Humans of Healthcare: Drs. Rojas and Hastings

On this episode of Humans of Healthcare, Drs. J. Clifton Hastings and Erine Raybon Rojas join Marie Krueger for a conversation about how the Covid-19 pandemic changed the face of healthcare and the importance of having a support group and mentors during difficult times.

Humans of Healthcare goes beyond the medical jargon to reveal what it means to care for others and unveil the extraordinary human connections that form within hospital walls. Each episode is a reminder that in healthcare, true healing stems from not just medical expertise but from the people behind healthcare. 

Thank you for listening to our podcast! If you have a topic you would like us to discuss, please visit nghs.com/podcast.

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Transcript

00:00:06 Marie Krueger 

Well, welcome everybody. 

00:00:07 Marie Krueger 

Welcome to the Health Perspectives Podcast brought to you by Northeast Georgia Health System and beautiful Gainesville, GA. 

00:00:13 Marie Krueger 

I'm your host, Marie Kruger, and today we have some very special guests and I can't wait for you to meet them. 

00:00:18 Marie Krueger 

We're doing something a little bit different on this episode. 

00:00:21 Marie Krueger 

We want you to meet the real frontline workers in healthcare and we're going to talk to our humans in healthcare and today we have Doctor Cliff Hastings. 

00:00:29 Marie Krueger 

Welcome. 

00:00:29 Marie Krueger 

Doctor Hastings. 

00:00:30 Marie Krueger 

Thank you. 

00:00:30 Marie Krueger 

And we have Doctor Rojas. 

00:00:32 Marie Krueger 

Are you hi. 

00:00:32 Marie Krueger 

Hi so let's get started with just some introductions. 

00:00:37 Marie Krueger 

Are you guys, where are you guys from? 

00:00:38 Marie Krueger 

Are you from Gainesville? 

00:00:39 Dr. Hastings 

I think you are actually. 

00:00:40 Dr. Hastings 

I was born here in Gainesville, born in the hospital that I work in, which is unique and different. 

00:00:44 Dr. Hastings 

Yeah, I started my medical career at age 16 as a janitor at the hospital, and eight of us decided we were going to start working. 

00:00:48 Marie Krueger 

Is that right? 

00:00:53 Dr. Hastings 

Somewhere in the pizza place I applied to didn't work. 

00:00:55 Dr. Hastings 

So we all started working at the hospital and worked that summer and then we're lucky enough that every time we had a spring break or a fall break or a winter break, we could come over and work a weekend or two. 

00:01:06 Dr. Hastings 

And so I spent eight years working within housekeeping, maintenance, central supply, the OR orderly anesthesia. And I just kind of. 

00:01:15 Dr. Hastings 

Did whatever people wanted me to do and got to see medicine from the inside out and that's really was the start of my desire to become a physician and then ultimately to become a. 

00:01:29 Marie Krueger 

So how many years have you been with the health system? 

00:01:31 Dr. Hastings 

If you count those years, it's a lot, but I've been. 

00:01:32 Marie Krueger 

Yeah, those are important. 

00:01:34 Dr. Hastings 

I've been back here in Gainesville for 16 years now. 

00:01:37 Marie Krueger 

16 years. 

00:01:38 Marie Krueger 

Thank you. 

00:01:39 Marie Krueger 

How about you, Doctor Ross? 

00:01:40 Marie Krueger 

Where were? 

00:01:40 Dr. Rojas 

You born I was born in Kankakee, IL. 

00:01:43 Marie Krueger 

OK. 

00:01:43 Dr. Rojas 

So it's a small city that is South of Chicago. 

00:01:48 Dr. Rojas 

I was, I always say I I'm from here because I moved here when I was about four. 

00:01:54 Dr. Rojas 

Dad was terminally ill and my mom had better support here in Georgia, so when I was probably three or four, we moved here to the Decatur area and I grew up not too far. 

00:02:07 Dr. Rojas 

From here. 

00:02:08 Marie Krueger 

Is that right? Would you say that your father's health condition just you wanted to be a doctor? Maybe. 

00:02:14 Marie Krueger 

Because of that. 

00:02:15 Dr. Rojas 

Yeah, I mean, the only things that I ever contemplated doing growing up was either being a doctor or a law. 

00:02:20 Dr. Rojas 

Here, and anybody who knows me well knows that I probably could have been. 

00:02:25 Dr. Rojas 

A lawyer. 

00:02:27 Dr. Hastings 

But you're much better at. 

00:02:28 Dr. Hastings 

Being a doctor. 

00:02:28 Dr. Rojas 

I am but yeah, but definitely yes. 

00:02:29 Dr. Hastings 

I could attest to that. 

00:02:33 Marie Krueger 

And I failed to mention this in the introduction. 

00:02:35 Marie Krueger 

Tell me what kind of physician you are. 

00:02:36 Dr. Rojas 

I am a pulmonary and critical care physician. 

00:02:38 Marie Krueger 

OK, OK. 

00:02:39 Marie Krueger 

So you guys worked closely together for many years. 

00:02:42 Marie Krueger 

OK, let's talk. 

00:02:44 Marie Krueger 

Let's take a little trip back in time. 

00:02:46 Marie Krueger 

I want to talk a little bit about COVID. 

00:02:48 Marie Krueger 

We can't have a conversation with. 

