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Emerging Leader: Ellen Ingraham-Shaw

By
Ellen Ingraham-Shaw
Healthcare Heroes

Pediatric Emergency Nurse, Baystate Medical Center

Her Passion for Behavioral Health Has Enhanced Care Across an Entire ER

Ellen Ingraham-Shaw

 

Ellen Ingraham-Shaw just couldn’t get away from children — even when she thought she wanted to.

And thanks to her leadership and innovative thinking, a lot of kids are better for it today.

“I actually started my career as a kindergarten teacher,” she said, before jumping back in time a little to when her interest in working with children really began.

“Growing up, I was a horseback rider, and I got into teaching younger kids how to horseback ride; that’s how I started working with children and adolescents, including working summer camps when I was in college,” she recalled.

Then she studied early childhood education and psychology at Mount Holyoke College before spending the first five years of her career as a kindergarten teacher.

There, Ingraham-Shaw saw needs that can’t always be addressed in the classroom.

“I worked in Chicopee, and in my classroom, I had a lot of homeless students,” she said. “So I started getting really interested in the socioeconomic status of kids and all the barriers that can really get in the way of how kids learn.

“I was happy, but I didn’t see myself doing it forever,” she continued, “so I went back to school for a second bachelor’s in nursing at UMass Amherst. After that program, I started working at Baystate Medical Center on one of the adult floors. And I just thought I didn’t want to work with kids anymore after feeling kind of burnt out.”

“Especially during the pandemic, the behavioral-health population just kind exploded in our ER. And I just got really passionate about it.”

So when friends asked her whether she wanted to enter pediatrics, she said no — but that feeling eventually thawed, and she applied for a position in Baystate’s pediatric ER. And she fell in love with it, calling it a well-run unit that, she realized early on, had an openness to new ideas and a focus on behavioral health that she would eventually expand in a number of ways.

“Especially during the pandemic, the behavioral-health population just kind exploded in our ER. And I just got really passionate about it,” she said. “And I’m lucky that my managers and my educators on my unit really support us working toward the things we’re interested in. If you want to seek out opportunities to do your own education, they give you opportunity to research.”

Thus began a fruitful career in pediatric emergency care with a focus creating more education and resources around behavioral health.

“I’ve been able to do education on de-escalating patients, just helping with the safety of the staff and the patients. And I think our physical restraint numbers have decreased; we have seen a decrease in having to resort to a restrictive environment with the kids.”

Ingraham-Shaw also worked closely with Pediatric ER Manager Jenn Do Carmo on Narcan take-home kits for the Pediatric Emergency Department. They were talking one day about how Baystate’s adult ED provides take-home kits to their substance-misuse population, but the Pediatric ED had no such process. So they decided to change that. Ingraham-Shaw created an education flier for nurses and doctors, made sure the kits were stocked, and educated every nurse on how to educate patients and families in their use.

“I did some education with our staff on how to identify patients that might be at higher risk,” she explained. “These are patients who come in with an overdose or, unfortunately, we’re seeing a lot of adolescents these days with suicide attempts and self-harm; sometimes they could be opioid-related, sometimes not. But if someone has a past overdose attempt, they’re at a higher risk of potentially overdosing on opioids in the future.

Ellen Ingraham-Shaw

Ellen Ingraham-Shaw says pediatric emergency nurses bring not only care, but large doses of compassion and education to parents.

“So we’re making sure we have Narcan out in the community,” she added. “The nursing job is to help identify the patients that could be at risk, then working with the providers to make sure Narcan gets prescribed.”

Do Carmo, who nominated Ingraham-Shaw, said this program has the potential to save the lives of pediatric patients who overdose on opioids in the community. “Ellen is also going into the community and teaching local schools about the process of administering Narcan,” she wrote. “Ellen is a strong advocate for her patients and is a Healthcare Hero.”

 

Knowledge Is Power

As another example of thinking — and leading — outside the box, Do Carmo noted that Ingraham-Shaw noticed a gap in education on the care of LGBTQ and transgender patients, and took it upon herself to create educational materials and a PowerPoint presentation on how to care for and support these individuals.

“The entire Emergency Department now provides her representation on transgender education in nursing orientation,” Do Carmo wrote. “This presentation provides a clear understanding of a population in dire need of support and words and ways that help support the care of this population.”

Ingraham-Shaw told BusinessWest that she developed that education on LGBTQ and transgender health for a staff meeting, and the educators in the ED now utilize it as a required part of onboarding training for all emergency-medicine staff at Baystate, not just in the Pediatric ED. “So all of our staff has some level of training in how to be respectful and understanding of patients in our community.”

That aspect of education can be lacking in the training and college programs medical professionals experience entering their careers, she added. “So I think our people are definitely able to support those patients a lot better.”

Providing care that’s not sensitive to that population typically isn’t a problem of malice, but ignorance, she was quick to add. “It’s just people not knowing. And now my unit especially has at least a little baseline of how to be more respectful and understanding of patients.”

Of course, sensitivity to what patients are experiencing comes naturally in a pediatric ER, where the days can be challenging and the situations dire.

“I did some education with our staff on how to identify patients that might be at higher risk. These are patients who come in with an overdose or, unfortunately, we’re seeing a lot of adolescents these days with suicide attempts and self-harm; sometimes they could be opioid-related, sometimes not.”

“One thing I do like about it is that every day is completely different. I think it’s gotten a little bit harder now that I just had my own baby; I’m still adjusting to that,” she said of the toughest cases. “But the majority of what we see is more urgent care, or things likely to be seen in a primary-care setting. Those usually have a happy ending — you help educate the family, you make sure the child is safe, is eating, drinking, breathing, and then they usually get discharged home.”

At the same time, “unfortunately, we do see some really devastating new cancer diagnoses, we see some car accidents, so it’s definitely emotional. I think my co-workers do a really good job of supporting each other through those difficult times. Healthcare can be sad, and I think it’s especially sad when you know something bad happens to a child. And we do a lot of compassion with the families as well; we take care of the whole family, not just the child.”

Again, she comes back to the education aspect of her work, even for things families don’t specifically bring in their kids for, like properly installing car seats.

“When we’re at the triage desk, we first bring the kid in, we make sure they’re safe, and then that’s another point where we can just educate them and do that community health and make sure everyone’s safe by teaching families simple things like car seats.”

Going beyond the basics is how Ingraham-Shaw has really made a difference, though, implementing new ideas in an organization she says is very interested in hearing them.

“My management team is just really open. We have a lot of freedom to do things,” she said, before giving another example in the behavioral-health realm.

“One of my co-workers and I, a few years ago, started a behavioral-health committee. We try to meet monthly, just to talk about what’s going on with the unit, trying to work on different projects,” she explained. “One thing we did was make an informational pamphlet for the families and the patients that come in for behavioral-health issues because the way we treat them is much different than other patients. And sometimes they’re there for a really long time. So we want to do what we can just to support the families a little bit more.”

Do Carmo praised Ingraham-Shaw for identifying barriers in communication and creating a tool that has improved communication between nurses and patients. “Ellen works very closely with the behavioral-health team to ensure the behavioral-health population receives the needed care plans and treatments.”

