First person perspective: Dr. Anthony S. Fauci & the NIH Clinical Center
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First person perspective: Dr. Anthony S. Fauci & the NIH Clinical Center - Dr. James K. Gilman, We had a young patient in the 7 SWN clinic One of Dr. Fauci’s daughters recently got NIH Clinical Center CEO who had the audacity (I say “audacity” with married in New Orleans. Only problem was a smile and tongue in cheek) to ask to meet that Dr. Fauci had COVID-19 and could not Everyone on the planet knows that Dr. Fauci Dr. Fauci. As his accompanying parent noted, get on a plane to be there. Watching your is leaving the NIH at the end of this year. the nature of the patient’s malady eliminated daughter get married on Facebook Live isn’t While there is no shortage of interviews and the lifesaving (at least in my case) flter any father’s dream. Again – no media stories in the national media marking this between his brain and his mouth. attention even though it would have been a event, Dr. Fauci’s unique relationship with the The patient made his request to a member great opportunity to enlist some sympathetic NIH Clinical Center deserves at least this brief of the Department of Perioperative Medicine support for Dr. Fauci. Putting this into the commentary. I think the relationship is best staff involved in his procedure. The staff public domain would have further detracted viewed through a series of short vignettes member sent an email to Dr. Fauci, and, sure from his daughter’s big day. that – as the CEO of the Clinical Center Now I do not want anyone to think – I have access to but others may not. that I am not aware of Dr. Fauci’s many None have occurred in the public faults. Some time ago I noticed a book whirlwind of Dr. Fauci’s activities during for children in the FAES (Foundation for the COVID-19 pandemic. I am Advanced Education in the Sciences) confdent that the essence of these bookstore window entitled Dr. Fauci vignettes is true, but I have not fact is Never Grouchy. I asked Dr. Christine checked with Dr. Fauci. There is Grady, Dr. Fauci’s wife, if she had been something pleasantly naughty about consulted about the book title. She writing this piece without his approval. assured me that she had not been Some time ago, the Clinical consulted and that the book should Center’s executive offcer, Dan probably be catalogued in the Lonnerdal, informed me that bookstore section devoted to fction. He participants in Project SEARCH, a gets grouchy. Who knew? program dedicated to providing Then there is that time when a hot education and training to young adults mic captured him calling a senator from with intellectual and developmental Kansas a bad word during a contentious disabilities, wanted to know if they hearing. Most signifcantly, there is that could have a picture taken with Dr. Anthony Fauci in the Clinical Center’s frst pitch at the Washington Nationals Dr. Fauci. I was pretty confdent that Special Clinical Studies Unit. game (no doubt memorialized on Dr. Fauci would be up for this request YouTube for those who didn’t bear but also knew – like everyone else – that he enough, Dr. Fauci paid the patient a visit. witness). Probably nothing more needs to be had more on his plate than anyone could Just as in the previous vignette, no fanfare, said about that. manage. I approached him through his inner no entourage, no media, no pictures in the The hyperpolarized world may debate Dr. circle and, sure enough, we had the green public domain – just Dr. Fauci providing a Fauci’s greatness. This piece has been about light to make the arrangements for the bright spot in the life of a young man who his goodness. If the price of greatness is the photo shoot. Because of scheduling issues, has few enough bright spots because of his price Dr. Fauci and his family have paid over the photo shoot had to be postponed and medical issues. the last couple of years, then I don’t know rescheduled two or three times. Note the The only important things Dr. Fauci and why anyone wants to be great anyway. But I wording here. The photo shoot was never I have in common are (1) we both married think I know a thing or two about cancelled. Dr. Fauci understood full well what well (somebody please tell my wife that goodness. I think Dr. Fauci’s inherent this photo op meant to our staff from Project I wrote this) and (2) we both have three goodness, as evidenced by the vignettes in SEARCH. The photos were eventually taken, daughters and no sons. this piece, is the epoxy that binds the NIH and I have it from a reliable witness that Dr. Parenthetically, acclaimed Drs. Steve Holland Clinical Center tightly to him. Those of us Fauci took time with these incredible young (NIAID) and Maryland Pao (NIMH), who also who work in the hospital have been people and he had a good time personally. work inside the Clinical Center, are members witnesses to Dr. Fauci’s goodness for over Note that there was no media present and of the three-daughters-with-no-sons club forty years. We know what he’s like when pictures never hit the public domain. This as well, while NIAID Deputy Director for the rest of the world isn’t looking, and we event was for the Project SEARCH folks. Clinical Research and Special Projects Dr. Cliff couldn’t be more proud of what we have Lane overachieved with four daughters and, been privileged to see. There is no debate hence, only qualifes for affliate status. for us.
