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Transformational Times
Words of Hope, Character & Resilience from our Virtual Community
Friday, September 9, 2022
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Director's Corner
Perspective/Opinion
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Kelli Brown, BS, MPH: Meeting the Community Where They Are At
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M. Chris Decker, MD: The Humanity of Tragedy: A Brief Emergency Department Story of a Heroin Overdose
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John Hayes, DO: The Highs and Lows of Medication Assisted Treatment
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Bryan Johnston, MD: 6 Feet Away
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Joshua D. Noe, MD: Reimagining Opiate Training to Support Community Needs
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Tracy Zundel, MD: "We Can Do Better"
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Amy Farkas, MD, MS. and Michael Braun, PhD: Reflections on One Year of the KICS Medical Education Journal Club
Poetry Corner
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David Nelson, PhD: Street Life Communities
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Your Turn
Upcoming Events/Announcements
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Director's Corner
What "Bowery Bums" Taught Me About Being a Doctor
By Adina Kalet, MD, MPH
In this week’s Director’s Corner, Dr. Kalet explores how for her, as for many of us, proximity to people who struggle with addiction forged her into the physician and medical educator she became...
I was crossing the street at the corner of 29th and 3rd when he lunged, clumsily, toward me. “Please help me,” he slurred, his breath an indescribable combination of cheap alcohol and poor dental hygiene. “I need to dry out,” he added in a whisper, his bewhiskered face too close to mine.
As an experienced city girl, I instinctively stepped back but quickly deduced that despite his size, easily 100 pounds heavier than me, he was no threat. He was intoxicated but not agitated. He moved slowly. His eyes were at half-mast. Although I had a well-honed ability to ignore or avoid such people on the subway or sidewalk, my recent graduation from medical school presented a dilemma. Days away from starting my internship at the city’s largest public hospital, I had a brand-spanking new ID card in my pocket, which clearly labeled me as a physician. I was now obligated to respond to this person in need.
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Perspective/Opinion
Meeting the Community Where They Are At
By Kelli Brown, BS, MPH
Ms. Brown shares her experiences serving at the Benedict Center
Exiting off Highway 43 to the North side of Milwaukee, I become acutely aware of my surroundings - seeing garbage scattered in the median, a Cash for Gold store on the corner, and a sign that says, "We buy diabetic test strips," stuck in the ground at a stop light. There are buildings with graffiti, some with boards on the windows, and some empty lots overgrown with weeds. I am not in my hometown of Waukesha anymore.
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Perspective/Opinion
The Humanity of Tragedy: A Brief Emergency Department Story of a Heroin Overdose
By M. Chris Decker, MD
Dr. Decker shares his reflections on one of the most important experiences over his 23-year career as an Emergency Medicine Physician at a Level 1 Trauma Center.
I still get emotional as I write this.
We received a department-wide page that a 25-year-old male was coming in unresponsive. I was the faculty working on the blue team. He was going to be our patient. I, the second-year resident, and the medical student walked to the resuscitation area to prepare for his ambulance arrival with the rest of the care team. While setting up, we learned his mother found the patient in his room unresponsive and called 911. She told the Paramedics he was addicted to narcotics and was using IV drugs. When they arrived, they put an IV in him, a “King LT” airway, gave him a dose of Narcan and started transporting him to our emergency department.
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Perspective/Opinion
The Highs and Lows of Medication Assisted Treatment
By John Hayes, DO, Family and Addiction Medicine Physician
Addiction Medicine can be incredibly rewarding and tragically frustrating. Dr. Hayes provides insight into the opioid epidemic in this short essay by sharing one patient’s story.
“The medical examiner is calling for more information regarding your patient.”
Unfortunately, this incredibly soul-sucking message pops up every few months in my Epic inbox. I spend most of my clinical effort as a primary care addiction medicine physician trying to prevent these messages from showing up. It means another one of my patients has joined the over 109,000 Americans who have died from drug overdoses in the last 12 months.