 

Long-time Passion

Ingraham-Shaw’s interest in mental health was clear when she first studied psychology in college, but at the time, she couldn’t have predicted how it would become an important aspect of her career.

“When I was looking for jobs, if I didn’t find a teaching job, I was looking for other psychology-related jobs,” she said, adding that she’s in graduate school now, working on her doctor of nursing practice degree (DNP) to be a psychiatric nurse practitioner.

“I always thought that was a possibility, but I didn’t think this was the route I’d take,” she said. “For nurse practitioners, at least, the education track is different. So you’re a nurse first, so you get that compassionate care and bedside manner down first. And then you start learning the more advanced things.”

Once she has her DNP, she said she’d like to stay in the pediatric arena, although she’s hoping to gain a wide range of experience through her clinical rotations.

“Baystate in general is very supportive of education,” she added, noting the system’s tuition-reimbursement and loan-forgiveness programs, in addition to its affiliation with UMass Medical School’s Springfield campus, which is where she’s taking her graduate track.

“One of the reasons why I chose that school is because they have a focus on diversity and behavioral health,” she noted. “So I’ve been working hard, but I have also been lucky to find myself in places, and around people, that are supportive and inspirational, and I’ve been given a lot of opportunities to focus on the things that I want to do.”

As part of her graduate education, Ingraham-Shaw is hoping to focus on opioid and overdose education in her scholarly project. “It’s something I’m passionate about, and I’ve done a lot of my own learning. So I’m hoping to do some more research and actually implement some projects with that.”

For her work creating and cultivating a handful of truly impactful projects at Baystate already, but especially for the promise of what she and her colleagues have yet to come up with, Ingraham-Shaw is certainly an emerging leader in her field, and a Healthcare Hero. n

Emerging Leader: Ashley LeBlanc

By
Ashley LeBlanc
Healthcare Heroes

Practice Manager of Thoracic Surgery, Nursing Director of the Lung Screening Program, Mercy Medical Center

She Has a Proven Ability to Take the Bull by the Horns

Ashley LeBlanc

 

It’s been seven years now, but Ashley LeBlanc clearly remembers the day Dr. Laki Rousou and Dr. Neal Chuang asked her to consider becoming the nurse navigator for their thoracic surgery practice at Mercy Medical Center.

She also clearly remembers her initial response to their invite: “absolutely not.”

She was working days in critical care at the hospital at the time, and liked both the work and the schedule: three days on, four days off, she told BusinessWest, adding that it takes a while for a new position like this to get approved and posted, for interviews to take place, and more — and the doctors used the following weeks to make additional entreaties, with reminders that she wouldn’t have to work any weekends or holidays.

But the answer was still ‘no’ until roughly six months after that initial invite, when she had one particularly challenging day on the floor with a very sick patient. Challenging enough that, when Rousou tried one more time that afternoon, ‘no’ became “I’ll update my résumé and hear you out.”

“He got me at a weak moment, and it was the best decision I ever made, because they have been amazing mentors, and they’ve opened my mind up to this whole other world,” she said, adding that her career underwent a profound and meaningful course change, one that led her to being named a Healthcare Hero for 2023 in the Emerging Leader category.

Indeed, during those seven years, LeBlanc has emerged as a true leader, both in that thoracic surgery practice, which she now manages, and in efforts to promote awareness and screening for lung cancer — one of the deadliest cancers, and one she can certainly relate to personally. Indeed, she has lost several family members to the disease, many of whom would have qualified for screening had it been available at the time of their diagnosis.

“He got me at a weak moment, and it was the best decision I ever made, because they have been amazing mentors, and they’ve opened my mind up to this whole other world.”

In many respects, and in many ways, she has become a fierce advocate for patients related to lung cancer screening, treatment, and research, and concentrates her efforts on ways to decrease the mortality rate of lung cancer and break down the stigma of that disease by educating the community, connecting them to resources, and, in many respects, guiding them on their journey as they fight lung cancer.

When the screening program was launched, those involved didn’t really know what to expect, LeBlanc said, adding that, in the beginning, maybe a handful of people were being screened each month. Now, that number exceeds 250 a month, and while only a small percentage of those who are screened have lung cancer, she said, each detected case is important because, while this cancer is deadly, early detection often leads to a better outcome.

This is turning out to be a big year for LeBlanc, at least when it comes to awards from BusinessWest. In the spring, she suitably impressed a panel of judges and became part of the 40 Under Forty Class of 2023. And in late October, she’ll accept the Healthcare Heroes award for Emerging Leader.

The plaques on her desk — or soon to be on it — speak to many qualities, but especially an ability to work with others to set, achieve, and, in many cases, exceed goals, not only with lung cancer screening, but other initiatives as well.

Dr. Laki Rousou never stopped trying to recruit Ashely LeBlanc

Dr. Laki Rousou never stopped trying to recruit Ashely LeBlanc to manage the thoracic-surgery practice at Mercy Medical Center, and he — and many others — are glad he didn’t.
Staff Photo

Rousou put LeBlanc’s many talents in their proper perspective.

“Before we even had the formal program, I would say something sort of off the cuff, like, ‘I wish we could do this’ … and the next week, I would have the answer, or it would be done,” he said. “Then it turned into ‘OK, let’s try and do this,’ and in the next week or two weeks, it would be done. And then it turned into a situation where she would have an idea and we would talk periodically, but she would take the bull by the horns and just do things that were best for thoracic surgery, but also the screening program.”

This ability to take the bull by the horns, and many other endearing and enduring qualities, explains why LeBlanc is a true Healthcare Hero.

 

The Big Screen

There’s a small whiteboard to the right of LeBlanc’s desk. Written at the top are the words ‘World Conquering Plans.’

This is an ambitious to-do list, or work-in-progress board, with lines referencing everything from a cancer screening program for firefighters to something called a Center for Healthy Lungs, which would be … well, just what it sounds like. “That’s a bit of a pipe dream,” she said. “We’re going to need our own building.”

While it might seem like a pipe dream, if it’s on LeBlanc’s list of things to get done … it will probably get done. That has been her MO since joining the thoracic surgery practice, and long before that, going back, for example, to the days when she worked the overnight shift as a unit extender at Mercy until 7, then drive to Springfield Technical Community College for nursing classes that began at 8.

“Sometimes, I would snooze in the car for 15 or 20 minutes,” she recalled, adding that she wasn’t getting much sleep at that time in her life. “You just do what you have to do to make it happen.”

Initially, she thought what she wanted to make happen was a career in law enforcement — her father was a police officer in Northampton — but her first stint as a unit extender at Mercy, while she was attending Holyoke Community College, convinced her she was more suited to healthcare.

But plans to enter that field were put on ice (sort of, and pun intended) when her fiancé, a Coast Guardsman, was stationed in Sitka, Alaska.

She spent three years there, taking in winters not as bad as most people would think, and summers not as warm as they are here, but still quite nice. And also working for the Department of Homeland Security as a federal security agent for National Transportation Safety Board at Sitka’s tiny airport.

