Dear White Colleagues

From the 6/26/2020 newsletter



Dear White Colleagues


Ashley M. Hines - MCW Diversity and Inclusion Manager

Ms. Hines shares her candid thoughts on being a wife, mother, full-time work-from-home MCW staff member during the COVID-19 pandemic and a Black woman amid the unending pandemic of racism ...

As a wife, mother, full-time work-from-home staff member during the COVID-19 pandemic and a Black woman amid the unending pandemic of racism, I’ve avoided facing my deep pain, hurt, confusion, anger and sadness because I must keep it all together. In this letter, I pause and candidly share my thoughts on our current time. I am not and will never speak for all Black people. I encourage you to read and to listen to the many stories of the Black experience.

Police brutality and other forms of systemic racism and structured inequity are being recognized and spoken  about in ways I’ve never experienced – magnifying the brokenness of our country. A country built, with intention, on racism and a 401-year-old system of oppression. Unfortunately, the system is working as it was intended. Breonna Taylor, Ahmaud Arbery and George Floyd are among the countless individuals who have lost their lives because this country was built by us and on us, not built for us. Their stories amplify the destructive nature of pervasive injustice. We aren’t talking about statistics; these are lives.

Many of my white colleagues have asked what they can do to support me. Here are some of my thoughts. Again, I cannot speak for all Black people. 

See me. Presenting evidence that racism exists is exhausting and painful. Please don’t discredit my personal experiences. Also, the impact of slavery is still felt today and is not far removed from many Black families. I’d argue that slavery has evolved – exposed by the disproportionate number of Black and brown people in our criminal system…but that’s an entirely different conversation.


This is complex, uncomfortable work. If there was an easy solution to racism and the systemic racism it produces, the work would be done. Inside MCW, a focus on pursuing learning and increased awareness, interrogating our practices, policies and procedures at all levels and transforming our system with bold changes is essential. Outside of MCW, protesting, voting and changes across all sectors must happen. You will be nervous; you won’t always say the right thing and you will make mistakes. Move forward in humility and don’t allow guilt to stop you. Plug in where you can and keep going! 

This is a marathon, not a sprint. I understand that a system that has thrived for centuries will not change overnight. As the saying goes, “slow down to go faster.”


It’s not enough to not be a racist. We must be anti-racist. A Black woman recently posed a question to white folks, “What are you doing to make sure your children don’t kill mine?” This is not the time to play it safe. Please don’t be silent. People’s lives depend on your commitment, voice and thoughtful use of your unearned privileges.


Be in it with us. Acknowledge we are grieving, processing and healing. Hold space for us to share and be patient and understanding if we can’t do this every day.


Racism isn’t new to me. In fact, like many people who identify as African American and Black in the United States, it’s an inescapable reality. I recognize some people haven’t had to think about racism at all and do not know the fear (or have not experienced the fear) elicited by its deadly impact. The “You took my spot!” comment hurt me for a long time. I carried it with me and struggled with impostor syndrome and non-belongingness. For me, implicit in her comment was a belief that she deserved something she had not earned – simply because she is white. The sting of her comment drove me to work harder to prove my value to white people…to prove I deserved to be there and to prove I deserve to be here. But such continued comments and the deaths of unarmed Black people tell me that I can never prove myself sufficiently to overcome the biases and inequities built into a racist social system. Black Lives Matters is about Black people owning our inherent worth in a system that tells us differently.


I’m writing this letter on June 19. Today we celebrate Juneteenth and recognize the last group of African Americans freed after the Civil War. This is Independence Day for African Americans and Blacks. Yet, we aren’t free from the disparaging and multigenerational impacts of racism and slavery. Still, we celebrate because we are a resilient and empowered people. So yes, I am hurt, confused, angry and sad. And yet, most days, hopeful. I am grateful to work at MCW and heartened by our commitment to be an anti-racist organization. The work needed to undo the legacy of racism is difficult and I believe it will get done. It must get done.





Ashley Hines is Diversity and Inclusion Manager in the MCW Office of Diversity
and Inclusion.

Mentee-ing matters

From the6/26/2020 newsletter

 

Mentee-ing matters

 

Adina Kalet, MD MPH

 

Dr. Kalet argues that we should be ensuring that all our students and trainees have the mentee-ing skills to have a successful life. Gaining those skills and helping mentees acquire a “mentorship network” are the main responsibilities of the mentor…

 

 

Yesterday I received an email from the father of two former “mentees” (not yet an official word in the English language- but it should be). “Both J and M acknowledge that your involvement in their lives was life altering. We are all grateful to you” he said. Attached was a newspaper article from the small city in which they were born and raised. It profiled the two young men who have joined, in their respective clinical disciplines, the health care system that serves their large rural area. In the accompanying photograph, the men stand back to back in their long white coats. Although it had been over eight years since I have seen them in the flesh, “that feeling” welled up in my chest. My people, Jews hailing from eastern Europe, call the special sense of pride and joy one gets from the accomplishments of one’s children, “Nachus.” That is what I felt.

