Transformational Times, April 3, 2020

Transformational Times

Words of Hope, Character & Resilience from our Virtual Community

Friday, April 3, 2020

In this Issue:

Director's Corner by Adina Kalet, MD, MPH: We Can't Wait!
Perspective from Cassie Ferguson, MD: COVID-19 and Grief
Perspective from Chris Davis, MD, MPH: Building Trust with Underserved Communities
Reflections: Our Changing Connections with those Outside Medicine
Take 3 from Joyce Sanchez, MD, Infectious Disease
Announcements, Resources, Ways You Can Help

Director's Corner

Medical Educational Scholarship: We Can't Afford to Wait!

by Adina Kalet, MD, MPH

Medical education scholarship is more important than ever. At first glance, this may seem paradoxical. We are facing an overwhelming and deadly situation. Shouldn’t we just put our heads down, save lives, do what we can, and minimize the distractions that education adds to our daily work of caring for patients? This isn’t the time for thinking, research, and dialogue about education, right? Wrong! This is exactly the time we should be focusing on both responding to immediate needs and planning for a desirable but uncertain future.

From the Front Line

Caring for COVID-19 Patients

Emergency Department Respiratory Care Tent

Froedtert Hospital, Milwaukee

Perspective

COVID-19 and Grief

by Cassie Ferguson, MD

This week I came across a Facebook post written by a friend from junior high school. She shared an article published in the Harvard Business Review featuring an interview with David Kessler, a bioethicist and well-known expert on grief, loss, death, and dying. In the interview, Kessler confirmed that the conditions are right for people to be grieving. "We feel the world has changed," he says, "and it has. We know this is temporary, but it doesn’t feel that way, and we realize things will be different."

Perspective

Building Trust with the Underserved Community in a Time of Pandemic

by Chris Davis, MD, MPH

COVID-19, like so many other diseases, strikes communities of color disproportionately. As of April 1, most of Milwaukee’s COVID-19 cases and deaths have been in the African American community. Here’s a frightening, real-life illustration: On February 29, 2020, about 200 friends and relatives attended the funeral of Andrew Jerome Mitchell, a retired janitor, in the small, rural, poor, underserved community of Albany, Georgia. It was one of two funerals held at the same chapel over the course of a few days.

Submit a Reflection for Next Week

"Well, currently my only interaction with non-medical folk is the great battle for the last package of toilet paper at Metro Market. However, I have noticed that even as a first-year medical student people in my family are turning to me a source of authority about this pandemic. I still know little about actual medicine, but I have been able to translate the risks of COVID-19 to my family and urge them to take all precautions to avoid outside contact. Medical students have the ability to interpret the messages from the frontlines and educate the masses to stay safe."

Anonymous , MCW-Milwaukee Student

"When I came into a room or answered a phone my grandfather would greet me like this: "Samanthaaaa" in a crescendo-decrescendo song.

When I was a child I would sit close to my grandfather at the brown piano he would tell me, "I want you to be a doctor," and he would teach me how to form my fingers to create songs. We sat close there.

When I come into a room or answer a phone my grandfather now greats me like this: "DOC-TOR" with each syllable like dropping a weight. I sit next to strangers and they say, "You're the doctor."

My teachers gave me the weight of knowledge to bear. My hands forget the songs learned. And I bear the weight of my name apart from those I know."

Anonymous, MCW-Milwaukee Resident

"So often when I catch up with friends who live miles away and who are all leading different lives, I am acutely aware of the separation between us and the variety of our interests. These days, however, our conversations are built upon the collective feelings of anxiety, loneliness, and fear. Now, we are all living through a common experience and ironically it feels like even with more isolation, my interpersonal bonds and connections with friends have become deeper and stronger."

