Alumni share what has disheartened and sustained them during the pandemic – and lessons learned in the process.
The tolls taken by nearly three years of the COVID-19 pandemic are evident in the health care workforce, shifting attitudes toward science and changing relationships between health care and public health professionals and the public. Newspapers have reported elevated workplace violence in hospitals, which are also dealing with unprecedented staffing shortages. Health professionals are experiencing more than basic burnout. A study published in April in the Journal of General Internal Medicine online compared the potential for “moral injury” among COVID-19 health care workers to rates among combat veterans. Defined as “the damage done to the conscience or identity of people who might witness, cause or fail to prevent acts that go against their own moral standards,” moral injury has occurred among health care workers who have seen people dying and struggled with the public’s disregard for preventing COVID-19 transmission, staffing shortages and more. So how have DMU graduates weathered the pandemic? What “moral injury” have they experienced, and what gives them the strength to carry on nonetheless? DMU Magazine asked, and here are some of the responses we received.
Robert Orenstein, D.O.’87, is a clinician and professor of medicine at the Mayo Clinic College of Medicine and Science in Phoenix, and he chairs the division of infectious diseases at Mayo Clinic Arizona. He has been editor-in-chief of the Journal of the American Osteopathic Association since January 2013 and is a reviewer for a number of other medical journals and publications in his area of expertise.
“As I have said many times during the COVID-19 pandemic to my colleagues, this is not my first rodeo…The same fear, misinformation and negative feelings existed in the HIV pandemic back in the late ’80s and early ’90s when I was just a few years out of DMU. Much of the conflict arises out of mistrust and poor communication. This has been highly evident in the current pandemic where everyone seems to claim to be an expert and has their own media outlet.
“Pandemics are public health crises. They involve all aspects of our society – social, political and health-related. As osteopathic physicians, we learn to respect and appreciate these interactions as part of our personal and societal well-being. Being dogmatic does not solve the challenges. As the sign on my office door says, ‘Stop the blame, up the game.’ This is how we will solve and survive this and other crises.”
Matthew Trump, D.O.’08, FACP, FCCP, is a pulmonary and critical care physician at the Iowa Clinic, the medical director for UnityPoint Pulmonary Rehabilitation in central Iowa and an instructor at DMU.
“The number-one takeaway: vaccines, vaccines, vaccines. That’s the biggest thing in reducing the burden of disease. You can still get COVID, but you likely won’t be as sick. Another big takeaway: good hospitals and medical care are very important. As time went on, we learned that the same principles we use to take care of other conditions still apply. The scientific advancement was just incredible. The way safe vaccines were developed was amazing. We’ve also been able to show that some things don’t work. Just being able to refine treatment has been great.
“We have a really good group with a balance of more experienced doctors who have been doing this for years. We vent to each other, rely on each other and lean on each other. I do think the pandemic taught me a lot about staying balanced and making time for myself.”
Robert G. Smith, D.P.M.’99, M.Sc., R.Ph., FNAP, a podiatrist, pharmacist, researcher and author in Ormond Beach, FL, and the founder and president of Studying Opioids’ Harm Inc., a nonprofit educational company that explores and researches opioid prescribing and opioid use disorder.
“The three years of this COVID-19 pandemic has been a hurdle to overcome, allowing for a dichotomous point of view of science by our citizens and political leaders. My belief is that it has deepened the divide between health care being a privilege and a right, allowing for a widening of health care disparities grounded in differences of belief, gender, race and sex.
“My time over the last few years was focused on the overlapping problems of COVID-19 and the opioid crisis. I have found comfort in researching, writing, teaching and volunteering as well as donating time and goods to those individuals who have been forgotten – homeless, elderly, veterans and the unemployed.”
Karl “Fritz” Disque, D.O.’07, R.Ph., is founder of the Disque Foundation and its Save a Life Initiative, a partnership between the foundation and National Health Care Provider Solutions to provide free online advanced health care education to people around the world. Having already empowered more than four million people in more than 182 countries to save a life, the foundation’s next goal is to empower 10 million people by the year 2025.
“What keeps me positive is seeing the contributions both health care providers and others are making every day in the wake of this new world we are living in, dealing with the impacts of COVID. I work with a global team at SaveaLife.com, where our day-to-day mission is making health care education accessible to all. In the wake of the pandemic, accessible training and education are more vital than ever, and we have been fortunate enough to be able to empower millions of people to save a life during COVID.
