In the Time of COVID with Dr. Adam Jarrett

We talk with Dr. Adam Jarrett, Chief Medical Officer and Author of "In the Time of COVID", about what it truly was like on the frontlines at Holy Name Medical Center.

"In the Time of Covid highlights the innovation, creativity and help from unexpected people and places that allowed the hospital to secure PPE and equipment, completely redesign the hospital, handle the growing number of dead, and treat what seemed like unending waves of new Covid-19 patients."

Available now on Amazon:

https://www.amazon.com/Time-Covid-Hospitals-Struggles-Triumphs-ebook/dp/B08NPJGMXD

Transcript:

not only were we struggling with the huge number of patients i really had fear that that our staff you guys you know nurses technicians that we're all going to be sick and not be able to do our jobs and that some of them some of us could have died and unfortunately some of us did die

all right i have props for this

yeah perhaps yeah let me put that put my props on okay

he's very good with this stuff there you go here you go can you see the book can you see that handsome face

yeah that dr sugger is pretty big mad about not being on the conversation i got to be in the book signing i'm okay and you have a quote in the book i have a quote uh although in retrospect i would have said something more profound i think if i had but you could either be the guy with the looks or the guy with the brain or or in our case both but that's in our podcast ladies and gentlemen that's the sweet sounding voice of dr sarad sugar i am dr clinton coleman welcome back to recommended daily dose now if you're listening or watching please make sure you subscribe rate and review um we have the guest of all guests you're gonna looking at him in his dapper outfit it's the site of adam jarrett executive vice president and chief medical officer at holy name medical center in teaneck new jersey and if you didn't see that cover author of this fabulous book and the time of covid one hospital struggle and triumph now available on amazon go get one it's also available on rxdailydose.com so please go cop that book as the young kids would say cop it or or buy it or purchase it it's a great holiday gift by the way i want to start off by reading the back because it's such a such a tour de force but i just want to say the first quote you have is is great so this is dr adam jarrett weaves a gripping tale from the front lines of the code pandemic and describes how a resilient staff responded without a playbook to care for a tsunami of critically ill patients whoa we can we can stop it there actually how about that there's a lot there's a lot going on that one quote so adam welcome welcome joining us today thank you gentlemen i really appreciate you letting me uh share your podcast it's your world we're just living in it you know so yeah we want to get into your book your inspiration um why you decided to write it so uh i guess start off with that why you decide to write this this amazing book so um well thank you for saying that it's amazing i appreciate that so i was actually um uh at a socially distant event in a friend's backyard my co-author paul rosengren someone that i've known for years and as doctors tend to do in a hipaa compliant way i was telling stories of covet and and they were you know about patient issues about the kind of things the hospital was doing and he said to me oh my goodness adam there is a book here and i and i said no paul come on you know i don't know whether there's a book and who has time to write a book right he said well adam look i write i love to write paul's a very good writer he's a very smart guy and he convinced me at that event that i should spend two or three hours with him one afternoon a week for a month one evening a week for a month and so he agreed to feed me and we met in his backyard it's important for three hours i think it was every tuesday evening and maybe an occasional saturday or sunday afternoon for about a month and he um he wrote the first chapter um after i think the first two three weeks and he said what do you think and i said oh it's it's it's intriguing and then i you know i actually he said well why don't you take a stab at this chapter so i wrote a big chunk of the chapter on death um and i actually wrote more than i thought i was going to write i really thought i'd meet with paul a couple hours a couple times a week and he would write the book and i would say great we wrote a book together but i ended up writing quite a bit more of it i i'd like to say that i wrote 50 of it and he wrote 50 of it although never would have happened without him he really motivated me to do it and and then we just started having conversations and some conversations turned into stories in the book and others did not we we tried to i wanted to do two things number one i wanted people um both in health care and out of health care to understand the remarkable job that holy name did because i really felt like we did something special during the first week and i think a lot of that has to do with the kind of hospital we are and then i also being a primary care doctor by training and being someone who likes to explain things to patients in ways that they can understand it i also wanted to write a book that non-medical people could understand the realities of covid the realities of testing the realities of treatment and and i i like to think i accomplished that i think it's a book that that non-medical people can sit down and read and walk away with an understanding of what holy name did and and the realities of covid especially during the first wave and at least the handful of physicians who read it told me they found it intriguing as well although certainly this book is not