November 21, 2025 • 57 mins
Sirens fade, charts close, and the questions linger: who cares for the caregivers when the system won’t? We share the life and legacy of Dr. Lorna Breen, a brilliant emergency physician whose dedication collided with an unprecedented crisis. Her story opens the door to a candid conversation about moral injury, burnout, and the quiet barriers that keep clinicians from seeking help when they need it most.
This is a conversation for anyone who’s ever carried the weight of the job home. If you believe better clinician well-being leads to better patient care, you’re in the right place. Listen, share with a colleague, and help shift the culture with us. If this resonates with your soul, follow the show, leave a review, and tell us the one change that would make your workday safer and saner.
Resources:
https://www.mayoclinicproceedings.org/article/S0025-6196(24)00668-2/fulltext
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:43):
Amanda.
Hey oh.
How you doing, girlfriend?
Uh good.
SPEAKER_02 (00:54):
You guys we're in a very silly mood today.
SPEAKER_00 (00:58):
So kind of, yeah, yeah, it's a silly mood.
SPEAKER_02 (01:02):
I know.
SPEAKER_00 (01:03):
It's a Tuesday.
SPEAKER_02 (01:04):
It is.
Yeah, I know.
It's not Mondays anymore.
It's a Tuesday.
SPEAKER_00 (01:10):
Right?
And so hopefully people aregetting the hang of the fact
that we are your Friday entryinto the weekend now.
SPEAKER_02 (01:18):
Yeah.
SPEAKER_00 (01:19):
Fridays are the girls.
SPEAKER_02 (01:20):
They're sending thoughts and prayers during the
week when you don't haveinternet.
SPEAKER_00 (01:28):
It's so weird because like the fact that we're
doing this now, oh, I suppose, Isuppose we're using cell signal,
but I mean, I can download, Ijust can't upload, and I just
never realized that there was adifference between down and up,
but apparently it's a bigdifference, it's a big deal.
So the woods can't handle theups, they can only handle the
downs.
(01:48):
What does that say for my futurehere in the woods?
SPEAKER_02 (01:54):
I don't know.
SPEAKER_00 (01:57):
Yeah.
I'm just kidding.
It's been a wildly positiveexperience.
People here are just so nice.
And if anything, it's so nice tothe point where I'm like, gosh,
was that Minnesota nice thingactually true?
Were they looking at people fromup north because so nice?
SPEAKER_02 (02:16):
Because down in southern Minnesota it's more
passive aggressive.
Yes.
Yeah.
Well, just up north are likegenuinely nice.
They're like, oh my gosh.
SPEAKER_00 (02:26):
Unless they got me all fooled.
Haven't met a person I don'tlike yet.
Yeah.
I love it for me too.
unknown (02:33):
Whoop whoop.
SPEAKER_00 (02:34):
I was just grossing Amanda out.
Maybe I shouldn't bring it upagain.
Because last time we talkedabout ladybug season, it
continues here.
And your girl's somebody who'sused to having a ton of pets,
but all I have are a ton ofladybugs.
And I don't know if I mentionedlast time that I drank one
accidentally and they taste likethey smelled just same.
SPEAKER_02 (02:58):
But she set the scene a little further.
It was like a nightstand glass,you guys.
So she didn't know.
And like in being tired, andthis this like hard shell thing
that's like totally infiltratedthe taste of your water is in
your Yeah.
SPEAKER_00 (03:15):
I mean, it's not like I I I went about it with a
knife and fork, like, come here,come here, lady, lady, come
here.
Mama wants dinner.
No, it was like, you know, yourglass of water by your side of
bed, the side of the bed, and Ireached up and I was like, oh,
this tastes really earthy andsour at the same time.
And I was like, oh, there's alittle bit of crunch.
Too wee.
(03:36):
Yep, out comes a ladybug.
So yeah, they will turtle in mywater glass if I don't cover it
up or use a I've I've learnedobviously to use a thing, but
the funniest part is justAmanda's face.
And I know you're pregnant, andit's probably making it worse.
SPEAKER_02 (03:56):
Well, just like I was telling her, it it feels
worse because the imagery andlike you feel like you can taste
it because you know how theysmell.
Yeah.
So then it's like, oh my god.
And then she's like, Yeah, theytaste how they smell.
SPEAKER_00 (04:10):
I'm like, Well, the northerners keep telling me to
vacuum them, but what good doesthat do?
They're just gonna crawl out ofthe vacuum, you know?
SPEAKER_02 (04:18):
Yeah, I don't know.
I've always heard that aboutspiders that don't bother
vacuuming a spider because itcan just crawl back out.
And I was like, Okay, good toknow.
SPEAKER_00 (04:28):
But imagine all of these ladybugs just like
rattling around in your in yourvacuum chamber.
SPEAKER_02 (04:36):
Um yeah, gross.
I think I know.
So when I lived in WashingtonState, you know the spiders
there are bigger, you know.
SPEAKER_00 (04:44):
Yes.
SPEAKER_02 (04:45):
My roommate and I like there.
We would take a like a candlelighter, you know, like a big,
like a long thing, and a can ofhairspray, and we would just
flame them.
SPEAKER_00 (05:02):
There's something sadistic and lovely about that.
It's like your own fireworkshow, but with like this
pleasure of like, be gone, youbad beast.
I love it.
SPEAKER_02 (05:12):
Yeah, because they're like wicked, right?
Outside of your front door, youopen the door, and there's like
this tarantula-sized gross, itjust doesn't get cold enough
there to kill those things.
SPEAKER_00 (05:23):
Oh, Dave, I don't want to make you mad, girl.
SPEAKER_02 (05:27):
Yeah, I'll torture.
I'm a nice lady.
Yes, you are.
Not to spiders.
SPEAKER_00 (05:35):
Yeah, well, they don't deserve it.
Uh although, do they eatladybugs?
Maybe my solution is to import afew spiders.
No, no importing.
I'd rather drink a ladybug.
Would you here's here's a here'sa question for you.
Would you rather drink a ladybugor have a spider inhabitant and
(05:56):
never have to drink a ladybug inyour life?
And you so every day the spidersare, you have to drink a
ladybug.
SPEAKER_02 (06:04):
Okay, no, I'd rather have one spider.
Are you kidding?
SPEAKER_00 (06:10):
You'd rather have a resident spider.
You're like, fine, I'm callinghim Teddy, so because it sounds
cute.
SPEAKER_02 (06:16):
If it wasn't a drink a ladybug every day, I probably
would have swung to ladybug.
But yeah, no, I'll take aresident spider.
And like, can it please just bea daddy long leg?
Because I'm fine with them.
SPEAKER_00 (06:28):
Oh my gosh, those are the worst.
I when I was like, I don't know,seven or eight years old, I had
this little bratty redheadfriend across the road, same age
as me, and he used to pull thelegs off of daddy long legs and
throw them at me, like put themdown my shirt and stuff.
I mean, it's problematic becausethey would still wiggle when
they weren't attacked.
(06:49):
Ew, and then the body wouldbounce around.
I mean, I'm traumatized.
Oh my god.
SPEAKER_02 (06:53):
So the what is that person grow up to be a serial
killer?
SPEAKER_00 (06:56):
I bet.
I'd need to look him up.
His name was David, he'sredheaded, that's all I know.
Was in Washington.
SPEAKER_02 (07:01):
Yeah, that's very hard to find.
SPEAKER_00 (07:04):
David, if you're out there, that was so rude.
I hope you're doing better,David.
SPEAKER_02 (07:11):
Oh God.
Well, on that note, um there areno corrections from last week.
Oh.
I even had a couple people say,Oh my gosh, did you guys do a
bonus episode?
There were two on Friday, sothey didn't even know we messed
up.
So hey, look at us.
SPEAKER_00 (07:30):
Yeah, you're welcome.
Bonus.
We corrected our mistakes thethird time around.
By we, I mean me.
Yeah, it took me a while to getthat 39er.
SPEAKER_02 (07:39):
Yeah.
Okay, so this week's episode isa little different.
It's not actually true crime.
There's no crime, unless youconsider the workplace, like a
medical workplace, notsupporting mental health as a
crime.
(07:59):
Then I guess we can say it's acrime.
So all of the resources that Iused will be in the show notes.
And the trigger warning issuicide.
Lorna Margaret Breen was born onOctober 9th, 1970, into a family
that blended medicine, service,and quiet ambition.
(08:21):
Her father, Philip Breen, was asurgeon whose surgical training
and career shaped thehousehold's rhythm and
expectations.
Her mother, Rosemary Breen, hadtrained as a nurse and brought
practical caring presents intothe family home.
Lorna was one of severalchildren.
Her siblings included an olderbrother, Michael, who later
(08:42):
became a radiologist, andsisters who pursued creative and
helping professions.
The family moved and lived inseveral places in the
mid-Atlantic, and Lorna spentformative years in Danville,
Pennsylvania, and maintainedties to Charlottesville,
Virginia, where she was born.
These early roots, a householdsteeped in medicine and a family
(09:04):
that valued education andservice, helped form the
contours of the life she wouldbuild.
Okay, from childhood throughcollege, Lorna showed both
intellectual drive and wideinterest.
She graduated from WyomingSeminary, a college preparatory
school, in 1988, then attendedCornell University, where she
(09:24):
completed undergraduate work inmicrobiology and also obtained a
Master of Science in Anatomy.
Those early academicaccomplishments foreshadowed the
dual energies that she wouldlater bring to clinical care and
to system-level thinking abouthow hospitals could serve
patients.
She then pursued medicaltraining at the Medical College
(09:45):
of Virginia, which is nowVirginia Commonwealth University
School of Medicine, completingher MD and continuing into
combined residency training.
Her postgraduate clinicaltraining was a combined
residency in emergency medicineand internal medicine at Long
Island Jewish Medical Center, arigorous program that prepared
(10:06):
her for the chaotic, high-stakesenvironment of hospital
emergency departments.
Absolute smarty pants, McGee.
And someone that's been in thetrenches.
SPEAKER_00 (10:16):
Absolutely, I agree.
SPEAKER_02 (10:18):
What a driven woman.
After residency, Lorna movedinto academic and clinical roles
that married bedside care withleadership.
And honestly, like what betterperson could you ask to be in
leadership to?
Like, they've been in thatclinical space.
(10:38):
They know what it's like on bothsides.
Like, that's the person I wantin leadership.
She became an attendingemergency physician at New York
Presbyterian Hospital, which wasthen Allen Hospital in
Manhattan, serving patients inone of the nation's busiest
emergency departments.
Aww, I love that.
(11:00):
Colleagues described her asdeeply committed to patient
access and communication.
She even took the time to helppatients who spoke limited
English and then took it evenfurther by learning Spanish so
that she could better connectwith them.
Over the years, she addedresponsibilities beyond clinical
shifts by teaching, clinicalprocess improvements, and
(11:21):
administrative leadership.
And in 2008, she assumed therole of director of the
emergency department at thehospital.
And in that position, shecombined frontline emergency
work with departmentstewardship, in addition to
faculty responsibilities, atColumbia University, Irvine
Medical Center, where she servedas an assistant professor of
(11:41):
emergency medicine.
So your girl was busy.
I love her.
SPEAKER_00 (11:45):
I mean, can you imagine having dinner with her?
She'd be an amazing friend.
SPEAKER_02 (11:50):
She's a busy woman.
