Peter King is on vacation until July 20, and he lined up some guest writers to fill his Monday spot on Football Morning in America. Today, it’s a collection of front-line workers from the coronavirus pandemic.
Previous guest columns: Michael MacCambridge (June 15)
Note from Peter King:
Today’s column is a bit different—five essays, with no notes, no Ten Things—but I wanted to pay tribute to those who worked selflessly for hours, and still do, in some cases. For all of you whose stories we did not choose, thank you for sending them along, and thanks for your work during one of the most trying times of your lives. That’s the real message of today. We should all be thankful that so many people worked so hard to lessen the tragic effects of this pandemic.
Getting 2 Percent Better Every Day
Dr. Myron Rolle is finishing his third year as a neurosurgical resident at Harvard Medical School and Massachusetts General Hospital. He played safety at Florida State and was drafted by the Titans in the sixth round in 2010, also spending time with the Steelers before leaving the NFL for medical school. With a massive influx of COVID-19 cases in New England, Rolle took on 24-hour shifts in the Mass General surge clinic, a “hospital within a hospital” for coronavirus patients, while still performing life-saving neurosurgical procedures on patients with and without the virus.
BY MYRON ROLLE
In May, I operated on a patient with COVID-19 who had a tumor that was causing obstruction to the fluid-filled spaces in his brain. I’ve operated on some very sick patients before, including those with full-blown tuberculosis, and at that point I had been working with coronavirus patients in the surge clinic for several months, so I was familiar with how to navigate. That said, my expertise is in the central nervous system, and coronavirus ravages the respiratory system. Our teams must take new steps, from the tests we order to the intubation process (I have to stand outside during intubation, to be sure I am not infected) to the way we position the patient to maximize oxygen intake to the lungs. We were able to successfully remove the tumor and do our part as neurosurgeons. While he’s still in the hospital with a long road ahead, he’s had several negative COVID-19 tests, so we’re moving in the right direction.
During my shifts in the surge clinic, my colleagues and I are foot soldiers in this larger fight. We manage and triage patients, put in orders for CAT scans and chest X-rays, set up consults and get patients where they need to be, all while taking extensive precautions to protect ourselves and avoid transmission. Despite the busyness of this team, one of the most jarring things is seeing empty hallways in the hospital, knowing that family members can’t come in, essential staff is limited and that people in need have had their procedures postponed to allow us to help the very sickest patients.
All the while, my football background has been huge for me—both in my medical career and during this coronavirus crisis. My defensive coordinator at Florida State was the legendary Mickey Andrews, who taught us this mantra: “Get 2 percent better every day.” He would challenge us to just take these small incremental bites in our tackling, in our stamina, in our blitz packages. If you add up all those incremental bites, it leads to a big change, and you’ll be so much better than you were when you started.
I’ve extrapolated that 2 percent mindset to life. I try to get 2 percent better whenever I do anything, especially in surgery and the technical skills we rely on every day. That includes learning daily about COVID-19 and getting myself up to speed with the new data and journal articles on how to manage these patients correctly. In everything, I work to get 2 percent better to be the best provider I can possibly be.
Throughout my career, football taught me how to find common ground. When I left my high school in Princeton, New Jersey and came to Florida State, I had teammates with dreadlocks and gold teeth, who listened to different music and ate country-fried steak and food I’d never heard of before. Trying to fit in as a prep school kid with glasses who tucked my shirt in my pants was difficult. But football brought us together and became a commonality. My teammates loved to freestyle rap before games, so I went home and learned how to rap watching YouTube videos. And the guys started to accept me—I wasn’t just some geek from New Jersey. Now, in medicine, when I tell a patient, “We’re going to slice in your back and try to fix your spine,” or, “We’re going to go into your brain,” I can stop and say, “Hey, let’s talk about football and how great the sport is.” It relaxes them and allows you to build that rapport we need so that patients trust us.
The thing that’s been most impactful for me throughout the pandemic has been knowing that this is a time when people look for providers to speak their truth, which is a role I hope to help fill for the disproportionate number of black and brown people who are being infected with COVID-19. Disparities in our healthcare system existed long before coronavirus and those are the communities being hit the hardest. For me and my colleagues to be advocates for those groups is an essential to me. I hope I have been helpful for patients we treated who felt encouraged seeing people who looked like them on the front lines of this fight.
