November 14, 2018 • 42 mins
Episode 9 of the ISAVE That Podcast sponsored by BD is an extremely special, standalone track, titled The History of AVA. It features a sit down with Suzanne L. Herbst, the founder of the Association for Vascular Access. Suzanne shares how she founded the organization and helped mold it into what it is today.
0:00 – AVA CEO Ramzy Nasrallah and 2019 President-Elect Ken Symington open the episode with a brief discussion about what Suzanne means to them and how this episode came about.
2:28 – Suzanne Herbst and The History of AVA
23:54 – A brief word from our Episode 9 sponsor, BD
41:00 – Thank you, Suzanne! Episode 9 wrap-up.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ramzy (00:00):
Hello, and welcome to a very special edition of the
ISAVE That Podcast.
This is Ramzy Nasrallah.
I'm joined by Dr.
Ken Symington, President-Electfor the Association for Vascular
Access.
This is the oral history of AVAedition of the podcast.
And after we finish talking,you're going to get to listen to
Suzanne Herbst, the founder ofthis association, walking you
(00:22):
through the timeline of how thisassociation came to be, how the
Vascular Access specialty wasidentified, and then slowly
defined and elevated through herwork.
Ken, you actually appear in thisoral history that we're going to
be hearing, because throughserendipity we're both in
(00:42):
upstate New York around the sametime.
Ken (00:44):
It's crazy.
Absolutely crazy.
Yeah.
I was just thinking this morningwhen I woke up and anticipation
of this, I can't remember thevery moment that I first met
Suzanne.
But I do remember when I startedworking with her with through
patients and I got to tell ya, Iimmediately I was sort of hooked
on her.
Her penetrating blue eyes, herdevotion to patients.
(01:07):
She was just such a sweet, kindperson.
And I wanted to do everything Icould to help her and to help
patients.
And that turned into being quitea project.
We did a Vascular Accesssymposium that first year and I
think 400 people came to it.
Ramzy (01:19):
Wow.
Ken (01:19):
It was a huge success, you know, out of nowhere, out of the
blue.
And then after that she got mehooked into doing other things
with her and stuffing flyers forher at her house and in her
garage and tripping over herlarge dog.
All these crazy things, this momand pop operation, it's just
amazing memories of her and Icouldn't be happier to see that
(01:39):
she's doing this and shedeserves every bit of credit and
recognition that she couldpossibly get.
Ramzy (01:45):
Yeah.
And speaking of credit andrecognition, this, this episode
is the brainchild of Dr.
Jack LeDonne.
So hearing about the grassrootsinception of how AVA came to be,
to now we have thousands ofmembers.
We had well north of a thousandpeople, clinicians, at our
conference in Columbus.
That all started somewhere, andit started with Suzanne Herbst,
(02:08):
who we will turn it over to now.
This episode has been madepossible by sponsorship from BD.
A great partner to VascularAccess and to AVA.
For more information on BD,please visit www.BD.com.
And now we'll give you SuzanneHerbst and the oral history of
the Association for VascularAccess.
Suzanne (02:28):
I'm going to just start with where I was in 1965.
I was a senior in nursing schooland I had a diagnostic tumor on
my thyroid.
And so I have a positive tumor.
And my first IV was on me.
(02:51):
I never thought that would everhappen.
And then the day of graduationfrom the school of nursing, I
went high school, senior ballwith Phil, my, my wonderful new
husband, and the day ofgraduation, the night of the
senior ball, I had extreme pain.
(03:15):
So, I didn't do the all nighterthing that you do when you're
crazy and graduating.
So it turned out that theyfigured out that I needed an
appendectomy.
And so I said, I'm going, I'mgoing to get my diploma and then
(03:38):
discuss this.
So again, with the surgeon, wehad a discussion and I had my
number two Vascular Access or IVand those are ancient in 1965.
Both of those In 1966, I haveone sibling, my brother Herb.
And he was diagnosed withleukemia when he was 24.
(04:03):
And I was going to do all thisstuff and go to Europe.
But we found out he had leukemiaand he was getting his doctorate
at Columbia and it was like twoweeks before his wedding that he
found out all this.
(04:25):
Anyway, I didn't go to Europe,but my brother and I talked and
I just traveled through theUnited States.
And kept in touch with mybrother and then I remember
coming back to Syracuse where hewas being treated at Upstate.
And all I could remember was howbad has arms looked from all the
(04:49):
intravenous drugs at that timefor leukemia.
And you know, it was awful.
His arms just looked awful.
So anyway, unfortunately, a fewmonths later, my brother died
and praise God, I could be likewith him when he went to God.
(05:12):
So, the thing that I had, thegreat thing to do was to, I went
to California and I loved it.
And after my brother died, Ileft town, I got out of dodge
because it was too painful forme.
(05:33):
And so I went to California,went back to San Francisco
working in critical care.
And the director of the criticalcare unit asked me if I'd like a
job in research.
I went,'Research?
A nurse in research?' And so, Istarted working at what's called
(05:55):
Riverside Research Institute.
And it was the US Division ofthe eastern research institute
in New York.
So, we started and one of ourfirst projects was to look at
different polymers, look atdifferent, pieces of plastic, so
(06:19):
to speak and see what would bethe most biocompatible with the
body.
I actually put these pieces ofdifferent polymers into rabbit's
ears so that, you know, I couldtake them out and see which ear
got really red and inflamed, andso on.
(06:39):
So I ran the animal researchinstitute there in California.
I couldn't do it again because Iwas working with the sheep and
dogs.
But I had this opportunity towork with some wonderful
(07:01):
engineers and we went to Seattleand met Dr.
Hickman and Dr.
Broviac, who were developingcatheters to stay in people for
long periods of time.
And it was, they wanted a way tosecure the catheter in place.
(07:21):
And so they found out, theywanted some kind of material on
the catheter itself.
So we looked at Dacron and welooked at different materials
that would adhere to thesubcutaneous tunnels and secure
the catheters in place.
(07:44):
There's a Hickman catheter namedafter Dr.
Hickman and a Broviac catheternamed after Chuck Broviac.
And then I worked with Dr Swanand Ganz to develop critical
care catheters again to look athow long you could keep the men
(08:06):
and so I had this incrediblementorship of these brilliant
scientists.
I had the opportunity to workwith them.
So, my research just kept movingon.
And I started working for ElizaCorporation and it was,
(08:33):
Alexandro Saferoni who waspresident of Syntax Americana
and he raised a whole bunch ofmoney.
He was making the birth controldevices.
And again, I was asked to jointhat group because they were
making a portable infusiondevice and it was called the
(08:57):
Allezor Research Medical Device.
