Joel Fishbain, M.D.
What do you do? Medical Director of Infection Prevention and Epidemiology at Beaumont Hospital, Grosse Pointe.
How has Covid-19 affected your work day? COVID-19 has pretty much doubled and tripled my patient care load, my administrative load and prevented any significant time off. I am not the only one and I was fortunate to get two days off in March. The pulmonary critical team has worked nonstop for more than seven weeks.
Do you have an inspiring experience? Not one story, many. Of how the nursing care team, respiratory care team and other care providers have come together with the most optimistic and positive attitudes in the face of sick, dying patients at their own risk. Stories of the patients who are appreciative every day despite the simple fact this is not like a simple bacterial infection where the correct antibiotic works, period. I also find it inspiring how patients can gasp for breath and yet not panic or be rude despite their own fear. Have you ever been short of breath? For days on end? It is very scary. I am humbled and amazed by how so many have graciously maintained their composure.
What has this taught you? What have I learned in a few sentences......that social media is a blessing and curse and that inaccurate information takes a human toll. That we have decided to turn real world diseases into political theater where decisions being made are not necessarily based on actual fact or science. This crosses all party lines. I have also learned that society largely prefers rapid fire responses when despite the existence of some of the best medical science ever, actual application of medical science still takes time. I have learned that the best people will pull together in a crisis and do what needs to be done and will do so not only exceedingly well but also with incredible competence, perseverance and compassion. I have learned of the incredible resilience of the human spirit and the amazing tolerance of the suffering of a loved one, in the face of no real, expected means of recovery. I have learned I have much to offer my patients, and at the same time very little. Lastly, I have learned to cherish and appreciate my free time a little more.
Robert G. Riney
What do you do? President, Healthcare Operations & Chief Operating Officer of Henry Ford Health System.
How has the Covid-19 pandemic affected your work day? With the onset of COVID 19 my days quickly turned into 16 hour days 7 days per week. Managing that coplextity with a combination of zoom, webex, skype, phone and every other mechanism out there. We had to go into crisis incident command mode and prioritize on serving our patients, providing a safe environment for our employees, and excelerating innovation around how care is delivered.
Do you have any inspiring stories that you’d like to share? This crisis reaffirmed how blessed I am to work with truly mission focused colleagues. The particular heroism that impacted me the most was the role that our nurses and physicians had to play of being the communicator between critically ill patients and their loved ones during this time when no visitors could be allowed. Specifically, learning of team members that held hands, sang, provided spiritual support and anything else that comforted a patient as they passed away, will be something that I will never forget. On a brighter side, I am awed by seeing the joy in the eyes of our caregivers every time they wheel a patient that has been discharged after successfully battling COVID 19, out of the hospital to recover at home. It speaks volumes to me about their character.
What has this taught you? In times of crisis, when much is expected of you, focus on what is needed most, on what you can control and/or significantly influence. Put aside all other issues and revisit them when you reach stability.
Thomas G. Graves, M.D.
What do you do? I am a family physician, a medical doctor, who treats patients of all ages. In my opinion, family doctors need to focus not only on physical issues-but rather-giving attention to their mind, body and spirit. I have worked for Bay Area Family Physicians in New Baltimore, MI since 1987. Our mission is to treat each patient as if they were a member of our family.
How has the Covid-19 pandemic affected your work day? It has been the greatest change in my daily routine in 33 years of being a doctor. People are quarantined and don’t want to risk leaving home, so we shifted many patient visits to “telemedicine” where we conduct a medical visit via a video screen. This is better than no visit at all, but it is so different - and lacks so much of the interaction which normally transpires between a family doctor and a patient. In addition, people are very frightened now. I receive many (many) more calls, emails, texts and Facebook messages asking for advice (and comfort).
Do you have any inspiring stories that you’d like to share? This pandemic has made one thing perfectly clear in my mind: people are so good - they are kind, generous and compassionate. Early on, our medical staff could not get masks. It was frightening for our medical assistants, lab personnel and X-ray technicians.
Our lack of PPE (Personal Protective Equipment) was made known in the community - and the response from people reminded me of the end of the movie, “It’s a Wonderful Life.” Patients, friends (even people we didn’t know) came to our office donating masks and even hand sanitizer, gowns, and gloves. Some had only one to spare and others said they “had a box in the garage” and donated them all.
Then several people started sewing masks - hundreds of them! And donating them first to our staff, and later to patients who had none.
My daughter Sarah lives in Cincinnati - but she found out the Atwater Brewing Company was making hand sanitizer. She ordered 2 gallons for us! Later, our friend Tricia Kesteloot did the same thing - donating Atwater hand sanitizer to doctors’ offices in need.
Even emotionally, people were kind and generous. We have received so many “thank you” emails, cards and texts for continuing to serve patients in the pandemic - it has been absolutely heart warming to see the goodness of people.
What has this challenging experience taught you? Two things! One, it is better to do “something” than nothing at all. A group of men in our Catholic Men’s Fellowship wanted to help in some way - but didn’t know what they could do to be a blessing in the pandemic. They made the decided to pray - every day at 3 PM - in front of St. John Hospital (which we have done for over a month now).
The first day there were two of us, some days as many as 20 (properly socially distanced, we would walk in front of the Hospital as a group and pray for the patients, staff, and all hospital workers at St. john and the whole world). So many nurses, doctors and other staff have stopped to thank us - telling us the comfort they have received having people praying for them and their patients.