It’s time to ask the hard questions about the future of work Changes implemented over the pandemic can help us rethink our approach - Dr. James K. Gilman, NIH Clinical Center CEO Using the analogy of a family, a 360- degree survey would involve our parents, Questions for all staff At the October town hall meeting, I introduced our children and our siblings – all frst degree the general topic of the “future of work” relatives. (I do not advocate 360-degree sur- (1) Is my supervisor satisfied with (hereafter abbreviated FoW). I indicated that as we have the opportunity to think about our veys in families, just trying to make a point.) However, just as teamwork is a little too the quantity and quality of my work and our place of work because of the simplistic to describe relational work, a transactional work? reduced need to focus on COVID-19, we have 360-degree survey is still too narrow to to think about all the work that we do. For the encompass our relational work. Even if we (2) Is my supervisor readily purposes of discussion, the work is divided into get thoughtful assessments from our accessible? transactional work and relational work. supervisor (another member of the Clinical Transactional work may be thought of as Center staff), our direct reports (also (3) Am I readily accessible to my “my” work. It represents my individual members of the CC staff) and our peers (yep, supervisor? assignment and the specifc work product on also members of the CC staff), we neglect which my contributions to the NIH and the crucial constituents. I will get to those in the (4) Am I fully abreast of indi- Clinical Center are assessed. The attributes of conclusion of this piece, but the quickest way vidual and collective goals of my transactional work are enumerated in my performance plan and assessed in my to make a problem too hard to solve is to make it so big and so complicated that we work unit? performance appraisal. At least some of the lose hope. So, let’s start with a simple elements of my transactional workload are 360-degree assessment of our relational (5) Are our staff meetings as readily measurable. My frst premise is that we work. Here are the hard questions to get this productive in the virtual have managed to get pretty good at assessment going. environment as when they were doing transactional work during the pandemic There are lots of questions and, in one way held face-to-face? whether we are present in the workplace, or another, they all have importance. working remotely or working in a hybrid However, I think these questions are only the (6) Do my co-workers think I am fashion – sometimes here and starting point for the discussions that need pulling my weight, doing my fair sometimes remote. to occur. If we go back to the analogy of the share? On the other hand, relational work is “our” family, what happens when we extend the work or the work we do together. It represents my contributions to the transactional work of assessment to our extended family – all the cousins, aunts, uncles, grandparents, etc. For (7) If I am someone who has others and their contributions to mine. I don’t instance, the questions listed do not address been in our work unit a while, am think there is a better synonym for relational perceptions by the other NIH Institutes and I able to lend my experience and work than teamwork but teamwork is still too Centers of our level of support while expertise to co-workers who may restrictive to encompass all aspects of working from home or the perceptions of be new? Am I accessible to them? relational work. For instance, my relational our patients and their families. The questions How do they know I am work includes contributions to workplace do not adequately describe the impact our accessible to them? culture and climate; flling in for my physical presence or absence has on supervisor when they are ill or on leave; workplace climate and workplace culture. (8) Do I know what my problem-solving discussions in departmental But wait! There’s more. While it is great co-workers are doing and what and work unit meetings and teaching and to try to answer objectively questions about work priorities have been coaching the latest accession to the workplace until they can function independently. what is or isn’t going as well while we telework, there is still the issue of whether, assigned to them? Inherently more diffcult to measure, it is also now that we are aware of the issues, we can more diffcult to hold any individual or get back to our pre-pandemic relational work (9) If I am new to the individuals accountable when the products of productivity without all having to work organization, do I have enough relational work diminish or the quality of work onsite. What technology is available to us access to those who have been performed is reduced. My second premise is and will it help. My fnal premise is that here