00:02:49 Marie Krueger 

That that was and continues to be a challenge. 

00:02:54 Marie Krueger 

You, I what I hear is that when people are in traumatic situations, they bond and their friends for life, right? 

00:03:00 Marie Krueger 

There was a point during COVID where Doctor Hastings made a phone call to you, and I'm wondering if you can share with us what. 

00:03:07 Dr. Rojas 

That meant to you, I'm going to try not to. 

00:03:10 Dr. Rojas 

Get too emotional. 

00:03:11 Dr. Rojas 

It was. 

00:03:11 Marie Krueger 

OK. 

00:03:13 Dr. Rojas 

It was probably one of the. 

00:03:21 Dr. Rojas 

Impactful and helpful conversations that I think I had, I actually was working nights because normally for critical care we worked. 

00:03:34 Dr. Rojas 

1415 shifts a month, but during COVID we were working upwards of 2627 days out of the month and I was heading into nights, and Doctor Hastings called me just to just to check on me to see how I was doing and not only how I was doing with COVID, but this was right after George Floyd. And so he really was just calling me to see. 

00:03:56 Dr. Rojas 

How I was doing and so I was really thankful that he recognized that I may be feeling different things than than other people because of the the the situation with George Floyd, but that he took time out just to. 

00:04:18 Dr. Rojas 

To really just be not only a good colleague, but a good mentor at that time and really talk me through some things and I felt so comfortable in that moment to take like he's like are how are you doing? 

00:04:28 Dr. Rojas 

I'm like I'm. 

00:04:29 Dr. Rojas 

Not OK. 

00:04:31 Marie Krueger 

Yeah, no, I've, I've shared that. 

00:04:33 Marie Krueger 

That meant the world to you. 

00:04:34 Marie Krueger 

And and that he's a friend and he cared about you and he continues to care about you. 

00:04:38 Dr. Hastings 

One of the things that most people don't realize that occurred during. 

00:04:42 Dr. Hastings 

Who it is we had to ramp up significantly. So we went from about 89 ICU beds to over 200 ICU beds and that was stretching staff. 

00:04:52 Dr. Hastings 

But it also stressed all the doctors. 

00:04:54 Dr. Hastings 

We didn't suddenly go out and hire a bunch of new doctors. 

00:04:57 Dr. Hastings 

What it meant was they went from the number of days. 

00:05:00 Dr. Hastings 

They basically doubled the amount of time that they worked. 

00:05:02 Dr. Hastings 

And they were here. 

00:05:03 Dr. Hastings 

Constantly we were redirecting a lot of physicians who were not as busy because we weren't doing elective surgery and and and other things. 

00:05:13 Dr. Hastings 

So we were redirecting patients, I mean physicians to do different. 

00:05:18 Dr. Hastings 

And one of my good friends, who was one of my PA's, was also your PA, and Joy said you need to check on Doctor Rojas. 

00:05:27 Dr. Hastings 

And I said OK and you know, I just called and said, hey, how you doing? 

00:05:30 Dr. Hastings 

I wasn't. 

00:05:31 Dr. Hastings 

Expecting to hear. 

00:05:32 Dr. Hastings 

Everything I heard but it was a it was a huge eye opener because we were 2 1/2 months into. 

00:05:38 Dr. Hastings 

COVID and at that point. 

00:05:42 Dr. Hastings 

It seemed like it was never going to end. 

00:05:43 Dr. Hastings 

We kept thinking, well, we can get to may. 

00:05:45 Dr. Hastings 

We'll be OK if we can just get to the middle of May if we can get just get to June and then suddenly we're in the middle of June and numbers are going up again. 

00:05:45 

Right. 

00:05:47 Dr. Rojas 

Right. 

00:05:52 Dr. Hastings 

And is is it ever going to end? 

00:05:55 Dr. Hastings 

And so it was. 

00:05:56 Dr. Hastings 

It was a very. 

00:05:57 Dr. Hastings 

Unsettling time, but everybody stepped up and did what they. 

00:06:01 Dr. Hastings 

Had to do. 

00:06:02 Dr. Hastings 

And it was fortunate for me because it gave me a lot more insight. 

00:06:06 Dr. Hastings 

I was chief of staff at the time, so trying to understand where the needs were or what was going on with the medical. 

00:06:13 Dr. Hastings 

Staff and then all of the social and cultural upheaval that was going on at the same time, we. 

00:06:21 Dr. Hastings 

Work a lot. 

00:06:22 Dr. Hastings 

But there's still the real world in our lives as well, and so not understanding and and not recognizing that would been a big mistake. 

00:06:32 Dr. Hastings 

And so it helped me. 

00:06:34 Dr. Hastings 

A great deal to know and understand where she was. 

00:06:36 Dr. Hastings 

And then I we were able to share a lot of the health system initiatives with the diversity and equity and inclusion that had already been in place. 

00:06:45 Dr. Hastings 

And So what I was able to do. 

00:06:47 Dr. Hastings 

Get her involved with the process and she's become a leader in that. 

00:06:52 Dr. Hastings 

I also recruited her and been known to her time to be part of our physician leadership growth program. 

00:07:00 Dr. Hastings 

And so it it really just a simple phone call went a long way. 

00:07:04 Dr. Rojas 

It did. 

