Air

“Oxygen”, he said pragmatically, with his usual soft tone. “I’m concerned that you aren’t getting enough.

Putting on the airplane oxygen mask was the first thing that came to mind. And with that, a mass dispense exercise I’d trained for in public health.

You’ve got to be able to work a bioterrorism disaster with your whole self at work, I was told that day at the anthrax response practice. So we will give you enough medicine for your entire household, and then you can be at work, present and not worried.

It was logical, conscientious and very direct. If the mission was to be as present for the public as possible, we had to put our own oxygen masks on first. And for true health, this meant ensuring our loved ones’ health. It’s easy to work for bosses who put their mission first, the public first, by putting personnel first. It had been hard to step away from the public health emergency management team to pursue broader system improvement goals, and this reason always stuck out.

“Air,” my doctor said again.

“When the air and oxygen you’re breathing in converts and gets to your heart, your heart may not be pumping it correctly. And it’ll affect your brain. I think that’s causing your anxiety, and you need to have an echo right away.”

I looked at our family doctor in June of 2013, yet had already decided that the year’s work-related details would go unmentioned. I felt saddened that he, like my parents, were unaware of the long-standing malevolence downtown. I also accepted that what he was saying might be true. My MVP, diagnosed around 2001, had never caused trouble before. Then again, I’d never been truly disrupted by work-related stress.

Tangent alert: I’d had great responsibilities prior to the downtown job. And, I’d only cried about a job for work-related reasons once. I was tearful, outside of the office, over inappropriate responsibilities assigned to a new role at a non-profit. The job had left the triaging of specialty medical referrals to a nurse, and the nurse was tasked with seeking ‘donated’ charitable medical visits. Often, paper referrals went outstanding for months. While well-intentioned, this setup required confrontation to short-term versus long-term capabilities. So I confronted it. After pulling the papers out of drawers and electronically cataloging the need, we were then able to speak to an advisory board about policy development for a triage system. And, we were able to have conversations about honest verbiage to members of the public who had signed up. Mostly, this was shedding light on wait times and expectations. We were able to do this because the non-profit truly did want to do what was right and what was most impactful. I left that job because, fundamentally, I believed I was meant to help shape systems beyond charitable ‘donation’ of a medical visit. The stress of community member despair, with nowhere to go for their care while we waited for a physician to ‘donate’ time, was exacerbated when ER routing discouragement was tracked. Knowing that industry had archaically allowed this patchwork left me equally, calmly fierce. The experience left me with lasting knowledge, ever-present ideas, and assurance that speaking up is right. And, the experience left me with kind colleagues who did not resent.

Prolonged resentment from another at work was always foreign until after that job. My mind was brought back to the present and I looked at my doctor.

Perhaps this was something more than mitral valve, perhaps he’s right, and this was the beginning of a worsening heart condition. After all my cardiac unit experience at the ever-incredible, lovely Elmhurst hospital, it would be unwise to write this off.

My doctor said his goodbyes with an emphasis not to wait on the echocardiogram. Then, he mentioned his long-standing, half-joke half-truth recommendation: consider golf.

Air. I took deep, deep breaths and went home. What if it was entering my heart and the timing was just off? What if my heart wasn’t placing it correctly?

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“FMLA.”

I couldn’t believe what I heard, and so I didn’t.

“What?”, I asked. “My doctor told me I need an echo and it cannot wait. It’s one appointment and so I’m asking for a day off.”

My downtown boss looked at me with real anger, and we both knew why. Over the course of a week, they had seen their illicit privilege in my personal life take a downturn. My parents brought me to the ED thinking I was having an anxiety attack. And, I hadn’t told work about my ED visit, nor the reason the ED referred me to my PCP. So I was particularly interested in her response.?

“Why would I need FMLA?” I asked.

“Because if it’s such an urgent issue and if it’s so important, you go to our doctors. You see our doctors and if it’s an emergency, you go to our emergency room.”

Noted. Wasn’t living next to one of their brothers in the apartment setup enough? I wondered silently.

I mentioned I’d take it up with an HR representative not involved in the past year, and I did. And wouldn’t you know? I was able to take PTO to have an echo done in the suburbs, where familiar cardiology teams awaited. I loved Midwest Heart so much anyway.?

The experience was the opposite to the kindness of the nonprofit and the conscientiousness logic of my preparedness manager.?

As one would guess, the issue wasn't related to my MVP. My heart is healthy and true.

Once again though, the experience brought ideas. Aside from the fact that malevolence was disrespectful to my loved ones, there was an obvious need to help employers ensure one’s oxygen mask is set.?

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Navigating the Family and Medical Leave Act is regulatory. Navigating an individual’s need for their oxygen mask is splashed with color. It requires consideration for the household beyond human resource law. We do this informally, with occupational scheduling flexibility for caregiving. We do this formally with PTO.

We don’t actively improve this oxygen mask situation for our world, though. And our hearts may be at risk. Who else takes up more space in those chambers than our loved ones, even if we’ve temporarily displaced emotions or dealt with poor timing?

People deserve to ensure that their parents, siblings, partners, children and loved ones' health has been addressed.

Some work-places love to share a storied modernism of their interpretation of employee wellbeing: open spaces, fun places and, nowadays, work from anywhere concepts. The traditional hold-outs point to maternity leave and good insurance benefits for dependents. Most of these concepts have true impact yet, just like a valve or pump issue, may be missing out on a lot of good stuff.

True change requires a broader confrontation to healthcare system improvement, on behalf of our loved ones. It’s what we want for them anyway: good health and happiness.??

So the issue is a health issue. Beyond productivity and focus, employees cannot work nor have optimal health if their loved ones’ health is unaddressed.

It is not complicated, nor do health system changes need to be.

In order to administer the best public health, and best private healthcare possible, we need to ensure that people put on their own oxygen masks first. Whether an individual works remotely in their home or whether they are deployed overseas, we ensure that their loves ones' health has been addressed.

Picking and choosing battles is important when improving healthcare. Yet there are many improvements that, when initiated, cross multiple health sectors. We can and should give this long-term strategy our best. Let's not miss out on the good stuff.

Influencing a culture change with the oxygen masks is like other health behavior change: it requires truth about current practices and convictions, presenting the science, presenting alternative and better options, actively improving one’s own scientific processes and repeated messaging. It also requires acceptance and planning preparedness for industries with temporary inertia.??

Let’s start with the truths, and go from there:?

Truth: The people we work with and the people who work for us deserve to ensure that their parents, siblings, children, partners and other loved ones receive necessary healthcare. Even if it requires their presence. We do not always ensure this, we are capable of improving, and we should improve.

Truth: A best way to ensure this oxygen mask strategy is to ensure access to healthcare, by improving healthcare.

Truth: The heart beats in its own way, and our loved ones reside there, and we need to ensure that the air we’ve inspired gets placed where it belongs.

Let’s bring the best gameplan to action with attention to all the players, not just any MVP.

See you on the field.