Ep 41-No More Pizza Parties: Fix the System, Support Healthcare Worker's Mental Health!

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: 

Wiki 

Vagelos College

EMRA  

Columbia Dept of EM 

Long Reads 

Time.com 

drlornabreen.org

ACEP

https://drlornabreen.org/   

Congress.gov 

https://www.mayoclinicproceedings.org/article/S0025-6196(24)00668-2/fulltext 

Chapters

• 0:00 Silly Tuesday Banter And Life Updates
• 8:17 Internet Woes And Woods Living
• 11:12 Bugs, Spiders, And Unwelcome Housemates
• 24:57 Pivot To Lorna Breen’s Story
• 31:47 Training, Leadership, And Life Beyond The ER
• 39:02 The NYC COVID Surge And Moral Injury
• 48:27 Warning Signs And Stigma In Medicine
• 53:12 Chart Note: Physician Burnout Data

Transcript

SPEAKER_00: 0:43

Amanda. Hey oh. How you doing, girlfriend? Uh good.

SPEAKER_02: 0:54

You guys we're in a very silly mood today.

SPEAKER_00: 0:58

So kind of, yeah, yeah, it's a silly mood.

SPEAKER_02: 1:02

I know.

SPEAKER_00: 1:03

It's a Tuesday.

SPEAKER_02: 1:04

It is. Yeah, I know. It's not Mondays anymore. It's a Tuesday.

SPEAKER_00: 1:10

Right? And so hopefully people are getting the hang of the fact that we are your Friday entry into the weekend now.

SPEAKER_02: 1:18

Yeah.

SPEAKER_00: 1:19

Fridays are the girls.

SPEAKER_02: 1:20

They're sending thoughts and prayers during the week when you don't have internet.

SPEAKER_00: 1:28

It's so weird because like the fact that we're doing this now, oh, I suppose, I suppose we're using cell signal, but I mean, I can download, I just can't upload, and I just never realized that there was a difference between down and up, but apparently it's a big difference, it's a big deal. So the woods can't handle the ups, they can only handle the downs. What does that say for my future here in the woods?

SPEAKER_02: 1:54

I don't know.

SPEAKER_00: 1:57

Yeah. I'm just kidding. It's been a wildly positive experience. People here are just so nice. And if anything, it's so nice to the point where I'm like, gosh, was that Minnesota nice thing actually true? Were they looking at people from up north because so nice?

SPEAKER_02: 2:16

Because down in southern Minnesota it's more passive aggressive. Yes. Yeah. Well, just up north are like genuinely nice. They're like, oh my gosh.

SPEAKER_00: 2:26

Unless they got me all fooled. Haven't met a person I don't like yet. Yeah. I love it for me too.

unknown: 2:33

Whoop whoop.

SPEAKER_00: 2:34

I was just grossing Amanda out. Maybe I shouldn't bring it up again. Because last time we talked about ladybug season, it continues here. And your girl's somebody who's used to having a ton of pets, but all I have are a ton of ladybugs. And I don't know if I mentioned last time that I drank one accidentally and they taste like they smelled just same.

SPEAKER_02: 2:58

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, and this this like hard shell thing that's like totally infiltrated the taste of your water is in your Yeah.

SPEAKER_00: 3:15

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, your glass of water by your side of bed, the side of the bed, and I reached up and I was like, oh, this tastes really earthy and sour at the same time. And I was like, oh, there's a little bit of crunch. Too wee. Yep, out comes a ladybug. So yeah, they will turtle in my water glass if I don't cover it up or use a I've I've learned obviously to use a thing, but the funniest part is just Amanda's face. And I know you're pregnant, and it's probably making it worse.

SPEAKER_02: 3:56

Well, just like I was telling her, it it feels worse because the imagery and like you feel like you can taste it because you know how they smell. Yeah. So then it's like, oh my god. And then she's like, Yeah, they taste how they smell.

SPEAKER_00: 4:10

I'm like, Well, the northerners keep telling me to vacuum them, but what good does that do? They're just gonna crawl out of the vacuum, you know?

SPEAKER_02: 4:18

Yeah, I don't know. I've always heard that about spiders that don't bother vacuuming a spider because it can just crawl back out. And I was like, Okay, good to know.

SPEAKER_00: 4:28

But imagine all of these ladybugs just like rattling around in your in your vacuum chamber.

SPEAKER_02: 4:36

Um yeah, gross. I think I know. So when I lived in Washington State, you know the spiders there are bigger, you know.

SPEAKER_00: 4:44

Yes.

SPEAKER_02: 4:45

My roommate and I like there. We would take a like a candle lighter, you know, like a big, like a long thing, and a can of hairspray, and we would just flame them.