One patient, Autumn, told us that when she was in the emergency room - the nurses there comforted her by telling her, “Don’t worry, there is a group of people outside the hospital right now praying for you.” Autumn said, “I knew when they told me that, I was going to be OK.” And praise God, she was - she was released that day and Autumn said her fever broke, and all her shortness of breath were gone. Every day, people honk their horns and wave to us - and that is so encouraging - but t we had NO idea that the hospital staff would share our prayers as a source of comfort for patients. That is amazing!
The second thing I learned was to pray expectantly. We begged God to heal Autumn and begged Him to let her know He did it. Every day, people sends intentions for prayer - many for Covid infected people….or for the families of people who died from Covid. Others for people who have addictions, anxiety, or depression. We have learned to expect that God will do something great.
And even though everyone we prayed for was not dramatically healed - we learned that our prayers had a soothing effect on the patients and their families. Sometimes you do something “good” and you may never find out that it helped others. In this case, our group has received many confirmations from nurses, staff, doctors, and patients that they could feel our prayers….and they were grateful.
Kevin J. Grady, M.D.
What Do You Do? President/CEO of Ascension St. John Hospital and Ascension River District Hospital. We are part of Ascension. Ascension Michigan has 16 hospitals state-wide. I am a pulmonary intensivist by training and have been on the Medical Staff at Ascension St. John for 35 years. Prior to becoming President/ CEO in August 2019, I was the Chief Medical Officer at Ascension St. John for 5 years. I had an active clinical practice up until the time I became President. My partners allow me to take weekend calls still.
How has the Covid-19 pandemic affected your work day? During the COVID-19 pandemic, it is quite easy to say that nothing in my usual daily life was the same. With so many sick individuals in our hospital, of which some lost their lives, sadness permeated our daily life. It was important that we communicated to our associates and caregivers that we did in fact save lives. We let our associates know that people with COVID were discharged home after getting well from the care we delivered as a team. As a hospital President, my job is to make sure high-level quality care is delivered every day and that the safety of all of our associates and all of our patients is maintained. As a Catholic health care institution, it is very critical that the poor, vulnerable and under-served are never forgotten. I have always been a very active clinical President and have been visible on the floors routinely. During COVID-19, I felt it is critical that my visibility on the floors to our associates/caregiver be even greater. I was able to walk the floors of the hospital daily, say thank you to the associates for being there, asked to make sure they had adequate personal protective equipment, and deliver food and gift cards to the associates. The community was so generous providing these opportunities for our associates.
The most obvious administrative change with COVID-19 was the lack of any in-person meetings. I have not been in the room with more than several people in the past 8 weeks. Out of necessity, many of us have become much better users of virtual meetings. Going forward, for efficiency, I do hope the trend of virtual meetings continues.
COVID-19 was a very rapidly changing clinical scenario. The treatment of the disease, the volume of cases and the severity of cases were ever-changing. Because of that, we had to be much more nimble in our clinical decision making and care delivery. Decisions had to be made very quickly to cohort units for care of the patients, treatment protocols and order sets needed to be initiated quickly and there was very active work hourly to ensure that all of our caregivers had the appropriate personal protective equipment. Hospitals became institutions that took care of mostly emergent cases. All elective activities ceased for the protection of our patients and our associates. We are unable to allow unlimited visitors in our institution because of COVID-19. We had to limit visitors in many situations. Additional teams needed to be set up to support those who were sick and dying. An expanded bereavement team was established at our institution to help comfort our patients and caregivers.
Do you have any inspiring stories that you’d like to share? I could write about this question forever. The number of inspiring stories that have come out of COVID-19 are breathtaking. At the top of the list is the unbelievable job that our associates and caregivers have done during this very difficult time. Not only did our caregivers do a marvelous job delivering care to our patients, they were in a major part the "beacon of hope" that we were going to get through this pandemic together as a team. There is not a single associate at our institution that I could not add to the list of individuals that went above and beyond during this pandemic. Thanks to the strength of Ascension Michigan, we are able to maintain all of our associates during this difficult time. Associates took on new jobs, in new locations to help support the clinicians who were caring for our sick patients with COVID-19.
Another amazing story has been the generous support that our communities have offered the hospitals and our associates. The communities surrounding our hospitals supported us with thank you notes and signs, food, personal protective equipment and financial support. Because of Ascension Michigan and thanks to the generous support from the community, we were able to develop a strong Associate Hardship Fund to help support our associates during this difficult time. One of the most enjoyable events that I will have going forward is providing thank you notes to the hundreds of individuals who donated support to our hospitals.
What has this taught you? From the very beginning of COVID-19, we thought that it was important that Ascension Michigan do 3 things. Develop a plan, do not panic, and maintain a smile. Ascension Michigan developed an incident command model weeks prior to the surge that we ultimately saw with COVID-19. The incident command model included national/state/hospital support. The teams had built-in backup to account for any illness and/or fatigue related to what we thought was going to be a long process. Each team had expert level support and was very nimble in their decision-making process. COVID-19 was an ever-changing process therefore we needed to respond to it at an equal degree of speed. As this disease volume/severity was new to healthcare, we needed to develop a care model that was also new to us. Both the federal and state government allowed us the flexibility to develop a care model that would deliver high-quality effective care to our patients during this pandemic. As previously mentioned, this was a team sport and individuals took on new jobs and responsibilities. The flexibility of using clinicians who were usually in the ambulatory status and put them in the inpatient setting, allowed us the extra-support and backup for our usual inpatient clinicians. I think it is critical to take COVID-19 and learn from it. In the future, I am quite confident that we will be better prepared if and when another similar health care crisis hits us within Ascension/within the nation.
