DC 08/19/2020 chair’s welcome message

“ Your knowledge and passion will allow us to reconnect and build enduring friendships.” -Robert J. Femia, MD, MBA Chair of Emergency Medicine

Ronald O. Perelman Department of Emergency MedicineDC 08/19/2020 chair’s welcome message

Dear Alumni and Friends,

Leading a creative department such as ours is a great privilege. I am pleased to share our vision with you through a medium that can stimulate discussion and make our community even stronger— NYU-Bellevue EMalumni Magazine.

In this inaugural issue, you will hear from fellow classmates and graduates, mentors and mentees, colleagues and friends, who will share their work experiences and personal accomplishments. Together, we can find answers to the critical questions that face us daily.

Our department is expanding rapidly throughout a city with a diverse population, and we continue to address many seemingly insurmountable issues: • Advocating for the vulnerable, disenfranchised, and marginalized. • Overcoming homelessness, opioid addiction, poverty, and lack of education and opportunities. • Educating our trainees and students to become leaders and innovators. • Enhancing safety to improve outcomes in the emergency department. • Engaging policymakers as we advocate for safer, healthier, and more engaged communities.

In this and subsequent issues, we will explore many of these challenges. We encourage you to join in the discussion. Your knowledge and passion will allow us to reconnect and build enduring friendships.

Enjoy the experience!

Sincerely,

ROBERT J. FEMIA, MD, MBA CHAIR OF EMERGENCY MEDICINE

DC 08/19/2020 editor’s note

Dear Alumni and Friends,

It is with delight and excitement that we introduce the inaugural issue of EMalumni magazine, a platform where relationships and a community of ideas will allow us to thrive as leaders in emergency medicine. EMalumni is your magazine. You are the strength of emergency medicine and you can connect with us in the most personal way. Your opinions and contributions matter and will ensure vibrancy and connectivity in every issue. In this and upcoming issues, you will read stories about people, programs, activities, and accomplishments of alumni, friends, and peers. The better we get to know each other, the more engaged we will become. I hope our renewed friendship will stimulate discussion and EMalumni becomes the go-to place to share your interests and experiences. I look forward to reading your stories.

Warmly,

Joan Demas

02 I EMalumni fall/winter 2018 DC 08/19/2020 EMalumni Dear Alumni and Friends, Contents Inaugural Issue Fall/Winter 2018

Joan, this space is for an image from the “Blending Human- ism” story. If we can’t find one, I can make the photo to the left42 larger.

Emergency Medicine 56 48 and Social Justice By Rohini Haar, MD (EM ‘09)

46

Blending Humanism with Science By Kelly Doran, MD (EM ‘11), Ryan McCormack MD, Audrey Bree Tse MD, Ethan Weiner MD

EM Alumni fallDC 2018 08/19/2020 I 03 50 MISSION ns C 13 Commitment to Diversity tio la 18 Transforming Teaching la s 25 The Front Line of Care u s 36 Innovations in Research t o a DEPARTMENTS f r 1 Chairs Welcome 2 Editor’s Note g 2

5 Congratulations Class of 2018 0

7 emNEWS n

1

58 Conversations: Rob Femia, MD o

60 Video 8

C

62 emLibrary

Pursuing a Life

63 Voices 48

of Service 65 In Memoriam

By Saleena Subaiya, MD

66 #Fun #Life 68 Then and Now 69 Credits

54

My Second Home By Sari Soghoian, MD (Med Tox ‘09)

EM Alumni fallDC 2018 08/19/2020 I 03

ns tio Cl a as l s u A big sigh of relief. The food is ready. The weather is great. t Pictures are all finished. ED coverage is assured. Moms and Dads have somehow navigated Lower Manhattan and have o a made it on time. And, most importantly, they made it. f r For all of its moving parts, all of the people, and all of the little details … the lead-up to graduation is a smoldering panic. But once everything begins, the true joy of the event shines through. Families meet all of the co-residents g 2 and mentors who have marched with their loved ones through the inordinately

long hours of training. The graduates finally get to see what all of their shared 0 n sacrifice of late nights and missed holidays have yielded.

The Class of 2018 toiled for four (or more) years to arrive at this moment, and 1

o they undoubtedly deserve such a wonderful night. And while the next stages of

their careers await them with more demands of time and sacrifice inherent to 8

C the life of a physician, tonight they all get to breathe a big sigh of relief.

They made it, and they did it together.

Congratulations to the Emergency Medicine Residency and

Fellowship Class of 2018!

By Jeremy Branzetti, MD

DC 08/19/2020 1 2

1. Lindsay Davis, MD (US EM ‘18), Fellow, Ultrasound Emergency Medicine 2. Alex Harding, MD (Med Tox ‘18), Fellow, Medical Toxicology 3. Nicole Gerber, MD (Peds EM ‘18), Fellow, Pediatric Emergency Medicine and her “constant source of support and joy” Max. In July Max became a big brother to twins! 4. Kelsey Fawcett, MD (Peds EM ‘18), Fellow, Pediatric Emergency Medicine 5. (Left to Right) Residents in Emergency Medicine (EM ‘18) Drs. Matthew McCarty, Michael 3 4 Kaufer, Steven McDonald, Julia Paris, Alan Guiney, Brian Lin, Eli- cia Skelton, Ryland Pace, Jeremy Branzetti (Director, NYU-Bellevue Residency Program), Timothy Gallagher, Alexandra Ortego, Trudi Cloyd, Michael Shamoon, Gordon Wu, Mark Mikhly and Allon Mordel

Caption

5 Photo: Alex Alex Photo: Bane

DC 08/19/2020 06 I EMalumni FALL/WINTER 2018 2

EMalumni

EMalumni fall/ winterDC 201808/19/2020 I 07 emNEWS (Below, Left to Right) Project Healthcare program coordinators Haley Barravecchia (Smith College), Maya Graves (Indiana University), Antalya Jano (New York University), Nathanael Rehmeyer (Skidmore College), and Anthony Orneta (Senior Program Coordinator, Volunteer Programs, Clinical Division)

Project Healthcare: Towards a Healthier Community

Project Healthcare prides itself on to prenatal health to heart disease. our best year. We were not mistaken being a program in service to its With 52 volunteers tirelessly work- as around 200 people made their community. Nothing represents ing, on top of their full schedules in way through the fair and received our passion to educate and engage the Emergency Department, to reach helpful information. We would like to more than the annual Health Fair. out to organizations for pamphlets in thank the coordinator team, volun- This year, we strived to go further to multiple languages, design exciting teers and all the Bellevue Hospital raise community awareness about 21 bulletin boards, and develop interac- staff who helped us pull off another various health topics—from influenza tive activities, we knew this would be successful event! Photos: Ricardo Monge Ricardo Photos:

(Second Left) Volunteer, Katty Wu (University of Michigan-Ann Arbor), educates members of the community on heart disease and cholesterol, during the Project Healthcare 2018 annual Health Fair.

08 I EMalumni fall/winter 2018 DC 08/19/2020 Photos: Ricardo Monge Education Day Medicine Emergency 1st Annual from the Highlights tency-based medical education. soning, diagnostic error, andcompe- scholarship focuses onclinical rea- and innovation, whileDr. Sherbino’s translation usingeducation theory making andimproving knowledge on contextualized clinical decision- Canada. Dr. Chan’s research centers and research atMcMaster University, in emergency medicineeducation MD—are bothrenowned professors Sherbino, MD, and Teresa Chan, The featured speakers—Jonathan gency MedicineEducation Day, Medicine hosted its inaugural Emer- Perelman Department of Emergency On May 2, 2018, theRonald O. Sea Change in Emergency Medicine Medicine Emergency in Change Sea Education. Education. em NEWS A A ing success. who madetheday suchanoutstand- Thank you to alltheparticipants takes place atNYU-Bellevue. the rigorous academic training that exceptional presentations highlighted projects to introduce theevent. Their (EM ’18)whopresented theirscholarly graduates of ourresidency program We were especially inspired by the were very well received. discussions, andinteractive activities The stimulating presentations, panel residents, andmedical students. implications for clinicianeducators, digital mediaineducation, andthe education andits assessment tools, on competency-based medical Throughout theday, they focused EM EDUC Save theDate! EM MD (EM ‘08) andMartinPusic, MD Lindsay Davis (US EM ‘18), MD, InnaLeybell, Jonathan Sherbino, MD, Teresa Chan, MD, (Below, Left to RightForeground) alumni A 2 We hope you you hope We N pril 10, 2019 can join us. join can D fall/ w ANN A T IO i U nter 2018 I09 DC N AL D 08/19/2020

A Y emNEWS (Left to Right) Robert I. Grossman, MD, Dean and CEO, Silas W. Smith, MD (EM ‘06, Med Tox ‘08), Mrs. JoAnn Wellner, Philantrophist and Neal A. Lewin, MD

The Wellners’ Generosity Advances Patient Safety and Quality

Silas W. Smith, MD, was recently quality across the departmental clinical Lewin, MD, the Druckenmiller Professor named the JoAnn G. and Kenneth sites, but also train the next generation of Emergency Medicine and Medicine, Wellner Endowed Associate Professor of leaders who will develop a new dis- a devoted faculty member, educator, of Emergency Medicine. The Wellners’ cipline in emergency medicine safety mentor, and fundraiser. longstanding support allows Silas to and quality. The Wellners’ extraordinary sup- utilize his immense scientific talents to This endowed position and the port will sustain the departmental advance the field of patient safety and previously established Kenneth and efforts to provide analytic capacity quality. He will pursue a mission to not JoAnn G. Wellner Fellowship in Emer- and work broadly across disciplines to only conceive, design, and implement gency Department Safety and Quality advance education, best practices, and programs to improve patient safety and (2013) were created in honor of Neal A. strategies that mitigate error.

10 I EMalumni fall/winter 2018 DC 08/19/2020 emNEWS

Promotion to Assistant VP of Policy and Administration

Andrew Ashkenase, MBA, senior years, Andrew accepted the many administrator in the Ronald O. challenges of our rapidly growing de- Perelman Department of Emergency partment. He strengthened depart- Medicine, was recently promoted to mental infrastructure and developed assistant vice president for policy policies and processes to ensure the and administration at NYU Lan- continued delivery of exceptional gone Health. Andrew will work care to our patients and impactful with Joseph Lhota, senior vice research and quality educational president and vice dean, experiences. Throughout his time in chief of staff, to manage our department, Andrew continu- a team of administrators ally worked towards maintaining a from various departments healthy and engaged workplace for to accomplish policy and faculty and staff. strategic goals through- Andrew’s efforts are much appre- out the organization. ciated. We wish him success in this Over the past two exciting new role.

Passing the Torch: New Administrator Named

Nicholas Dibble, MBA, director passionate about his mentor- of business operations, was ship of staff to meet their full named administrator of the potential. And his continued Ronald O. Perelman Depart- commitment to an expanding ment of Emergency Medicine department is noteworthy. replacing Andrew Ashkenase. Nick’s transition into his For the past four years, new role has been seamless. He Nick has advanced the mis- is determined to make a differ- sion of our department. He en- ence in the lives of patients, hanced our efforts by working students, trainees, staff and closely with faculty and staff the community we serve. on several initiatives including Congratulations finance, education, clinical op- Nick, we support your erations and research. Nick is outstanding efforts.