SPEAKER_00: 5:02

There's something sadistic and lovely about that. It's like your own firework show, but with like this pleasure of like, be gone, you bad beast. I love it.

SPEAKER_02: 5:12

Yeah, because they're like wicked, right? Outside of your front door, you open the door, and there's like this tarantula-sized gross, it just doesn't get cold enough there to kill those things.

SPEAKER_00: 5:23

Oh, Dave, I don't want to make you mad, girl.

SPEAKER_02: 5:27

Yeah, I'll torture. I'm a nice lady. Yes, you are. Not to spiders.

SPEAKER_00: 5:35

Yeah, well, they don't deserve it. Uh although, do they eat ladybugs? Maybe my solution is to import a few spiders. No, no importing. I'd rather drink a ladybug. Would you here's here's a here's a question for you. Would you rather drink a ladybug or have a spider inhabitant and never have to drink a ladybug in your life? And you so every day the spiders are, you have to drink a ladybug.

SPEAKER_02: 6:04

Okay, no, I'd rather have one spider. Are you kidding?

SPEAKER_00: 6:10

You'd rather have a resident spider. You're like, fine, I'm calling him Teddy, so because it sounds cute.

SPEAKER_02: 6:16

If it wasn't a drink a ladybug every day, I probably would have swung to ladybug. But yeah, no, I'll take a resident spider. And like, can it please just be a daddy long leg? Because I'm fine with them.

SPEAKER_00: 6:28

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 redhead friend across the road, same age as me, and he used to pull the legs off of daddy long legs and throw them at me, like put them down my shirt and stuff. I mean, it's problematic because they would still wiggle when they weren't attacked. Ew, and then the body would bounce around. I mean, I'm traumatized. Oh my god.

SPEAKER_02: 6:53

So the what is that person grow up to be a serial killer?

SPEAKER_00: 6:56

I bet. I'd need to look him up. His name was David, he's redheaded, that's all I know. Was in Washington.

SPEAKER_02: 7:01

Yeah, that's very hard to find.

SPEAKER_00: 7:04

David, if you're out there, that was so rude. I hope you're doing better, David.

SPEAKER_02: 7:11

Oh God. Well, on that note, um there are no 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, so they didn't even know we messed up. So hey, look at us.

SPEAKER_00: 7:30

Yeah, you're welcome. Bonus. We corrected our mistakes the third time around. By we, I mean me. Yeah, it took me a while to get that 39er.

SPEAKER_02: 7:39

Yeah. Okay, so this week's episode is a little different. It's not actually true crime. There's no crime, unless you consider the workplace, like a medical workplace, not supporting mental health as a crime. Then I guess we can say it's a crime. So all of the resources that I used will be in the show notes. And the trigger warning is suicide. Lorna Margaret Breen was born on October 9th, 1970, into a family that blended medicine, service, and quiet ambition. Her father, Philip Breen, was a surgeon whose surgical training and career shaped the household's rhythm and expectations. Her mother, Rosemary Breen, had trained as a nurse and brought practical caring presents into the family home. Lorna was one of several children. Her siblings included an older brother, Michael, who later became a radiologist, and sisters who pursued creative and helping professions. The family moved and lived in several places in the mid-Atlantic, and Lorna spent formative years in Danville, Pennsylvania, and maintained ties to Charlottesville, Virginia, where she was born. These early roots, a household steeped in medicine and a family that valued education and service, helped form the contours of the life she would build. Okay, from childhood through college, Lorna showed both intellectual drive and wide interest. She graduated from Wyoming Seminary, a college preparatory school, in 1988, then attended Cornell University, where she completed undergraduate work in microbiology and also obtained a Master of Science in Anatomy. Those early academic accomplishments foreshadowed the dual energies that she would later bring to clinical care and to system-level thinking about how hospitals could serve patients. She then pursued medical training at the Medical College of Virginia, which is now Virginia Commonwealth University School of Medicine, completing her MD and continuing into combined residency training. Her postgraduate clinical training was a combined residency in emergency medicine and internal medicine at Long Island Jewish Medical Center, a rigorous program that prepared her for the chaotic, high-stakes environment of hospital emergency departments. Absolute smarty pants, McGee. And someone that's been in the trenches.

SPEAKER_00: 10:16

Absolutely, I agree.

