Voices of Saratoga Hospital: Recent Episodes
Saratoga Hospital
The Voices of Saratoga Hospital is a series of stories. Each is a unique look inside Saratoga Hospital, told by the people you have come to trust – even if you had no idea they were a part of the care we provide for our community, this place we all call home.
Three bariatric surgery patients discuss their experiences with having bariatric surgery by Dr. Baranov at Saratoga Hospital.
Narrator: These are the Voices of Saratoga Hospital shared moments and insights to help us all understand a little bit more about the constantly changing world of health and care close to home.
Some people misunderstand weight loss surgery, thinking it's simply an option people take when they don't want to change their diet or get on an exercise program. In fact, having bariatric surgery is often a choice people make because they've tried everything, and their health keeps getting worse.
Take, for example, Scott of Clifton Park.
Scott: I was having all the side effect type situations you have with an overweight or obese person: high blood pressure, high cholesterol, sleep apnea, snoring, just a general lethargy. I didn't want to do anything. Just all these associated things happening. Prediabetes, back pain from carrying all this extra weight around. So I was sick. I was much sicker than I had thought and hiding it with aspirin and Tylenol and taking vitamins to just stay up, and nine cups of coffee to stay awake every morning. That was all part of it.
I was on cholesterol medication. I was about to probably go on some kind of prediabetes treatment. You know, my knees were hurting. It was not a good situation. I was unhealthy because of weight and still not able to do anything about it.
Narrator: Also consider Doris of Bolton Landing.
Doris: I've been overweight all my life. I fought this battle. I've tried every diet—the grapefruit diet, cottage cheese and peachs—every diet that would come out, every fad that would come out, I would try it. So it's always been a struggle.
I was having horrible, horrible back problems. I went to a back surgeon and the surgeon looked at me and he says, “Unless you lose the weight, I won't touch you.”
Narrator: And when it comes to weight loss issues, it isn't just the physical problems that pile up. There's the mental and emotional toll Brianna of Saratoga remembers.
Brianna: I looked in the mirror one day and just saw this huge girl and I couldn't believe it was me. So, it's been a constant struggle all my life.
I've always compared myself to my brother who is really athletic and toned, and all of my girlfriends who are these beautiful tiny things, and I just always had really low self-esteem because of it. So it's just been an ongoing struggle since I was a little girl. I don't remember if I ever didn't have these weight issues.
Narrator: So, entering a bariatric and weight loss program is, for many, the chance to feel like they can have the life that other people get to have and they don't. But it's also scary. Scott remembers attending the informational seminar that the Saratoga Hospital Bariatric program offers, and how it helped him overcome his fears. The key was meeting the program's director, Dr. Dimitri Baranov.
Scott: The very first thing when you meet Doctor Baranov is he doesn't judge you. There's no judgment. I think that's what's going to hold a lot of people back from possibly getting help with weight loss, is you feel like you're a stigma. You're going to get judged. My friends are going to judge me. None of that happens with Doctor Baranov. He talks. He says, here's our options. These are surgically, what we can do for you. He tells you what's going to happen. He shows you what's going to happen, what he's going to do, which procedure he's going to recommend for you. He talks to you as a person, but he doesn't oversell it.
Narrator: And then Scott had the surgery. It went well, and he could hardly believe how well.
Scott: I felt like I was in the hands of one of the best surgeons I've ever met. It was a TV experience, which we don't have in reality, we don't get this. I found it really difficult to believe that in Saratoga I had a top-notch surgeon who probably saved my life.
I actually exercise because I want to exercise, not because I have to. Also, I can enjoy exercising. I take stairs. I don't get out of breath. My blood pressure is under control. My cholesterol is under control. I feel like a different person. I look like a different person.
Actually, that's where I should have started. Because what I gained, more so than my health, was emotional confidence. I can walk into a room and nobody looks and sees a big guy coming in. They see Scott, and he's going to get something done.
I was worried when I first did the surgery that my kids would think less of me taking an easy way out. They think Daddy did an amazing thing.
Narrator: Doris had a similar experience after her surgery.
Doris: My life turned around. I can't even explain how much different it is now. I mean, I used to hide away. I didn't want to do anything. Now I'm out there all the time. I don't want to stay at home.
I lost a total of about 150 pounds from start to finish. I went down from a size 28 to a size 10. The biggest change, you're gonna laugh at this, is that I can walk into any store I want to buy a piece of clothing. Whereas before you have to go to all these specialty shops, you couldn't find what you wanted to wear. I was so happy with that. And then I don't have to be embarrassed.
Narrator: Brianna says words can hardly express how the surgery changed her.
Brianna: I kind of live every day, just happier. I have a lot more energy. I do CrossFit. I work out every single day. I mean, the bottom line is, is that I love my life and I didn't love my life three years ago.
I think life has just surprised me in general, if that makes any sense. You know, I've traveled a lot more. I’ve been a better teacher. I've been a better friend, a better child to my parents, like just all around. I'm a better human being because of it. Because I'm happier.
And I have other things to worry about now. I don't need to worry about my weight. I mean, it's obviously on my mind. I'm conscious about what I put in my mouth. I'm conscious about what I do. But I followed everything that Dr. Baranov said to do, and that's why I'm successful.
Narrator: All episodes of this podcast, Voices at Saratoga Hospital, can be found on our website, saratogahospital.org/voices, and on your favorite podcast channel.
Post-partum depression has been redefined because we have learned it is so much more for a new mom and her partner. And it can affect anybody. Anybody. It looks like you. It looks like your sister. It looks like your friends. Your coworker. But most important – you are not alone. Listen and learn more about our Maternal Mental Health Support Group.
Interviewer:
These are the voices of Saratoga Hospital. Shared moments and insights to help us all understand a little bit more about the constantly changing world of health and care close to home. The concept of postpartum depression has been redefined. We have come to learn it is so much more for a new mom and her partner.
Kelly Mosher:
It looks like you. You look in the mirror, it looks like your sister. It looks like your friends. It looks like your coworkers. Absolutely anybody can be affected.
Interviewer:
Two of our nurses have a conversation and share experiences about how important it is to reach out for help and to understand you're not alone.
Kelly Mosher:
I can think of a couple that I took care. I was in the patient's room. The support person kinda very quietly, "I have a question." So I turned around and was like, "Yeah, what's going on? How can I help you?" And I could just see their face had changed. I was like, "What- what's going on?" And just the tears started and, "I don't know what's happening. I don't know why I feel this way. I- I've had kids before. I- I've never... Something's wrong. It... Why do I feel like this?" And it was just such a great opportunity. It was right after we finished our training, which touched a lot upon support people, and we had not yet started offering services. The program was still really in its infancy and planning stages, but we had been trained. And I sat down and I said, "Look, this is normal. This happens. This isn't talked about a lot, but it's something that happens." And I was able to at least give resources, really great resources, for families, patients, support people, same sex couples, single parents.
Courtney Keller:
And funnily enough, I took care of them the day after you provided that tender loving care, and they were so grateful. And she said that she already felt better just because she had the resources.
Kelly Mosher:
I am Kelly Mosher. I'm a registered nurse at Saratoga Hospital. I work on our women's health unit. You might hear it called lots of different things, C1, Labor and Delivery, Maternity. It's where people come to have their babies.