So not only was Lorna anenergetic and intense clinician,
she also played the cello andcommunity groups, went salsa
dancing, hosted gatherings forfriends, and pursued continuing
education and leadership byenrolling in executive programs
aimed at healthcare leadership.
(12:10):
Her CV reflected scholarlycontributions on practical
topics, for instance, addressingthe needs of patients who do not
speak English and practicalemergency medicine pathways.
Those facets of her personality,a drive to learn, to connect, to
lead, and to perform at a highlevel were strengths and
ordinary times, but would becomestress points when extraordinary
(12:33):
crisis arrived.
In early 2020, New York Citybecame one of the first and most
intense epicenters of the novelcoronavirus outbreak in the
United States.
Hospitals filled with patientswho had rapidly progressive
respiratory failure.
Emergency physicians andhospital staff faced crushing
patient volumes, shortages ofpersonal protective equipment,
(12:55):
and the daily trauma of watchingpreviously healthy people
succumb to a disease thatclinicians at the time did not
fully understand.
SPEAKER_00 (13:03):
I can't imagine.
Can you imagine how devastatingthat was?
And we didn't know if or when itwould end and how many would
die.
SPEAKER_02 (13:12):
Yeah.
As an emergency departmentdirector at the Allen Hospital,
Lorna was at the center of thestorm.
She worked long, exhaustingshifts treating patients with
COVID-19 simultaneously, tryingto figure out staffing,
preserving supplies, andshielding her team as best as
she could.
It was, yeah, unprecedented,scary, horrible.
(13:35):
Can't believe that was over fiveyears ago.
Like many clinicians on thefront lines, Lorna contracted
COVID-19 in March 2020.
After becoming ill, she wasisolated and then returned to
work after a period of recovery,which was a choice that many
clinicians made, driven by theduty and the shortage of
personnel.
The virus had not only infectedher body, the experiences of the
(13:59):
months that followed exposedclinicians to repeated scenes of
death, loss, and moral distress,feeling the inability to save
patients who, in otherconditions, would have had a
fighting chance.
Families were barred frombedside goodbyes, and clinicians
felt the relentless pressure totriage with limited resources.
The combination of physicalillness, extreme workload,
(14:21):
social isolation from the nationthat was, at the time, as we
know, largely locked down, andthe large moral injury of
watching so much human sufferingdemanded a heavy toll on many
healthcare workers.
For Lorna, those pressuresdeepened into despair.
By early April, colleagues andfriends were aware that she was
(14:42):
struggling.
Text messages and calls capturedfleeting pleas and alarming
admissions that were out ofcharacter for someone so readily
steady.
A friend asked her how she wascoping, and according to
contemporary reporting, Lornareplied, quote, I'm doing
better, but dealing with thedevastation in the ER,
struggling a bit, end quote.
(15:04):
She had trouble sleeping.
Insomnia was unusual for her.
On April 9th, when she calledher sister, Jennifer Feist,
Lorna said, quote, This is theend of my career.
I can't keep up, and reportedlymade remarks about wanting to
die.
Words her sister would later saywere so out of character, they
felt like someone speaking intongues.
(15:26):
Those early signals of extremedistress unfolded against the
background of a health systemwhose administrative responses
varied, and in which clinicianssometimes feared career
repercussions for seeking mentalhealth help.
And with that somber note, we'llhead into our chart note.
(15:49):
Sad chart note.
SPEAKER_00 (15:51):
Sad chart note.
SPEAKER_02 (15:53):
Um, welcome to the chart note segment where we
learn about what's happening inmedicine and healthcare.
I really wanted to actually lookinto like clinicians and other
physical anyone like what doesthis look like for them?
Have they done any studies onmental health, health, and like
what are we doing now?
Because obviously COVID was anunprecedented time, but I'm sure
(16:16):
this has like kind of waxed andwaned in severity throughout the
decades anyway.
So, like, absolutely, what arewe doing?
Are we making improvements?
Where are we?
So that's what I did.
SPEAKER_01 (16:28):
Cool.
SPEAKER_02 (16:28):
So over the past decade, physician burnout in the
United States has been a growingconcern, capturing the attention
of both the medical communityand the public.
A recent study published in MayoClinic Proceedings by Shanafeld
and colleagues examined howburnout and satisfaction with
work-life integration hasevolved among U.S.
physicians between 2011 and2023, offering a rare long-term
(16:54):
view of the critical issue.
The study surveyed more than7,600 physicians between October
2023 and March 2024 usingvalidated instruments consistent
with earlier surveys conductedin 2011, 2014, 2017, 2020, and
2021.
(17:15):
By comparing physician responsesto a probability-based sample of
the general U.S.
working population, theresearchers sought to understand
not only how burnout has changedover time, but also how the
physician experience compareswith the broader workforce.
The results tell a nuancedstory.
In 2023, 45.2% of physiciansreported at least one symptom of
(17:40):
burnout, defined as emotionalexhaustion or depersonalization.
While this represents asubstantial drop from the peak
of 62.8% observed in 2021 duringthe height of the COVID-19
pandemic, it is strikinglysimilar to levels reported in
2011 and 2017.
This suggests that while theacute pressures of the pandemic
(18:04):
have eased, physician burnoutremains deeply embedded in the
profession.
Compared with other U.S.
workers, physicians are stillnearly twice as likely to
experience burnout, highlightingthat the stresses of medical
practice go beyond the generalworkforce pressures.
Work-life integration, a measureof how well physicians feel
(18:25):
their profession and personallives fit together, has shown
some improvement.
In 2023, 42.2% of physiciansreported being satisfied with
their work-life balance, up froma low of 30.3% in 2021.
Yet even with this improvement,satisfaction has not returned to
levels seen in earlier years,and physicians remain
(18:48):
significantly less satisfiedthan other workers.
The picture is one of slowrecovery rather than a complete
return to normal.
So then I was like, okay, well,what are the reasons?
So digging deeper, the study andprior-related research
illuminate the underlyingfactors driving these persistent
challenges.
(19:09):
Physicians themselves haverepeatedly identified
administrative and clericalburdens as major contributors to
burnout, particularly thetime-consuming demands of
electronic health records.
While intended to streamlinecare, EHRs have added hours of
data entry, inbox management,and documentation work that
pulls physicians away fromdirect patient care.
(19:32):
Beyond technology, many doctorscite a loss of professional
autonomy, constrained byinsurance requirements, prior
authorizations, and complexregulatory rules that limit
their clinical decision making.
The pandemic added furtherpressures, including long hours,
emotional strain from criticallyill patients, staffing
(19:53):
shortages, and moral distress.
These cumulative factorsunderscore that burnout is
rarely about personal weaknessor resilience.
I can't believe that was even athought.
SPEAKER_00 (20:23):
Hello, bean counters.
Listen up.
SPEAKER_02 (20:27):
The study's findings emphasize that physician burnout
is not a temporary phenomenoncaused solely by the
extraordinary events like thepandemic.
It is a persistent challengereflecting systemic realities,
long hours, heavy administrativeburdens, high-stakes decision
making, and the tension betweenprofessional duties and personal
life.
While individual strategies suchas resilience training, wellness
(20:50):
programs, and self-care remainimportant, this research
highlights the meaningfulsolutions that will require
system-level changes instaffing, workflow,
administrative supports, and theoverall organization of
healthcare delivery.
SPEAKER_00 (21:05):
Jumping up a data nature.
Thank you.
Thank you.
Thank you.
Thank you so much forhighlighting this.
Honestly, because I'm not oneto, you know, poo-poo resilience
training and wellness, but itfalls flat in the face of system
level insufficiencies that needto change.
SPEAKER_02 (21:26):
So it feels like the pizza party when times are
tough.
SPEAKER_00 (21:30):
Yes.
Exactly.
It needs to be an overhaul.
And I don't know what the answeris, but maybe you'll guide us
there.
SPEAKER_02 (21:39):
Maybe we'll have some hope shed on us later.
But lastly, in essence, thisstudy provides a sobering but
hopeful perspective.
Burnout is not disappearing, butthe gradual improvement since
the pandemic suggests thattargeted interventions, both
individual and systemic, canmake a meaningful difference.
And these findings are areminder that caring for those
(22:00):
who care for others is notoptional.
It is essential.
Physicians' voices make itclear, unless the structures
that drive burnout areaddressed, the risks to their
well-being and to patient carewill persist.
SPEAKER_00 (22:13):
It's so true.
And there is evidence-basedscientific research that shows
that in healthcare, and probablyother it probably translates to
other fields as well.
But specifically, this was donein healthcare.
That employee satisfactionsatisfaction was directly linked
(22:36):
to patient outcomes, improvedpatient outcomes.
So really the focus should be onemployee satisfaction and how
can we take away some of theburden that is so clearly taking
away from you know work-lifebalance.
You can do yoga, you can do allthis other stuff and feel like
your organization appreciatesyou, but if you're the only one,
(22:58):
you know, you're there untileight o'clock at night and you
missed your kids' soccerpractice and all this other
stuff, it's not gonna help.
So we need And guess what?
Then you don't have time to goto the yoga anyway.
Right.
So I love that the focus shouldbe on fostering wellness with
the providers so that they canthen do their job and the
(23:24):
outcomes will be better withpatients.
And science and research haveshown that higher levels of
employee satisfaction lead tobetter outcomes, better
compliance with treatment plans,and the whole bit.
So I think the problem it mightbe a little bit bigger than this
because I feel like healthcareorganizations are still focused
(23:47):
on quantity over quality becauseof shrinking reimbursements.
So we have to figure who'srunning the show, and that's
bigger than me.
But yeah, you really highlightedan interesting and important
issue in healthcare.
That until we find a solution,it's gonna continue and probably
(24:08):
worsen again.
SPEAKER_02 (24:09):
So yeah, yeah, yeah.
There was a term thrown out alot previous workplace, but not
only just burnout, right?
But compassion fatigue.
And that's where that comes intoplay of like if everyone's doing
well at work, the betteroutcomes, right?
If you have compassion fatigueand like nobody can get into the
(24:29):
clinic, and then that's all youhear about for the first 15
minutes of a 30-minuteappointment, and like you need
to hear the person outrightbecause they're the human in
front of you, but also you'relike, I've got five people
waiting for me in the lobby, andit just it's a lot, it's a lot.
SPEAKER_00 (24:46):
Yeah, it is.
It's um, but the correlation isstrong.
You treat your employees well,you're gonna get better patient
outcomes.
Um, and I think the focus needsto go back to that as opposed to
metrics which look at quantity,you know, productivity over
actually the quality of care.
And the quality of care isdirectly correlated to how the
(25:08):
employees are being treated.
How much time do you have with apatient?
What are the expectations?
What is the administrativeburden?
Are you expected to how muchtime are you expected to to deal
with these prior authorizationsand all of this insurance
craziness that's required ofproviders?
(25:28):
So I mean there's a lot thatthere's no one single villain,
but you know, our whole systemneeds to change.
It really does.
So thank you for highlighting.
SPEAKER_02 (25:39):
Agreed.
On October 26, 2020, I forgot tosay back to the story.
Obviously, we're back to thestory.
On October 26, 2020, while on afamily trip in Charlottesville,
Virginia, Lorna tragically diedby suicide.
(25:59):
The news reverberated acrosshospital corridors, academic
departments, and the broaderpublic.
Her father, Philip, toldreporters that his daughter had
been, quote, truly in thetrenches of the front line, and
that she tried to do her job andit killed her, end quote.
Those blunt words captured agrief that mingled pride for a
(26:23):
life of service with a profoundsense of loss and a demand for
reflection.