geared towards them i'm sure it's more just a handful right because i i understand you are ranking very high currently on the amazon chart for respiratory diseases i think we should let everyone know that you're currently number one in that category well you know what i'm not i'm not done anymore when we spoke a couple days ago i was number one who overtook you that's unbelievable yeah yeah i think being number one in a specific sub category is um is a very very very very small accomplishment um but we were excited to see that sure and we hope that people uh are interested enough to give the book a shot it's a it's an easy read i think it's a relatively quick read and i think you'll walk away knowing a little bit more about covet and i like what you said about a the tsunami which indeed it was right clinton we all lived it but certainly tsunami uh but i like the idea of unscripted you know because it truly was unscripted right something we never heard about uh before quite frankly december 31st of 2019 but before we dive into the book i mean i'm just interested in the process is this something you guys wrote linearly or did you you know in a linear fashion or did you just kind of take uh thoughts experiences as they came to you the first time we sat down we tried to come up with 10 or 12 ideas and and then we said we'd write a chapter about those 10 or 12 ideas um and it it so it was not linear and of those 10 or 12 ideas probably only five or six of them got into the book and then as we're writing another five or six ideas came up and you know we we didn't initially there's a whole chapter about hiv and aids and comparing and contrasting not only the diseases to some degree but my experiences because i i did my internal medicine training uh really right in the middle of that pandemic um that was not something we initially thought we were going to write about but as i'm telling stories it just came about and then and then we move things around the editing process is really fascinating right something i've never done for an entire book so i think the first chapter ended up not being the first chapter so when paul wrote that first chapter and i said oh that's intriguing i think that end actually ended up being the second chapter um so you know the whole editing process was was was fascinating and it was not linear it was really more subject-based right topic based and no i knew that i wanted to do the chapter on testing because i think that there's a lack of understanding in health care about the reality of how doctors should and do use testing and i thought it was an opportunity to explain that and that was particularly crucial as it relates to covid because the testing especially in the beginning was not only not present but not particularly accurate um and so i i i like talking about that i couldn't resist um talking about uh what happened at the white house and and the garden party um so that and i used that to talk about uh testing because i think the white house you know appropriately touted that they were testing everyone and therefore they thought they were safe right right and i think that made the point that testing of itself does not keep people safe um it is a piece of of the puzzle it's like we couldn't resist writing a chapter that started with actually i think it tells part of the story um and you know i wanted i wanted to tell a chapter about the the people right yeah um you know not just our patients but our holy name um staff and we lost another staff member in the last couple days right yeah and and the impact that has obviously on on their family but also on the whole holy name community and and i thought that was a chance to really bring this disease home not just for people here at holy name but but everywhere so did you find it difficult to tell so many different perspectives you mentioned the hiv epidemic but you were actually as uh like on the front lines treating patients this is like you're the head of the hospital um dealing you know with with patients and administration and things like that was that hard to capture that different type of perspective well it wasn't hard talking about it right um but i do think that i still lived it yes yeah but i i don't know whether any book um and and and not being a trained writer and to be frank paul also not being a trained writer although he's certainly a better writer than i am um i don't know how how you can take the experience we had because you guys lived it i saw you guys every day you were there you were on the front lines much more than i was i don't know how you could possibly take that experience and put it into words that that do it justice so we tried right um i do know that people have said to me that it brought a tear to their eye or people have said to me that they hear my voice people i know that that means a lot to me that people have said you know i hear you like like and it makes me smile because i i know what you're talking about for me it was very surreal because i remember like when you laid out the dates like i remember me on call one week and maybe the first weekend in march and it was maybe like six patients and then i the next weekend i came back it was the hospital was almost full it was just so surreal reliving it and now you're like you forget all those details because it was such i don't know if it's post-traumatic or what it's just like a fog it seems like it happened years ago so i i don't know if you can speak on that like just i'm glad you captured it that's what i'm saying well thank you i hope i did um you know the thing that i recall most and i don't know whether i hope i captured this i remember probably around the second or third week so you know towards the end of march i remember really feeling