Courtney Keller:
My name is Courtney Keller and I am a nurse on C1, and I work as a labor and delivery, postpartum, and nursery or newborn care nurse. What postpartum depression used to be called we now call it perinatal mood disorder, and that encompasses the journey from conception through pregnancy through the first year of life. And that includes major and minor depression, anxiety, OCD, PTSD and even postpartum psychosis. What used to be called just postpartum depression now encompasses a lot more in the perinatal mood disorder category, from conception through the first year postpartum.
Kelly Mosher:
Anybody can be affected. Everybody.
Courtney Keller:
Yeah.
Kelly Mosher:
Anybody. It- it looks like you. You look in the mirror, it looks like your sister. It looks like your friends. It looks like your coworkers. It's absolutely anybody can be affected.
Kelly Mosher:
We got an email about a donation for the Fourth Trimester program which has evolved into the maternal mental health support group. I replied immediately that I wanted to be involved in that.
Courtney Keller:
We received a grant from River Farm America Foundation. Part of the donation was to certify staff members so that we can better support our families and our community. The training was one of the most influential certifications I have received and been a part of my entire nursing career.
Courtney Keller:
I was in first grade and a woman came in and described how she takes care of babies all day, and I was absolutely crazy about babies at that time. And I came home, in first grade, and said, "I'm going to be a baby nurse." And so when I applied to nursing school, it was to become a baby nurse. I always say I'm living my dream. (laughs)
Kelly Mosher:
(laughs) It's funny though that Courtney says that she wanted to be a baby nurse, because our unit is LDRP which stands for labor, delivery, recovery and postpartum. It's funny because I have that memory of, "I want to deliver babies." And Courtney said, "I want to be a baby nurse." And everybody has their passion within our unit. Courtney and I do have a lot of common interests.
Courtney Keller:
You become a nurse because you love people and you want to help them. You want them to find wellness, and people connecting. And this program allows us to further connect with our patients in our community and go back to the reason of why we become nurses, of wanting to help them and make them feel better, and continue that deeper connection.
Kelly Mosher:
I think connect is such an important word for so many reasons, because like you said, we're nurses. We want to connect with our patients.
Courtney Keller:
I have three children, and my pregnancy was great and I thought I had everything all set. I had been a maternity nurse for a couple of years. I was a overnight nanny. And I remember sitting in a rocking chair, rocking my daughter and crying and thinking, "Oh, my gosh. This is how I'm supposed to feel." I had tremendous anxiety. I just felt so overwhelmed with everything to the point where I had to leave grocery carts and go back to my car. And some pieces finally started to click. I'm like, "Well, Courtney, you had a hard time with your first postpartum experience. Although it's different, this is not normal." And I was also very open with my family rather than, it sounds cliché, but suffering in silence. I told my family members, "I have a hard time postpartum and I might need you." And so my hope is to provide the resources and the support that so many women deserve. So many people are affected by perinatal mood disorders, but many go without treatment.
Kelly Mosher:
It's not just postpartum depression. There's so much more to it than that. My own personal experience postpartum was not dissimilar from Courtney's. I was happy. Everything was going well, but I remember them saying, "Oh, write down your feedings and the wet and dirty diapers. When you go to the pediatrician, they're going to want to see that." So I'm like, "Oh, I better write this down." And I really took that to heart and I focused so much on the things that I probably shouldn't have been focusing on. I was so focused on, "Well, I have to write this down. I have to schedule this. I have to plan this nap." And I was so focused on this routine and this structure, and in retrospect, I'm like, wow, I was really focusing on the wrong things. I- I wish I lived more in the moment. And I wish I had a group of moms, a group of caregivers, just to sit down with and have them say, "Me too." Just to find people that I shared common ground with.
Courtney Keller:
This perinatal mental health support group is not just for moms that are struggling. It is a place to come and find that common ground and just have a conversation of, "Gosh, I feel so overwhelmed." And hearing that a couple other mothers say, "Oh, me too," is just that connection and takes away a lot of the feelings of isolation that sometimes can happen postpartum. So this support group is really meant for anybody who wants to join.
Kelly Mosher:
I think it's becoming easier for women to say something's not right. I think there has been a shift in the culture where it's become more acceptable for people to say to their nurses at the hospital, to their providers at their appointments, whoever it might be, "Hey, I think I need a little bit of help with this."
Courtney Keller:
I feel like it's a little bit of a wall that some women do create.
Kelly Mosher:
Yes.
Courtney Keller:
In, "I am an organized person. I am put together. I am professional, and therefore I am going to figure it out." And that is who they are known for by whoever they surround, their circle. And so that set of strong women, um, so I feel like they have a harder time coming forth saying, "Something's going on here." Sometimes we just think that it's very maternal oriented, but it does affect the partner as well.
Kelly Mosher:
I think the birth mother's support person, partner, plays such an important role in their experience, and that's something I often tell patients when I'm getting them ready for discharge from the hospital. I turn to the support person and I say, "If something doesn't seem right, you might be the first one to notice it because this new mother is so wrapped up in her day to day, her learning this new role, learning her new self, her baby, she might not be able to take that step back and notice this isn't right." And I always say that the support person, I always tell them, "If something isn't right, if the behavior isn't quite herself, say something." I don't know if the mother can always notice it when she's in the moment. I think the support person plays a huge, huge role. You know, we always tell them there's baby blues. That's a real thing. You might feel emotional and weepy for a week or two after the baby is born. That's normal. That's okay. That happens.
Courtney Keller:
Mm-hmm.
Kelly Mosher:
But if that's continuing on and you're a month, two months in now and you're still feeling that way, it's oftentimes tends to be someone else in their circle, in their family, that notices that, hey, something doesn't seem right here.
Courtney Keller:
When I teach childbirth education, I do take that time to talk about the emotional change that occurs with the partner due to increased responsibilities, with taking care of mom, baby, financial, managing the job. And so, one in 10 partners experience postpartum mood disorder.
Kelly Mosher:
I can even, to a point that you said, where this mom has been growing this life for the 40 give or take weeks, and has kind of evolved into this role, and yes they are suddenly thrust into, okay, now you're a mom. But for the support person, they know this change is coming. They're anticipating this change. But then it's more of a sudden switch, I feel like, for them, to all of the sudden be, "Okay, it's the two of us." Now it's, "The three of us all the sudden," or four, or whatever it might be. So I feel like it's just such a drastic change that happens so fast for the support person that it can really catch them by surprise.
Courtney Keller:
I have talked to a couple of, in this instance, fathers that had a hard time bonding with their baby. And again, they thought that it was just them. But by voicing their experience, which took a lot of courage, found that other, in this case fathers, were experiencing the same thing. Being able to voice how you're feeling, you can find that connection and decreasing the sensation of isolation.
Kelly Mosher:
I think the value of a hospital-based program, something through Saratoga Hospital, is so important for the patients that we're seeing, because they'll have that home base. They've have that continuity of, "Okay, I was going to my doctor here. I had my baby here. I am continuing receiving support with these other women that had this shared experience here." And it'll just be this very safe space for them.
Courtney Keller:
Our patients are screened in the perinatal period. They are also screened postpartum while they're in the hospital, prior to discharge.
Kelly Mosher:
And this is how we are going to help them, this support group.
Courtney Keller:
Our providers have a lot more awareness now and are eager to hear our patients and offer the support that they really deserve, just with this greater awareness of perinatal mood disorders and the Fourth Trimester.