My father always wanted me to have role models who looked like me: Kofi Annan, Paul Robeson, Nelson Mandela, Malcolm X. I took personal inspiration in the story of Dr. Ben Carson. Not only was he gifted technically as a surgeon, but he also came from a modest background like I did, he had parents who focused on education like mine did and he had a bit of a temper like I did. I saw a lot of parallels in his life and my life.
In 2012, my final summer in football, I was in Steelers camp in Pennsylvania. I remember being in the lunch line with Mike Tomlin. I told him I wanted to be a neurosurgeon, like Ben Carson, after football.
“You should want to be like Myron Rolle,” Tomlin told me. “I’ve followed your career—I know you’ll succeed. But you don’t have to be like someone else to succeed. Make your own path. Be the first you.”
That remains essential advice for me to this day.
Sports: Not A Prerequisite To Serving
Dr. Bruce Meyer is the president of Jefferson Health, and oversees 14 hospitals in the Philadelphia area, with 2,200 doctors, 8,000 nurses and more than 25,000 employees in all. He took issue with my request for what people on the front lines of the coronavirus crisis have learned from their sports backgrounds. “I never played high school or college sports but certainly think that I and my team know a lot about group success and protecting the unit from harm,” Meyer said. “We know that we have to protect each other in unpredictable situations. These are critical lessons that do not require a sports background.”
BY BRUCE MEYER
Every morning at Jefferson Health, the leaders on our team meet in a virtual conference room for a one-hour meeting we call our Daily Huddle. There, we review a daily scorecard about the COVID-19 numbers at our facilities—how many positive tests, how many hospital admissions and discharges, ventilator usage, PPE usage, how much PPE is stocked at each hospital, things like that. For instance, we typically use 14,000 gowns and 5,000 masks in a day. We have a horizontal structure. We force accountability, but everyone’s voice is heard.
The PPE usage is an interesting story. We did disaster planning—what would happen if there was a bomb that exploded at a Phillies or Eagles game, and we had to treat thousands? We realized we needed to really lay in the supplies for PPE, because we might have to prepare to treat a lot of people in an emergency situation for weeks. We overstocked, basically. No one in our hospitals would ever work without proper protective equipment. So in the second week of March, before the virus took hold, we went to an all-mask environment at every one of our facilities. So far, we have cared for more than 10,000 people with COVID-19, and more than 700 patients in our hospitals on a given day—and we have had only 25 of more than 25,000 of our people on the front lines hospitalized with COVID-19, and only two deaths.
I love watching the NFL for the incredible athletic and intellectual feats going on all over the field, although I am somewhat conflicted by the orthopedic and neurologic sacrifices being made. I believe that the same kind of team dynamic, willingness to sacrifice for others, and set of intellectual feats that we see in professional sports happen innumerable times, every day, in hospitals and clinics all over the country.
It has been intense and sometimes tragic, but we have never been overwhelmed because of our preparation through disaster planning exercises and execution of an extremely organized daily incident command structure that cascades throughout the organization. Those daily virtual team meetings ensure that personnel and supplies are distributed to where they are most needed. We disseminate information in a systematic way during “huddles” on every shift across our care environments. Because we work as a single team spanning all of our sites, we can and have changed treatment protocols for all patients across our system in a single day in order to ensure that everyone receives the best care and has an opportunity for the best outcome. Anxiety has been high because this was a new disease for which we do not have perfect treatments, but none of us gets flustered. We focus on the task at hand (just like professional athletes) and, as a result, we have been able to care for our community effectively.
As happens in sports, our teams have many unsung heroes, including our nursing, physician, and direct care staff. There are also thousands of other heroes working behind the scenes, like the supply-chain team that maintains PPE, the environmental services teams that disinfect all of our sites, the social workers and palliative care teams that provide comfort to patients and families, and even the people who work in the morgues who ensure that the souls we have lost leave us with dignity. Those teams perform at a high level because we practice a lot, we care for each other, we pay attention to our mental health. The stakes are so high for everyone.