How had a caring, competentphysician who absolutely loved
her work reached a point whereshe felt she had no way out?
In the immediate aftermath,colleagues and family sought to
understand what happened and topush for changes that might
(26:44):
prevent similar tragedies.
The family took care toemphasize that doctors, like any
other people, can beoverwhelmed, and that the
medical profession's licensingand credentialing systems
sometimes discourage cliniciansfrom seeking mental health care.
As her family and friends shareddetails and advocates raised
alarms, the story becamesymbolic.
(27:06):
It was not only about oneperson's heartbreak about
structural issues that madeclinicians vulnerable, stigma
about mental health, reportingrequirements that can jeopardize
medical licenses if physiciansdisclose psychiatric care, the
relentless schedules andcultural expectations in
medicine to appear infallible,and the scarcity of system level
(27:29):
supports in crisis conditions.
To honor Lorna's memory and toaddress those systemic problems,
her family and supporterscreated the Dr.
Lorna Breen's Heroes Fund, anallied efforts to destigmatize
mental health care forclinicians, expand wellness
(27:49):
resources, and changeinstitutional policies that
inadvertently punish careseeking.
The foundation and alliedadvocacies linked personal grief
to public action, fundingresearch and programs, educating
health system leaders, andadvocating for policy changes
that would lower barriers tocare.
(28:11):
The narrative that emergedcombined intimate family
testimony with policyprescriptions, both emotional
reckoning and practical reform.
The advocacy that followedLorna's death led to one
concrete legislative outcome,the Dr.
Lorna Breen Health Care ProviderProtection Act, which was
(28:32):
introduced in Congress andsigned into law on March 18,
2022, two years after herpassing.
The statute authorized federalgrants, research initiatives,
and training programs aimed atsupporting mental and behavioral
health among healthcareproviders, with a particular
focus on preventing burnout andsuicide.
(28:54):
This included funding to medicalschools, health systems, and
community organizations to buildresilience programs and study
clinician well-being.
These efforts were modest inscale compared with the
magnitude of the pandemic, butthe law's symbolic weight was
considerable.
It signaled a national, nope.
(29:14):
It signaled a nationalacknowledgement that protecting
the mental health of those onthe front lines is a matter of
public interest.
Professional organizations,including the American Medical
Association and EmergencyMedicine Societies, praised that
the act was a meaningful stepforward in a medical culture
that encourages care seekingwithout career repercussions and
(29:36):
builds systems that preventclinician burnout from becoming
a fatal outcome.
Reporting and commentary in themonths and years after Lorna's
death placed the national lawand the family's foundation into
context.
Profiles of Lorna emphasize bothher professional excellence and
the overload she faced duringNew York's first viral surge.
(29:56):
A long New York Times featureand subsequent profiles and
outlets such as Vanity Fair andTime painted a portrait of a
high-achieving, warm and drivenwoman suddenly bruised by an
event no single clinician couldhave prevented.
A pandemic that wreckedexpectations about what medicine
could do.
The Times piece recordedcolleagues and friends' memories
(30:18):
and quotes that crystallized thestrain.
Quote, I couldn't help anyone, Icouldn't do anything, quote.
Or end quote.
A phrase reported to reflect theclinical helplessness that she
felt during treating thepatients during that pandemic,
whose outcomes were grim despiteheroic efforts.
(30:39):
Which is just so sad.
Those words, stark and humane,helped the public understand the
kind of moral injury manyhealthcare workers experienced.
The aftermath also promptedintrospection within medical
culture.
Professional societies, hospitalsystems, and academic centers
(31:00):
began to examine credentialingquestions, which sometimes
require clinicians to disclosemental health treatment, to
expand confidential counselingand peer support programs, and
also to reframe wellness from anindividual moral obligation into
an organizationalresponsibility.
Amen.
Yep.
Hello, amen.
(31:21):
Many institutions started toinvest in programs envisioned by
the Breen's family's advocacy totrain leaders to recognize
distress.
Amen.
Create crisis response teams,and offer evidence-based mental
health services designed withclinician confidentiality in
mind.
The Dr.
Lorna Breen Health Care ProviderProtection Act created federal
(31:45):
support to scale such efforts,and the foundation organized
grants, education, and publicawareness campaigns to reduce
the stigma to save lives.
Lorna's death revealed painfulcontradictions.
She was, by many accounts, adoctor who loved her work and
who sought to help patients,yet, the very system in which
(32:06):
she was celebrated alsoconstrained the help that she
couldn't obtain.
As her father said, and manycommentators agreed, she had
been a casualty of the pandemicin a sense that extended beyond
viral infection.
The human toll included mentalhealth aftermath.
Family members did not wantLorna's name to be the only
(32:27):
headline of a tragedy.
They wanted her story to becomea spur to make medicine safer
for caregivers, to changelicensing and credentialing
reporting rules, and deterclinicians from seeking help,
and to institutionalize supportsthat the next generation of
clinicians would be less likelyto suffer similarly.
(32:50):
Lorna's story remains a taleabout the limits of a hero
rhetoric when applied tohealthcare workers.
Calling clinicians heroespublicly can obscure structural
avoidance of responsibility.
Heroism suggests individualfortitude rather than the
obligation of institutions andgovernments to provide safe
(33:11):
working conditions, adequatestaffing, and mental health
resources.
The family's advocacy and thelaw bearing her name attempt to
shift the focus from individualsacrifice to systemic
protection.
As one former colleague put itin public reflections, I know
how much good came from Lorna'slife.
Now I hope some good can comefrom her death.
(33:35):
And those are the hopes thatmotivated the foundation, the
advocacy, and the congressionalresponse.
In telling Lorna's story, it isimportant to avoid reductive
narratives that make her deathonly an instrument for policy.
She was, by every account, byfamily and friends, an engaged
physician, a musician, a friend,and a sister who provides a
(33:58):
person who loved both her workand a life full of small joys,
such as music, dancing, partieson rooftops, and community.
The contours of her life makethe tragedy feel more acute.
Someone with so much energy anda love for life reaching a point
of unbearable despair.
(34:33):
And the institutional barriersfrom punitive license
questioning, the culturalexpectation that clinicians
somehow must withstand everytrauma quietly is corrosive.
And the institutional barriersfrom punitive licensing
questions to inadequate sourcesof confidential help must be
addressed systematically.
If Lorna's name promptsadministrators to revise
(34:56):
policies, supervisors to checkon exhausted staff, and fellow
clinicians to reach out honestlyto one another, then from that
grief, something practical andhumane has emerged.
SPEAKER_00 (35:08):
Oh, I have goosebumps.
Amen.
Thank you so much.
Well done.
Well done for bringing this up.
Thank you.
Oh my gosh, I have so manythoughts.
Okay.
More recently, the what youtalked when you talked about the
hero rhetoric as applied tohealthcare workers, and how that
(35:30):
really shifts the responsibilityof the organization to look,
this person was able to go aboveand beyond.
Yay, well done, in spite of ourinability to support them.
We need to normalize mentalhealth.
And honestly, I feel like itshould be at the point where
someone in a position likeLorna, where she's in the
(35:56):
trenches and she's seeing all ofthis day in and day out.
And maybe even all healthcareproviders, but certainly those
in the emergency room, those inhealthcare themselves, should be
offered a mental healthprofessional.
Just as part of like, this isyour mental health professional.
You'll be meeting with so-and-soonce a week.
(36:18):
Full disclosure, I've had amental health care professional
for 10 years.
And I asked her, because I can'timagine my life without her.
And I asked her, Do you have amental health care professional?
Because how do you maintain yourresilience and all these
catchphrases that you'll hearorganizations say, oh, wellness
(36:39):
and you need to walk more anddrink lots of water and
resilience, you know, do someyoga and think positive
thoughts.
No, actually, the onus is on theorganization to create a culture
where it's okay, where it'sactually fostered and
recommended, and it's difficultnot to seek mental health
(37:00):
because that's just as importantas physical exercise.
So especially when hello,especially when your job is, you
know, determining life and deathsituations like Lorna, I can't
even imagine.
I mean, I'm an audiologist, andI don't do life and death stuff,
but you know, I'm a person, Iface burnout, I face situations
(37:25):
where I think I can't meet apatient's need.
And and good clinicians, goodgood providers are are tortured
by that.
We lay awake at night going,what could I have done better
for this person?
How could I have helped more?
Or just the fact that the theirstories are resonating with you
(37:45):
and you're empathizing.
So empaths and good cliniciansalike, we're all in it to help.
And helping professions meanyou're vulnerable to mental
health distress.
So why is this not actuallyrequired?
I'm gonna pull it even a furtherstep, not just recommended.
Why aren't people required?
(38:08):
Like part of a benefits package,yeah.
SPEAKER_02 (38:11):
Like when you work this is something, a part of
your benefit.
You get access to this mentalhealth professional.
If you don't want to use it,fine.
But if you want to, yeah, andthen you have a dedicated time
set aside in your schedule touse it.
Exactly.
SPEAKER_00 (38:27):
So there's next problem.
The next problem is when thehell am I supposed to meet this
person?
Listen, we're gonna cover thetelehealth.
Her name is Jamie Smith.
If you don't like her, there's awhole other if you are if you
don't click with her, there's awhole other, you know, consort
of uh behavioral healthprofessionals in the wings.
(38:48):
But you know, we we think Jamiewould be good for you.
We want you to meet with heronce a week because everybody
meets with a behavioralprofessional for resilience and
healthcare once a week.
Screw I'm sorry, but screw thecherry yoga and the sunrise
stretches and all this stuff.
Yes, that's important.
But can we actually normalizemental health help?
SPEAKER_02 (39:13):
Can we actually address the source here, the
roots, and not just cover itwith a pizza party and I mean I
love a pizza party, don't get mewrong.
No, but yeah, but this wholeresilient-water and yeah and and
do this there.
It's like I can't drink water atwork because I don't have time
to go to the bathroom.
Yeah.
SPEAKER_00 (39:33):
But also, it's like, well, you know, you are your
work-life balance, you need toprioritize this, you need to go
for walks, you need to sendgratitude notes.
I mean, all that stuff, don'tget me wrong, it's great and
it's enriching and it and itcontributes to quality of life
if you can, if you have thetime.
But it's putting the onusonitiate its place.
It's it's putting the onus onthe employee.
(39:55):
It's not actually uh to me, it'sa cop-out from these
organizations.
Like, oh, you're burned out.
Well, you know, you're nottaking enough time for you.
Go for and do that.
Although we're not allowing youto with our schedule.
You will do it on your own.
We're not acknowledging it'skeeping you up at night, which
is your stress and your you, youknow, uh not enough time and too
(40:16):
many patients, too manyproblems, not enough tools to
get there a high, a too highadministrative burden.
Like, let's let's give somethingthat actually has a long-lasting
effect, which would be mentalhealth care.
Not to mention, you know, ascribe and some other solutions
that might help reduceadministrative burdens, but
(40:38):
first and foremost, mentalhealth.
Mental health is to me almostmore important than physical
like exercise.
And that might get me likethrown under a bus somewhere,
but I can think of a certainexercise physiologist named Joe
at meal that would have my havemy he'd have something to say
(40:58):
about this.
Sorry, Chip.
But like if you're mentally nothealthy, you're not ready for
exercise.
You're not ready for any of theother things because all you're
doing is further exacerbatingthe issue, then.
Yeah.