like we were going to turn into a hospital that i could not conceive right i really had visions of of staff of so many doctors so many nurses so many technicians being sick and not being able to take care of of our patients i mean that to me that was what had the most impact on me until we lost actual staff members that obviously had even a greater impact but i really had a vision of a completely different health care system a completely different hospital because not only were we struggling with the huge number of patients i really had fear that that our staff you guys you know nurses technicians that we're all gonna be sick and not be able to do our jobs and that some of them some of us could have died and unfortunately some of us did die amazingly and i think a lot of it was because of the good work that that the holy name team did very few clinicians got sick not a single critical care doctor got sick only one infectious disease doctor got sick our critical care nurses a handful of them got sick but it was not overwhelming a couple of our ed doctors got sick but they got sick early on when we were not being as careful because we didn't know we needed to be as careful and so once i realized that that we were going to be okay from a staffing perspective and okay doesn't mean it was going to be business as usual but once i realized that there was there wasn't going to be patients who couldn't get cared for or gurneys lined up in the emergency room or patients not getting just the basic care than that they needed um it it didn't become not stressful but it became a whole lot less stressful from my perspective now yeah whether that became less stressful for you guys who are still on the front line i don't know probably not right but but i think certainly in all of us whether we're physicians nurses um administration you kind of get into a zone where you have this adrenaline pumping and every day you're just moving forward and i think to speak to your point once we knew we were protected ppe was not an issue supply chain and you talked about this um you know we i think we powered on as as as we had to and as we have no choice and and as you mentioned at your book signing uh this time of code is not over and we're experiencing it again so i think it's very good that you acknowledge that and but you know we take that experience that you have so eloquently written about and now apply it to our current situation yeah i mean the current situation is very different right sure but but i am still worried about staff i'm not worried about staff now so much because i think they're going to get infected at the hospital i'm because we're not seeing that thank goodness i'm worried about staff because people are trying to live somewhat of a normal life and there's so much disease in the community now that we're seeing staff every day who are getting infected in the community and then having to be out but it's not as overwhelming in terms you guys know in terms of the number of patients the other thing that was that's worth talking about is mike being out right so uh you know our ceo uh was out for about three weeks with covet early on the book talks about that quite a bit and that was a fascinating experience for me because i was kind of in charge right by default um and uh that was interesting for me i thought i was next in line no john paul our chief of uh our president of medical staff tells me that he's next in line oh i didn't get that memo then so it's like the president of the united states vice president speaker of the house type of thing well i mean i think it goes down to the treasurer who's the treasurer of the of the medical staff there you go he's ahead of me i think he is by quite a bit by quite quite a bit to be frank so so that was fascinating and in the beginning when mike first went out he was he was well enough that we talked multiple times throughout the day but ultimately i mean and thank goodness he never got sick enough to be in the hospital but ultimately he he was so out of it he he kind of said okay adam you know i trust you do what needs to get done right and that you know particularly in a time of of of incredible stress for the entire organization was a challenge and and and i wish mike was with was with us the whole time but i think we got through it no i mean if something's very similar happens on our podcast oftentimes um i have to take over here we go as well when he is either napping or doing his extracurricular activity so i can understand how you feel maybe to a lesser degree uh but i oftentimes feel like i'm running things around here at least in our little podcast okay but but what that means is that dr coleman is the ceo of the podcast he's really in charge and you're just a a number two that happens to be there to support him he'll always be number one he i don't mind being the the worker bee it's okay you know it's fine it's fine as long as i'm the face of the next book it's okay but no you're there's not a chance you're the face of the next oh all right that was a little comic andrew lube you know for me adam i have to ask you um you know you bring in the stories about uh staff holy name family how did the families of some of the especially nurses that may have been mentioned how did they take tutor how did you approach that very sensitive topic yeah so paul and i talked a lot about this do we do we not tell those stories do we change names but tell the stories and and and you know uh adjust them so they're not recognizable and paul appropriately said to me it's not the same book unless we tell the stories um it's not the same book unless we tell them the way they truly happen what do you think about approaching people and asking for their permission right so everyone