Kelly Mosher:
So it feels really good to be identifying patients in the hospital now, through screening, and being able to say, "Wow, look. I'm concerned about what you've told me here, and I would like to offer you some help here while you're in the hospital." They can say, "Please, yes, that would be great." They can say, "No, thank you." Some of them already have a plan. But for those people that didn't have a plan, and all the sudden are in this position, it's really a relief to be able to offer that.
Courtney Keller:
The postpartum support group is open to women who have delivered outside of Saratoga Hospital as well. And I feel like there is great value in being able to experience any kind of support whenever there is a need or a desire, but also being able to meet in your own community.
Kelly Mosher:
What I would tell somebody right now who is an expectant parent is just that we see you, we have been you, we know you, and we know that it's not always what the kind of mainstream media portrays new motherhood to be. It's not always easy, and there are ways to find that support that you need. We're going to be launching this postpartum maternal mental health support group for moms in our community. That theme, that is so important for the new parents with other parents, for the new parent with their child, just to find that connection and support and realize that they're not alone in their experience.
Interviewer:
To learn more about the Fourth Trimester and the maternal mental health support group, call 518-580-2871 or visit saratogahospital.org/fourthtrimester. All episodes of this podcast, Voices of Saratoga Hospital, can be found on our website, saratogahospital.org/voices, and on your favorite podcast channel.
Our Public Safety team comes in to work with one thing on their mind, keeping Saratoga Hospital safe for our patients and for our staff – because, at the end of the day, we all want to go home, we all want to go home safe, we want everybody safe. It takes a special type of person to be a part of our public safety team at Saratoga Hospital because you never know what the next phone call will be.
Interviewer:
These are the voices of Saratoga Hospital. Shared moments and insights to help us all understand a little-bit more about the constantly changing world of health and care, close to home. Our public safety team comes into work with one thing on their mind, keeping Saratoga Hospital safe for our patients and for our staff.
Danielle Jourdan:
Because at the end of the day, we all want to go home. We all want to go home safe. We want everybody safe.
Interviewer:
There is constant training for Code Amber, a missing baby, for Code Red, a fire, and techniques to de-escalate a volatile situation. Our public safety team works with police agencies across the region including Homeland Security. And then, there's making sure the loading dock is open for the Pepsi guy.
Marvin Maldonado:
My goal, in any situation, is to de-escalate the situation. One of my old coaches used to tell me, when you go into a situation and somebody's agitated and then you fall into that agitation, now you've become part of the problem rather than the solution.
Danielle Jourdan:
My name is Danielle Jourdan. I've been here at the hospital for five years. I have been in this field since I was 16 years old. Started off dispatching for park wide services at the Great Escape, security, EMS, the whole gamut.
Marvin Maldonado:
My name is Marvin Maldonado. I've been with Saratoga Hospital since 2015. I've worked every single shift in our department, from day shift, to evening, to overnights. That's where I met Danielle. Uh, Danielle and I have worked together for, I believe, about a year or so, or a little over a year?
Danielle Jourdan:
To-, yeah.
Marvin Maldonado:
Yeah.
Danielle Jourdan:
A year or two.
Marvin Maldonado:
Yeah. We're, uh, June 21, two females. We're trying to encourage more females to come on.
Danielle Jourdan:
Yep. And, I was the first one in 10 years.
Marvin Maldonado:
That was, that was quite a change for (laughs), for us.
Danielle Jourdan:
Yeah.
Marvin Maldonado:
We had to adjust when that came about.
Danielle Jourdan:
Yeah. I don't know if they really adjusted. As a female in this field, you end up being one of the guys, per se. I, sometimes, I feel like the mother of the department, and sometimes I feel like I'm just one of the guys. I've got a bunch of my brothers around me. (laughs).
Marvin Maldonado:
Yeah. I think that's a huge avenge for us, on having females on our team. 'Cause a lot of times, yeah, you're right. You know, you have somebody, you have a male who's completely agitated and not listening to anybody. And then we have, you know, four or five guys coming and we also have a female, and a lot of times, just having a female in front of them, kind of, gets them to de-escalate.
Danielle Jourdan:
Yeah. If, I wasn't experienced, one midnight, I was dealing with a female patient in crisis, and across the hall there was a very large man, going nose to nose yelling at one of our very large men. And, I took a timeout from dealing with what I was dealing with, made sure that was good, and stepped across the hall, and kinda, just disbursed the situation a little and he worked with me just fine. It's all in, in the presentation.
Marvin Maldonado:
We have a variety of people or members, in our department, we have ex-military, we have retired police officers, we have social workers, we have people who hold master's degrees, and that's something that I don't think people realize. We work with just about every law enforcement agency, close and far from Warren County to Saratoga County, State Police, Homeland Security.
Danielle Jourdan:
Yeah. And, that's one thing a lot of people don't think about. Racing season. A lot of high profile people come into the area. Homeland Security, does, give us a call, realizing that we're part of the community. This is where someone would come if someone, high profile, had a medical emergency.
Marvin Maldonado:
I always find that fascinating. That, if something happens, okay, this is the plan, and it's for us to know what's going. The Public Safety Department and the Saratoga Hospital Staff, I- I believe we have a really close relationship, and we work together well. So much so, that we can look at each other, and without even saying that, I can just step forward and intervene in whatever's going on. We want to make sure that everybody's safe when they're doing their job.
Marvin Maldonado:
The training in our department, credits due, David Nelson, our coordinator, he does really well with our education, and he keeps up-to-date with everything, not just in our department, but the whole Saratoga Hospital staff, the emergency department, ICU, MHU. The mental health area is where they need it, so that way they can protect themselves and keep the patients safe.
Danielle Jourdan:
We're also trained, Code Amber, with a baby missing, to Code Red, fire drill, and how to respond to it, to, team training, techniques for effective aggression management, so people know how to respond.
Marvin Maldonado:
I would have never thought that we will be teaching a doctor, how to perform restraint.
Danielle Jourdan:
Yeah.
Marvin Maldonado:
How to keep somebody down on the bed.
Danielle Jourdan:
But, you mentioned a very important point, working with police and helping them in the emergency room. Whenever they come in with people, they give us a call that they're coming in, and that they want our assistance.
Marvin Maldonado:
Yeah.
Danielle Jourdan:
And, want us to be there. So, that says a lot, I think, for our department, as, they know that they can work with us. They know that they're comfortable working with us, that we'll have their back. And that, we're always there for them, the patient and the staff, because we want to be that front line.
Marvin Maldonado:
Mm-hmm.
Danielle Jourdan:
We want to able to interject when something doesn't feel right. We are in a beneficial spot to be able to come in to de-escalate, and at that time, getting to hold that person steady, so they can come, so they can look you in the eye and connect with you. Telling them to look you in the eye, communicating with them while you're holding them steady, to keep themself safe and to keep staff safe.
Danielle Jourdan:
Even, rubbing their hand, something as simple as the other day, I said, can I hold your hand. She's known to be violent, so I held her hand for a second. She wasn't feeling good, her stomach hurt, her head hurt, a lot was going on with her. But, at the same time, I rubbed her hand, because she said many times before to us, I just want to be loved. I need somebody to love me.
Danielle Jourdan:
So, being that person to be there for her, to be able to rub her hand, and she ended up rubbing back and it, kinda, brought us together for that moment. Being able to push the hair out of somebody's eyes when it's there, and that's what's bugging them, that's part of the trigger of what's going on.