SPEAKER_02: 10:18

What a driven woman. After residency, Lorna moved into academic and clinical roles that married bedside care with leadership. And honestly, like what better person could you ask to be in leadership to? Like, they've been in that clinical space. They know what it's like on both sides. Like, that's the person I want in leadership. She became an attending emergency physician at New York Presbyterian Hospital, which was then Allen Hospital in Manhattan, serving patients in one of the nation's busiest emergency departments. Aww, I love that. Colleagues described her as deeply committed to patient access and communication. She even took the time to help patients who spoke limited English and then took it even further by learning Spanish so that she could better connect with them. Over the years, she added responsibilities beyond clinical shifts by teaching, clinical process improvements, and administrative leadership. And in 2008, she assumed the role of director of the emergency department at the hospital. And in that position, she combined frontline emergency work with department stewardship, in addition to faculty responsibilities, at Columbia University, Irvine Medical Center, where she served as an assistant professor of 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 an energetic and intense clinician, she also played the cello and community groups, went salsa dancing, hosted gatherings for friends, and pursued continuing education and leadership by enrolling in executive programs aimed at healthcare leadership. Her CV reflected scholarly contributions on practical topics, for instance, addressing the needs of patients who do not speak English and practical emergency medicine pathways. Those facets of her personality, a drive to learn, to connect, to lead, and to perform at a high level were strengths and ordinary times, but would become stress points when extraordinary crisis arrived. In early 2020, New York City became one of the first and most intense epicenters of the novel coronavirus outbreak in the United States. Hospitals filled with patients who had rapidly progressive respiratory failure. Emergency physicians and hospital staff faced crushing patient volumes, shortages of personal protective equipment, and the daily trauma of watching previously healthy people succumb to a disease that clinicians at the time did not fully understand.

SPEAKER_00: 13:03

I can't imagine. Can you imagine how devastating that was? And we didn't know if or when it would end and how many would die.

SPEAKER_02: 13:12

Yeah. As an emergency department director at the Allen Hospital, Lorna was at the center of the storm. She worked long, exhausting shifts treating patients with COVID-19 simultaneously, trying to figure out staffing, preserving supplies, and shielding her team as best as she could. It was, yeah, unprecedented, scary, horrible. Can't believe that was over five years ago. Like many clinicians on the front lines, Lorna contracted COVID-19 in March 2020. After becoming ill, she was isolated and then returned to work after a period of recovery, which was a choice that many clinicians made, driven by the duty and the shortage of personnel. The virus had not only infected her body, the experiences of the months that followed exposed clinicians to repeated scenes of death, loss, and moral distress, feeling the inability to save patients who, in other conditions, would have had a fighting chance. Families were barred from bedside goodbyes, and clinicians felt the relentless pressure to triage with limited resources. The combination of physical illness, extreme workload, social isolation from the nation that was, at the time, as we know, largely locked down, and the large moral injury of watching so much human suffering demanded a heavy toll on many healthcare workers. For Lorna, those pressures deepened into despair. By early April, colleagues and friends were aware that she was struggling. Text messages and calls captured fleeting pleas and alarming admissions that were out of character for someone so readily steady. A friend asked her how she was coping, and according to contemporary reporting, Lorna replied, quote, I'm doing better, but dealing with the devastation in the ER, struggling a bit, end quote. She had trouble sleeping. Insomnia was unusual for her. On April 9th, when she called her sister, Jennifer Feist, Lorna said, quote, This is the end of my career. I can't keep up, and reportedly made remarks about wanting to die. Words her sister would later say were so out of character, they felt like someone speaking in tongues. Those early signals of extreme distress unfolded against the background of a health system whose administrative responses varied, and in which clinicians sometimes feared career repercussions for seeking mental health help. And with that somber note, we'll head into our chart note. 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 in medicine and healthcare. I really wanted to actually look into like clinicians and other physical anyone like what does this look like for them? Have they done any studies on mental health, health, and like what are we doing now? Because obviously COVID was an unprecedented time, but I'm sure this has like kind of waxed and waned in severity throughout the decades anyway. So, like, absolutely, what are we 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 growing concern, capturing the attention of both the medical community and the public. A recent study published in Mayo Clinic Proceedings by Shanafeld and colleagues examined how burnout and satisfaction with work-life integration has evolved among U.S. physicians between 2011 and 2023, offering a rare long-term view of the critical issue. The study surveyed more than 7,600 physicians between October 2023 and March 2024 using validated instruments consistent with earlier surveys conducted in 2011, 2014, 2017, 2020, and 2021. By comparing physician responses to a probability-based sample of the general U.S. working population, the researchers sought to understand not only how burnout has changed over time, but also how the physician experience compares with the broader workforce. The results tell a nuanced story. In 2023, 45.2% of physicians reported at least one symptom of burnout, defined as emotional exhaustion or depersonalization. While this represents a substantial drop from the peak of 62.8% observed in 2021 during the height of the COVID-19 pandemic, it is strikingly similar to levels reported in 2011 and 2017. This suggests that while the acute pressures of the pandemic have eased, physician burnout remains deeply embedded in the profession. Compared with other U.S. workers, physicians are still nearly twice as likely to experience burnout, highlighting that the stresses of medical practice go beyond the general workforce pressures. Work-life integration, a measure of how well physicians feel their profession and personal lives fit together, has shown some improvement. In 2023, 42.2% of physicians reported being satisfied with their work-life balance, up from a low of 30.3% in 2021. Yet even with this improvement, satisfaction has not returned to levels seen in earlier years, and physicians remain significantly less satisfied than other workers. The picture is one of slow recovery rather than a complete return to normal. So then I was like, okay, well, what are the reasons? So digging deeper, the study and prior-related research illuminate the underlying factors driving these persistent challenges. Physicians themselves have repeatedly identified administrative and clerical burdens as major contributors to burnout, particularly the time-consuming demands of electronic health records. While intended to streamline care, EHRs have added hours of data entry, inbox management, and documentation work that pulls physicians away from direct patient care. Beyond technology, many doctors cite a loss of professional autonomy, constrained by insurance requirements, prior authorizations, and complex regulatory rules that limit their clinical decision making. The pandemic added further pressures, including long hours, emotional strain from critically ill patients, staffing shortages, and moral distress. These cumulative factors underscore that burnout is rarely about personal weakness or resilience. I can't believe that was even a thought.