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Perspective/Opinion
6 Feet Away
By Bryan Johnston, MD
Dr. Johnson shares his experiences with one family in his care.
A’s voice came in wobbly over the video feed. She told me, “I heard you were supposed to stay 6 feet away from everyone. I do not think I am ever 6 feet from someone else.” Her kids were sick of being stuck at home, sick of each other, sick even of their devices. She spoke to me on a brisk morning, bundled up on her front porch. Her kids asked every day when they could go back. They missed their friends, missed recess. They missed school food, and she could not believe how much they could eat. Every time she checked the cupboard, the cereal box was empty.
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Perspective/Opinion
Reimagining Opiate Training to Support Community Needs
By Joshua D. Noe, MD
Dr. Noe highlights the need for opiate training, its role in improving patient care and its future challenges.
Every two years in Wisconsin, physicians must undergo “opiate training” to maintain their licensure. The presence of quotation marks is not a grammatical error, as opiate training has come to mean different things over the years. What perhaps initially comes to mind is more mundane: learning to be cautious about prescribing opiate medication to minimize the risk of dependency. More recently, the medical community has started to embrace more proactive tools: online population health databases to minimize multiple prescribers for a single patient, the NARCAN® Direct program to get reversal agents in the hands of first- or early-responders, and safety programs that address storage and disposal.
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Perspective/Opinion
"We Can Do Better"
By Tracy Zundel, MD
Dr. Zundel shares his experiences with a team of residents serving the Milwaukee community.
I am out with two handfuls of resident physicians as their Associate Program Director, hitting the streets with food and supplies as part of an outreach program. As I look out of the van window, I see a great contrast. Young physicians with education, income, a bright future, and social safety are walking the streets as visitors to those who live here and, to understate vastly, need support. For most residents, this is a world they have never seen.
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Perspective/Opinion
Reflections on One Year of the KICS Medical Education Journal Club
By Amy Farkas, MD, MS and Michael Braun, PhD
Drs. Farkas and Braun share their reflections on the past year of the KICS Journal Club and look forward to year two…
One year ago, we launched the Kern Institute Collaboration for Scholarship (KICS) Medical Education Journal Club to foster a place where medical educators could come and discuss the latest, influential, and/or thought-provoking articles in medical education with the authors who wrote them. In our first year we invited 10 different authors to discuss their work with us and covered diverse topics from the Delphi method, professional identify formation, leadership training in GME, patient-centered EPAs, to visual arts-based education. After each session, we asked participants to share their thoughts about the event. Collected below are exemplar quotations about the value participants found from journal club.
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Street Life Communities
By David Nelson, PhD
Clean and sober.
Eyes alive rather than dull.
A bandage covers a vein after the removal of a needle.
This time not a heroin needle mark,
but one where medicine would begin the process of healing and recovery.
Not just one person but two, a couple.
While the team provided lunches, socks, and t-shirts,
the couple, together for over 15 years,
spoke openly about their challenges and their chance of surviving addiction.
They are still on the streets but have a resolve in their stance, looks, and speech.
Together means a greater likelihood of success
since nothing is more important than having someone in your corner
rooting for you and beside you when failure looms.
Both are on the right path toward recovery.
They are moving towards recovery by making housing, jobs, and normalcy steps.
Failed attempts to get clean litter the road to recovery.
See, the dealer will always be your friend when you have a few bucks.
The dealer might give you credit if they know you have some money coming in.
If not, others might ask, “hey, your party?”.
Another day, another hustle,
another potential lost at the end of the needle.
Heroin is a supply and demand industry.
It will keep coming because the social structure for support is broken and in disarray.
So many lost lives and potential to the end of the needle.
At last count, over 200 by name with this team.
First to last, the faces and the characters become blurred.
The team is not giving up hope.
It is the resolve to provide support,
perhaps to avoid number 201 and beyond.
Throughout the day, joy buoys the team with the possibility of recovery for this pair.