who's in the book whether they're a patient or a family member of a patient i sat down with and i said look i'm writing a book um don't know whether you know it's going to sell and it's not really about that at this point it's about memorializing what happened here at holy name and what happened to you and your family was a huge part of that story are you okay with me telling your brother's story are you okay with me telling your husband's story and across the board they all said yes and then across the board i actually showed them you know not the earliest edits but close to final edits and literally got there i didn't i didn't put anything in writing i didn't think i needed to do that because these are all factual stories right but i got an okay from all of them to share their stories and then appropriately the you know the book is in memory of all the people that we lost at holy name and more specifically um our staff members or family members of our of our staff members so across the board they were all very supportive they were not easy conversations for me so they must have been very difficult conversations i mean i think the stories to me the story that's most amazing is the two nurses and their husbands yes so you know it's it's it's two nurses who've been here in holy name for quite a while whose husbands about the same time were in the hospital with covid both of them became critically ill and both of them got to the point where further aggressive care was futile and um the nurses were approached by the care team and the nurses made the brave but appropriate decision to take their husbands off of life support and allowed them to die a natural more comfortable uh death and the nurses didn't miss a day at work no yeah just you know and i i actually knew these nurses but didn't know them well enough to when i brought them in you know i mean tears and you know uh and you know look what can you say right and that's why the book doesn't do it justice it can't well i tell you what i think it's like hey sir can i ask the question sorry i mean i know i just want to say this

um i'm particularly very good friends with one of them and i was uh you know involved with the care of her husband i will tell you um it was amazing to me that when he was claire was withdrawn out of the icu they wanted the husband to come to the floor uh the sixth floor to be exact um and the entire holy name family all the nurses there all came in and it was really i think just a testament really a beautiful thing that they all came in at midnight one o'clock so that she would not be alone uh when her husband lee ultimately succumbed so it was a beautiful moment i know she's mentioned to me that she's very appreciative of the the fact that you mentioned is almost like therapeutic for her um you know and basically giving that importance of the in and recognizing what happened yeah yeah yeah just a tag on i think what you said as far as important i think it's so vital to uh capture the humanity because you know if you just watch tv you see numbers and you know two thousand people died today and all that it has no humanity and covet i think is unique because it's such an isolating disease right we really didn't see that much with any other epidemic that yeah you know family members couldn't see their loved ones and you just felt so isolated and set that emotional um problem that you know we had to face so i i think it's capturing that is really difficult but i think it's it's very important that you know we we relay that message to the to the audience it's also i i find random right i mean and i don't i don't know if i made this point as well as i wanted to in the book i mean you literally could be walking down the street one day and you're fine right right right and then in two weeks you could be dying in an icu with coping right and are there other diseases that can do that yeah but not really right i mean you know i try to draw some parallels to aids a little bit and i guess you're walking down the street one day and two weeks later you get your diagnosis of cancer so it's you know it changes your life but but this is it's so random right um and and unfortunately you know we're seeing people who don't think of themselves as being chronically ill or high risk yeah right they don't think of themselves as high risk they're 15 20 pounds overweight they know that's a little bit of an issue but they don't think of themselves as sick and that's just the reality of this disease and then you know they get a little bit of a runny nose and within three four days they're acutely ill and then some of them oh you know thank god a very small percentage of them but some of them go on and and and and die it's just the numbers don't do it justice clinton you're right don't do it just so important to humanize i mean you know this this because like you said there's still a disconnect i feel and we've talked about this in our own podcast and before of what we see as physicians and frontline workers and working in the hospital what other people may see that you know it's not my problem it's someone else's problem as we know this is a misinformation age in this pandemic so i think things like your book really the human eyes but do more so they really are still educating and like you said in in a manner that everyone can understand so people can truly understand the impact of this disease it's not something you see in the news it's not a political issue right this is an equal opportunity just you know bringer of death and destruction and uh and you did an excellent job you know portraying that we're talking with dr adam jarrett author of the amazing in the time of covet one's hospital struggles and triumphs um which i thought was really an