Are We Tone Deaf?

I emergently took the Red Eye at midnight this past Wednesday from LA to Boston. I was trying to get to Philly as soon as possible, but an episode of Planes, Trains, and Automobiles caused the noon arrival on Thursday. My Dad was in the ICU with severe septic shock, and the medicine is interesting, but not my point with this piece.

I have two takeaways from this experience thus far, and only three full days in, I can comment on my rapid thought process and interpretation of this experience. Keeping in mind my dad’s condition and his ongoing battle couldn't be further away from being about me, I have some takeaways for three sets of people.??Those who work in ANY company, those who work in Healthcare, or those who have family members who could be sick at any time. I'm sure you meet one of these categories, so please read on.

We often see, hear, and are influenced by the thought process of our family is more important than anything, especially your work. I recently saw a meme on social media reminding employees that they are replaceable, and work will quickly move on. Spend time with family because they care about you, work does not. Family can be defined in many ways, those that are blood-related, those you marry into, or those people you call your family even though they are not technically related. In a leadership video piece, Simon Sinek reminds us that at work we should strive to operate like the military where they have “brothers and sisters”.??He proceeds to qualify this statement that fighting like “Cats and Dogs” at work or in a close-knit company can be helpful and productive but once an outsider goes after my brother or sister, you must “get through me first.” Firing brothers or sisters can be quite difficult, so leaders can choose to not have a family or sibling philosophy in the workplace, but ultimately every high-performing organization I have ever been a part of is relatable to this idea. I received a phone call yesterday from a previous “brother”. Hadn't spoken in a hot minute, the occasional text back and forth, we picked up where we left off and we would go to battle for each other without a doubt. I subscribe to Simon’s theory.

From the moment I got my Stepmom’s phone call communicating that my dad was wildly hypotensive and the pressors had been started, our whole work team jumped into action. I had never seen anything like it. One colleague looked at my calendar and handled the redistribution of my meetings for the next two days, one googled flights, one made a report so our new VP of Ops could present on time to our hospital partners, one handled a crucial and difficult conversation and one said, “ Let me change my plans, so I can be there for you like you have been there for me”.

I was anxious getting on that six-hour, 3000-mile flight, nervous about my dad, nervous to fly, and mildly hypoglycemic as I couldn’t eat anything all day, My colleagues continued to check in through text and Teams ensuring they could support us any way possible. My CEO even refereed to my dad, who is called Daddy or Barry Clyde, if we disagree, as “Pops” which is what he calls his dad. I smirked and felt like they all had a connection to Barry C.

If you require me to comment on Family v. work, I will emphatically tell you I’d leave work to assist or spend time with my family, but I don’t know if you ever must choose.??Great leaders can balance priorities in a way that is meaningful and fulfilling to them while driving results for their organizations. I have learned that effort in my support, tone, words, honesty, caring deeply, and radical candor towards my work brothers and sisters, has built trust and forged strong relationships. Relationships that withstand trying times at work or in our personal lives. Relationships dependent on communication and a team effort, where we rally to pick each other up and straighten crowns, with nothing to be owed in return. The way I speak to them and the way I value them, reflects my true feelings about them as humans. Work colleagues or otherwise, respect, integrity, and decency are always afforded to them. They paid this back in spades over the past few days, I can't thank them enough.

Fast forward to full day 1 in the ICU, the RN, a force not to be reckoned with, was abrupt but knew her stuff.??She was proactive and the kind of patient advocate you would want by your side while ill. I wouldn’t say polite but respectful, not calm but calculated, and not overly sweet but effective. Spoke in appropriate medical terminology as she knew I’d understand and scolded me for cycling a BP by myself as she wanted to be in the loop on all of them, fair.

The Infectious Disease doctor, on the other hand, needed some skills. The lack of introduction, complete disregard for my presence, tone, and chosen words infuriated me. I immediately assumed she was a resident which was an unfair generalization to all residents, and when brought to my attention that she was the Attending Physician, elevated my already high BP. I tried to engage with her, unknown name, and she informed me she “only dealt with antibiotics”.??Totally fine if my dad “only had an infection”. I immediately felt a lack of confidence and increased concern about my perception of my dad’s worsening condition. I began looking through my connections to seek out connected medical professionals in Pennsylvania and looking up the current hospital's statistics.??It didn’t feel good, it didn’t feel the best.

He was cold, warm blankets are one of the finest accommodations hospitals can offer. Due to having to doff my gown from precautions, I surveyed the hall from the door hoping to solicit a passerby who could grab a toasty treat for Barry C. After 10 or so minutes and recognizing that the staff was busy dealing with a few acutely ill guests, I asked a roaming tech if I could just pop over to the blankies and grab one for my dad. “You are not allowed to do that” she stated curtly. As she continued down the hall, I was extremely unclear if she would return with a cotton surprise. Appropriate closed-looped communication in times of stress or when all is good is always the goal. About an hour later I asked the Unit Admin, and she motioned over to a heated locker 5 feet from the Nurse's desk and told me to grab one. Was that so hard? Was the rule I could, or I couldn’t get one? What would I do next time?

Conversely this morning upon arrival the rules had changed, scratch that the rules were now being enforced, and in-room visitors were being limited. Yesterday, not limited, today limited.??The RN stated the reason, explained how cooperation made it better, and that if she broke the rules for our family, other families would be at a disadvantage. We completely understood, thanked her, and revamped our visiting strategy.?

Soon after the Intensivist came by. Introduced himself and his PA. included me in the conversation and asked my opinion (even if it was a let’s talk, but I already decided scenario). I immediately felt confident in his abilities, and that the treatment course was appropriate. It felt good, it felt the best. Five-star review on Yelp 10/10. He was upbeat and realistic, we created a plan that worked for everyone, and my dad cracked a joke for the first time in a while.

I have one sister and two bonus sisters through my dad’s remarriage. The group text was full of support and requests for clarifying information. His sisters, my cousins, my friends, family of friends, and my mother, all were respectful and pulling for recovery. I thank them greatly. The tone and thought paid about selected words were akin to the IFT provider holding the hand of the 90-year-old dialysis patient. You do what you can do when you can. You go out of your way as much as possible to help those you care about personally or professionally.?

As my dad continues to receive many medications and has a long road ahead of him, I couldn’t help but think of the family, friends, colleagues, and healthcare provider communication over the last 72 hours. The mostly good sprinkled with the infuriating bad. The kindness of the many was almost out shadowed by the lack of emotional intelligence of the few.

What can we learn as EMSers, as Healthcare Providers, and as humans? Tone and attitude, affective characteristics, play a large part in family member perception in medical cases. The comfort provided by kindness and respect, even while receiving hard-to-hear news, is crucial to what happens next. Which comes first the chicken or the egg? In my case, the chicken. My perception is that all was fine until the hospital staff chose to initiate, react, or respond in a less-than-appropriate way. Was it me, the egg? My statements or questions were polite and appropriate, could I have done anything differently? Nope. I’m not ordering a hamburger at a fast-food joint here. Although I enjoy great customer service, you get what you pay for. I’m at a prestigious teaching hospital in a city with 17 private schools, Villanova, and 24 Starbucks. A little professional courtesy, scratch that, a little grace could go a long way.??

Next time you are treating a patient or talking to a colleague or supporting a friend, resort back to kindergarten. Treat those as you would like to be treated, the golden rule. Use your family member as your filter. Would you be ok with your family member being treated, talked to, or transported in the manner that your patient is experiencing? If the answer is YES, give me a shout, I’d like to work with you.

Goodwill, like respect and trust, is won by many acts and lost by one.