EMalumni FALL/WINTERDC 08/19/2020 2018 I 11 4 emNEWS

Women@NYUEM: Empowering Women in Emergency Medicine and Girls in the Community

Advocating for the health of women and launched Women@NYUEM. Health and Facts Night at PS20 in and girls has always been a passion Through their support of each other lower Manhattan. for Drs. Liz Haines and Katherine they are empowered to change lives. Liz and Katherine look forward Jahnes. Through their educational To achieve this goal, Women@NYUEM to ongoing programming that brings and clinical roles at the Ronald O. organizes social events throughout women together in order to support

Perelman Department of Emergency, New York City and meets quarterly each other in work and advocacy. they observe how health education for Happy Hour to network and seek allows women in medicine and girls support for their cause. to make informed choices for them- In just one year, Women@NYUEM selves, their community, and the next sponsored 11 events on wellness and generation. meditation that included informative In January 2017, they mobilized feedback sessions and successful a group of emergency medicine (EM) public school outreach and educa- Write to us: women clinicians at NYU-Bellevue tional nights that included a Girls’ [email protected]

The Girls’ Health and Facts Night at PS20 in lower Manhattan.

12 I EMalumni fall/winter 2018 DC 08/19/2020 Class of 2022 Class of 2022 Class of 2022

Andres Mallipudi Damilola Idowu Marlis Gnirke Arnab Sarker

Andres Mallipudi Damilola Idowu Marlis Gnirke Arnab Sarker

Jenica McMullen Janelle Lamb Madison Hunt Mukul Ramakrishnan

Jenica McMullen Janelle Lambert Madison Hunt Mukul Ramakrishnan

Nicholas Warstadt Rachel Sobolev Salman Ahsan Sana Maheshwati

Nicholus Warstadt Rachel Sobolev Salman Ahsan Sana Maheshwari

Matthew Gross Sumanth Kaja Joshua Rodriguez Stasha OcallaghanDC 08/19/2020 Matthew Gross Sumanth Kaja Joshua Rodriguez Stasha O’Callaghan commitment to diversity

A dvocating for the Advancement and Inclusion of Faculty members of Color and Women at NYU Langone Health

Uché A. Blackstock, MD, an assistant and analysis of each department’s hiring professor of emergency medicine at the activities and outcomes,” says Uché. “This Ronald O. Perelman Department of Emer- will ensure that we achieve the bench- gency Medicine, was recently appointed marks set by the Association of American director of Retention, Recruitment, and Medical Colleges (AAMC).” To help Inclusion in the Office of Diversity Affairs eliminate unintentional discrimi- at NYU School of Medicine. In her new natory behavior, she is recom- role, Uché oversees recruitment and mending that departmental and retention, and leads efforts to promote institutional search committees the advancement and inclusion of people receive implicit bias training of color and women to the faculty at and to set diversity goals. NYU Langone Health. She is also the co- Uché is confident that founder and co-director of the emergency these efforts will significantly medicine Ultrasound Fellowship, and the improve the representation founder and director of the Ultrasound of people of color and women Curriculum for medical students. in leadership positions. “As I Because the Office of Diversity Affairs heard a colleague recently say: and the school’s leadership recognize di- ‘Diversity is being invited to the versity and inclusion as core values, Uché party, but inclusion is being asked is approaching her new role with great to dance at the party.’ For real enthusiasm and optimism. “The strategy structural change to occur, diversity for leading significant cultural change and inclusion efforts must go hand in must include the collection, assessment, hand.” n

Uché A. Blackstock, MD Assistant Professor of Emergency Medicine Director, Recruitment Retention and Inclusion Office of Diversity Affairs Director, Ultrasound Content NYU School of Medicine Co-Director, Emergency Ultrasound Fellowship

14 I EMalumni fall/winter 2018 DC 08/19/2020 commitment to diversity Promoting Diversity and Inclusion

Aaron Arredondo, MD, a graduate of the Perelman Department of Emergency larger effort to recruit URiM resi- NYU-Bellevue residency program (EM ’16) Medicine. His new responsibilities dents. Ten applicants from medical and an assistant professor of emergency include leading the effort to promote schools across the country dined medicine, was recently appointed as the diversity and inclusion in the depart- with our faculty and residents to Diversity Ambassador for the Ronald O. ment. exchange ideas and shared goals in a Aaron is enthusiastic about his new supportive environment. Three of the role and believes that the “diversity and URiM applicants were matched to inclusion initiative will give everyone a our program and began their emer- voice and a platform to express them- gency medicine residency at NYU- selves on equal ground, no matter Bellevue for the new academic year. their race or ethnic background, Damilola Idowu (Brown University), culture, sexual orientation or Janelle Lambert (Columbia Univer- gender identity, religion, or unique sity), and Joshua Rodriguez (Brown life experience.” One of his major University) are now enthusiastic first goals is to develop a multi-tiered year residents. “We hope to make the approach to recruiting medical URiM dinner an annual tradition!” students, residents, and faculty Aaron attributes this success members. In addition to creating to the tremendous support from a mentorship program, he plans the leadership, who believe that to hold workshops and interactive our differences make us a stronger simulation sessions on implicit bias community. For me, “Working with training. such an incredibly diverse patient This past February, the depart- population in New York City is one ment hosted its first dinner for of the primary reasons I wanted to underrepresented in medicine continue working at NYU Langone (URiM) applicants as part of a Health and Bellevue Hospital.” n

Aaron Arredondo, MD Assistant Professor of Emergency Medicine Diversity Ambassador

EMalumni fall/winterDC 08/19/20202018 I 15 commitment to diversity A dvancing Underrepresented Minorities and Diversity in Emergency Medicine by auDrey bree tse, MD sessions at our state-of-the-art Simulation lyn, NYU Langone Emergency Cobble Hill, Center, social medicine initiatives, and pro- and Bellevue Hospital Center, where they Research shows that patients may be cedure and ultrasound workshops to resi- were exposed to patient populations from more responsive to physicians with dent conferences, journal clubs, faculty and diverse communities. A highlight of their whom they feel a connection, whether resident lectures, and toxicology rounds. summer fellowship was a Grand Rounds through culture, race, or language. Thirty They shadowed an individual faculty on July 18 when the guest speaker was percent of the US population are con- mentor on their shifts at the Ronald O. Alden Landry, MD, of Harvard Medical sidered underrepresented minorities Perelman Department of Emergency School, a nationally recognized leader in (URMs), yet only 9 percent of emergency Medicine, NYU Langone Hospital-Brook- diversity in medicine. physicians and 15 percent of medical stu- dents self-identify as URMs. Overall, while We hope that this experience will pre- the numbers of matriculants for black pare students to serve the rapidly chang- or African American, Hispanic or Latino, ing healthcare needs of minorities, who and American Indian or Alaska Native are the nation’s most vulnerable popula- students have increased modestly over tions, throughout their careers in medi- time, the gains have not been as robust cine. Under-represented minorities are as might have been expected in light of more likely to return and serve in their diversity efforts. Despite the almost communities and care for populations 27 percent increase in the number of that are traditionally underserved in available medical school seats over medicine. n the past 36 years, the representa- tion in 2016 of black or African Americans, Hispanic or Latino, and American Indian or Alaska A udrey Native is only at 13.7 percent. At NYU Langone Health and Bree Tse, MD Bellevue Hospital Center, we are Assistant Professor of committed to advancing diver- Emergency Medicine sity in emergency medicine. As Director, Undergraduate part of this effort, we developed an NYU Summer Fellowship for Medical Education URMs in Medicine (URiMs). In July of this year we supported an inaugural class of four second-year URiM medical students from diverse backgrounds across the country. Students partici- pated in a wide range of learning experiences—from

16 I EMalumni fall/winter 2018 DC 08/19/2020 1 2

3 4

Audrey Bree Tse, MD Photo: Michael Tanzillo Assistant Professor of 5 6 Emergency Medicine Director, Undergraduate Medical Education

Photo: Michael Tanzillo

1. (Left to Right) Underrepresented in medicine fel- 3. (Second Left Back Row) Aaron Hultgren, MD Michelle Oberoi, (summer fellow URiM) Ellie Pena lowship (URiM) inaugural EM summer fellows 2018: (EM ’10), Audrey Bree Tse, MD, Masashi Rotte, MD, (Administrator Education), Kira Brayan (summer Shuaibu Ali, Geiser School of Medicine at Dart- (Right) May Li, MD and son Booker Li with the Fun- fellow, MS2, NYU SOM). mouth, Daniel Mbom, Medical College of Georgia, damentals of EM NYU Summer Fellows during the Michelle Oberoi, University of California, Riverside, inaugural NYU undergraduate medical education 5. Dr. Hultgren demonstrating the inefficacious Betsy Rojas, University of Rochester. (UME) Wilderness Medicine Adventure. “venom extractors” on the market during the inau- gural NYU UME Wilderness Medicine Adventure. 2. Central venous access simulation workshop led 4. (Forefront to background) At the ballgame by co-resident directors, Leigh Nesheiwat, MD (EM Shuaibu Ali, (summer fellow URiM), Akyl Hughes, 6. URiM and NYU SOM EM summer fellows learn- ’20) and Max Berger, MD (EM ’20). MD (EM ’21), Janelle Lambert, MD (EM ‘22), ing about IVs with Max Berger, MD (EM ‘20). Alejandro Ruiz (summer fellow, MS2, NYU SOM),

EMalumni FALL/WINTERDC 08/19/2020 2018 I 17 18 I EMalumni fall/winter 2018 EM Alumni fall/wDCinter 08/19/2020 2018 I 17 “ We continue to further enhance our scholarly output and achievements, continue to create novel curricula, and develop new assessment and evaluation tools for our faculty, fellows, residents, and students.”

Kristin Carmody, MD, MHPE Vice Chair for Academic Affairs and Education Innovation

Laura Weber, MD (EM ‘21) representing the residency at the North American Con- gress of Clinical Toxicology (NACCT) 2017.

