Archive for May, 2011

Bringing the Relationship Back Home

This article first appeared on the PBS affiliated Website This Emotional Life.

“As you get older, it is harder to have heroes, but it is sort of necessary.” — Ernest Hemingway

It starts with lavender.  Then I notice the tiny, neatly folded outfit set aside by the changing table. A dragon in the corner smiles at me, performing ironic double-duty as humidifier and protector, providing respiratory ease rather than spewing the requisite fire so common to his kind.

Through the dim lighting I spot a small bottle waiting to provide the next meal when necessary, along with an array of accoutrements placed strategically throughout the room in anticipation of what the night may bring. And, of course, I hear the alternating tonic and dominant harmony in D flat.  This is my house, and yet I cannot help but ask myself where this room has come from.  It seems to have magically appeared overnight, while I was at the office crunching numbers and doing my best to contain health care-related chaos.

As I have mentioned in earlier articles, the last few months have been interesting for me, for a variety of reasons. Thus far, 2011 has seen fit to grant me a beautiful baby boy as I relinquished ownership of a family hospital handed down to me by my father.  Never before have I seen the Wheel of Life turn so up close and personal than in the last few months, and the combined experience has forced me to take account of the daily minutiae.  Simply put, things are changing, and fast.  The past seems suddenly far behind while the future stretches out before me, full of exciting new events that remind me just how far out of my league I am.  And through it all, the scent of lavender lingers as a reminder of my transition.

With the livelihood of over 400 employees – who I consider extended family members – at stake during the ongoing sale process of a local hospital on which the very community has come to depend for more than 50 years, I am the first to admit that the last two months have not afforded me as much time to spend with my newborn as I would have liked.  Late night phone conferences and early morning briefings have left little time for more than the occasional bottle-feeding or diaper change. That’s what comes to mind as I make my way across this odd little room in the heart of my house and realize just how much work my wife has put into creating a warm, safe haven in which to raise our son.  My lack of familiarity with many of the products on the nightstand only serves to reinforce how much she has learned recently, and put into practice on her own.

While I have been managing to survive my recent professional upheaval with the support of a hospital family nine years in the making, two strong-willed brothers, a handful of professional advisors with over 75 collective years of experience, and plenty of luck, that dragon’s smile stands as a reminder that she alone has borne the brunt of maneuvering through the uncharted waters of first time parenthood.  Any initial feelings of personal guilt as a result of my situation are quickly succeeded by the pride I feel on her behalf as it dawns on me that the foundation she has so gracefully provided exists not just for my son in his first months, but for me as well as I close out an important and emotional chapter in the history of my family tree.

While I was focusing my energies on external responsibilities, it was my wife who kept the home front intact. We never did plan any such allocation of duties, nor could we have anticipated this perfect storm of sorts when her pregnancy was first announced.  Yet somehow during the process, perhaps when I wasn’t even paying attention, Natalya became both anchor and life preserver, in many ways taking care of me in much the same way as she did our son.  In this forum I have had ample opportunity to discuss the many relationships that have formed my understanding of health care and its continued survival throughout innumerable pressures. But I may have been remiss by not making it unmistakably clear that the relationships that form behind the scenes within the family nest are often what make it possible for health care workers to give their best in emergency situations day in and day out. Personally speaking, my support group is an army of one. On behalf of my son, my hospital family, and myself, I am forever grateful to my wife and my hero, Natalya.

As an aside, my mother-in-law recently arrived from Belgium to lend a hand and offer advice.  Her arrival underscores what I am sure the dragon must also be thinking as he watches what transpires in that little room: “A mother’s work is never done.”

The Relationships Behind the Healing

This article first appeared on the PBS affiliated Website This Emotional Life.

In an 1889 essay, The Decay of Lying, Oscar Wilde argued that life often imitates art because “the self-conscious aim of life is to find expression,” and art provides an appropriate release. In many ways the same could be said of the current relationship between those who provide health care to the community and those who draft legislation governing such care. As the debate around health care reform enters its second year, perhaps it is time to stop and consider the full impact of the bill, not just on the health care system as a concept, but on the fate of the local hospital as a living, breathing entity.