00:07:04 Dr. Hastings 

We were friends before and I. 

00:07:05 Dr. Hastings 

Can tell you other stories about it. 

00:07:07 Dr. Hastings 

But it was. 

00:07:08 Dr. Hastings 

Just being concerned enough to make a. 

00:07:11 Marie Krueger 

Phone call. 

00:07:12 Marie Krueger 

Right. 

00:07:12 Marie Krueger 

And it made all the difference. 

00:07:14 Marie Krueger 

And it's propelled you into a new direction in the hospital. 

00:07:18 Dr. Rojas 

Very much so, you know I. 

00:07:21 Dr. Rojas 

I had probably only been here just a couple of maybe three years before. 

00:07:28 Dr. Rojas 

Before COVID really got going, and so and me not being from the Gainesville area and not as familiar with Northeast Georgia, I really didn't have a good, you know, pulse on like everything that was going on. 

00:07:42 Dr. Rojas 

And so the one you know, good thing that did come from COVID was. 

00:07:48 Dr. Rojas 

Just recognition of what the health system has been doing for decades, and then after talking about Hastings figuring out my role and how I could. 

00:07:59 Dr. Rojas 

You know, work synergistically with the organization to UM, you know, help meet the needs of not just the employees, but also the community in the space of diversity, equity and. 

00:08:09 Marie Krueger 

Inclusion right? 

00:08:10 Marie Krueger 

No, that's incredible. 

00:08:12 Marie Krueger 

I I don't want to harp on COVID, but it's it's such a big piece of of what we've gone through. 

00:08:18 Marie Krueger 

Can you recall? 

00:08:19 Marie Krueger 

I'm sure every day was challenging in its own right, but what? 

00:08:22 Marie Krueger 

What are some of the things that you're really proud of that that we got through? 

00:08:26 Marie Krueger 

I mean, we've, we've we've built. 

00:08:28 Marie Krueger 

Emergency departments in the parking lot. 

00:08:30 Marie Krueger 

I mean, so many things. 

00:08:32 Marie Krueger 

Is there what? 

00:08:33 Marie Krueger 

We all came together as a community. 

00:08:35 Marie Krueger 

But is there is there a point in your in your mind that you can recall? 

00:08:38 Marie Krueger 

That was like, gosh, you know we we got through it, we're we're OK we went home to our families. 

00:08:43 Marie Krueger 

I'm just trying to think of like a scenario that you can pinpoint in your mind. 

00:08:49 Marie Krueger 

And it may, it may be all blended together. 

00:08:50 Marie Krueger 

At this point, I would. 

00:08:53 Dr. Hastings 

I would and and I'm sure. 

00:08:55 Dr. Hastings 

With you earlier, there was a patient, a 32 year old, who was sick, frustrated because there's a lot of different things going on left against medical advice, came back and was dying. 

00:09:06 Dr. Hastings 

And it was you and two nurses in there. 

00:09:09 Dr. Hastings 

And this was at a time when we had run out of PPE. 

00:09:12 Dr. Hastings 

So they're wearing trash bags and that are taped together. 

00:09:16 Dr. Hastings 

They're in a room that's probably 80 degrees plus. 

00:09:20 Dr. Hastings 

And she's her heart stopping. 

00:09:22 Dr. Hastings 

They're doing CPR, but normally when that happens, people will come in and help. 

00:09:28 Dr. Hastings 

Well, this is the middle of COVID. 

00:09:30 Dr. Hastings 

We think she's got COVID. 

00:09:32 Dr. Hastings 

So she's in a a private room that has negative pressure. 

00:09:36 Dr. Hastings 

So the most we can do is open the door and hand them things, and they're in there literally cutting this poor lady for three hours until she finally passed. 

00:09:45 Dr. Hastings 

And just to see the three of them literally in tears. 

00:09:51 Dr. Hastings 

And then finally, I patted her on the back and everything, and I said, well, you know, at least you got that behind you and you said, yeah, I've got. 

00:09:58 Dr. Hastings 

Eight more hours in my shift. 

00:10:00 Dr. Hastings 

And you went on to the next room and kept doing what you were doing. 

00:10:03 Dr. Hastings 

The thing that was different was when you went home, because when you went home, most of us didn't see our. 

00:10:09 Dr. Hastings 

Families, most of us, if we did, took a shower beforehand and dressed in the in the garage, so we're probably putting a show on for the neighbors, depending on what time of day and if you had the lights on, who knows. 

00:10:14 Dr. Rojas 

In the. 

00:10:21 

But it was a. 

00:10:22 Dr. Hastings 

Very different time and you know, my dad was 90, almost 93 at the time, and I chose not to go see him. 

00:10:31 Dr. Hastings 

Which was a mistake in retrospect, because he ended up passing away about two months in. 

00:10:36 Dr. Hastings 

But I I felt kind of cheated. 

00:10:38 Dr. Hastings 

But after a while. 

00:10:39 Dr. Hastings 

I said, you know, I really don't care if I get it or not. 

00:10:41 Dr. Hastings 

I'm not going to the hospital anyway. 

00:10:43 Dr. Hastings 

Come see me. 

00:10:44 Dr. Hastings 

So we did so. 

00:10:44 

Right. 

00:10:45 Dr. Hastings 

It was a very different time each day you kind of went home exhausted. 