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 phenomenon caused solely by the extraordinary events like the pandemic. It is a persistent challenge reflecting systemic realities, long hours, heavy administrative burdens, high-stakes decision making, and the tension between professional duties and personal life. While individual strategies such as resilience training, wellness programs, and self-care remain important, this research highlights the meaningful solutions that will require system-level changes in staffing, workflow, administrative supports, and the overall organization of healthcare delivery.

SPEAKER_00: 21:05

Jumping up a data nature. Thank you. Thank you. Thank you. Thank you so much for highlighting this. Honestly, because I'm not one to, you know, poo-poo resilience training and wellness, but it falls flat in the face of system level insufficiencies that need to 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 answer is, 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, this study provides a sobering but hopeful perspective. Burnout is not disappearing, but the gradual improvement since the pandemic suggests that targeted interventions, both individual and systemic, can make a meaningful difference. And these findings are a reminder that caring for those who care for others is not optional. It is essential. Physicians' voices make it clear, unless the structures that drive burnout are addressed, the risks to their well-being and to patient care will persist.

SPEAKER_00: 22:13

It's so true. And there is evidence-based scientific research that shows that in healthcare, and probably other it probably translates to other fields as well. But specifically, this was done in healthcare. That employee satisfaction satisfaction was directly linked to patient outcomes, improved patient outcomes. So really the focus should be on employee satisfaction and how can we take away some of the burden that is so clearly taking away from you know work-life balance. You can do yoga, you can do all this other stuff and feel like your organization appreciates you, but if you're the only one, you know, you're there until eight o'clock at night and you missed your kids' soccer practice and all this other stuff, it's not gonna help. So we need And guess what? Then you don't have time to go to the yoga anyway. Right. So I love that the focus should be on fostering wellness with the providers so that they can then do their job and the outcomes will be better with patients. And science and research have shown that higher levels of employee satisfaction lead to better outcomes, better compliance with treatment plans, and the whole bit. So I think the problem it might be a little bit bigger than this because I feel like healthcare organizations are still focused on quantity over quality because of shrinking reimbursements. So we have to figure who's running the show, and that's bigger than me. But yeah, you really highlighted an interesting and important issue in healthcare. That until we find a solution, it's gonna continue and probably worsen again.

SPEAKER_02: 24:09

So yeah, yeah, yeah. There was a term thrown out a lot previous workplace, but not only just burnout, right? But compassion fatigue. And that's where that comes into play of like if everyone's doing well at work, the better outcomes, right? If you have compassion fatigue and like nobody can get into the clinic, and then that's all you hear about for the first 15 minutes of a 30-minute appointment, and like you need to hear the person outright because they're the human in front of you, but also you're like, I've got five people waiting for me in the lobby, and it just it's a lot, it's a lot.

SPEAKER_00: 24:46

Yeah, it is. It's um, but the correlation is strong. You treat your employees well, you're gonna get better patient outcomes. Um, and I think the focus needs to 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 is directly correlated to how the employees are being treated. How much time do you have with a patient? What are the expectations? What is the administrative burden? Are you expected to how much time are you expected to to deal with these prior authorizations and all of this insurance craziness that's required of providers? So I mean there's a lot that there's no one single villain, but you know, our whole system needs to change. It really does. So thank you for highlighting.