Danielle Jourdan:
So, we have a really great spot to be able to connect with these people, and stop and slow things down. Slow things that can be such a volatile situation, bring it down, bring it back to life. At the end of the day, I think, as a department, as a whole, we realize that there's humanity in everybody, and that's our goal, is to find, find what is deep down in them, that's irritating them. We all had those feelings. Trying to get a deeper understanding of, exactly, what they're going through.
Marvin Maldonado:
Yeah.
Danielle Jourdan:
I'm a security instructor for the State, for State security guard licensing. And, I tell people all the time, your biggest benefit, the biggest tool that you have on your belt is, your mouth, and being able to use it correctly, and being able to de-escalate situations. Because, at the end of the day, we all want to go home, we all want to go home safe, we want everybody safe. The better that we can use our mouth and be able to communicate with people, the better we'll get our job done. A way of, less incident.
Danielle Jourdan:
I think the main reason that Marvin and I both teach techniques for effective aggression management, because at the end of the day, eh- we will be there. We will be there the minute you need us. We'll be the first one's there. We'll have your back. But, at the same time, we need people to take their safety into their hands, too. And, take these trainings, and take care of themselves, be aware. Not everybody's nice, uh, we have little old ladies be very combative. We've had very young children be very combative. We will be the first ones there with them.
Danielle Jourdan:
We have one person that comes in, she used to come in with her mother when she was younger. And, if you look at her, she walks with this, thousand yard stare, her hair is crazy. If, she likes you and, you'll know she likes you, because she will give you a nice big, toothy grin. Sometimes, she'll come in angry, and that's when we get called. We get called when people are in crisis. We don't always get called when their happy. Getting to know her and knowing that she knows, that she knows us, and she's comfortable with us, is really what we thrive on.
Danielle Jourdan:
Being able to say to her, hey, how are you? What's going on today? What's made you mad today? What we can we do to help that? And, that's, really, where we're at with her, now, because we've dealt with her so much. We're able to say, "Hey, what made you mad today?" And, we can work with it from there. She has drawn me a picture that is now in my locker. (laughs). And, I keep asking her to draw me more.
Marvin Maldonado:
What's that picture?
Danielle Jourdan:
It looks like her, with a little interpretation, it looks like her, with a bunch of different colored crayons.
Marvin Maldonado:
This made me think about that time we were... Remember, I had to put a tiara on, because somebody was just having a fit, and I think they always carry a tiara. And, here I am, she gave it to me. She told me to put it on, so I put it on.
Danielle Jourdan:
One of my favorite parts of working with some of these guys. Like, they end up being just like your brother, and this big burly guy that you see in front of me, MMA fighter, is putting a tiara on for a patient, to make them feel comfortable. (laughs).
Marvin Maldonado:
(laughs). Yeah.
Danielle Jourdan:
That's really how our department is, as a whole, and it's beautiful.
Marvin Maldonado:
The Public Safety Department, as served to a hospital, it's just, not only are we a team, but we're a team with all the rest of departments in the buildings. Did I ever ask you what your first experience was, downstairs in, in the morgue?
Danielle Jourdan:
We are the gatekeeper of the morgue. That, is one of our most important tasks, because they are still a patient, and they are still someone's loved one. And, regardless of how they passed, what's going on in their circumstances, they are loved and they have somebody that loves them back.
Marvin Maldonado:
I don't think people are aware of the fact that, that's something that we run into when a family member needs to come here and identify the body. And, we have to be there if they, all of sudden go in crisis, that we have to able to, to handle a situation, like that. I don't want to call it a challenge, but it's just one of the responsibilities.
Marvin Maldonado:
Somebody who comes into a trauma room, in the emergency department, we are there. We're there. And, the reason being is, we're there as a presence. But, I've seen in- in my experience here, where I had a 16 year old. It still kinda takes me back a little-bit, because I remember the father who was so upset, and he just lost it. And, it becomes our job to, make sure he doesn't hurt himself, the father, and he doesn't hurt anybody else there, because he's so upset that, the fact that he just lost his son.
Marvin Maldonado:
Do we tell him to stop and sit down, or be quiet? Or, do we just let it happen, let him grieve? I had a difficult situation like that, and i- it's so difficult, and it takes a lot of experience for somebody to just sit back, and just, okay, just let it happen. Let him grieve for the moment. The chair that he just broke, we can replace that, no problem.
Danielle Jourdan:
Our day, it really, runs the gamut. People acting out-
Marvin Maldonado:
Coming in intoxicated, mental health issues, car accidents, you name it. This, is just so unpredictable.
Danielle Jourdan:
Back to, opening the back door, for the vendor to get in, for Pepsi to get dropped off. (laughs). It's boring, until it's not, is what I like to say.
Marvin Maldonado:
I mean look at our phones, they never stop ringing. Once that phone rings, we don't what we're gonna get, and we gotta be ready for it. To have for an answer for the person on the other side. That's, what I like about the job, so much.
Danielle Jourdan:
Or, if, when you picked up a shift, calling home to your family, and saying, "Hey, just wanted to say goodnight to the girls." Just wanted to get my kids to sleep. And, seeing a car pull in and it ignite, in flames, and going, oh, game on. And, I think that's one reason our department is so goofy, as well. Because we do deal with the high energy, high emotion situations. Going back to the office to relax, to debrief, to let it out, to be goofy together, and just breathe.
Marvin Maldonado:
Yeah.
Danielle Jourdan:
This job is very boring, until it's not. And when it's not, it's not, and you know it. Expect the unexpected.
Interviewer:
It takes a special type of person to be part of our Public Safety Team at Saratoga Hospital, because you never know what the next phone call will be. All episodes of this podcast, Voices of Saratoga Hospital, can be found on our website, saratogahospital.org/voices and on your favorite podcast channel.
It was scary. Some patients go straight to the ICU, but a lot of them come to our floor first, and it's crazy how many would then end up in the ICU within hours, some within the next day or two.
And then we would wait for them to come back to us...
Nurse 1:
The first thing I remember is … we kind of got this high alert message. And I don't think that at that time we knew that it was going to be hitting us so soon. But I think that was the moment that it really got real.
Nurse 2:
We had heard it in the news and everything was overseas and wasn't really hitting here in Saratoga, but when we got those emails and I remember that it started to feel real. And then it hit.
Nurse 3:
I can remember the first patient in the ICU … and I can remember where the patient was and who the nurse was.
Nurse 2:
I think everybody who walked onto the floor for the first time, seeing all the doors shut, the drawers outside the room with all of our PPE in it. It made you feel unsure of yourself and what was going to happen.
On the med surg floor, typically most Covids are able to come. They come into the med surg floor, obviously they're sick enough. Some of them where they had to go straight to the ICU, but a lot of them come to med surg floors, and it's crazy how many patients would end up in the ICU within, some of them within hours, some of them within the next day, a couple days. And then we wait for them to come back to us - and they didn't.
Nurse 3:
Working in critical care you know that you will see death, you will see people who will lose their battle. You will see people pass away and that's not easy, but that's a part of the job and we had a lot of loss and our ICU is 19 beds and you could count maybe there would be eight, nine, 10, 11 COVID patients and that's half of our ICU.