00:10:51 Dr. Hastings 

And each morning you kind of came back exhausted as well. 

00:10:53 Dr. Hastings 

But when you were going through this together with you, with your team and and such, it was, you just kind of kept plowing ahead. 

00:11:04 Dr. Hastings 

And not knowing if and when it was ever going to end. 

00:11:07 Marie Krueger 

You know, sometimes folks look at physicians as robots. 

00:11:10 Marie Krueger 

You you know, you, you, you're, you're there, you're there all the time. 

00:11:13 Marie Krueger 

You're always working. 

00:11:15 Marie Krueger 

But you are having some of the same frustrations and sadness and and mental health episodes that everybody else was. 

00:11:22 Marie Krueger 

And I think sometimes we don't. 

00:11:23 Marie Krueger 

We don't think about that. 

00:11:24 Marie Krueger 

You know, how are we doing today? 

00:11:27 Marie Krueger 

What's the current state? 

00:11:28 Marie Krueger 

Is it from what I understand, we are dealing with. 

00:11:31 Marie Krueger 

Patients that are even sicker than before because they didn't come to the hospital when they when they needed care. 

00:11:35 Marie Krueger 

So what's that been like? 

00:11:38 Dr. Rojas 

I will say that I've seen. 

00:11:45 Dr. Rojas 

Things that I've seen read about in textbooks. 

00:11:49 Dr. Rojas 

Yeah, come come in to the hospital now. 

00:11:53 Dr. Rojas 

That I've never seen before, COVID, and I think that that's just a a testament to what you're speaking about is people being fearful of contracting COVID by coming into the healthcare setting. 

00:12:04 Dr. Rojas 

And that's the one thing that I always remind people when we're having conversations about COVID is, it's not just about getting COVID surviving COVID or or not surviving COVID. 

00:12:12 Dr. Rojas 

It's about. 

00:12:13 Dr. Rojas 

All the other, UM, aspects of health care. 

00:12:18 Dr. Rojas 

People couldn't avail themselves to because of COVID. 

00:12:22 Dr. Rojas 

I mean, you know, Doctor Hastings, a cardiothoracic surgeon, he, you know, is important role in cardiovascular disease and the cardiovascular disease that we're seeing now that hasn't been adequately addressed. 

00:12:37 Dr. Rojas 

And the families and the patients that suffer. 

00:12:41 Dr. Rojas 

Because of that, are the effects that we're seeing from COVID. 

00:12:44 Dr. Rojas 

So it's not COVID positive necessarily, but it's still I think COVID adjacent and COVID related. 

00:12:51 Dr. Hastings 

And we had several patients that we couldn't operate on because we weren't doing elective surgeries. 

00:12:56 Dr. Hastings 

A lot of these were cancer patients and that a lady who was in her 40s who? 

00:12:57 Dr. Rojas 

Right. 

00:13:02 Dr. Hastings 

Was due to have surgery in May I, I mean March and I ended up doing her surgery in July. 

00:13:08 Dr. Hastings 

So her surgery was delayed, and even then it was somewhat risky. 

00:13:12 Dr. Hastings 

We had did we did kind of what the rest of the world did, and then we shut everything down. 

00:13:17 Dr. Hastings 

Then we kind of started realizing, wait a minute, this is not the right thing to do. 

00:13:21 Dr. Hastings 

So we started. 

00:13:22 Dr. Hastings 

Expanding in May and we kept operating from that point on. 

00:13:26 Dr. Hastings 

We did a lot of outpatient and people that are only going to be in the hospital for a day or two. 

00:13:30 Dr. Hastings 

If you're going to come in and be in the hospital for a week. 

00:13:33 Dr. Hastings 

We cancelled that surgery because we needed the beds for other people, but there were, there were many, many days where we were totally full. 

00:13:43 Dr. Hastings 

There was one day when I walked through the ER outside and there were 8 ambulances and they were all sitting there with their doors open and there were nurses and doctors crawling in and out of the ambulances. 

00:13:54 Dr. Hastings 

We never went on to version and so when other places did, we had people from Atlanta and Athens and Gwinnett and further South that showed ambulances showed up here because they've been to six different hospitals and they all said no, we're on diversion. 

00:13:56 Marie Krueger 

Right. 

00:14:02 Dr. Rojas 

Further South. 

00:14:10 Dr. Hastings 

So we got through that a lot of people in the hallways. 

00:14:16 Dr. Hastings 

I remember 80 plus in the ER hallways. 

00:14:19 Dr. Hastings 

In addition to the 90 different ER rooms that were full, plus a hospital that was full. 

00:14:23 Dr. Hastings 

So it was. 

00:14:25 Dr. Hastings 

It was stressful for everybody. 

00:14:28 Dr. Hastings 

Interestingly, the patients and the families were extremely gracious about the inconvenience of laying in the hallway, but so many of them were are very positive about it and we kind of got through it all together. 

00:14:42 Marie Krueger 

And you know there, there's you. 

00:14:43 Marie Krueger 

You speak about the patients being grateful. 

00:14:45 Marie Krueger 

And I agree there's there's been some amazing stories, healthcare. 

00:14:49 Marie Krueger 

The support that we got from from the community. 

00:14:52 Marie Krueger 

Unfortunately there is a little bit of a of a trend, if I might say, and maybe you guys can speak to this about some violence, some very frustrated patients. 