EMalumni fall/winterDC 08/19/20202018 I 19 Transforming teaching Rana Biary, MD (Med Tox ‘14), Director, Medical Toxicology Fellowship Silas Smith, MD (EM ‘06, Med Tox ‘08), Section Chief, Quality, Safety, and Practice Innovation

Division of Toxicology Launches a New Resident EM Curriculum

Following a needs assessment of residents and faculty, significant deficiencies in toxicology and patient safety were discovered. In response, the Division of Toxicology recently designed a comprehensive toxicology and patient safety curriculum that emphasizes the importance of assessment during the learning and feedback process. This experiential method of learning transforms the learner experience by immersing trainees in real-life scenarios and interactions that enhance both their medical knowledge and their skills. Redesigning the residency sched- use their call experience to present one club, quality and safety meetings, phar- ule to accommodate the curriculum case at morning report. This monthly macy and therapeutics meetings, and changes was a major challenge. “We participation has the added benefit of institutional Root Cause Analyses ses- achieved this goal by combining two consistently incorporating toxicology sions. They shadow the ED pharmacist previously separate two-week rotations cases into the morning report structure. to review medication reconciliation, in the second and fourth years into one Other aspects of the revised curriculum oversight, release, preparation, and continuous, required month-long block,” include participation in the weekly fellow code participation, and then apply their says Rana Biary, the director of the Fel- teaching, the weekly journal club, at least experience to present at the Morbidity lowship Program. “Residents now rotate two simulation sessions, a skills session and Mortality conference. during their third year, which allows dedicated to orogastric decontamination, The success of the new EM resident them to anticipate the need to supervise and participation in the Prevention and curriculum is confirmed by the monthly the management of poisoned patients Education mission. feedback we receive from residents and consider patient quality and safety “The quality and safety aspect and faculty, and the direct observation factors in their fourth year. ” The didactic of the curriculum includes lectures of clinical and didactic responsibilities. series was designed to specifically cover about basic patient safety, medication “Our next step,” says Rana, “will be the the core content of the American Board safety, and diagnostic errors, with an evaluation of in-service performance of Emergency Medicine (ABEM). aim to bridge safety and toxicology and planned residency curricular focus Once a week, residents take pri- practice in a systems-based approach,” groups, which we expect will also ad- mary consultant calls at the NYC-POI- notes Silas. Residents also attend the vance our efforts to improve toxicology SONS call center. Third-year residents departmental patient safety journal practice and patient safety.” n

20 I EMalumni fall/winter 2018 DC 08/19/2020 EMalumni fall/winterDC 2018 08/19/2020 I 21 22 I EMalumni fall/winter 2018 EM Alumni fallDC 201808/19/2020 I 21 Transforming teaching

Innovating Health Education to Keep NYC Youth Healthy and Safe

Aaron Hultgren, MD (EM ‘10) and a team of medical students take PEP STEP interns to a medical simulation lab. Here, they practiced responding to an emergency heart attack.

Gordon Wu, MD (EM ‘18) teaching a PEP Talk on “Cigarettes and Vaping” at @EssexStreetAcademy.

In 2015, Drs. Larissa Laskowski and fellows, residents, nurses, and medi- Aaron Hultgren, both assistant pro- cal students have been teaching a fessors in emergency medicine at yearly 10-lesson unit of PEP Talks at the Ronald O. Perelman Department the Essex Street Academy, a public of Emergency Medicine, founded the school on the Lower East Side, and Prevention and Education Partner- engaging 12th-grade students from ship (PEP). Today, these passionate all five boroughs in meaningful con- young physicians serve as co-direc- versations about the risky behaviors tors of this highly successful and surrounding drugs, alcohol, and sex. innovative educational program. “The PEP Talk curriculum fo- “PEP collaborates with the New cuses on enhancing students’ risk York City Office of School Wellness assessment skills and providing Programs to improve school well- access to healthcare resources out- ness and health education,” explains side of the emergency department,” Larissa. “Our mission is to keep youth says Aaron. “By providing accurate safe, healthy, and out of our emer- and expert information, we hope to gency departments.” decrease high-risk behavior among For the last three years, faculty, adolescents.”

EM Alumni fall 2018 I 21 EMalumni fall/winterDC 08/19/20202018 I 23 Our ER docs stand What we do to loud and proud increase positivity? against homopho- Lots of snacking, bia, transphobia chatting, and and biphobia. smoothies. Join us! Tell us what you do to stay positive!

Through collaboration with drugs and alcohol, sexual health, “The PEP Talk the NYC Office of School Well- mental health, and injury preven- ness and the Department of Edu- tion, delivered through short videos, curriculum focuses cation and the NYC Poison Con- facts, stats, and pop music lyrics. on enhancing trol Center, PEP has led training The personal testimonies of NYC students’ risk workshops to more than 80 New high school and college students, assessment skills York City high school substance NYU School of Medicine medical abuse prevention and interven- students, emergency department and providing tion specialists and health edu- nurses, residents, and attendings access to healthcare cators. These workshops, in turn, resonate with the audience and resources outside have led to greater opportunities receive the most likes. After almost to provide targeted outreach to one year, there are 956 followers of the emergency youth throughout the city. In and over 5,000 Instagram viewers. department.” this past year, PEP has expanded Larissa and Aaron aim to make to reach over 1,400 students in a difference in the community 10 NYC public middle and high and inspire future generations of schools. emergency leaders. “Our vision is Recently, PEP launched a social to provide the highest quality edu- media campaign via Instagram. Dai- cation for all NYC schools, parents ly posts cover topics ranging from and students.” n

(Center left and right) PEP co-directors, Drs. Aaron Hultgren (EM ‘10) and Larissa Laskowski (EM ‘13, Med Tox ‘15) joined by NYU medical students, residents, and toxicology fellows at Essex Street Academy High School delivering a drug education PEP Talk.

Follow us! @nycpep

24 I EMalumni fall/winter 2018 DC 08/19/2020 What we do to increase positivity? Lots of snacking, chatting, and smoothies. Tell us what you do to stay positive!

EM Alumni EMfall/walumniinterDC fall 08/19/2020 2018 2018 I 23I 25 “A fter more than two decades at NYU-Bellevue, I am still amazed at the privilege of being able to work with our patients during their most vulnerable moments. We find ways to further improve the experience for both our patients and our staff.” It’s okay that this page is empty since it will not exist when this PDF is converted William Goldberg, MDto single pages. Vice Chair for Business Operations and Strategic Planning

NYU sponsors the Atlantic Antic Festival, Cobble Hill, Brooklyn and the KIDS ZONE activities yearly. (Left to Right) Liz Haines, MD, Lauren Fel- tington, RN, Amanda Carr, RN, and David Barlas, MD, Chief of Service of the Cobble Hill Emergency Department.

26 I EMalumni fall/winter 2018 DC 08/19/2020 the front line of care

NYU Langone– Cobble Hill: Delivering Exceptional Care to Brooklyn and Beyond

The NYU Langone–Cobble Hill Emergency of emergency diagnostic and therapeutic or acute psychiatric emergencies. Department (ED) was established in 2014 services, including laboratory, pharmacy, Due to its high standards of quality through a partnership between NYU Lan- ultrasound, radiology, and CAT scan. care, the Cobble Hill ED earns consistently gone Health and Fortis Property Group, the Patient volume has steadily grown by 15 high patient satisfaction scores. We are developer of the former Long Island College percent annually to more than 22,000 ranked nationally in the 90th percentile. Hospital (LICH) site. visits this past year. Over 90 percent of patients are seen within When LICH closed its doors, the site To provide acutely sick patients with the first 10 minutes of arrival, and dis- was renovated and converted into a free- inpatient and specialty services, Cobble charged patients typically go home within standing ED in order to preserve essential Hill ED has established comprehensive two hours. Patients refer to us as their “best health care services for the community. The protocols. Patients with life-threatening ER experience ever” and speak highly of the second phase of erecting an ambulatory conditions, such as sepsis, heart attack, kindness, compassion, and competence of 125,000 sq. ft. health care facility adjacent stroke, and other traumatic injuries, are our ED team. to the ED is currently under way. Recog- transported by critical care ambulances “The future is bright as we await the nized for its state-of-the-art technology stationed on-site to one of NYU Langone opening of the new ambulatory services and highest-quality care, Cobble Hill has Health’s affiliates in Brooklyn and Manhat- pavilion with expanded services next to the become the go-to hospital in Brooklyn. tan. The 8 percent of patients who require ED at the corner of Hicks Street and Atlan- As a free-standing ED, NYU Langone– hospitalization after diagnosis and sta- tic Avenue,” says Dr. David Barlas, chief of Cobble Hill has all the capabilities of a bilization at Cobble Hill ED can be trans- service of NYU Langone-Cobble Hill ED. In typical community hospital ED without ported directly to an inpatient bed. Our addition to the new ED, there will be physi- an attached hospital. It is open 24 hours a integrated health systems and electronic cian practices, an ambulatory surgery suite, day, seven days a week, and is staffed with medical record system allow us to access an infusion center, a clinical laboratory, and a team of skilled emergency physicians, patient records instantly from any of our an imaging facility. “This will soon bring physician assistants, nurses, and other receiving sites, and telemedicine can pro- a comprehensive range of NYU Langone essential staff. Cobble Hill ED receives 911 vide immediate consultation with an NYU outpatient services to the communities in ambulances and offers a complete range Langone specialist for patients with stroke and around downtown Brooklyn.” n

“ Recognized for its state-of-the-art technol- ogy and highest-quality care, Cobble Hill has become the go-to hospital in Brooklyn.”

EMalumni fall/winterDC 08/19/20202018 I 27 the front line of care the front line of care

Expanding Our Footprint and Cross-Disciplinary Collaboration

For the past five years, the Ronald O. Perelman Center for Emergency Services has experi- enced significant growth. In 2017, the center saw close to 80,000 patients—a more than 7 percent increase in volume over the past few years. This growth is due to the creation of NYU Langone ambulance services, the ex- pansion of the NYU Langone Health system, and excellent patient care. Not only is the volume increasing, but so too is the severity of illness in the patient population. “Because of the expansion in our pulmonary hypertension, heart failure, and transplant services, we care for more medically complex patients and higher- acuity patients than in the past,” explains Dr. Catherine Jamin, chief of service of the center and director of Emergency Medicine Critical Care. “We are proud of our residents, faculty, physician assistants (PAs), and nurs- ing staff who provide such outstanding care. Their dedication, selflessness, and compas- sion are impressive.” With growth comes challenges, and one of the center’s biggest challenges is its physical space. “Although we moved into a beautiful new emergency department (ED) in 2014, we quickly outgrew the footprint,” notes Catherine. Due to the lack of space, it became difficult to get patients into the main ED from the waiting room. “We had to develop innovative models to ensure that we could continue to deliver qual- ity care with speed and efficiency.” To address the space challenge, the center collaborated with nursing, PAs, faculty, the administrative team, and hospital leadership. Together, they carved out treatment space from the waiting room to create “Team 5.” Since its inception, Team 5 has cared for more than 7,400 low-acuity patients in the waiting room. “This model enhances care for patients,” she says, “because we can rapidly care for low- acuity patients and more efficiently evaluate

28 I EMalumni fall/winter 2018 EM Alumni fall/wDCinter 08/19/2020 2018 I 27 the front line of care moderate-improving and liveshigh-acuity patients volume has outpaced its physical focus on streamlining high-quality in the main ED.” growth, Catherine is happy to an- care, enhancing communication, Another way the center nounce that this is already chang- and improving the admissions sought to address the issue of ing. “We gained six new bays in our process. This type of progress can limited space was to focus on care Team 4 space in January 2018, and already be seen in the manage- models that shift traditional hos- will expand our ED by 18 additional ment of patients with inflamma- pital-based care to the outpatient beds by the end of 2018 when tory bowel disease and those with setting. Partnering with leaders we move into the state-of-the-art congestive heart failure. from Infectious Disease, Phar- Helen L. and Martin S. Kimmel “It is a privilege to work at a macy, Medical Center Information Pavilion. Given that our current patient-centered and innovative Technology, Telehealth, and the footprint is 33 bays, we welcome organization,” says Catherine. “Our ED Follow-up Center, they cre- the increase of bays and eagerly principal goal is to ensure meaning- ated a pathway to treat moderate await the expansion.” ful change for our patients, com- cellulitis as an outpatient service. Over the next five years, one munity, and staff in all our efforts to This collaboration had a positive of the center’s major goals is to improve care.” n impact on patients, because they increase institutional cross- can now receive closely coordi- disciplinary collaboration. nated care as outpatients and do She is looking to develop not require hospitalization. innovative, multidisci- While the center’s increased plinary projects that

“ W e are proud of our residents, faculty, physician assistants (PAs), and nursing staff who provide such outstanding care. Their dedication, selflessness, and compassion are impressive.”

