Transformational Times
Stories of Hope, Community, Character & Resilience
Friday, March 20, 2020
Welcome to the Kern Institute's Transformational Times
by Adina Kalet, MD, MPH
Director, Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin

As our leaders focus on the immediate and evolving challenges of the COVID-19 pandemic, the Kern Institute can provide a place to discuss and reflect on the transformative learning opportunities these difficult times offer.

While we have little control over this rapidly evolving situation, we can respond in community. Sometimes, the moments are dramatic, but more often they manifest as simple opportunities to express and appreciate courage, compassion, and accountability in small ways. 

In this spirit, we will deliver this weekly communication highlighting caring and character amid your full inbox of technical emails. Our aim is to support and celebrate caregivers, provide a forum, and examine the role of trainees as we explore uncharted territory together.

I invite you, and everyone in our community, to contribute your reflections as we navigate these times together. Let me start with my own reflection...

My Reflection of 9/11 in NYC
On the morning of September 11, 2001, I dropped my daughter with our babysitter and my son at his second grade class. The sun was shining and the air clear as I took the steps down to the New York City subway platform and headed to work at the medical school. When I emerged from the subway, I noticed people on the street, who normally would be rushing off to work, were congregating in small groups or staring at their phones. I passed a television and saw, for the first time, The Twin Towers, with gray smoke streaming from their midsections. The rest of that day was not a blur. Every minute was burned into my memory and still replays. Within twenty-four hours, I was on a team of physicians, all with prior group facilitation training, deployed to provide psychosocial support for the residents who waited anxiously for the surge of very sick patients that never materialized.

Right now, physicians, nurses, health care and public health administrators around the world are faced with dramatic surges of very ill patients, limited resources, and difficult ethical decisions. Others wait for the surge that will surely come. We are them. They are us.
"What I have learned
is that how we respond to
emergencies matters."
For this first issue, we've collected reflections from students, staff, residents and faculty on how the new restrictions have af fected them. I hope you'll find comfort and support in this weekly exchange of stories, as we celebrate caring and character during this pandemic.

Please consider sharing your thoughts by responding to next week's prompt below. Thank you, stay well and keep in touch. 
"In the CHW ED we are wearing CAPRs into our patient rooms. These look like bike helmets with large plastic face shields and there is a battery pack worn on your hip that powers the circulation of air through a HEPA filter. They make it difficult to hear and see. I worry about scaring my patients and about what this separation from our patients will mean moving forward. But then the other night, I was caring for a 2-year-old with croup. The PA was sitting at her bedside when she sat up and leaned over the bedrail. She tapped on his face shield and whispered, "I love you." And the fear melted."

Cassie Ferguson, MD
Pediatric Emergency Medicine
Pictured L-R: Kelli Coleman, MD; Cassie Ferguson, MD
"The classroom restriction has deeply affected me because being in class is the essence of who I am now and who I hope to be. Here, I absorb the knowledge and think critically about the material. Here, my PowerPoints become filled with red stars and highlights as I emphasize the symptoms and clinical pearls of diseases that I will one day be treating. Here, I sit and admire our professors' vast array of knowledge. It is an honor to learn from and interact with them, and I hope one day students may view me in the same light."

Jess Sachs
MCW-Milwaukee Medical Student
"I communicate via touch. A hand on the shoulder, a shoulder bump, a high-five; these are my social currency. My favorite transporter and I drop non-essential work to hug each other whenever possible. Today, it’s different. We consider fist-bumping too much touch. We settle for a foot tap instead. He tells me, “You’ve got this, queen.” This day, in particular, may be the least queen-like I’ve ever felt, unless queens thrive on social distancing and telemedicine. I suppose, on further reflection, that the queens of old used it to avoid lice and typhoid; I’ll use it to protect my patients."

Allison McLellan
Resident, Pediatrics
"Since school's out, I attended the party of my life. My siblings – ages 7, 9, and 13 – spared no effort in turning this self-quarantine into Party Town, USA. Population: our household. Replete with an invitation, menu, and schedule, the evening kicked off with a three-course meal. We were then ushered down to the basement where they had spent hours setting up a karaoke station (YouTube music videos), yoga corner (YouTube yoga instructor), “dance floor,” pool table, and board games. A whirlwind 90 minutes of Basement Fun brought us back upstairs to a piano and violin concert in the living room."

Donglin Zhang
MCW-Milwaukee Medical Student
"Pink Noise. I didn’t know that pink noise was even a thing until I moved into my new office just about two years ago now. My office is surrounded by touch-down spaces, open cubicles, more offices, and plenty of space for foot traffic, all often filled by voices, keyboard clicks, and commotion. The pink noise is pumped into the space as a buffer against the endless possible disruptions from all the bustle. But not today. Today, as I sit at my desk peering out into the larger office space, it all stands motionless and silent. Well, almost silent. All I hear is pink noise and it is deafening."

Kris Tym
Staff, Bioethics and Medical Humanities
"For four years, I've been dreaming of graduation day. Walking across the stage alongside my friends, being called Doctor for the first time, taking pictures with my family. Most importantly, taking the Oath in public, the voices of my classmates in unison with my own, publicly declaring our commitment to our patients. In the tough moments, I'd picture graduation. Med school is a largely thankless time, and I think we all were looking forward to having one moment that was just ours. Obviously in the grand scheme of life, this is not the most consequential thing going on right now--but it stings just the same."

Kim Tyler
MCW-Milwaukee Medical Student
Share a reflection for our next issue:
Three Questions for
Michael A. Kron, MD

Michael A. Kron, MD, MSc, FACP is Professor of Medicine in the Division of Infectious Diseases at MCW. In addition to his clinical practice, Dr. Kron maintains interests in Clinical Tropical Medicine through collaborations with institutions in Asia, Africa, and South America. He has been caring for patients during the outbreak.

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

"I don't understand this question.  What is a "routine" outbreak?? If anything, COVID reminds us of how lucky we are that EBOLA did not find its way to the USA more quickly, since the spread of COVID (same mechanism of spread as Ebola - both droplet) is clearly overwhelming resources even with only a 1-2% mortality rate."

Where are these events taking you?   

"Taking me? This afternoon these events will take me home earlier than usual to quarantine/isolation until my NP swab is tested."

What has surprised you?   

"Nothing about this surprises me. It just reinforces my preexisting suspicion that people don't practice normal hand/cold hygiene."

Life is about not knowing, having to change, taking the moment and making the best of it, without knowing what's going to happen next.
Delicious Ambiguity.”

― Gilda Radner
With the COVID-19 pandemic, we have a nation-wide shortage of blood and blood products. Your donation is urgently needed right now for our oncology, trauma, transplant, and chronically transfused patients.

The collection centers are practicing social distancing techniques and are attentive to current CDC safety guidelines. If you are looking to have a positive impact in our community and you are healthy, please schedule an appointment today! 
The Transformational Times will be published weekly, each Friday, during the worldwide COVID-19 pandemic - delivering stories of hope, community, caring and resilience to our Medical College of Wisconsin community and our Kern National Network for Caring and Character in Medicine.
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