interesting part of your book um you talk about all the innovations at the hospital there's a there's a quote that you mentioned necessity is the mother of all invention can you tell us about some of the the cool things that you guys did yeah well yeah i mean i got to give a lot of credit to steve mosser who's our vice president of facilities um as really being the mastermind for some of this so early on um the cdc i think appropriately pointed out that this is an aerosolized disease meaning that all patients who are tested and treated should have that done in a negative pressure environment to minimize the risk to people um outside of the room that that patient and caregivers in the cdc has waffled on that a little bit um they waffle a lot i mean we don't want to get into the waffling but they do waffle a lot so we can talk about that later but we decided uh based on i think good clinical evidence that we should do everything we can to treat patients in negative pressure and steve really came into my office one day and said adam we could do this i can build hundreds of negative pressure rooms um it doesn't take that much what's his background that so the interesting so steve um uh was was trained as a merchant marine yeah yeah so he was in an environment for years where he'd be out on a ship with three or four guys and something would break and he'd have to figure out how to fix it with whatever he had it's almost like the apollo i forget which which what the movie is one of the apollo movies i know what you mean where they had to make the scrubber to uh keep the oxygen and get rid of them and the nasa guys collect everything they have on the ship and they pour it on the desk and say okay here's what we have to make and we will figure it out on the ground so the guys up in space can can um can utilize that that was sort of steve's mentality so you know steve we literally went to three states to get the equipment we needed to to to create negative pressure rooms we ended up creating over 260 negative pressure rooms and there's an interesting uh graph in the in the book that shows the number of covet patients in the number of negative pressure rooms and we literally stayed hours ahead of the curve with steve constantly building out negative pressure rooms on a typical day you know i'd walk up to the icu and and the construction guys would say okay do you want us to finish icu negative pressure or do you want us to go up onto the medical floor where do you need more negative pressure and and then a couple hours later i might shift them again and we literally you know kept hours ahead of where we needed to be with negative pressure and then i think this was the most impressive thing that steve did um you know in the early days of this testing was slow right in the early days there was no testing and then when testing there was no thing where we had to get permission to test we had to get permission and it took a week very early days we had to get permission and and the guidelines for for what you needed to get permission for were not good they were not right um and then once we could get tests it still took five to seven days and so now you have a patient who you don't really know has covered with or two patients that you don't really know have copies you think they do but you would feel a lot better if you had a negative if you had a test result and now you're running out of rooms so you don't want to put those patients in one room together because one of what if one of them is really positive and one of them is negative and so steve came up with this concept of an isopod which is essentially a a cha a single negative pressure chamber that sits over the patient i was very skeptical i was like see this is never gonna work right you can't create a negative pressure environment like that um and he did and it worked and and the book talks about it and it allowed us to not get overwhelmed because we could keep two patients who we thought likely had covid but we didn't have test results back in one room because they would each be in their pod and the pod had some problems they were heavy and they were difficult to work around and we're not using them now because testing results come back so quick that we don't need them now we have them just in case um but in the in the first month of this in march they they were remarkable right they made a huge difference now as you know because obviously you're humanizing experience you know we part of our job as a humanize you so just as a side note uh as a star trekkie uh self-emitted star trek did you find this i'm gonna check it out satisfying to talk about this new chapter so let me know if you guys are done so i i described the isopods to my co-author paul rosengren and he said to me that's like the cone of silence from get smart that's right right and i said well not exactly he said yeah but it'll help people understand it and so um he put that in my my uh daughter who helped us copy edit the thing did a really good job helping us copy edit it hated that part of the book and said no one's gonna understand what the get smart cone of silence is so do you guys know what that is i have no idea again i was born in seville i do because i'm a well-read person i'm pretty sure clinton does not right so so my daughter said no one's going to understand that so clinton you got to go home tonight and and and hulu get smart and is it black and white or color

