Thriving Amidst COVID-19 – With the Wheat and the Chaff – Well being and Life-style
By Saturnino P. Javier MD
Medical Director, Makati Medical Center
We all certainly remember the first few times.
I woke up on March 8th of this year and was greeted by the chairman of the Infection Prevention Control Unit for missed calls on my phone [IPCU] of the Makati Medical Center [MMC]. The reason for the call? One of our patients was included as an examined person [PUI] It turned out to be the first documented case of nCoV-2019 [now referred to as COVID-19] at Makati City’s premier hospital.
After nearly two months of uneventful surveillance for Wuhan virus since January when MMC put strict screening protocols in the emergency room, and nearly a month since the first officially documented cases of nCoV-19 in the country, it was the 7th case in the country of my center – an award I was not very happy about.
Background: Five months prior to Patient # 7, I was appointed MMC Medical Director. In the last week of January, MMC’s CEO left the position for personal reasons [as she originally intended]. So I was the five-month-old medical director on duty, who then became the interim co-CEO of this eight billion peso healthcare facility [along with the Vice President for Finance as the other CEO]. Bad luck indeed.
When the first COVID case landed on MMC, all I could think about was, “How will this affect hospital operations? How will this affect healthcare providers? How is this viewed by the medical community? “
When I was just trying to reach the members of the MMC Crisis Task Force, I was told that DOH staff would be visiting MMC this weekend to gather more information and see how the government agency could help defuse the situation. I tried to dissuade the DOH officials from identifying MMC in the media as a hospital with nCovid-19. [Previously, another hospital was able to briefly ‘hide’ its identity.] But on the phone, DOH Secretary Francisco Duque stated without a doubt that he could not comply with my request: “I’m sorry, Dr. Javier, I need to identify your hospital. That is all in the spirit of transparency. “
After that, I had to contact Mr. Augie Palisoc, director of Metro Pacific Hospital Holdings Inc. [which MMC is part of]to give him a heads up – “Augie, you just have to be ready for the front page news tomorrow. “
Fast forward to November 2020. More than eight months after this first case, MMC has looked after more than 43,000 COVID-19 suspects. From # 7 we already count more than # 5,200 confirmed cases. Now I can only laugh at the inconsequential nature and apparent recklessness of my initial concerns. My fears have become trivial and banal as they have been replaced by more substantive questions, wider concerns, and more threatening uncertainties. Concerns about the hospital’s image have been dwarfed by more urgent and broader situations with far-reaching implications.
According to patient # 7, the country collected more than 407,000 cases and more than 7,800 deaths. The unprecedented medical crisis has brought to the fore the inadequacy and inability of health authorities to respond to a crisis of this magnitude – despite the wealth of time and opportunity we had as we watched the crisis decimated lives and crippled economies Wuhan, New York or even Italy.
The last two weeks of March turned out to be the greatest challenge – personally and administratively. MMC had to declare full capacity – as COVID cases kept coming up, all available beds on the floors specified by COVID and in the emergency room were used. The supply of PPE including masks was running low, many health care workers were quarantined, some were hospitalized, a number of doctors at other centers had succumbed to the virus, and the morale of the medical community was constantly being challenged.
But it also brought on the silver lining that nobody had expected or imagined. When a duly elected Senate official violated MMC’s infection control and contamination protocols, it mobilized the entire MMC medical community to stand by the truth and stand behind the leadership. It has accelerated support for health care workers and front liner institutions not just for MMC but for all other health care workers in general. It proved cathartic for many sectors marked by an anti-VIP sentiment, as many citizens complained about inadequate testing by government officials despite inadequate test kits. The perceived prioritization of politicians was anathema to most ordinary citizens who realized the lack of valuable test kits.
The pandemic also blurred the lines of competition between hospitals when collaboration was the focus. Immediately there were several external contacts with other hospital managers and administrators – mainly via social media platforms. It became clear that the battle could not be won alone, as a unified and coordinated strategy was required to address the viral threat.
As solidarity and unity have suddenly become buzzwords in medical circles and other social institutions, one wonders whether engagement has always produced the expected response or the desired result. While there may not be concrete and tangible results, realizing that you are not alone – trying to conquer the unknown, the unknown and the invisible in a time of crisis kind of mitigates the blow.
The important thing is that the crisis managed to get the best and the worst out of some of us. As true leaders and trailblazers emerged, it also spawned power-hungry and publicly deprived grandstanders, borrowers, or pseudo-experts in various fields. As a hospital director and administrator, my greatest challenge was to recognize “noise” by real voice. I had to filter the essential targeted grain out of the useless chaff of thoughtless chatter and beautiful, but essentially unhelpful, maternity statements that seek nothing more than media visibility and social glorification.
By going through multiple communication platforms in the past five months, it was easy to see who really made sense, who would make a difference, or who was just engaging in pathetically meaningless rhetoric. I’ve always welcomed listening to other people, even when their ideas contradicted mine – because they let me see the substance of my own. Or the need to destroy mine when the wisdom of others prevails.
As the pandemic rages on, I manage to thrive – deciphering the essential principles of true leaders from the errors of the frustratingly hopeless. The former will lead you to worthwhile results and good decisions, while the latter will make it clear to you that all you have to do is throw away the chaff that makes the grain really valuable. They both serve a useful purpose. [For comments, [email protected]]
[Dr. Javier is the medical director of Makati Medical Center; he was interim co-CEO from March until August 2020. He is an interventional cardiologist practicing in Makati Medical Center and in Asian Hospital and Medical Center..]