00:15:03 Marie Krueger 

Really having a problem with with our doctors and nurses and I'd like to know if you've experienced that first hand and and how you handle it or what your view is about that? 

00:15:13 Dr. Hastings 

I haven't had. 

00:15:14 Dr. Hastings 

Well, I have one time in my career, but that was 40 years ago. 

00:15:20 Dr. Hastings 

A patient or a patient family member become violent. 

00:15:22 Dr. Hastings 

I've had them very upset and angry and yelling and screaming and that's the time when you just have to maintain your cool and your objectivity. 

00:15:32 Dr. Hastings 

And focus whatever the issue is back onto, we're going to take care of this patient. 

00:15:38 Dr. Hastings 

We're going to do this and this is what we got to do. 

00:15:41 Dr. Hastings 

The health system has had a lot of support in exploring and trying to prevent workplace violence, either from. 

00:15:52 Dr. Hastings 

Families or patients or disgruntled workers and such and their programs in place, they've been working towards supporting that, but really making people aware of it has really I think gone a long way towards that. 

00:16:08 Dr. Hastings 

You're seeing patients and families that are at the most difficult part of an illness when they are on a ventilator and potentially dying and such. 

00:16:17 Dr. Hastings 

And so I know you guys see and and experience that a lot, but after you've been through it, you kind of learn how to navigate that with most families and most. 

00:16:26 

Right. 

00:16:27 Dr. Hastings 

Most of the time they're OK, but it's definitely an issue. 

00:16:32 Dr. Hastings 

And UM and I knew a guy. 

00:16:35 Dr. Hastings 

Was got shot and killed in Boston. 

00:16:38 Dr. Hastings 

He was a cardiothoracic surgeon and and it was, you know, knowing the guy you kind of just go. 

00:16:45 Dr. Hastings 

Well, how could that happen? 

00:16:47 Dr. Hastings 

You speak to your experience and what you. 

00:16:50 Dr. Rojas 

Think well I I have been on the receiving end of some patient family aggression during COVID. 

00:17:00 Dr. Rojas 

But I will say a big shout out to the Braselton security. 

00:17:06 Dr. Rojas 

And actually it was two of our female security officers who did everything right to make sure that the entire unit, including myself and another physician who was barricaded in the room, they kept the unit safe. 

00:17:21 Dr. Rojas 

They kept us safe and and diffuse the situation. 

00:17:24 Dr. Rojas 

And so I think that. 

00:17:25 Dr. Rojas 

By, you know, the investment that the health system is making into making sure or putting into making sure that our staff and the people that are here to protect us and make sure that. 

00:17:37 Dr. Rojas 

We are safe to do our jobs, but that our our patients and families also have a good experience. 

00:17:42 Dr. Rojas 

There's been a lot of work done there. 

00:17:45 Dr. Rojas 

I do think that the one thing I would like for for families to know is that even though we're coming to you and we may not be able to, I mean, we may not be able. 

00:17:54 Dr. Rojas 

To tell you what you want to hear. 

00:17:57 Dr. Rojas 

I always tell my patients, families like when I'm giving them news, that's not so great. 

00:18:03 Dr. Rojas 

Or, you know, terminal news. 

00:18:05 Dr. Rojas 

I want to be wrong. 

00:18:07 Dr. Rojas 

I would be happy to be. 

00:18:08 Dr. Rojas 

Wrong, right? 

00:18:09 Dr. Rojas 

There's no ego. 

00:18:10 Dr. Rojas 

There's no pride that we want the same things. 

00:18:13 Dr. Rojas 

We want their loved ones to get better. 

00:18:16 Dr. Rojas 

I know there's a lot of anxiety and anguish when your loved one isn't isn't well, but just to remember that you know. 

00:18:22 Dr. Rojas 

We are also people and we also. 

00:18:27 Dr. Rojas 

Are dealing with with our own things as well, and again that we all want the same thing we want for their family member to do well and for them to, you know, safely leave and and and do better. 

00:18:42 Dr. Rojas 

But the reality is, is that that doesn't always happen. 

00:18:47 Dr. Rojas 

But we do try to make sure that the patient experiences and the family experiences are respectful and compassionate, and I will say that I. 

00:18:59 Dr. Rojas 

Really not seeing a palliative care team and service like the ones that we have here that don't even just take care of the patients, but take care. 

00:19:09 Dr. Rojas 

Of the families as well. 

00:19:11 Dr. Hastings 

One of the big things about COVID was we didn't have visitors and so most patients were here by themselves and then later in our room for three weeks and the patient experience and and other people went to great lengths getting iPads and such. 

00:19:15 Marie Krueger 

Right. 

00:19:16 Marie Krueger 

Freya scared to death. 

00:19:25 Dr. Hastings 

And had two friends who ultimately died from COVID, but their children were my age, and so I would go by and see them, and then I'd take my phone out and we'd FaceTime and say, hey, and they would say, hey, so it was a totally different experience, but we had teams of people who were calling families. 

00:19:44 Dr. Rojas 

Just to call family all day long. 

00:19:45 Dr. Hastings 

All day long updating this, updating that and you know, we had almost 900 patients at at one point. 

00:19:52 Dr. Hastings 

And so these were teams of people that were calling. 