“Our reach is possible because of the health care providers that returned to the hospital when they were needed most and to the citizens who stayed at home and wanted to learn a new life-saving skill. Even in what are dark times, you have to look for the bright spots of those who are reaching out a hand to help, because they are there – you just have to be open to seeing them.”
Heather Fowler, D.O.’94, M.R.E., FAAFP, has been practicing as a physician in Bangladesh since 1999.
“COVID-19 left me exiled in Thailand and the U.S. for about five months, and yet I was eager to return to the known chaos of working in Bangladesh. The virus has left a challenged health care infrastructure even more vulnerable as many clinics and hospitals are no longer able to provide services. Our medical team found that patients were wandering from an hour south of our hospital up to four hours north of our hospital and were finding no open doors for their problems.
“This led to me examining a patient at 6:30 a.m. and realizing that I needed to do something. She had already been up and down the road for more than 24 hours. In labor at 30 weeks, the baby’s arm had prolapsed, and that little guy wasn’t going to survive much longer without care. On another day we rushed in to help the COVID mom who wasn’t oxygenating any longer to save the life of the baby at 35 weeks. We deliver moms with eclampsia and bleeding previa and triplets because they are at our door and no one else will receive them. We have so little to offer and yet we care enough to offer what we have, which is hope.
“I would never claim that my job was easy, and yet I head to work every morning so that I can offer hope to the people I serve. I press on with the help of my expat and national coworkers, finding stamina for the long days to share this hope. I don’t give into the fear that could overwhelm and paralyze because of the great hope brought about by faith.”
Kelly John, D.P.M.’99, M.H.A.’99, FACFAS, is a podiatric physician and surgeon with OrthoIllinois in Rockford, IL, and a member of the DMU Alumni Board of Directors.
“Although I am always behind the mask now, not just in the operating room, but in the clinic as well, I have tried to smile regardless. I know that my smiling mouth can’t be seen, but hopefully my smiling eyes come through. And just the physical movement of the smile can lead to happiness.”
Greg Cohen, D.O.’91, is a family medicine physician at the Lucas County Health Center in Chariton, IA, a Fellow of the American College of Osteopathic Family Physicians (ACOFP), past president of the Iowa ACOFP Chapter and a member of the ACOFP Board of Governors.
“It’s been a very long two years, I can’t lie. For quite some time, I was waking up several days a week in a dream where I was suffocating in an ICU, and that made it very hard to go to work.
“I have patients I’ve seen for 20, 25 years. When I had to tell patients they had COVID, tragically, some would say, ‘No, I don’t. You’re lying. This isn’t real.’ And to have their trust for all those years with their hearts and their lungs and their diabetes and everything else, for them to have trusted me with their life for 20 or 25 years, and then find they think I’m lying about this, but that some stranger on TV or on the Internet is telling them the truth, was disheartening.
“You give people the best information you have, and you try to draw upon some of that trust previously and realize that that’s the best you can do. You can’t save all of them. There’s a saying in the Talmud that to save a life is to save the world. So I’ve tried to make it my goal to save whoever I can, to help whoever I can, and realize that even if it’s just one person here and there, that person has meaning. And if I can’t do it for the others because they won’t accept that information, that’s just the way it is. I’ve made peace with it that way.”
Omar Lateef, D.O.’99, is president and CEO of Rush University System for Health in Chicago. Under his leadership, its medical center received national attention for its effective management of the COVID-19 pandemic, which included building a forward triage and being one of the first health systems to offer antibody testing.
“The unwavering commitment of our Rush staff, going above and beyond for our patients, gives me strength. Their resilience is extraordinary. Their excellence, unmatched.”
Shannon Ramsey Jimenez, D.O.’96, FACOFP, H.P.F., is interim dean and an associate professor of family medicine at the Sam Houston State University College of Osteopathic Medicine in Conroe, TX.
“I am a spiritual person, so my strength comes from God in me…My church had a theme one year, “it’s not about me.” It is the first line in a book called The Purpose Driven Life. This theme helped me clarify my mission – to serve my God, my family and my community. That mission is my compass. It keeps me grounded when I get lost in the less important things in this world.”
Jami Haberl, M.P.H.’03, M.H.A.’03, is executive director of the Iowa Healthiest State Initiative and a member and outgoing president of the DMU Alumni Board of Directors.
“The work we do every day is touching the lives of Iowans, whether it’s helping low-income individuals and families access healthy fruits and vegetables or working to reduce the stigma of mental illness. My strength comes knowing the work we do every day benefits others. The team of professionals whom I work with also gives me strength, being a team working toward the same goal even on the days that can be challenging and frustrating.