Catherine Jamin, MD Associate Professor of Emergency Medicine Chief of Service and Chief of Critical Care Ronald O. Perelman Department of Emergency Medicine

The Helen L. and Martin S. Kimmel Pavilion opened in June 2018. A state of the art, 830,000 square foot facility. DC 08/19/2020 EMalumni fall/winter 2018 I 29 the front line of care

Highlights of Our Success in 2017

BY RAJ GULATI, MD (EM ‘06) and most complex issues affecting our nurse practitioners and physician as- IAN WITTMAN, MD (EM ‘12) patients—including alcoholism, other sistants, to our clinical staff in urgent substance use disorders, novel drugs care and the main ED, and have transi- We all have different memories of how of abuse, homelessness, food security, tioned to an electronic medical record NYU-Bellevue’s Emergency Depart- and access to timely primary care. system. We operationalized the first ment (ED) has shaped our growth In recent years, we have added free-standing ED in New York during and how we have been a part of its advanced practice providers, including Hurricane Sandy, staffed and oper- remarkable history. Today, our mis- ated the Emergency Ward as a short- sion remains unchanged. The Bellevue stay Intensive Care Unit, developed ED continues to evolve and remains the screening protocols for potential a leader in emergency care delivery. Ebola patients, and responded to We provide compassionate care to many of the city’s worst mass- every patient, including the most casualty incidents. NYU-Bellevue vulnerable populations in New York, will be presented with challenges and we continue to solve some of the as we continue working to imple-

Raj Gulati, MD Associate Professor of Emergency Medicine Chief of Service Bellevue Hospital Center

30 I EMalumni fall/winter 2018 DC 08/19/2020 ment innovative models of care working with new leadership to A Few Highlights delivery, provide an exceptional improve hospital finances, imple- platform for educating our future ment a new care area to provide of Our Accomplish- clinicians and leaders, and create quality care to our cohort of ments in 2017: an environment for research to intoxicated patients, and prepare solve seemingly insurmountable to launch the EPIC EMR system at n We finished the first full year problems. Bellevue ED in early 2019. of a fourth-year resident team, This year, we have a new We believe that Dr. Katz’s adding a more robust supervisory president and CEO of NYC Health + vision aligns with our humanistic training experience for third-year Hospitals, Dr. Mitchell Katz from the values. With his support—and residents. Los Angeles County Health Agency, with the leadership of Dr. Robert J. n The American College of Surgeons to provide leadership and direction to Femia, chair of the Ronald O. Perel- the public hospital system. man Department of Emergency designated Bellevue Hospital as a Our goals for 2018 include Medicine, we are ideally positioned Level 1 trauma center. to achieve our goals. n n We managed several large-scale mass-casualty incidents, includ- ing the Times Square Automobile terrorist attack and the Halloween Box Truck terrorist attack on the West Side Highway. n We have one of the lowest sepsis mortality rates in New York State as a result of our early recogni- tion, treatment, and sepsis care. n Our ED team received the Hospital Patient Safety Champions Award.

“ We provide compassionate care to every patient, including the most vulnerable populations in New York.”

Ian Wittman, MD Associate Professor of Emergency Medicine Associate Chief of Service Bellevue Hospital Center (Newly named Chief of Service, Emergency Department, NYU-Langone-Brooklyn. Congratulations!)

EMalumni fall/winterDC 08/19/2020 2018 I 31 improving lives the front line of care T ransforming an Urgent Care Center into a Best-Practice Delivery Model Post Hurricane Sandy

On the night of October 29, 2012, Hur- along with an associated nine-bed ob- for two months, after completing his ricane Sandy devastated the New York servation unit for short term care was residency at NYU-Bellevue. Five years City metropolitan area. The storm created to restore acute care services later, he is the chief of observation surge dumped 15 million gallons of to lower Manhattan. medicine for the Ronald O. Perelman seawater into NYU Langone Medical At that time, Christopher Caspers, Department of Emergency Medicine, Center, destroying the emergency MD (EM ‘12) had been a faculty overseeing the observation and short department (ED). To prevent a public member in the Ronald O. Perelman stay units for the NYU Langone Health health disaster, an urgent care center Department of Emergency Medicine System.

Christopher Caspers, MD Chief of Observation Medicine (Chair Elect of ACEP Observation Medicine Section. Congratulations!)

32 I EMalumni fall/winter 2018 DC 08/19/2020 Photos: Alex Bane

“Today, the 35-bed NYU Lan- are low and patient satisfaction (Left to Right) gone Tisch Hospital observation scores are high. Both units perform Anessa Uretsky, RN-BC, Nurse Manager, Obser- vation Unit, Diane E. Lee, RN, Care Manager, unit cares for thousands of patients better than national benchmarks for Care Management Department, Lauren Nash, annually across the NYU Langone clinical performance, quality, safety, Senior PA, Observation Unit Health system,” he says, “and NYU and patient experience. Langone Brooklyn–Hospital is Recently, the department recognized as a high-performing expanded the observation unit 12-bed observation unit.” Through care model across the NYU Lan- the design and implementation of gone Health system to include the evidence-based clinical protocols, delivery of short-term inpatient these observation units produce care. The resulting benefits include “ Today, the 35-bed high-quality clinical outcomes at a reduced length of stay, readmis- NYU Langone Tisch lower cost to both the patient and sions, and mortality, as well as im- the healthcare system. proved patient outcomes at a lower Hospital observa- The observation units are staffed cost than conventional inpatient tion unit cares for 24/7 with specialized attending phy- care. “This delivery model is now thousands of sicians, emergency physicians, physi- at the forefront of clinical innova- cian assistants, nurses, and care tion,” notes Christopher, “and the patients annually managers to deliver the best patient department’s observation medicine across the NYU outcomes. Given the close collabora- program is a best-practice model tion between primary care providers for short term care for other insti- Langone Health and specialists, readmission rates tutions across the country.” n system.”

EMalumni fall/winterDC 08/19/2020 2018 I 33 the front line of care

Telemedicine is Virtually Changing the Way We Deliver Care

NYU Langone Health opened the Cobble the Department of Neurology at NYU Lan- Langone Hospital–Brooklyn Department Hill Emergency Department in downtown gone Tisch Hospital. When patients at the of Psychiatry became the second service Brooklyn on October 31, 2014. From the Cobble Hill ED are suspected of having an to provide Cobble Hill ED with emergency outset, the leadership at NYU Langone acute stroke, the neurologist evaluates telemedicine consultations. Previously, and the Ronald O. Perelman Department those with difficult or unusual cases via patients in need of emergency psychiatric of Emergency Medicine realized that tele- the telemedicine system from the main consultation were transferred by ambu- medicine would play an important role in campus in Manhattan. The time-sensitive lance to NYU Langone Hospital–Brooklyn providing quality patient care to this free- decision to administer t-PA therapy to to receive emergency assessments and standing emergency department (ED). eligible acute stroke patients can then care. Today, consultations take place Without an attached hospital or on-site be made collaboratively with a hospital- over the secure telemedicine link, which subspecialists, the freestanding ED needed based neurologic emergency physician. preserves patient privacy and improves to provide critical consultations for our Since 2014, telemedicine has been comfort and convenience. Over the last patients. The use of telemedicine was the successfully used four times to assist in year, more than 20 consultations have oc- most innovative way to communicate the evaluation and treatment of acute curred, with 70 percent of those patients between the NYU Langone Medical Center stroke patients. In 2017, following the directly discharged from the Cobble Hill in Manhattan and the Cobble Hill ED. integration of the Joint Commission- ED following evaluation. The system consists of two mobile certified comprehensive stroke programs “Building on these successes, carts with high-quality audio/video in the at NYU Langone Tisch Hospital and NYU additional telemedicine consultation ED that communicate with base stations Langone Hospital–Brooklyn, “tele-stroke” services—including critical care, oph- installed at NYU Langone Medical Center consultations were expected to begin at thalmology, and dermatology—are now and NYU Langone Hospital–Brooklyn. the Brooklyn site. This not only allows for under evaluation,” says Dr. Barlas. With Through a secure connection, physicians enhanced coverage, but also seamlessly the addition of these and other services and patients can enjoy a virtual consulta- bridges the patient to inpatient care and in the future, “we aim to expand the depth tion on demand. advanced interventional techniques in and breadth of clinical expertise provided The first consultants to utilize this Brooklyn. to patients in the NYU Langone–Cobble system were the stroke specialists from In the summer of 2017, the NYU Hill ED communities.” n

“ Today, consultations take place over the secure telemedicine link, which preserves patient privacy and improves comfort and convenience.”

34 I EMalumni fall/winter 2018 DC 08/19/2020 the front line of care Virtual Urgent Care: Changing How We Practice Medicine

A convenient way to video chat with an emergency physician for non-emergency medical conditions in the comfort of your home, office or on the go. Mobile technology interfacing with patient care to meet the needs of our patients.

L earn More: https://nyulangone.org/virtualurgentcare

V irtual Visit

Viraj Lakdawala, MD Director, Division of Telemedicine

EMalumni fall/winterDC 08/19/20202018 I 35 36 I EMalumni fall/winter 2018 EM AlumniEM A lumni fall/w fallinterDC 201808/19/2020 2018 I I 33 35 “ In the next year, we hope to continue growing our research portfolio while exceeding expectations with our current grants.”

Corita Grudzen, MD Vice Chair for Research (EM ‘05)

Identifying retail Food Swamps in New York City where there are no healthy food options. These are areas with more bodegas and convenience stores than supermarkets.