00:19:54 Dr. Hastings 

They were talking to Doctor Rojas, saying, what do I, what they were then extending themselves to keep families informed. 

00:20:01 Dr. Hastings 

And really the the feedback from that was really. 

00:20:04 Dr. Hastings 

The positive and but it was a different world because there weren't families around. 

00:20:11 Dr. Hastings 

And it was. 

00:20:12 Dr. Hastings 

It was just us for the. 

00:20:13 Dr. Hastings 

Most part. 

00:20:14 Marie Krueger 

Yeah, right. 

00:20:15 Marie Krueger 

Was was there a point during all of this where you guys were like I'm done? 

00:20:20 Marie Krueger 

I'm done. 

00:20:20 Marie Krueger 

I had a great career. 

00:20:22 Marie Krueger 

I'm going to the Bahamas and I'm just. 

00:20:24 Marie Krueger 

I'm done. 

00:20:25 Marie Krueger 

I mean, I think that's maybe there was a point where you felt that way, but something brought you back your why your your resilience want to hear about that, that journey from what you just described to today because you guys are different today than you were two, three years ago. 

00:20:41 Marie Krueger 

I mean every we all are in in some respects, right? 

00:20:45 Marie Krueger 

You're, but you're here. 

00:20:46 Marie Krueger 

You're still working. 

00:20:47 Marie Krueger 

What is that? 

00:20:48 Dr. Rojas 

I mean. 

00:20:50 Dr. Rojas 

Times where we wanted, where I wanted to every day. 

00:20:54 Marie Krueger 

Yeah, every day. 

00:20:55 Dr. Rojas 

Yeah, I mean it. 

00:20:57 Dr. Rojas 

With the amount of. 

00:21:01 Dr. Rojas 

Death and. 

00:21:04 Dr. Rojas 

You know, just that I've seen over the past several years. 

00:21:09 Dr. Rojas 

You start to think is this worth it? 

00:21:11 Dr. Rojas 

Why am I doing this? 

00:21:13 Dr. Rojas 

But when you can stand in the gap for someone? 

00:21:19 Dr. Rojas 

And be there with them in a difficult time when their family cannot. 

00:21:25 Dr. Rojas 

Those are the reasons that. 

00:21:27 Dr. Rojas 

Made me continue to go on. 

00:21:31 Dr. Rojas 

Because I couldn't imagine being in a scarier situation to be alone, be by myself and a lot of times during the first wave, a lot of our patients were our Hispanic Gainesville community that really didn't, you know, understand the workings of the hospital and. 

00:21:50 Dr. Rojas 

And even the. 

00:21:50 Dr. Rojas 

You know. 

00:21:52 Dr. Rojas 

Even the English language, right, and so being able to hold their hands and speak to them and give them comfort, you know, was were the things that really did my heart well. 

00:22:07 Dr. Rojas 

And seeing people follow up in pulmonary clinic that were on ventilators that had tracks that we even did CPR on several times to see them walk into clinic. 

00:22:19 Dr. Rojas 

It makes you feel like you know what? 

00:22:22 Dr. Rojas 

We did something. 

00:22:22 Marie Krueger 

That's right. 

00:22:24 Dr. Rojas 

We did something right so. 

00:22:26 Marie Krueger 

That's great. 

00:22:27 Dr. Hastings 

And they really thought about walking away, but I there were multiple times. I kept thinking this is ever going to end in January of 21, we were having 10 to 15 deaths per day. We had mobile morgue and. 

00:22:43 Dr. Hastings 

We had 360 something COVID patients in the hospital at that time and the the question that kept coming to me was how do we how do you take care of the next one. But everybody kept showing up, kept doing, they did and did what they had to do. I will say that one of the most unpleasant and difficult. 

00:23:05 Dr. Hastings 

Things I did was early in COVID when we realized that there was a very good chance we were going to become overrun. 

00:23:11 Dr. Hastings 

What do we do when we don't have enough ventilators? 

00:23:13 Dr. Hastings 

Who gets a ventilator? 

00:23:14 Dr. Hastings 

Who doesn't? 

00:23:15 Dr. Hastings 

What do we do when we don't have a room? 

00:23:17 Dr. Hastings 

What do we do when we don't have enough of this particular drug? 

00:23:20 Dr. Hastings 

What if we run out of steroids? 

00:23:21 Dr. Hastings 

What I mean, these were all life saving treatments that we had to give. 

00:23:26 Dr. Hastings 

Who's going to make that decision? 

00:23:28 Dr. Hastings 

The last person in the world that needs to make? 

00:23:30 Dr. Hastings 

The decision is. 

00:23:31 Dr. Hastings 

Her standing at the bedside who's personally and physically invested in everything they've been working for hours. 

00:23:38 Dr. Hastings 

Of this patient, so we created a system. 

00:23:40 Dr. Hastings 

That was equitable, fair and blinded, and actually trained the entire medical staff on. 

00:23:48 Dr. Hastings 

If we get to this point, then you're going to call in give U.S. 

00:23:53 Dr. Hastings 

There's a scoring system and then based on your score would be determined who would get the level of care that we could. 

00:24:00 Dr. Hastings 

We managed to give because we wanted to have the greatest impact positive for our society and our Community, but you also want to be supportive and and humane to everyone. 

