Pediatrics Flyer

The official newsletter of the Department of Pediatrics
July 2020 | Issue 11
SPOTLIGHT
Jeff Schunk, MD
Professor of Pediatrics
Division of Pediatric Emergency Medicine
Associate Chief Medical Officer, Primary Children's Hospital

In 1979, upon deciding to go to medical school in lieu of graduate school in Mathematics, a friend asked me why I was not going into Mathematics. I explained that though the idea of teaching Mathematics was very appealing, I was not stoked to have my career characterized by constant ties to a university, pressure to research, and endless participation in administrative and committee activities. In that moment, I inadvertently coined the phrase “the anti-prescient.” There are other examples that would solidify my reputation as an anti-prescient, such as my first visit to Park City in 1979 (“This town is dead and going nowhere”), and a 1989 visit to Moab (“Can’t see this town taking off” and “Mountain biking is hard, no one is coming here to do this, it’s too out of the way…”).
 
I immigrated to Utah for residency where I was nurtured by the 30-40 faculty within the Department of Pediatrics, working mostly at PCH with supportive faculty like Tom Metcalf, Joel Thompson, George Veasy, Bill Nixon, Dick O’Brien, Linda Book, Bob Christiansen and John Bohnsack, whom we dubbed ‘the encyclopedia’ – back when there were encyclopedias. In my intern year, I remember being shaken by the deterioration of a young child with ITP due to an acute intracranial hemorrhage. Katy Welkie [PCH CEO] recently reminded me that was her patient – the great circle of life. But it was two new faculty that drew me to Pediatric Emergency Medicine – [Bob] Bolte and [Howard] Corneli (forever alphabetical and for years paired like Loggins and Messina, Seals and Crofts, Hall and Oates, Sonny and Cher…). It was during my third year that I hold myself personally responsible for selling the program to a young resident applicant named [Bruce] Herman, a seemingly inconsequential moment whose repercussions would be felt for decades, like wing flaps of a butterfly in a distant, distant land. Sylvia and I married, and after a chief residency year with obligatory participation in interviews with young faculty candidates like [Mike] Dean and [Don] Vernon, we left Utah, with me off to Children’s Hospital of Los Angeles for PEM fellowship. We returned after my fellowship, and I lifted the PEM faculty to 5 in 1989, at a time when an attending charting consisted of the phrase “seen and agree.” Another one for my prediction infamy: “Don’t worry, we’ll just stay for 3 years.”
 
Emergency Medicine was a section under the Division of General Pediatrics, and when we hired our first set of triplets ([Nan] Dudley, [Doug] Nelson and [Ron] Furnival) things were off and running. One of the early fellows I had the pleasure or working with was a Californian named [Howard] Kadish. We submitted what would become an oft overlooked, but seminal paper on Basilar Skull Fractures. Since the results questioned common practice, one reviewer, standing at the corner of Dogma and Data, stated that he “questioned the veracity of the results.” First thing first; we looked up the definition of veracity.
 
Fast forward to a fateful 2017 encounter with Katy Welkie where she offered me the opportunity to serve as hospital CMO for “a few months, just until the new chairman arrives,” an offer that gave Katy a junior membership in the anti-prescient club.
 
Now, after an over 30-year journey in one house, with 2 boys grown, a ‘new’ hospital (1991), a hospital name change, an ambulatory building, the creation of a translation service, a stint on the Library Committee, Chairman of the Medical Records Committee, and runs as PEM Fellowship Director, Division Chief for Pediatric Emergency Medicine, and Medical Director of the Pediatric Specialties Clinical Program, with an ED rollout of a tracking board, an EHR rollout system wide, unmitigated attacks by H1N1 and now COVID-19, and the opportunity to work with physician leaders including the likes of Jill [Sweney], Gitte [Larsen], Madolin [Witte], David [Chaulk], Irene [Kocolas], Chris [Miller], Con Yee [Ling], Joyce [Soprano], Angelo [Giardino] and Dougs [Barnhart and Nelson], allow me to reflect by sharing comments from others:
 
Just remember,
 
“Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not.”
 
And though
 
“The years teach much which the days never know.”
 
And
 
“Experience is simply the name we give our mistakes.”
 