EM AlumniEM A lumni fall/w fallinter 2018 2018 I I 33 35 EMalumni fall/winterDC 08/19/20202018 I 37 innovations in research

Innovative Design for Palliative Care for Older Adults with Serious Illness

Nearly 50 percent of older Americans hospital stays with less need for “ It’s the largest grant visit the emergency department (ED) intensive care. Such palliative care to manage their pain, symptoms, interventions in the ED can reduce in the history of NYU stress, loneliness, and depression the loneliness and depression of Langone Health’s during the last month of their lives. patients, family anxiety, and overall Department of Palliative care has become an ED cost savings. The ED is an ideal place subspecialty as doctors and nurses to identify patients who could benefit Emergency Medicine.” work with patients and their families from palliative care services and to to establish a plan of care. ED inter- connect them to appropriate care. ventions can provide an extra layer of Across the country, more than support not only for older adults, but 1,300 patients will be recruited from also for their caregivers. nine EDs, including NYU Langone Recently, Corita Grudzen, MD Hospital, NYU Langone Hospital- (EM ‘05), vice chair for research in the Brooklyn, and Bellevue Hospital Cen- Ronald O. Perelman Department of ter. Patients are eligible to participate Emergency Medicine and a nationally in the study if they present to the ED recognized expert on ED palliative and are 50 years of age or older, living care, received a nearly $12 million at home with advanced cancer, or grant funded by the Patient-Centered end-stage organ failure, among other Outcomes Research Institute (PCORI) criteria. When patients enroll in the to study Emergency Medicine Pallia- study, they are randomized to one of tive Care Access (EMPallA). “It’s the two distinct palliative care delivery “We’re committed largest grant in the history of NYU modalities. to determining Langone Health’s Department of The study will compare two Emergency Medicine,” says Corita, distinct models—the traditional which model works the primary investigator of the multi- outpatient setting where a physician best and why.” site national study. “Over the next five delivers care in-person and an innova- years, our research will focus on how tive new approach where palliative- to deliver palliative care in the most care trained nurses manage care by efficient way.” phone. “We’re committed to deter- Research shows that creating mining which model works best and innovative models to manage pallia- why,” says Corita, “so we can improve tive care for older patients results the quality of life for patients and in improved outcomes—shortened their caregivers nationwide.” n

38 I EMalumni fall/winter 2018 DC 08/19/2020 innovations in research The relationship between obesity and diabetes for 3100 counties in the US in 2013. County-level diabetes prevalence was strongly correlated with obesity prevalence. We are studying the geo- graphic distribution of these diseases and what environmental factors may be the reason for them.

EMalumni fall/winterDC 201808/19/2020 I 39 innovations in research

“ Our analyses can identify the exact neighborhoods that have a higher prevalence of disease, which gives us a better picture of how health varies geographically.”

David C. Lee, MD, MS Assistant Professor of Emergency Medicine and Population Health Ronald O. Perelman Department of Emergency Medicine (EM ‘12)

40 I EMalumni fall/winter 2018 DC 08/19/2020 DC 08/19/2020 42 I EMalumni fall/winter 2018 DC 08/19/2020 By Rohini Haar, MD (EM ‘09)

Photos: Salahuddin Ahmed Paulash for Physicians for Human Rights EMalumni fall/winterDC 08/19/20202018 I 43 H ello, fellow residents and alumni! Choi (EM ’10). During the rest of my time, I’ve been teaching classes and conducting It is an honor to reflect on my time at NYU– research with UC Berkeley’s Human Rights Bellevue and share my experiences. Since Center and the School of Public Health. graduating in 2009, I have grown to appreci- The moral compass set by Dr. Lewis ate more and more both the medical training Goldfrank and many of our mentors held pro- and the commitment to social justice driven found meaning throughout my time at Bellevue home at Bellevue. and beyond. My stay in New York and familiarity After working full time in New York City for with the issues of our immigrant population has several years, my family and I moved to Berkeley, deeply touched me. California, for warmer weather and a change of Most recently, this knowledge was useful pace. Personally, #4 was born this May! Clini- when I traveled with Physicians for Human cally, I took the risk to step away as a full-time Rights to Cox’s Bazaar in Bangladesh. Over the emergency physician. past five months, nearly 800,000 Rohingya Now I work part-time at the Highland refugees have settled into makeshift camps Emergency Department (ED) with our West after a brutal military campaign of forced ex- Coast county-minded doppelgängers and at pulsion from Myanmar. Kaiser Medical Center in Oakland with our I don’t know if I ever saw a Rohingya as a very own Amy Dennis (EM ’10) and Jimmy patient at Bellevue. But like many of you, I saw

Rohini Haar

44 I EMalumni fall/winter 2018 DC 08/19/2020 countless Bangladeshi immigrants with and learning how to move on after tough “In Bangladesh, chest pain, burns, and myriad other shifts and patient deaths, helped me find complaints. Being in their homeland an outlet for these emotions. I used the skills helped me better understand how While I work abroad frequently, I usu- Iearned while a difficult their migration to the United ally don’t see patients there. I am gener- resident at Bellevue States must have been and how hard it ally documenting human rights abuses must have been to be a refugee in that or figuring out how to use epidemiology to conduct forensic very same impoverished and densely to call attention to violations of interna- medical evaluations populated region. tional law. In Bangladesh, I used the skills I When I feel that I’ve fallen short of of survivors of learned while a resident at Bellevue to making an impact because the wars torture and other conduct forensic medical evaluations and violations continue unabated, I can crimes against of survivors of torture and other crimes often sleep at night knowing I helped against humanity. I saw children shot in patients in the ED in Oakland or taught humanity.” the back while fleeing, women burned a resident a procedure I learned at and left for dead after unspeakable viola- Bellevue. For that, and for feeling that tions, and families torn apart during the there is a role in both worlds for emer- violence. gency physicians, I am deeply thankful I returned home troubled and had for my training. difficulty reconciling our nation’s politics I look forward to hearing some of with the reality of the world around us. your stories! If anyone is heading to the (I think they call it secondary trauma.) Bay Area, we have a lovely community of But thankfully, years of working among alumni here and are always looking for immigrants and the destitute in the ED, new members. n EMalumni fall/winterDC 08/19/20202018 I 45 “ Sinc e the founding of our country, home has been the center of the American Dream. Stable housing is the foundation upon which everything else in a family’s or individual’s life is built—without a safe, affordable place to live, it is much tougher to maintain good health, get a good education, or reach your full potential” –Barack Obama

Audrey Bree Tse, MD Ryan McCormack, MD Ethan Wiener, MD Director, Undergraduate Assistant Professor of Chief, Pediatric DC 08/19/2020 16 I EMMedical AlumN iEducation fall 2018 Emergency Medicine Emergency Medicine Blending Humanism with Science to End Homelessness

In New York City, more than 70,000 people are homeless on any given night. Even more startling is the fact that two-thirds of the people experiencing home- lessness are families and children who live in shelters run by the city. There is no one reason why people find themselves homeless, but the consequences are devastating—those chronically homeless, who are frequently seen in the Emergency Department (ED), are at the highest risk for poor health outcomes and early mortality. At NYU-Bellevue, Drs. Kelly Doran, Audrey Bree Tse, Ryan McCormack, and Ethan Wiener are among the many emergency physicians who are dedicated to ending homelessness. Their strategies may differ, but the outcomes they seek are the same—prevention, compassionate care, affordable housing, advocacy, and hope.

Moving Beyond Caring for the Homeless to Ending Homelessness Kelly, who describes herself as an optimistic realist, is convinced that interven- tions can make a difference in preventing homelessness before it occurs. Cur- rently, Kelly and her team are developing a predictive model that she believes will be able to determine which ED patients are likely to be at risk for future homelessness. When those patients are identified, she and her team can con- nect them with programs whose mission is to prevent homelessness. While such programs exist in New York City, many are not utilized effectively. With that in mind, Kelly is focused on helping the health care system move beyond caring for people who are homeless to ending homelessness. Her passion to end homelessness started in San Francisco. Before entering medical school, Kelly worked for a year with 15 homeless and formerly homeless men and women. “They shared their lives with me in a very intimate way,” says Kelly. She keeps photos of them, many of whom are now deceased, on the wall in her office at Bellevue. “They are a source of inspiration to continue my research and find a solution to end homelessness.” Today, Kelly regularly teaches residents and medical students on how to care for people who are homeless. “Increased educational and support opportunities for trainees,” she says, “would assist the next generation of emergency physi- cians in providing better care for patients who are homeless.” Kelly Doran, MD (EM ‘11) Assistant Professor, Emergency Medicine and Population Health EMalumni fall/wiDCnter 08/19/2020 2018 I 47 “ Increased educational and support opportunities for trainees would assist the next generation of emergency physicians in providing better care for patients who are homeless” –Kelly Doran, MD

Running to Help the emergency department treating the youth—and he surpassed his fundrais- Homeless Community Get numerous physical and mental health ing expectations. Back on Their Feet illnesses of homeless people made it He is so impressed by the level of Bree, like Kelly, began working toward even clearer to Bree that this popu- care for homeless youth at Covenant ending homeless several years ago. lation is not equipped to function with- House that he put together a team While in medical school, she joined out help. “I know that all the factors at NYU-Bellevue to join him this year Back on My Feet (BOMF), a nonprofit that play into their cycle of homeless- for the Covenant House Sleep Out for founded in Philadelphia whose guiding ness are ever present, whether it is homeless youth. “Every time I do this, principles to end homelessness are: scarcity of food and finances, lack of sometime between 3:00 and 4:00 “Running is the Catalyst. Commu- health insurance, exposure to crime am when I am very tired, very cold, nity is the missing link. Employment and abuse, risk of addiction and re- and very uncomfortable,” he says, and Housing are the endgame.” It is lapses, or discrimination.” “I wonder if I will make it to nearly through BOMF that Bree began run- Running at the crack of dawn dawn when I can get up and make my ning to break the cycle of homeless- with individuals from shelters who are way home. I wonder what I would be ness. committed to running three times a thinking if I only had the same thing Joining BOMF was natural for week meant that Bree ran before her to look forward to the next night and Bree not only because she ran com- classes, rotations, and clinical shifts. with no foreseeable end in sight.” petitively through elementary school, “It is brutal, but I was waking up in a Ethan is adamant in his belief high school, and college, but also warm bed instead of a cold bunk in a that homeless youth can reclaim their because of the exhilaration she felt room beside 40 other men in a shel- dreams, self-worth, and hope if they while running. “I have always been so ter.” Since moving to New York City, have a support system that fulfills grateful for running,” she says. “The Bree has joined a BOMF team in Times their basic needs—safe shelter, food, sport has given me serenity, excite- Square that serves veterans. “Just and medical care. “This is a way for ment, a sense of wonder, community, having a shared human experience, them to navigate their way out of their and an incredible number of adven- such as running, is incredibly impact- homelessness, free from worrying tures.” The BOMF guiding principles ful,” she says. about where they will get their next reflect her hope to become more in meal or place to sleep,” he says. Ethan tune with patients who experience Empowering Homeless sees the transformation of homeless homelessness. “As an emergency Youth to Reclaim Their Dreams youth firsthand and will continue to physician, when a homeless person and Self-Esteem be their advocate. “Volunteering at was discharged, I struggled with how This year was Ethan’s fifth year of Covenant House allows me to see how to actually make a meaningful impact sleeping on the pavement in New York the work there is done with a level of on that patient’s life.” City, a Covenant House effort to raise passion and love that is both inspiring The many hours spent in the awareness of the plight of homeless and humbling.”

