your apartment had been left empty for a period of time where your felt it was safe. They there was a pool to volunteer your apartment. You could say to the health systems, here's an apartment at such and such a street and we let the doctors use it and we'll figure way to let them in and everything. So yeah, well, extraordinary times. Everybody had to rally in an extraordinary way. But I do love that, because we talked about this, that there's the frontline workers are clearly heroes, but there's no small players on the team. Everybody's got to play their role in order for it to work, as you mentioned, the supply chains got to be able to provide them with the necessary equipment for them to be safe. One of the thing that I want to I'd love for you to explain, to which you've got a lot of you heard about in the media and stuff, was your guy's ability to mobilize and set things up using central park. How did that come about a little bit and what were some of the logistical challenges to, you know, to take over part of central park and set it up as a makeshift hospital, as a mobile hospital? Yeah, there's no song here. There's a bunch on some heros behind this one too, but one of them, the one of them from signs, his name is down and he's so unsung and behind the radar at all times that I owe your dinner if you can get them on the podcast, but I highly doubt it. I will. I will sell them out and give you his email on his phone number. But he is the guide behind the scenes all the time. He runs emergency management for our health system, which is the biggest health system in New...

York City. It's a big job emergency management for those who sort of don't know what that is. So I'm an emergency physician in mergency medicine. Were to know what that is. Emergency Management is the operational logistics side of taking care of the healthcare systems needs during sort of any sort of threat, whether that be a flood in the basement to obviously, sort of a global pandemic. It is you you know it or think of it mostly as FEMA, the Federal Emergency Management Right. Yeah, but so don runs that and don had and worked in the federal government previously and work in Boston previously, at work in New York in this space previously. And I will embarrass him even more and say, you know, in addition to being an Experti murs management, he's a lawyer and he, you know, sort of uses a multiple different skill sets to approach these problems. But he had experience with a couple different relief organizations and these relief organizations are generally deployed in places where there is not a sophisticate healthcare system, which is to say typically and globally and developing world. And in fact this is the first time. It was a fil hospital in central parks into the civil war. Now. So you know, I called the CMO of one of these really organizations. He called his contact. I think the COOO had one of these relief organizations. We asked you could come help and it was a whole bunch more on some heroes showed up, which is to say the next day, the Security Guy, the engineering guy, the guy that sort of you know, the medical lead, you know, a central the administrator for the for the thing, and nurse lead. A very small number of people showed up and they flew that afternoon, met us the next morning. We looked at a bunch of sites and they said we're ready to go if you're ready to go, and they picked a site and then they made a phone call and the truck started rolling with the field hospitals in it. So that was the partnership with an External Organization. That was not sort of sign I driven. The sign I receptor for it was to plug into everything that we do, whether that be our laboratory, our pharmacy, are electronic medical record, because we treated them as a virtual unit inside of our hospital m but you know, you and I this is add to the list. The Pharmacy folks, the you know, the the Mord frankly needed to sort of we became an extension of that, the information technology people that every six hours we would say we just built a whole new suite of rooms in the hospital lobby or they're setting up a field hospital in central park across the street. Can you build a virtual unit that didn't used to exist inside of our electronic medical records so that we can track everybody? And they just they were just grinding and grind and from the time you said yes, we will take your help and they said we'll make get the trucks rolling to the time they were fully kind of up and running. How long was that period of time? It's a bit question how quickly they able to mobilize. I think it's seventy two hours. It might be wound just a little bit more. I think they opened April one. I just can't remember exactly what Saturday it was. I'm yeah, Saturday morning. We call them Friday night. I think on the plane we met him of Seven Am Saturday morning and their truck started rolling by noon or so out of North Carolina. Got Up there and they just started building. And how big was the so what was kind of the capacity once they kind of got up and set up? How many patients were you guys able to serve in there, you know. So in there we was sixty eight beds, wow, and they treated almost two hundred patients. We think of this as, I'll non traditional space. I'll turn of CARE space. A field hospital certainly counts. But our engineers did amazing things that they built inside of our lot of the pictures or straordinary built inside of our lobby with, you know, to by fours and tending material, canvas material. They build hospital rooms all the way down, you know, the hallway between the fancy lobby, where there's usually like a starbucks in a reception area, all the way down to the hallway the leaves from the medical school. You know, the engineer's silently all night long converting empty space into rooms to put people. Added another I don't know, sixty beds just in the hallway or just in the atrium. So you know, between all these different spaces that we created, we surged. You know,...