Just like high-performing football teams, we trust and respect each other, we are committed and accountable to each other, and we are results-oriented. You don’t need to have coached or played sports to be a great team member or leader. Brilliant, high-performing teams and leaders are built from people of diverse experiences. I am proud to be their captain.
Let Me Be Brave In The Attempt
Meg Marie Ford wrote on behalf of her younger sister Sara Thiel, a Special Olympics athlete and essential worker at Pavilions grocery store in Mission Viejo, Calif. Sara has worked at Pavilions for 11 years and has played sports with Special Olympics of Southern California for over two decades.
BY MEG MARIE FORD
My sister Sara has participated in Special Olympics since grade school but found her truest teammates on the Laguna Hills Hawks in 2003, shortly after her graduation from high school. Sara has focused mainly on sports like basketball, softball and floor hockey, because they allow her to be a part of a team after growing up in a world where people like her are often left out, or picked last, or mocked just for trying to play with other kids. She loves being a Hawk, high-fiving her teammates after a great play, standing together to accept their medals, cheering one another on from the stands.
Her job duties as a Pavilions courtesy clerk include bagging groceries for customers, making sure the store is clean and ensuring carts are available for shoppers as they enter, but now the stakes are much higher. Early in the coronavirus pandemic, she did have days where she worked through worry and frustration. Customers have not always been their best selves while panic shopping, and the stress of heading into work every day while the media implores everyone to stay at home and shelter in place has weighed on her. During the first few weeks, when the store was crowded with people who were frightened and angry and trying to hoard food and supplies, she would text home to say she was scared. The uncertainly around health protocols was also a stressor and sometimes had her in tears on the way to and home from work. Initial reports recommended against masks, then required masks, and she has had to deal with customers who ignore posted requirements about social distancing and refuse to wear masks. At first, reusable bags were still okay to use in store, then only acceptable if customers bagged their own groceries so as not to put workers at risk. Now shoppers cannot bring reusable bags into the store, for fear of germs. Checkers were standing behind a sheet of protective plexiglass, but Sara worried that there wasn’t something similar at the bagging end of the checkout line to keep her and other courtesy clerks safe.
Many of her coworkers have been unable to return to work, but as long as she’s healthy and able, Sara will be at her store. She’d as soon quit her job as walk off the playing field and has filled in extra shifts and stayed late when asked. She is rigorous in practicing good COVID hygiene at work and at home, wearing her mask as required, vigorously washing her hands and face throughout the day, and showering as soon as she walks through the door at the end of a shift to minimize her risk of getting sick, or infecting another member of our family. Like many people, her work is part of what defines her day and gives her meaning. Going in and doing her best stabilizes her during this uncertain time. Her favorite week during the pandemic was the leadup to Mother’s Day when she got to work in the floral department, surrounded by flowers and helping put together bouquets to bring cheer. Her employer has also worked to make the shopping experience the best and safest possible—Pavilions was one of the first in our area to put social distancing measures into place for the safety of customers and employees, and Sara and her co-workers have become even more tight knit in their efforts to work through the pandemic as a team.
In 2007, Sara was chosen to represent California as part of Team USA at the Special Olympics World Games in Shanghai, China. She competed in several track events as a solo competitor, which was unusual for her, but she loved being part of the larger national team. Normally a homebody and deeply attached to our family, her time in China was Sara’s first long stint where she was in the care of non-family members. We were concerned that she would be homesick or emotional, but the energy of the games and esprit de corps overtook her so profoundly that she didn’t even have time to feel lonely. In recognition of her accomplishments on and off the field, Special Olympics of Southern California named her the Betty Belden Palmer Athlete of the Year in 2011, and even then, her acceptance speech focused more on her team than herself.
While Special Olympics of California has suspended activities during the pandemic, one of Sara’s best work days was when her coach drove a half hour out of his way to visit her at work. The coach bought a single avocado—just so he could say hello. The Special Olympics athletes credo, which they recite before the beginning of games is “if I cannot win, let me be brave in the attempt.” I’m proud to have Sara on my team.