And it was a small pump becausepeople needed the pump for
insulin, for some of the drugswe were learning were better
given for hematology problems ifthey were given over a period of
(09:19):
time.
And so I worked with that and itwas called the, R-med infuser.
And again, there were nobatteries or anything like that
in this device.
It was a balloon.
And we had to work with theengineers to keep the pressure
(09:39):
in the balloon constant so thatyou just have this little piece
of plastic that was like aturnkey, you turn it on and then
the fluids could be deliveredthrough this balloon on a
consistent basis.
I had a lot of background onpump development, the portable
(10:04):
infusion pump that was developedby Dr.
Ensminger in Michigan.
And then I started working withhome infusion because I knew a
lot about the pumps.
We had developed the firstvolumetric pump with the
(10:26):
research institute.
And so, these pharmacists fromStanford started Stanford Home
Treatment Services and so theywere mixing up the bruise, the
TPN in their garages andstandard wasn't interested in
doing that kind of thing.
(10:49):
I said, well, I can do that.
I know the pump, no problem.
Got to know and work with thevarying newness of pumps as they
came along.
And then I got into homeinfusion doing total parental
(11:09):
nutrition on many of the people.
That's all they were using.
And I suggested that, you know,they could be giving
chemotherapy drugs through thesepumps they could be giving in
infection control.
Jack (11:27):
Antibiotics?
Speaker 2 (11:31):
Yeah.
So, I sit within, and HIV wasjust running wild in San
Francisco and I had people thatjust wouldn't come to work with
me because they didn't want tosee these patients, people with
(11:51):
AIDS.
So I just started, doing 24/7,going to these people's homes.
And one of the things that wouldwould happen is I called it
catheter abuse.
That was– an AIDS patient wouldgo into the hospital and have a
(12:14):
fever and everybody, they alldid.
And infection control, peoplejust wanted to pull the line and
they did.
And oftentimes that was the onlyline we had left.
I had two of my best friendswere getting sicker and sicker.
Jack (12:34):
What kind of lines are you're talking about?
Suzanne (12:35):
These were tunneled catheters supports the Groshar
catheter.
And so I would get really upsetbecause in many cases, that was
also the only line we hadavailable with people with
Kaposi sarcoma everywhere.
Infection control wanted to pullthat line and then we had no
(12:58):
place to put it because of allthe lesions from the Kaposi
sarcoma.
So I had two friends that weredying, but I was ministering to
them, but I was seeing patients24/7 and I ended up in the
critical cardiac unit withsevere chest pain.
(13:23):
I was in San Francisco and Isaid,'Well, I'll stay in the
right hand lane and I'll driveto my internist' who was in
Redwood City/Menlo Park areanear Stanford.
And so I drove down, he did anEKG and his wife took me right
(13:49):
to the hospital.
So my friends, my two friendssaid,'Suze, are you going to die
before us?' I said,'Uh, no.
I, well, yeah, I could.' So, thecardiac cath showed that my
heart was fine, but thecardiologist that they sent me
(14:12):
to said, you just can't do this,you can't be doing 24/7, because
I would be on call and I hiresomeone and get them up to speed
on all the things you needed inhome infusion.
And the next thing I know, I wasat the one nurse's house.
(14:35):
And so she was in the bathroomand she had gotten blood on her
hands and she was going nuts,you know, so she, she left.
And then suddenly else, I hiredher, and then she got pregnant.
She left.
And so I was doing call 24/7like I said, and my cardiologist
(14:57):
said, no, you're not going to,you're not going to do it.
So, I went a disability for like6 months.
I mean, he would not let me.
He said:"Suzanne,, you can't dothis.
You can't keep doing that.' ButI stuck with my friends who had
these lines (15:17):
Gary and Bobby.
Gary said to me,'Suze, you gotto do something about this'
because he had gone to thehospital, he had a fever and
they had pulled his line and wewere using that for pain
control, for morphine and forhis Kaposi Sarcoma.
(15:38):
And I got to his house and I waslivid that they would just pull
the line and have no options forthat.
At the same time, I was doingresearch at MD Anderson in
Houston and they sent me to thehematology meetings and while I
(15:59):
was there, one of the thingsthat was hard to do, you had to
cut down to put a soft, siliconecatheter in.
You couldn't put it reallythrough anything or around
anything.
Anyway, it was this, it lookedlike a fishing pole out of spool
(16:22):
and it fed the catheter.
The catheter was on a wire inthis spool, and then I called it
'the bayonet' would come out ofthis end and you'd, you'd stick
'the bayonet,' 18-gauge, prettylarge slit sided needle and
start turning the round part ofthe, where the catheter was
(16:46):
coiled.
It will go right through andinto the body.
And I said,'Brilliant!' Becausepeople were doing cut downs and
doing and terrible jobs doingcut downs.
Speaker 2 (16:57):
I brought that back to MD Anderson and I said,'Can
we try this?' And so I practicedand practiced and practiced.
Dr.
Frye Reich who was the head ofthe leukemia hematology groups
and looking a lot into AIDS andHIV.
(17:20):
So I said,'Can we try this?' So,I kept practicing on these arms
that they were making.
Jack (17:30):
What year was this?
Roughly.
Suzanne (17:30):
1968, 1970.
So, Dr.
Frye Reich let me put in thefirst line.
And so I did.
And it was very successful.
I put in the, the first PICCline in the United States as a
(17:58):
nurse.
There were docs that would putthem in here and there, but they
didn't, they put in two a year,maybe.
And you needed some skill, youneeded to put in more than just
one.
Jack (18:11):
Funny how that works.
Suzanne (18:12):
Yeah.
So, then I brought them back andwe started using them and then
manufacturers got involved withthem and improved the technique
of not just the polymer itself,but the ways you could put it
through the body without puttingit through this 18-gauge
(18:36):
'bayonet.' And so, I did mydisability and recovered, but
you know, at the same time I wasjust so, so excited about these
catheters.
I stayed in touch with Dr.
Hickman and Dr.
Broviac.
(18:57):
Doctor Swan wanted not just onelumen–, they wanted one or two
or three lumens and they wantedthe balloon and the catheter.
We had to figure out how to doall that.
And I worked with thesewonderful engineers.
So here I am watching this abusetake place.
(19:21):
Like you'd have a patient comehome from the hospital and
they'd say they just got stucklike 5 times, by the same
person, and they never hadanother person that was up to
speed.
So, I did a survey on 370patients and clinicians who put
(19:48):
these lines in and most of theclinicians put lines in like
twice a year.
Again, you got all thesephysicians, they were doing
them.
It didn't really become anursing specialty until I could
kind of prove something.
