Stethoscope, Erie County Medical Society Newsletter, June 2022

the Stethoscope the Stethoscope

September 2019 Issue

Quarterly Newsletter of the Erie County Medical Society

Quarterly Newsletter of the Erie County Medical Society • June 2022 Issue

A Message From Your President

by Kelli DeSanctis, DO Hello, fellow physicians of the Erie County Medical Society,

Kelli DeSanctis, DO President, ECMS Kaela Luchs Association Coordinator kluchs@pamedsoc.org Phone: 833-770-1542 1438 West 38th Street Erie, PA 16508 Administrative Office/ Mailing Address: 400 Winding Creek Blvd.

Mechanicsburg, PA 17050 eriecountymedicalsociety.org

The opinions expressed in this publication are for general information only and are not intended to provide specific medical, legal or other advice for any individuals. The placement of editorial content, opinions, and paid advertising does not imply endorsement by the Erie County Medical Society.

The past several months have been busy, with multiple opportunities for engagement with one another, as well as the medical community in Ukraine. In April, over 100 physicians and medical students independently viewed the film Do No Harm, an expose about physician burnout and suicide. Then, we came together via Zoom to participate in a moderated roundtable discussion to share our opinions and reflect on the powerful film. I would like to thank Dr. Steve Levy, Dr. Chris Strzalka, Dr. Melanie Dunbar, and Ms. Selina Uglow for comprising our expert panel for the discussion. Multiple over-arching themes surfaced, including the persistence of “bully culture” during training, the difficulty of processing complex feelings like grief and loss in healthy ways, and the ever-present quest to find time for self care and maintain a healthy work-life balance. I think everyone who attended would agree that one of the take-home messages from the event was the need for us to support one another as colleagues and friends, in addition to working toward our own individual health. It is my sincere hope that this is not the last time we will come together to discuss these important topics.

Last month, the ECMS entered into a collaboration with Logistics Plus, a local company in Erie with direct ties to Ukraine. We received a request for help and call to action from Ukrainian physicians after most of their major supply chains for medications and supplies were disrupted. They spoke of an urgent need for everything from Tylenol to 4x4s. The Board of ECMS sent out an urgent missive to our members asking for any surplus medications, medical supplies, or monetary donations to be dropped off at Logistics Plus, where they would send them to Ukraine. Multiple physicians responded, and the medical community both here and abroad is forever grateful. Logistics Plus continues to collect supplies, and these can be dropped off at their main location in downtown Erie during business hours. Thank you in advance for your consideration.

Please continue to check your emails, as the Board of the Erie County Medical Society will continue to be in contact regarding social and philanthropic opportunities in the near future. My best wishes to you and yours for a happy and safe summer.

Best regards, Dr. Kelli DeSanctis President, Erie County Medical Society

Inside Out Alisha Maity M.D.

I re-watched the movie Inside Out on my post-call day and wow did it hit me hard. Inside Out for those who don’t know is a Pixar animated film about a young girl who learns to deal with her emotions.

This was a movie that I adored the first time I saw and then never had the time to revisit. It’s a movie that ultimately tells us that sadness is essential to life. It’s a simple enough message but one that is easy to overlook – we live in a world that is constantly trying to spin us on the positives, to sell us the American Dream, to deny that as much of life is about suffering as it is about joy. Deepening the emotions that we hold is a part of growing up, not just during puberty, but a constant lifelong, snowball effect of recognizing how complicated our feelings can be.

Pushing away grief is something that you are required to do in medicine. Grief lingers everywhere – there are disheveled, elderly patients with no family in sight, young kids addicted to opioids, and most recently, people of all ages whose families have been touched by Covid.

In the ICU just a few months ago, it was routine to watch people and see their O2 requirements go up and up until they were intubated. Every day we would throw steroids and remdesivir at them but still nationwide around 80% of those who were intubated, would die. Every day as interns, we were responsible for calling these peoples’ families – putting on our best new doctor voices and trying to balance providing a little hope while maintaining expectations so that there were no surprises when their loved one finally reached the end.

I started my 28-hr shift with a death – a 55-year old man who had rapidly deteriorated from COVID. I called the family as his BP and O2 continued dropping. I had met them in person the day before and his wife had said to me rather sharply – “why is this happening, I had a walking-talking, loving husband 1 week ago.” On this morning, I called her and told her to come in as soon as possible.