SPEAKER_02 (41:11):
If you're pushing yourself to work out physically
while you're already mentallyexhausted, that's not okay.
Okay, like obviously anyphysical movement is good for
you, but yeah, I don't know.
I'm on the same boat, the samechoir as you right now.
SPEAKER_00 (41:25):
Yeah, I I I obviously feel very passionately
about this, which I didn'trealize until you brought this
up, but it's like, yeah, I mean,I'm so sick of being fed the
whole for the record.
Huh.
Sorry, keep going.
I'm sick of being fed the whole.
Well, the onus is on you to beresilient.
If you would just do yoga andyou would just like shut up and
(41:47):
have some gratitude, you'll befine.
Yeah.
SPEAKER_02 (41:52):
Yeah.
I and I was just gonna say, forthe record, in case this will
help break any sort of stigmathat's still out there.
I also have a mental healthprofessional and I love meeting
with her.
SPEAKER_00 (42:02):
Well, yes.
I mean, when we were like mytherapist could beat up your.
It's not a bad thing.
Not at all.
But like, I've brought friendsinto my therapist, and we've had
dance parties, and like I can'timagine life without her.
Even you don't have to be incrisis to have someone that you
meet with that helps kind offrame your thoughts to make sure
(42:25):
that you're you know, you're onthe right track, you're on the
track to be the best you thatyou can be, and that's all that
is.
And and families and you don'thave to meet weekly.
If things are going good, great.
Meet quarterly exactly bymonthly.
There's something to be said forsomeone who's trained in
psychology and counseling, whois not your friend, who can
(42:48):
really give you that objectiveview of whether or not your
thought process is, you know,what's the word?
Not normal, but like makessense.
SPEAKER_02 (43:02):
So like are you on track, not like thinking with
emotion?
Right.
SPEAKER_00 (43:06):
Well, that's not what I wanted to say.
I I would say to make sure thatyou have the coping skill.
I will to make sure that youhave the coping skills for what
life is throwing at you, youknow?
Yes, yeah, and if you don't, howdo you get there?
And so that's important foreverybody, regardless.
SPEAKER_02 (43:25):
And I probably could have benefited from a mental
health professional many, manymoons before I got one, but I
will say that I first got onebecause of the burnout I was
having at work.
SPEAKER_00 (43:41):
So I know I might just use her for everything in
my life, so I love that for you.
And I keep telling mine, like,if you go anywhere, I'm gonna
follow.
She probably thinks I'm astalker.
I will follow.
I will follow.
But you know what is also good?
Not just for mental health, butfor well-being.
(44:06):
Tell me.
Cookies.
SPEAKER_02 (44:09):
I was gonna say, is it our new sponsor?
You found a cookie sponsor.
I love that.
I know, and you guys, you haveto go to this website and look
at these cookies.
They look outrageously good.
Let me tell you.
And let me a good cookie.
So our newest sponsor is MollyB's, and that's a B Z, but it is
(44:34):
pronounced B like Bubble B.
So Molly Bees Gourmet Cookies.
So they're available atMollyB's.com.
They bring bold, artistic, smallbatch craft cookies straight to
your pantry.
They are known for melting yourmouth texture.
(44:55):
I mean, what more could you wantin a cookie?
High quality ingredients andincentive flavor combinations.
Each cookie delivers layeredtextures and surprising,
indulgent tastes.
Fans rave about standouts likethe tea cookies, smooth lavender
goodness and white chocolate,and delectable lemon glaze.
(45:20):
And B cordials, which is aperfect blend of chocolate and
cherry, calling every bite anadventure.
Founded by Molly, a single momfrom Alaska, the brand has
become a national sensation injust three years, earning
features on the Food Network,Martha Stewart Living, and even
the Grammy Awards.
Wow.
(45:40):
Signature creations like BeCordial, Milk Chocolate,
Marciano Cherries, Amaretto, BigJoe, Baba Doodles, which is
Snicker Doodles with the Boboa,Boboa pearls, Hot Mess, which is
mango, white chocolate, and hotCheetos.
SPEAKER_00 (46:02):
Oh my god.
SPEAKER_02 (46:04):
P.
Nicoladas, which is whitechocolate, coconut and fruity
pebbles.
Royally Awesome, which is whiteand milk chocolate, coconut,
macadamia nuts, and spiced rum.
Straight fire, which ismarshmallows, chocolate,
cinnamon, cereal, and cinnamonwhiskey.
(46:25):
The Boss Man, which is maplesyrup, bacon whiskey, and white
chocolate.
And the tea, which is Earl GreyTea, Lavender, White Chocolate,
and Lemon Frosting.
So again, you guys have to go tothis website, look at them.
Oh my god, they look amazing.
They're perfect for gifting orindulging yourself.
(46:45):
Molly Bees Cookies bring gourmetartesian crafted delight home
with no bakery trip required.
Find them at Mollybees.com.
That's M-O-L-L-Y-B-Z.com andenjoy 10% off with our code stay
suspicious.
I will share that when you go totheir website, you'll see, oh my
(47:07):
god, they already offer 10%.
Yeah, but you have to put inyour email to sign up to get
10%.
So if you use our code staysuspicious, it won't fill up
your inbox.
SPEAKER_00 (47:17):
There we go.
You're welcome.
There we go.
Oh my gosh.
And I will also say, I thinkthat Molly B Z would add to
resilience.
I am ready.
So, you know, get some.
Get a whole box of those andbring those to work.
(47:39):
Everyone's gonna love you andyou're gonna feel great.
And like, what's some wildflavors that you wouldn't
expect?
And they're probably really goodbecause it sounds so weird.
Like, obviously, they're notgonna sell the mango, white
chocolate, and hot Cheetos.
I know I'm like cooking hotCheetos and Cookie.
Molly B is.
I'm thinking I want to try that.
I really do.
(48:00):
I'm gonna order some and try it,and we'll I'll tell our
listeners what the verdict is.
But is it time for our medicalmishap?
It is time.
Is shall I read it?
SPEAKER_02 (48:16):
Sure.
I mean, yeah.
Okay.
I started to derail towards theend of mine, so the listeners
would probably appreciate somefresh eyeballs on the screen.
SPEAKER_00 (48:26):
No, you did great.
You did great.
But so the subject of this emailis the albuterol incident that
still keeps me up sometimes.
Uh-oh.
It says, Hi Jenna and Amanda.
I've never written into apodcast before, but this one has
stayed with me for years, and Ithink my fellow Alley cats will
understand why.
(48:47):
I'm an emergency departmentnurse.
Bless your heart.
And even though nothing tragichappened, exactly, the what if
still catches in my throatsometimes.
Here we're here this is what wewere just talking about.
How people who are really goodproviders uh you don't clock
out.
You know, you go home and youagonize over what could be, what
(49:10):
if, what if not, what can I do.
Anyway.
So she writes, or he writes, itwas a slammed weekend shift.
There were no open beds, hallwaypatients, everything from chest
pain to broken wrists rollingin.
I was caring for a patient whocame in with an asthma
exacerbation.
The patient was in their mid-30sand they were scared, but they
(49:32):
were stable enough.
So the provider orderedback-to-back nebulizer
treatments to get ahead of it.
Respiratory therapy departmentwas tied up with a trauma in
another room, so I grabbed anebulizer and set it up myself.
It's something I've done athousand times.
I opened the drawer labeled nebmeds, tore open a packet, drew
(49:53):
it up, popped it in the nebchamber, and got the treatment
running.
So, for those of you who aren'tin the know, it's like really
quick acting way of providingthe same stuff that's in an
inhaler, but in a in anebulizer, which means that
they're in the medication isbeing physically blown into the
(50:16):
patient's face through a mask ina chamber that's mixed with
water.
So and usually it involves somesteroids too to help with the
inflammation.
So she tore open a pac or he shtore open a packet, drew it up,
popped it into the neb chamber,and got the treatment running.
Five minutes in, the patientlooked wrong.
(50:38):
Not just anxious, but panicked.
His heart was pounding so hardand his that I could see his
gown moving with everyheartbeat.
He kept trying to sit up andsaying he felt like his chest
was going to jump out of hisbody.
Oh no.
I checked the monitor.
His heart rate was 208.
(50:58):
So I said crap.
I stopped the treatmentimmediately.
I called the provider, calledrespiratory therapy, we put him
on oxygen, started an EKG, andgot an IV access in case we
needed to intervene.
He was shaking so violently hecould barely hold still.
The respiratory therapistarrived, grabbed the nebulizer
(51:20):
cup, looked at me, and saidquietly, This isn't albuterol.
It was racemic epinephrine,which came in the same
packaging, the same drawer, andidentical little vials.
But in the shuffle of the day,someone had restocked the drawer
wrongly.
And if I hadn't double-checkedbecause I'd done it a thousand
(51:43):
times.
The provider stayed calm,managed the reaction, and the
patient stabilized.
His asthma actually improvedbecause, well, racemic
epinephrine will absolutely dothat because the faster your
heart beats, the more your lungmuscles relax.
But the cardiac side effectswere no joke.
(52:03):
It could have gone sideways,very sideways.
Afterwards, I sat in the breakroom shaking.
No one yelled at me, no oneblamed me.
Leadership reviewed the stockingissue, but I knew that if that
patient had been older orfragile in their heart, or if we
hadn't caught it as fast as wedid, who knows what would have
(52:25):
happened.
So that part of me still hits mewhen he's the patient said when
he left, I could tell you cared.
That's why I wasn't scared thewhole time.
He didn't know what happened,but he didn't need to.
All he knew was that the teamtook care of him.
But I drove home that night,replaying every moment, every
(52:47):
instinct, and every missed clue.
I still check every vial twice,even when I'm moving quickly,
even when the label is obvious,and even when I think I already
know.
Because that patient taught methat, and those thorough checks
will never leave me.
Signed an ED nurse who learnedthe hard way that familiarity
(53:09):
can be dangerous.
Oh, listen, you did Yeah, we allmake mistakes.
We all would have felt a victimto that same scenario.
Absolutely, and the fact thatyou are using this as a
learning, you'll never do thatagain.
And also you'll probably preventother people from doing that
(53:30):
because of your the lesson thatyou learned and the fact that
you care so much.
So thank you for writing thatin.
SPEAKER_02 (53:36):
And that you're sharing it, yeah.
SPEAKER_00 (53:38):
Yeah, thank you.
SPEAKER_02 (53:39):
And seriously, what a perfect medical mishap to have
at the end of this episode whenwe're talking about how our like
brains, when we care, they don'tshut off.
SPEAKER_00 (53:51):
Absolutely.
SPEAKER_02 (53:53):
So, Jenna, what can we expect to hear next week?
SPEAKER_00 (54:02):
I haven't decided.
I torn in a couple differentdirections.
I I'm kind of into the old timeyworld right now.
So we did like the what I didwas the kind of the origins of
this what we now know assurgical consent.
And so then it started melooking at old-timey stuff and
(54:25):
mental health institutions andused to call sanatoriums and
insane asylums and lobotomies.
So I I have a feeling it's gonnabe old timey.
I like it.
But yeah, listen, you'll have totune in for it to get it, you
know, the actual subject becauseI don't know yet.
(54:54):
But meanwhile, don't miss abeat.
Subscribe or follow Doctoringthe Truth wherever you enjoy
your podcast for stories thatshock, intrigue, and educate.
Trust, after all, is a delicatething.
You can text us directly on ourwebsite at Doctoringthe Truth at
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(55:15):
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(55:37):
Please rate and review so we canbring you more content next
week.