longer that I have the that our relational work has not been technology helps enormously, but there are opportunity to learn and grow accomplished so well during the pandemic, situations when it is a poor substitute for and become an even more and we need to make certain that our proximity and familiarity. No group of productive NIH’er? strategies for the FoW account for the outstanding basketball players became a relational work that is crucial to great team just by hours and hours of (10) In well-developed teams able organizational success. In order to approach the FoW correctly, we individual practice. We will not solve the FoW conundrum to telework very successfully, are must endure a signifcant period of once and for all anytime soon, but we start there plans for when a shake-up critical assessment. Our own personal and the process by identifying all the work we do, in the team occurs due to work situations introduce undeniable biases transactional and relational, and then promotion, retirement or sickness? into self-assessments. Most of us are familiar asking all the hard questions. When we have with 360-degree surveys. A 360-degree survey answered those questions objectively and involves assessment by supervisors, direct honestly, we have the beginning for reports and peers – up, down, left and right. understanding what the FoW is all about. 2 Clinical Center news Dec/Jan 22-23
Symposium focuses on blood donors (11) Are team members willing to adjust their schedules as the team dynamics adjust to new and less familiar staff or even the same staff in new positions? (12) What are the dimensions of inclusivity that are still important as we work in a distributed way? 2022 RJD Award recipient Dr. Yvette M. Miller The NIH Clinical Center’s Department of Transfusion Medicine (DTM) and the American Red Cross co-hosted the 41st Annual Immunohematology & Blood Transfusion Symposium in September. The program was designed for healthcare providers who participate in the collection, Questions for supervisors production, transfusion and monitoring of blood products. (1) If I am in the supervisory chain, The virtual symposium focused on current topics challenging transfusion medicine do I have enough interaction with my professionals, including red cell antibodies, supervisor that I can fill in for them CAR T-cells, COVID-19 and donor if they are absent for one reason or recruitment efforts. The symposium also another? featured three clinical vignettes presented by transfusion medicine fellows, Dr. James (2) If I am in the supervisory chain, Long (Administration of RhIG after have I passed along enough transfusion of RhD positive product), knowledge to those reporting to me Dr. Cathy Marcucci (Urgent Plasma so that one of them can fill in for me Exchange for Atypical Myasthenia Gravis if I am absent for a period of time? Syndrome after Immune Checkpoint Therapy) and Dr. Tsung-Lin Tsai (Mobilization and collection of (3) If I am in the supervisory chain, hematopoietic stem cells from a patient do I have enough interaction with my with sickle cell disease). direct reports that I know who is The annual Richard J. Davey, MD, being successful and who is Lectureship was awarded to a past DTM struggling? Do I know my direct transfusion medicine fellow, Dr. Yvette M. reports well enough to know why Miller, for her contributions in the feld of they might be struggling? transfusion medicine in research, clinical practice, commitment to education and (4) Do my direct reports know that I her continuing efforts to recruit minority want them to be successful? donors. Dr. Miller is an Executive Medical Offcer at the American Red Cross in Charlotte, N.C. For more information on the symposium, visit http://bit.ly/3Pbt3io - Karen M. Byrne, MDE, MT(ASCP)SBB Dec/Jan 22-23 Clinical Center news 3
Clinical Center highlights extraordinary clinicians & administrator A cancer doctor, an eye specialist, an ICU Also selected was Her positive professional rapport, ability nurse practitioner and an IT administrator Dr. Teresa Magone to forge strong relationships with patients were selected for their outstanding efforts as who serves as chief and family members and empathy is widely a part of the Clinical Center’s 2022 Clinical of the Consult respected. “Ms. Kent is an exceptionally Recognition award program. Services Section at profcient advanced care practitioner who The CC Clinical Recognition Program was the National Eye provides outstanding and compassionate launched in 2018. Initially, the program Institute (NEI). care for patients in the NIH Clinical Center recognized NIH’s outstanding staff clinicians, Magone was cited ICU and makes important, multi-faceted nurse practitioners and physician assistants. as a team player contributions to the In 2019, the program expanded to include focused on patient Intramural Research outstanding administrators at the