 Creating and supporting mentors is critical to the mission of the Kern Institute.

• Transformational Innovation (TI2) projects: As Chris Decker, MD and Julia Schmitt of the Kern Culture and Systems Pillar described in detail in their piece in the Transformational Times last week, a very large group of students, staff and faculty are involved in creatively developing a set of sixteen Transformational Innovation (TI2) projects focused on mentoring of – and enhancing a deep sense of belonging for – our underrepresented minority (URM) students.

• Virtual Health Science (VHS) mentor program: Last week we, Jean Mallette, Program Manager for Student Inclusion and Academic Enrichment, Malika Siker, MD, Associate Dean for Student Inclusion and Diversity, in collaboration with Cassie Ferguson, MD, Kern Student Pillar Director, kicked off the Virtual Health Science (VHS) mentor program for five MCW medical students selected to mentor local high and middle school students into health professions careers.

• URM scientist peer mentoring development: I am now preparing, for the 10th year in a row, to run an annual summer, week-long near-peer mentor development program for URM health services scientists as part of an NIH funded Program to Increase Diversity in Behavioral Medicine and Sleep Disorders Research (PRIDE) Institute. I want to share my view on the mentoring “secret sauce.”  

 

“Mentoring” as a misunderstood concept
 

“Mentoring” is what linguists call a “god term.” Mentoring is used frequently without consensus about what it specifically means, but it is seen universally to be a good thing – like “love” and “mothering” – which makes it seem magical. The limited number of rigorous research manuscripts confirm that highly successful academicians are much more likely to report having had at least one significant mentor in their lives. Most mentors believe they are good at it. 

But, beware! There are pitfalls and problems. The available commentaries and thought pieces have been primarily written by white men. Women and URM individuals are less likely than white men to report having had a mentor. It is possible for mentors to be harmful to their proteges.

 

As a white woman with at least six highly influential mentors in my life, I have tried to “pay it forward” by serving as a mentor for hundreds of others. Here is what I believe, It is mentee-ing skills, not mentoring skills, that matter most to the success of the mentee-mentor relationship.

 

Characteristics of successful mentees

Have you noticed that successful individuals are active participants in their own mentoring and allow themselves to be mentored? They seek advice and feedback everywhere. They “manage up” being persistent, reaching out and being prepared for all contact with their mentors with specific questions and next steps. They usually, but not always, seem to know where they are going and why – even when not certain. Oh, yeah, and they are very forgiving of the human foibles of their mentors. They are realistic about other humans; they respect and are respectful of their mentors; yet they do not put their mentors on a tottering pedestal from which they will, in all likelihood, fall.

Successful mentees are open to everyone, but selective. They become good at accumulating mentors who are people with integrity, who will not take advantage of them, but will provide them with supervised opportunities to learn how the world works.  And most importantly, they collect people they can trust to hold them to high standards and provide an abundance of – especially critical – feedback. They understand how to get very busy people to spend time with them, advocate for them and dare, I say, “love them.”

 

Deliberately assembling a mentoring network

The truth is that most of us who report having a mentor have, in reality, assembled a “mentoring network” or, as Dr. Greer Jordan calls them her, “board of directors.” The single mentor model – or the “great man in the lab” model of mentoring – while successful for a few is not, and probably has never been, the predominant model in medicine and science. Knowing all this, when I first meet with a new “mentee” I pull out an empty Mentoring Map from the website of the National Center for Faculty Development and Diversity. I walk away for 10 minutes giving them time alone to fill it in as completely as possible. Then we review it together. There are almost always areas of richness and obvious gaps. Then we talk about what they discovered and plot out ways to fill and cultivate the gaps.

Becoming a great mentor

Don’t get me wrong, being a mentor is by no means a passive role. Effective mentors make sure their protégés learn to be effective mentees. Mentors build the protégé’s skills so they will be confident and respectful when they reach out to busy people, expand their networks, and get what they need.

Effective mentoring requires special insights and skills, as well. Mentors must never take advantage of their mentee’s admiration. The mentor balances the roles and relationships with the mentee – boss, lab leader, teacher, mentor – each of which can carry competing interests.

The mentor provides a sense of vision that helps the mentee see their potential future selves, identify sets of attainable goals, navigate institutional politics, gain insight into organizational politics, manage failure, and provide resources for financial management.

The mentor encourages the mentee to maintain balance by planning personal and career goals in tandem.

The mentor must have exquisite maturity, communication skills, availability, responsiveness, generativity, and a willingness to focus on the needs of others over self. The mentor must be self -aware, have solid emotional intelligence, and be a model of excellent time management. Especially time management. Mentees need time, advocacy, access to resources, and not just love.