00:24:11 Dr. Hastings 

We never got to that point. 

00:24:13 Dr. Hastings 

But I was very afraid and I went to our board and explained. 

00:24:19 Dr. Hastings 

All of that to them got their approval. 

00:24:22 Dr. Hastings 

We were working with the state and all of the hospitals had this. 

00:24:25 Dr. Hastings 

This is one of those things that you never, ever want to think about. 

00:24:30 Dr. Hastings 

What do we do if we ever get to that point? 

00:24:32 Dr. Hastings 

If I've got a 32 year old mother in the ER who needs a ventilator and I've got. 

00:24:39 Dr. Hastings 

My dad at 93, on a ventilator upstairs. Well. 

00:24:44 Dr. Hastings 

I need to take the Venter off and give it to her and he would do that and fortunately we never got that. 

00:24:49 Dr. Hastings 

But those are not things we've ever had to think of in our country, and we had to think about that in New York all throughout and there were patients that could have benefited coming to Gainesville for us to take care of them that never got here because we didn't have. 

00:25:04 Dr. Hastings 

So we didn't ration care, but we just ran out of space for a lot of times. 

00:25:10 Dr. Hastings 

And so that's not something anybody ever thinks of. 

00:25:13 Dr. Hastings 

And I hope I never think of it again, but we need to be prepared because the persons and the people on the frontline, the nurses. 

00:25:20 Dr. Hastings 

Because the doctors, the ER doctors, they don't need to be the ones making those decisions. 

00:25:25 Dr. Hastings 

And so we had a a blinded system where an anonymous person would make the decision and I called 16 doctors and said I need you to do this. 

00:25:34 Dr. Hastings 

You'll be anonymous in all, 16 said. 

00:25:37 Dr. Hastings 

I'll do it. 

00:25:37 Dr. Hastings 

It's the right thing to do and that was. 

00:25:41 Dr. Hastings 

That was profound. 

00:25:41 Marie Krueger 

I bet. 

00:25:42 Marie Krueger 

I bet that's incredible. 

00:25:44 Marie Krueger 

And I think one thing that that COVID shines a light on his mental health for sure, for for our, our community, for our providers, our nurses. 

00:25:55 Marie Krueger 

It's always been there. 

00:25:56 Marie Krueger 

It's always been there but it. 

00:25:57 Marie Krueger 

But we have, I feel this is really a time that we're actually addressing it and talking about it and taking away the stigma, but we need our doctors to be healthy mentally. 

00:26:07 Marie Krueger 

For sure, physician suicide, all sorts of things going on. 

00:26:11 Marie Krueger 

So you know, I just. 

00:26:15 Marie Krueger 

The work that we're. 

00:26:15 Marie Krueger 

Doing as we're training our new physicians, you know we we have a graduate medical education program and you're a fellowship director and. 

00:26:22 Marie Krueger 

And So what sort of things do you want? 

00:26:25 Marie Krueger 

Our new doctors coming up to to know about mental health and and what are we treating? 

00:26:29 Marie Krueger 

What are we training them in taking care of themselves in this? 

00:26:32 Marie Krueger 

Way so. 

00:26:35 Dr. Rojas 

We're very fortunate for our graduate medical education that we have a Director of Wellness and we have EAP. 

00:26:44 Dr. Rojas 

Which we relied heavily on during. 

00:26:46 Marie Krueger 

COVID as employee assistance. 

00:26:48 Dr. Rojas 

Program Employee assistance program. 

00:26:52 Dr. Rojas 

I think the one thing that I would just want to to like if if I were thinking about. 

00:26:58 Dr. Rojas 

Training now versus when I was and maybe even back in. 

00:27:01 Dr. Rojas 

The 1800s, that's on camera. 

00:27:02 Dr. Hastings 

Not that far. 

00:27:03 Dr. Hastings 

Not that old. 

00:27:07 Dr. Hastings 

100 I remember this. 

00:27:07 Marie Krueger 

1800s. Yeah, just so you. 

00:27:10 Dr. Hastings 

Know we were friends. 

00:27:14 Dr. Rojas 

It's just that we realized that. 

00:27:17 Dr. Rojas 

We are human, we're. 

00:27:19 Dr. Rojas 

We don't have superpowers and that it's always important to create a work life, balance your healthier self can be more effective at your place of business. 

00:27:31 Dr. Rojas 

You're better for your patients, you're better for your colleagues. 

00:27:35 Dr. Rojas 

And you're better for yourself. 

00:27:38 Dr. Rojas 

We are very good at telling people as physicians, you know, seek care, seek help from a mental health aspect, but we don't necessarily practice that and I think. 

00:27:51 Dr. Rojas 

One of the reasons why is because just as a discipline, there is a stigma even amongst physicians about mental health, and I think that COVID has again shine the light on it. 

00:28:03 Dr. Rojas 

But also there have been so much federal and state funding that has gone to provider. 

00:28:11 Dr. Rojas 

Mental Wellness. 

00:28:14 Dr. Rojas 

And you referenced physician suicide the the physician that the ER physician that committed suicide in New York. 

00:28:21 Dr. Rojas 

She didn't commit suicide because of, you know, she she was going to get COVID she actually had already had COVID and and had done well from it. 

00:28:28 Dr. Rojas 

But she was seeing a lot of death. 