“The evidence is staggering concerning the number of people who have a scan done, and they have an incidental finding, and there is no follow-up for that incidental finding.”

LeBlanc and her husband eventually returned to Western Mass. after a stint on the Cape, and she essentially picked up where she left off, working as a unit extender at Mercy.

“It was five years later, and it felt like I never left,” she said, adding that she soon enrolled in the Nursing program at STCC and, upon graduation, took a job on the Intermediate Care floor, which brings us back to the point where she kept saying ‘no’ and eventually said ‘yes’ to Rousou and Chuang (who is no longer with the practice).

Rousou told BusinessWest they recruited her heavily because they knew she would be perfect for the role they had carved out — and they were right.

Over the past seven years, LeBlanc has put a number of line items on the ‘World Conquering Plans’ list, and made most of them reality, especially a lung cancer screening program, which wasn’t even on her radar screen when she finally agreed to interview for the job.

Indeed, she was prepared to talk about patient education and how to improve it and make it more comprehensive when Rousou and Chuang changed things up and focused on a screening program.

 

Thinking Big

Once she got the job, she focused on both, with some dramatic and far-reaching results.

As for the screening program, she said such initiatives were new at the time because the Centers for Medicare Services had only recently approved insurance coverage for such screenings. At Mercy, with Rousou, Chuang, and, increasingly, LeBlanc charting a course, extensive research was undertaken with the goal of incorporating best practices from existing programs into Mercy’s initiative.

“We had no idea what our expectations should be or how it would be received in the community — it was a very new thing,” she recalled. “That first month in 2017, we did seven scans; then we did 29, and by the end of the year, it was over 50 scans a month. A year after we started, it was over 100.”

Now, that number is more than 250, she said, adding that such screenings are important because, while lung cancer is the deadliest of cancers, there are usually no visible signs of it — such as unexplained weight loss, coughing up blood, or pneumonia — until its later stages.

“When patients are diagnosed with stage 4 lung cancer, the treatment is, by and large, palliative, not curative,” she explained, “which makes it extra important to try to diagnose these people with lung cancer at an earlier stage.”

In addition to her work coordinating the screening program, LeBlanc also handles work implied by her initial title — nurse navigator.

This is work to help the patient understand and prepare for the procedure they are facing, such as removal of a portion of their lung, and answer any questions they may have.

“When the surgeon leaves the room … that’s when a patient will take that deep breath and say, ‘I have so many questions,’” she told BusinessWest. “It can be overwhelming, and this gives me an opportunity to answer those questions, which can involve anything from the seriousness of the procedure to where to park or what to bring to the hospital with them.”

Meanwhile, she has taken a lead role in efforts to build a strong culture within the thoracic surgery and cancer screening programs, where 14 people now work, and make it an enjoyable workplace, where birthdays and National Popcorn Day are celebrated, and teamwork is fostered.

“I think it’s important to enjoy where you work, and when we’re happy, I think that carries over to patients, and they feel that,” she said. “At Easter, we have an Easter egg hunt, with grown, professional adults running around the office looking for Easter eggs. It seems silly, but it’s wonderful at the same time.”

Then, there’s that ‘World Conquering Plans’ board next to her desk. LeBlanc said she and the team at the practice have made considerable progress with many of the items on that list, including plans to expand the office into vacated space next door with an interventional pulmonary department and an ‘incidental nodule’ program.

The interventional pulmonary program is a relatively new specialty that focuses on diagnosis of lung disease, she said, adding that an interventional pulmonologist has been hired, facilities have been created, and patients have been scheduled starting early this month.

Progress is also being made on the incidental nodule program, which, as that name implies, is a safety-net initiative focused on following up on the small, incidental nodules on the lungs that show up on scans other than lung cancer screenings and are often overlooked.

“The evidence is staggering concerning the number of people who have a scan done, and they have an incidental finding, and there is no follow-up for that incidental finding,” she explained, adding that such findings often get buried or lost in reports. “When patients come to Dr. Rousou, they’ll often say, ‘I’ve had a scan every year for the last so many years; how come no one saw this until now?’”

 

Breathing Easier

As for the Center for Healthy Lungs … that is a very ambitious plan, she said, one that exists mainly in dreams right now.

But, as noted earlier, LeBlanc has become proficient in making dreams reality and in drawing lines through items on her whiteboard.

That’s what Rousou and Chuang saw when they recruited LeBlanc — and kept on recruiting her after she kept saying ‘no.’

They could see that she was an emerging leader — and a Healthcare Hero. n

Emerging Leader, Dr. Sundeep Shukla

By
Healthcare Heroes

Chief and Physician, Baystate Noble Hospital Emergency Department

He Has Devoted His Career to Improving the Community’s ‘Safety Net’ Net’

Leah Martin Photography

Dr. Sundeep Shukla, or ‘Sunny,’ as most everyone calls him, has always felt at home in the emergency room, and he has never really wanted to work anywhere else.

There is a fast pace and decidedly unpredictable nature to the work, he told BusinessWest, noting that each day, and each hour, are different from the one before and the one after. But there are many more reasons why he has chosen to spend his career in this setting, the most important being the ER’s important role, both to the hospital in question and to the community it serves.

“The emergency room is the safety net for all patients,” Shukla explained. “Many patients do not have access to healthcare; we feel that the ER can provide care to anyone who walks through the door, regardless of whether you have insurance, regardless of your background; we’ll see anyone who walks through our doors, and I’m proud to say that.”

But Shukla has done more than work in the ER. Indeed, throughout his career he has devoted time and energy to bringing new efficiencies, better ways of serving patients, and, yes, better ways of doing business to the ER, especially in his current role as chief of the Emergency Department at Baystate Noble Hospital in Westfield.

And he brings what would be considered a somewhat unique background to this assignment. In addition to his undergraduate degree from the University of Missouri and his medical degree from Manpial University in Karnatka, India, Shukla also earned an MBA, with an emphasis in medical management, from UMass Amherst in 2017.

He has used all these degrees, as well as his hands-on experience in the ER, to help improve service, efficiency, and quality, and reduce wait times and what are known as ‘walkouts’ — people who come to the ER but leave before being seen, for whatever reason.

“Having earned that MBA, I was able to reconfigure how I look at things in my brain. Before, it was all medicine-related, but by doing the MBA, I was able to focus on flow and how we could improve certain processes to make an impact on the total visit.”

“Having earned that MBA, I was able to reconfigure how I look at things in my brain,” he told BusnessWest. “Before, it was all medicine-related, but by doing the MBA, I was able to focus on flow and how we could improve certain processes to make an impact on the total visit.

“At Baystate Noble, we do small thinks like put a greeter in the waiting room so when patients come in there’s someone they can talk to, someone they ask questions to; they round, they give patients blankets or small things just to make them feel appreciated,” he went on. “We also strive to push our nurses and docs to really bring patients in when they come into the ER; they don’t sit very long in the waiting room.”