Finally, the mentor must be able to recognize when it is time to let go and move into a peer-to-peer relationship.

 

Mentoring despite differences

Traditionally URM folks have not had mentors who “look like them.” This is not always a bad thing, but it provides a greater challenge for both the mentee and the mentor. Differences must be navigated with openness, trust, and a willingness to listen nonjudgmentally to the mentee’s lived experiences.  

I learned early in my career that I needed to judiciously avoid potential male mentors who didn’t speak with obvious love and respect for the women in their lives – their wives, daughters, mothers, sisters, colleagues, and friends. Men who are not in the habit of listening and believing the world view and experiences of women were not going to be able to guide me in the way I needed. And of course, there have been many women in my life who were not, as disappointing as it was, “good-fit” mentors for me.

 

Back to J. and M.

After identifying a shared interest in ethics and the moral development of physicians J, the eldest, sought me out. I have a rule. If a student – any student – requests a meeting, I always make time. That was the beginning of a series of regular conversations in person and by email throughout the years he was a medical student and then a resident at our institution.  We have had wide ranging discussions. He worked with me on a series of projects. I introduced him to others, wrote him letters of recommendation, sent wedding gifts, and – when he asked – provided personal advice and recommendations. I met his parents and fiancé on Match Day and at a graduation celebration.  When his little brother joined our school, I agreed to meet with him as well.

I was not their only mentor, there were many others. But now I feel I have made a significant contribution to the lives they lead, the physicians they have become and the patients they care for. That’s Nachus.

 

References:

 

Williams, N., Ravenell, J., Duncan, A. F., Butler, M., Jean-Louis, G., & Kalet, A. (2020). Peer Mentor Development Program: Lessons Learned in Mentoring Racial/Ethnic Minority Faculty. Ethnicity & disease, 30(2), 321.

 

Jean-Louis, G., Ayappa, I., Rapoport, D., Zizi, F., Airhihenbuwa, C., Okuyemi, K., & Ogedegbe, G. (2016). Program to Increase Diversity in Behavioral Medicine and Sleep Disorders Research: Mentoring junior URM scientists to engage in sleep health disparities research: experience of the NYU PRIDE Institute. Sleep Medicine, 18, 108-117.

 

 

 

Adina Kalet, MD MPH is the Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education and holder of the Stephen and Shelagh Roell Endowed Chair at the Medical College of Wisconsin.

 

 

 

 

First-Year Medical Students React to COVID-19: Feeling Isolated, Seeking Knowledge, and Becoming Empowered

From the 6/26/2020 newsletter

Fourteen Medical Student Voices

First-Year Medical Students React to COVID-19: Feeling Isolated, Seeking Knowledge, and Becoming Empowered

 

 

Despite being isolated because of the pandemic, first year medical students came together virtually to hear basic science and clinical information about SARS-CoV-2 and most created written reflections on the session and their pandemic experiences. Here is a summary of the session and excerpts from fourteen of their essays…

 

  

Medical students, like most people in healthcare, are bombarded with questions about the novel coronavirus. Families, friends, Facebook acquaintances all want to know what to do. A group of MCW educators filled in the gaps.

 

On May 15, 2020 – while students were banned from attending in-person classes and ten days before George Floyd was killed in Minneapolis – medical students from all three MCW campuses joined together virtually to hear presentations on the current state of knowledge about SARS-CoV-2. The session was designed by Mark McNally, PhD (Associate Professor of Microbiology & Immunology), Sandra Pfister, PhD (Professor of Pharmacology & Toxicology), and Kern Institute faculty and staff to be interactive, innovative, interesting, and relevant. The session included clinical and basic science presentations.

 

·         Jayshil Patel, MD (Associate Professor of Medicine – Pulmonary, Critical Care and Sleep Medicine) presented the clinical case of a “super-tired” 28-year-old healthy man who came to the hospital with breathing problems. Dr. Patel told the students about his physical examination, describing and demonstrating his bronchial breath sounds and labored breathing. He reviewed the laboratory studies showing evidence of infection and inflammation. He then went step-by-step through the thought processes needed to make a diagnosis.

 

·         Vera Tarakanova, PhD (Associate Professor of Microbiology & Immunology) debunked several popular myths about the coronavirus. Although much remains to be discovered, this particular virus does not seem to mutate, immunity is protective, and it remains transmissible for a long time.

 

·         Sandra Pfister, PhD (Professor of Pharmacology & Toxicology) reviewed the process of drug discovery, noting that it takes years to get effective new drugs to market. Society benefits when treatments are shown to be safe and effective before they are widely prescribed, and even off-label use of established drugs carries risk.