i think it's in color um but um she hated that um and then there was that then then there was a star trek reference she loved that so she was she said dad keep the star trek reference in because that's great and and because you really are more of a star trek guy than a kona silence guy true and okay but the really good news is the first 10 people who read the book for us specifically pointed out they love the kona silence thing so i was able to go to my daughter and say you were wrong that was great that was great but star trek still was very i think uh very cool and i think if you could have put a lord of the rings uh reference somehow maybe in the in the squeaker you know then that would really completely well maybe maybe there'll be a trilogy ah see i love that i love it i hope not i mean i mean for your for the book yes but for the pandemonium for the world i think there's enough material for a trilogy you know right yeah and maybe you will have to go back and and you know do the hobbit like you know do it like if you lost coleman but you've got me i'm i'm in all the way as you know because uh i'll dress up i'll dress up for it in my hobbit my middle earth year that's that's scary as an administrator in the hospital um as the chief medical officer were there times where you disagreed with the cdc or found it difficult to run a hospital we already mentioned the example of testing and that was a fiasco you know recommendations of testing asymptomatic patients and also the negative pressure issues whether it's airborne droplets how did you how how are we able to function when you didn't agree with some recommendations well so here's the really good news right the really good news is that uh mike our ceo is not a big believer in just blindly accepting um guidelines right because guidelines are just that their guidelines we know they change we know they changed you know for routine recommendations in day-to-day healthcare let alone in the middle of a pandemic with a disease we know nothing about so mike's you know edict is don't just accept what the cdc says don't break any laws adam right you have to bend some rules that's okay but don't break any laws but don't just blindly follow the guidelines and i don't want to be critical of the cdc i think that that they made the best recommendations they could make knowing what they know or knew but i have to tell you i don't think anyone knew better than health care workers and hospitals that were on the front line and and i think that they were wrong sometimes and i think i think they're wrong about negative pressure now they still have come out um not saying they they've they've waffled and now say that this disease is spread by aerosol and droplet right but they don't specifically say and so therefore it should be treated in negative pressure i don't understand that at all but i don't understand how you can say a disease is aerosolized like tb right right and and and not recommend if you treat it with negative pressure that i'm still confused by the only thing i can think of is they're concerned about the ability for hospitals to create 260 negative pressure rooms like we did i agree 100 i think you're absolutely right you know they've said that hey it's not spread so much by contact it's probably mostly droplet but even in the id literature they'll say could be aerosolization but you're right i think they stop short of making those mandates because they're afraid or ascertained that the the ability to make enough negative pressure rooms it just will you know be exceeded by the the patient uh onslaught but i tell you it wasn't that hard i mean i the three of us couldn't do it but steve monster and his team knocked out windows cut holes in pieces of plywood got hvac pipe ducts cooked it up hooked it up to a fan and a hepa filter it wasn't that hard um so i'm i'm a little i think that's the thing that's most frustrating me in terms of what the cpc uh uh um uh where they stand now um and i gotta wanna be critical they're very smart people um uh i think that anthony fauci did an amazing he's not part of the cdc but i think in a very difficult situation you know walked a very fine line that he had to walk through this pandemic and i think he did an amazing job in a very difficult situation and these people are are brilliant and smart but they're not always on the front line you know and and i was a little frustrated um with the the pop-up hospitals i talked about that in the book as well and i i don't understand um how the why the pop-up hospitals became what they were and i understand that there might be a need for a pop-up hospital but i don't think that we did it as a nation and are still doing it as a nation as well as we as well as we could have um i think that if we design pop-up facilities and i talk about this in the book potentially serve as quarantine facilities for patients who are well enough to go home but can't go home we would have done a whole lot better job at decompressing the hospitals as compared to using pop-up hospitals initially they were designed for non-cova patients and and and the reality is those hospitals were just not equipped to take care of non-covet patients because yeah taking care of patients today is complex and then they i decided to use again i'm sorry no no no but you're absolutely i just wanted to loot like i think a lot of those pop-up hospitals were not utilized and i remember the and i'm forgetting the name of the ship that came into new york harbor and left i think after a few days and was very vastly underutilized so i think it's just again a reflection as you mentioned the lack of central leadership you know especially early on um but i want to ask you know because you've been and the administration here has been very open and transparent all along about our experience about what was happening maybe more so than other places especially in northern new jersey i just wonder if that was something that was um that was on purpose you know that was was was deliberate or was that something just kind of happened i think it's the