“Prior to the pandemic, we had launched two programs addressing food insecurity and mental health stigma. The significant growth we’ve had is my reminder of the impact we are having on individuals and that there is still work to be done.
“I’m not on the front lines of COVID, but we have been working on the other issues of living in a time of a pandemic and addressing issues that will have long-term impacts beyond the immediate response of this public health disaster.”
Kelsey Millonig, D.P.M.’17, M.P.H.’17, completed her residency at the Franciscan Foot and Ankle Institute in Federal Way, WA, and a fellowship at the Rubin Institute for Advanced Orthopedics and International Center for Limb Lengthening in Baltimore. She is a member of the preventive health committee of the American Podiatric Medical Association and student coordinator for the American Association of Women Podiatrists.
“I was in Seattle when it was ground zero. The year I was chief resident, we went from being fully busy, then everything was shut down. We were getting email messages that we needed to be prepared to get thrown into these COVID-related scenarios and get ventilator training. Fortunately, we weren’t needed, but it was so weird.
“Patients were hurt by needing procedures that had to be interrupted or postponed. I saw patients at risk of amputation and severe infections. There were a huge number of patients who put off seeing their doctors and whose conditions worsened as a result. The name of the game was adaptation.”
Eric Neverman, D.O.’12, M.H.A.’11, FAAP, FACP, is chief medical officer at Grundy County, IA, Memorial Hospital and physician dyad leader of UnityPoint Clinic – Grundy Center. He also is a member of the DMU Alumni Board and hosts students on pediatric and internal medicine rotations as an adjunct assistant professor at DMU.
“Early on, our staff called our highest-risk patients with underlying respiratory and cardiovascular conditions, making sure they had their medications refilled, going over COVID information and how it might affect them and their breathing. We received a number of positive responses from our patients, particularly from elderly people who probably were very afraid, on how well they felt cared for. Even when things get political or divisive, we have to remember that a lot of people are still very thankful, and we’re doing really good things for people. Those are the little wins that get me through the day.
“When vaccines became available, our public health department arranged an awesome group of stakeholders including our county’s three private pharmacies and my clinic, which were our four vaccine locations in our county. We held operational and logistical meetings on the number of vaccines coming to our county and what and where our needs were. I think we saw more than ever how private organizations and health care entities can work together in the county to meet a common need really rapidly.
“As a health care organization, we’re thinking more about preparedness and supply chain issues. I think there will be layers of reflection on the pandemic for a long time. We’re seeing patients who have post-COVID sequelae, and potentially throughout my whole career some patients may be battling complications from it. If you were a young public health person doing a Ph.D., what a time to write a thesis!”
Thomas A. Cavalieri, D.O.’76, MACOI, FACP, is dean, the endowed chair for primary care research and professor of medicine at the Rowan University School of Osteopathic Medicine.
“As dean at the Rowan University School of Osteopathic Medicine, I oversaw the student-run RowanSOM COVID-19 Vaccination Center last winter at the peak of the pandemic. Through the efforts of our great medical students, 55,000 patients received their COVID-19 vaccination. Many of those patients were frail elderly and others had significant co-morbidities. Our students treated them with utmost respect and compassion…The amazing effort of our students was a manifestation of their earnest desire of their goal to become great physicians in the future. It reminded me of how I felt when I was a student at DMU.”
Robert Good, D.O.’77, MACOI, served as the chief medical officer of health alliance medical plans and of medical management at Carle Health Systems in Champaign, IL, until he retired in 2020. He continued as a medical director at Carle Foundation Hospital until December 2021. He currently is president of the DMU Alumni Board of Directors and continues to practice part-time internal medicine at Carle Health Systems.
“It’s all about the mission. If people lose their mission or the sense of where they are going, they end up getting burned out or unhappy. Resilience is built around your mission. It is all about knowing your why.
“The world has changed. You not only experience fatigue, but now recurring deaths on top of the usual stresses, like heart attacks and strokes. The population is frustrated. It’s now safe to yell at your doctor or nurse. Then as a country, the press adds sometimes inaccurate medical statements that confuse people. All of this is compounding. Violence has increased, what I call the second epidemic. The incidents of gunshot wounds have increased significantly.
“The pandemic and the stress are not something you run from; you run to. The majority of people in the health care system are doing their role and their mission and have accepted the challenge.”