(20:08):
And so I just saw this abuseover and over and over.
And so I was one of the foundersof the Oncology Nursing Society
and we wrote the firstguidelines for the oncology
nursing group.
We had our, I had thought we hadour protocols down pretty
(20:36):
consistent and so on, but therest of the world didn't have
that.
And so I've wrote a letter, Iwas coming back from an oncology
meeting and again, witnessingall kinds of abuse, people being
stuck way too many times.
And I know what happens.
(20:57):
I was working on my doctorate atthe time.
And I understand that, you know,you just can't keep repeating
sticking someone because theirveins are going to constrict.
They're going to get fearful,they're going to be more, have
morbid fear of an IV beingstarted.
(21:22):
I wrote a letter, I had thisidea if I could get everyone
that was putting these lines andlike in most of the major
hospitals in the San FranciscoBay area and I started, it was
called the Bay Area VascularAccess Committee– BAVAC.
Jack (21:43):
What year?
Suzanne (21:46):
1979.
BAVAC.
Jack (21:51):
This was your idea
This was your idea– to puttogether a group of who?
Suzanne (21:56):
A group of people that were putting in lines and
dealing with...
Jack (22:03):
Nurses?
Doctors?
Who?
Suzanne (22:06):
Nurses, primarily.
Doctors just felt they knew whatthey were doing.
So I wrote this letter, and Istill have it and I wrote down
what I saw as a benefits ofbringing everyone together.
That was a piece of the pie,including manufacturing at the
(22:28):
time because they were comingout with things, but they
weren't listening to the nursesthat were at the bedside.
And the consumers were veryimportant to me that I just
didn't want to see any moreabuse.
And so I wrote this letter and Ishowed what my mission was to
(22:49):
bring everybody that was a pieceof the pie– pharmacists, because
they could change the ph and thefluids that was going in so that
it wouldn't burn the vein sobadly.
And so, that day 15 people camefrom Presbyterian Hospital, St.
(23:13):
Luke's Children's Hospital,Oakland, Stanford, of course.
Ramzy (23:17):
Where did you have it?
Menlo Park?
Suzanne (23:20):
Menlo Park.
That's where I was living.
And so I, I wrote, I was on theairplane and I, I wrote this
idea down and then sent it out.
And the people that said theycouldn't come– they had reasons.
Jack (23:35):
Were the 15 people San Francisco-based?
Or?
Suzanne (23:38):
San Francisco-based.
And so I invited, I wrote theletter to oncology nurses
primarily because then we're theones doing IVs.
Speaker 3 (23:54):
This special episode of ISAVE That Podcast is made
possible by BD.
BD is a global medicaltechnology company that is
advancing the world of health byimproving medical discovery,
diagnostics and the delivery ofcare.
For more information, pleasevisit www.bd.com.
Suzanne (24:13):
So, we met at Presbyterian Hospital and like I
said, 15 people came.
But one of the things that I hadlearned is that if you bring
some food, people will come.
So, I made this great big thingof ziti and said food will be
(24:36):
there available, whatever.
So anyway, we started meeting ona monthly basis and coming up
and changing, I had written downfive of my goals.
I said,'We all have to be on thesame page and our consumers need
to understand that they do nothave to put up with this abuse.'
(24:59):
OK.
So that happened.
And then we named it BAVAN afterthe committee.
The Bay Area Vascular AccessNetwork we called it.
And so it was networkingeveryone that I could get my
(25:21):
hands on to come.
Well the FDA, it was juststarting a central venous
catheter working group.
And when they looked at theirstatistics, they found that the
failure rates were due tohealthcare professionals not
(25:42):
having enough training andteaching and never heard about
it in schools, nursing ormedicine.
But our pharmacists were verywell involved in this kind of
thing.
So, every month I had a goodfriend who was a caterer and she
(26:06):
would make awesome things andpeople would come and eat and
talk.
And so 15 came, then 30, then 35and then 40.
And then I get a call from theperson who's heading up the
central venous catheter workinggroup and had just gone over the
statistics.
And His name was Dr.
(26:28):
Walter Scott.
And he and his nursepractitioner came to San
Francisco to one of ourmeetings.
And then I said, I want to be onthe central venous catheter
working group.
He said,'Well, you know, you cansit in the gallery.' But you
(26:48):
know, I wouldn't have a seat atthe table.
So, I went to Washington and satdown in the gallery and kept
looking at this name tag infront of this chair and it says
'Suzanne Herbst.' So I went,'Holy smokes! I could sit at the
big table with all those bigguys!' Because they were
(27:10):
primarily men.
Jack (27:12):
What year are we?
Just for the timeline sake.
Early 80s?
Suzanne (27:14):
Yes.
Ramzy (27:17):
So BAVAC'79, BAVAN a couple years later.
Suzanne (27:21):
Right.
And then, then I got asked to beon the central venous catheter
working group and I said, youhave to come to some of our
meetings.
I remember wanting to have myversion of the first meeting,
like a convention.
(27:44):
If we had 50 people, that wouldbe wonderful.
But what we did was we hadtables around this ballroom or
this room at the Holiday Inn inSan Francisco.
And I remember writing mypersonal check to cover the
(28:05):
space.
And we had, it was George Cinco,and he had a pediatric catheter
silicone that you could put inthese little kids.
There were Menlo Park, I mean itwas called Menlo something and
(28:33):
they were coming out with somedifferent new, new newness, this
new technology.
I think they spent like$25 tohave the tables.
And so we had like 50 peoplecome that first year and it was
(28:54):
only from 12 p.m.
– we did it in the afternoon– 12to 6 p.m., something like that.
So people getting off at 3 or 4could come.
That was the first meeting,general meeting.
(29:17):
And then, it just kept growingand catching on.
And people would call and say,'could we join?' And it was
southern California, OrangeCounty, Josie Stone, called me
up and said,'We'd like to starta network in our area.' And she
(29:38):
came up to San Francisco and Iremember that the rooms were
shrinking and people weresitting on the floors.
Then it took off from there.
Ramzy (29:51):
So the second network was in Southern California?
Suzanne (29:54):
Yes.
Orange County.
San Diego.
Then one of the doctors from MDAnderson went to Utah, Salt Lake
City, and he started a groupthere.
And so it was like,'OK, now wegotta call it NAVAN– National
(30:16):
Association.
Jack (30:17):
What year was this?
Suzanne (30:19):
It was like'84,'85.
It was amazing because I justfelt that something was
happening, something, somethingthat was really grabbing people
to keep coming and making phonecalls to us.
(30:40):
And so then we called the NAVAN,National Association.
One of the board members on thevery first board, gave me a
globe and I laughed.