As a result of such initiatives, Noble’s ER has made great strides during Shukla’s tenure. The unit has dramatically increased patient-satisfaction scores, for example, while also gaining certification as a geriatric ED, well-suited to serve the needs of older patients in the community.

The sum of these efforts has earned Shukla the Healthcare Heroes award in the highly competitive category known as Emerging Leader. And he is worthy of that designation, not only for his work in the ER, but also at Baystate Health (he is on the system’s board of directors), in the community (he sits on the nonprofit People’s Institute and also coaches youth soccer and baseball), and even on the ice.

Indeed, Shukla is one of the team physicians for the Springfield Thunderbirds, and was with the team through its exciting run to the Calder Cup finals last season.

He described that work as fun and rewarding — adjectives he would apply to every aspect of his work in medicine and administration.

 

Degrees of Improvement

Shukla was born in England and came to this country with his family in 1980. Early on, he said, his father, a professor of Pharmacology at the University of Missouri, and mother, a school teacher, impressed upon him the importance of not only education, but service to the community.

He achieved both while serving as a volunteer at the University of Missouri Hospital and Clinics while in junior high school, work he described as a learning experience on many levels.

“During the summer, I went there every Tuesday and Wednesday and spent eight hours each day volunteering in different parts of the hospital,” he recalled. “It was then that I realized that this was my true calling because I really wanted to help people and really wanted to make a difference.”

After graduating from medical school, he became a resident at Baystate Medical Center with a focus initially on general surgery. But at the advice of some friends who implored him to consider emergency medicine because he seemed a natural for that kind of work, his career outlook began to shift.

Dr. Sundeep Shukla, seen here with his son, Deven

Dr. Sundeep Shukla, seen here with his son, Deven, is one of the team physicians for the Springfield Thunderbirds, one of the many ways he is involved in the community.

“I did some shadowing, I did some shifts in the ER, and eventually I went through the process of applying to be an ER resident,” he said, adding that he quickly fell in love with that setting — again, not just because of the fast pace and each-day-is-different aspect of the work.

“Not everyone has access to healthcare, and I’m a big proponent of health equity because I feel everyone should have the same access to healthcare as your next-door neighbor,” said Shukla, who, before coming to Noble, served as associate medical director in the Emergency Department at Baystate Franklin Medical Center. “When patients some come to my ER, I treat them with respect, I treat them exactly how I’d want to treat my family members, and I try to everything I can to make sure their health is better when they leave the ER.”

Elaborating, he said many people are coming to the ER on the worst day of their life, whether they’re having a stroke, a heart attack, or other medical problem, and it is the job of the ER doctor to “step up and help those patients.”

“It’s our goal to help lift them up and help them feel better,” he went on. “And in terms of mindset, you have to be able to function on the go and multi-task many different things, because there so many problems that are detail-oriented: the lab or CT scan, whether you have to stitch someone up, give different medications … there are all these processes you have to follow, and with every visit, there’s quality involved, and you have to meet certain metrics.”

Despite the fast pace and the constant flow of new patients, Shukla said he makes it a priority to truly connect with his patients.

“I always try to make a connection with my patients because, if I’m able to make that connection, whether it’s with a sports team that they like or a restaurant that they enjoy or some type of hobby they like, I feel like we can relate much better, and they can trust me. They just met me just a few minutes ago, so it’s really important that I build a trust and a relationship with them so that when I give them advice or we have what’s called ‘shared decision making,’ we can come with a good plan together. That’s why I’ll always spend the extra minute just to know them a little better.”

“They just met me just a few minutes ago, so it’s really important that I build a trust and a relationship with them so that when I give them advice or we have what’s called ‘shared decision making,’ we can come with a good plan together. That’s why I’ll always spend the extra minute just to know them a little better.”

Shukla currently works at all the hospitals in the Baystate system — Baystate Medical Center, Baystate Wing, and Baystate Noble — and became chief of the ER at Noble in March 2020, just as the pandemic was reaching Western Mass.

In each setting, and especially at Noble, he has been consumed with not only treating patients and making those important connections, but improving the overall experience.

“We try to look at the entire process — from when a patient walks into the waiting room all the way to when they go home,” he explained, adding that little things, such as having a greeter in the ER and having nurses, doctors, and other care providers working collaboratively so that patients don’t have to repeat their history and answer the same questions over and over again, often add up to big improvements in service, patient-satisfaction ratings, and statistics such as those concerning walkouts.

“The most dreaded word that most people see in emergency medicine is walkouts, which is basically a person who registered but wasn’t actually seen,” Shukla said. “That’s a problem throughout the United States, so we work really hard in the Baystate Health system to bring those numbers down. Even one patient walking out troubles us.”

Meanwhile, throughout his career, and even more so during COVID, he has put considerable emphasis on outreach and educating the community, with the goal of helping people make better, smarter choices about their health and well-being.

Indeed, he’s a frequent guest on area radio stations and has penned articles for several media outlets, all with the goal of creating a better-informed community.

“If people are educated, they can take care if their health better,” he said, adding that such efforts took on greater importance during the height of the pandemic, when the public had more questions — and needed more answers — and trust was a huge factor.

“We had a lot of COVID issues to contend with, but we also had to build up trust in the community,” he said, “because a lot of people were concerned about the ways people were contracting COVID, how they would protect themselves, the vaccines … there were many thongs we had to educate people on, and we did a lot of outreach for that.”

 

ERing on the Side of Caution

Overall, Shukla, as chief of the ER, assumes a role that blends medicine with administration, and, with his background and MBA training, he can bring a unique perspective to the table.

“Not many physicians go back and get a degree like an MBA; most of us go to school for a very long time as physicians, so not a lot of us go back,” he explained, adding that he enjoys both sides of the equation — business and especially medicine.

“It’s important for me to be well-rounded and understand how things are run,” he said, adding that he took a marketing class in 10th grade and since then has always been fascinated by business and management. “I really enjoy business, and so there’s the budget/financial aspect that I really like in administration, because I feel I can look at spreadsheets and Excel sheets in a different way than I did a few years ago before I earned my MBA.

“I understand the budget and the finances a lot more than I used to,” he went on, “and also how I can cut costs and improve efficiency in the ER, whether it’s flow in the ER or how I can reduce the cost of staffing or increase staffing to help show a return on investment.”

Going all the way back to when he was volunteering at the University of Missouri Hospital as a junior-high student, Sunny Shulka has known that he was destined to be in a profession — and a place — where he could help people.

That profession turned out to be healthcare, and the place is the ER, or the safety net, as he called it, which is now more his home.

For his efforts to continually improve that safety net, make it stronger, more welcoming, more comfortable, and better able to serve all those who come through its doors, Shukla is certainly an emerging leader, and truly a Healthcare Hero.

 

George O’Brien can be reached at [email protected]

Dr. Sarah Haessler

By
Healthcare Heroes

Emerging Leader

Hospital Epidemiologist, Baystate Medical Center; Vice Chair for Clinical Affairs, Department of Medicine, Baystate Health

Dr. Sarah Haessler

Dr. Sarah Haessler

She ‘Stands on a Wall Between the Community and Infectious Diseases’

Dr. Sarah Haessler has already been honored as a Healthcare Hero. Actually, a ‘Healthcare Superhero,’ to be more precise.