Still
 
“A man who carries a cat by the tail learns something he can learn in no other way.”
 
And frankly sometimes
 
“We make s#$& up.”
 
Remember,
 
“It is a mine field out there.”
 
But,
 
“A person’s a person, no matter how small.”
 
Thanks, and apologies to Seuss, Emerson, Wilde, Twain, Kadish, Bolte, and Seuss (again).

– Jeff Schunk
HELLO! MY NAME IS...
Yukiko Asaki, MD
Assistant Professor of Pediatrics
Pediatric Cardiology

  1. What's your preferred name? Yukiko Asaki, or Yuki for short. Yukiko’s actually my middle name—my first name is Sarah, which folks might see on paperwork here and there, but no one calls me that. Yuki means “snow” in Japanese.
  2. When did you join the Department of Pediatrics? September 2017
  3. What is/are your role(s) in the department? I primarily practice in pediatric electrophysiology, with some cardiology consult service. Most of my time is split between the EP lab doing ablations or implanting pacemakers/ICDs, in clinic, EP consult call and ECG/Holter/stress test interpretation, or research. I also serve as the unofficial millennial representative to the cardiology division and try to explain how Instagram and Snapchat are different.
  4. What's your favorite part of your job? I work with the best team, both in my little EP group as well as the larger cardiology division. Cardiologists can sometimes be a group of…let’s say *strong* personalities, and I genuinely enjoy working with everyone here. I love what I do and I’m very lucky to be able to do it. My favorite ablations are for WPW, because they’re fun to map and it’s very satisfying to see a delta wave go away in a single heartbeat and feel like you’ve changed the patient’s risk for sudden cardiac death. And not to brag, but my patients are the best!
  5. Do you have any pets? I have a weird little dog named Fionn. I’m half Irish, and I named him after Fionn mac Cumhaill (Finn McCool), the most fearsome Irish mythological warrior. But it turns out he’s a scaredy dog, so it’s more of an ironic name, like calling a big guy “Tiny.” He’s a rescue, so I don’t know his breed, but he’s black and white and looks like a border collie.
  6. Do you collect anything? I’m not a big collector. I’m more of a KonMari enthusiast. My parents think I have no sentimentality because I don’t keep every movie ticket stub or whatever for a scrapbook. But I will say I keep books that I’ve read that have had an impact on me!
  7. What are your hobbies and/or talents? I used to think I could sing, but now I mostly just sing at the top of my lungs in my car with the windows up. I’m not sure if it’s a hobby, but I’m into fitness and I enjoy boxing, strength training, and riding my Peloton bike. I like to ski in the winter, though I’d never skied before I moved to Utah and sometimes I feel like a baby giraffe. I’m also a bit of a news junkie and every day I’ll read several articles from the NY Times and the Washington Post, and listen to NPR.
  8. What is your favorite motto or quote? The Summer Day by Mary Oliver
  9. What’s your favorite band, musical artist, or music genre? Just ask any of the cath lab nurses—Beyonce! 
  10. What’s your favorite book or movie? I love to read, so I have a long list of favorite books. Probably at the top would be The God of Small Things by Arundhati Roy and Go Tell It On The Mountain by James Baldwin. My favorite movie, which I’ve seen approximately 8,000 times and can quote most of by heart, is The Princess Bride!
  11. What are you currently reading, watching, or listening to? My mom recently sent me a book called No Man’s Land by Wendy Moore. It tells the story of the Endell Street Military Hospital in London from 1915-1919 in which all the doctors and nurses were women, which was virtually unheard of at the time. They cared for thousands of wounded WWI vets and influenza patients. And the two founding doctors (one physician, one surgeon) still found time to work as suffragettes and fight for women’s right to vote!
  12. Who or what inspires you? I am very inspired by people who are guided by their principles and work to effect positive change. That’s a long list of well-known people and personal friends. I admire the courage it takes to stand by your convictions in the face of systemic injustice and a whole chorus of folks trying to maintain the status quo.
  13. What is your favorite way to decompress after work/on the weekends? I like to cook while I listen to Pod Save America or Pod Save the World, usually with a glass of wine in hand. Zoom happy hours with my siblings or friends from med school or training have replaced the in-person kind!
  14. If you could snap your fingers and become an expert in one thing, what would it be? Something sporty?
  15. What’s the most interesting or weirdest job you’ve ever had? Hard to choose! I’ve had some weird gigs. I remember working as a summer intern in a basic science immunology lab at Johns Hopkins when I was in college. It was mostly bench research with cell culture and molecular biology stuff. One day we helped with a large project in another lab that involved anaphylaxis following bee envenomation. We cut off the tips of 10 cc syringes and glued some wire mesh to the cut end, and then put a bee in the syringe, placed the mesh end on the subject’s arm, and slowly depressed the plunger until the bee got mad enough to sting the subject. Then we sat around and recorded their vital signs and watched for them to develop signs of anaphylaxis. I remember one of the subjects was trying to flirt with me and I kept wishing he’d just go into anaphylactic shock already, but alas, he did not.
  16. What is your guilty pleasure? None! I refuse to feel guilt about what brings me pleasure! Why should I feel bad just because you think it’s silly to dance to 90s R&B music videos in my living room?
  17. What's the most daring thing you've ever done? Last year, I took a week long sea kayaking tour around some of the islands off the Dalmatian coast of Croatia. I went by myself and met up with three other women. I’m not sure it’s that daring, because we had a guide, but I was pretty nervous as to whether I’d be able to keep up, but it went great! And I got to see one of the most stunning, unspoiled parts of the world.
  18. What is something that might surprise us about you? In seventh grade, I won a Halloween costume contest dressed as a dolphin caught in a tuna net (a big issue at the time). Perhaps that’s not actually surprising to people who know me.
Debbie Sandt
Nurse Practitioner
Pediatric Nephrology