We pray for protection and healing – one day at a time for those of faith.
Clean and sober, day by day.
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Readers Respond to last week's reflection prompt:
What movie best represents your summer?
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Mrs. Harris Goes to Paris. A lovely story about a woman whose fierce devotion and advocacy for others reminds us that we make the world a better place when we act on our dreams.
– Greg Whitcomb, DC, Faculty
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Gone in 60 Seconds
– Marty Muntz, MD, Faculty
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Unbroken
– Amy Prunuske, PhD, Faculty
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For this week's reflection prompt, please answer the following question:
If you could travel anywhere to experience fall, where would you go and why?
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New England Journal of Medicine Invited Article
The Physician-Patient Relationship
Arthur Derse, MD, JD recently published an invited article on the physician-patient relationship.
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Attention US Medical Students:
Please Complete Survey on Remediation Practices
MCW Medical Students Madeline Ebert and Julia Bosco are working on a research project examining attitudes toward remediation practices amongst US medical students.
The first step in their project is to conduct a survey designed to assess students’ understanding of their institution’s remediation practices and how they feel about remediation in various contexts.
If you are a US Medical student, please consider taking a moment to fill out the survey below.
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Please Join Us!
KICS Journal Club with Dr. Sara Spinella
Register to join us at our monthly Kern Institute Collaboration for Scholarship Medical Education Journal Club! Each month, we discuss recent medical education scholarship with its author for a lively, intimate conversation about the transformation of medical education.
In September, Dr. Sara Spinella will be discussing her curriculum on the management of alcohol use disorder and the process of publishing curriculum in MedEd Portal.
Dr. Spinella is a physician at the Pittsburgh VA Medical Center where she specializes in the care of women with substance use disorders. She completed her Master's in Medical Education and GIM fellowship at the University of Pittsburgh.
September 14, 2022
12:15 - 1:00 pm CT
Live Via Zoom
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Please Join Us!
Kern Connection Cafe: Saturday Clinic for the Uninsured
Saturday Clinic for the Uninsured (SCU) is a primary care clinic run by medical and pharmacy students that offers free health services to the uninsured patients of Milwaukee. SCU strives to provide comprehensive, quality care that empowers patients to achieve their optimal health outcomes through the following initiatives: primary care both in-person and virtually, specialty care access, social determinants of health screening and assistance, clinical continuity, and various committee efforts that contribute to patient care.
Join the Kern Institute and SCU to find out about this longstanding MCW community partnership, followed by information on becoming involved and a Q&A session with current SCU members.
September 27, 2022
12:00 - 1:00 pm CT
Live Via Zoom
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The Transition to Residency Symposium
Night-onCall, co-founded by Dr. Sondra Zabar and Dr. Adina Kalet, is an immersive, clinically- authentic simulation experience for near-graduating medical students that provides the student, and the medical school, with comprehensive, debriefed feedback on readiness from multiple perspectives. Please join the NOC Symposium for a virtual interactive discussion on communication and clinical competency during the transition to residency.
During this Symposium, you will have an opportunity to:
- Hear from Dr. Holly Humphrey, the President of the Macy Foundation, on how consortia like Night-onCall contribute to the future of medical education
- Learn about the impact of simulation from medical schools that have implemented Night-onCall
- Understand how using data-rich feedback for learners can help your curriculum and learners' transition into residency
October 28, 2022
10:00 - 2:00 pm CT
Live Via Zoom
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The Transformational Times publishes weekly, delivering stories of hope, character and resilience to our virtual community. | |
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Jeff Fritz, PhD, Editor-in-Chief
Editorial Board: Bruce Campbell, MD, Kathlyn Fletcher, MD, Adina Kalet, MD, Wendy Peltier, MD, Erin Weileder, Nabil Attlassy, Julia Bosco, Ana Istrate, Wolf Pulsiano, Eileen Peterson, Anna Visser, James Wu & Emelyn Zaworski
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