Jess Sachs, MCW-Milwaukee Medical Student

"Many of my friends and family members not in medicine have reached out to me over email and social media in an effort to support and thank me and my ED colleagues for our courage. The world is sharing cartoons of physicians in superhero capes and stories of my colleagues' tireless efforts to keep their patients alive. While it is incredible to feel that support, it has been very humbling as well. How do explain that between shifts I feel powerless and worry almost obsessively that I am not doing enough? That when I am at work I wish desperately to be at home? That my anxiety about what is to come often eclipses my motivation to be productive? How do I explain that I don't feel brave?"

Cassie Ferguson, MD, Pediatric Emergency Medicine

"I've noticed that everyone I encounter is much friendlier now - strangers walking their dogs on the sidewalk across the street make a point to wave and say hello, and shoppers at the grocery store are quick to smile as they yield a wide berth. I think this shared experience has reminded us that no matter who we are, where we come from, what we do for a living, the color of our skin or what religion we follow - we're all united in this together. It's been the silver lining to this very dark cloud we're living under."

Julia Schmitt, Kern Institute

Share a reflection for our next issue:

Next Week's Prompt

From the Front Line

Three Questions for

Joyce Sanchez, MD

Infectious Disease

1. What moment made you realize that COVID-19 was unlike a routine outbreak?

"This was a slow realization. Like watching an accident unfold in slow motion. Given my travel medicine practice, I began following the situation when reports described a cluster of people diagnosed with a mysterious viral pneumonia in Wuhan at the end of December. Every week thereafter, things appeared more severe and closer to home. On March 7 ^th , we made the incredibly hard decision to cancel our medical trip to Kenya, less than one week before our departure. That was the day I stopped denying this was going to hit our community in a drastic way."

2. What has surprised you?

"This virus has infiltrated every aspect of my life. It is the first thing I think about when I wake up, and the last thing I think about when I go to sleep. It has put the usual day-to-day tasks of my life on hold. No, that’s not right. It has turned the previous structure of my days completely upside-down. It has worked its way into nearly every conversation with family, friends, patients, colleagues and trainees. It has squeezed its way into every project that I am involved with. It has taken over my Twitter and Facebook news feeds. It has caused my screen time to double. It has kept my family members from returning to the United States. It has forced the hospital system that I am proud to serve to its knees."

3. How has COVID-19 impacted you?

"It has encouraged me to become more transparent with the limitations of my expertise. It has made me more honest with those around me about my anxieties of where we will be left when this chapter is over. It has made me practice what I preach when I say “wash your hands.” It has given me motivation to empower those around me to pursue new ideas, develop innovative solutions, and embrace creativity to cope with this new normal. It has accelerated the speed of scientific inquiry, information dissemination, collaboration, and discovery. It has caused me to re-evaluate what is truly important in my life. It has given me new purpose. It has validated my choice of medicine as a vocation and infectious disease as a career. It has made me see more good and humanity in people. It emboldens me to share my story because just as we are all affected, we are all connected."

Clinician to family member:

"This means that we need to accept that she will die, and that we need to take her off the ventilator. I wish things were different."

by Jennifer Senior, New York Times, 3/29/20

The Psychological Trauma That Awaits Our Doctors and Nurses: Don’t Underestimate the Moral Anguish of Deciding Who Gets a Ventilator

Full NYT Article

Student Telehealth Program

MCW Central Wisconsin and MCW School of Pharmacy are currently piloting an interprofessional student telehealth program to address the healthcare needs in our communities. Learn more below.

Telehealth Pilot Program

MCW Students Compete in

COVID-19 Design Challenge

MCW students Kelli Cole , Gopika SenthilKumar and Taylor Williams teamed up with UWM architecture student Chelsea Wait in the Johns Hopkins COVID-19 Design Challenge this past week. Watch their innovative presentation below.

Their goal was to design a solution to reduce the number of patients with non-emergent COVID-19-like symptoms that present to hospitals and EDs. The team is working to move forward with their idea in the Milwaukee community, and welcomes all feedback, advice and resources.