  1. When did you join the Department of Pediatrics? 2003
  2. What's your favorite part of your job? The people. My co-workers are like family. Because of the chronic nature of most of the kidney conditions we follow, we get to know the patients and families over the course of their childhood and adolescence. I love watching them grow up through all the stages.  
  3. Do you have any pets? I have a big white Labradoodle named Lulu Belle. She’s a sweetheart. 8 years old and very energetic!
  4. Do you collect anything? I guess you could say I collect garden plants. Too many to count. 
  5. What are your hobbies and/or talents? I love to read, cook and bake. Gardening is my real passion and is what has kept me sane and happy during this pandemic. My garden is at its best this summer because I don’t have anything else to do (other than painting, staining, remodeling my kitchen, etc)!
  6. What’s your favorite band, musical artist, or music genre? I love many different artists and genres. In a “normal” summer, I would be volunteering at a couple Red Butte Concerts per week. I love Adele and David Gray. My absolute favorite who I have seen twice at RBG is Jackson Browne.
  7. What’s your favorite book or movie? I read a lot. Two favorites are Jane Eyre by Charlotte Bronte and Angle of Repose by Wallace Stegner.
  8. What are you currently reading, watching, or listening to? Just finished a wonderful book, “Where the Crawdads Sing”. Just finished binge watching Homeland. I listen to the David Gray Pandora station A LOT!
  9. Who or what inspires you? My daughter amazes and inspires me.
  10. What is your favorite way to decompress after work/on the weekends? Gardening, walking Lulu Belle.
  11. If you could snap your fingers and become an expert in one thing, what would it be? Knitting
  12. What’s the most interesting or weirdest job you’ve ever had? Most interesting is this one! Weirdest was probably doing home nursing shift work, taking care of babies in peoples’ homes when the parents were sleeping at night.
  13. What is something you learned recently? This is embarrassing, but using a drill. I’ve always had my dad or my daughter to do it for me and I stupidly never learned from them.
  14. If you could share a meal with any three well-known individuals, who would they be? Melissa McCarthy because she is so funny and so real, Barack Obama and Michelle Obama
  15. What do you consider your superpower? My co-workers would probably say baking. I would say gardening and raising my daughter. 
  16. What is your guilty pleasure? Binge watching British crime dramas.
  17. What’s something you saw recently that made you smile? One of my amazing 10-year-old patients who knew all of his meds and they weren’t easy ones.
  18. What's the most daring thing you've ever done? I went hang gliding on the sand dunes in Mexico. Ask me about the outcome!
  19. What is something that might surprise us about you? I was pretty wild in my teen years. Hey, it was the 60s!
GREETINGS & FAREWELLS
Welcome to the Team!
To see the new faculty and staff who joined us in June, click here .
Thanks for the Memories!
Two of our colleagues retired:
Jerald King, MD - Professor of Pediatrics, Division of Neonatology
Mary Ann Rackham - Administrative Assistant, Division of Inpatient Medicine
ACCOMPLISHMENTS
Trevor Slater - Ambulatory Operations Director : Completed his Master of Healthcare Administration (MHA) degree through the David Eccles School of Business at the University of Utah. Congratulations, Trevor, on all your hard work!
Congratulations to our faculty who were promoted and awarded tenure this year!
Award of Tenure
Candice D. Fike, MD
Wendy Hobson-Rohrer, MD, MPH