SPEAKER_02: 25:39

Agreed. On October 26, 2020, I forgot to say back to the story. Obviously, we're back to the story. On October 26, 2020, while on a family trip in Charlottesville, Virginia, Lorna tragically died by suicide. The news reverberated across hospital corridors, academic departments, and the broader public. Her father, Philip, told reporters that his daughter had been, quote, truly in the trenches of the front line, and that she tried to do her job and it killed her, end quote. Those blunt words captured a grief that mingled pride for a life of service with a profound sense of loss and a demand for reflection. How had a caring, competent physician who absolutely loved her work reached a point where she felt she had no way out? In the immediate aftermath, colleagues and family sought to understand what happened and to push for changes that might prevent similar tragedies. The family took care to emphasize that doctors, like any other people, can be overwhelmed, and that the medical profession's licensing and credentialing systems sometimes discourage clinicians from seeking mental health care. As her family and friends shared details and advocates raised alarms, the story became symbolic. It was not only about one person's heartbreak about structural issues that made clinicians vulnerable, stigma about mental health, reporting requirements that can jeopardize medical licenses if physicians disclose psychiatric care, the relentless schedules and cultural expectations in medicine to appear infallible, and the scarcity of system level supports in crisis conditions. To honor Lorna's memory and to address those systemic problems, her family and supporters created the Dr. Lorna Breen's Heroes Fund, an allied efforts to destigmatize mental health care for clinicians, expand wellness resources, and change institutional policies that inadvertently punish care seeking. The foundation and allied advocacies linked personal grief to public action, funding research and programs, educating health system leaders, and advocating for policy changes that would lower barriers to care. The narrative that emerged combined intimate family testimony with policy prescriptions, both emotional reckoning and practical reform. The advocacy that followed Lorna's death led to one concrete legislative outcome, the Dr. Lorna Breen Health Care Provider Protection Act, which was introduced in Congress and signed into law on March 18, 2022, two years after her passing. The statute authorized federal grants, research initiatives, and training programs aimed at supporting mental and behavioral health among healthcare providers, with a particular focus on preventing burnout and suicide. This included funding to medical schools, health systems, and community organizations to build resilience programs and study clinician well-being. These efforts were modest in scale compared with the magnitude of the pandemic, but the law's symbolic weight was considerable. It signaled a national, nope. It signaled a national acknowledgement that protecting the mental health of those on the front lines is a matter of public interest. Professional organizations, including the American Medical Association and Emergency Medicine Societies, praised that the act was a meaningful step forward in a medical culture that encourages care seeking without career repercussions and builds systems that prevent clinician burnout from becoming a fatal outcome. Reporting and commentary in the months and years after Lorna's death placed the national law and the family's foundation into context. Profiles of Lorna emphasize both her professional excellence and the overload she faced during New York's first viral surge. A long New York Times feature and subsequent profiles and outlets such as Vanity Fair and Time painted a portrait of a high-achieving, warm and driven woman suddenly bruised by an event no single clinician could have prevented. A pandemic that wrecked expectations about what medicine could do. The Times piece recorded colleagues and friends' memories and quotes that crystallized the strain. Quote, I couldn't help anyone, I couldn't do anything, quote. Or end quote. A phrase reported to reflect the clinical helplessness that she felt during treating the patients during that pandemic, whose outcomes were grim despite heroic efforts. Which is just so sad. Those words, stark and humane, helped the public understand the kind of moral injury many healthcare workers experienced. The aftermath also prompted introspection within medical culture. Professional societies, hospital systems, and academic centers began to examine credentialing questions, which sometimes require clinicians to disclose mental health treatment, to expand confidential counseling and peer support programs, and also to reframe wellness from an individual moral obligation into an organizational responsibility. Amen. Yep. Hello, amen. Many institutions started to invest in programs envisioned by the Breen's family's advocacy to train leaders to recognize distress. Amen. Create crisis response teams, and offer evidence-based mental health services designed with clinician confidentiality in mind. The Dr. Lorna Breen Health Care Provider Protection Act created federal support to scale such efforts, and the foundation organized grants, education, and public awareness campaigns to reduce the stigma to save lives. Lorna's death revealed painful contradictions. She was, by many accounts, a doctor who loved her work and who sought to help patients, yet, the very system in which she was celebrated also constrained the help that she couldn't obtain. As her father said, and many commentators agreed, she had been a casualty of the pandemic in a sense that extended beyond viral infection. The human toll included mental health aftermath. Family members did not want Lorna's name to be the only headline of a tragedy. They wanted her story to become a spur to make medicine safer for caregivers, to change licensing and credentialing reporting rules, and deter clinicians from seeking help, and to institutionalize supports that the next generation of clinicians would be less likely to suffer similarly. Lorna's story remains a tale about the limits of a hero rhetoric when applied to healthcare workers. Calling clinicians heroes publicly can obscure structural avoidance of responsibility. Heroism suggests individual fortitude rather than the obligation of institutions and governments to provide safe working conditions, adequate staffing, and mental health resources. The family's advocacy and the law bearing her name attempt to shift the focus from individual sacrifice to systemic protection. As one former colleague put it in public reflections, I know how much good came from Lorna's life. Now I hope some good can come from her death. And those are the hopes that motivated the foundation, the advocacy, and the congressional response. In telling Lorna's story, it is important to avoid reductive narratives that make her death only an instrument for policy. She was, by every account, by family and friends, an engaged physician, a musician, a friend, and a sister who provides a person who loved both her work and a life full of small joys, such as music, dancing, parties on rooftops, and community. The contours of her life make the tragedy feel more acute. Someone with so much energy and a love for life reaching a point of unbearable despair. And the institutional barriers from punitive license questioning, the cultural expectation that clinicians somehow must withstand every trauma quietly is corrosive. And the institutional barriers from punitive licensing questions to inadequate sources of confidential help must be addressed systematically. If Lorna's name prompts administrators to revise policies, supervisors to check on exhausted staff, and fellow clinicians to reach out honestly to one another, then from that grief, something practical and humane 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 many thoughts. Okay. More recently, the what you talked when you talked about the hero rhetoric as applied to healthcare workers, and how that really shifts the responsibility of the organization to look, this person was able to go above and beyond. Yay, well done, in spite of our inability to support them. We need to normalize mental health. And honestly, I feel like it should be at the point where someone in a position like Lorna, where she's in the trenches and she's seeing all of this day in and day out. And maybe even all healthcare providers, but certainly those in the emergency room, those in healthcare themselves, should be offered a mental health professional. Just as part of like, this is your mental health professional. You'll be meeting with so-and-so once a week. Full disclosure, I've had a mental health care professional for 10 years. And I asked her, because I can't imagine my life without her. And I asked her, Do you have a mental health care professional? Because how do you maintain your resilience and all these catchphrases that you'll hear organizations say, oh, wellness and you need to walk more and drink lots of water and resilience, you know, do some yoga and think positive thoughts. No, actually, the onus is on the organization to create a culture where it's okay, where it's actually fostered and recommended, and it's difficult not to seek mental health because that's just as important as physical exercise. So especially when hello, especially when your job is, you know, determining life and death situations like Lorna, I can't even imagine. I mean, I'm an audiologist, and I don't do life and death stuff, but you know, I'm a person, I face burnout, I face situations where I think I can't meet a patient's need. And and good clinicians, good good 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 their stories are resonating with you and you're empathizing. So empaths and good clinicians alike, we're all in it to help. And helping professions mean you're vulnerable to mental health distress. So why is this not actually required? I'm gonna pull it even a further step, not just recommended. Why aren't people required? 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 mental health professional. If you don't want to use it, fine. But if you want to, yeah, and then you have a dedicated time set aside in your schedule to use it. Exactly.