Ensuring Educational Access In A Pandemic
Josh Hager works as an assistant principal for the Las Vegas Academy of the Arts, a school of 1,700 students in Clark County School District. When the district went from in-person to virtual education in a matter of days, Hager took charge of getting computers and internet access to students who wouldn’t otherwise have them. In doing so, he says he took inspiration from his mentality as a former football and baseball player and long-time rock climber.
BY JOSH HAGER
Sinatra famously crooned that New York is the city that never sleeps. I thought this was true until my wife and I left New Jersey for Las Vegas during the summer of 1997. Truly, Vegas never sleeps. There is no down time, no last call. When a casino opens its doors, they remain open 24/7/365. Forever. Or so we all thought. That all changed on March 15, when our governor declared an emergency and shuttered all “non-essential” businesses, schools, and, yes, casinos.
At Las Vegas Academy, our last day of face-to-face classes was Friday, March 13. That Sunday, however, word came from Nevada Gov. Steve Sisolak that it was all shutting down. My daughter is a freshman at the University of Nevada, Reno. She was home for spring break and simply never went back. My son attends UNLV, in a program for students with learning disabilities. He’s learning virtually too.
We moved, by necessity, ridiculously quickly into distance education operations.(To sum up many memes I’ve seen recently: Have a problem? Give it to educators to solve. Then get out of the way.) If you know Las Vegas at all, we have very disparate social economic strata here. There’s a lot of money in some places and true poverty in others. As we made this transition to virtual classrooms, we wanted to ensure right away that all the students who were receiving nutrition through their schools would continue to do so, and that is still going on. Every day at sites around the district, students can pull in with their parents and get breakfast and lunch for that day, five days a week. That resource is going to continue all through the summer.
The other thing we realized, and the area I was responsible for at our school, is that we had to get technology into the hands of students who didn’t have it. You can’t participate in virtual classes if you don’t have Wi-Fi and a computer. I collected names of students who would need computers, and my Site-Based Technician Richard and I met at our school, took apart five Chromebook carts and repurposed 200 of them for student distribution. We then set up a series of days where students could drive by the school and pick up the supplies they needed. District-wide, we had a great process for getting resources to students while minimizing contact. That said, we still don’t fully know all the vectors through which this virus spreads. My wife is highly susceptible to respiratory infections and had been very sick in February. We both had antibody tests that came back negative, so I needed to be as careful as possible. The major driving force throughout the process of distributing supplies to students was a concern for access and equity for all. Most of our students have some kind of technology where they can participate in digital learning. But kids who don’t have that access were at risk of falling behind. That is not fair, it’s not right, and we needed to address it as quickly and as thoroughly as possible.
Our first efforts focused on our seniors. When the lockdown began, we had nearly two dozen seniors in danger of not graduating, and many of them lacked technology at home. Traditionally, seniors use the fourth grading quarter to correct any grade or credit issues they face. With school cancelled, that opportunity shifted to working to raise third quarter grades, which became their semester grades, in order to become eligible for graduation. In addition, Advanced Placement exams evolved to an online platform, and we had students who needed computers to participate, and hopefully earn some college credit. On that first “seniors only” day, we distributed nearly two dozen computers. In total, we distributed over 100 Chromebooks to students in need. The results? Every student who signed up for an AP exam had the opportunity to sit for the test. Even better, we held a drive-up, parade-style graduation for June 6, and all but one of our seniors has completed everything needed to graduate. (The lone remaining student can still complete the graduation requirements and participate in the district’s summer graduation). The pandemic certainly changed education, but educators worked exhaustively to make the experience as positive as possible for students.
So, where does my athletic experience come in? Growing up, I played baseball all spring and summer, and football all fall and winter. I was always very familiar with the idea that the team wins collectively but it’s individual performances within those team activities that make the difference. Through my teens and 20s, I was an avid rock climber, and while I get out less than I used to, Nevada is a great place for the sport. Rock climbing is completely individual. You either make it or you don’t. It’s entirely on your own strength, skill and tenacity. In those athletic experiences I’ve found a clue to the mentality a lot of people are taking on to successfully navigate this pandemic: Individual effort helps the team earn the victory.