You would see when people get really, really, really sick by COVID, and when they end up in an ICU, they end up on a ventilator. Some of them were chemically paralyzed to make them synchronous with the ventilator. Their chance of survival is not high. People were having a really tough time. And at that point it seems like, okay, we're six, seven, eight months into this. Maybe we should be accustomed to it. And we weren't because these are people.
I think, as a team, we really supported each other
Nurse 1:
We all had to look out for each other and still do.
And you're genuinely, genuinely concerned for your peers, wondering how they're doing. I think everyone's really pulled together. We have an awesome team that there's many days that I think I wouldn't do this, or I couldn't do this without them because everyone kind of has everyone's back. It's always when you leave work, you're like, okay, I don't have to think about work, but that's not true. That doesn't really happen. You're always concerned and thinking about how everyone is holding up here.
it was predicted that we were going to have a nursing shortage long before COVID even happened. But obviously it's been exacerbated by the pandemic, with people leaving, people choosing to do different careers. And then certainly, you're faced with people that are out sick with COVID themselves or caring for a family member that has COVID. So the shortage is a lot of stress on one, any given day.
Nurse 3:
It's not just that we've lost nurses, but we've lost really good ones. … People that really care about their patients and kind of put their heart and soul into what they do. So that's been hard. It's hard. It's more than just losing numbers.
From early 2020 to now, early 2022, I think we're somewhat more comfortable caring for COVID patients. I think we're more familiar with the medications and kind of the course of treatment. I think we feel somewhat more protected being vaccinated, being boosted. I think we probably feel a little bit more confident and comfortable giving care.
Another thing is that emotions have changed. I think nurses are tired and I don't really like the term burnt out, but I think nurses feel defeated. I think we feel like by this point we should be doing better. Our numbers should be lower.
Nurse 1:
I think the lack of vaccination has led to that significantly.
I think in some ways I think the vaccine has made us a little bit divided.
I was thinking about it … as I came in to give monoclonals. And the criteria for monoclonals has changed because of the shortages of the drug on hand. And the people that are now qualifying are the people that are unvaccinated. And in some ways, I'm angry, like, I'm mad that I'm going into work to give this to somebody who didn't help themselves first.
When I walk in and see a patient, and we're trained as nurses, that you have to deal with what's in front of you. I mean, you can't think about what the patient didn't do or could have done differently. You need to help them. It's innate within us that we want to help somebody. I remind myself that that's somebody's mom or somebody's dad or somebody's sister and they didn't make the right choice and they're here, and we have to help them. But it's also an opportunity to provide education to somebody and open up that dialogue and say let me tell you what I know about vaccines.
Nurse 2:
You do, you start thinking, you don't have to be here. I mean, there was a very good chance if you had got vaccinated, your symptoms would not be so severe, but when they are, and they're right in front of you, that does get pushed to the side. You want to do what's best because they are your patients,
Some of them still don't believe they actually have COVID. However, they're sitting in front of me, but some of them do reflect on their decisions.
Nurse 1:
There was a patient I was treating yesterday and he had not been vaccinated. Before he was leaving, said, "do you think I should get the vaccine?" I was like, absolutely, you need to protect yourself.
Nurse 3:
I think one thing from the beginning of the pandemic, where there wasn't a vaccine, to now there is, I think we all thought this was going to be kind of a turning point when the vaccine came out.
And I think we thought, okay, finally, it's here. We can move on from COVID, we can get vaccinated, and we can move on. I would've never have predicted that so many people would be hesitant to get it.
Nurse 2:
I try not to listen to the news, but it's everywhere on social media, and the news and how people feel and how people think that this is, you know, a ruse and I don't know if we'll ever really end this pandemic and will it get better? Yes sure, I hope so. But I really, eight months ago, I really thought that we were going to get to a place a lot sooner than we are going to get.
We think a lot about what's going on here at the hospital when we're not here.
Nurse 3:
I think we've become somewhat accustomed to the stress. You know, I think, all of this, it seems to almost give you a new threshold, like a new tolerance for what's stressful. But I think we've kind of learned to manage stress. I try to just enjoy my days off, I try to enjoy my time with my kids, with my family and I try to keep my mind off of it as much as you can. But you don't, as much as, do we text each other and ask, how's the unit. Yeah, I did it yesterday.
I just want to know, what am I walking into? Because you don't know, it could be four, it could be twelve, the unit could be mostly full with COVID. And we're curious, I think that's kind of what we've been doing for two years. So you try to get away and take your time off, but you do still wonder, it's a big part of our lives right now. And also we ask about patients.
We care about these people. It's really hard to take care of someone who's in their thirties or forties and to think maybe they're on the brink of death and then to go home and forget about that. You don't.
I think personally, we also, we look at people differently. I think, during this pandemic we've certainly learned a lot about the virus and how we take care of these patients. But I think we've learned a lot about ourselves and our teamwork, but really about other people and kind of what are the lengths that people are willing to go to, to protect each other.
So when I come to work and I see someone so sick with COVID, that they're on a ventilator or that they're, maybe not going to make it and then on the flip side, you see someone who's not willing to wear a mask to go into a store. And it just makes me think a little bit differently, kind of about, people, and the way that we care for each other and kind of what we're willing to do to make this better. Like, are we willing to kind of alter, our comfort level, our lifestyle to care for people that we don't know to care for the greater good, are we willing to sacrifice something to, for the greater good?
Nurse 2:
I dunno I just feel like we felt more the small joys if you will, a year ago. It's been a really rough fall, beginning of the winter and I just, I'm still looking for those small joys right now.
Nurse 1:
I can remember having a patient who was going to die and we wanted his daughters and his wife to come. And I believe the answer was they could come for 15 minutes.
Nurse 3:
I think a lot of times we pushed it, we said, okay, we would let them stay a little bit longer, that was the right thing to do to give the man a little time, with his wife, with his daughters and he did pass away, he did the next day.
I can remember crying that day. I can remember many nurses kind of breaking down that day because it was when we had a lot of loss.
Nurse 2:
The fact that we now allow them to come and visit, and people are not saying goodbye over an iPad. That's a joy, as much as it can be, and families are really grateful.
Nurse 3:
I think outside of the hospital setting, there's certainly some things, did come from the pandemic that are good. I think people spent more time with family. I think people spent more time outdoors. I think people kind of slowed down a little bit. You know, people sort of, some people changed their outlook. People were able to work from home. So I think in that sense it did bring some light to people's lives.
Nurse 2:
You know, the community has really been supportive of us and now we need them to do their part and get the vaccine.
Nurse 3:
I often wish that people who don't understand who haven't seen it, I wish they could come to work with us. I wish they could see what we see because to us, it's clear that this is a threat. Even if your risk is small, you don't want to be that person on the other side of that glass, who's struggling to breathe. You don't.
My hope is just that people would look at statistics and data and studies and make their decision based on that and not on what they see on social media or what they hear from their friends. Because I think that's what we hear when people get really sick, we hear people having regret. And I think people think that their risk is low, but if they were able to see what we see, they would understand that even if the risk is low, it's there and it's scary. It's terrifying.
If your risk is 2%, it doesn't feel like 2% to the person who's in that room, isolated for weeks on end struggling to survive.
And I think this wave of the pandemic, has reached the young people and it's gotten them really sick and more so than in the beginning, we've seen young people die.
We had a father and son pass away who were 27 and 57, unvaccinated. And to look at them and think, maybe this was preventable. I mean, they lost two of their family members. They lost half of their family to COVID and they were young.
