Transformational Times
Words of Hope, Character & Resilience from our Virtual Community
Friday, April 10, 2020
In this Issue:

  1. Director's Corner by Adina Kalet, MD: Practical Wisdom in Action
  2. Perspective from Fabrice Jotterand, PhD: Seizing the Moment 
  3. Perspective from Mary Homan, DrPH: It's Not About the Vent
  4. Reflections: What Do You See From Where You Are Right Now?
  5. Take 3 from Michael Stadler, MD, Interim Chief Medical Officer, FH
  6. Announcements | Resources | Ways You Can Help
Director's Corner
Practical Wisdom in Action
by Adina Kalet, MD, MPH

This past Sunday, Fred* became acutely disoriented, physically agitated, and distressed, likely as a consequence of another antibiotic-resistant urinary tract infection. Over the course of his 89 years, Fred has been an accomplished novelist, creator of children’s books, a Korean War veteran, a rabid baseball fan, and a chocaholic. The past couple of years, though, have brought changes for Fred and his wife, Josephine; as his memory faded, they have been increasingly confined to their apartment. That said, they have continued to enjoy their time together, often sharing good food, classic movies, and reruns of old baseball games.
 
Their apartment is just a few blocks from the public hospital, his medical home. Fred is smitten with his brilliant and caring geriatrician, Dr. Lee. Under normal circumstances, when he gets sick, Fred and Josephine would call her, and she would meet them in the emergency room for lab tests, antibiotics, and a liter or two of IV fluids. A visiting nurse would stop by the apartment a couple of days later to provide an assessment and collect a urine sample.
 
But these are not normal times and Fred lives in New York City. 
Our Heros
Photos from the Front Line
Emergency Department, Froedtert Hospital
Perspective
Seizing the Moment: Medicine’s Social Contract and the COVID-19 Pandemic
by Fabrice Jotterand, PhD


People reveal their true selves during crises, and the reactions to the COVID-19 pandemic are no exception. In the last few weeks, first responders, nurses, health care workers, and physicians have stepped up to the plate to provide care and comfort to the tsunami of patients. Not only have these individuals demonstrated their professionalism, but they have displayed altruism, courage, and humility. These efforts, though, might not be enough to deal with the magnitude of the challenge, and the worst is likely ahead of us. Alas! Following the adage “better to light a candle than curse the darkness,” it is worth offering a glimmer of hope in these moments.
Perspective
It's Not About the Vent: Reflections on Resource Allocation in a Time of Crisis
by Mary Homan, DrPH


 F or those who remember Oprah on daytime television, she often surprised her audience members with a set of car keys under their chairs and pointed at individual attendees and shouted, “You get a car! And you get a car! Everybody gets a car!” Right now, there is a meme going around with a picture of Oprah yelling, “You get a vent, you get a vent! Everybody gets a vent!” Although it is a humorous – albeit macabre – sentiment, the actual concern over who will receive (and remain on) a ventilator differs depending on how you perceive equity in the health care system.
"Right now, I can see my bare feet, propped up on a pillow on my sunlit patio. My little world seems so beautiful right now that it belies the fact that my colleagues in other cities are fighting something that I don’t want to acknowledge. Social distancing means leaving early and spending more time with my husband. How can nurses and doctors have lost their lives when I am sipping a beer and watching the birds at my feeder? How can I be lucky enough to have a mask to wear every day and colleagues to support me when people are getting their pay cut and getting disciplined for using PPE? From where I sit, I see guilt and privilege. I want to see hope, but it feels too early for that."

Allison McLellan, MD, Resident-Pediatircs


"I see triumph and tragedy. In triumph, the international healthcare community has come together to provide the best patient care, and at the same time, protect one another and procure novel solutions to local problems like workforce and resource shortages. Despite 70,000 deaths worldwide, dying, per se, is not the tragedy. The tragedy is dying alone and in a personally unacceptable manner. Fortunately, triumph and tragedy converge on opportunity. I hope the exercise in physical distancing will stoke and sustain a collective yearning for human connection, innovation and care planning - resulting in dying alone and in a personally unacceptable manner to dwindle into a fleeting memory."
 

Jay Patel, MD, Faculty-Pulmonary Medicine


"I have a window in my new work-from-home location. I am looking out on the bay. Every hour a ship comes in or goes out from the Port of Milwaukee. Everything is calm, as long as I don't open another browser tab and check the news. Or check in on my sister who is treating COVID-19 patients in Detroit. Or worry about my mom who is delivering mail, or my dad and husband who are laid off and directionless. Or my dziadziu who wishes we would come for Easter. Or my colleagues who try to shield their fear from their patients. Last night I dreamt myself back in the cafeteria at work. My favorite chef and barista were still employed. Life was returning to normal. I hope my dream will come true."

Kelsey Porada, Staff - Pediatrics


"I feel like I am in a state of uncertainty. I am expected to act like everything is the same even though the future is unknown. While I know there are many students who feel the same way, I don't think that all faculty understand the anxiety, the stress, the fear for our families and friends, USMLE exams, that we have on top of the normal school work that we are just supposed to ignore. I find myself constantly worrying about something that I can't control. Conversations that go round and round. It has surprised me how easy it is to get into my own head when there is a lack of human contact."