International?
I don't think so.
Ramzy (30:55):
Not possible.
Suzanne (30:57):
No, not at all.
No.
We're lucky to be in it as bigas we were getting in
California.
Yeah.
So, we changed it to NAVAN andthen it ultimately got changed
to AVA because it's all over theworld now.
Jack (31:18):
So, let's go back.
So, NAVAN– let's start, soyou're at NAVAN and you went
national, so let's say when itbecame AVA.
Talk a little bit about what youwere doing.
There's a little bit of a bigjump there.
Suzanne (31:35):
I moved back from from San Francisco, back to Syracuse,
New York.
That's where I was born andraised.
I kept hearing about theseinterventional radiologists and
what they were doing and so on.
And so I stayed as President foras long as I could.
Jack (32:01):
What time frame?
What year– the late'80s?
Suzanne (32:04):
Yeah, I think AVA came up in'92,'93, they changed NAVA
to AVA.
Jack (32:12):
And were you involved with that change?
Suzanne (32:15):
Yes.
I just said, one of the things,Jack, that you've heard me say
this many times, but I workedfor an incredible boss.
You know, my license plates read'CEO FOR GOD.' And We actually
had a group of people who wouldpray before these meetings.
(32:36):
Anyway, so I came back toSyracuse and I got a call from
Ken Symington at Crouse Hospitalin Syracuse.
And he wanted to put together aworkshop day about Vascular
(32:58):
Access and explain whatinterventional radiologists had
to offer in terms of imaging andvisualizing.
At that time there was a big warbetween the surgeons and these
interventional radiologists thatwanted to start doing it because
they could see what they weredoing as opposed to blind.
Jack (33:22):
Were they using fluoroscopy at the time, do you
know?
Suzanne (33:24):
No, it was, I'm trying to think of when, because I
worked on that the firstultrasound thing.
But then I went to their suiteand the interventional
radiologist showed me what theycould see and how, you know,
(33:49):
they could, they could actuallytrace the vessel rather than
shoot blindly.
Jack (33:56):
Now, were these an ultrasound?
Or fluoro?
At that time.
Suzanne (34:00):
I don't know.
I was just learning about whatthey could do.
And so I remember that Ken gotme involved with Crouse Hospital
and we would have these meetingsand the CEO would never show up
(34:20):
for these meetings and theystarted at 6 a.m.
So we could plan how, how to notconvert so much as to if the
technology's there, why not usethat rather than have the
surgeon put in two(catheters) ayear?
I remember having that.
(34:41):
Everybody got a folder and myparents stuffed the folders with
information and Ken came over tothe house and my mom and dad
were so helpful.
My mom and dad founded theleukemia society in central New
York after my brother died.
(35:02):
And so they really got involvedmore and more with the leukemia
and lymphoma society.
Jack (35:10):
When did you move back to Syracuse?
Suzanne (35:13):
'91.
So, that's pretty much it unlessyou have some questions for me.
Jack (35:20):
OK– so at this point it was the Association for Vascular
Access.
Ramzy (35:24):
Moved back in'91–'92,'93, it's AVA now.
Suzanne (35:29):
Yes.
Ramzy (35:30):
Which means we're 25 years into being AVA.
Jack (35:34):
And how many, about how many members did you have at
that time?
Suzanne (35:39):
Maybe 250.
Jack (35:42):
Members– almost exclusively nurses?
Suzanne (35:44):
Yes.
And an interventionalradiologists.
Jack (35:47):
OK.
At this point were you'reholding, when did you start
holding annual conferences?
Around then?
In the early 90s?
Suzanne (35:55):
Yeah.
Jack (35:55):
And you would move it around to different cities?
Suzanne (35:59):
No, there was– Marcia Ryder, I hired her, so to speak
as a Director of Education andshe had a lot of background from
Davis Hospital.
I had helped develop the firstports, a lot of the catheters
(36:24):
and such.
And so I knew generally aboutit.
I would give a general overviewof Vascular Access and then she
would go more into the PICClines.
The two of us went from city tocity and it was supported by
Menlo Care.
(36:45):
It was called Menlo Care.
And I'm trying to think of,Dwayne Hardy, he was our first
financial treasurer of theboard, and it was called Menlo
Care.
And they supported it.
They supported us for a while.
But my checkbook getting lowerand lower and lower and lower
(37:08):
because I was ready to take arisk.
And I knew I was doing somethingright because people were just
showing up and making phonecalls and talking to me and I
was talking to them and they didnot work with me somewhere else
and I'd go wherever they wantedme.
Jack (37:33):
What's your impression about how the BAVAC developed
into AVA and how it's related toVascular Access in the United
States today?
Suzanne (37:42):
Well, I think that just from the very, very first
meeting back when we just calledit a committee, that we started
bringing Vascular Access moreinto the real world of
education.
(38:04):
But it still isn't in nursingschools and medical schools and
so on.
And today I think we're gettingthere.
I think that, well you helped somuch with that, Jack.
You made it so real.
I mean, when I first saw some ofyour presentations, I was like,
(38:29):
wow.
Correct me if I'm wrong, but theSonograms are set up so that if
you're right handed, you couldput the Sonogram on the right
side and you have a video whereyou took the bed out, turn it
around in case somebody wanted aleft-side orientation or
(38:55):
whatever.
It was just a riot.
And I went,'Gosh, he's got it.
He has a got it.
He just knows it and he is awarethat there's one way of doing it
and then there's all the others.
That's what your mother wouldsay, right?
Jack (39:18):
Pretty much.
Suzanne (39:19):
Yeah.
For me, I really still getfrustrated when, here's Crouse
that I help set up theinterventional radiologist group
and Ken Symington left and wentto outside of Spokane.
(39:44):
But you know, we just becamereally, really good friends,
before he had moved back.
And when he told me he wasmoving to the northwest, I was
like,'No, you can't do that!'
Jack (39:57):
So how do you feel about the overall state of Vascular
Access today?
Like its recognition, education,where it is compared to where it
started?
Suzanne (40:09):
Oh my goodness.
It's moving.
I think with the boards, TheFoundation, the support that
we're getting more and more thatthe education is coming.
One of the things I also wantedto make sure of is that we all
(40:29):
use the same terminology.
I mean everything was a HickmanCatheter.
But I think we're moving in theright direction.
I've recently over the past yearhave had some very bad
experiences with IVs.
(40:50):
We still have some, a lot ofwork to do and we will do it.
Speaker 1 (41:01):
You have been listening to the oral history of
the Association for VascularAccess as told by its founder,
Suzanne Herbst.
Thank you Suzanne for your timeand your decades of work in
advancing Vascular Access.