SPEAKER_00: 38:27

So there's next problem. The next problem is when the hell am I supposed to meet this person? Listen, we're gonna cover the telehealth. Her name is Jamie Smith. If you don't like her, there's a whole other if you are if you don't click with her, there's a whole other, you know, consort of uh behavioral health professionals in the wings. But you know, we we think Jamie would be good for you. We want you to meet with her once a week because everybody meets with a behavioral professional for resilience and healthcare once a week. Screw I'm sorry, but screw the cherry yoga and the sunrise stretches and all this stuff. Yes, that's important. But can we actually normalize mental health help?

SPEAKER_02: 39:13

Can we actually address the source here, the roots, and not just cover it with a pizza party and I mean I love a pizza party, don't get me wrong. No, but yeah, but this whole resilient-water and yeah and and do this there. It's like I can't drink water at work 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 to prioritize this, you need to go for walks, you need to send gratitude notes. I mean, all that stuff, don't get me wrong, it's great and it's enriching and it and it contributes to quality of life if you can, if you have the time. But it's putting the onus onitiate its place. It's it's putting the onus on the employee. It's not actually uh to me, it's a cop-out from these organizations. Like, oh, you're burned out. Well, you know, you're not taking enough time for you. Go for and do that. Although we're not allowing you to with our schedule. You will do it on your own. We're not acknowledging it's keeping you up at night, which is your stress and your you, you know, uh not enough time and too many patients, too many problems, not enough tools to get there a high, a too high administrative burden. Like, let's let's give something that actually has a long-lasting effect, which would be mental health care. Not to mention, you know, a scribe and some other solutions that might help reduce administrative burdens, but first and foremost, mental health. Mental health is to me almost more important than physical like exercise. And that might get me like thrown under a bus somewhere, but I can think of a certain exercise physiologist named Joe at meal that would have my have my he'd have something to say about this. Sorry, Chip. But like if you're mentally not healthy, you're not ready for exercise. You're not ready for any of the other things because all you're doing is further exacerbating the issue, then. Yeah.

