Faculty and staff of the Department of Medicine (Cardiology) took part in International Yoga Day. Front row, from right: Annapoorna S. Kini, MD; Lori B. Croft, MD, Associate Professor; and Joseph M. Sweeny, MD, Assistant Professor.
Mount Sinai Heart faculty and staff recently participated in International Yoga Day at Guggenheim Pavilion, with multiple sessions starting at 7:30 am. However, the enthusiasm for the practice goes well beyond a one-day event. The organizer, Annapoorna S. Kini, MD, Director of the Cardiac Catheterization Laboratory at The Mount Sinai Hospital, and the Zena and Michael A. Wiener Professor of Medicine, Icahn School of Medicine at Mount Sinai, practices yoga herself and recently published a list of recommended yoga and meditation techniques in the CRT Times, including a 10-minute sequence specifically for physicians in the Cardiac Catheterization Laboratory.
Dr. Kini says, “At Mount Sinai, we strongly advocate yoga and meditation to counter musculoskeletal discomfort, to relieve stress, and to maintain focus and concentration.”
From left: panelists David Muller, MD, FACP; Erica Rubinstein, LCSW; and Chaplain Rocky Walker, MDiv; keynote speaker Mary-Frances Winters; Pamela Y. Abner, MPA; panel moderator Maxine Legall, MBA, MSW; and Gary C. Butts, MD, Dean for Diversity Programs, Policy and Community Affairs, Icahn School of Medicine at Mount Sinai.
Participants received information on efforts throughout the Mount Sinai Health System.
At a networking and informational session, Nolan Kagetsu, MD, FACR, left, Vice Chair Quality, Associate Professor of Clinical Radiology, Department of Radiology, Mount Sinai West, talks with Mari Umpierre, PhD, LCSW, Director, Mount Sinai Calm, right, and Shehan Chin, LMSW.
From left: Edgar Vargas, MPH, LMSW, LGBT Program Manager; Leona Hess, PhD, Director of Strategy and Equity Education Programs; and Bee Jaworski, Education Program Assistant in Medical Education
At the start of a meeting, give participants a few moments to reflect quietly on the subject at hand, then call on each person for their thoughts. When people do speak, “listen to understand, and not to reply.”
These were some of the specific and achievable strategies discussed in the inaugural Health Care Inclusion Summit, which was in June at the Corporate Services Center and sponsored by leadership in Service Excellence and Patient Experience.
The keynote speaker of the event was Mary-Frances Winters, founder and Chief Executive Officer of the Winters Group, a consulting firm that has been working with top leaders of the Mount Sinai Health System on inclusion strategies for more than a year. “It is important to recognize that inclusion is a developmental process,” Ms. Winters said. “We must address changes in attitudes one stage at a time.”
Ms. Winters used an interactive tool to ask the 150 attendees how they defined themselves. The anonymous answers appeared on a screen at the front of the room: A daughter, a Buddhist, an African American mom, a gay man, a husband, a millennial, a person with ADHD. These “identity markers”—some visible and some not visible—influence how each person sees and reacts to the world, Ms. Winters said, and understanding this is the beginning of understanding and accepting others.
Panelists during the half-day summit were David Muller, MD, FACP, Dean for Medical Education, Icahn School of Medicine at Mount Sinai; Chaplain Rocky Walker, MDiv, Center for Spirituality and Health, Mount Sinai Health System; and Erica Rubinstein, LCSW, CPXP, Vice President, Service Excellence and Patient Experience, Mount Sinai Health System. Maxine Legall, MBA, MSW, Assistant Director, Patient Experience, Mount Sinai St. Luke’s, served as the moderator.
The panelists said that both staff and patients were benefiting from inclusion efforts—which have the overarching goal of making every person feel heard, understood, and respected. Among other measures, the Health System has revamped a panel that addresses patient complaints and created the Strategic Leadership Collaborative to improve equity in medical education. In addition, ODI has expanded its portfolio of education and training on unconscious bias, LGBTQ health care and workplace equity, and cultural and disability awareness.