And AVA would like to give aspecial thank you to BD for its
sponsorship of this specialepisode of the ISAVE That
Podcast.
AVA members can listen to theentire unedited history of AVA
(41:22):
by going towww.avainfo.org/podcast.
If you have any comments orquestions, you can send them to
podcast@avainfo.org.
Thank you.
Hello, and welcome to a very special edition of the
ISAVE That Podcast.
This is Ramzy Nasrallah.
I'm joined by Dr.
Ken Symington, President-Electfor the Association for Vascular
Access.
This is the oral history of AVAedition of the podcast.
And after we finish talking,you're going to get to listen to
Suzanne Herbst, the founder ofthis association, walking you
(00:22):
through the timeline of how thisassociation came to be, how the
Vascular Access specialty wasidentified, and then slowly
defined and elevated through herwork.
Ken, you actually appear in thisoral history that we're going to
be hearing, because throughserendipity we're both in
(00:42):
upstate New York around the sametime.
Ken (00:44):
It's crazy.
Absolutely crazy.
Yeah.
I was just thinking this morningwhen I woke up and anticipation
of this, I can't remember thevery moment that I first met
Suzanne.
But I do remember when I startedworking with her with through
patients and I got to tell ya, Iimmediately I was sort of hooked
on her.
Her penetrating blue eyes, herdevotion to patients.
(01:07):
She was just such a sweet, kindperson.
And I wanted to do everything Icould to help her and to help
patients.
And that turned into being quitea project.
We did a Vascular Accesssymposium that first year and I
think 400 people came to it.
Ramzy (01:19):
Wow.
Ken (01:19):
It was a huge success, you know, out of nowhere, out of the
blue.
And then after that she got mehooked into doing other things
with her and stuffing flyers forher at her house and in her
garage and tripping over herlarge dog.
All these crazy things, this momand pop operation, it's just
amazing memories of her and Icouldn't be happier to see that
(01:39):
she's doing this and shedeserves every bit of credit and
recognition that she couldpossibly get.
Ramzy (01:45):
Yeah.
And speaking of credit andrecognition, this, this episode
is the brainchild of Dr.
Jack LeDonne.
So hearing about the grassrootsinception of how AVA came to be,
to now we have thousands ofmembers.
We had well north of a thousandpeople, clinicians, at our
conference in Columbus.
That all started somewhere, andit started with Suzanne Herbst,
(02:08):
who we will turn it over to now.
This episode has been madepossible by sponsorship from BD.
A great partner to VascularAccess and to AVA.
For more information on BD,please visit www.BD.com.
And now we'll give you SuzanneHerbst and the oral history of
the Association for VascularAccess.
Suzanne (02:28):
I'm going to just start with where I was in 1965.
I was a senior in nursing schooland I had a diagnostic tumor on
my thyroid.
And so I have a positive tumor.
And my first IV was on me.
(02:51):
I never thought that would everhappen.
And then the day of graduationfrom the school of nursing, I
went high school, senior ballwith Phil, my, my wonderful new
husband, and the day ofgraduation, the night of the
senior ball, I had extreme pain.
(03:15):
So, I didn't do the all nighterthing that you do when you're
crazy and graduating.
So it turned out that theyfigured out that I needed an
appendectomy.
And so I said, I'm going, I'mgoing to get my diploma and then
(03:38):
discuss this.
So again, with the surgeon, wehad a discussion and I had my
number two Vascular Access or IVand those are ancient in 1965.
Both of those In 1966, I haveone sibling, my brother Herb.
And he was diagnosed withleukemia when he was 24.
(04:03):
And I was going to do all thisstuff and go to Europe.
But we found out he had leukemiaand he was getting his doctorate
at Columbia and it was like twoweeks before his wedding that he
found out all this.
(04:25):
Anyway, I didn't go to Europe,but my brother and I talked and
I just traveled through theUnited States.
And kept in touch with mybrother and then I remember
coming back to Syracuse where hewas being treated at Upstate.
And all I could remember was howbad has arms looked from all the
(04:49):
intravenous drugs at that timefor leukemia.
And you know, it was awful.
His arms just looked awful.
So anyway, unfortunately, a fewmonths later, my brother died
and praise God, I could be likewith him when he went to God.
(05:12):
So, the thing that I had, thegreat thing to do was to, I went
to California and I loved it.
And after my brother died, Ileft town, I got out of dodge
because it was too painful forme.
(05:33):
And so I went to California,went back to San Francisco
working in critical care.
And the director of the criticalcare unit asked me if I'd like a
job in research.
I went,'Research?
A nurse in research?' And so, Istarted working at what's called
(05:55):
Riverside Research Institute.
And it was the US Division ofthe eastern research institute
in New York.
So, we started and one of ourfirst projects was to look at
different polymers, look atdifferent, pieces of plastic, so
(06:19):
to speak and see what would bethe most biocompatible with the
body.
I actually put these pieces ofdifferent polymers into rabbit's
ears so that, you know, I couldtake them out and see which ear
got really red and inflamed, andso on.
(06:39):
So I ran the animal researchinstitute there in California.
I couldn't do it again because Iwas working with the sheep and
dogs.
But I had this opportunity towork with some wonderful
(07:01):
engineers and we went to Seattleand met Dr.
Hickman and Dr.
Broviac, who were developingcatheters to stay in people for
long periods of time.
And it was, they wanted a way tosecure the catheter in place.
(07:21):
And so they found out, theywanted some kind of material on
the catheter itself.
So we looked at Dacron and welooked at different materials
that would adhere to thesubcutaneous tunnels and secure
the catheters in place.
(07:44):
There's a Hickman catheter namedafter Dr.
Hickman and a Broviac catheternamed after Chuck Broviac.
And then I worked with Dr Swanand Ganz to develop critical
care catheters again to look athow long you could keep the men
(08:06):
and so I had this incrediblementorship of these brilliant
scientists.
I had the opportunity to workwith them.
So, my research just kept movingon.
And I started working for ElizaCorporation and it was,
(08:33):
Alexandro Saferoni who waspresident of Syntax Americana
and he raised a whole bunch ofmoney.
He was making the birth controldevices.
And again, I was asked to jointhat group because they were
making a portable infusiondevice and it was called the
(08:57):
Allezor Research Medical Device.
And it was a small pump becausepeople needed the pump for
insulin, for some of the drugswe were learning were better
given for hematology problems ifthey were given over a period of
(09:19):
time.
And so I worked with that and itwas called the, R-med infuser.
And again, there were nobatteries or anything like that
in this device.
It was a balloon.