 

·         Dr Patel then returned to tell the rest of the patient’s story. The man, despite being young and previously healthy, worsened and, despite aggressive treatment, died on the fifth day in the hospital. Dr. Patel talked about the effect his death had on the hospital staff. He lamented how the need to keep the patient isolated affected both his family and the caregivers. Every death – especially in this situation – carries collateral damage and leads to moral distress. Dr. Patel also talked about how, as the virus has become more common, physicians can suffer from tunnel vision, thinking that every patient has COVID-19, even when they might not. Dr. Patel finished by telling the students that there have been some triumphs, as well. There is a camaraderie amongst staff. There have been some engineering innovations and the process of repetitive care has sharpened physical exam skill sets. Humanity shows through in the process of caring.

 

 

Students were given the opportunity to obtain one extra-credit point by writing a reflection on the presentation and how the pandemic has impacted their lives. Of the approximately 250 students who were assigned to watch the presentation, 174 took advantage of the opportunity. Several faculty members volunteered to review the essays and were moved by what they read. Those faculty members each recommended essays for this article.

 

 

Below are brief excerpts from several of the submitted essays that reflect the first-year medical students’ concerns, challenges, and dreams. Each author has given permission to share their excerpt and their name.

 

 

 

British Fields – MCW-Milwaukee

 

I am really happy that this lecture was delivered. I have to admit that I [had been] pretty disappointed [that we] are in the middle of a pandemic … being covered [with] no live lectures, so I was very happy that [MCW] did not miss this wonderful opportunity to deliver something different. Speaking from the heart, I was sad that the disparity that we’re seeing in Milwaukee among the African American patients was not even mentioned during the talk prior to me asking [about it in the Q&A session]. I know that there was a lot to include during the hour, but I was hoping that the patient population that is constantly being overlooked would be discussed in some way.

 

I know a lot of people that have either had COVID and have thankfully recovered, but I also know many that have had to bury a loved one that died from COVID. [O]ne of my mentees’ mom is a nurse that contracted the virus and ended up on a ventilator. Thankfully, she is recovering, but I say that to say healthcare workers are risking it all for us. However, the triumph in togetherness does come with a tragedy. I have seen many ignorant people banning together to break laws openly and they are handed a mask by authorities. However, when a Black man takes a jog, he’s murdered, and his murderers were freely walking after the incident. … Or the countless videos of Black gatherings being physically forced to break up by officers. COVID has brought on a sense of togetherness, but it’s also allowed the nasty principles that this country was built on to flourish and has put more fear in my heart about people more than the bug causing this virus.

 

 

 

Megan Quamme – MCW-Milwaukee  

 

This virus has taken a huge toll on me in a very personal way. My roommate, K, went on a trip … in March, right when all of the restrictions were JUST beginning. She just turned 26 and has not had any significant medial history. It was the first weekend of our spring break. [I was still out of town when] K returned. The next day she felt sick and was told to get tested by her workplace. The following day, March 15th, we heard the news that she was positive for SARS-CoV-2. At the time, I thought that she would be in quarantine for two weeks and then I would be able to go home, on April 1st.

 

The following week, K went to the hospital for shortness of breath. A few days later, she had to call 911 on herself to be taken to the ER. Her saturation was 80% when she arrived at the ER. She was given oxygen and some asthma treatments and was sent home with an albuterol inhaler. She said she could barely walk 10 feet down the hall to use the restroom for a few weeks. She went to her PCP 3 times for follow-up chest x-rays after her symptoms would not go away. She was treated for bacterial pneumonia. On April 20th, she finally had her first fever-free day. On May 4th, she officially tested negative for SARS-CoV-2. What started as a week-long [spring break] trip turned into a 7 week quarantine. My roommate was alone. If her situation had gotten worse, she could have ended up on a ventilator or even died, alone in the hospital.

 

I dealt with a lot of guilt during that time, and still am. I wonder if I am the one who gave it to her and just didn’t have any symptoms? I wonder if there was more I could do to support her? I wonder at how I was so lucky to avoid getting infected, and being ill at the same time as her. I wonder how her health will be affected for the rest of her life. Her PCP told her she will likely always have exercise-induced asthma.

 

… I feel that I have a responsibility to tell my story, but it often falls on deaf ears. The only people who want to hear it are those who listen. I find myself in a struggle between trying to be a leader of my community and to be outspoken about evidence and my story and protecting my own mental health and well-being.

 

 

 

Benjamin Hodapp – MCW-Green Bay  

 

The greatest personal challenge I have felt during this pandemic has been the lack of agency in being able to affect positive change for those at risk. I chose to enter medicine for this specific reason. As students, my colleagues and I are in the unique situation of being in a helping profession with little-to-no agency when it comes to serving the public in any tangible way. I have done my best to define ways I can assist those less fortunate, but it feels woefully inadequate. Now that we approach entering the clinic on June 1st, I am concerned for the safety of my ‘soon-to-be’ patients. Will I be the one who possibly transmits the virus to them? The strain of the dichotomy to be involved in the health care response while protecting my patients (after all, I am only a student with little to offer) has been a challenge as we approach the clinic commencement.