“A s an emergency physician, when a homeless person was discharged, I struggled with how to actually make a meaningful impact on that patient’s life.” –Audrey Bree Tse, MD

48 I EMalumni fall/winter 2018 DC 08/19/2020 Creating a Pilot Project That’s recognized the importance of the dra- “Volunteering at Restoring Lives, Dignity, and Hope matic improvements and adopted the Ryan’s research to address solutions initial model into its first care manage- Covenant House for the chronically homeless people ment program designated for high-risk allows me to see with severe alcohol use disorders be- patients experiencing alcohol use how the work gan in 2009. A 32-year-old homeless disorders and homelessness. man who visited the ED 430 times in In 2016, Ryan received a grant al- there is done with less than three years died as a result lowing him to work with another 50 sim- a level of passion of complications from hypothermia. ilarly needy adults and to initiate treat- His death was disturbing to the ED ment with extended-release naltrexone, and love that staff, who had come to know him as he an FDA-approved medication for the is both inspiring came to the ED not only for care, but treatment of alcohol dependence—a and humbling.” also for a place of refuge. medication these individuals would oth- Devastated by the death, in 2011 erwise have little opportunity to receive. –Ethan Wiener, MD Ryan took the advice of the then chair- He notes, “There have been dramatic man and his personal mentor, Lewis successes, both in the restored lives of Goldfrank, who urged him to figure out patients and the changed perspectives how they could raise the standard of of healthcare providers.” care to effectively meet the complex Ryan is optimistic that he can needs of those suffering a similar fate. further refine the delivery of essential To learn more, he assembled interventions and develop additional stakeholders from diverse city insti- models for diverse marginalized indi- tutions involved in public health and viduals who experience alcohol use social welfare and conducted chart disorders and homelessness. “People reviews of hundreds of patients who who are chronically homeless,” he frequently came to the Bellevue ED says, “do so well when we can send for problems related to alcohol use. them from the hospital to a bed with Almost universally, these individuals supportive services attached. were chronically “street” homeless, living outside or otherwise unshel- Solving Homelessness tered for years; yet only a handful One Patient at a Time, One were on the caseload of the Depart- Day at a Time ment of Homeless Services. Ryan, Kelly, Bree, and Ethan are just a “ P eople who are To address this tragic need and few of our emergency physicians who are chronically home- the limited use of available services, solving homelessness one day at a time. less do so well as well as the tremendous morbid- As emergency physicians, they know how ity and mortality suffered by this damaging the consequences of home- when we can send population, Ryan implemented a pilot lessness can be and are dedicated to sav- them from the program. Twenty patients with alcohol ing lives and restoring dignity and hope. use disorders, who averaged 14 years Kelly Doran and Maria Raven, hospital to a bed of street homelessness, were intro- (EM ‘05) both graduates of the NYU- with supportive duced and added to the caseload of Bellevue residency program and services attached.” the homeless outreach teams. Ryan subsequently faculty at NYU-Bellevue, also collaborated with healthcare pro- summed up their core beliefs in a –Ryan Mccormack, MD viders and staff across disciplines and recent paper: “Though knowledge of departments to provide more coordi- patients’ housing status is critical to nated, patient-centered care. providing good, routine emergency After just six months of care, their care, we also believe that emergency ED visits decreased by 35 percent, medicine could—and should—be inpatient stays decreased by 56 per- playing a larger role in helping to end cent, and cost to the health system homelessness. We have unique op- decreased by 50 percent. Nearly all of portunities to assist as part of larger the patients accepted housing. Bellevue efforts to end it.” n

EMalumni fall/winterDC 201808/19/2020 I 49 Pursuing a Life of Service

Plains of Samburu Kenya DC 08/19/2020 from the Himalayas to NYU Langone Health

By Saleena Subaiya, MD

EMalumni fall/winterDC 201808/19/2020 I 51 My interest in international health began Taking a Break from Medical “It is this inherent during a summer clinical rotation after School to Provide Care in Kenya my first year of medical school. I joined a Inspired by this experience, I took two duality in public group of traveling physicians and medi- years away from my clinical training and health—the un- cal students who spent a month in the traveled to Kenya with the Millennium Vil- necessary divide of Tibetan region of the Himalayas. We pro- lages Project, founded by Jeffrey Sachs. humanity and the vided primary care to villagers in areas so The mission was an ambitious effort to remote that medical care was impossible. reduce childhood mortality. I worked beauty and impact As we traveled through the staggeringly beside community healthcare workers that collaboration beautiful landscapes of the Himalayas in a catchment area of 65,000 people. can bring—that reaching villages without access to basic We taught them to diagnose malaria and clinical care, I found my calling. serious diarrheal illnesses using rapid drives me.” It was here that I met Raj, a native diagnostic testing by text messaging on to the region, who spent his childhood simple Nokia phones with new technol- traveling the 18,000-foot-high mountain ogy in SMS messaging. Several months passes on foot to seek out villagers who after the launch of the project, we found were unable to access medical care due more cases of illnesses treated through to the terrain. While his siblings went on instant messaging and fewer cases pre- to become lawyers, businessmen, and senting to the clinics. physicians, he knew his place lay in the It was there that I met Lindsey. She communities of his homeland. He dedi- was a 24-year-old who had a massive cated his life to raising money through smile and a big heart. We became fast traveling medical camps, and built one of friends. Over the course of the year, I the first permanent clinics in the region. came to learn that despite Lindsey’s pub-

“Heartbeats”, Ladakh, India Photos by Saleena Subaiya Saleena by Photos

53 I EMalumni fall/winter 2018 DC 08/19/2020 Photos by Saleena Subaiya Photographer andFilmmaker Saleena Subaiya, MD Assistant Professor of Emergency Medicine Nairobi, Kenya. “Smiles andvaccines”, D P ing thatIleft behind inmedical school. was tantamountto theyears of teach- an allyandafriend. This life experience value of standing beside someone as in thefield, I realized theimmeasurable sisterhood withLindsey andmy work time—so Ilistened. And through my and unsure whatadvice to give atthat choice to fall inlove.” Iwas powerless as sheadmitted, “I just hopeIhave the do this.” There was asense of despair when shetold me “all theKisumugirls Iheard thesadness inhervoice circumstances. common practice for women inher became asex worker—an alltoo City. To supplementherincome, she money to make endsmeetinKisumu lic health job, shedidn’t have enough for Disease Control (CDC) and fortunate to work withtheCenters At theendof my residency, Iwas t F byseconds. escaping Taliban gunfire intheirclinic own siblings diefrom malnutritionto health, ranging from watching their stories thatdrove themto public countries, andwas humbledby their students from over 50different cally ill. Ifound myself training beside and caring for those whoare criti- reaching marginalized populations medicine because of my passion for health withaspecialty inemergency ing countries andenvironmental my research ontrauma indevelop- middle-income countries. Ifocused on collaborative work withlow- and degree. Itisaschool thatprides itself come countries, to obtainamaster’s orative work withlow- andmiddle-in- cine, aschool committed to collab- School of Hygiene and Tropical Medi- global health Iattended theLondon to deepenmy understanding of Before returning to medical school, ini u u egree rning r s su hing ing

in

to M

L a ondon

M y Kenya T a raining s ter

a ’ s s s a

D and octor R e - EM Kenya. Kenya. scale andimpact of thisvictory for collaboration, andoverjoyed by the of friends, amazed atthepower of colleagues, touched by thekindness I was inspired by thededication of cination campaign of theirhistory. successful measles andrubellavac- tion were vaccinated inthemost 95% of theeligible Kenyan popula- 8,000 homes was completed, and delivered, ourresearch study of over half. Intheend, ourmessages were the cell-phone company onourbe- Minister of Health wrote letters to 10-minute turnaround time, andthe review Kiswahili translations ona time inthecountry jumpedinto cess. Oldfriendsfrom my previous around theclockto ensure its suc- government andourpartners work country. Iwitnessed theKenyan largest cell phonecompany inthe to apolitical scandal involving the the country, was threatened due campaign, geared to reach halfof social mobilization text-messaging Itwas duringthistimethatour greatest fear hadbeenrealized. riage withamandecades older. Her Kenya—forced into anarranged mar saddened thatshenolonger lived in I searched for Lindsey andwas tion campaign of 19millionchildren. tion methodsduringamass vaccina- led aresearch study oncommunica- brought meback to Kenya, where I Service. Surprisingly, my first project Prevention Epidemic Intelligence of thisjourney. Langone Health for thenext chapter and Iamtrulyhonored to beatNYU inspire me to pursue alife of service, drives me. These stories continue to that collaboration can bring—that humanity andthebeauty andimpact health—the unnecessary divideof It isthisinherent duality inpublic L C F ontin rom angone alumni

the u ing fall/w H CDC ealth

the n to

J NY o i DC nter 2018 I53 u rney U

08/19/2020 : - 54 I EMalumni fall/winter 2018 DC 08/19/2020 EMalumni fall/winterDC 08/19/20202018 I 55 “So, are you ready to go to Africa?” he Hospital opened an emergency depart- asked. “NYU is considering a global ment with 100 nurses, ten orderlies, six health partnership with the University security guards, six accounts staff, a of Ghana.” I was a toxicology fellow in part-time administrator, and two physi- the midst of reviewing a poison manage- cians—a semi-retired internist and me. ment document with the then Chairman We started to get organized using the of Emergency Medicine Lewis Goldfrank. basic medical requirements for emer- “ We don’t wait for It seemed exciting and challenging, but gency department function: soap for family members was I ready? My international upbringing hand-washing, pulse oximetry to ration and prior training in medical anthropol- our limited oxygen supply, triage to see to pay before ogy led me to believe that I was. the sickest patients first, and an Ambu starting care, On that first trip to Accra, we sat in bag, defibrillator, and supply of essential and don’t prac- a beat-up van for hours each day, inch- medications for patients in need. ing through traffic for meetings at the Today, our facility no longer smells tice “medical University, the National Hospital, offensive, and we rarely have nosoco- jail” if they can’t and beyond. Our welcome was both mial tuberculosis due to new hygiene generous and cautious. “All medicine in protocols. Our patients no longer die on settle the bill Ghana is emergency medicine,” laughed the floor or while waiting to be seen. We on discharge.” the rector. Patients in Ghana often don’t don’t wait for family members to pay come for care until the situation is criti- before starting care, and don’t practice cal, so everyone was already practicing “medical jail” if they can’t settle the bill emergency medicine. The specialty was on discharge. We let patients go to inpa- recognized, but it was not clear how we tient floors when a bed is available, or go would fit in. “NYU is like an octopus,” home with a promise to pay as and when said the head of internal medicine, who they can. We have doctors in training was interested but worried. Would we who are hungry for knowledge and skills engage his faculty to help them advance to do better. Sari’s team at Korle Bu Teaching emergency care in Ghana, or control the A few weeks ago, I was walking home Hospital in Accra, Ghana. She af- fectionately calls them the “dream process? from work when a woman darted at me team” because of their compas- Four years later, the National from across the road. Shescooped me sion and dedication to service.