I think it's been difficult for us to kind of watch this progress and to think that this was a light and then it turns out it's maybe not
So to me, this part of the pandemic where the vaccine is available and some have chosen not to get has been more difficult because you tend to look at this and say maybe this was preventable.
Nurse 1:
I think that the nurses on our units have become stronger nurses. I think that the patients that we keep on the floor, two years ago, they would've been in ICU. We've learned a lot through the pandemic
The staff is still incredible. So proud of them. They truly care.
I think leadership has been very supportive. Certainly, our director has been incredible, but …. There's only much that you can say when you're in it. I think you relate to the people that are working side by side, you kind of just share that same bond and you know what the other person's going through and it helps you get through the day.
Nurse 2:
It's nice to know that you have friends that you work with. I think that helps. I'm looking at one.
Back in 2020, everybody was … looking up to frontline workers and healthcare workers, and we were heroes. And really, I think none of us really could wrap our heads around being called a hero. I still don't feel like a hero. If I could say anything to anybody right now, if you are unvaccinated, go and get vaccinated, you become the hero. Be somebody else's hero. You may not get a thank you. You may not hear that, but somewhere, somebody will actually be thanking you.
The tools are out there, the tools being the vaccine and the booster, they're available. And wouldn't it be great if everybody just did the right thing.
Nurse 3:
This has been a long road.
I had lived a life of addiction for many years. And, it took some time for me to finally wake up and say, "Hey, this isn't working. This is a problem. I'm not going to live if I continue down this path.
This is a disease that prefers you be in the dark by yourself...
Lori:
My name is Lori. I've been coming to Community Health now for a little over a year.
I went to the hospital. I had an episode. Nobody knew what it was at the time. I was in intensive care for a week. And alcohol had a lot to do with it.
Randy:
My name's Randy, I'm 28 years old. I've had trials and tribulations, um but I eventually landed with the Community Health Center, and, so it's been about two plus years now.
Lauren:
I'm Lauren Kelly. I'm an addiction counselor at the Addiction Medicine Program at the Community Health Center.
One of the things that I really wanted to do when I got into school was help people. And, one of the things that drew me to working in the addiction field was seeing people get better.
Randy:
I had lived a life of addiction for many years. And, it took some time for me to finally kind of wake up and say, "Hey, this isn't working. This is a problem. I'm not going to live if I continue down this path.
I was around other people who were in my scenario, we would find a way to make friends and get into trouble.
So the process really started with me first. And, luckily, I have a really good support system in my family. And, I have a girlfriend.
I've tried various different programs. I couldn't find something that worked for me. 07:18 Unfortunately, a lot of programs, if you enter into their program and you make a mistake, that's... they pretty much are like, "you're out of here."
We continued to look for help … And, we landed upon Lauren over here at Community Health Center. And, right from the beginning, she just really pushed me and helped me and pointed me in the right direction and gave me a second chance.
Lauren:
I think it would be cool if you guys could speak to sort of the transition from first coming in and what that sort of feels like initially, the not knowing. And, then kind of getting settled into sobriety and then to where you are now. Because I know you guys are both working on some pretty big stuff now in your lives.
Lori:
I first came to Community Health Center from the hospital … wasn't mandated or anything, but I went. And it was helpful. It helps every day.
Randy:
I really stuck with this place, because they've worked with me and I can tell that they really care. … so getting there initially was a big change for me, having to change, basically, my whole lifestyle.
It took me so long to finally say, "hey, I need to get help." It was really scary, because I'm thinking, "how am I going to survive? I feel like I'm barely surviving with substance abuse." In the back of my mind, I'm thinking, "oh, my God, that means that the one thing that makes me feel better about my everyday life, the one thing I use that kinda gets me through, I'm going to get rid of it."
It really takes a brave person to come forward and say, "hey, listen, I got a problem. Somebody help me."
I tell people that constantly. I'm like, hey, man, getting sober is scary, and it's freaky, and it's hard. It's really hard.
Lori:
It's hard.
Randy:
I mean, it's scary.
Lori:
It's confusing. You want to be validated.
In the beginning, something I really had a hard time with was knowing what was normal life, normal behavior, circumstances, and what was due to alcohol. So, when I stopped drinking, I didn't know what to do and what was right or what was wrong or what feelings or emotions.
Randy:
Yeah. Your whole, I mean ...
Lori:
It's so much better … ‘cause I was in pretty bad shape. Since I was in my twenties. I'm 60 now. So, for quite a long time. But, I was functional.
Well, I thought I was.
Randy:
Mm-hmm (affirmative). Yeah.
I was a functioning opioid addict. I had jobs and I could come up to you while using substances and you probably wouldn't really even recognize that I was high on drugs. I think with alcoholism too, same thing. These people are, basically, after a while using substances just to feel like a functioning member of society. It's just how it is, you know.
I think people get lost in their substance abuse and especially when it's over a long period of time. Like for me and Lori. you kind of lose yourself and you really don't understand who you even are without the substance that you're abusing. I mean …
Lori:
I felt like I was floundering when I stopped.
Randy:
But, that feeling goes away. I mean once you start living sober, it does take a little bit. And, I think, for people, that's why it's hard, because they're expecting, "I'm going to put the substance down and tomorrow I'm going to be back to normal." And, it just doesn't work that way. You have to give your brain and your body and the people around you a chance to really kinda, you know, situate and get used to the newness of it all.
Lori:
I just met somebody who hasn't had anything in a few months and I wanted to tell him, "really stick in there and you're going to feel better.” Because, it's like you said, it really does get better and it's so worth it.
Randy:
The key component is to get yourself in the door is really the first step. That is the most important step because once you get in the door and you sit down with a group and then you start conversating, you go, "Oh." You know what I mean? "There's people here just like me."
Lori:
When I walked in my first group, I was terrified
Lauren:
We talk about this as a physical recovery and emotional recovery and a spiritual recovery, and really being able to tap into all those areas so that you stick with it, and not settling. And, that's something these guys have done really well, and they haven't settled for what they were settling for before, which was just to survive every day, by any means possible. So to see them continuing to transition it to different levels over the last year, a couple of years, has been really cool to be a part of that.
Lori:
Oh, what's cool too, is that with me anyway, I think I speak for other people too, is that having the support, the encouragement that's given to us that, "you did good." That's what keeps me, helps keep me going as far as moving ahead.
Randy:
Mm-hmm. Yeah, totally.
Lauren:
Every day is different. Anything's possible. It's never the same day twice and you never know. We really don’t know, when people come in, start their journey. We really don't know where it's going to go. One of the things I like is that when there's somebody initially starting their journey, it's really a blank slate for us.
There's a tremendous amount of guilt and shame. And, to Randy's point, it takes a tremendous amount of courage to walk through the door and say, "I have this problem,” because this is a disease that prefers you to be in the dark by yourself.
So to be able to have that courage and saying, "hey, I have this issue." and then being able to be a part of that journey, watching people become new people. It's pretty rewarding.
Randy:
I will say this, um, just because I'm sober doesn't mean now all of a sudden I wake up and I'm like, "Oh, today's going to be rainbows and unicorns." Life is life, regardless, and you're going to face challenges. It's really important for people who suffer from addiction to hear that you're worth it in the things that you've done, your past, doesn't make you who you are.