Promotion to Associate Professor & Award of Tenure
Brooks Keeshin, MD

Promotion to Professor
T. Charles Casper, PhD
C. Con Yost, MD
Karin Dent, MS
Mark Fluchel, MD
Joe Sherbotie, MD
Promotion to Associate Professor
Scott Clements, MD
Camille Fung, MD
Jennifer Goldman-Luthy, MD, MRP
Beth Knackstedt, MD
Irene Kocolas, MD, MS
Vandana Raman, MD, MBBS
Jeff Robison, MD
Jacob Robson, MD
Julie Shakib, DO, MPH
Dongngan Truong, MD
ANNOUNCEMENTS
New Emergency Medicine Fellows
The Division of Pediatric Emergency Medicine would like to welcome their new fellows!
Dominique Chevalier
PEM Fellow
University of Utah
Theresa Tran
PEM Fellow
Children's Hospital Los Angeles
Natalie Tedford
PEM Global Health Fellow
University of Wisconsin-Madison
IN THE NEWS
Eric Coon, MD (Inpatient Medicine) and team determined that scheduled follow-up visits for children hospitalized with  bronchiolitis  may not be an absolutely necessary practice. The investigators conducted a randomized, controlled Bronchiolitis Follow-up Intervention Trial (BeneFIT) involving 304 children hospitalized for bronchiolitis at both Primary Children's Hospital, as well as the Lucile Packard Children’s Hospital in Palo Alto, CA. Read more here . 

Dr. Paul Carbone discusses the need to improve quality and reduce disparity in primary care autism screening. The study included 36,223 toddlers who came in for check-ups at 18 and 24 months in 20 Utah clinics. Read more here.
SCHOLARLY ACTIVITY
Research News from the Division of Emergency Medicine
After 3 months working from home, the Pediatric Emergency Medicine coordinators have returned to the ED to enroll in their research studies. We are excited to be back and be able to contribute to the national focus on improving health outcomes in children.

In addition, as a member of the Pediatric Emergency Care Applied Research Network, the pediatric emergency medicine research team is happy to receive word that we will be funded in an international study called PRoMPT BOLUS (PRagMatic Pediatric Trial of Balanced vs. nOrmal Saily FlUid in Sepsis). This study is a clinical trial to compare two commonly used treatments for pediatric sepsis to see if one is more effective and safer than the other. The treatments in this study are two different intravenous fluids: normal saline and lactated Ringer’s. This study will involve FDA approved exception from informed consent or EFIC.
Recognize Someone for a Job Well Done!
The department has a new online tool you can use to show appreciation for other members of Pediatrics and recognize them for exemplifying the PROMISE behavior standards: People Centered, Respect, Ownership, Making a Difference, Innovation, Safety, and Excellence.

Recognitions will be published in an upcoming issue of the newsletter. Please note: if a submitter's name is not given, we will not publish the comment.  However, the submitter's name will remain anonymous in the newsletter.
 