And until then, stay safe andstay suspicious.
Please stay suspicious.
Suspicious.
Bye.
Okay, goodbye.
Amanda.
Hey oh.
How you doing, girlfriend?
Uh good.
SPEAKER_02 (00:54):
You guys we're in a very silly mood today.
SPEAKER_00 (00:58):
So kind of, yeah, yeah, it's a silly mood.
SPEAKER_02 (01:02):
I know.
SPEAKER_00 (01:03):
It's a Tuesday.
SPEAKER_02 (01:04):
It is.
Yeah, I know.
It's not Mondays anymore.
It's a Tuesday.
SPEAKER_00 (01:10):
Right?
And so hopefully people aregetting the hang of the fact
that we are your Friday entryinto the weekend now.
SPEAKER_02 (01:18):
Yeah.
SPEAKER_00 (01:19):
Fridays are the girls.
SPEAKER_02 (01:20):
They're sending thoughts and prayers during the
week when you don't haveinternet.
SPEAKER_00 (01:28):
It's so weird because like the fact that we're
doing this now, oh, I suppose, Isuppose we're using cell signal,
but I mean, I can download, Ijust can't upload, and I just
never realized that there was adifference between down and up,
but apparently it's a bigdifference, it's a big deal.
So the woods can't handle theups, they can only handle the
downs.
(01:48):
What does that say for my futurehere in the woods?
SPEAKER_02 (01:54):
I don't know.
SPEAKER_00 (01:57):
Yeah.
I'm just kidding.
It's been a wildly positiveexperience.
People here are just so nice.
And if anything, it's so nice tothe point where I'm like, gosh,
was that Minnesota nice thingactually true?
Were they looking at people fromup north because so nice?
SPEAKER_02 (02:16):
Because down in southern Minnesota it's more
passive aggressive.
Yes.
Yeah.
Well, just up north are likegenuinely nice.
They're like, oh my gosh.
SPEAKER_00 (02:26):
Unless they got me all fooled.
Haven't met a person I don'tlike yet.
Yeah.
I love it for me too.
unknown (02:33):
Whoop whoop.
SPEAKER_00 (02:34):
I was just grossing Amanda out.
Maybe I shouldn't bring it upagain.
Because last time we talkedabout ladybug season, it
continues here.
And your girl's somebody who'sused to having a ton of pets,
but all I have are a ton ofladybugs.
And I don't know if I mentionedlast time that I drank one
accidentally and they taste likethey smelled just same.
SPEAKER_02 (02:58):
But she set the scene a little further.
It was like a nightstand glass,you guys.
So she didn't know.
And like in being tired, andthis this like hard shell thing
that's like totally infiltratedthe taste of your water is in
your Yeah.
SPEAKER_00 (03:15):
I mean, it's not like I I I went about it with a
knife and fork, like, come here,come here, lady, lady, come
here.
Mama wants dinner.
No, it was like, you know, yourglass of water by your side of
bed, the side of the bed, and Ireached up and I was like, oh,
this tastes really earthy andsour at the same time.
And I was like, oh, there's alittle bit of crunch.
Too wee.
(03:36):
Yep, out comes a ladybug.
So yeah, they will turtle in mywater glass if I don't cover it
up or use a I've I've learnedobviously to use a thing, but
the funniest part is justAmanda's face.
And I know you're pregnant, andit's probably making it worse.
SPEAKER_02 (03:56):
Well, just like I was telling her, it it feels
worse because the imagery andlike you feel like you can taste
it because you know how theysmell.
Yeah.
So then it's like, oh my god.
And then she's like, Yeah, theytaste how they smell.
SPEAKER_00 (04:10):
I'm like, Well, the northerners keep telling me to
vacuum them, but what good doesthat do?
They're just gonna crawl out ofthe vacuum, you know?
SPEAKER_02 (04:18):
Yeah, I don't know.
I've always heard that aboutspiders that don't bother
vacuuming a spider because itcan just crawl back out.
And I was like, Okay, good toknow.
SPEAKER_00 (04:28):
But imagine all of these ladybugs just like
rattling around in your in yourvacuum chamber.
SPEAKER_02 (04:36):
Um yeah, gross.
I think I know.
So when I lived in WashingtonState, you know the spiders
there are bigger, you know.
SPEAKER_00 (04:44):
Yes.
SPEAKER_02 (04:45):
My roommate and I like there.
We would take a like a candlelighter, you know, like a big,
like a long thing, and a can ofhairspray, and we would just
flame them.
SPEAKER_00 (05:02):
There's something sadistic and lovely about that.
It's like your own fireworkshow, but with like this
pleasure of like, be gone, youbad beast.
I love it.
SPEAKER_02 (05:12):
Yeah, because they're like wicked, right?
Outside of your front door, youopen the door, and there's like
this tarantula-sized gross, itjust doesn't get cold enough
there to kill those things.
SPEAKER_00 (05:23):
Oh, Dave, I don't want to make you mad, girl.
SPEAKER_02 (05:27):
Yeah, I'll torture.
I'm a nice lady.
Yes, you are.
Not to spiders.
SPEAKER_00 (05:35):
Yeah, well, they don't deserve it.
Uh although, do they eatladybugs?
Maybe my solution is to import afew spiders.
No, no importing.
I'd rather drink a ladybug.
Would you here's here's a here'sa question for you.
Would you rather drink a ladybugor have a spider inhabitant and
(05:56):
never have to drink a ladybug inyour life?
And you so every day the spidersare, you have to drink a
ladybug.
SPEAKER_02 (06:04):
Okay, no, I'd rather have one spider.
Are you kidding?
SPEAKER_00 (06:10):
You'd rather have a resident spider.
You're like, fine, I'm callinghim Teddy, so because it sounds
cute.
SPEAKER_02 (06:16):
If it wasn't a drink a ladybug every day, I probably
would have swung to ladybug.
But yeah, no, I'll take aresident spider.
And like, can it please just bea daddy long leg?
Because I'm fine with them.
SPEAKER_00 (06:28):
Oh my gosh, those are the worst.
I when I was like, I don't know,seven or eight years old, I had
this little bratty redheadfriend across the road, same age
as me, and he used to pull thelegs off of daddy long legs and
throw them at me, like put themdown my shirt and stuff.
I mean, it's problematic becausethey would still wiggle when
they weren't attacked.
(06:49):
Ew, and then the body wouldbounce around.
I mean, I'm traumatized.
Oh my god.
SPEAKER_02 (06:53):
So the what is that person grow up to be a serial
killer?
SPEAKER_00 (06:56):
I bet.
I'd need to look him up.
His name was David, he'sredheaded, that's all I know.
Was in Washington.
SPEAKER_02 (07:01):
Yeah, that's very hard to find.
SPEAKER_00 (07:04):
David, if you're out there, that was so rude.
I hope you're doing better,David.
SPEAKER_02 (07:11):
Oh God.
Well, on that note, um there areno corrections from last week.
Oh.
I even had a couple people say,Oh my gosh, did you guys do a
bonus episode?
There were two on Friday, sothey didn't even know we messed
up.
So hey, look at us.
SPEAKER_00 (07:30):
Yeah, you're welcome.
Bonus.
We corrected our mistakes thethird time around.
By we, I mean me.
Yeah, it took me a while to getthat 39er.
SPEAKER_02 (07:39):
Yeah.
Okay, so this week's episode isa little different.
It's not actually true crime.
There's no crime, unless youconsider the workplace, like a
medical workplace, notsupporting mental health as a
crime.
(07:59):
Then I guess we can say it's acrime.
So all of the resources that Iused will be in the show notes.
And the trigger warning issuicide.
Lorna Margaret Breen was born onOctober 9th, 1970, into a family
that blended medicine, service,and quiet ambition.
(08:21):
Her father, Philip Breen, was asurgeon whose surgical training
and career shaped thehousehold's rhythm and
expectations.
Her mother, Rosemary Breen, hadtrained as a nurse and brought
practical caring presents intothe family home.
Lorna was one of severalchildren.
Her siblings included an olderbrother, Michael, who later
(08:42):
became a radiologist, andsisters who pursued creative and
helping professions.
The family moved and lived inseveral places in the
mid-Atlantic, and Lorna spentformative years in Danville,
Pennsylvania, and maintainedties to Charlottesville,
Virginia, where she was born.
These early roots, a householdsteeped in medicine and a family
(09:04):
that valued education andservice, helped form the
contours of the life she wouldbuild.
Okay, from childhood throughcollege, Lorna showed both
intellectual drive and wideinterest.
She graduated from WyomingSeminary, a college preparatory
school, in 1988, then attendedCornell University, where she
(09:24):
completed undergraduate work inmicrobiology and also obtained a
Master of Science in Anatomy.
Those early academicaccomplishments foreshadowed the
dual energies that she wouldlater bring to clinical care and
to system-level thinking abouthow hospitals could serve
patients.
She then pursued medicaltraining at the Medical College
(09:45):
of Virginia, which is nowVirginia Commonwealth University
School of Medicine, completingher MD and continuing into
combined residency training.
Her postgraduate clinicaltraining was a combined
residency in emergency medicineand internal medicine at Long
Island Jewish Medical Center, arigorous program that prepared
(10:06):
her for the chaotic, high-stakesenvironment of hospital
emergency departments.
Absolute smarty pants, McGee.
And someone that's been in thetrenches.
SPEAKER_00 (10:16):
Absolutely, I agree.
SPEAKER_02 (10:18):
What a driven woman.
After residency, Lorna movedinto academic and clinical roles
that married bedside care withleadership.
And honestly, like what betterperson could you ask to be in
leadership to?
Like, they've been in thatclinical space.
(10:38):
They know what it's like on bothsides.
Like, that's the person I wantin leadership.
She became an attendingemergency physician at New York
Presbyterian Hospital, which wasthen Allen Hospital in
Manhattan, serving patients inone of the nation's busiest
emergency departments.
Aww, I love that.
(11:00):
Colleagues described her asdeeply committed to patient
access and communication.
She even took the time to helppatients who spoke limited
English and then took it evenfurther by learning Spanish so
that she could better connectwith them.
Over the years, she addedresponsibilities beyond clinical
shifts by teaching, clinicalprocess improvements, and
(11:21):
administrative leadership.
And in 2008, she assumed therole of director of the
emergency department at thehospital.
And in that position, shecombined frontline emergency
work with departmentstewardship, in addition to
faculty responsibilities, atColumbia University, Irvine
Medical Center, where she servedas an assistant professor of
(11:41):
emergency medicine.
So your girl was busy.
I love her.
SPEAKER_00 (11:45):
I mean, can you imagine having dinner with her?
She'd be an amazing friend.
SPEAKER_02 (11:50):
She's a busy woman.
So not only was Lorna anenergetic and intense clinician,
she also played the cello andcommunity groups, went salsa
dancing, hosted gatherings forfriends, and pursued continuing
education and leadership byenrolling in executive programs
aimed at healthcare leadership.
(12:10):
Her CV reflected scholarlycontributions on practical
topics, for instance, addressingthe needs of patients who do not
speak English and practicalemergency medicine pathways.
Those facets of her personality,a drive to learn, to connect, to
lead, and to perform at a highlevel were strengths and
ordinary times, but would becomestress points when extraordinary
(12:33):
crisis arrived.
In early 2020, New York Citybecame one of the first and most
intense epicenters of the novelcoronavirus outbreak in the
United States.
