A Locum’s ScrapBook: Hospital 55:  Level I Trauma Baybeee!


Editor’s Note:

As a new and growing perfusion team, (when I say new I mean new to this particular program) we are slowly growing together, our diversity is culturally mixed (Indian, Middle Eastern, Chinese, Caucasian) and significantly as well- in terms of experience, age, and practice expertise.

This is not only a level I trauma center, it is certainly a pediatric program that is growing and will grow to support the needs of the local as well as regional communities providing an ECMO program that is on the front end of becoming potentially brilliant.

Thank you Chelsea, Chris, Javed, and Jim 🙂

A Locum’s ScrapBook: Hospital 55:  Level I Trauma Baybeee!

The number 55 is irrelevant to me except for the fact that this is indeed the 55th hospital that I will have worked as a clinical perfusionist, actually putting somebody on bypass at the institution. I don’t count hospitals that I have just visited in a backup role – where all I actuality ended up doing was very little except representing a plug for whatever situation the hospital or perfusion group was in.

This particular hospital is a little deeper South than I have been accustomed to going to, with the exception of the great state of Texas, which is its own little country – so I don’t really consider it “the South”.  It did however remind of  a two-year stint in Charleston South Carolina as a Navy as hospital corpsman back a few decades ago.

When I drove down here there was a little bit of trepidation, as it was during the crest of the Covid 19 virus, there was a tremendous amount of social unrest and political upheaval as a result some very significant racial injustices that had finally, and justifiably – broke the camels back so speak. It was becoming very clear that we are a fractured nation, and one has to sit back and recognize the total and complete social injustices that were staring us in the face every single day with new and terrible news.

I was coming off a 10 week furlough – due to the virus and its impact on elective versus non-elective open heart surgery. The financial climate, and dearth of our typical clinical workload, was crippling the big three perfusion contract groups as well as hospital-based perfusion teams. People were scared, uncertain of their own futures, the unknown risk of an infection that is probably the most virulent epidemic we will have faced in our lifetimes. Being a little older had its own special blend of insecurity, as my particular age group was 56 times more likely to die if infected, than the two generations younger than myself.

Having had 10 weeks to quarantine and percolate, digesting the daily news was like watching a death count of uncertainty. It bothered me that I was uninvolved, and not in the fight. Watching from the sidelines, witnessing and seeing the indecision and ineffectiveness that slowly leaves to unease and a general underlying sense of public panic, while in my opinion – that is personally more undermining and detrimental to self-confidence, then just diving in to those rough waters that my colleagues were being faced with.

As luck would have it, this is a level I trauma center in a very diverse and culturally mixed homogeneous population, so that also represents an enlightenment of one’s perspective and social orientation/preconceptions. For myself I consider this and amazing opportunity to be immersed in what for me was essentially a different world. I don’t consider myself a northern white boy, a northern anything, a white anything, just a soul trying to make a living at what I love to do.

So this is a first for me, where I find myself in a hospital where there is more diversity than I had experienced or witnessed before, being white was not the majority, African-Americans, Asians, Indians, prevailing here as a team and getting the job done – and getting that job done right.

Why would I bring this up?

I typically stay away from making any social/racial commentary, but because I have always been brutally honest – and this was a new experience for me. That’s really all there is to it, nothing suggested, nothing inferred, just a blunt realization that I was surrounded by a culture that I was not as familiar with as I previously thought.

I think America is going through a whole lot of social awakening right now – and I’m glad that I am part of that wave that I hope will bring true peace to us as a country.

I would be a liar if I failed to mention that yes, when I do walk down the halls, or head to the parking garage, and look into the eyes of other colleagues and/or patients of color, many times there are genuine smiles of trust, but so very often there is a look of diffidence- either cautious hope, or expectations that have been diminished as a result of years of distrust and social abuse. It doesn’t feel like disdain, it doesn’t feel like dislike, but it has the unmistakable air of social distancing that is totally unrelated to the virus.

It hurts me to see this or feel this way, but what hurts worse is realizing how utterly ignorant I as a professed medical professional have been, to not recognize the true damage that racial inequality has done to us as a country, and in particular to the black community as a whole. I trained in Detroit and thought I was cool because of that. But I wasn’t cool. I really never factored in any of the things that should have been totally obvious and right in front of me – I guess the main thing I realize having been here now for a month or so, is that in that brief space of clinical time, I found myself being able to ask the patient whether or not they have a sickle cell trait in their family medical history. That is a question I used to ask in Detroit, but since then has been an amazingly rare occurrence.

And that is not because black people have less heart disease than white people- it is because black people have less of an opportunity to have open heart surgery in general. Here in hospital 55, I have seen more black patients undergo open heart bypass than at any of the other heart hospitals I have worked prior to this – including Detroit.

To me that spells out only one thing. Denial of access to medical care – in this case cardiac care based on race and the inability to acquire decent medical coverage. That is a big wake-up call. So I consider myself pretty clueless for having lived in my white bubble. A total ostrich move-on my part, we bury our heads in the sand because reality is not something we really want to deal with and it’s easier to ignore it and pretend that healthcare for all is truly a version of Camelot for all.

I guess it is if you are white or wealthy…


Pump Strong