Five minutes after that call, I called to tell her that he had died. She and their two daughters came in while we were rounding – we were all alerted to their presence by the wails that echoed down the ICU hallways. I made my way over to them and stood there while they wept in front of me.

There was nothing I could say.

The day passed, the evening passed, and the next morning began. The ICU never stops humming with activity, and I had forgotten about my patient, his wife, their two kids who would never get to see their dad again. Then at 7 am sharp, another man’s heart stopped - this one’s not from COVID but from a mysterious illness that we hadn’t even had time to diagnose. I was responsible for calling the patient’s wife as we began to initiate chest compressions and shocks. Throughout the code, she pleaded with me to do everything. I told her we would and hung up. Then finally, I called her back – “I am so sorry to tell you this but at 7:24 am, your husband died.” I didn’t hear anything on the other end.

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Like a grotesque reflection of the events of the previous day, she came in with two daughters, all were in tears. Again, I wordlessly entered the room. I have never had such a feeling of mis-belonging than when I’m in these rooms. The wife was holding her husband’s hand. The two grown daughters were weeping. We stood there for some time, feeling the silence.

Sometimes as a doctor, you feel like a wind-up monkey, stuck repeating words of hope and reassurance – “we did everything we could” “I’m so sorry” without really feeling anything. In that moment though, I couldn’t help myself. I turned to the daughters as we watched their mom holding her husband’s hand - “It was so hard to talk to your mother this morning. You seem like such a close family”. “We were. We are,” they said, smiling. I bit my lip under my mask. Tears were visibly welling up behind my glasses, and it was hard to keep from completely losing it. His wife told me about their 50 years of marriage, how they had met when she was 15 and he was 17 and how he had promised on a weekly basis to quit smoking but how he had a mind of his own.

I felt myself releasing. I felt the events of the last 24 hours wash over me. I felt pure, pure sadness. And I lived in that sadness for several minutes until it was time for me to finish my notes, pack up my things, and turn off my hospital brain. I went to sleep, woke up, and watched Inside Out.

PAMED Awards Top Physicians Under 40 Pennsylvania Medical Society announces recipients of its annual Top Physicians Under 40 Awards. This is an annual award given out to the best of the best early career physicians, nominated by their peers, and selected by a committee of PAMED members. “ With their ambition and innovative ideas, these candidates are more than qualified to be recognized with the top physicians’ award,” said F. Wilson Jackson, M.D., PAMED President-Elect and Chair of the award committee. “They will shape and shine bright in the future of medicine.”

Dr. Dempsey is a family medicine resident physician with the Allegheny Health Network. He is a medical school graduate of Geisel School of Medicine at Dartmouth College. He is passionate about syringe service programs in Pennsylvania and his dedicated to patient care and advocacy.

His nominator said “He has been on the forefront of frontline care for patients with COVID-19 in the hospital and ambulatory settings. He has consistently been there for his patients and helps them navigate through the global pandemic.”

ECMS congratulates Dr. Dempsey on his recent award!

PAMED is currently accepting nominations for the 2023 top physicians under 40 list at www.pamedsoc.org/awards

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Dear Physicians of the Erie County Medical Society I have received a request from the local company Logistics Plus for medical supplies to send to Ukraine. The physicians and healthcare workers in Ukraine are having difficulty acquiring even the most basic medications and medical supplies to treat their patients. Logistics Plus has a direct connection and ability to ship these supplies to where they are most needed. I am writing to ask your assistance. If you could please check your supply closet, sample closet, or personal collection, and identify if there are any items which you could donate, I would be most grateful. These can be dropped off at Logistics Plus at 1406 Peach Street, at the loading dock, Monday thru Friday, 8-5. The dropoff location is always staffed. They will accept monetary donations as well if you are so inclined. They will accept any medication or medical supply including bandages, gauze, etc, even if they are expired. I have attached an excel spreadsheet from their contacts in Ukraine detailing several specific requests. Their contacts have indicated that the situation is quite dire, and they would be grateful for any help we can provide.

On behalf of the Board of the ECMS, I thank you in advance for your generosity.

Please reach out to me directly with any questions or concerns.

Best regards, Kelli DeSanctis, DO ECMS President

VIEW SUPPLY LIST

Legislative Update Please review the latest PAMED Legislative Update

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A Patient, A Person, A Friend Joseph F. Answine MD FASA

More anesthetics occurred, and less complications thankfully.