Hospitals filled with patientswho had rapidly progressive
respiratory failure.
Emergency physicians andhospital staff faced crushing
patient volumes, shortages ofpersonal protective equipment,
(12:55):
and the daily trauma of watchingpreviously healthy people
succumb to a disease thatclinicians at the time did not
fully understand.
SPEAKER_00 (13:03):
I can't imagine.
Can you imagine how devastatingthat was?
And we didn't know if or when itwould end and how many would
die.
SPEAKER_02 (13:12):
Yeah.
As an emergency departmentdirector at the Allen Hospital,
Lorna was at the center of thestorm.
She worked long, exhaustingshifts treating patients with
COVID-19 simultaneously, tryingto figure out staffing,
preserving supplies, andshielding her team as best as
she could.
It was, yeah, unprecedented,scary, horrible.
(13:35):
Can't believe that was over fiveyears ago.
Like many clinicians on thefront lines, Lorna contracted
COVID-19 in March 2020.
After becoming ill, she wasisolated and then returned to
work after a period of recovery,which was a choice that many
clinicians made, driven by theduty and the shortage of
personnel.
The virus had not only infectedher body, the experiences of the
(13:59):
months that followed exposedclinicians to repeated scenes of
death, loss, and moral distress,feeling the inability to save
patients who, in otherconditions, would have had a
fighting chance.
Families were barred frombedside goodbyes, and clinicians
felt the relentless pressure totriage with limited resources.
The combination of physicalillness, extreme workload,
(14:21):
social isolation from the nationthat was, at the time, as we
know, largely locked down, andthe large moral injury of
watching so much human sufferingdemanded a heavy toll on many
healthcare workers.
For Lorna, those pressuresdeepened into despair.
By early April, colleagues andfriends were aware that she was
(14:42):
struggling.
Text messages and calls capturedfleeting pleas and alarming
admissions that were out ofcharacter for someone so readily
steady.
A friend asked her how she wascoping, and according to
contemporary reporting, Lornareplied, quote, I'm doing
better, but dealing with thedevastation in the ER,
struggling a bit, end quote.
(15:04):
She had trouble sleeping.
Insomnia was unusual for her.
On April 9th, when she calledher sister, Jennifer Feist,
Lorna said, quote, This is theend of my career.
I can't keep up, and reportedlymade remarks about wanting to
die.
Words her sister would later saywere so out of character, they
felt like someone speaking intongues.
(15:26):
Those early signals of extremedistress unfolded against the
background of a health systemwhose administrative responses
varied, and in which clinicianssometimes feared career
repercussions for seeking mentalhealth help.
And with that somber note, we'llhead into our chart note.
(15:49):
Sad chart note.
SPEAKER_00 (15:51):
Sad chart note.
SPEAKER_02 (15:53):
Um, welcome to the chart note segment where we
learn about what's happening inmedicine and healthcare.
I really wanted to actually lookinto like clinicians and other
physical anyone like what doesthis look like for them?
Have they done any studies onmental health, health, and like
what are we doing now?
Because obviously COVID was anunprecedented time, but I'm sure
(16:16):
this has like kind of waxed andwaned in severity throughout the
decades anyway.
So, like, absolutely, what arewe doing?
Are we making improvements?
Where are we?
So that's what I did.
SPEAKER_01 (16:28):
Cool.
SPEAKER_02 (16:28):
So over the past decade, physician burnout in the
United States has been a growingconcern, capturing the attention
of both the medical communityand the public.
A recent study published in MayoClinic Proceedings by Shanafeld
and colleagues examined howburnout and satisfaction with
work-life integration hasevolved among U.S.
physicians between 2011 and2023, offering a rare long-term
(16:54):
view of the critical issue.
The study surveyed more than7,600 physicians between October
2023 and March 2024 usingvalidated instruments consistent
with earlier surveys conductedin 2011, 2014, 2017, 2020, and
2021.
(17:15):
By comparing physician responsesto a probability-based sample of
the general U.S.
working population, theresearchers sought to understand
not only how burnout has changedover time, but also how the
physician experience compareswith the broader workforce.
The results tell a nuancedstory.
In 2023, 45.2% of physiciansreported at least one symptom of
(17:40):
burnout, defined as emotionalexhaustion or depersonalization.
While this represents asubstantial drop from the peak
of 62.8% observed in 2021 duringthe height of the COVID-19
pandemic, it is strikinglysimilar to levels reported in
2011 and 2017.
This suggests that while theacute pressures of the pandemic
(18:04):
have eased, physician burnoutremains deeply embedded in the
profession.
Compared with other U.S.
workers, physicians are stillnearly twice as likely to
experience burnout, highlightingthat the stresses of medical
practice go beyond the generalworkforce pressures.
Work-life integration, a measureof how well physicians feel
(18:25):
their profession and personallives fit together, has shown
some improvement.
In 2023, 42.2% of physiciansreported being satisfied with
their work-life balance, up froma low of 30.3% in 2021.
Yet even with this improvement,satisfaction has not returned to
levels seen in earlier years,and physicians remain
(18:48):
significantly less satisfiedthan other workers.
The picture is one of slowrecovery rather than a complete
return to normal.
So then I was like, okay, well,what are the reasons?
So digging deeper, the study andprior-related research
illuminate the underlyingfactors driving these persistent
challenges.
(19:09):
Physicians themselves haverepeatedly identified
administrative and clericalburdens as major contributors to
burnout, particularly thetime-consuming demands of
electronic health records.
While intended to streamlinecare, EHRs have added hours of
data entry, inbox management,and documentation work that
pulls physicians away fromdirect patient care.
(19:32):
Beyond technology, many doctorscite a loss of professional
autonomy, constrained byinsurance requirements, prior
authorizations, and complexregulatory rules that limit
their clinical decision making.
The pandemic added furtherpressures, including long hours,
emotional strain from criticallyill patients, staffing
(19:53):
shortages, and moral distress.
These cumulative factorsunderscore that burnout is
rarely about personal weaknessor resilience.
I can't believe that was even athought.
SPEAKER_00 (20:23):
Hello, bean counters.
Listen up.
SPEAKER_02 (20:27):
The study's findings emphasize that physician burnout
is not a temporary phenomenoncaused solely by the
extraordinary events like thepandemic.
It is a persistent challengereflecting systemic realities,
long hours, heavy administrativeburdens, high-stakes decision
making, and the tension betweenprofessional duties and personal
life.
While individual strategies suchas resilience training, wellness
(20:50):
programs, and self-care remainimportant, this research
highlights the meaningfulsolutions that will require
system-level changes instaffing, workflow,
administrative supports, and theoverall organization of
healthcare delivery.
SPEAKER_00 (21:05):
Jumping up a data nature.
Thank you.
Thank you.
Thank you.
Thank you so much forhighlighting this.
Honestly, because I'm not oneto, you know, poo-poo resilience
training and wellness, but itfalls flat in the face of system
level insufficiencies that needto change.
SPEAKER_02 (21:26):
So it feels like the pizza party when times are
tough.
SPEAKER_00 (21:30):
Yes.
Exactly.
It needs to be an overhaul.
And I don't know what the answeris, but maybe you'll guide us
there.
SPEAKER_02 (21:39):
Maybe we'll have some hope shed on us later.
But lastly, in essence, thisstudy provides a sobering but
hopeful perspective.
Burnout is not disappearing, butthe gradual improvement since
the pandemic suggests thattargeted interventions, both
individual and systemic, canmake a meaningful difference.
And these findings are areminder that caring for those
(22:00):
who care for others is notoptional.
It is essential.
Physicians' voices make itclear, unless the structures
that drive burnout areaddressed, the risks to their
well-being and to patient carewill persist.
SPEAKER_00 (22:13):
It's so true.
And there is evidence-basedscientific research that shows
that in healthcare, and probablyother it probably translates to
other fields as well.
But specifically, this was donein healthcare.
That employee satisfactionsatisfaction was directly linked
(22:36):
to patient outcomes, improvedpatient outcomes.
So really the focus should be onemployee satisfaction and how
can we take away some of theburden that is so clearly taking
away from you know work-lifebalance.
You can do yoga, you can do allthis other stuff and feel like
your organization appreciatesyou, but if you're the only one,
(22:58):
you know, you're there untileight o'clock at night and you
missed your kids' soccerpractice and all this other
stuff, it's not gonna help.
So we need And guess what?
Then you don't have time to goto the yoga anyway.
Right.
So I love that the focus shouldbe on fostering wellness with
the providers so that they canthen do their job and the
(23:24):
outcomes will be better withpatients.
And science and research haveshown that higher levels of
employee satisfaction lead tobetter outcomes, better
compliance with treatment plans,and the whole bit.
So I think the problem it mightbe a little bit bigger than this
because I feel like healthcareorganizations are still focused
(23:47):
on quantity over quality becauseof shrinking reimbursements.
So we have to figure who'srunning the show, and that's
bigger than me.
But yeah, you really highlightedan interesting and important
issue in healthcare.
That until we find a solution,it's gonna continue and probably
(24:08):
worsen again.
SPEAKER_02 (24:09):
So yeah, yeah, yeah.
There was a term thrown out alot previous workplace, but not
only just burnout, right?
But compassion fatigue.
And that's where that comes intoplay of like if everyone's doing
well at work, the betteroutcomes, right?
If you have compassion fatigueand like nobody can get into the
(24:29):
clinic, and then that's all youhear about for the first 15
minutes of a 30-minuteappointment, and like you need
to hear the person outrightbecause they're the human in
front of you, but also you'relike, I've got five people
waiting for me in the lobby, andit just it's a lot, it's a lot.
SPEAKER_00 (24:46):
Yeah, it is.
It's um, but the correlation isstrong.
You treat your employees well,you're gonna get better patient
outcomes.
Um, and I think the focus needsto go back to that as opposed to
metrics which look at quantity,you know, productivity over
actually the quality of care.
And the quality of care isdirectly correlated to how the
(25:08):
employees are being treated.
How much time do you have with apatient?
What are the expectations?
What is the administrativeburden?
Are you expected to how muchtime are you expected to to deal
with these prior authorizationsand all of this insurance
craziness that's required ofproviders?
(25:28):
So I mean there's a lot thatthere's no one single villain,
but you know, our whole systemneeds to change.
It really does.
So thank you for highlighting.
SPEAKER_02 (25:39):
Agreed.
On October 26, 2020, I forgot tosay back to the story.
Obviously, we're back to thestory.
On October 26, 2020, while on afamily trip in Charlottesville,
Virginia, Lorna tragically diedby suicide.
(25:59):
The news reverberated acrosshospital corridors, academic
departments, and the broaderpublic.
Her father, Philip, toldreporters that his daughter had
been, quote, truly in thetrenches of the front line, and
that she tried to do her job andit killed her, end quote.
Those blunt words captured agrief that mingled pride for a
(26:23):
life of service with a profoundsense of loss and a demand for
reflection.
How had a caring, competentphysician who absolutely loved
her work reached a point whereshe felt she had no way out?
In the immediate aftermath,colleagues and family sought to
understand what happened and topush for changes that might
(26:44):
prevent similar tragedies.
The family took care toemphasize that doctors, like any
other people, can beoverwhelmed, and that the
medical profession's licensingand credentialing systems
sometimes discourage cliniciansfrom seeking mental health care.
As her family and friends shareddetails and advocates raised
alarms, the story becamesymbolic.