That was the unofficial title bestowed upon 76 fully vaccinated healthcare workers from across New England who attended the Super Bowl last February as guests of New England Patriots owner Robert Kraft. The group flew down on the Patriots’ team plane and got to see Tom Brady win his seventh Super Bowl — and promote vaccination while they were at it.

Haessler, hospital epidemiologist at Baystate Medical Center and vice chair for Clinical Affairs in the Department of Medicine at Baystate Health, was one of three from this region to be so honored; she was joined by Baystate colleague Stephen Boyle Sr., senior director of Hospitality; and Cherie Rodriguez, a respiratory therapist at Mercy Medical Center.

Haessler has many memories from that day, with only some of them involving the action on the field.

“It was the quintessential American experience,” she recalled, noting that healthcare workers from across the country were recognized at the game. “It was big. Everything about it was big. The music was loud, there were fireworks for everything, there were military flyovers, the jumbo screens had the president on them … America doesn’t do anything small. This was very big and very American.”

“Her role is to stand watch on the wall between our patients, our team members, our community, and the infectious agents that threaten their health. And she has successfully done this for more than a decade, not only in the face of a global pandemic the likes of which we have not experienced for more than 100 years, but every day of the year. Because in healthcare, those threats never cease.”

Haessler said pairs of tickets to the game were made available to various hospitals, and she was chosen by officials at Baystate to attend; she’s not sure how or why.

Matters are a little more clear when it comes to her being chosen as the winner in the intensely competitive Emerging Leader category for BusinessWest’s Healthcare Heroes awards. She has been chosen in large part for her many efforts to prepare those at Baystate for what was coming in early 2020 and for her ongoing work throughout the pandemic to plan, educate, and help carry out all the operations of a hospital during extraordinary circumstances. But there is certainly more to the story. Indeed, COVID-19 wasn’t her first experience with a highly infectious disease, and she acknowledged, with some resignation born from experience in her voice, that it won’t be her last.

Meanwhile, she has taken on more leadership roles over the years, serving as interim chief medical officer at Baystate Noble Hospital and currently sitting on the board of the Society of Healthcare Epidemiologists of America.

Her work in her chosen field, and her status as an emerging leader in Western Mass. and beyond, is best summed up by Dr. Andrew Artenstein, chief physician executive and chief academic officer, incident commander, COVID-19 Response, at Baystate Health, who nominated her for this honor.

“Her role is to stand watch on the wall between our patients, our team members, our community, and the infectious agents that threaten their health,” he wrote. “And she has successfully done this for more than a decade, not only in the face of a global pandemic the likes of which we have not experienced for more than 100 years, but every day of the year. Because in healthcare, those threats never cease.”

In a candid interview, Haessler talked about that harsh reality, her work at Baystate, her chosen career in epidemiology, and the many kinds of rewards that come with it.

 

At the Top of Her Game

When asked how she chose epidemiology as a specialty, Haessler started by saying that, during her residency at Dartmouth, she was interested — make that fascinated — by all aspects of medicine. It soon became clear to her that she needed to pick something broad that would cross all other specialties.

“When I sat down to pick one, I ultimately decided that the specialty where the cases that kept me up late or got me up early in the morning to learn more and read more and try to figure out what was wrong with this person — these puzzles — were the cases that were most interesting to me, and the most satisfying and challenging. And that was infectious disease,” she told BusinessWest.

Dr. Sarah Haessler was one of many ‘Healthcare Superheroes’

Dr. Sarah Haessler was one of many ‘Healthcare Superheroes’ in attendance at last February’s Super Bowl in Tampa.

“I’ve never looked back — I’ve always loved it,” she went on, adding that, in this field, she does get to interact with specialists of all kinds. “It’s been an interesting career — I’ve never been bored. And the other thing about it is that it just keeps moving. I’m a high-energy person — I keep moving — so it suits me very well.”

Things were certainly moving in the latter days of 2019, said Haessler, noting that the information coming to her from hospital epidemiologists in China, and later the state of Washington, made it clear that something ominous was on the horizon.

“We saw the pandemic potential for it because it was so swift and had created a huge influx of patients in those hospitals in Wuhan,” she recalled. “It essentially overwhelmed those hospitals immediately, and the fact that China’s approach was to put the area in lockdown … that is the kind of organism, like SARS, that causes a pandemic.”

She said Baystate was ready, in large part because it had gone through this before with other infectious diseases and had learned many valuable lessons. And she was at the forefront of these efforts.

“We had been through H1N1, and then we had been through the Ebola epidemic,” she explained. “And this really created an impetus, and a framework, across the United States for preparedness for the world’s most contagious diseases.”

Because of Ebola, Baystate had created a Special Pathogens Unit to manage extremely contagious patients, said Haessler, who manages this unit and the team that operates it. And as part of that team’s work, it created protocols and procedures for how it would manage patients, took steps to ensure that there would be adequate supplies of PPE, put in place scenarios for how patients would be cared for and where, determined if, when, and under what circumstances elective surgeries would be halted, and much more.

In short, as Artenstein noted in his nomination, Haessler was the point person for preparing the medical center for what everyone could see was coming.

“Her work provided great comfort to all, knowing that we had such an expert in such a key role,” he wrote. “Her team’s magnificent work in collaboration with employee health services led to the earliest possible recognition of infectious contacts and allowed us to limit the risks for patients and staff during a time of great uncertainty and fear.”

While the past tense is being used for most of these comments, the work battling COVID is obviously ongoing, said Haessler, adding that the Delta variant brings a new and very dangerous thread to this story.

When asked about what the past 18 months has been like, personally and professionally, she said, in essence, that it’s been the culmination of all her training and hard work.

“It’s been one of biggest events that I’ve had to participate in, and while it’s been challenging, it’s also been very gratifying, because Baystate has been an incredible organization, rising to the occasion in this. I’m so proud of Baystate; I’ve never been more proud to work at this organization and to be part of the leadership team.

“The responsiveness, the focus on what was important and what remains important, has been incredible,” she went on. “It’s been a laser focus on the safety of the healthcare workers, and protecting our patients and our healthcare workers from getting and passing this disease, getting the resources we needed to enable safe management of these patients, and staying really, really focused on what’s important here has been a phenomenal experience and an opportunity for tremendous personal and professional growth.”

 

Passing Thoughts

Returning to Raymond James Stadium and Super Bowl LV, Haessler said she had the opportunity to meet with healthcare workers from across the country who had been, at that time, battling with COVID for roughly a year.

“It was an opportunity to meet with other people, commiserate, and just be among kindred spirits — people had been through so much,” she said, adding that, seven months later, the fight continues, and in some ways, it has escalated.

In the future, there will be other fights against infectious diseases, she said, adding that the best hospitals and healthcare systems can do is try to be prepared, because, as Artenstein noted, these threats never cease.