Leona Hess, PhD, Director of Strategy and Equity Education Programs for Medical Education led a discussion on the mindsets of the inclusive change-maker with Ann-Gel Palermo, DrPH, MPH, and Chief Program Officer. Attendees were advised to focus on how their mindset as a leader was created and how it informs their interactions with staff and patients. “Understanding your own personal and social identity is critical for the development of the skills and behaviors needed to understand, work with, and integrate the perspectives of staff and patients with a diversity of identities.” Dr. Hess said.
Planning is already underway for a summit next year, said Pamela Y. Abner, MPA, CPXP, Vice President and Chief Administrative Officer. “The response has been overwhelmingly positive,” she said after the event. “We see an opportunity to make inclusion and equity even more integral to patient care, medical education, and every other facet of the Health System.”
Takeaway thoughts
“I have grown into the understanding that others face challenges that I’m not aware of. When I went to seminary for four years, one of my biggest takeaway lessons was what women go through in this world.”
Chaplain Rocky Walker, MDiv
“You have to stay open to different perspectives and different mindsets. Be open to other voices that might challenge you.”
Erica Rubinstein, LCSW, CPXP
“Inclusion begins with I and happens with us.”
Mary-Frances Winters, Founder and Chief Executive Officer of the Winters Group
“I have learned that you have to have humility—professionally and personally. Just take a step back and listen to people.”
Charlotte Vrod, left, an aspiring tennis player, at the US Open with Alexis Chiang Colvin, MD, an orthopedic surgeon at Mount Sinai who helped Charlotte get back on the court after tearing her ACL.
It’s one of those diagnoses every young athlete, and their parents, fear: A torn ACL—the anterior cruciate ligament, one of the major ligaments in the knee.
The injury can happen to young athletes who play sports that involve twisting, turning, jumping, and rapid changes in direction, such as soccer, basketball, football, and tennis.
“We are seeing a trend with so many more kids playing sports these days,” said Alexis Chiang Colvin, MD, Associate Professor of Sports Medicine in the Leni and Peter W. May Department of Orthopedic Surgery at the Icahn School of Medicine at Mount Sinai. Dr. Colvin is also the Chief Medical Officer of the US Open and team physician for the US Fed Cup team. Mount Sinai is the official medical services provider of the USTA Eastern Section and the US Open.
Charlotte Vrod had a classic case of an ACL tear. An advanced junior tennis player, 14-year-old Charlotte was doing some intensive conditioning work at the John McEnroe Tennis Academy in New York where she was training. During a drill, she sprinted and then stopped suddenly. That’s when she heard and felt a pop, and felt her left knee cave in. She could barely walk. Her trainer could immediately see something was wrong.
Charlotte and her mother chose to return to Mount Sinai for her knee injury where she had had previous orthopedic care. She saw Dr. Colvin, who discussed treatment options with her and her mother. Ultimately, they decided to proceed with ACL reconstruction in order to allow her to pursue her dream of playing college tennis. Without surgery, Charlotte would have trouble even playing tennis for fun, according to Dr. Colvin.
A week later, she had the surgery to reconstruct the ACL—a ligament which provides stability in the knee—and to repair the meniscus, a pad that forms a cushion between the bones of the knee. One reason she and her family picked Dr. Colvin was knowing that she had worked with some of the world’s top tennis players at the US Open.
After eight months of rehabilitation, Charlotte, now 15, has resumed playing tennis. She’s optimistic about the future, and so is Dr. Colvin, who visited with her at the US Open this year.
“The amazing thing about Charlotte is her attitude. From day one, she’s been so positive,” said Dr. Colvin, who specializes in the surgical treatment of knee, shoulder, and hip disorders and has extensive experience in treating athletes. “It has been a long road for her. But she has always rolled with the punches. Now I am seeing her on the US Open grounds as a spectator. I hope to see her in a couple of years playing on the courts.”
For Charlotte, who began playing tennis when she was five years old, the recovery period has been an opportunity to appreciate how much she enjoys tennis and how fortunate she is that she can expect to return to the game. But the recovery has required a commitment to physical therapy and a change in attitude.
“One thing I learned is that it’s okay to take a minute and stop playing because you need to take care of yourself,” she said. “Even though I was really into tennis, I had to stop. I will get back to it.”