philosophy of this place right i think that you know we know who we are we know that transparency is almost always if not always better sure um and so that's just the way we function um we don't always get it right right especially in the middle of you know a brand new pandemic but it doesn't do any good to to not admit what you know admit what you don't know and if you don't get something right learn from it and move on i talk about that in the book with masks right we we did not do a good job as a health care community as it relates to maths early on i was one of the people i remember having a conversation with my wife you know now you don't need to wear a mask i don't why wouldn't i wear masks why wouldn't people wear masks i said because mass don't really work in this situation i couldn't have been more wrong and you know and we just need to admit when we get something wrong and then move on and not dwell on it because we're going to be wrong as it relates to new diseases um and that's where we were so yeah we we i don't think we specifically said let's be transparent as it relates to kovid i think that's just the philosopher in this place in general is there anything that you would do different as far as managing the hospital in retrospect wow that's a great question hey i'm the barbara walters of podcasting well yeah barbara wallace are you too young to even know the barber wawa reference yeah of course starting on saturday night live i remember good very good what would i do um so i had some very contentious conversations with doctors early on about mask wearing doctors who were wearing masks and were smarter than me about the need to wear masks so i had at least three or four contentious conversations where i said to the doctors there's no reason to wear a mask outside of a patient room and you're setting a bad example because maths are in limited supply and you need to function like a leader and not wear a mask boy was i wrong and not only was i wrong i was tough about being wrong i regret those conversations a lot because those doctors were right once we realized that the risk of getting covet for staff was not from patients but from each other and those doctors figured that out before i did um well i would take that back in a second and i would have put maths on everyone really early i think i would have um um when we initially planned we we thought six to ten patients in the ed we thought that's all we were going to have so in retrospect i would have gone back and and then it wouldn't have been such a race to build out negative pressure rooms i would have done that you know weeks or months ahead of time um let's talk about some therapeutics i mean we really push some of the interleukin 6 drugs right not they seem to have worked but the evidence is now pretty clear that they don't work right so you know that's an issue but at the same time we have been i think you know it's a good place to as we as we wrap up we have been at the forefront of therapeutics right through our institute of clinical research through your very strong ied department uh those names will be mentioned a very strong leader very strong infectious disease leader with a shiny head very shiny hit um yeah but we have been you know in in fact we are now playing with the big boys so to speak or big girl is it however yeah i think in terms of clinical trials we have the things that we have to offer i mean i think that has really put us to the forefront yeah we have seven active uh covet trials i think that's more than anyone else in the region we are enrolling patients every day we were the first hospital i don't know whether you guys have talked about this on the podcast we were the first hospital in the world to give a monoclonal antibody uh to a patient uh outside of a trial no in a trial we were the first in a trial it was done by a uh id doctor with a shiny head that's incredible you know the the drug that the president got through emergency use we were the first hospital in the world we were the first hospital in the country to use placental stem cells now the jury's still out on on placental stem cells so we we think we we saw a good response uh from it but the jury's still out i think the jury is a little bit further along on monoclonal antibodies we had patients who were transferred in from the entire tri-state area for trials we had patients that were transferred in from hospitals seven miles from here because because we had access to medication and treatment that they did not have um so you know i i feel very a lot of that has to do with our chief of infectious disease i i won't mention his name um and and our and our head of research um dr barkama who really did the hard work of getting manufacturers to understand that we had the ability to to get patients these medications in a trial setting and do it in an efficient way so they could get the information they needed right because what what they care about is getting enough patients enrolled so they can prove that their medicine hopefully works and we showed them that we do that actually quite well and in fact in some cases better than big fancy academic places um because of our size allows us to be more nimble i have another tough question i don't know if you're ready for this one um what would you say the happy ending would be in the book like if you could tie it up because i want to leave everybody on a good note okay so so as you guys learned i don't answer a question you know with a few words i'm i'm as i'm as long-winded as you you guys are so when we were writing right literally up till the last three or four weeks of of of writing i thought the happy ending might be that there might not be a second wave in northern new jersey i really i foolishly