And, so when I wake up in the morning, that's really my thought process, is like, "Wow,", I'm like, today might be a crappy day, but at least I'm sober and I have a fighting chance today, where I couldn't say that before, when I was using. You know what I mean?
Lori:
When you wake up in the morning and it's nice to just wake up feeling … lighter. I don't know how to describe it. But, that you could do things today, you could handle it. Definitely feel more optimistic about everything. And, you still have those days. Excuse me. But, it's a lot … it’s a lot better. It's a whole better life.
Randy:
Yeah, definitely.
I've known Lauren for two plus years now, and we've grown to a point where she pretty much knows my whole story.
If you saw your doctor for almost every week for two years, you start talking about your life and their life and, "Oh, yeah. I experienced this too." So, I mean, she's really your counselor, but she also talks to you like, he doesn't treat you lesser than her, which is good, because I feel like that's an issue with this whole topic. People will look down on you, and addicts aren't stupid. We know when we're being talked down to or judged.
I've never felt judged.
Lori
Very trusting.
I'm not afraid to tell her anything.
She listens to what you have to say.
Randy:
She helps you make progress, which is all that really matters.
Lori:
It's from the heart with her, you can tell. She's my hero.
Lauren:
I'm just grateful to be part of the journey.
That judgment piece these guys are talking about is a lot of the reasons why people don't ask for help, so trying to just stay in that non-judgmental realm is really really key, and patience is a key. And, it's not easy. I'm human, I'm certainly far from perfect.
Recovery is possible, you know I mean, people recover every day, and a lot of that doesn't get a lot of coverage. It doesn't get a lot of stories. We don't really hear about that side.
It's a huge problem we're dealing with right now in our culture but there are people like Lori and Randy that are actively working in recovery.
I like what Randy said about, "You're worth it, even people who don't think that they are."
Lori:
I found out that there was a professional next to me and I had asked her in one of the groups, I said, "How did you...?" Because she just looked so professional. She said it happens to everybody. I think I knew that, but she really drove that point home during the group, so that was a big help. That's when I think I knew just how serious it was.
Lauren:
This disease knows no category or class, or race, religion, economic status. I see people from all walks of life: professionals in the community to folks that were once professionals in their communities who have unfortunately lost that because of their use. It really is everybody. It can affect everybody. Nobody's immune to it.
Lori:
I think that there are so many people out there struggling that we don't know about that… and, I think there's a horrible stigma attached. And, I wish I could tell people, "just go.", to please go and speak with somebody, because the people are there, they want to help. But I think people are afraid. I was. I didn't want to admit it. It was hard.
Randy:
It's a deep subject and it's not easy for people, I don't think, to come forward about it.
Lauren:
Something we really tried in designing the program over at the Community Health Center was really trying to strip away any of the barriers to care. Trying to be available to be able to see people when they're ready is really, really critical. And then, knowing that the service is available in the community as opposed to having to go to another community to get services, you know, is big.
Lori:
It's nice to feel like you want to be good to yourself now. I didn't care before. But now, I want to be good. … I think I deserve to have a shot at this.
Randy:
I still push every day and I still wake up and I say, "Hey, we're working towards our future today," and that feels really good.
I've wasted a lot of years unfortunately not really focusing on the future because like I said, I was very scared of the future, so I was just on a day-to-day basis. So I'm just making up for lost time.
Lori:
Right now I can't even describe how good I feel talking with Randy. We're looking right at each other in each other's eye and we know we get it.
Lauren:
Lori, the last year, watching you grow from when you first came in to where you are now has, again, been a big thing.
Lori:
Nothing that I'm doing would be possible. And at community health, everybody there says that, "Well, you're doing the work." It's like, "well, I've been given the tools to do the work and I would not be anywhere near where I am today if it weren't without you."
Lauren:
Randy, you and I go back. And it was definitely a journey in the beginning and I'm really proud of everything you've accomplished in the last couple of years and just continuing to work harder and really level up your recovery and not settle for less.
Randy:
I'm really proud of Lauren for the work that she does every day. I know that it's not easy for her, but she wakes up and she pushes to help people. And really, quite honestly, I think she's like a modern day superhero who’s too humble, I really think that she's saving lives. She just point blank is saving people's lives.
And I'm super proud of Lori for being like me and just saying "enough is enough."
Lori:
Oh, I'm proud of you.
Randy:
It’s been a good journey.
If somebody is not feeling well, how do you fix it? That's what it means, right, to palliate, to support, to treat symptoms. It's not taking away care. It's actually adding more care, specialized care for seriously ill people to help them and their families. And I always accentuate their families.
Being in this space with people where it's just so vulnerable and raw. It's such a humbling experience to be in that space. It’s an honor...
Here is a story about two doctors, their strong passion for patient care, and discovering there was something more they could share with their patients, and their families, when they are at their most vulnerable. Together they reimagined what palliative care should be and uncovered the rewards they experienced along the way.
Dr. Ayesha Sooriabalan:
So how should we introduce ourselves?
Why don't we just say inpatient and you say outpatient?
Dr. Ayesha Sooriabalan, inpatient palliative care physician here at Saratoga Hospital.
Dr. John Pezzulo:
And I'm Dr. John Pezzulo, outpatient palliative care physician here at Saratoga.
John:
One of my favorite things is bringing out young medical students to sort of show them what real medicine is.
We drove from the Battlefield down to Waterford to Clifton Park, Vischers Ferry, back up to Ballston Lake. We saw these patients, but we also passed a half a dozen other houses. I'm like, "Oh yeah, I've made a home visit in that house once before.
You could go into a room and first time you're meeting somebody and they just got out of the hospital, and you get there and you don't know what to expect because patients look different on paper. And "Oh, hey, where's dad?" "He didn't come downstairs. He's upstairs in his bedroom." "Okay. Let's go." And we go upstairs and I'm sitting on the laundry basket upside down and the wife's on the edge of the bed and the daughter's on the other edge of the bed and the daughter from out of town's on the telephone and on FaceTime. And dad's sitting in bed, he's like, "Oh, thank you for coming."
…she was like, "This is crazy. I never would've thought” … there's a population of people that need an extra layer of care, home-bound. And they just can't get out any longer.
Ayesha:
There's a misconception that palliative care is hospice, so because hospice is a form of palliative care for patients at the end of life when you're doing purely comfort care. And I think the big difference that I try to get across is palliative care, specialty in itself, it is different from hospice. … it's really very patient centered. We focus on comfort, but we can come in concurrently with treatment. And I think that's the big piece people don't understand.
John:
It's a specialized care for seriously ill people to help them and their families. And I always accentuate their families, symptom management goals of care … of an illness ...
Ayesha:
Any age, any stage.
John:
But it's deeper. It's more nebulous than that. It's sort of like, "Hey, wait, you're just supposed to just do the right thing." If somebody is not feeling well, how do you fix it? And that's what it means, right, to palliate, to support, to treat symptoms. It's not taking away care. It's actually adding more care.
Ayesha:
It’s really trying to meet people where they're at.
John:
And it is sort of a unique role because people are very vulnerable and you have the compassion. You can learn so much about a family in an hour and a half … and that's an honor.
Ayesha:
If we can just leave the family intact.
It's such a humbling experience to be in that space. I think that's a term that I've definitely heard within the palliative care community. It's like being in this space with people where it's just so vulnerable and raw. And when I'm meeting people in the inpatient setting, it's like I have to develop this trust and rapport fairly quickly.