SPEAKER_02: 41:11

If you're pushing yourself to work out physically while you're already mentally exhausted, that's not okay. Okay, like obviously any physical movement is good for you, but yeah, I don't know. I'm on the same boat, the same choir as you right now.

SPEAKER_00: 41:25

Yeah, I I I obviously feel very passionately about this, which I didn't realize 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 be resilient. If you would just do yoga and you would just like shut up and have some gratitude, you'll be fine. Yeah.

SPEAKER_02: 41:52

Yeah. I and I was just gonna say, for the record, in case this will help break any sort of stigma that's still out there. I also have a mental health professional and I love meeting with her.

SPEAKER_00: 42:02

Well, yes. I mean, when we were like my therapist could beat up your. It's not a bad thing. Not at all. But like, I've brought friends into my therapist, and we've had dance parties, and like I can't imagine life without her. Even you don't have to be in crisis to have someone that you meet with that helps kind of frame your thoughts to make sure that you're you know, you're on the right track, you're on the track to be the best you that you can be, and that's all that is. And and families and you don't have to meet weekly. If things are going good, great. Meet quarterly exactly by monthly. There's something to be said for someone who's trained in psychology and counseling, who is not your friend, who can really give you that objective view of whether or not your thought process is, you know, what's the word? Not normal, but like makes sense.

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 that you have the coping skill. I will to make sure that you have the coping skills for what life is throwing at you, you know? Yes, yeah, and if you don't, how do you get there? And so that's important for everybody, regardless.

SPEAKER_02: 43:25

And I probably could have benefited from a mental health professional many, many moons before I got one, but I will say that I first got one because 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 a stalker. I will follow. I will follow. But you know what is also good? Not just for mental health, but for well-being. 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 have to 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 Molly B's, and that's a B Z, but it is pronounced B like Bubble B. So Molly Bees Gourmet Cookies. So they're available at MollyB's.com. They bring bold, artistic, small batch craft cookies straight to your pantry. They are known for melting your mouth texture. I mean, what more could you want in a cookie? High quality ingredients and incentive flavor combinations. Each cookie delivers layered textures and surprising, indulgent tastes. Fans rave about standouts like the tea cookies, smooth lavender goodness and white chocolate, and delectable lemon glaze. And B cordials, which is a perfect blend of chocolate and cherry, calling every bite an adventure. Founded by Molly, a single mom from Alaska, the brand has become a national sensation in just three years, earning features on the Food Network, Martha Stewart Living, and even the Grammy Awards. Wow. Signature creations like Be Cordial, Milk Chocolate, Marciano Cherries, Amaretto, Big Joe, Baba Doodles, which is Snicker Doodles with the Boboa, Boboa pearls, Hot Mess, which is mango, white chocolate, and hot Cheetos.

SPEAKER_00: 46:02

Oh my god.

SPEAKER_02: 46:04

P. Nicoladas, which is white chocolate, coconut and fruity pebbles. Royally Awesome, which is white and milk chocolate, coconut, macadamia nuts, and spiced rum. Straight fire, which is marshmallows, chocolate, cinnamon, cereal, and cinnamon whiskey. The Boss Man, which is maple syrup, bacon whiskey, and white chocolate. And the tea, which is Earl Grey Tea, Lavender, White Chocolate, and Lemon Frosting. So again, you guys have to go to this website, look at them. Oh my god, they look amazing. They're perfect for gifting or indulging yourself. Molly Bees Cookies bring gourmet artesian crafted delight home with no bakery trip required. Find them at Mollybees.com. That's M-O-L-L-Y-B-Z.com and enjoy 10% off with our code stay suspicious. I will share that when you go to their website, you'll see, oh my god, they already offer 10%. Yeah, but you have to put in your email to sign up to get 10%. So if you use our code stay suspicious, 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 think that Molly B Z would add to resilience. I am ready. So, you know, get some. Get a whole box of those and bring those to work. Everyone's gonna love you and you're gonna feel great. And like, what's some wild flavors that you wouldn't expect? And they're probably really good because it sounds so weird. Like, obviously, they're not gonna sell the mango, white chocolate, and hot Cheetos. I know I'm like cooking hot Cheetos and Cookie. Molly B is. I'm thinking I want to try that. I really do. 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 medical mishap? It is time. Is shall I read it?

SPEAKER_02: 48:16

Sure. I mean, yeah. Okay. I started to derail towards the end of mine, so the listeners would probably appreciate some fresh eyeballs on the screen.