That, in a nutshell, is what her career has been all about. Her ability to exceed in that role and many others has made her a Healthcare Hero — and a ‘superhero’ — as well as an emerging leader in Western Mass. and her chosen field.

 

George O’Brien can be reached at [email protected]

Tara Ferrante

By
Healthcare Heroes

She’s Forging Pathways to Help People Overcome OCD and Hoarding Disorder

Tara Ferrante

To illustrate one of the many ways obsessive-compulsive disorder, or OCD, can manifest itself, Tara Ferrante said everyone has stood at a rail atop a high building, looked down, and thought, what if I jumped? It’s a little scary, and basically harmless.

“But with OCD,” she continued, “you actually evaluate that thought and think it could happen, and then, ‘I must be a terrible person to have that thought.’ Or it creates anxiety because that thought means something, and you have to do something to feel better.”

OCD often begins as an intrusive thought, she explained, and everyone has intrusive thoughts. What sets OCD sufferers apart, though, is their response to those thoughts. “Sometimes it’s a compulsion, sometimes avoidance — ‘I can’t be in tall places,’ or ‘I can’t be around knives, because I imagined myself stabbing someone once, so I must be a dangerous person. What person must think something like that? I must be a horrible person. People shouldn’t be around me.’”

But while avoidance — or whatever compulsive, repetitive action helps to mitigate that intrusive thought — might bring temporary relief, it also reinforces the initial evaluation of that thought, she went on, “so the next time that thought comes up, you’re stuck in that same cycle where you have to do something to feel better.”

Then there’s the behavior known as hoarding, which buries people, both psychologically and literally, in their own possessions because they’re unable to get rid of anything — presenting a wide variety of dangers.

“It can be a fire risk, or it can be a fall risk, especially as people get older, or someone may have other health issues and the path’s not wide enough for a gurney to get into their house for emergency support,” Ferrante said.

“It also causes people to isolate more — they’re afraid to have people in the home, or to reach out to people,” she went on. “There’s a thing called clutter blindness, where they might not see all the clutter, but when another person is there, it’s striking. There’s the shame and the guilt and everything else that comes up around that, so a lot of people do isolate more because of the clutter.”

Ferrante is program director of the Holyoke Outpatient Clinic at ServiceNet, one of the region’s largest behavioral-health agencies, and treats patients with a wide range of behavioral-health conditions. But it’s her work leading ServiceNet’s OCD and Hoarding Disorder Program that earned her recognition as a Healthcare Hero in the category of Emerging Leader.

To be sure, Ferrante doesn’t see herself as a hero — just someone passionate about helping people overcome behaviors that range, depending on the patient, from mildly annoying to completely debilitating.

“It feels so good to see people thriving in their lives who wanted to die at points,” she told BusinessWest. “While their lives may not be perfect by any means, they’re able to live their lives the way they want to, with much more ease.”

Starting the Journey

Ferrante’s journey in this specialized field began while working with a client who was experiencing extreme distress from OCD symptoms. She had read about emerging OCD treatments, learning that the most effective approach seemed to include a mix of structured clinical treatment and home-based and peer support.

So, two years ago, when ServiceNet’s senior leadership proposed the launch of an OCD program in Western Mass., she jumped at the opportunity to lead the program.

“They saw this area as a kind of desert in terms of people who can really specialize and are able to provide good care to people with OCD and hoarding disorder,” she explained. “I was super interested, and I expressed interest in overseeing it.”

“It feels so good to see people thriving in their lives who wanted to die at points. While their lives may not be perfect by any means, they’re able to live their lives the way they want to, with much more ease.”

Before launching the program, Ferrante and fellow clinicians first completed four days of training in OCD and hoarding disorder, then conducted a series of consultations with two nationally recognized experts on these conditions: Dr. Randy Frost, a professor of Psychology at Smith College, and Denise Egan Stack, a behavioral therapist who launched the OCD Institute at McLean Hospital in Belmont, a Boston suburb.

“We’ve been so lucky,” Ferrante said. “People have invested so much time and energy in our program to get it off the ground and get it going and helping me as a leader. It’s been really great.”

Currently, six ServiceNet clinicians provide specialized OCD and hoarding-disorder treatment at the agency’s Holyoke, Greenfield, and Northampton clinics. The program’s model continues to evolve, but several facets have crystalized, including the use of Smith College students as interns in the program. Frost trains the students for adjunct work in the community, such as conducting ‘exposures’ with clients battling OCD, Ferrante explained.

“They’ll give emotional support to people [with hoarding disorder] as they are sorting and discarding, or as they go out and practice non-acquiring — going to a store where they like buying things, and then not getting anything, sort of building up the tolerance of resisting that urge.”

Tara Ferrante says people with OCD and hoarding disorder span all ages and demographics.

The student collaboration has been valuable and productive, she noted. “We’re limited in how much we can get out into the community or into the home between sessions. The introduction of the interns has helped create steady progress.”

The term ‘hoarder’ is actually out of fashion, she noted, having taken on a stigma in recent years, thanks partly to TV shows that often vilify those who struggle with the condition. Frost has written extensively about the reasons people hoard; some call themselves ‘collectors’ or ‘finders-keepers’ because they see value in every item in their cluttered homes.

“That’s a strength, to be able to see value where other people don’t, or to see beauty where other people don’t,” Ferrante said. “But it’s a strength that’s gone too far, and that can make a hindrance in being able to get rid of things. Also, people don’t want to be wasteful, they don’t want things to go into landfills, and again, that’s really a wonderful quality — but it then impedes their quality of life.”

Hoarding is also a form of perfectionism, at least in the eyes of collectors, she went on. “You want to use something to its full ability, or it needs to go to the just right place. Or, if it’s going to be given away, it needs to be given to just the right person who’s going to love it fully, and if you can’t find that person, then you’re just going to keep it, and that can stall progress sometimes.”

As for OCD, like many mental-health conditions, it can differ in severity from one person to another, Ferrante said.

“Sometimes people can function pretty well, but even for those people who aren’t seeking treatment, it can affect their ability to have relationships, to get to work on time, even to leave their house,” she explained. “There are so many ways it can make people’s lives difficult. And even if they can function sometimes, they’re living in this constant state of anxiety and panic, which is really unpleasant.”

Then there are the more severe cases — stories of people unable to touch their children or their partners for years, or unable to leave their home, hold a job, or participate in life in any way.

The standard treatment in Ferrante’s program is known as exposure and response prevention, a form of cognitive behavior therapy.

“We form a relationship and create situations where they get exposed to the anxiety, the intrusive thought, and we don’t do the compulsion,” she explained. “We do it in a supported way at first, in session, and then we have the interns who can do that out in the community, and eventually we want people to do it on their own. We make exposure part of life — this idea of, ‘let’s turn toward anxiety rather than away from anxiety.’ It takes the power out of it, and they’re able to really start living their lives the way they want to be living.”

Many patients are treated with a combination of therapy and medications, often anti-depressants. “But not everyone needs meds,” she said. “I see a lot of positive outcomes with just exposure and response prevention on its own.”