 

The main take-away from the three lecturers was simply: while we know a great deal about this virus and its components, we know very little about treatment, disease progression, and how it will proceed in the coming months. Caution is our number one friend in this time of crisis and it was heartwarming to hear rational, incredibly well-educated people that I sincerely respect speak about how we should be approaching future steps with care.

 

 

 

Sarah Steffen – MCW-Central Wisconsin

 

As a medical student, and therefore someone who has committed herself to the idea and importance of scientific evidence and evidence-based practices, and to keep people safe from harm, COVID has brought to reality, perhaps at one of its most nightmarish levels, the idea that a significant portion of our society dismisses science, education, and the universal human need to have empathy and take care of one another. …

 

…I come from a small, rural, and definitely more conservative town in the state of Wisconsin, my social media, in particular Facebook, has been flooded with conspiracy theories and misinformation from people who often post about “not wanting to blindly follow others, and wanting to think for themselves.” But following scientifically proven information is not following blindly. … But how do you get others to realize there is a difference between scientific evidence and an opinion? How do you get them to care? …

 

For me today, the biggest takeaways from this session quite simply revolved around the themes of scientific information and compassion. Scientific information that was from credible sources and experts of multiple fields, and the compassion that went side by side with presenting that information for how we can work towards a better future to take care of one another.

 

 

 

Erica Engstrand – MCW–Milwaukee  

 

… Whether it be a pandemic, medical school rejections, or life in general, I know that anxiety is something that will always be present in my life. You’d think that because screens have replaced so many of the faces I looked forward to seeing every day, it’d be worse. But because of this pandemic, I’ve never felt so supported by my friends and family. While living at home with my family right now isn’t ideal, I am so grateful for the fact that at least there’s no screen between us anymore.

 

I rest easier now. I have enjoyed mornings talking to my dad [who is a general surgeon] about our shared love for anatomy lab. He’s told stories about his own time in medical school and how he met my mom [an anesthesiologist] there. We reminisced about loved ones gone too soon and debated the future of health care. …  Later we made pancakes.

 

 

 

Connor Ford – MCW-Milwaukee  

 

I love sports. I rarely find time to watch them in medical school. … [but] the stars aligned when spring break fell during the same week of March Madness, the NCAA Men’s basketball tournament. … The week prior to spring break … everything was shutting down. … The NCAA tournament, US Soccer games that I had been looking forward to for months, the Bucks soon to be in the playoffs, start of MLB, all of it gone.

 

I know that sports don’t really matter much in the grand scheme of things. … But in the high stress interval of exam week … I was incredibly bummed out by how much I was looking forward to watching ten men try to throw a leather ball through a basket. It all seems so miniscule now.

 

[J]ust about everyone around me has had it worse. I wish I could take on some of others’ burdens. … To think that I was upset about sports being cancelled ... I feel guilty to even admit it.

 

I think the biggest takeaway I’ve had from this experience is that there are so many good people out there - selfless people doing so much for the benefit of all of us. … I’ve read so many stories of giving, of sacrifice, of communities coming together, and those stories give me hope that we will persevere and we will eventually defeat this virus.

 

 

 

Anna Janke – MCW-Milwaukee  

 

So many pieces of information I had previously taken as facts were flipped on their heads, as our panelists separated fact from fiction. … I had not realized that the transfer of information from virology/medical experts to popular press is a bit like the game ‘telephone,’ where facts and terms may get lost in translation. For example, COVID-19 is a disease, rather than an infection; the infection is called SARS-CoV-2. Furthermore, some information spread by the media and laypeople on social media is downright false. Before this presentation, I had no idea that is it unlikely we will see a new strain of SARS-CoV-2, as it mutates slowly compared to influenza due to the proofreading ability of its replicase complex. … I was quite shocked to learn that “social distancing” and “six feet apart” will not, in fact, completely prevent the spread of SARS-CoV-2, as infected aerosols can stay in the air and travel for hours.

 

As my first year of medical school comes to an end, I am left with a lot more … concerns than I started, in all honesty. Partly from the pressures of medical school and partly due to holing up at home in the midst of an unprecedented pandemic, I struggle to find meaning in the monotony of my days. However, I do not have to look hard to find those for whom I care and those who care for me, whether it be my friends, fiancé, family, or faculty at MCW.