56 I EMalumni fall/winter 2018 DC 08/19/2020 up and began juggling me in her arms, whooping and hollering in Togolese. A crowd gathered to translate, and to hug and congratulate me. The woman was the mother of a 21-year-old woman who had arrived to us by taxi one morning, unresponsive with agonal breathing. The referral letter from an outside hospital read, “Patient gasp- ing. Referred for further management.” We began treatment and ventilated her with an Ambu bag for six hours while piecing her story together. She had spent the past week in a prayer camp after suffering for months with severe dyspnea and unresponsive to asthma medications. Her family had no money for even basic medical care. We gathered some donated funds and negotiated transfer to the hos- pital’s two-bed medical ICU. She is now discharged and living

“ With time, patience, and resilience, we can continue to advance emergency care.”

withextended family in Accra, still has an 80 percent occluding subglottic mass, and still has no money for an operation. How- ever, she does have a diagnosis, a large group of people who love her, a chance to get organized—and hope. This is emergency medicine, and this is progress. It is why I came here, and have stayed for the past six plus years (Top Photo) Early trips were spirited brain- despite multiple bouts of malaria, three storming sessions that started years of hauling water in a bucket to at breakfast and lasted well into flush my home toilet, fears of Ebola in the the evening...for days! (left to right) Ama deGraft-Aikins, PhD, midst of a massive cholera epidemic, and Olugbenga Ogedegbe, MD, MPH, over 2,000 demoralizing deaths. Living Sari Soghoian, MD (Med Tox as a visible minority woman doctor with ‘09) Lewis Goldfrank, MD, John Gershman, MA, Mary Brennan, a lofty social change mission is not easy, PhD, Sue Kaplan, JD personally or professionally. I have a fantastic team, wonderful patients, and a chance each day to do better. With time, (Bottom Photo) Several participants and patience, and resilience, we can continue speakers at the Chronic Kidney to advance emergency care. n Disease Symposium held in February of this year in Accra, Ghana. The key developers and organizers of the event were Dr. Vincent Boima (left) and Sari (fourth left). EMalumni fall/wiDCnter 08/19/2020 2018 I 57 conversations

From a summer job at 16 in a hospital in a working-class town to the chair of emergency medicine at NYU Langone Health

An in-depth conversation with Robert Femia, MD, Chair of Emergency Medicine at the Ronald O. Perelman Department of Emergency Medicine at NYU Langone Health

By Nick Gavin, MD, Chief of Service of emergency medicine at NYU Langone­–Brooklyn Nick will be the new Vice Chair of Clinical Operations at Columbia University in the new year. Congratulations!

Dr. Femia, thank you so much for cal carts. Joe Connolly, an outgoing and John Wiegenstein and Earl Reisdorff. taking the time to introduce likeable ED physician, often showed me And, even more unexpectedly, I met my yourself to our alumni and friends. X-rays and explained medical findings. wife, a nurse in the ED, the first year of Let’s start at the beginning. This led me to the University of Con- my internship. Sherry and I were married I grew up in Meriden, a working-class necticut for undergraduate studies and during my senior year—the best decision town in central Connecticut. My parents then to medical school. that I ever made. were both schoolteachers, my mother an After completing my training, I was immigrant from Italy and my father an Where did you do your training? focused on being clinically excellent. I Italian American. My dad, the youngest I did my residency at Michigan State, learned quickly that there is a lot more of nine, was the first to go to college. At one of the few universities that didn’t to patient care than a diagnosis. You age 12, I delivered newspapers, but the have a university hospital. Instead, have to meet patients’ expectations with most interesting job was announcing and they used Sparrow Hospital, a large positive interactions, and anticipate and scorekeeping for Little League Baseball. tertiary care community hospital in respond to uncomfortable, embarrass- When I was 16, I took a summer job Lansing to train emergency medicine ing situations. as an attendant in an emergency de- residents. It was the go-to place for partment (ED) where my aunt worked everything in the town. There were 31 What were your first as a shift charge nurse. It was there ambulance services that also served leadership roles? that I began to think about medicine, rural communities, and we saw the My first job out of residency was at Kaiser while making crutches, cleaning suture sickest of the sick patients. in Northern California, but after one year kits, wheeling patients to and from X- I had the honor of working with two we moved back to Indiana to be close to ray, making beds, and arranging medi- founding fathers of emergency medicine, my wife’s family. It was there that I learned

58 I EMalumni fall/winter 2018 DC 08/19/2020 how to fix a busy community ED. We titan of emergency medicine. When we our residents to how we create our pro- cared for patients and were responsible did meet, I immediately sensed that he grams. All of this has to be intentional. for student, emergency medical services, was a genuine, kind, and caring human and resident education as well as quality, being. That was important. Who was your best mentor? safety, and process improvement. The My best role model and mentor was my administrative experience led me back What accomplishments are you father, a quiet and humble guy. After col- to Indiana Wesleyan University, because I most proud of at NYU? lege, he served in the military and later thought that a business degree would al- Our young leaders are a creative group of became a schoolteacher, a guidance low me to grow and give me the credibility professionals who are excelling and mak- counselor, and a high school principal. He to continue working in hospital adminis- ing a difference. What keeps me up at was a councilman in our town of 50,000, tration. night is how we can continue to motivate and ended his career by going back to After graduation, we moved back east them so that they can thrive clinically guidance counseling. He led by example. where I became the medical director at and academically. It’s all about finding When my father died, people talked Greenwich Hospital in Connecticut. Soon ways to nurture people on your team so about his generosity and kindness. A after, I was offered a job as a system-wide that they can realize their potential. young woman wrote to my mother: chief of emergency medicine at the same Each year, we see 400,000 patients “When I was in high school I was going hospital in Michigan where I had trained. At and continue to develop innovative strate- nowhere. And he kept calling me to the that time, the main hospital saw 100,000 gies to improve patient care and advance office to fill out college applications but patients and was affiliated with two EDs. It quality and safety. We have increased I wouldn’t do it. So, without my knowl- was the first time I had to get things done the number of fellowship programs, and edge, he filled out a college application through other people. We made a big dif- several are now integrated with our mas- to nursing school and sent it in and then ference in the community. ter’s degree programs at the NYU Wagner told me. That was the best thing that ever School of Public Health and Maastricht happened to me.” What brought you back east University in the Netherlands. My father had an immense influ- to NYU? Our investigators are using innovative ence in my life, and I was really happy we A few years later my dad got sick, and methods to address social disparities in moved back east. I had the opportunity we came back east to southern Con- society—lack of access to care, educa- to spend the last ten years of his life with necticut. I went to Lenox Hill Hospi- tion, a stable home, and opportunities to him, and that was so important to me. tal as the first chair of emergency succeed. To that end, we are expanding medicine in a new department. I always Project Healthcare, a successful sum- What’s the best book you’ve read gravitated toward opportunities that mer volunteer program founded by Dr. in the last year? are fixer-uppers. The key is figuring out Goldfrank at Bellevue Hospital, to NYU I like Malcolm Gladwell’s books. Blink what’s broken but fixable and what’s Langone Hospital-Brooklyn. We want helped me to understand why when I met broken and not fixable. We hired skilled young people to have inspiring mentors my wife for the first time I thought: “I’m doctors, put systems in place, and who say: “You can be a doctor, a nurse, going to marry this girl.” Going with your focused on quality—the ED became an a pharmacist, or any other healthcare gut is a good thing. David and Goliath is essential part of the hospital, and the professional.” As community leaders, we another Gladwell book that teaches us patient satisfaction scores were at their have a platform to create opportunities. that giants are not as powerful as they highest. may seem and that disadvantages can As we improved, the hospital became What are your plans for advancing turn into advantages. Recently, I wanted involved in merger discussions with diversity and inclusion within the to understand the Arab-Israeli conflict North Shore and NYU. I had great conver- department? and read a book called My Promised sations with the leadership at NYU. One Diversity and inclusion allow us to Land by Ari Shavit. thing led to another, and I ended up hav- make better decisions. When you bring ing a conversation with Dr. Goldfrank. different life experiences to the table, With all the responsibilities you have you find richer solutions. One example as chair, how do you relax? What excited you most about NYU is our summer fellowship program I get a lot of joy when I spend time with and Dr. Goldfrank’s vision? for underrepresented first-year and my family. I love athletics, and when my NYU was a world-class organization second-year minority medical students kids were younger I coached basketball and I sensed that the leadership style from across the country. We must be and lacrosse and refereed high school was collaborative with a commitment aware of the need for diversity and in- basketball. As a family, we do many to excellence. I had never met Dr. Gold- clusion in everything we do—from how enjoyable outdoor, athletic activities. frank, but I knew of his reputation as a we hire our faculty to how we recruit That’s really important to me. n

EMalumni fall/winterDC 08/19/2020 2018 I 59 VIDEO

A Day in the Lives of NYU-Bellevue Emergency Medicine Residents: Four unforgettable years that last a lifetime in a place that will always be home. By Allon Mordel, MD (EM ‘18) Allon Directed and Produced this video in collaboration with the NYU Creative Services Team

60 I EMalumni fall/winter 2018 DC 08/19/2020 EMalumni fall/wDCinter 08/19/2020 2018 I 61 emLibrary

Goldfrank’s Toxicologic Enviromedics: The PEM CARS: Pediatric What’s Left Out Emergencies, 11th ed. Impact of Climate Emergency Medi- (Literature and Eds. Lewis S. Nelson, Change on Human cine Critical Article Medicine): Stories Mary Ann Howland, Neal Health by Jay Lemery Reviews by Michael by Jay Baruch. The A. Lewin, Silas W. Smith, and Paul Auerbach. Mojica. NYU Langone Kent State University Lewis R. Goldfrank, Rowman & Littlefield, Health, iTunes, New Press. Kent, Ohio, Robert S. Hoffman. The Lanham, MD, 2017. York, NY, 2017 2015. McGraw-Hill Companies, New York, NY, 2018. Many of us have con- It is essential that providers In this collection of short cerns about the effects utilize the best available fiction, I tried to capture Toxicologic emergencies are of climate change on evidence when making the various ways particular everywhere. Those poisoned Earth, but we often over- clinical decisions. However, individuals make sense of a patients who come to our look the essential issue it is difficult for providers reality that does not make emergency department of human health. to incorporate both the sense and often defies and whose cases are called -Jay Lemery, MD foundational articles from logic, and how they find into the NYC Poison Control (EM ‘04) the past and the rapidly ac- meaning in familiar worlds Center created the material cumulating current studies that can feel otherworldly. for this book. Our faculty, fel- that inform the clinical care Many of these stories lows, nurses, clinical pharma- of the acutely ill and injured grew out of complicated cists, residents, and former child in the acute care emotional experiences in residents and students have setting. The PEM CARS my life as an emergency helped care for these patients. iBook provides over 150 medicine physician, unset- This book has been a life comprehensive, structured tling moments that defied work for the editors. We have reviews from the medical easy explanations. Pushing shared the task with almost literature that form the these experiences toward 100 fellows and many other basis of pediatric emergen- the strange felt necessary associated faculty who are cy medicine practice. We because the world of heal- committed to the creation of assess each article based ing and illness has felt more this book. We hope that you on its methodology’s risk of surreal to me. will enjoy reading it, and that bias, results, and applicabil- -Jay Baruch, MD you still find textbooks valu- ity. A “clinical bottom line” able whether in print or online. provides a concise sum- -Lewis Goldfrank, MD mary of the article and its potential impact. -Michael Mojica, MD (Peds EM ‘93) 62 I EMalumni fall/winter 2018 DC 08/19/2020 voices

A conversation with two graduates of NYU-Bellevue Residency both passionate about their current focus and making a difference Maria Raven, MD (EM ‘05) Jay Lemery, MD (EM ‘04)