...we serve probably several hundred percent above our normal capacity. Well, you know, when we talk about all the things, you've mentioned so many things that, as the listeners are hearing, you don't think about, right is it's is behind the scenes. I think you mentioned that even the strain on the oxygen system was a challenge the straight yeah, I mean, anybody who took care of a large viome of covid patients at any time, especially during that time, knows that their line start to freeze up if your oxygen demand is too high. You know, these are things. You know. I've worked at the intersection of birds in medicine and preparedness and burdency management. I have no, no expertise in that area compared to people that do this for a living. And when people call with a problem like that, I watch them solve that problem right, I watch, you know, they just do the math and they start thinking, all right, well, this is what we're going to need, right, and they turn into make a phone call right and and that's extraordinary. And that happens very quietly. And you know they have these they create portable Otchen capacity that all the mental the system. Yeah, yeah, it's just you. You're so grateful for the depth of expertise that people have that you never need ask about yeah, you know, and I think even talked about the getting power into the park was a logistical issue. And how do you deal with a public utility? The size of Con Edison in New York City and say to them, Hey, we need a little bit of power over in this little section of the park. Yeah, so, you know, not just power but water and, you know, sewage if we can have it, and you know, ps. What if we need to land a helicopter? Would that be okay? Hey, how about security? It's a park in the middle of New York. Right, we're going to write we're all of a sudden gonna have all kinds of computers around and technology around and patients around and families around. Yeah, it was one after another. So that was that afternoon. Actually, the morning of was was the meeting and then we went to a couple different sites and once we identified the site, that afternoon there was a long call with both city and state, between outside, I Samaritans purse, which was the relief agency that supported and in the city of state to talk through the several dozen different permitting things and logistics challenges that are pretty incomprehensive. Yeah, I think I love the last time we talked. I loved your expression. You said, I think you said your guys would have had said in the past that would have taken us a year to get a know and in twenty four or forty eight hours we will to get a yes. And boy was at a sign that the times were different. We were facing something very different, extraordinary. Yeah, yeah, people knew. I mean life was on the line. You know the other I'll tell you. You know. So we think about the field hospital out in front of our primary hospital in the upper east side, for people who know New York, but we have hospital all over the city and the upper east side hospitals the biggest, by far the biggest, and so the other hospitals across the city also had to surge and we transferred a lot of patients, a lot of patients. In fact, most of the patients, I would venture to say, I don't have this in front of the most of the patients treated in the field hospital came from hospitals other than the upper east side hospital. Okay, we balance the load across our across our system, across the city by moving patients to where there is an open bed because, you know, the front door was still open. There are more people coming in. HMM. So extraordinary, unsung heroes everywhere. Love that. And here we are. Let's fast forward. We come to the holidays. We got a holiday surge, we had the fall surge. That came back and then Thanksgiving added another component to it and Christmas is added another component to it, or those the December holidays, for sure. What did you see? Lessons learned from Spring and summer that you guys were able to apply now? That has made this easier. Always, always, the known is easier than the unknown, and certainly you guys were dealing with a lot of unknown like you talked about not even knowing the airborne capability of this and how long does it keep on surfaces and all those things that we didn't know. And clearly our ability to treat this is now better than it was. But what were some of the big things that, as this has come back to stress the system again, have you lessons learned, if you guys,...