Breaking Through

The ServiceNet program runs a series of support groups called Buried in Treasures, named after a book Frost co-authored. Ferrante also sits on the board of the Western Massachusetts Hoarding Disorder Resource Network, which puts on conferences that focus on what resources are available in the community for those who struggle with the condition. ServiceNet also brings in experts for lectures where mental-health professionals can earn CEUs for learning more about hoarding and OCD.

All this training is aimed at broadening resources for a patient population that cuts across all socioeconomic barriers and cultures around the world. Hoarding, in particular, is often seen as an older person’s condition, but that may be because they’ve had more time to accumulate, so the signs are more readily apparent.

Progress in overcoming a compulsion to hoard can be slow, Ferrante added. “That stuff didn’t get in the home overnight, and it’s not going to get out overnight. I mean, it can get out of the house overnight, but that generally is going to make things worse — it creates a trauma, it makes the person treatment-resistant, and doesn’t actually address how it all happened.

“It’s almost a guarantee, if someone has a forced cleanup, they’re going to fill their space up again,” she went on. “So we take a slower approach that looks at what got someone there and creates the skills they need to declutter on their own, and not have it return.”

While people who hoard often struggle with stigma, OCD sufferers are plagued with the opposite: the many Americans who think they have OCD because they have certain routines, and proclaim it with an odd sense of pride.

“They say, ‘oh, I’m so OCD,’ and it really minimizes it for people who are suffering,” Ferrante explained. “It’s not just being really clean or wanting things in a certain order. If those things are torturing you and you can’t function, sure, but people can have certain obsessions or compulsions and not have OCD. The ‘D’ part of OCD is that it’s impairing your ability to function, and most people who say, ‘I’m a little OCD’ … well, they’re not.”

On the other hand, it’s also frustrating for someone with OCD to be misdiagnosed, she added.

“I get calls from people saying, ‘I’ve been looking for help forever; no one knows what I’m talking about.’ Sometimes, when people think they’re dangerous because of an intrusive thought, then a therapist buys into that because they’re not sure what this is, and it reinforces that belief. But even suicidal thoughts can be OCD. People can get hospitalized when that’s not the right intervention. You want an expert making sure you’re making the right call there.”

Outside of her OCD and hoarding work, Ferrante continues to manage all the clinicians at the Holyoke clinic, and handles a caseload of about 15 patients at a time, dealing with a wide range of mental-health concerns, from substance-use disorders to trauma, anxiety, and depression. In that sense, she and her team were already doing heroic work before launching the OCD and Hoarding Disorder Program.

But since that launch, she’s been able to help a patient population that often finds it difficult to access resources — and wind up suffering in silence, and often falling prey to other conditions; in fact people who hoard are 80% more likely than the general population to develop depression.

“It’s amazing to see people get better,” she told BusinessWest, whether progress occurs quickly or not. “It’s not always simple — sometimes there’s more than just OCD going on, and it’s more complicated. But if people are coming in, they’re already motivated to do the work, and progress can be pretty quick.”

She thinks of the client who inspired her interest in OCD research, and said “it blows my mind” how far he’s come.

“It’s so, so great when people graduate and don’t need therapy anymore. To see even small progress — people being able to do things they couldn’t do before — makes my job totally worth it.”

Joseph Bednar can be reached at [email protected]

Emerging Leader: Peter A. DePergola II

By
Peter A. DePergola II
Healthcare Heroes

In the Emerging Field of Bioethics, He’s a Leader and a Pioneer

Peter A. DePergola II

Peter A. DePergola II

Oddly, he doesn’t actually remember where or when he got it.

But Peter DePergola’s copy of Rembrandt’s renowned The Return of the Prodigal Son looms large in his small office (it takes up most of the back wall) and, far more importantly, in his life and his work.

The painting, as most know, depicts the moment in the Biblical parable when the prodigal son returns to his father after wasting his inheritance and falling into poverty and despair. He kneels before his father in repentance, wishing for forgiveness and a renewed place in the family.

DePergola, director of Clinical Ethics at Baystate Health, the first person to wear a name badge with that title on it and the only clinical bioethicist in the region, says the painting — and the story of the prodigal son — provides a constant reminder of the importance of not judging others and providing them with what they need, not what they deserve. And that serves him very well in his work.

“The story is about sins and forgiveness, but what it teaches me about healthcare is that we should never treat our patients based on what we think they deserve morally, but on what they need, and only what they need,” he explained. “We don’t get to say, ‘you’re a murderer,’ or ‘you’re an adulterer,’ or ‘you’re an alcoholic — if you really wanted to stop, you can.’

“We have to meet them in the middle of their chaos, to sort of run out to them,” he went on, “and to treat them based on what they need and who they are, not on what we think they deserve.”

“It’s not that they don’t understand that medicine has its limits — I think they do. But they’re living in this larger narrative of ‘who am I if I don’t do everything I can for the person I love most?’”

‘Meeting them in the middle of their chaos’ very often translates into a time when decisions have to be made — difficult decisions — about what can be done for a patient and what should be done; about what is proper and what is needed (there’s that word again).

“There are plenty of things we can do, but shouldn’t,” he went on, adding that such dilemmas are becoming ever more common as the population ages and modern science finds new and different ways to extend life.

The issue he confronts most often involves what kind of life is being extended — and whether that kind of life should be extended. And within that broad universe there are countless other matters to consider, discuss, and debate — and they involve everything from raw science to individuals’ base emotions and perceptions about what is right, wrong, and proper.

“Family members will say, ‘I know this isn’t going well, but am I a loving daughter if I say this is the end? How do I think through this?’” he told BusinessWest as he recounted the type of conversation he has most often. “It’s not that they don’t understand that medicine has its limits — I think they do. But they’re living in this larger narrative of ‘who am I if I don’t do everything I can for the person I love most?’”

Overall, his work in the broad realm of bioethics involves everything from these end-of-life issues to the use of animals in research to potential conflicts of interest and conflicts of commitment. DePergola summed it all up in intriguing fashion by saying “no one ever calls me when something good is happening.”

Despite this, and despite the difficulty of his work — not to mention the long hours and often unusual hours; he was recently called to Baystate at 1 a.m. — DePergola finds it rewarding on many levels.

He likes to say he helps people make sense of nonsense and not necessarily answer questions that can’t be answered, but enable people to cope with them.

“People will say, ‘I’ve lived a good life, and I’ve always done the right thing, and here I am, with six months to live. Why must I suffer? Why do I have to be in pain? Why do I have to be in the hospital?’” he noted. “And at the end of the day, I’d say, ‘I don’t know, it’s not fair, I don’t understand. But let’s not understand together.’

“You don’t have to go through not knowing alone,” he went on, hitting upon the best answer to the question of why his role now exists. “And that may be the only antidote to that question; I can’t tell them why bad things happen to good people, but I can be there with them when they’re asking that question and looking for answers and looking for compassion.”

For his multi-faceted efforts — many if not all of which fall into the category of pioneering — DePergola has, well, emerged, into not just a leader in his field, but a Healthcare Hero.

Work That Suits Him

There’s a white lab coat hanging on a hook just inside the door to DePergola’s office, and it’s there for a reason.