What drew you a major influence on how I prioritize my I started a wilderness medicine program to emergency medicine? clinical practice and research. at NYP/Weill Cornell Medical Center as Maria. I knew that office-based medi- Training at Bellevue made me a bit grit- a vehicle for medical education, but that cine was not for me. I enjoy connecting tier, and gave me the opportunity to see a social justice perspective transformed quickly with people, often in times of huge swath of society in New York City and my vision. Within a few years, I pivoted stress or crisis. The emergency depart- the gaps in medical and social care that within the environmental sphere to focus ment (ED) is the one place in the “house” often bring people to Bellevue. I will never on climate change and human health— of medicine where we must provide care forget my time in the Comprehensive Psy- particularly as it relates to vulnerable for all comers at all hours. We are basically chiatric Emergency Program (CPEP) provid- populations—something that all of us are agnostic to insurance and other issues ing care for people with acute mental illness familiar with in EM. that can plague other specialties. And of and afflicted by alcoholism and homeless- What are your fondest memories course—it’s fun. I like working on a team, ness—this experience influenced my need and the people who choose emergency to find ways to end homelessness. of your time at NYU-Bellevue and medicine felt like my people! All things that are relatively unique in New York City? to the city have stayed with me. When Maria. In terms of Bellevue, I recall Jay. I was drawn to the idea of being able the World Trade Center towers were one day when a very high-level govern- to practice “real” medicine. In the hyper- attacked, it was my first day off after six ment official came into the ED for care. Dr. specialized environment of 21st-century straight days working and the second Goldfrank and I were working a day shift medicine, emergency physicians are con- month into my residency. I was clueless together, and he approached me and said: fident in treating the very young and the but worked really hard to make sure “Dr. Raven, there is someone who will be very old, the incredibly sick and the not so everyone was well cared for. needing your help.” It was so like him to sick, and everything in between. We were give me the once-in-a-lifetime chance to trained to be unflappable care providers in Jay. First, we came out of training with meet and care for this person even though the face of trauma, in critical care, and in outstanding clinical skills and acu- he could have done it himself. The next day, overcrowded, chaotic settings. That really men— that really helped in allowing my my handiwork was (very subtly) featured in appealed to me as a medical student, and I residency colleagues and me to excel in a New York Times photo of this individual. was in awe of our NYU-Bellevue professors our new jobs. I was drawn to an academic Only at Bellevue! In terms of New York and senior residents who were fantastic career, because I very much enjoyed the City—what can I say? role models and advocates for our field. teaching aspect and threw myself into My husband and I moved here right that early on. But the differentiator that after we got married and lived in down- How has your training at NYU-Bel- NYU-Bellevue offered was its perspective town Manhattan, and I had both our kids levue informed your career path? on social justice. This was something that at NYU Langone Hospital. Our kids spent Maria. Bellevue was the foundation to I really didn’t experience earlier in my their first years riding their scooters my current path in emergency medicine. education, and that aspect of training de- unabashedly through throngs of tourists Dr. Lewis Goldfrank’s philosophy is still veloped later in my career. For example, in the park and riding the subway to the

DC 08/19/2020 EMalumni fall/winter 2018 I 63 Museum of Natural History. We heard stay present in this amazing and ulti- opportunities they have been given—and great music and ate great food (when- mately fleeting experience. is someone who first does no harm. ever we weren’t working). We made great friends. Everyone should live in New York What are the toughest problems Jay. Intellectual tenacity and the ability City if they have the opportunity. facing healthcare today? to pull compassion from even the most Maria. One major challenge is our na- trying moments in the ED—all my heroes Jay. For sure, my residency mates are at tion’s increasing spending on healthcare in EM have these common denominators. the top of that list, which has now turned and comparatively low spending on social into a formidable “Who’s Who in EM.” They services and social determinants of health— What are the proudest achieve- are still my besties, the type of friends I’ll such as housing, community-based mental ments in your life—both career never gain again, as we forged our bonds health and substance-use services, food and personal? during the intensity of training and New insecurity, and so much more. Maria. Career: Training at Bellevue York City life. I was a second-year resident Another critical problem is the cur- under Dr. Goldfrank and during 9/11; during 9/11/01—those memories, and the rent administration’s assault on publicly creating connections between the New people I was with—are some of the most financed healthcare via the Medicaid York City Department of Homelessness powerful that I’ve ever experienced. And program and the Affordable Care and NYC Health + Hospitals as a part of I’m still inspired by our teachers and their Act marketplaces that help subsidize my current research path to attempt to commitment to making us some of the low-income individuals’ ability to improve care for frequent users of the best doctors in the world. purchase insurance. health system; and continuing this work Siloed data and systems of care that with great colleagues at the University of What advice can you give to the prevent care coordination, especially for California, San Francisco while maintain- next generation of NYU-Bellevue some of our most vulnerable patients, is ing my connections from NYU-Bellevue. emergency physicians? another pressing issue. Two of these chal- Personal: Marrying a great person; Maria. Find an area of interest that you lenges may require an election in order to having good friends I can count on; being can specialize in and create a niche for change. So, get out the vote!!!!! a mom to two fantastic kids—neither of yourself, so you can mix clinical work with whom currently wants to go into medicine, other aspects of medicine. Administra- Jay. It remains access to care. although my son did just wear my clogs, tion, research, ultrasound, critical care, We know it can be done economically and stethoscope, and a scrubs top for his role public health—many areas require ad- affordably, and yet our national discourse as a doctor in a play—and running a few ditional training or a fellowship but can be precludes this from happening. And so, half-marathons. Still though…lots more invaluable for your long-term career. it falls on EM to act as the safety net for to do! Maintain your own well-being. Set huge swaths of the population to find aside time for family, friends, exercise, care. Hopefully, accessible technology Jay. Professionally, I’ve been able to trashy TV, great movies—anything so can mitigate some of this, but in the end, pursue interesting projects with brilliant that your whole life is not medicine. It we have to find a way to take care of one people all while staying grounded in EM. will serve you and your patients well in another. Healthcare is now too expensive Too many of us succumb to burnout and the long run. to expect a working-class American to strive to find ways to escape from a ca- Debrief after upsetting clinical events adequately insure his or her family. reer that we’ve spent so much time and (or if you’re feeling overwhelmed) with money in achieving. Here is the advice I colleagues or friends. If you need profes- What makes an exceptional give to young attendings and residents: sional support, get it. emergency physician? Find diversity within medicine to stay en- Maria. An exceptional emergency gaged and stimulated. There is no doubt Jay. Soak it up because it doesn’t last physician is someone who can maintain in my mind that these opportunities are forever. Despite how tired or fatigued you composure in the face of chaos, is an everywhere in EM. might be, know that these are precious expert multi-tasker, is not hung up on hi- Personally, it has to be my kids, two times that will make you a world-class erarchy so can work well on a multidisci- girls 5 and 7, and striving to be a consis- physician. For the rest of your life, you plinary team, is willing to work really hard tent, positive force in their lives. They will gain accolades from being “Bellevue- realizing they may not “get out on time,” both want to be doctors, LOL—credit Doc trained.” And as tough as it is at times, is humble about what they know and the McStuffins for that one. n

Maria Raven, MD is an Associate professor of Emergency Medicine at the University of California, San Francisco and an advocate for people who are homeless and Jay Lemery, MD is an Associate Professor of Emergency Medicine at the University of Colorado and is Chief of the Section of Wilderness and Environmental Medicine.

64 I EMalumni fall/winter 2018 DC 08/19/2020 in memoriam

It is with great sadness that I share the news of the death and the School of Nursing. He approached investiga- of Ian Portelli, a close friend and collaborator of many of tions in the uncertainty of emergency preparedness for us. Ian succumbed to a vicious malignancy recognized the Department of Homeland Security, the Department less than five months before his death in Poughkeepsie, of the Army, and our department. Ian wrote extensively New York, Friday, May 25, at the age of 39. as a clinician and creative investigator, while devoting Ian was born in Malta and obtained his nursing innumerable hours to his editorial roles in numerous degree at the University of Malta and Trinity Col- journals in his fields. lege in Dublin, Ireland. He served abroad in medical Ian was the loving husband of Paula and the de- roles for the United Nations and Médecins Sans voted father of Tylor and Cole, his two young sons. We Frontières. Ian obtained his master’s and pediatric all have lost a great friend and coworker. We will fondly nurse practitioner degrees from the University remember that Ian was always on call, leaving Pough- of Manchester, England, and received a PhD in keepsie early in the morning and returning home late research and statistics from the NYU School of in the evening. He left us memories of brilliant thought Nursing. Ever the ongoing scholar, Ian did further from an inquisitive mind. training with us at NYU, and this past year he con- Our deepest sympathies are with Paula, Tylor, tinued postdoctoral work in medical informatics at and Cole, whom many of us knew quite well. We offer Columbia University. our warmest feelings for an accomplished friend and Ian moved on to Vassar Brothers Medical Center devoted father, husband, scientist, and clinician. Ian’s of Poughkeepsie in numerous leadership roles. He de- parents, Saviour and Elizabeth; siblings, Anita and veloped the institution’s research portfolio and trauma George; and Paula’s parents represent a close-knit fam- program, and recently became a vice president for op- ily devoted to his memories and the future of his family. erations, medical research, and trauma. But Ian never We offer them our respect and support. really left NYU as he continued to investigate complex It is an honor to have been such a substantial problems in our department. part of Ian Portelli’s life. The world is a better place in Ian was a creative investigator, coupling his intel- many ways through his thoughts, words, and deeds. lectual and creative skills with many in this department Ian will be dearly missed by many. n

EMalumni fall/winterDC 08/19/20202018 I 65 66 I EMalumni fall/winter 2018 DC 08/19/2020 EMalumni fall/winterDC 201808/19/2020 I 67 then and now credits

Rounds

Rounds 1996 or 1997?: (Left to Right) Gavin Barr, MD (EM ‘97), William Goetz, MD, Behdad Jamshahi, MD (EM ‘96), (background) Sean Rees, MD (EM ‘98), Jeffrey Manko, MD (EM ‘95), Steve Heffer, 68 I EMalumni fall/winter 2018 MD (EM ‘98). All residents except for Drs. GoetzDC and Manko.08/19/2020 credits

The alumni magazine of the Ronald O. Perelman Department of Emergency Medicine, NYU Langone Health FALL/WINTER 2018

Robert J. Femia, MD, MBA Chairman

Kristin Carmody, MD, MHPE Vice Chair for Academic Affairs and Education Innovation

William Goldberg, MD Vice Chair for Business Operations and Strategic Planning

Corita Grudzen, MD Vice Chair for Research

EMalumni Magazine

Joan Demas Editor

Christopher Chew Publication Design

Linda Walsh Editorial Services

Artwork on front and back covers: Terri Moore, “Nests.” A reminder that together we can create a nurturing environment. www.terrimoorestudio.com

SHARE YOUR STORIES We will be delighted to receive your suggestions for articles, names of alumni and friends to feature, submission of comments and letters for publication, stories, poems, photos of family, events and any exciting news you wish to share.

Write to us: [email protected]

STAY IN TOUCH!

NYU School of Medicine Ronald O. Perelman Department of Emergency Medicine med.nyu.edu/emergency

NYU Langone Health comprises NYU Langone Hospitals and NYU School of Medicine EMalumni fall/winterDC 08/19/20202018 I 69 DC 08/19/2020 DC 08/19/2020