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
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.
First person perspective: Dr. Anthony S. Fauci & the NIH Clinical Center
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
First person perspective: Dr. Anthony S. Fauci & the NIH Clinical Center
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
First person perspective: Dr. Anthony S. Fauci & the NIH Clinical Center
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

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                    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
First person perspective: Dr. Anthony S. Fauci & the NIH Clinical Center First person perspective: Dr. Anthony S. Fauci & the NIH Clinical Center First person perspective: Dr. Anthony S. Fauci & the NIH Clinical Center
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