Of the roller coaster of emotions that has marked the past few weeks, personally and for the nation, one talk at TEDMED tied them all together for me, with the theme of our interdependence and how much we can accomplish if we work together.
I’d like to share with you several seemingly unrelated events, with a commonality that crystallized for me at TEDMED.
Preface: For me, this chapter started a little earlier, with a late night call that my daughter had fallen and was in an Emergency Room several hours from where I live. Fortunately, a friend went with her, and then my brother and her housemates got her back home and carried her in…along with her x-rays, which she was able to transmit to me. I’m an Infectious Disease doc, yet even I recognized that her shattered ankle would need prompt surgery; the other may soon. The poor judgment of the ER to discharge someone with bilateral ankle fractures, who was unable to bear weight, to a handicapped-inaccessible house with no one to care for her was impressive. So much for ensuring a safe discharge plan, and looking at patient’s needs in a holistic context.
So my husband and I drove to the big city, he and her friends carried her down the stairs and laid her on a mattress in the back of our van, and we drove her to Cumberland. We had strong, generous friends who met us here to help unload her. With knowledge gleaned from my patients and practice, and my husband’s creativity, we were able to cobble up a hospital room in our living room, including a hoist, since she was totally non-weightbearing. Our daughter promptly had surgery by an excellent team at an independent surgicenter. It was a good experience and reminded me of the sense of community I used to have here—before a hospital merger destroyed that. (The old Memorial Hospital where I had my practice was a secular community hospital with a grassroots, non-hierarchical, collaborative feel. It merged with Sacred Heart some years ago, adopting an authoritarian, top-down management style, among other changes. There was considerable concern about the imposition of Catholic religious directives on care in the entire rural region. The merger divided the community and led to an exodus of physicians and nurses from the health system, myself included. Some of those disillusioned with the Western Maryland Health System have opened independent surgicenters, giving patients a welcome option for health care).
With great ambivalence, I then left home to fulfill my patient care commitment at a Pittsburgh area hospital, torn between maternal concern and professional obligations—an unresolved conflict for many working mothers.
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Another tragedy struck the week before TEDMED, when a close family friend died of Acute Lymphoblastic Leukemia. We’d known Troy Todd for almost 30 years, since he was a teen; he helped build our home and care for our young children. There was a tremendous outpouring of support in the community for Troy and his family, with several fundraisers; everyone loved him. At his funeral, the Pastor’s eulogy was “Can a UPS driver change the world?” The answer was resounding. One of Troy’s friends described him as “someone who just didn't do their job but actually cared about people. He remembered everyone's names, Remembered everything about our family, and never complained about delivering our heavy packages to the top floor. Troy was encouraging and infectious....you wanted to smile because he was smiling. He never missed a beat!” But the young Vicar recounted Troy’s most hopeful legacy. In this community of ~20,000, there were three bone marrow drives, and 278 people signed up in a bone marrow donor registry. While no match was ever found for Troy, his most fervent wish was that he would help find a donor to save someone else’s life.
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Fast forward to the shock of the Boston Marathon bombings with the juxtaposition of the horror of the carnage in our midst and the heroism and generosity of bystanders, other runners, and first responders. Stories continue to emerge of acts of kindness and courage, as well as the remarkable skill of the medical and surgical teams at the Boston hospitals.* That there have been no further deaths is astonishing.
And from that, I had a sudden rapid immersion in the whirlwind of thought provoking, glitzy talks at TEDMED. I liked the conference much more than last year—and will have more to say about specific sessions shortly. But one of the last sessions brought it full circle for me. Brazen Eli Beer spoke of the successes of the Israeli emergency response system, United Hatzalah (Rescue). This is a volunteer response network that has an impressive response time of only 3 minutes—and now has a goal of reducing that by half, to just 90 seconds. The volunteer medics (all EMTs, paramedics, MDs) are equipped with ambucycles —specially equipped motorcycles—rather than relying on ambulances. The cycles are fast, maneuverable, and well-equipped with emergency medical equipment, enabling EMTs to arrive and initiate emergency care well before the average of 12-15 minutes for an ambulance. With perhaps typical modesty, Beer notes describes his “lifesaving flash mob:” “Our response is the fastest in the world. We call our approach a lifesaving flash mob. On motorcycles, traffic doesn’t stop us. Nothing does.”
The underlying technology enabling the efficient, rapid response was also quite impressive. Using cell phone GPS, dispatchers are able to send alerts out specifically to the 5 closest EMTs to an accident—and can even identify specific volunteers with the requisite level of expertise to send. They treated more than 200,000 people last year; 42,000 had life-threatening conditions.
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The response to the Boston Marathon bombing, on an individual and community level, brought out the best in our country.
When I see the broader political response of fear-mongering, hate-filled anti-immigrant rhetoric, I am sickened. It is the same with calls to dispense with the Constitution and civil liberties under the guise of enhancing “security.” And even more so with Congress and the draconian cuts to Head Start, aid for seniors, and safety net programs, at the same time displaying corporate greed and self-righteous arrogance and entitlement like some kind of macho mating ritual.
There was another stark reminder of this contrast in values yesterday, described in Ezra Klein’s Wonkblog post. He recounts a highly successful program, Health Quality Partners (HQP), that “has reduced hospitalizations by 33 percent and cut Medicare costs by 22 percent.” At the same time, seniors are cared for and visited weekly by a nurse, providing medical care and human contact with an old-fashioned caregiver. This is not sexy, high tech care. It is care with a capital C and a human touch. It works, it helps the poor and elderly—and so it will likely lose its funding.
In addition to its emergency services, United Hatzalah provides a similar service for seniors as does HQP. Theirs is a small pilot program, Ten Kavod (The Twilight of Heroes), which provides weekly visits to the elderly to monitor their health and well-being.
United Hatzalah reaches across barriers of race, religion, and income—both among their volunteers and the people they serve. They are attempting to broaden use their model—including to Brazil and India.
Community building. Connections. Collaboration.
That was the message of Troy’s life…and of Boston’s resilience. That was the message of United Hatzalah. And that was a major theme at this year’s TEDMED.
Thanks to Heather Stone and Suzanne Todd for permission to tell their stories.
Thanks to the Boston Globe for their superb coverage of the Boston Marathon bombing and aftermath.
Roller coaster: Lee Haywood/Flickr
Eli Beer: courtesy Sandy Huffaker/ TEDMED
LifeCompass screenshot: courtesy NowForce
"Molecules to Medicine" banner Michelle Banks