...have helped you to be more prepared? Yeah, so maybe we'll just sort of say real quickly and then push aside the clinical stuff. You know, everything from plasma to steroids, to monoclonal antibodies to, you know what, different medicines that we should shouldn't use. All of that, whether or not to intobate but breathing. You've been to people are early versus to allot to allow for some relatively low oxygen levels for a while, blood thinners. You know, it's extraordinary what we've learned clinically. Yep, moving that aside, I think your sort of question a little bit is on the logistics and operation side, which is which is where many, you know. I mean not for nothing, we should probably say. I'll allow there's a whole lot of people that spent their lives understanding vaccines, right and and RNA that are yeah, but deserve a little bit of a shout out for the unsung nature. Yeah, totally. Yeah. But on the logistic side, some of what I was just talking about in the way that we sort of balance across the system. Let's let's say, some of these names, Abe and carly and Kevin, you know, and Helen, the people that just that their whole day, their whole life, is balancing across the enterprise. It's astounding to make sure that nobody gets so stretched that care gets compromised. So that's a big piece of what we learned. We learned how to leverage staffing in ways that, you know, you when not otherwise had to during their remember, during the initial surge, people were willing to come from other parts of the country. Right. Yeah, during this surge, everybody surgeon, you know, there's not all the sudden a pool of people. Yep, thinking about, you know, how to sort of leverage this skill set of some of people by creating teams is an important lesson. And then I guess I would say, you know, some of some of the other things that really come to mind from me are focused around some of the other podcast that you've done, which is how to take care of the staff and how to keep taking so that they can come to work, so that they are able to, you know, not just get out of bed and put their shoes on and come to work, but show up at work with enough gas and the tank to be able to take care of people. Yeah, out of one more just which is that the communication with families. It's so hard, it's so, so hard that the families are never in the room, never at the bedside, that we can't, you know, depend on them to take care of their loved ones, small activities of daily living and needs more to help us with a history. The patient doesn't doesn't know it. That really has changed things that need to the need to communicate only by phone and on the internetently with families who otherwise would be there to help. Yeah, you know, we just kind of it's kind of one of the episodes. It's going to be coming out. We talked with an Adventis hospital out and see me valley. What are the locations and see me valley, California. That's dealing with the whole la surgeon. You know, one of the things that they've been having a lot of success with is what they call hospital at home, where they're having the people go home and through Tella and through nursing on on site and stuff, they're able to treat certain classifications better. But what they're seeing is faster recovery times because of the home, because of the family, because of the connectedness that they have. They believe that that's a big contributing factor to the recovery times of somebody who normally might have been in the hospital for two weeks. They're recovering at home faster, in a week or ten days because just that connectedness which now with the as you said, but the virus, family members aren't up there, so you don't even have the visitor, you don't even have, as you know, the person who can come and bring you the flowers or bring you something, or bring you a pair of see your favorite pair of socks or something that you know it's good to those creature comforts that just make us feel that there's some semblance of normalcy to it. Yeah, I don't know the data on that, but but I'm a buyer, I'm a believer. That is the power of hope is pretty extraordinary and when you have family surrounding you and when you believe that you can continue to right improve, I believe that. Yeah, well, and you even touched upon it earlier. To the information, right, just the access to the information that maybe somebody who is older or a little more incapacitated...