John:
When we met and started training together, I was still in private practice.
Ayesha:
I was doing hospital medicine, still. I wasn't doing palliative care, yeah.
John:
And at the beginning, I was like, "You know, we need outpatient palliative care." And you were starting to forge the inpatient.
Ayesha:
When we started the inpatient palliative care, it was like we'd spend all this time with these patients making these plans. But it also is just like there are so many complexities to them that having some specialized outpatient palliative care to help the primary out, we didn't have that until you were able to start doing this. And it just makes us feel so good that the work that we're kind of accomplishing in this crisis situation can be like then just kind of warm handoff to somebody that we know is going to be looking at all that big picture stuff.
John:
Saratoga Hospital is the only hospital in the area that offers specialty inpatient and outpatient palliative care.
Ayesha:
It's such a unique service.
There's such a gap with these home-bound patients. And especially with the palliative care patients, they're at the highest risk of being re-hospitalized and not wanting to be here. And sometimes it's a matter of just having someone to call when their symptoms are getting worse or transitioning them to a different care plan.
John:
Especially when either of us see them, they've gone through the gauntlet of all the specialists and the interventional radiologies and CAT scans and PET scans and biopsies and 30 days of radiation therapy.
Ayesha:
I'm seeing people in crisis mode.
So I feel like palliative care also has added some continuity, too, for some of these complex patients that are here for a long, prolonged hospitalization. Also, if they come back on re-hospitalizations, they're going to get the same palliative care people.
John:
In outpatient, there's a lot of patients we've seen that haven't even been to the hospital in five years. But all of a sudden they're late stage dementia, late stage Parkinson's, late stage emphysema. They've been going to dialysis for five years and now they're having a hard time.
When I was in second grade and thought, "Oh, being a doctor would be really cool." And then in sixth grade and then in college and then finally going to school, I always dreamt about coming back to my hometown. And I grew up here and I feel like it's just coming back to take care of your own. …there is a community here that needs an extra layer of care.
John:
There's a lot of other issues in Saratoga county, for whatever reason. I mean, we have high rates of pretty serious illnesses including, relative to other parts of the state there's higher rates of some cancers around here. There's higher rates of emphysema, and those people need that extra level of care as they're trying to fight those diseases.
John:
To know that Saratoga Hospital's given me a green light to do a mission in my heart, a vocation and not a job, is actually very satisfying. To wake up and say, "Hey, this isn't going to be work, this is different than a job." And when I come home at the end of the day and say, "That was a good job today," it's because we helped other people.
Ayesha:
It's actually my kind of mantra is to be at my highest service in whatever capacity that I can when I come to work.
It's a way of giving control to a patient that feels like they have no control with their disease.
John:
That's where you make a difference.
My first surgery here at Saratoga Hospital, I walked into the OR, and all of a sudden, I got a text message and there was the picture of the scheduling board, and it said, Reynolds in room four and Reynolds in room five. My brother was in the OR right next to me. That first day was really special.
This story is about family. A sister and a brother, the influence of their parents, and how, while their paths took them to different places, their shared passion for medicine ultimately brought them back together again. Here, at Saratoga Hospital.
Rick:
You can go.
Dorothy:
I'm Dorothy Reynolds. I'm a pediatric ophthalmologist with Saratoga Hospital. I'm happy to be here, sitting with my brother, Rick Reynolds.
Rick:
I'm a general surgeon here at Saratoga Hospital. I've been here in Saratoga since 2005.
As family you don't quite realize how close you are, and you know for Dorothy and I, it takes a lot of reflecting for me to go back and realize, yeah, we were side by side. I mean, truthfully, for most of our life.
I think the notion of going into medicine has always been there for us.
Mom is in medicine and our father, dad, was an engineer. So, you know, you take the two together, those combined interests, and you look at what we do today, we are both surgeons in medicine.
Dorothy:
We did things a little differently. I went and joined a university hospital, a teaching institution. So, I worked with residents. I love teaching. I love my patients.
Rick:
You know, I think for me, the challenge, the greater challenge was trying to figure out how I could incorporate myself into medicine and still do the things that I'm passionate about. Surgery is, at least, for me, it's the ideal field because I'm a part of the medical field, but I still get the chance to work with my hands and to do what comes naturally to me.
Dorothy:
So, I have lots of memories of Rick taking things apart and putting them back together. I remember coming home one day, and there was my 10 speed with none of the... what are those strings? Those …
Rick:
Oh, the...
Dorothy:
From the gears.
Rick:
I needed something, and your bike happened to be sitting in the corner.
Dorothy:
That 10 speed sat in the corner for a few more years waiting for those, whatever those things were.
It's interesting, how over the years, we keep sharing these paths in terms of where we've been, and I guess where we were going. I went to college in the city at Columbia University, and he subsequently went to college in the city at Columbia University. So we were both there at the same time. He was pre-med, but I studied art history, and worked in a museum and enjoyed New York things. He subsequently went on to medical school, and I thought about it. And I pursued medical school.
We used to sometimes study together and there's always fast food restaurants around medical schools, and we always would get chicken with broccoli extra spicy with that hot oil. That was a Rick thing. And then, the other thing that Rick was the roast beef sandwich with jalapenos on it. Right? With hot peppers.
Rick:
You know what's so funny? I don't like spices.
Dorothy:
But you introduced me to those two things.
Rick:
Well, we used to study with them. That was our reward.
There's a connection that you have with children that it's not taught. … you have the same connection with my kids.
Dorothy:
Children are just so special. They're so honest.
Prior to going to medical school, I worked for two summers for a pediatric ophthalmologist. And I just enjoyed the process.
Dorothy:
It touches on different aspects of medicine in terms of neurology, ophthalmology. And then, it's also a surgical field.
I know how happy Rick has been. … when the opportunity came up, I thought about it. You know, sometimes you run away from something, but that's not what I did. I actually had the opportunity to run towards something. And what I ran towards, and was so lucky to ultimately become a part of was this great medical group here at Saratoga Hospital with such wonderful people, caring people.
Starting a practice with a hospital in such a lovely community, as Saratoga Springs, with lakes on one side and farms on the other side and really good people up here, good community.
Rick:
We are a community hospital, meaning that as the community hospital, we care for our friends, we care for our neighbors, we care for everyone within the community, but we are far more than that. We offer well beyond what one might think of in the traditional sense of a community hospital, meaning we're not small town medicine.
Dorothy:
But it’s special because it’s a community hospital. It has it all here. It has people who want to be here who are practicing great medicine, whoh are innovative, who are using the latest techniques. I remember when Rick started doing robotic surgery and I was at an academic center and I was like, “Oh!”, he was right on par with what we were doing down there.
Rick:
We provide the latest and the greatest in medical care here.
Dorothy:
My first surgery here at Saratoga Hospital, I walked into the OR, and little did I know that my brother was in the OR right next to me. And all of a sudden, I got a picture, a text message with a picture, and there was the picture of the board, and it said, Reynolds in room four or five?
Rick:
I think it was room four...
Dorothy:
Four...
Rick:
... and room five.
Dorothy:
... and room five. Reynolds, and then, Reynolds.
Rick:
That's fantastic.
Dorothy :
So that was really special.
Dorothy:
I really like my brother.
Rick:
Thank you.
Dorothy:
It's a nice thing. I love him.
Rick:
I like you too.
Dorothy:
Yeah, those hot peppers. Yeah.