And we had to work with theengineers to keep the pressure
(09:39):
in the balloon constant so thatyou just have this little piece
of plastic that was like aturnkey, you turn it on and then
the fluids could be deliveredthrough this balloon on a
consistent basis.
I had a lot of background onpump development, the portable
(10:04):
infusion pump that was developedby Dr.
Ensminger in Michigan.
And then I started working withhome infusion because I knew a
lot about the pumps.
We had developed the firstvolumetric pump with the
(10:26):
research institute.
And so, these pharmacists fromStanford started Stanford Home
Treatment Services and so theywere mixing up the bruise, the
TPN in their garages andstandard wasn't interested in
doing that kind of thing.
(10:49):
I said, well, I can do that.
I know the pump, no problem.
Got to know and work with thevarying newness of pumps as they
came along.
And then I got into homeinfusion doing total parental
(11:09):
nutrition on many of the people.
That's all they were using.
And I suggested that, you know,they could be giving
chemotherapy drugs through thesepumps they could be giving in
infection control.
Jack (11:27):
Antibiotics?
Speaker 2 (11:31):
Yeah.
So, I sit within, and HIV wasjust running wild in San
Francisco and I had people thatjust wouldn't come to work with
me because they didn't want tosee these patients, people with
(11:51):
AIDS.
So I just started, doing 24/7,going to these people's homes.
And one of the things that wouldwould happen is I called it
catheter abuse.
That was– an AIDS patient wouldgo into the hospital and have a
(12:14):
fever and everybody, they alldid.
And infection control, peoplejust wanted to pull the line and
they did.
And oftentimes that was the onlyline we had left.
I had two of my best friendswere getting sicker and sicker.
Jack (12:34):
What kind of lines are you're talking about?
Suzanne (12:35):
These were tunneled catheters supports the Groshar
catheter.
And so I would get really upsetbecause in many cases, that was
also the only line we hadavailable with people with
Kaposi sarcoma everywhere.
Infection control wanted to pullthat line and then we had no
(12:58):
place to put it because of allthe lesions from the Kaposi
sarcoma.
So I had two friends that weredying, but I was ministering to
them, but I was seeing patients24/7 and I ended up in the
critical cardiac unit withsevere chest pain.
(13:23):
I was in San Francisco and Isaid,'Well, I'll stay in the
right hand lane and I'll driveto my internist' who was in
Redwood City/Menlo Park areanear Stanford.
And so I drove down, he did anEKG and his wife took me right
(13:49):
to the hospital.
So my friends, my two friendssaid,'Suze, are you going to die
before us?' I said,'Uh, no.
I, well, yeah, I could.' So, thecardiac cath showed that my
heart was fine, but thecardiologist that they sent me
(14:12):
to said, you just can't do this,you can't be doing 24/7, because
I would be on call and I hiresomeone and get them up to speed
on all the things you needed inhome infusion.
And the next thing I know, I wasat the one nurse's house.
(14:35):
And so she was in the bathroomand she had gotten blood on her
hands and she was going nuts,you know, so she, she left.
And then suddenly else, I hiredher, and then she got pregnant.
She left.
And so I was doing call 24/7like I said, and my cardiologist
(14:57):
said, no, you're not going to,you're not going to do it.
So, I went a disability for like6 months.
I mean, he would not let me.
He said:"Suzanne,, you can't dothis.
You can't keep doing that.' ButI stuck with my friends who had
these lines (15:17):
Gary and Bobby.
Gary said to me,'Suze, you gotto do something about this'
because he had gone to thehospital, he had a fever and
they had pulled his line and wewere using that for pain
control, for morphine and forhis Kaposi Sarcoma.
(15:38):
And I got to his house and I waslivid that they would just pull
the line and have no options forthat.
At the same time, I was doingresearch at MD Anderson in
Houston and they sent me to thehematology meetings and while I
(15:59):
was there, one of the thingsthat was hard to do, you had to
cut down to put a soft, siliconecatheter in.
You couldn't put it reallythrough anything or around
anything.
Anyway, it was this, it lookedlike a fishing pole out of spool
(16:22):
and it fed the catheter.
The catheter was on a wire inthis spool, and then I called it
'the bayonet' would come out ofthis end and you'd, you'd stick
'the bayonet,' 18-gauge, prettylarge slit sided needle and
start turning the round part ofthe, where the catheter was
(16:46):
coiled.
It will go right through andinto the body.
And I said,'Brilliant!' Becausepeople were doing cut downs and
doing and terrible jobs doingcut downs.
Speaker 2 (16:57):
I brought that back to MD Anderson and I said,'Can
we try this?' And so I practicedand practiced and practiced.
Dr.
Frye Reich who was the head ofthe leukemia hematology groups
and looking a lot into AIDS andHIV.
(17:20):
So I said,'Can we try this?' So,I kept practicing on these arms
that they were making.
Jack (17:30):
What year was this?
Roughly.
Suzanne (17:30):
1968, 1970.
So, Dr.
Frye Reich let me put in thefirst line.
And so I did.
And it was very successful.
I put in the, the first PICCline in the United States as a
(17:58):
nurse.
There were docs that would putthem in here and there, but they
didn't, they put in two a year,maybe.
And you needed some skill, youneeded to put in more than just
one.
Jack (18:11):
Funny how that works.
Suzanne (18:12):
Yeah.
So, then I brought them back andwe started using them and then
manufacturers got involved withthem and improved the technique
of not just the polymer itself,but the ways you could put it
through the body without puttingit through this 18-gauge
(18:36):
'bayonet.' And so, I did mydisability and recovered, but
you know, at the same time I wasjust so, so excited about these
catheters.
I stayed in touch with Dr.
Hickman and Dr.
Broviac.
(18:57):
Doctor Swan wanted not just onelumen–, they wanted one or two
or three lumens and they wantedthe balloon and the catheter.
We had to figure out how to doall that.
And I worked with thesewonderful engineers.
So here I am watching this abusetake place.
(19:21):
Like you'd have a patient comehome from the hospital and
they'd say they just got stucklike 5 times, by the same
person, and they never hadanother person that was up to
speed.
So, I did a survey on 370patients and clinicians who put
(19:48):
these lines in and most of theclinicians put lines in like
twice a year.
Again, you got all thesephysicians, they were doing
them.
It didn't really become anursing specialty until I could
kind of prove something.
(20:08):
And so I just saw this abuseover and over and over.
And so I was one of the foundersof the Oncology Nursing Society
and we wrote the firstguidelines for the oncology
nursing group.
We had our, I had thought we hadour protocols down pretty
(20:36):
consistent and so on, but therest of the world didn't have
that.