 

 

 

Annie Tuman – MCW-Milwaukee  

 

As a medical student during this pandemic I have felt pretty lost regarding knowing what my purpose or role is. Being almost one-quarter of a doctor has put me in limbo of knowing just enough to understand when news outlets/Facebook friends are probably spreading false information, but not knowing enough to be clinically useful or helpful. Lately, I’ve been landing at the conclusion that the most helpful thing I can do right now is to lead by example and practice correct social distancing. However, there has seemed to be a national attitude divergence away from “flatten the curve” and a shift toward an extreme dichotomy of either “self-isolate until there’s a vaccine” or “a virus can’t stop me from living my life.” I’ve heard valid arguments and personal stories in favor of both camps, and I have been left wondering if there really is a correct way to social distance—and if there is, what it should look like.

 

… I have been disappointed that a lot of my friends have not been wearing masks because they think they’ve already been exposed, it doesn’t look cool, or any other number of reasons. I plan on using Dr. McNally’s point that a mask looks a whole lot less cool than a ventilator. I think it’s important to add that we all have a right to do and go where we want, but we do not have a right to put other people’s lives in danger. If people want to go out in public, it is their duty to at least wear a mask.

 

 

 

Dima Jaber – MCW-Central Wisconsin

 

In the beginning I felt like we were all in this together, but then people decided they were just sick of the new rules and started to protest. I am mostly disappointed in those people, some of which are friends, family, and classmates and feel that this experience has placed a lot of strain on my relationships and vision of the future.

 

I have always believed that people are entitled to their own opinions and beliefs, however I have a hard time seeing the viewpoint of those who are spreading false facts about COVID-19 and being reckless around others.

 

… I am sad to say that the nurse who recently went viral for proudly stating she was a nurse while at a bar is one that I used to work with, and while I did not know her very well, I thought I wouldn’t see this type of behavior from her or anyone I knew. This is especially considering my friends in healthcare who are working nonstop to help patients while knowing they are risking their own lives and those of them who have gotten sick. … This type of behavior will bring COVID-19 to the most vulnerable populations of Milwaukee County who are already feeling the wrath of this pandemic.

 

… We all know someone who has been affected by loss during this pandemic and is hurting. I would really hate for all this loss to have been for nothing.

 

 

 

Amanda Wright – MCW-Central Wisconsin  

 

We often learn about countless disease processes in medical school that we could never contract or develop firsthand. Maybe it has been eradicated from the country in which we reside. Maybe it no longer applies to our own age group as we survived the critical time one becomes infected. Maybe we were fortunate enough to receive a vaccine, or perhaps our own functioning immune spotted an infection and prevented its host from ever gaining knowledge that they may have ever became infected. … However, I didn’t realize what true fear of contracting a disease could be until the 2020 COVID-19 pandemic.

 

… I am terrified to begin my clinical experience in just over two weeks. Under most circumstances, the typical med student worries of even knowing which questions to ask or how to perform certain elements of the physical exam or note taking, but these processes pale in comparison to the thoughts that have been occupying my mind in light of this pandemic time. Instead of practicing how to properly stitch a suture, I am sewing my own reusable cloth mask to protect from the spread of this virus. Instead of rehearsing the nuances of the physical exam skills, I am rehearsing how I plan to come home at the end of the day from clinic by changing my clothes in my garage and running immediately to the shower all while avoid the potential crossing of paths with my family or even my dog. The fear of not being able to protect myself anymore from the virus looms over me, especially after doing my absolute best to not come in contact with the virus by not leaving my house for the last two months.

 

 

 

Chase LaRue – MCW-Milwaukee  

 

I actually enjoy personal time and thrive in being able to recharge by myself. But that doesn’t make up for the inability to go outside freely, go to the store without a mask, or the overall tense feeling that fell over everyone. …

 

Nothing really sank in until my friends that are nurses, doctors, and other healthcare professionals started flying across the country to sign short contracts in New York City. I then realized that the emotional trauma suffered by our front line is something that is going to last forever. This isn’t going to be something fondly looked back on in textbooks. It’s going to be as tear-filled and painful as war, famine, and economic crisis.

 

And so, I need to preface my next comment carefully… I’m thankful for the opportunity to develop perspective and mindset. I hope that as people step away from this, they take the personal and public challenges and develop a sense of … community. … How did they respond? How did you respond? Will there be a reflection to make sure that the damages and destruction by nature aren’t done so in vain?

 

 

 

David Wittmann – MCW-Milwaukee  

 

I cannot imagine how I would respond to a patient in clinic demanding immediate, and potentially experimental, treatment that has not at least been approved for clinical trials. As was stated in the lecture, any drug without some sort of benefit will only have negative side effects. It is amazing to me that given this information, some individuals still push for various agents … I am hopeful that a vaccine can be developed as soon as possible, but we must all realize that this process is lengthy, and it would be better to wait for a proper vaccine to be produced than simply take a “trial-and-error” approach with potentially harmful agents.