While not a medical doctor, DePergola is a member of a clinical team that interacts with patients and their families. The white coat isn’t required attire, and he didn’t wear it earlier on his career. But he does now, and the explanation as to why speaks volumes about the passion he brings to this unique job every day.

“When I used to come dressed in a suit to have these very important conversations with patients and families, I think it was intimidating in a way,” he explained. “I did it out of respect … you’re going to have the most intimate conversation a family’s ever had — what would you wear to that? You’d want to wear something that says, ‘I really care about this. and I care about you.’

“But it looked like I was a lawyer, and people couldn’t get past the outward appearance,” he went on. “Sometimes just a shirt and tie is too casual, but the combination of the lab coat and the tie seems to send the right message.”

There are other examples of this depth of his passion for this work, including his desire to understand the role religion plays in making those hard decisions described earlier.

“I knew that what I was getting into had a lot of value implications,” he explained, “and that the primary pathway into those values was religious commitments. So I got a master’s degree in theological bioethics so I could make sure that I understood what Hindus and Buddhists believed about end-of-life care the same as Orthodox Jews and Catholics, and what Muslims thought about autopsy, so I could meet them not just where they are clinically, but where they are biographically and in their values.”

As he talked about his career and what he was getting into, DePergola stated what must be considered the obvious — that he didn’t set out to be a bioethicist. That’s because this field hasn’t been around for very long — only since the early ’80s, by his estimates — and it’s especially new in the Western Mass. region. In essence, and to paraphrase many working in healthcare, the field chose him.

“Larger American cities — New York, Boston, Los Angeles — have had full-time clinical bioethicists since probably the end of the 1980s,” he explained, adding, again, that he’s the first in the 413. And in many respects, he helped create the position he’s in and write the lengthy job description.

To fully explain, we need to back up a bit.

After earning his bachelor’s degree in philosophy and religious studies at Elms College (early on, he thought he might join he priesthood, but settled on a different path), and then a master’s degree in ethics at Boston University and his Ph.D. in healthcare ethics at Duquesne University, DePergola completed a residency in neuroethics at University of Pittsburgh Medical School and then a fellowship in neuropsychiatric ethics at Baystate, then the western campus of Tufts Medical School, in 2016.

“The patient is always the priority. In risk management, it’s the hospital first, then the patient. With me, it’s the exact opposite; I make sure everyone’s voice is heard.”

While completing that fellowship, he took on some duties in the broad realm of research ethics, a large subset of this emerging field, but this work was eventually expanded into a new leadership position at Baystate — director of Clinical Ethics, a role he said he helped create in partnership with the health system.

“I did a lot of convincing, and I sort of sold the problem,” he said.

“Medicine tells us what we’re able to, and the law tells us what we’re allowed to do. But neither one tells us what’s good to do. And how we navigate the mean between extremes? If we did everything possible for our patients, we’d be deficient, and there are plenty of things we could do without breaking any laws, but that wouldn’t be in itself good for patients. So we needed someone to step into a leadership role.”

In creating the position and its job description, he and members of Baystate’s leadership team borrowed from models already in existence at similarly sized healthcare systems, especially those at Maine Health, the Carolinas Health System, and the Henry Ford Health System.

DePergola said there are four main categories, or pillars, to his work: clinical ethics, research ethics, organizational ethics, and academic ethics, or ethics education.

The primary domain, as one might expect, is clinical ethics, and in that role, he meets with patients, family members, and healthcare professionals “as they navigate the moral terrain of life-and-death decision making at the beginning, middle, and end of life,” he explained.

“I see everyone — from patients and their families in the Neonatal Intensive Care Unit to our geriatric patients, to everyone in between, whether it’s a patient in infectious diseases or genetics or ob/gyn.

And, as he said, no ever calls him when anything good is going on.

Questions and Answers

As he talked about his work in bioethics and many of the difficult conversations he becomes part of, DePergola summoned a quote from Aristotle that he’s undoubtedly already used countless times in his short career.

“He said, in essence, that something is good if its fulfills the purpose for which it was made, and bad if it doesn’t,” said DePergola, adding that such a benchmark, if one chooses to call it that, should be applied to all aspects of healthcare, including everything from a feeding tube to any other step that might be taken in an effort to prolong life.

“If it’s not going to fulfill the purpose, is it good? We need to think about the logic of what it would mean to provide a clinical treatment without a clinical reason,” he went on, adding that such questions loom large in his field of work and often bring him to another difficult discussion — the one juxtaposing quantity of life against quality of life.

Such thought patterns help DePergola as he goes about his various duties, during which — and he makes this point abundantly clear — he advocates for the patient first, not the health system that employs him.

And this distinguishes his work from that of those in the broad realm of risk management.

“The patient is always the priority,” he explained. “In risk management, it’s the hospital first, then the patient. With me, it’s the exact opposite; I make sure everyone’s voice is heard.”

And not only heard, but understood, he went on, adding that the cornerstone of success in this field (if one can even use that word within it) is establishing trust.

Wearing a white coat instead of a suit coat is part of it, but a bigger part is understanding exactly where someone is coming from. And this comes from taking the time to understand their situation, their religious beliefs, and much more.

Even then, the decisions don’t come easy, he went on, adding that his work often comes down to helping parties decide between the better of two bad options and coping with questions that, as he noted, can’t really be answered.

Such sentiments are reflected in DePergola’s thoughts on other aspects of his work, especially his teaching — he’s an assistant professor of Medical Humanics at Elms College, where, in the small-world department, had Erin Daley, director of the Emergency Department at Mercy Medical Center and the first Healthcare Hero in the Emerging Leader category, as one of his students.

“I always try to emphasize to my students that the big questions of medicine that patients are asking have little to do with medicine, that the big problems in medicine have little to do with medicine,” he told BusinessWest. “They’re questions of meaning, purpose, identity, and value.

“They don’t show up on X-rays, you can’t write prescriptions for them, and we can’t bill for that,” he went on. “Medicine is very good at addressing ‘how’ questions — as in ‘how does ammonia work?’ — but it’s very poor at addressing the ‘why’ questions. And I think that, when we fail to connect with our patients in medicine, it’s because we’re giving ‘how’ answers to ‘why’ questions.”

Framing the Question

Returning to Rembrandt’s Return of the Prodigal Son, DePergola said there’s another reason why that painting resonates with him.

It has to do with how many times he has the same conversations with different people, such as the one about miracles, and walking them through the argument that there’s no logical connection between believing in a miracle and concluding that life-sustaining medical treatment should continue.

“You don’t offer life-sustaining medical treatment for miracles to occur, and I often dread having another one of these conversations,” he said. “But then, I remember that every time I have any of these conversations, it might be the 12th one of the day, but it’s the first for these families. They deserve for me to treat it as the most important and the only conversation, not the 12th.

“Again, I give them what they need,” DePergola went on, expressing sentiments that clearly explain why he’s an emerging leader, a pioneer, and a Healthcare Hero.

George O’Brien can be reached at [email protected]

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