And so I've wrote a letter, Iwas coming back from an oncology
meeting and again, witnessingall kinds of abuse, people being
stuck way too many times.
And I know what happens.
(20:57):
I was working on my doctorate atthe time.
And I understand that, you know,you just can't keep repeating
sticking someone because theirveins are going to constrict.
They're going to get fearful,they're going to be more, have
morbid fear of an IV beingstarted.
(21:22):
I wrote a letter, I had thisidea if I could get everyone
that was putting these lines andlike in most of the major
hospitals in the San FranciscoBay area and I started, it was
called the Bay Area VascularAccess Committee– BAVAC.
Jack (21:43):
What year?
Suzanne (21:46):
1979.
BAVAC.
Jack (21:51):
This was your idea
This was your idea– to puttogether a group of who?
Suzanne (21:56):
A group of people that were putting in lines and
dealing with...
Jack (22:03):
Nurses?
Doctors?
Who?
Suzanne (22:06):
Nurses, primarily.
Doctors just felt they knew whatthey were doing.
So I wrote this letter, and Istill have it and I wrote down
what I saw as a benefits ofbringing everyone together.
That was a piece of the pie,including manufacturing at the
(22:28):
time because they were comingout with things, but they
weren't listening to the nursesthat were at the bedside.
And the consumers were veryimportant to me that I just
didn't want to see any moreabuse.
And so I wrote this letter and Ishowed what my mission was to
(22:49):
bring everybody that was a pieceof the pie– pharmacists, because
they could change the ph and thefluids that was going in so that
it wouldn't burn the vein sobadly.
And so, that day 15 people camefrom Presbyterian Hospital, St.
(23:13):
Luke's Children's Hospital,Oakland, Stanford, of course.
Ramzy (23:17):
Where did you have it?
Menlo Park?
Suzanne (23:20):
Menlo Park.
That's where I was living.
And so I, I wrote, I was on theairplane and I, I wrote this
idea down and then sent it out.
And the people that said theycouldn't come– they had reasons.
Jack (23:35):
Were the 15 people San Francisco-based?
Or?
Suzanne (23:38):
San Francisco-based.
And so I invited, I wrote theletter to oncology nurses
primarily because then we're theones doing IVs.
Speaker 3 (23:54):
This special episode of ISAVE That Podcast is made
possible by BD.
BD is a global medicaltechnology company that is
advancing the world of health byimproving medical discovery,
diagnostics and the delivery ofcare.
For more information, pleasevisit www.bd.com.
Suzanne (24:13):
So, we met at Presbyterian Hospital and like I
said, 15 people came.
But one of the things that I hadlearned is that if you bring
some food, people will come.
So, I made this great big thingof ziti and said food will be
(24:36):
there available, whatever.
So anyway, we started meeting ona monthly basis and coming up
and changing, I had written downfive of my goals.
I said,'We all have to be on thesame page and our consumers need
to understand that they do nothave to put up with this abuse.'
(24:59):
OK.
So that happened.
And then we named it BAVAN afterthe committee.
The Bay Area Vascular AccessNetwork we called it.
And so it was networkingeveryone that I could get my
(25:21):
hands on to come.
Well the FDA, it was juststarting a central venous
catheter working group.
And when they looked at theirstatistics, they found that the
failure rates were due tohealthcare professionals not
(25:42):
having enough training andteaching and never heard about
it in schools, nursing ormedicine.
But our pharmacists were verywell involved in this kind of
thing.
So, every month I had a goodfriend who was a caterer and she
(26:06):
would make awesome things andpeople would come and eat and
talk.
And so 15 came, then 30, then 35and then 40.
And then I get a call from theperson who's heading up the
central venous catheter workinggroup and had just gone over the
statistics.
And His name was Dr.
(26:28):
Walter Scott.
And he and his nursepractitioner came to San
Francisco to one of ourmeetings.
And then I said, I want to be onthe central venous catheter
working group.
He said,'Well, you know, you cansit in the gallery.' But you
(26:48):
know, I wouldn't have a seat atthe table.
So, I went to Washington and satdown in the gallery and kept
looking at this name tag infront of this chair and it says
'Suzanne Herbst.' So I went,'Holy smokes! I could sit at the
big table with all those bigguys!' Because they were
(27:10):
primarily men.
Jack (27:12):
What year are we?
Just for the timeline sake.
Early 80s?
Suzanne (27:14):
Yes.
Ramzy (27:17):
So BAVAC'79, BAVAN a couple years later.
Suzanne (27:21):
Right.
And then, then I got asked to beon the central venous catheter
working group and I said, youhave to come to some of our
meetings.
I remember wanting to have myversion of the first meeting,
like a convention.
(27:44):
If we had 50 people, that wouldbe wonderful.
But what we did was we hadtables around this ballroom or
this room at the Holiday Inn inSan Francisco.
And I remember writing mypersonal check to cover the
(28:05):
space.
And we had, it was George Cinco,and he had a pediatric catheter
silicone that you could put inthese little kids.
There were Menlo Park, I mean itwas called Menlo something and
(28:33):
they were coming out with somedifferent new, new newness, this
new technology.
I think they spent like$25 tohave the tables.
And so we had like 50 peoplecome that first year and it was
(28:54):
only from 12 p.m.
– we did it in the afternoon– 12to 6 p.m., something like that.
So people getting off at 3 or 4could come.
That was the first meeting,general meeting.
(29:17):
And then, it just kept growingand catching on.
And people would call and say,'could we join?' And it was
southern California, OrangeCounty, Josie Stone, called me
up and said,'We'd like to starta network in our area.' And she
(29:38):
came up to San Francisco and Iremember that the rooms were
shrinking and people weresitting on the floors.
Then it took off from there.
Ramzy (29:51):
So the second network was in Southern California?
Suzanne (29:54):
Yes.
Orange County.
San Diego.
Then one of the doctors from MDAnderson went to Utah, Salt Lake
City, and he started a groupthere.
And so it was like,'OK, now wegotta call it NAVAN– National
(30:16):
Association.
Jack (30:17):
What year was this?
Suzanne (30:19):
It was like'84,'85.
It was amazing because I justfelt that something was
happening, something, somethingthat was really grabbing people
to keep coming and making phonecalls to us.
(30:40):
And so then we called the NAVAN,National Association.
One of the board members on thevery first board, gave me a
globe and I laughed.
International?
I don't think so.
Ramzy (30:55):
Not possible.
Suzanne (30:57):
No, not at all.
No.
We're lucky to be in it as bigas we were getting in
California.
Yeah.
So, we changed it to NAVAN andthen it ultimately got changed
to AVA because it's all over theworld now.
Jack (31:18):
So, let's go back.