...or, God forbid, intubated, right, they can't communicate with you about other past, you know, problems that they've had or allergies or you know, or any of those other how you feeling right those sorts of things, when and when you don't have the family members around to help or communicate with it, it just compounds the challenge. Yeah, so let's talk a little bit about what are you seeing today? What are you seeing kind of coming down the road, and tell me a little bit more about your passion which is the the Er and why you love those people so much. You have thanks, you know. I mean. So coming down the road, we're all watching and I don't know, I won't pretend to have anything terribly intelligent to say about the newts right in the variants that we're all watching. We're all hoping, you know, the vaccines continue to be effective. We're hoping that enough people get vaccinated that these the mutations don't become widespread, though, you know, the race at this point seems like the virus is going to win, not the vaccinations. So then it's really going to be about what mutates, whether or not something that mutates that changes the vaccine response significantly or not. So there was a lot of hope, you know, a couple weeks ago when healthcare workers also to get vaccinated. There has been a little bit more caution. Fear that has re emerged as we've been listening to all the different variants that are showing up across the globe and what that might mean. There was a lot of talk just a couple weeks ago about this notion that this summer, this summer is what we anchor on. You know, the winter's gone the spring is going to be gone ish, but in the summer we can be outside again, so it's easier to socialize even distance and in Mass on. It's been very cold in the northeast the last couple weeks and you know, you don't take a walk in the park with a friend for, you know, more than twenty minutes or half an hour before you're ready to you know, before you're ready to find some warm spot again. So we had been anchored on that and I'd like to believe that we can still think that that's true. And it's going to depend a lot on the variance that are showing up and the speed with which we can get vaccinations and arms, the emergency medicine piece that you touched on, and thanks for bringing that back up. You know, as we think about unsung heroes, I don't mean to be too hyperbolic here, but you know, most people's understanding of what the Ar is is sort of a place that they don't want to be. It's a layover on the way to wherever they want to be. You know that we think of it as this extraordinary place where you get, you know, an outpatient diagnostic work up and or stabilization or treatment in several hours instead of stretching out over weeks. You go get you dirty, go see your doctor, then you get your lab work and then you go get your x ray or your cat scan and then you go back and see the specialist and then they you know, they sort of want to do a couple more things. You do those things and then you come back and this time we talk about a strategy. You know, we think that it's pretty extraordinary we do that over the course of, you know, six hours. Most people, at the six hour marks say I can't take it anymore, getting me out of here, and I I really understand both, both sides of it anyway. But you know, the meergency department is a it's a complicated place. It looks a lot like chaos to the uninitiated, and yet if you spend your life they're right. You see the rhythms, they are happening, you will understand the workflow and we need to do a better job of explaining to patients what's happening, to to demistify it, to communicate with them better, to help them to understand the process. HMM. But it is this place that doesn't close the front door doesn't lock, doesn't lock, the front door doesn't can't close the front door right that most of them don't have a lock on them. You can walk in seven and we hand off to each other non stop. There's docks, there's nurses, there's text there's always people to receive you. And on the one hand that's a huge responsibility. Means a lot of missed dinners and kids ball games and weekends and lights of sleep. You know, we're shift workers, like every other shift worker that you know sort of quietly is staffing. The thing in the middle of the night that you happen to me that night that you're up and one night out of the month that you're driving home late and you stop and get gas. And we know that those folks are largely not visible to people that are just...