(27:06):
It was not only about oneperson's heartbreak about
structural issues that madeclinicians vulnerable, stigma
about mental health, reportingrequirements that can jeopardize
medical licenses if physiciansdisclose psychiatric care, the
relentless schedules andcultural expectations in
medicine to appear infallible,and the scarcity of system level
(27:29):
supports in crisis conditions.
To honor Lorna's memory and toaddress those systemic problems,
her family and supporterscreated the Dr.
Lorna Breen's Heroes Fund, anallied efforts to destigmatize
mental health care forclinicians, expand wellness
(27:49):
resources, and changeinstitutional policies that
inadvertently punish careseeking.
The foundation and alliedadvocacies linked personal grief
to public action, fundingresearch and programs, educating
health system leaders, andadvocating for policy changes
that would lower barriers tocare.
(28:11):
The narrative that emergedcombined intimate family
testimony with policyprescriptions, both emotional
reckoning and practical reform.
The advocacy that followedLorna's death led to one
concrete legislative outcome,the Dr.
Lorna Breen Health Care ProviderProtection Act, which was
(28:32):
introduced in Congress andsigned into law on March 18,
2022, two years after herpassing.
The statute authorized federalgrants, research initiatives,
and training programs aimed atsupporting mental and behavioral
health among healthcareproviders, with a particular
focus on preventing burnout andsuicide.
(28:54):
This included funding to medicalschools, health systems, and
community organizations to buildresilience programs and study
clinician well-being.
These efforts were modest inscale compared with the
magnitude of the pandemic, butthe law's symbolic weight was
considerable.
It signaled a national, nope.
(29:14):
It signaled a nationalacknowledgement that protecting
the mental health of those onthe front lines is a matter of
public interest.
Professional organizations,including the American Medical
Association and EmergencyMedicine Societies, praised that
the act was a meaningful stepforward in a medical culture
that encourages care seekingwithout career repercussions and
(29:36):
builds systems that preventclinician burnout from becoming
a fatal outcome.
Reporting and commentary in themonths and years after Lorna's
death placed the national lawand the family's foundation into
context.
Profiles of Lorna emphasize bothher professional excellence and
the overload she faced duringNew York's first viral surge.
(29:56):
A long New York Times featureand subsequent profiles and
outlets such as Vanity Fair andTime painted a portrait of a
high-achieving, warm and drivenwoman suddenly bruised by an
event no single clinician couldhave prevented.
A pandemic that wreckedexpectations about what medicine
could do.
The Times piece recordedcolleagues and friends' memories
(30:18):
and quotes that crystallized thestrain.
Quote, I couldn't help anyone, Icouldn't do anything, quote.
Or end quote.
A phrase reported to reflect theclinical helplessness that she
felt during treating thepatients during that pandemic,
whose outcomes were grim despiteheroic efforts.
(30:39):
Which is just so sad.
Those words, stark and humane,helped the public understand the
kind of moral injury manyhealthcare workers experienced.
The aftermath also promptedintrospection within medical
culture.
Professional societies, hospitalsystems, and academic centers
(31:00):
began to examine credentialingquestions, which sometimes
require clinicians to disclosemental health treatment, to
expand confidential counselingand peer support programs, and
also to reframe wellness from anindividual moral obligation into
an organizationalresponsibility.
Amen.
Yep.
Hello, amen.
(31:21):
Many institutions started toinvest in programs envisioned by
the Breen's family's advocacy totrain leaders to recognize
distress.
Amen.
Create crisis response teams,and offer evidence-based mental
health services designed withclinician confidentiality in
mind.
The Dr.
Lorna Breen Health Care ProviderProtection Act created federal
(31:45):
support to scale such efforts,and the foundation organized
grants, education, and publicawareness campaigns to reduce
the stigma to save lives.
Lorna's death revealed painfulcontradictions.
She was, by many accounts, adoctor who loved her work and
who sought to help patients,yet, the very system in which
(32:06):
she was celebrated alsoconstrained the help that she
couldn't obtain.
As her father said, and manycommentators agreed, she had
been a casualty of the pandemicin a sense that extended beyond
viral infection.
The human toll included mentalhealth aftermath.
Family members did not wantLorna's name to be the only
(32:27):
headline of a tragedy.
They wanted her story to becomea spur to make medicine safer
for caregivers, to changelicensing and credentialing
reporting rules, and deterclinicians from seeking help,
and to institutionalize supportsthat the next generation of
clinicians would be less likelyto suffer similarly.
(32:50):
Lorna's story remains a taleabout the limits of a hero
rhetoric when applied tohealthcare workers.
Calling clinicians heroespublicly can obscure structural
avoidance of responsibility.
Heroism suggests individualfortitude rather than the
obligation of institutions andgovernments to provide safe
(33:11):
working conditions, adequatestaffing, and mental health
resources.
The family's advocacy and thelaw bearing her name attempt to
shift the focus from individualsacrifice to systemic
protection.
As one former colleague put itin public reflections, I know
how much good came from Lorna'slife.
Now I hope some good can comefrom her death.
(33:35):
And those are the hopes thatmotivated the foundation, the
advocacy, and the congressionalresponse.
In telling Lorna's story, it isimportant to avoid reductive
narratives that make her deathonly an instrument for policy.
She was, by every account, byfamily and friends, an engaged
physician, a musician, a friend,and a sister who provides a
(33:58):
person who loved both her workand a life full of small joys,
such as music, dancing, partieson rooftops, and community.
The contours of her life makethe tragedy feel more acute.
Someone with so much energy anda love for life reaching a point
of unbearable despair.
(34:33):
And the institutional barriersfrom punitive license
questioning, the culturalexpectation that clinicians
somehow must withstand everytrauma quietly is corrosive.
And the institutional barriersfrom punitive licensing
questions to inadequate sourcesof confidential help must be
addressed systematically.
If Lorna's name promptsadministrators to revise
(34:56):
policies, supervisors to checkon exhausted staff, and fellow
clinicians to reach out honestlyto one another, then from that
grief, something practical andhumane has emerged.
SPEAKER_00 (35:08):
Oh, I have goosebumps.
Amen.
Thank you so much.
Well done.
Well done for bringing this up.
Thank you.
Oh my gosh, I have so manythoughts.
Okay.
More recently, the what youtalked when you talked about the
hero rhetoric as applied tohealthcare workers, and how that
(35:30):
really shifts the responsibilityof the organization to look,
this person was able to go aboveand beyond.
Yay, well done, in spite of ourinability to support them.
We need to normalize mentalhealth.
And honestly, I feel like itshould be at the point where
someone in a position likeLorna, where she's in the
(35:56):
trenches and she's seeing all ofthis day in and day out.
And maybe even all healthcareproviders, but certainly those
in the emergency room, those inhealthcare themselves, should be
offered a mental healthprofessional.
Just as part of like, this isyour mental health professional.
You'll be meeting with so-and-soonce a week.
(36:18):
Full disclosure, I've had amental health care professional
for 10 years.
And I asked her, because I can'timagine my life without her.
And I asked her, Do you have amental health care professional?
Because how do you maintain yourresilience and all these
catchphrases that you'll hearorganizations say, oh, wellness
(36:39):
and you need to walk more anddrink lots of water and
resilience, you know, do someyoga and think positive
thoughts.
No, actually, the onus is on theorganization to create a culture
where it's okay, where it'sactually fostered and
recommended, and it's difficultnot to seek mental health
(37:00):
because that's just as importantas physical exercise.
So especially when hello,especially when your job is, you
know, determining life and deathsituations like Lorna, I can't
even imagine.
I mean, I'm an audiologist, andI don't do life and death stuff,
but you know, I'm a person, Iface burnout, I face situations
(37:25):
where I think I can't meet apatient's need.
And and good clinicians, goodgood providers are are tortured
by that.
We lay awake at night going,what could I have done better
for this person?
How could I have helped more?
Or just the fact that the theirstories are resonating with you
(37:45):
and you're empathizing.
So empaths and good cliniciansalike, we're all in it to help.
And helping professions meanyou're vulnerable to mental
health distress.
So why is this not actuallyrequired?
I'm gonna pull it even a furtherstep, not just recommended.
Why aren't people required?
(38:08):
Like part of a benefits package,yeah.
SPEAKER_02 (38:11):
Like when you work this is something, a part of
your benefit.
You get access to this mentalhealth professional.
If you don't want to use it,fine.
But if you want to, yeah, andthen you have a dedicated time
set aside in your schedule touse it.
Exactly.
SPEAKER_00 (38:27):
So there's next problem.
The next problem is when thehell am I supposed to meet this
person?
Listen, we're gonna cover thetelehealth.
Her name is Jamie Smith.
If you don't like her, there's awhole other if you are if you
don't click with her, there's awhole other, you know, consort
of uh behavioral healthprofessionals in the wings.
(38:48):
But you know, we we think Jamiewould be good for you.
We want you to meet with heronce a week because everybody
meets with a behavioralprofessional for resilience and
healthcare once a week.
Screw I'm sorry, but screw thecherry yoga and the sunrise
stretches and all this stuff.
Yes, that's important.
But can we actually normalizemental health help?
SPEAKER_02 (39:13):
Can we actually address the source here, the
roots, and not just cover itwith a pizza party and I mean I
love a pizza party, don't get mewrong.
No, but yeah, but this wholeresilient-water and yeah and and
do this there.
It's like I can't drink water atwork because I don't have time
to go to the bathroom.
Yeah.
SPEAKER_00 (39:33):
But also, it's like, well, you know, you are your
work-life balance, you need toprioritize this, you need to go
for walks, you need to sendgratitude notes.
I mean, all that stuff, don'tget me wrong, it's great and
it's enriching and it and itcontributes to quality of life
if you can, if you have thetime.
But it's putting the onusonitiate its place.
It's it's putting the onus onthe employee.
(39:55):
It's not actually uh to me, it'sa cop-out from these
organizations.
Like, oh, you're burned out.
Well, you know, you're nottaking enough time for you.
Go for and do that.
Although we're not allowing youto with our schedule.
You will do it on your own.
We're not acknowledging it'skeeping you up at night, which
is your stress and your you, youknow, uh not enough time and too
(40:16):
many patients, too manyproblems, not enough tools to
get there a high, a too highadministrative burden.
Like, let's let's give somethingthat actually has a long-lasting
effect, which would be mentalhealth care.
Not to mention, you know, ascribe and some other solutions
that might help reduceadministrative burdens, but
(40:38):
first and foremost, mentalhealth.
Mental health is to me almostmore important than physical
like exercise.
And that might get me likethrown under a bus somewhere,
but I can think of a certainexercise physiologist named Joe
at meal that would have my havemy he'd have something to say
(40:58):
about this.
Sorry, Chip.
But like if you're mentally nothealthy, you're not ready for
exercise.
You're not ready for any of theother things because all you're
doing is further exacerbatingthe issue, then.
Yeah.
SPEAKER_02 (41:11):
If you're pushing yourself to work out physically
while you're already mentallyexhausted, that's not okay.
Okay, like obviously anyphysical movement is good for
you, but yeah, I don't know.
I'm on the same boat, the samechoir as you right now.
SPEAKER_00 (41:25):
Yeah, I I I obviously feel very passionately
about this, which I didn'trealize until you brought this
up, but it's like, yeah, I mean,I'm so sick of being fed the
whole for the record.
Huh.
Sorry, keep going.
I'm sick of being fed the whole.
Well, the onus is on you to beresilient.