 

In times that seem like we are constantly pinned against ourselves, I have never witnessed camaraderie as has occurred since the virus spread throughout the country. The solidarity between the public and healthcare works, first responders, and essential workers gives me hope that once this is over, we will be more united than we were previously and we will learn to work together to fight future issues.

 

 

 

Abbie Scheidt – MCW-Milwaukee

 

In my last semester of undergrad last spring, I took an infectious diseases course where we talked about what would be the next pandemic. We talked about a new avian flu, smallpox, a multi-drug resistant gonorrhea, and Ebola. We even talked about SARS/MERS but concluded as a class that the most likely future pandemic would be a flu strain, likely H5N1 or other strains of avian flu. As I write this, I am looking back at my notes from that class session and I laugh a little to myself. My small class of 20 students and our professor, less than a year ago, sat around a classroom brainstorming the viruses that would wreak havoc on the world, not knowing what was to come and how wrong we were. All around the globe, scientists and doctors were having similar conversations. They all knew the world was due for a new pandemic, and soon. In my notes from that class, I have written that “90% of epidemiologists expect there will be a disruptive, deadly, global cataclysmic pandemic sometime in the next two generations.” It wasn’t a matter of if, but when. So, if the scientific community knew that a pandemic was coming, why was the world so unprepared? Why didn’t we all stop and listen to them?

 

… It hasn’t been easy watching from the sidelines as several of my own family members fell ill to SARS-CoV-2, including my cousin who is only a few years older than me. Seeing him require brief hospitalization from coronavirus at such a young age shocked me.

 

…With no end in sight, no one can say how our world and medical community will recover and grow from all this destruction. I can only hope that the world we build after the dust has settled is a better one.

 

 

 

Greta Berger – MCW-Milwaukee

 

I feel frustration, as I see the contrast between facts we know to be true, from evidence based research and public health officials, against the spread of information based entirely in suspicion and angst. I can’t understand the audacity some have to decide they know better than the recommendations from public health professionals. And, I also feel sad. It isn’t often during medical school you allow yourself the time necessary to process the events occurring around you. As Dr. Patel described the tragedy of watching a patient fight this virus, alone, and watch another patient die, alone, without their loved ones, my eyes filled with tears.

 

This last month has become more and more isolating as the studies have continued – feeling disengaged with the material, and far from my classmates. It has started to feel unimportant, studying so much, as the world around me is so loud, with fear and opinions and pain. I want to spend more time on Facetime with my mom and dad, and connect with my friends who are overwhelmed, and go for walks to process this moment.

 

There has … been an overwhelming sense of togetherness. Among my family and friends – we are all reaching out often. I have been exchanging emails and phone calls with my grandma weekly. And I feel so connected to this profession, full of heart, amidst the chaos and fear. It is a scary time to be entering the field, but I know I will be in good hands surrounded by inspiring, compassionate colleagues.

 

Martin Luther King, Jr Drive - Milwaukee WI 6/19/2020

From the 6/26/2020 newsletter

Martin Luther King, Jr Drive - Milwaukee WI 6/19/2020

Photo credit: Julia Schmitt

Parenting in the Time of Black Lives Matter

From the 6/19/2020 newsletter

Parenting in the Time of Black Lives Matter

Lara Voigt, MD

When my son was born in March 2020, I thought the most dramatic stories I would be telling him about his birth would be related to the pandemic. I had been in quarantine for only a few days after my husband tested positive for COVID-19, when I went into labor, becoming one of the countless new moms to go through labor and delivery without their partner or a support person.

I thought I would be telling him how my anesthesiologist held the phone to video call my husband for the birth and how my nurse took pictures of us when he was just minutes old. I thought the main tragedy surrounding his birth would be all the families separated and lives lost during the pandemic. We were lucky that my husband never had to be admitted, and we were only separated for the first week of our son’s life.

Two months later, I sat on the couch with his tiny head resting on my chest, scanning news articles, and watching as communities took to the streets to protest the murder of George Floyd. As non-white communities stood up to say "Enough," I became acutely aware of the incredible privilege my son had been born with as a white male child of two physicians, and that our stories surrounding his birth would be about far more than quarantine and PPE shortages.

Long before I planned to have children, I imagined how one day I would teach mine about race, gender, sexuality, privilege, poverty, inequality, and how to be a good human. I was worried about how society, including my children’s school friends and the media, would shape their biases despite my best efforts. 

But what would “my best efforts” be?

Our son is not going to grow up in a world where everyone is treated as equals and respected regardless of their color, but I hope I can foster in him a respect and recognition that all life as equal. I often start to think, "Well, growing up in South Africa, my experiences..." then stop myself as I realize this is me making excuses for the implicit biases I know I hold. I try to recognize and analyze these biases on a daily basis and want to teach my child to do the same. 