...on the way of their invasion bed or just had that one time thing that they need to get seen for or wreck their car or had a heart attack and or unconscious. So I do, I do have a warm spot in my heart for this sort of always present, quiet safety net that exists so that we know that if our life are our limbs are threatened, there someone will grab you. So will be there into the hall. Yeah, I think you know, I agree. It's a special calling, you know, in terms of wanting to and willing to do that. The emergency room obviously is the front lines. You know that the trauma that comes in, the things that they see is different than I think, as any doctor who's getting ready to declare their specialty and move into an area that they want to, you know, live the rest of their life working in has to find that passion. The people who say I'm ready to go work on those front lines in the emergency room. It's a special calling to have that passion and special treatment of care. I think I mentioned to you when I saw that, when my dad was sitting in the covid emergency room locally at the hospital and just watching those healthcare workers selflessly go to a patient who might be getting sick or go to a patient who is clearly in pulmonary distress and not think anything of their own safety and go and to help that person selflessly. That's the only other word I can keep coming up with. So they are special breed, those people, and certainly are the frontline heroes and I'm glad we get to spend some time talking about the backline heroes or the unsung heroes, as we say. Yeah, thanks. You know, it's interesting. I mean I work at a giant referral center, dry in academic medical center, and I can't help but wonder what our medical students are thinking. I don't know which way this pushes them. I don't know if this pushes them to run into the fire or sort of try to find a place to run away from. I'm worried about our pipeline for nurses, because they're the nursing shortages. Even if it was you're calling, or is your calling. It's exhausting. Yeah, you know, and so I don't I mean I worry and wonder what this is going to do to the workforce of the future. Yeah, I did see one article. I can't remember his Newsweek or who, but somebody said that there was a surge of medical school applications as a result of this, and so I'm wondering whether it is having that typical, that's interesting call to action, which is it's a it's bringing some of that purpose. You know this this generation for sure is pursuing purpose and passion in everything that they want to do, and you know, millennials and generation Z sometimes getting bad knock, but they certainly are passionate. I think it was time. Magazine had an article and it talked about millenniums that says their self centered, there this, there, this, all these negative things, and they said and they just might chase save the world because, yeah, you know, I mean because that. You know, that's the subtext. Is some of your other some of other pockets have talked about this a lot, but this is really sort of exposed some deep inequities that exist in healthcare delivery and far beyond right, I mean the disparate outcomes between the halves. And they have not even with the disease that you know should impact everybody on the biologic side, it doesn't. It doesn't. You know, pick or choose. But if you live in a multigenerational house, in a small space, if you are essential worker and you have to be on the subway, if you are, you know, if you are exposed in a million different other ways, if you have chronict medical conditions that are out of control because healthcare is complicated and expensive and you don't have health insurance, you know there's for all the reasons that you know, they don't need to be articulated here, but that are that need to be articulated. It has really increased our awareness around the inequity and, frankly, some of the racism that exists in the country and in the healthcare system anyway, and that you know, and you are right, we spend a lot of time with that, that the generation that is not going to take it anymore. You know, it is both. It is in is extraordinarily inspirational and refreshing, but sometimes it also is too much...

...to take on. You know, for those of us you're just trying to keep your lips above the water, you know, and they're doing the right thing and they're forcing you to recognize there's this other, deeper layer. We have to fix that too, and God bless them, you know, because they're tenacious and and they are forcing us to ask questions that are really hard and really really essential that we get right. We have a moment. I think we really have a moment. What we can pivot and we can say the words out loud and address out loud the importance of framing everything that we do in the country, in the world, but in healthcare delivery, through a lens of race and equity, you know, and we're trying to get there, but we're all then, we all see it the way we have been trained to see it and we have to learn new ways and we have to evolve and it is interesting, but you know. But yes, they are. Every time you work with the met student, you work with a resident and and they ask questions that you long ago stopped asking because you got blind to it. Yeah, yeah, you reminded you know that that and you know, and they're in every opportunity, right, if you see with fresh eyes, you get to see, you get to see it a new and you get to think about it critically. Yeah, well, and I love that you call that out, because it is a time for us to to challenge ourselves, because these things in the past we either had grown blind to or we had chosen not to or socially we you know, just we know we were allowed to make that's a great way to put it. Didn't know if we were allowed to. Yeah, yeah, and now we can, and that's the moment of opportunity that I think we have to seize, which is okay, we can talk about it, we can talk about that the racism is going on and we can talk about these things and we have to and we have to continue to push each other not to just crawl back into our whole or pretend it doesn't exist or say it'll all be okay. And, as you know, as we do move towards some level of whatever we call normalcy, back into our world and our times and our routine, we just have to remember not to we can't, we can't forget. We have to continue to get better. You know, it's not something will be fixed overnight, in my view, but we have to continue to get better and we have to continue to address it and try to be better. I agree with you, with you know, but I also I mean as as thinking over the last I guess it's been. It's been almost a year. Yeah, January twenty six were recording this and you know, we diagnosed our first case March one. Yeah, so you were almost of a year and certainly at this point actually, I think probably Washington state was already on fire. You're not on fire. There were wildfires last summer there last year too, but I actually meant very, very hot with covid but you know, sort of thinking about the people that were asking to sort of to take on this challenge. It does also change the way that you think about leading. You know, this idea that there is a command and control, top down structure, you're just going to follow orders, royal boy. That is that. You know, that is not what we found was effective over the last year. What was effective was a lot of authenticity, a lot of empathy, a lot of transparency, a lot of dialog around what it is like to be part of this team that is that is trying to get through this and so, you know, I mean those are the pieces that I will be forever grateful for. The you know, the late night, early morning, middle of the night conversations with colleagues where we sort of all recognize that our shared humanity, our shared humanity, is really the only way that we can get through this. We have to lean on each other and trust each other and and try to grow together, because otherwise it's just too lonely. and sort of thinking back to what he said about people dying alone, those are the images that will haunt people for years and years and years to come as they sort out how to manage their most dramatic stress from being a covid responder. Yeah, it's about watching people die alone. We Watch planning to die sadly, and it's always, it's usually a miserable thing. There are...