Anonymous , Medical Student-Milwaukee


"From where I am, I can see how long it has been since I have been in isolation, and yet I cannot see the end. There is much uncertainty, and I miss my 'normal.' I also see the community coming together and contributing to the fight against this virus, understanding that we are all in this together, alone. I see that I can be scared, uncertain, and sad about my present and future, but also grateful that my family and friends are safe at the same time."


Megan Quamme, Medical Student-Milwaukee 


"My Saturday call is eerily quiet, as I make a bereavement call to the family of my first COVID 19 hospice patient. Caring for him has felt a bit like being a carpenter without my tool belt. It pings a bit when his niece is overwhelmed that I took the time to call, and thanks me for the care, as it really feels what we provided was miserably inadequate. I find solace in the amazing bond we have as care providers amongst our Palliative Care team, growing fiercer by the day as we try to navigate our new world. Safely doning our new PPE procedures together, strategizing communication together, finding humor and solace together, this fills me with hope we are ready for what is to come."

Wendy Peltier, MD, Faculty - Palliative Care
Share a reflection for our next issue:

From the Front Line
Three Questions for
Michael Stadler, MD, FACS
Otolaryngology & Communication Sciences
Interim Chief Medical Officer of the Froedtert Hospital and Medical College Physicians


1. What do you hope we all learn from this experience?

"Here are the three lessons I hope we learn: First, we need to embrace the importance of empathy . We are all trying our very best to do the right thing for our patients, staff, and health care teams; being empathetic for one another during this time is so important.

Next, I believe we are, indeed, “Better Together,” and we need each other. Whether or not there is a crisis, we need one another and are better for it.

Finally, I know we CAN do things differently and better in our current healthcare system. No crisis should go to waste, and I hope we will better understand our ability to adapt, execute, and thrive in areas of innovation and in new care delivery models."

2. Where is this process taking you?  

"This process has required our institutional leaders to quickly respond, adapt, decide, and communicate on a variety of issues that – prior to this situation – were nearly unimaginable. To say this has been a unique situation is an understatement. Our colleagues and staff are suffering through these very dynamic and anxiety-provoking times in a variety of ways and we need to be responsive to them all, with evidence-based and logical decisions that balance all of the competing factors.

I want to help make the lives of our patients and our healthcare workers better. I am committed to this and work every day to represent these values. This process has solidified my desire to continue to do so far into the future, beyond this challenging chapter in our lives."

3. What has surprised you most?   

"I am constantly impressed by our ability to respond to this crisis. While I have never questioned the fact that we have tremendous, dedicated people within our organization, their commitment to always doing the right thing despite the magnitude of change we have seen in just over a month has been truly inspiring. I am more proud than ever to be part of the Froedtert + MCW family."
In the Time of the Pandemic
by Catherine M. O’Meara



And the people stayed home.

And they read books, and listened, and rested, and exercised, and made art, and played games, and learned new ways of being, and were still.

And they listened more deeply. Some meditated, some prayed, some danced. Some met their shadows. And the people began to think differently.

And the people healed.

And, in the absence of people living in ignorant, dangerous, mindless, and heartless ways, the earth began to heal.

And when the danger passed, and the people joined together again, they grieved their losses, and made new choices, and dreamed new images, and created new ways to live and heal the earth fully, as they had been healed.


The Daily Round, Author's Blog  

"I’ve been shocked sometimes when I walk in and see the patients. Most of the ones I’ve intubated are young — 30s, 40s, 50s. These are people who walked into the ER because they were coughing a day or two ago...[and now] they are in severe respiratory distress." 


by Cory Deburghgraeve, MD
Anesthesiologist, University of Illinois - Chicago
"You're Basically Right Next to the Nuclear Reactor"
The Washington Post , April 5, 2020
Kern Institute Coordinates Mask Assembly

The Kern Institute is coordinating an initiative to assemble and distribute face coverings throughout Metro Milwaukee. Rebel Converting, a local manufacturing firm provided nonwoven meltblown polypropylene fabric - the same material used in regular surgical masks - in kits to fashion the fabric into face coverings using rubber bands. 

Roughly 80,000 masks have been assembled by students, faculty and staff this week, and over 11,000 have been distributed to community clinics throughout the City of Milwaukee already.
Please contact Joan Weiss if you want to get involved.

Chris Davis (left) receives mask kits at MCW. Dean Kerschner (above) helps assemble masks at his home.
Write on our Virtual Gratitude Board!

As we navigate our new normal as an MCW Community, we wanted to make our MCW Gratitude Board available to everyone, virtually! Life is presenting a tremendous number of opportunities to practice gratitude right now. Whether you're grateful for the volunteers who are assembling masks for our community, or for the people leaving colorful chalk messages all over our medical campus, we are all working hard to be there for each other in ways that deserve to be acknowledged.

Click on link below and share what you're grateful for! We'll publish your responses in next week's Transformational Times so we can all enjoy the caring, compassion and generosity that's all around us.
Kern Cookies for Workers
at Froedtert, Children's
and VA Hospitals

What better way to show our appreciation for healthcare workers than a delivery of our famous Kern Institute cookies? We will be delivering cookies weekly to care units throughout Froedtert, Children's and the VA with character strength messages such as Hope, Bravery, Compassion, Leadership, Kindness, Teamwork, Empathy, and Love. If you know of a care unit that would appreciate a delivery, please contact Julia Schmitt to schedule.
Be a Hero - Donate Blood!
The Transformational Times publishes weekly, delivering stories of hope, character and resilience to our virtual community.
Bruce Campbell, MD, Editor-in-Chief
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