SPEAKER_00: 48:26

No, you did great. You did great. But so the subject of this email is the albuterol incident that still keeps me up sometimes. Uh-oh. It says, Hi Jenna and Amanda. I've never written into a podcast before, but this one has stayed with me for years, and I think my fellow Alley cats will understand why. I'm an emergency department nurse. Bless your heart. And even though nothing tragic happened, exactly, the what if still catches in my throat sometimes. Here we're here this is what we were just talking about. How people who are really good providers uh you don't clock out. You know, you go home and you agonize over what could be, what if, what if not, what can I do. Anyway. So she writes, or he writes, it was a slammed weekend shift. There were no open beds, hallway patients, everything from chest pain to broken wrists rolling in. I was caring for a patient who came in with an asthma exacerbation. The patient was in their mid-30s and they were scared, but they were stable enough. So the provider ordered back-to-back nebulizer treatments to get ahead of it. Respiratory therapy department was tied up with a trauma in another room, so I grabbed a nebulizer and set it up myself. It's something I've done a thousand times. I opened the drawer labeled neb meds, tore open a packet, drew it up, popped it in the neb chamber, and got the treatment running. So, for those of you who aren't in the know, it's like really quick acting way of providing the same stuff that's in an inhaler, but in a in a nebulizer, which means that they're in the medication is being physically blown into the patient's face through a mask in a chamber that's mixed with water. So and usually it involves some steroids too to help with the inflammation. So she tore open a pac or he sh tore open a packet, drew it up, popped it into the neb chamber, and got the treatment running. Five minutes in, the patient looked wrong. Not just anxious, but panicked. His heart was pounding so hard and his that I could see his gown moving with every heartbeat. He kept trying to sit up and saying he felt like his chest was going to jump out of his body. Oh no. I checked the monitor. His heart rate was 208. So I said crap. I stopped the treatment immediately. I called the provider, called respiratory therapy, we put him on oxygen, started an EKG, and got an IV access in case we needed to intervene. He was shaking so violently he could barely hold still. The respiratory therapist arrived, grabbed the nebulizer cup, looked at me, and said quietly, This isn't albuterol. It was racemic epinephrine, which came in the same packaging, the same drawer, and identical little vials. But in the shuffle of the day, someone had restocked the drawer wrongly. And if I hadn't double-checked because I'd done it a thousand times. The provider stayed calm, managed the reaction, and the patient stabilized. His asthma actually improved because, well, racemic epinephrine will absolutely do that because the faster your heart beats, the more your lung muscles relax. But the cardiac side effects were no joke. It could have gone sideways, very sideways. Afterwards, I sat in the break room shaking. No one yelled at me, no one blamed me. Leadership reviewed the stocking issue, but I knew that if that patient had been older or fragile in their heart, or if we hadn't caught it as fast as we did, who knows what would have happened. So that part of me still hits me when he's the patient said when he left, I could tell you cared. That's why I wasn't scared the whole time. He didn't know what happened, but he didn't need to. All he knew was that the team took care of him. But I drove home that night, replaying every moment, every 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 me that, and those thorough checks will never leave me. Signed an ED nurse who learned the hard way that familiarity can be dangerous. Oh, listen, you did Yeah, we all make mistakes. We all would have felt a victim to that same scenario. Absolutely, and the fact that you are using this as a learning, you'll never do that again. And also you'll probably prevent other people from doing that because of your the lesson that you learned and the fact that you care so much. So thank you for writing that in.

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 when we're talking about how our like brains, when we care, they don't shut 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 different directions. I I'm kind of into the old timey world right now. So we did like the what I did was the kind of the origins of this what we now know as surgical consent. And so then it started me looking at old-timey stuff and mental health institutions and used to call sanatoriums and insane asylums and lobotomies. So I I have a feeling it's gonna be old timey. I like it. But yeah, listen, you'll have to tune in for it to get it, you know, the actual subject because I don't know yet. But meanwhile, don't miss a beat. Subscribe or follow Doctoring the Truth wherever you enjoy your podcast for stories that shock, intrigue, and educate. Trust, after all, is a delicate thing. You can text us directly on our website at Doctoringthe Truth at Buzzsprout.com or email us your own story ideas and comments at Doctoringthe Truth at Gmail. Be sure to follow us on Instagram at Doctoring the Truth Podcast and on Facebook at Doctoring the Truth. We're also on TikTok at Doctoring the Truth and ed odd pod E-D-A-O-D-P-O-D. Don't forget to download please rate us. It just takes an extra second, but it means so much to us. Please rate and review so we can bring you more content next week. And until then, stay safe and stay suspicious. Please stay suspicious. Suspicious. Bye. Okay, goodbye.