...times, you know, where it looks like peace, but there's a lot of times, especially in the learn's department most times, where it's miserable. This was different. Yeah, it's time to resurrect our humanity. Let's hope it still intact. And Yeah, yeah, there's a little bit of a left well show as we wrap up here. Hey, thank you very much for your time. I know it's a busy time for you. No shortage of work to be done, even in the midst of as we continue to battle through this thing. So thanks for peeling off a little bit of time to spend and share your stories with us and our listeners. I know they'll appreciate it very much as well, and thanks for your transparency and your heart, and thank you for everything you do as well, because you're a big part of it as well. I want to give a special thanks to Carlos Tom Abe, carly, Kevin and Don. Those are the names that you threw out as some of the unsung heroes as I was taking notes with and hopefully they'll listen in and know that we gave them a big shout out and you did too. You did, and thanks for doing that. As we end each show, I'd be remiss if I don't ask you, growing up or currently, who is your hero that, when you think back to it in your life, who was one of your big role models or heroes? You know, I want to deconstruct it a little bit. I know it's cheating, but I'll do it anyway. You know, top of mine, is top of mind, is a guy who trained me and fellowshit residency and fellowship, who was a trauma surgeon that University of Pennsylvania, who was a army reserve as she was killed in a rack when a war came over the wall on Christmas Day. Wow, you know. So this is a guy that ran into the fire and easily could, easily could have lived a very nice, you know, casual life and Philadelphia suburbs, working hard as a surgeon. I'm going to take away from that. Yeah, but instead put on a uniform and was ultimately killed. So it's hard enough think about him for his selflessness, but I have to balance with two other people. I went to a Jesuit University and Father Tim Brown has a set. He's a lawyer and priest and he just deeply believes injustice and equity and kindness at all times and I always think about how he would see the world. And then the last one is the is a solid rock, the steadiness that no one could ever ever match, which is the lovely woman at home that I call my life. She's extraordinary through all this. So sorry, I know I took a three, four, but you know now that's take. It's yeah, the selflessness. There is no right answer. It's your right. You got to own it and there's too many pieces. Yeah, no, and and that's it. You know, it doesn't have to be one person. There's a lot of people who influence us as we go through our lives and so lots of heroes. So that's that's great. I love you shared that with us. Again, thanks for your time, thanks for your candor and your heart, and we just continue to wish you best of luck and continue to fight the good fight and we hope to circle back with you in some time in the future and get some good updates and hear about how things are changing for the better. I look forward to those days very, very very much. Thanks, Dr Car thank you, sir. You've been listening to heroes of healthcare for more subscribe to the show in your favorite podcast player or visit us at heroes of healthcare podcastcom.

In-Stream Audio Search

NEW

Search across all episodes within this podcast

Episodes (40)