The obvious uncertainties brought to life by today’s health care climate have over time become an unfortunate source of anxiety affecting nearly every patient-doctor relationship, as well as giving pause to the hundreds of thousands of health care workers industry-wide. For those on either side of the equation, the future of these relationships is now at a crossroads, in large part because neither professionals nor patients know what may be waiting around the next corner. Sadly, this all too often adds undue pressure to the already difficult task of care for the sick in the event of an emergency.

Next month will mark my nine-year anniversary as CEO of a hospital in Los Angeles County, California, in a role I had honestly never expected. I remember walking into that job on my first day, to face a group of intelligent, dedicated hospital managers who were devastated by the loss of their former leader.  As I addressed this room full of people – some of whom were in tears, some of whom remained stoic, all of whom were scared of what the future might hold – I wondered how I could ever comfort them for the loss they had just endured and assuage their fears of what was to come. The Hospital’s former CEO had died the day before from injuries sustained in a car accident, and it was my job to regain control of the facility and keep things functioning while learning the ropes as I went. There was no question I had some rather large shoes to fill, and but for the fact that the prior CEO had also been my father, I imagine I never would have accepted the challenge.

On the day of that first meeting with my new staff, we did not focus on our need to provide health care to the surrounding community.  Instead, we addressed the obvious issues of how best to continue forward as a team. Even so, no one working that day forgot the primary goal of any hospital, regardless of the surrounding chaos. Notwithstanding, for the next 3,300 consecutive days – almost 80,000 uninterrupted hours – the hospital did exactly as it should, using the network of relationships already in place and building on the new to continue its focus on providing care to the community.  In hindsight, the past nine years under my tenure were in many ways defined by these relationships, and our focus was strong.  As a result, the community received exactly what it had come to expect and deserve — a hospital.

Five months ago I began what would become a new chapter in this story, although initially I had no reason to anticipate the scope of its impact. It had become increasingly clear that the time had come to enter into discussions to sell the hospital to a larger health care group with the resources necessary to continue providing the area with top quality care. Throughout the process, which was long, arduous, and quite emotional for me, our focus was always to ensure that the community received what it deserved — that same hospital it had come to rely on for over fifty years.  Yet even in those moments when my focus waned, I knew I could depend on an extended family nearly 400 strong who made sure that we were well-positioned to deliver medical care to those who needed us. In the end, that’s what health care is all about.

Just the other day I entered that same room, filled with many of the same people from nine years ago.  While there were plenty of new faces as well, most of them had long ago become a part of our family. I explained that I had been preparing for this day for nearly nine years, although what was originally a day to which I had looked forward with anticipation was now one I truly dreaded. This time, I was to deliver a different message – that I would soon be stepping down as their leader. Looking out at the crowd as I gave news, every face reminded me of a lesson taught or learned, a favor asked or granted, or an experience shared.

I’ve heard it said that the whole is greater than the sum of its parts. When it comes to health care in the modern age that is certainly true, be it the correlation between community and hospital, employees and hospital, or even investors and hospital. As different as each of these bonds is from the other, all three survive only by existing together. These past few days I have witnessed first hand the ways in which change can make for a stressful environment.  The staff is nervous, the patients may be confused, and emotions run high. Nine years of consistency will undoubtedly lead to fear and uncertainty for a time, no matter who is waiting in the “on-deck circle”.

But that is what makes a hospital such a special place to work.  As chaos tries to rule the day, something happens, and a wake up call of sorts is given, reminding us all of the reason we have come together in this building on this day. Our dose of reality connects us with the real issue at hand. We remember that our community truly values the support we give in times of need, just as we do the same for one another.  After all, that is what relationships are all about.

If life could really imitate art, or at least the spirit of the law, it would make health care reform a much easier pill to swallow. To succeed in this endeavor, our primary goal should be to remember not just why we are here, but what the underlying purpose of health care in America is really all about.  For me, it has always meant faithfully serving the people who depend on us.  Though we may all sometimes forget why we do what we do, the relationships around us that maintain the hospital infrastructure so that it can operate all day, every day, are too important to ever be taken for granted.  Hopefully those who oversee the nationwide debate will one day come to accept this fact.


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