So, NAVAN– let's start, soyou're at NAVAN and you went
national, so let's say when itbecame AVA.
Talk a little bit about what youwere doing.
There's a little bit of a bigjump there.
Suzanne (31:35):
I moved back from from San Francisco, back to Syracuse,
New York.
That's where I was born andraised.
I kept hearing about theseinterventional radiologists and
what they were doing and so on.
And so I stayed as President foras long as I could.
Jack (32:01):
What time frame?
What year– the late'80s?
Suzanne (32:04):
Yeah, I think AVA came up in'92,'93, they changed NAVA
to AVA.
Jack (32:12):
And were you involved with that change?
Suzanne (32:15):
Yes.
I just said, one of the things,Jack, that you've heard me say
this many times, but I workedfor an incredible boss.
You know, my license plates read'CEO FOR GOD.' And We actually
had a group of people who wouldpray before these meetings.
(32:36):
Anyway, so I came back toSyracuse and I got a call from
Ken Symington at Crouse Hospitalin Syracuse.
And he wanted to put together aworkshop day about Vascular
(32:58):
Access and explain whatinterventional radiologists had
to offer in terms of imaging andvisualizing.
At that time there was a big warbetween the surgeons and these
interventional radiologists thatwanted to start doing it because
they could see what they weredoing as opposed to blind.
Jack (33:22):
Were they using fluoroscopy at the time, do you
know?
Suzanne (33:24):
No, it was, I'm trying to think of when, because I
worked on that the firstultrasound thing.
But then I went to their suiteand the interventional
radiologist showed me what theycould see and how, you know,
(33:49):
they could, they could actuallytrace the vessel rather than
shoot blindly.
Jack (33:56):
Now, were these an ultrasound?
Or fluoro?
At that time.
Suzanne (34:00):
I don't know.
I was just learning about whatthey could do.
And so I remember that Ken gotme involved with Crouse Hospital
and we would have these meetingsand the CEO would never show up
(34:20):
for these meetings and theystarted at 6 a.m.
So we could plan how, how to notconvert so much as to if the
technology's there, why not usethat rather than have the
surgeon put in two(catheters) ayear?
I remember having that.
(34:41):
Everybody got a folder and myparents stuffed the folders with
information and Ken came over tothe house and my mom and dad
were so helpful.
My mom and dad founded theleukemia society in central New
York after my brother died.
(35:02):
And so they really got involvedmore and more with the leukemia
and lymphoma society.
Jack (35:10):
When did you move back to Syracuse?
Suzanne (35:13):
'91.
So, that's pretty much it unlessyou have some questions for me.
Jack (35:20):
OK– so at this point it was the Association for Vascular
Access.
Ramzy (35:24):
Moved back in'91–'92,'93, it's AVA now.
Suzanne (35:29):
Yes.
Ramzy (35:30):
Which means we're 25 years into being AVA.
Jack (35:34):
And how many, about how many members did you have at
that time?
Suzanne (35:39):
Maybe 250.
Jack (35:42):
Members– almost exclusively nurses?
Suzanne (35:44):
Yes.
And an interventionalradiologists.
Jack (35:47):
OK.
At this point were you'reholding, when did you start
holding annual conferences?
Around then?
In the early 90s?
Suzanne (35:55):
Yeah.
Jack (35:55):
And you would move it around to different cities?
Suzanne (35:59):
No, there was– Marcia Ryder, I hired her, so to speak
as a Director of Education andshe had a lot of background from
Davis Hospital.
I had helped develop the firstports, a lot of the catheters
(36:24):
and such.
And so I knew generally aboutit.
I would give a general overviewof Vascular Access and then she
would go more into the PICClines.
The two of us went from city tocity and it was supported by
Menlo Care.
(36:45):
It was called Menlo Care.
And I'm trying to think of,Dwayne Hardy, he was our first
financial treasurer of theboard, and it was called Menlo
Care.
And they supported it.
They supported us for a while.
But my checkbook getting lowerand lower and lower and lower
(37:08):
because I was ready to take arisk.
And I knew I was doing somethingright because people were just
showing up and making phonecalls and talking to me and I
was talking to them and they didnot work with me somewhere else
and I'd go wherever they wantedme.
Jack (37:33):
What's your impression about how the BAVAC developed
into AVA and how it's related toVascular Access in the United
States today?
Suzanne (37:42):
Well, I think that just from the very, very first
meeting back when we just calledit a committee, that we started
bringing Vascular Access moreinto the real world of
education.
(38:04):
But it still isn't in nursingschools and medical schools and
so on.
And today I think we're gettingthere.
I think that, well you helped somuch with that, Jack.
You made it so real.
I mean, when I first saw some ofyour presentations, I was like,
(38:29):
wow.
Correct me if I'm wrong, but theSonograms are set up so that if
you're right handed, you couldput the Sonogram on the right
side and you have a video whereyou took the bed out, turn it
around in case somebody wanted aleft-side orientation or
(38:55):
whatever.
It was just a riot.
And I went,'Gosh, he's got it.
He has a got it.
He just knows it and he is awarethat there's one way of doing it
and then there's all the others.
That's what your mother wouldsay, right?
Jack (39:18):
Pretty much.
Suzanne (39:19):
Yeah.
For me, I really still getfrustrated when, here's Crouse
that I help set up theinterventional radiologist group
and Ken Symington left and wentto outside of Spokane.
(39:44):
But you know, we just becamereally, really good friends,
before he had moved back.
And when he told me he wasmoving to the northwest, I was
like,'No, you can't do that!'
Jack (39:57):
So how do you feel about the overall state of Vascular
Access today?
Like its recognition, education,where it is compared to where it
started?
Suzanne (40:09):
Oh my goodness.
It's moving.
I think with the boards, TheFoundation, the support that
we're getting more and more thatthe education is coming.
One of the things I also wantedto make sure of is that we all
(40:29):
use the same terminology.
I mean everything was a HickmanCatheter.
But I think we're moving in theright direction.
I've recently over the past yearhave had some very bad
experiences with IVs.
(40:50):
We still have some, a lot ofwork to do and we will do it.
Speaker 1 (41:01):
You have been listening to the oral history of
the Association for VascularAccess as told by its founder,
Suzanne Herbst.
Thank you Suzanne for your timeand your decades of work in
advancing Vascular Access.
And AVA would like to give aspecial thank you to BD for its
sponsorship of this specialepisode of the ISAVE That
Podcast.
AVA members can listen to theentire unedited history of AVA
(41:22):
by going towww.avainfo.org/podcast.
If you have any comments orquestions, you can send them to
podcast@avainfo.org.
Thank you.
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