Sadly, the class of 2020 is hurting from this. And the only thing that really heals such pain is the passage of time, but it’s when you’re in pain that time seems to move the slowest. Finally, to all of my students, and all students going through this, I’d say: Look to the future, because that’s what’s going to give you that needed sense of hope. And know this heartache will pass and eventually you’ll look back at this as one of the most unique experiences in American history.
New Role For Long-Time Cardiologist
Dr. Scott Shurmur is the Division Chief of Cardiology at Texas Tech Health Centers in Lubbock, Texas, and comes from a family of football coaches and players. His cousin, Pat Shurmur, is the offensive coordinator of the Broncos and his father, Fritz Shurmur, coached in the league for two decades. To address a surge of COVID-19 cases, Dr. Shurmur and the cardiology team stepped in to care for ICU patients, testing medical skills some hadn’t used in decades. After an initial decline near the end of May, Lubbock is currently experiencing a resurgence of COVID-19 cases, with a significant spike over the last seven days.
BY SCOTT SHURMUR
In early March, our team watched the national news and wondered what might lie ahead, but in our cardiology world, things were largely business as usual. Then on Monday, March 16, we walked into our monthly Performance Improvement meeting where we usually discuss topics like hospital safety measures and improvement of efficiency and processes. The agenda started out that way, but the subject matter seemed to evolve in the middle of meeting itself, as the hospital leaders present in the room began to read messages on their phones, and the general surgeon sitting next to me received a text which seemed to shock him. Moments later, the hospital leadership announced that all elective surgeries and catheter lab-based procedures, where we do things like place stents in arteries of the heart to relieve blockages, and sometimes even replace heart valves, were suspended immediately and indefinitely. The reason was not a current or anticipated shortages of hospital beds or ventilators but in fact of personal protective equipment. As of that moment, the hospital had only a five-day supply of gowns and masks, and the supply chain had been interrupted. Our world had changed dramatically in front of our eyes, in the course of an hour.
Shortly thereafter, we as cardiologists began taking care of medically ill ICU patients so that over-burdened pulmonary and critical care staff could focus on the COVID-19 patients. This was a return to our roots as general internists and intensivists. Treating conditions like septic shock, diabetic ketoacidosis, and gastrointestinal bleeding was something I and some members of my team had not been primarily responsible for doing in decades. The initial discomfort was quickly replaced, however, by growing confidence, and satisfaction that, in our own small way, we were contributing to the larger, unprecedented effort. We clung to the basic truth that virtually no one, in any walk of life, was doing exactly what they wanted to be doing at that moment. I was extremely proud of the way our group stepped up and expertly faced the challenge. As division chief and leader of the group, I was glad I myself was assigned to the coronary care unit in May where it was my responsibility to take care of these medically ill patients, a departure from the norm for the cardiologist. This way I did not have to ask my colleagues to do that which I had not done myself.
As division chief, I am the de facto leader of the group and in many ways responsible for setting the overall course for our activities as well as assigning individual responsibilities. In this way, I see myself functioning somewhat as a head coach. This analogy frequently comes to mind, I suppose likely because I’ve had close family members in the NFL both at the assistant and head coach level continuously for the past 45 years. The dynamics of the coaching staff and the definition of its roles are an area where I’ve had the great privilege of having intimate knowledge.
I had the good fortune of playing football at the FBS level as well. Group success was the top priority, never asking one to do what you wouldn’t do or haven’t done yourself and finding ways to elevate those around you are valuable lessons that still resonate today.
Around Memorial Day, our COVID case rates rapidly waned, and we began to shift our focus back to our traditional cardiology work. Unfortunately, around that same time, bars, restaurants, and other public gathering spaces in Texas began to re-open. And somehow, much of the public seemed to believe the pandemic had passed, bypassing many of the precautions that are key to minimizing transmission. Here in Lubbock, we are now a hotspot, with case rates at all-time highs, and a feeling that we have lost at least as much ground in the fight as we had gained.
This rush to reopen the country, at least our corner of it, appears to have come too early, and the way our hospital system will handle that will continue to evolve in the days and weeks ahead. From the beginning, COVID-19 has required us to manage the unprecedented. As the pandemic continues into summer, our team will continue to take on whatever responsibilities allow us to help most, no matter how far a departure from the norm.