hospital. care. Within her frst Program,” said Dr. year as the consult Henry Masur, chief Two physicians shared the Staff Clinicians of Dr. Teresa Magone chief, Magone of the hospital’s the Year award in 2022. observed the fow Critical Care and care of patients and made changes that Medicine The frst is Dr. have decreased consult patients’ waiting, Department. Jaydira del Rivero, testing and treatment time by half. Her easy Seth Carlson, a a staff clinician in communication with patients and families supervisory IT the Developmental helps put their needs front and center and specialist for the Therapeutics Branch reduced confusion by thoroughly Department of for the National explaining treatments. Seth Carlson Clinical Research Cancer Institute. Dr. Magone’s leadership and problem-solving Informatics (DCRI) at del Rivero was cited skills are appreciated by the staff in the the NIH Clinical Center, was recognized as for providing ophthalmology clinic, and she is skilled at Administrator of the Year. Carlson is the professional, bringing the various departments in the NEI clinical architect at DCRI and translates compassionate and to together as one to serve the needs clinical needs into practical IT applications. high-quality care of patients. For the past 12 months, this has included Dr. Jaydira del Rivero to patients with “In 18-plus years of nursing, she is one projects based on COVID such as lab advanced physician who asymptomatic and symptomatic testing, the neuroendocrine malignancies and acting as knows the vaccine clinics and infuenza clinic. a role model in the clinical research importance of He was also cited with making a large community, helping nurture, teach and nurses and treats list of improvements for CRIS, the Clinical develop trainees and colleagues. them like the Research Information System, that manages She regularly trains and mentors clinical professionals they patient and clinical records, improving fellows and physician scientists, serves as a are,” said her communication to providers and his mentor for the Staff Clinician/Staff Scientist nursing colleague leadership in the development of a Pediatric Career Enrichment Program and is a faculty Celestina Igbinosun. Blood Volume tube. When shortages forced member for the FLARE (Future Leaders Therese Kent, a the Clinical Center to switch to a new set of Advancing Research in Endocrinology) pro- supervisory nurse test tubes, he helped the hospital adjust to gram. An effective collaborator, del Rivero practitioner for the account for what tubes are available on site. works across Clinical Center and other NIH Therese Kent Critical Care As the hospital had to adjust to treating Institutes and Centers to forge new Medicine patients during the COVID-19 pandemic, relationships and enhance Department in the NIH Clinical Center, was Carlson helped the hospital set up “a virtual existing connections. selected as the Nurse Practitioner of the Year. patient registration tool, manage the “She is a true visionary in the feld. This Kent was cited for creating a diverse and infrastructure for telehealth is evident, as she is a highly sought-after vibrant group of advanced care practitioners communication, set up telehealth speaker at multiple national and who have been an essential part of the ICU appointments, virtual rounding, virtual visits international Neuroendocrine conferences,” multidisciplinary care team. and comply with new telehealth said her colleague Dr. Sadhana Jackson an Kent was praised for her outstanding requirements,” said Dr. Jon McKeeby, the investigator in the Developmental clinical knowledge, composed demeanor - chief information offcer for the NIH Therapeutics and Pharmacology Unit at the even in highly stressful scenarios - Clinical Center, the chief of DCRI and the National Institute of Neurological Disorders professionalism and compassion towards all acting chief of Biomedical Translational and Stroke. patients and is highly regarded by all Research Information System. consultants and primary teams as a reference point when their patients are in the ICU. - Donovan Kuehn VIEW ARTICLES ONLINE: Clinical Center News NIH...Turning Discovery Into Health® • National Symphony plays Editor: Donovan Kuehn | Layout: Justin Baker at hospital Published by the Offce of Communications and Contributors: Robert Burleson, Janice Duran, Cindy • Patient Recruitment Media Relations, Justin Cohen, Chief Fisher, Maria Maslennikov, Daniel Silber, Yvonne updates Hylton, Karen M. Byrne, James K. Gilman News, article ideas, calendar events and photos are • Scientifc Diversity Advisor welcome. Submissions may be edited. selected National Institutes of Health Clinical Center Contact: Donovan Kuehn www.cc.nih.gov/ccnews 10 Center Drive, Room 6-2551 donovan.kuehn@nih.gov Bethesda, MD 20892-1504 4 Clinical Center news Dec/Jan 22-23
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