If you would just do yoga andyou would just like shut up and
(41:47):
have some gratitude, you'll befine.
Yeah.
SPEAKER_02 (41:52):
Yeah.
I and I was just gonna say, forthe record, in case this will
help break any sort of stigmathat's still out there.
I also have a mental healthprofessional and I love meeting
with her.
SPEAKER_00 (42:02):
Well, yes.
I mean, when we were like mytherapist could beat up your.
It's not a bad thing.
Not at all.
But like, I've brought friendsinto my therapist, and we've had
dance parties, and like I can'timagine life without her.
Even you don't have to be incrisis to have someone that you
meet with that helps kind offrame your thoughts to make sure
(42:25):
that you're you know, you're onthe right track, you're on the
track to be the best you thatyou can be, and that's all that
is.
And and families and you don'thave to meet weekly.
If things are going good, great.
Meet quarterly exactly bymonthly.
There's something to be said forsomeone who's trained in
psychology and counseling, whois not your friend, who can
(42:48):
really give you that objectiveview of whether or not your
thought process is, you know,what's the word?
Not normal, but like makessense.
SPEAKER_02 (43:02):
So like are you on track, not like thinking with
emotion?
Right.
SPEAKER_00 (43:06):
Well, that's not what I wanted to say.
I I would say to make sure thatyou have the coping skill.
I will to make sure that youhave the coping skills for what
life is throwing at you, youknow?
Yes, yeah, and if you don't, howdo you get there?
And so that's important foreverybody, regardless.
SPEAKER_02 (43:25):
And I probably could have benefited from a mental
health professional many, manymoons before I got one, but I
will say that I first got onebecause of the burnout I was
having at work.
SPEAKER_00 (43:41):
So I know I might just use her for everything in
my life, so I love that for you.
And I keep telling mine, like,if you go anywhere, I'm gonna
follow.
She probably thinks I'm astalker.
I will follow.
I will follow.
But you know what is also good?
Not just for mental health, butfor well-being.
(44:06):
Tell me.
Cookies.
SPEAKER_02 (44:09):
I was gonna say, is it our new sponsor?
You found a cookie sponsor.
I love that.
I know, and you guys, you haveto go to this website and look
at these cookies.
They look outrageously good.
Let me tell you.
And let me a good cookie.
So our newest sponsor is MollyB's, and that's a B Z, but it is
(44:34):
pronounced B like Bubble B.
So Molly Bees Gourmet Cookies.
So they're available atMollyB's.com.
They bring bold, artistic, smallbatch craft cookies straight to
your pantry.
They are known for melting yourmouth texture.
(44:55):
I mean, what more could you wantin a cookie?
High quality ingredients andincentive flavor combinations.
Each cookie delivers layeredtextures and surprising,
indulgent tastes.
Fans rave about standouts likethe tea cookies, smooth lavender
goodness and white chocolate,and delectable lemon glaze.
(45:20):
And B cordials, which is aperfect blend of chocolate and
cherry, calling every bite anadventure.
Founded by Molly, a single momfrom Alaska, the brand has
become a national sensation injust three years, earning
features on the Food Network,Martha Stewart Living, and even
the Grammy Awards.
Wow.
(45:40):
Signature creations like BeCordial, Milk Chocolate,
Marciano Cherries, Amaretto, BigJoe, Baba Doodles, which is
Snicker Doodles with the Boboa,Boboa pearls, Hot Mess, which is
mango, white chocolate, and hotCheetos.
SPEAKER_00 (46:02):
Oh my god.
SPEAKER_02 (46:04):
P.
Nicoladas, which is whitechocolate, coconut and fruity
pebbles.
Royally Awesome, which is whiteand milk chocolate, coconut,
macadamia nuts, and spiced rum.
Straight fire, which ismarshmallows, chocolate,
cinnamon, cereal, and cinnamonwhiskey.
(46:25):
The Boss Man, which is maplesyrup, bacon whiskey, and white
chocolate.
And the tea, which is Earl GreyTea, Lavender, White Chocolate,
and Lemon Frosting.
So again, you guys have to go tothis website, look at them.
Oh my god, they look amazing.
They're perfect for gifting orindulging yourself.
(46:45):
Molly Bees Cookies bring gourmetartesian crafted delight home
with no bakery trip required.
Find them at Mollybees.com.
That's M-O-L-L-Y-B-Z.com andenjoy 10% off with our code stay
suspicious.
I will share that when you go totheir website, you'll see, oh my
(47:07):
god, they already offer 10%.
Yeah, but you have to put inyour email to sign up to get
10%.
So if you use our code staysuspicious, it won't fill up
your inbox.
SPEAKER_00 (47:17):
There we go.
You're welcome.
There we go.
Oh my gosh.
And I will also say, I thinkthat Molly B Z would add to
resilience.
I am ready.
So, you know, get some.
Get a whole box of those andbring those to work.
(47:39):
Everyone's gonna love you andyou're gonna feel great.
And like, what's some wildflavors that you wouldn't
expect?
And they're probably really goodbecause it sounds so weird.
Like, obviously, they're notgonna sell the mango, white
chocolate, and hot Cheetos.
I know I'm like cooking hotCheetos and Cookie.
Molly B is.
I'm thinking I want to try that.
I really do.
(48:00):
I'm gonna order some and try it,and we'll I'll tell our
listeners what the verdict is.
But is it time for our medicalmishap?
It is time.
Is shall I read it?
SPEAKER_02 (48:16):
Sure.
I mean, yeah.
Okay.
I started to derail towards theend of mine, so the listeners
would probably appreciate somefresh eyeballs on the screen.
SPEAKER_00 (48:26):
No, you did great.
You did great.
But so the subject of this emailis the albuterol incident that
still keeps me up sometimes.
Uh-oh.
It says, Hi Jenna and Amanda.
I've never written into apodcast before, but this one has
stayed with me for years, and Ithink my fellow Alley cats will
understand why.
(48:47):
I'm an emergency departmentnurse.
Bless your heart.
And even though nothing tragichappened, exactly, the what if
still catches in my throatsometimes.
Here we're here this is what wewere just talking about.
How people who are really goodproviders uh you don't clock
out.
You know, you go home and youagonize over what could be, what
(49:10):
if, what if not, what can I do.
Anyway.
So she writes, or he writes, itwas a slammed weekend shift.
There were no open beds, hallwaypatients, everything from chest
pain to broken wrists rollingin.
I was caring for a patient whocame in with an asthma
exacerbation.
The patient was in their mid-30sand they were scared, but they
(49:32):
were stable enough.
So the provider orderedback-to-back nebulizer
treatments to get ahead of it.
Respiratory therapy departmentwas tied up with a trauma in
another room, so I grabbed anebulizer and set it up myself.
It's something I've done athousand times.
I opened the drawer labeled nebmeds, tore open a packet, drew
(49:53):
it up, popped it in the nebchamber, and got the treatment
running.
So, for those of you who aren'tin the know, it's like really
quick acting way of providingthe same stuff that's in an
inhaler, but in a in anebulizer, which means that
they're in the medication isbeing physically blown into the
(50:16):
patient's face through a mask ina chamber that's mixed with
water.
So and usually it involves somesteroids too to help with the
inflammation.
So she tore open a pac or he shtore open a packet, drew it up,
popped it into the neb chamber,and got the treatment running.
Five minutes in, the patientlooked wrong.
(50:38):
Not just anxious, but panicked.
His heart was pounding so hardand his that I could see his
gown moving with everyheartbeat.
He kept trying to sit up andsaying he felt like his chest
was going to jump out of hisbody.
Oh no.
I checked the monitor.
His heart rate was 208.
(50:58):
So I said crap.
I stopped the treatmentimmediately.
I called the provider, calledrespiratory therapy, we put him
on oxygen, started an EKG, andgot an IV access in case we
needed to intervene.
He was shaking so violently hecould barely hold still.
The respiratory therapistarrived, grabbed the nebulizer
(51:20):
cup, looked at me, and saidquietly, This isn't albuterol.
It was racemic epinephrine,which came in the same
packaging, the same drawer, andidentical little vials.
But in the shuffle of the day,someone had restocked the drawer
wrongly.
And if I hadn't double-checkedbecause I'd done it a thousand
(51:43):
times.
The provider stayed calm,managed the reaction, and the
patient stabilized.
His asthma actually improvedbecause, well, racemic
epinephrine will absolutely dothat because the faster your
heart beats, the more your lungmuscles relax.
But the cardiac side effectswere no joke.
(52:03):
It could have gone sideways,very sideways.
Afterwards, I sat in the breakroom shaking.
No one yelled at me, no oneblamed me.
Leadership reviewed the stockingissue, but I knew that if that
patient had been older orfragile in their heart, or if we
hadn't caught it as fast as wedid, who knows what would have
(52:25):
happened.
So that part of me still hits mewhen he's the patient said when
he left, I could tell you cared.
That's why I wasn't scared thewhole time.
He didn't know what happened,but he didn't need to.
All he knew was that the teamtook care of him.
But I drove home that night,replaying every moment, every
(52:47):
instinct, and every missed clue.
I still check every vial twice,even when I'm moving quickly,
even when the label is obvious,and even when I think I already
know.
Because that patient taught methat, and those thorough checks
will never leave me.
Signed an ED nurse who learnedthe hard way that familiarity
(53:09):
can be dangerous.
Oh, listen, you did Yeah, we allmake mistakes.
We all would have felt a victimto that same scenario.
Absolutely, and the fact thatyou are using this as a
learning, you'll never do thatagain.
And also you'll probably preventother people from doing that
(53:30):
because of your the lesson thatyou learned and the fact that
you care so much.
So thank you for writing thatin.
SPEAKER_02 (53:36):
And that you're sharing it, yeah.
SPEAKER_00 (53:38):
Yeah, thank you.
SPEAKER_02 (53:39):
And seriously, what a perfect medical mishap to have
at the end of this episode whenwe're talking about how our like
brains, when we care, they don'tshut off.
SPEAKER_00 (53:51):
Absolutely.
SPEAKER_02 (53:53):
So, Jenna, what can we expect to hear next week?
SPEAKER_00 (54:02):
I haven't decided.
I torn in a couple differentdirections.
I I'm kind of into the old timeyworld right now.
So we did like the what I didwas the kind of the origins of
this what we now know assurgical consent.
And so then it started melooking at old-timey stuff and
(54:25):
mental health institutions andused to call sanatoriums and
insane asylums and lobotomies.
So I I have a feeling it's gonnabe old timey.
I like it.
But yeah, listen, you'll have totune in for it to get it, you
know, the actual subject becauseI don't know yet.
(54:54):
But meanwhile, don't miss abeat.
Subscribe or follow Doctoringthe Truth wherever you enjoy
your podcast for stories thatshock, intrigue, and educate.
Trust, after all, is a delicatething.
You can text us directly on ourwebsite at Doctoringthe Truth at
Buzzsprout.com or email us yourown story ideas and comments at
(55:15):
Doctoringthe Truth at Gmail.
Be sure to follow us onInstagram at Doctoring the Truth
Podcast and on Facebook atDoctoring the Truth.
We're also on TikTok atDoctoring the Truth and ed odd
pod E-D-A-O-D-P-O-D.
Don't forget to download pleaserate us.
It just takes an extra second,but it means so much to us.
(55:37):
Please rate and review so we canbring you more content next
week.
And until then, stay safe andstay suspicious.
Please stay suspicious.
Suspicious.
Bye.
Okay, goodbye.
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