00:28:34 Dr. Rojas 

And she had to seek mental health services. 

00:28:36 Dr. Rojas 

And she was afraid of what her colleagues and what her prospective employers would think about her after that. 

00:28:42 Dr. Rojas 

And so we just want to make sure that we're elevating the dialogue of mental health from where it was to where it is and that it's OK to say when you're not OK, which is what I did with Doctor Hastings and he was able to step in and to support me where I needed at that moment, even even he would he didn't, you know, make. 

00:29:02 Dr. Rojas 

Wave up magic wand and make it all go away. 

00:29:04 Dr. Rojas 

But he listened to me, he validated. 

00:29:07 Dr. Rojas 

My feelings and just heard me. 

00:29:09 Marie Krueger 

Validated your feelings? 

00:29:10 Marie Krueger 

I think that is so important. 

00:29:11 Marie Krueger 

He didn't make you feel. 

00:29:12 Marie Krueger 

Weak or less than weak? 

00:29:14 Marie Krueger 

Right, because you're not. 

00:29:16 Marie Krueger 

Got it. 

00:29:17 Marie Krueger 

Before we wrap up and you kind of touched on this a little bit, but what do you want the community or patients to know about you guys as doctors again sometimes we just we you guys are Kate, you got capes, you're superheroes, you save lives, right? 

00:29:32 Marie Krueger 

You're human. 

00:29:33 Marie Krueger 

What is that? 

00:29:34 Marie Krueger 

What do you want them to know about you? 

00:29:36 Marie Krueger 

That they may not know. 

00:29:40 Dr. Rojas 

I think just what I mentioned earlier is that. 

00:29:45 Dr. Rojas 

Me personally, and I know my colleagues. 

00:29:49 Dr. Rojas 

We take care of people like they our own family, because either ourselves or our family members are going to be in a situation where we're going to. 

00:29:57 Dr. Rojas 

Have to. 

00:29:58 Dr. Rojas 

Trust someone else, and so I would just like for people to know that we are human, that we. 

00:30:05 Dr. Rojas 

We're not perfect and we make mistakes like everyone else. 

00:30:11 Dr. Rojas 

We may not be great at communicating all the time, but we do have their best interests and their families best interest and ultimately. 

00:30:21 Dr. Rojas 

We want the same thing that they want, which is for themselves and their families to live long and healthy lives. 

00:30:28 Marie Krueger 

That's right. 

00:30:28 Marie Krueger 

Thank you. 

00:30:29 Marie Krueger 

Thank you, Doctor Rojas. 

00:30:30 Dr. Hastings 

There's a balance when you do cardiac. 

00:30:34 Dr. Hastings 

When you do critical care when you do neurosurgery, when you do. 

00:30:38 Dr. Hastings 

Whatever you literally have. 

00:30:43 Dr. Hastings 

The opportunity to do life saving immediate things. 

00:30:49 Dr. Hastings 

It's a pretty cool feeling to walk into a desperate situation and have the answer and to do a procedure or do a surgery or do something and that person walk out of the hospital and you see him back. 

00:31:02 Dr. Hastings 

Not equally devastating to fail, and I don't handle failure very well. 

00:31:08 Dr. Hastings 

And I was talking to a family last week that one of the more difficult things for me to do is when I've invested days and weeks in care and I have a more hopeless situation. 

00:31:22 Dr. Hastings 

To be able to say it's better that we not put you through all of this anymore, to talk to families about that. 

00:31:29 Dr. Hastings 

And I've grown in that respect as a surgeon. 

00:31:33 Dr. Hastings 

My colleagues, they tell us. 

00:31:34 Dr. Hastings 

What are you doing? 

00:31:35 Dr. Hastings 

I'm doing well because we think we can. 

00:31:38 Dr. Hastings 

Fix everything. 

00:31:39 Dr. Hastings 

And we try, but it doesn't always work and it's devastating when it doesn't. 

00:31:45 Dr. Hastings 

And so to to work through that. 

00:31:47 Dr. Hastings 

Personally, a lot of times I just suppress it and move on to the next problem and don't deal with it. 

00:31:53 Dr. Hastings 

But it it all comes back at some point so. 

00:31:58 Dr. Hastings 

Even when we fail, that's I always feel that somebody's got to be in control. And when chaotic situations or bad situations, and I feel like it needs to be me. So finding the way to release that at some point, it's hard. 

00:32:20 Marie Krueger 

Yeah, it can be hard for sure. 

00:32:23 Dr. Hastings 

But it's what we. 

00:32:24 Marie Krueger 

Do it's what you do. 

00:32:25 Marie Krueger 

It's what you do. 

00:32:26 Marie Krueger 

And it's what keeps you coming back after everything. 

00:32:28 Marie Krueger 

Thank you. 

00:32:29 Marie Krueger 

Thank you both so much for your candor and for being here. 

00:32:32 Marie Krueger 

I really appreciate your time. 

00:32:33 Marie Krueger 

Thank you. 

00:32:34 Marie Krueger 

Thank you everyone for watching and listening at home. 

00:32:36 Marie Krueger 

And if you haven't already, great review and subscribe to health perspectives. 

00:32:40 Marie Krueger 

Podcast and we'll see you next time. 

00:32:42 Marie Krueger 

Take care.