I'm sure I am one of the many who feels useless as I sit safely at home with my newborn. I feel guilty that I am not in the streets supporting my community, nor in the hospital treating patients on the front line of the pandemic. I think nothing I would do is "enough" because I am just one person.

But we are all "just one person" and together we are a national voice. There are so many seemingly small things we can do that, in sum, make a difference. We can educate ourselves, be honest about our biases and actively work on them. We can donate our time or money to organizations, and speak up when we see racism, injustice, and inequality in action. These are actions and values I hope I can instill in my children.

When the protests first started, I cynically thought this would be another flash in the pan for racial equality, a recurring movement that gets brief national attention every few years when an atrocity gets caught on camera and we are reminded of the horrendous inequality our non-white communities experience on a daily basis. But as the protests continue and real change seems to be more than just a pipe dream, I think I may have to change the stories I tell my child about his birth. He will no longer be a #COVID baby, but also a Black Lives Matter baby, and hopefully a child and adult who recognizes the differences between us but does not treat those differences as either a negative or a positive.

Until we get to tell him these stories, I will continue to educate myself, work on my biases, stand up for those around me, find ways to support my community, and find ways to teach this small human that Black lives matter just as much as his tiny white life does.

Lara Voigt, MD is an Assistant Professor of Medicine (Hospitalist Division) at MCW. She is the Associate Director of the Bedside Procedure Service.

North Avenue at Holton Street, Milwaukee - June 13, 2020

From the 6/19/2020 newsletter

North Avenue at Holton Street, Milwaukee WI 

June 13, 2020

Photo courtesy of Venus Coates, MBA

Pushing Institutional Climate Change for Underrepresented Minority Students

From the 6/19/2020 newsletter

Pushing Institutional Climate Change for Underrepresented Minority Students

Chris Decker, MD, and Julia Schmitt

Malika Siker, MD, MCW’s Dean of Student Diversity and Inclusion challenged our Kern Institute design team to dive into an important question: Why don’t our Underrepresented Students in Medicine (URM) apply to residency programs here at MCW?


Surveys had been conducted over the years, but the data did not reveal what was really happening with these students during their medical school years. Why did so many of these students want to leave?


At the Kern Institute, we use human-centered design to elicit stories and experiences around an issue. We crafted an exercise, coined a “design sprint,” and asked volunteer URM students to share a story from their medical school experience when they felt they didn’t belong. We paired the twenty students and, as they shared stories with each other, we captured and grouped the narratives into themes.




Gathering Input from Students, Faculty, and Staff

Next, a Kern Café was convened, titled “Cultivating a Culture of Inclusion for Underrepresented Students,” in September 2019. The session attracted approximately a hundred participants. We reviewed the results from two MCW surveys on student experiences and the design sprint findings. The surveys demonstrated that students who self-identified as being from racial/ethnic minorities felt gaps in diversity, campus-wide engagement in diversity activities, and negative differences in how they are perceived and treated on clinical rotations. The design sprint identified three themes: lack of respect, lack of support, and lack of connection.


After hearing the results, a student in the audience challenged us all: “These results are not surprising. What is the plan for the institution to change the climate?”


This challenge was supported by the rest of the audience. The combination of survey data and stories from the students made for a powerful presentation. Everyone wanted meaningful change.




Focusing Innovation on MCW’s Cultural Climate

As a result, we made “URM Student Inclusion” the theme of this year’s Transformation Ideas Initiative (TI2). This is the Kern Institute’s seed grant program – three years running – where students, staff and faculty are invited to submit ideas on how to innovate medical education.


The call for ideas went out in January 2020. Of the more than fifty ideas received, we advanced sixteen into development this academic year – fourteen of which are focused on URM student inclusion and eight of which are student-lead teams. The teams are organized into four cohorts: mentorship, implicit bias, cultural humility, and leadership/professional development.


The program kicked off with a virtual workshop on June 10, 2020, with over eighty participants excited to get started! This will be a team effort by all, evidenced by the “virtual high-five” photo from our Zoom workshop.

Next Steps

This summer, we’ll take them through workshops to help them refine and scope their project teaching and using an innovator’s mindset. The foundation of this work is empathy and a relentless pursuit of creating value in their programs, using curiosity and creating partnerships. Each team will be surrounded by experts and facilitators along the journey.


The goal is to begin the rewrite the URM student experience at MCW - and to make good on our promise to those who want to change the climate for future students.


TI2 2020 Projects:

M. Chris Decker, MD is a Professor in the MCW Department of Emergency Medicine and Chief Transformational Officer for the Froedtert & MCW Medical College Physicians. He serves as Director of the Culture and Systems Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.

Julia Schmitt is Program Manager of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. She also serves as an editor of the Transformational Times.