About a decade and a half ago, I was a new trustee on the Pennsylvania Medical Society board.

During one of my first society board meetings, a staff person asked if I could talk to another about anesthesia. She needed surgery and wanted to know if I could take care of her. She was going to be admitted to one of my local hospitals. I met my future patient and found out that she needed a relatively quick urological procedure. However, she wasn’t without co-morbidities especially significant lung disease. The day came and in my opinion, I gave her the perfect anesthetic. As I was patting myself on the back, she went into major bronchospasm and spent the night in the ICU. The next day, she recovered nicely, and I gave her my cell number and said call if I can help you in any other way. Little did I know that she was a wizard at texting, and I would get daily messages and pictures of Daisy, her dog.

As time went on, her health continued to deteriorate, but her spirits never faltered.

She eventually went into nursing home care.

Her biggest concern was not being with Daisy.

Daisy eventually went into foster care and passed away peacefully at a ripe old dog age.

My patient was given Daisy’s ashes to keep with her as a memento of the most photogenic pooch.

My patient’s health continued to deteriorate over the months and years including a cancer battle, however her spirits never wavered, and the anesthetics continued for various reasons.

But each one came with a massive bag of M&Ms and a “There’s my number 1” each time I arrived. Every nurse and doctor she came in contact with knew of our friendship.

As time went on, she needed another short procedure. I gave the perfect anesthetic again, and she ended up in the ICU again. I began to question my abilities, but she was forgiving and our friendship continued. I received more texts and more pictures of Daisy dressed in outfits appropriate for the season, a pirate costume for Halloween or Stars and Stripes for the Fourth of July.

Even the American Society of Anesthesiologists knew of it since she contacted them telling them of “my amazing skills”. A few trips to the ICU post op but who is keeping track.

This kind lady even broke her femur while the nurses were transferring her from the bed to a stretcher after a procedure in order to get her back to the long-term care facility. A few were concerned about a lawsuit, but I told them they would likely just get M&Ms.

In 2014, I broke my ankle, had surgery and was using a knee walker while at work. She asked how I was doing so I sent her a picture of me in scrubs with my scooter. Within a week I received a picture of Daisy in scrubs on a scooter. Daisy and I became August in the 2015 Daisy calendar that my patient had made.

She passed away January of this year. Our last text exchange: “Don’t want to go under anesthesia without you. You won’t but better not to have it. You are right again.”

She was blessed with great friends and two took it upon themselves to take care of her after her death. They gathered her belongings and contacted her “power-of-attorney” which is a distant relative since she had no close living ones. As occurs commonly, with the long-term care needs, my patient was left without the funds for burial. However, her friends were determined to have she and Daisy buried with her mom. They worked their magic and a very reasonable price was set by the funeral home to get my patient and her dog to their final resting place.

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continued on page 8

A Patient, A Person, A Friend continued from page 7

We still needed some money though and the three of us could have put it together ourselves, however, we decided to ask our friends at the Pennsylvania Medical Society for help. We each took our own paths to contact friends at her old stomping grounds. It was decided that I would handle any funds we would receive. The ladies asked for my PayPal account number. I said “huh”. So, all were told to send checks or cash to my home address. Whatever we didn’t collect, the three of us would cover the rest. Within two weeks, I collected three times what was needed to pay the funeral home in full. Let me write this

one more time. I received “3” times the amount needed from her friends at the Med Society!

We decided that the balance of the money will be donated to charities including the Foundation in my patient’s name.

My final message: Patients are people and friends, and the world is full of generous and kind individuals.

Thank you all from the bottom of my heart.

Join or Renew Your Membership today!

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Click the image above to watch the DO NO HARM RECAP! 7

2021–2023 ECMS Board of Directors Kelli K. DeSanctis, DO County President

Thomas D. Falasca, DO At Large Member

Jeffrey P. McGovern, MD Immediate Past President

Narendra S. Bhagwandien, MD At Large Member

Terence O. Lillis, MD County President Elect

Kirk W. Steehler, DO At Large Member

Amanda Marie Wincik, MD County Treasurer

Laura Gephart, MD At Large Member

Peter S. Lund, MD, FACS AMA Representative

Geoffrey Betz, MD At Large Member

Timothy D. Pelkowski, MD At Large Member

Brendan Dempsey, MD Resident Representative Stefano Castagnola, MD Resident Representative