The link to the recognition form can be found on the department intranet home page, or click the box below.
This Month's Recognition
Lindsay Browning, Lucia Blasko, Ashly Medlyn – Eccles Admin Team
Recognized for Excellence
" In a time when things seem unknown, the Eccles Admin Team has come together. Lindsay Browning, Lucia Blasko and Ashly Medlyn have each asked "What can I do to help?" and "Does anyone need anything?" during a time when we are down a person on our team. Each of them has stepped into assist where needed. I'm privileged to work with each of them and am so thankful to be on their team. Sometimes during a pandemic, you can see great things! Being on the Eccles Admin Team is the silver lining during COVID-19.
DEPARTMENT CHAIR'S SUGGESTION BOX
Dr. Giardino wants to hear from you!
If you have any ideas or concerns you'd like to share with Dr. Giardino, please submit your comments to his suggestion box. The link can be found on the department intranet home page in the "Contact Us" tile, or send a suggestion now by clicking box below.
WELLNESS
In a recent article in Harvard Business Review , Richard G. Tedeschi, a professor of psychology emeritus at the University of North Carolina at Charlotte, discusses how to facilitate growth – both personally and as an organization – after times of stress or crisis. Below are a few excerpts.
Growth After Trauma
What good can come of this? In times of stress, crisis, or trauma, people often ask that question. This year we've been hit by a pandemic that has caused hundreds of thousands of deaths, unprecedented unemployment, and a global economic downturn. In the face of such a tragedy – personal and collective – it might appear that the answer is "Nothing." However, at some point we will be able to reflect on the long-term consequences of this terrible time and what it has wrought for each of us as individuals and for our organizations, communities, and nations. Almost certainly those outcomes will include some good along with the bad. Over the past 25 years, psychologists have been studying this phenomenon. We refer to it as posttraumatic growth.

We've learned that negative experiences can spur positive change, including a recognition of personal strength, the exploration of new possibilities, improved relationships, and a greater appreciation for life. So despite the misery resulting from the coronavirus outbreak, many of us can expect to develop in beneficial ways in its aftermath. You can emerge stronger yourself. And you can serve as what we call an expert companion for others, encouraging introspection and curiosity, actively listening, and offering compassionate feedback.
Posttraumatic growth can be facilitated in five ways:

Education: To move through trauma to growth, one must first get educated about what the former is: a disruption of core belief systems. For example, before the pandemic, many of us thought we were safe from the types of diseases that endangered people in the past; that bad things happened in other parts of the world, but not ours; and that our social and economic systems were resilient enough to weather all storms. None of that was true. So now we need to figure out what to believe instead. When our assumptions are challenged, we are forced to rethink who we are, what kind of people surround us, what world we live in, and what future we will have. It can be extremely painful. But as research shows, it can also usher in change that will be of value. We must begin by learning and understanding that truth.

Emotional regulation: To do any learning, one must be in the right frame of mind. Instead of focusing on losses, failures, uncertainties, and worst-case scenarios, try to recall successes, consider best-case possibilities, reflect on your own or your organization's resources and preparation, and think reasonably about what you–personally and as a group–can do. You can regulate emotions directly by observing them as they are experienced. Physical exercise and meditative practices such as breathing also help. Employ these techniques yourself and share them to help others. Acknowledge that circumstances continue to be both challenging and frightening; then demonstrate poise under that pressure. And encourage more-frequent communication so that people feel less isolated and see their collective emotional strength more clearly.

Disclosure: This is the part of the process in which you talk about what has happened and is happening: its effects–both small and broad, short- and long-term, personal and professional, individual and organizational–and what you are struggling with in its wake. Articulating these things helps us to make sense of the trauma and turn debilitating thoughts into more-productive reflections.
Narrative development: When you're ready, start to shape the narrative of this year's trauma for yourself and your organization. How has it caused you to recalibrate your priorities? What new paths or opportunities have emerged from it?  As we move through the current health and economic crisis, consider how you can reinforce–to yourself and others–the recognition that it may have a positive as well as a negative impact. Remember that you and others in your team and organization can reimagine how you operate and innovate in new circumstances. That may already be evident in the emergency measures taken to keep things going. 

Service: People do better in the aftermath of trauma if they find work that benefits others – helping people close to them or their broader community. Focusing on how you can help provide relief during the continuing crisis – whether by sewing masks or producing content, stocking shelves or retraining teammates, supporting small businesses or agreeing to a temporary pay cut – can lead to growth. So can simply expressing gratitude and showing compassion and empathy to others.

To read the full article, including the benefits posttraumatic growth affords to both individuals and organizations, click here: Growth After Trauma