convinced myself there was enough immunity out there there was something about what happened in northern new jersey in the new york city area right that we were hit so hard there wasn't going to be this second wave and that you know we would continue to see low levels of disease but it wasn't going to be the second wave so i actually was cautiously optimistic that that might be the happy ending and obviously i i was wrong in fact we were rewriting the the book literally up until our deadline that we that we had um because things were changing on the ground so much now the happy ending is that the vaccine is easily dispersed um that the american people and the people around the world are willing to take it i don't think it's going to be as effective as the initial studies show at 90 95 but that's okay even if it's 50 60 70 effective the happy ending is that unfortunately we got to get through this wave which the vaccine's not going to help and the unhappy part is we probably will lose another couple hundred thousand americans so that's not happy um i think that the writing is already on the wall for that but i do think the happy ending is that by middle of this summer and i'd be curious what you guys think about this um that we are back in a life that is not a pandemic covet hasn't gotten away but that we're back to normal life no masks uh the economy and society being open right and then unfortunately covid becomes one of those diseases that you guys continue to see on an occasional basis is not an overwhelming way likely for years so that's the realistic mostly happy ending mostly i think the happy ending is the realization of the humanity of the of the doctors and the staff and the nurses and people in the hospital because i think we may have gotten to a point in healthcare where it's just you know factory working and you know a concession line and we really don't have that that humanity so you know it's i think that camaraderie that you know we we saw and uh put light to i think that that is the silver lining i think well that that would be a better ending to the sequel book right okay i'm cool i i i hope you're right i'm a little skeptical but i hope you're right i know that medicine will never be the same i know that i'll never be the same i mean i felt that way after the aids epidemic and now i feel that way again yeah i'll never be the same and i don't think healthcare will be well i think these are all you know important points you raised um i would say that you know one thing is that this is exposed kind of the uh you know unequal access to health care that we've seen because we know that certain lower socioeconomic and minority populations are on you know unfairly being burdened by this disease so hopefully as we say making eliminated lemons this can bring to light these disparities and and really um you know bring these to the to the discussion later that we need to do a better job as a as as physicians as a health care system right so you can see you guys answered that question much better than i did i'm going to take both of those and put them in my neck next book boring your answer was good who would play you who would play you in the movie version of this that's my last and final question okay so so i i've been asked this before and i had the person who i'd want to play me and the person who probably should play me so brad pitt is unavailable okay so so brad pitt is the person i want to play me but i i know that's not going to happen so i'm more likely to get played by jason alexander

i think that is more likely you know my character that's disappointing but that's who i am that's not who i am as a person but you're saying you're more of a costanza lust of a seinfeld well i think that the actor physically can portray me better and i think he's a talent enough actor that that it's not george but but jason alexander has an actor who can i got it for me he'll always be george i think he'll always be constanza but that but then but then now you guys are in the book so are you playing yourselves no i think i'm going to have i think morgan freeman will be playing uh clinton and um uh for me probably a bollywood actor you know du jour uh will be playing me um for hopefully with a little bit more hair so we'll have to wait and see we're hoping for the movie to come out sometime soon morgan freeman that's pretty impressive we'll do it

dr adam jarrett not only chief medical officer but author uh we want to thank you so much for coming on today um so we can find it on amazon kindle just tell us just before we go where where uh readers listeners can can can check you out oh um it's on amazon and kindle uh in the time of covet is the title if you type that in it comes up it's easily findable on amazon i'd love people to give it a shot love you to give me honest feedback either in person or by writing a review makes a great holiday gift for people you know this is really about trying to get the word out in terms of what holy name uh did great stocking stuffer that's just the right size um and you know clinton's pictures on it so i i actually ripped the cover off and put it in a uh a frame by my bed i need to blow it up you know yeah it's on my nightstand but i have to turn it over because i can't wake up in the morning or go to sleep at night looking at clinton's face i just can't do it so i turn around wanting you it's he's haunting me we want to thank dr adam jarrett again chief medical officer holy name medical center author runner lover of all things star trek and lord of the rings uh thank you for your insight thank you for your leadership we very much appreciate it as always i'm dr sir sagar clinton coleman my co-host find us on spotify apple stitcher rxdailydose.com until next time be well