In fact, she came to enjoy the physical therapy and working with a personal trainer on targeted strength and conditioning for tennis.
“It was hard, but surprisingly it was actually a lot of fun,” she said. “PT was always something I looked forward to. I went three times a week before school.”
Now she’s looking forward to returning in the fall to playing varsity tennis at Trevor Day School in New York City. Then she hopes to resume training at the John McEnroe Tennis Academy and playing in some USTA tournaments in New York and New Jersey. She says she’s a bit emotional about it.
“I am not going to lie. Recovery was hard both mentally and physically, but it was all worth it because I learned so much from this journey,” she said. “It was hard in the beginning because the courts felt so far away, but I got my head into the game and just put everything I had into recovery and self-care. As I was working harder and passing milestones, like starting to walk again without crutches or even when I was able to bend my leg an extra five degrees, it made recovery so much easier and made the courts seem closer than ever.”
Jeannie Gaffigan, left, and, at right, Ms. Gaffigan with her family.
Five kids. Four Grammy nominations. One pear-shaped brain tumor. When a life-threatening diagnosis turns comedy writer, producer and director Jeannie Gaffigan’s life upside-down, she and her husband, comedian Jim Gaffigan, turn to faith, family, and of course—humor.
Ms. Gaffigan was successfully treated for a large and rare brain tumor by Joshua Bederson, MD, Chair of the Department of Neurosurgery at the Mount Sinai Health System. In the operating room, Dr. Bederson used virtual reality technology that he pioneered to help surgeons operate more safely and precisely.
Ms. Gaffigan talks about her terrifying health crisis and how it’s served as a source of renewed purpose for both her and her family. Her new memoir, “When Life Gives You Pears,” will be published October 1.
Road to Resilience brings you stories and insights to help you thrive in a challenging world. From fighting burnout and trauma to building resilient families and communities, the podcast explores what’s possible when science meets the human spirit. To listen, visit Apple Podcasts, Spotify, Stitcher, Google Play, or the Road to Resilience website.
Participants at one of several community workshops sponsored by the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai
There is wide acknowledgement that health care and social services need to be better integrated to achieve community health, especially for the most vulnerable. The best way to do this is not always clear. Health systems and community-based organizations need to better understand how to create these successful, sustainable partnerships.
The Institute recently convened representatives from community organizations and Mount Sinai Health System, along with philanthropic donors and thought leaders.
During a panel on August 1 at the New York Academy of Medicine, participants discussed the benefits of participating in a year-long initiative led by the Arnhold Institute for Global Health and ideas on how multi-organization collaborations can be improved to better serve community members. The participants included Maxine Golub, Senior Vice President, Planning and Development at the Institute for Family Health; Stephanie Wang, MD, Assistant Professor, Medicine (General Internal Medicine) and a primary care physician at Mount Sinai Saint Luke’s; Shoshanah Brown, Chief Executive Officer at AIRnyc; and Judy Secon, Senior Director of Programs and Operations at New York Common Pantry. The panel was moderated by Principal Investigator Natalie Privett, PhD, Assistant Professor, Global Health, Medicine (General Internal Medicine).
Panelists highlighted that building relationships and having candid conversations with people from other organizations is a critical initial step. Ms. Golub emphasized the importance of making a long-term commitment to working in a community to truly effect change. Participants felt strongly that as the work progresses, it is vital to incorporate members of the community into the process. An important aspect of this will be looking at how care can be better coordinated across health care systems and community-based organizations.
Laurie Zephyrin, MD, MPH, MBA, left, Vice President, Delivery System Reform, the Commonwealth Fund, and Rachel Vreeman, MD, MS, Interim Director of the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, Vice Chair of Research for the Department of Health System Design and Global Health, and Director of the Global Sites Network. Photo credit: Andrea Archer
In 2018, the Institute received support from the Commonwealth Fund to develop and implement a participatory process to bring together community health stakeholders to identify and brainstorm how to collectively improve a community health issue in Central Harlem. The Institute facilitated several workshops that included leaders from Central Harlem-based community organizations and health systems.
Stakeholders included AIRnyc, New York Common Pantry, City Health Works, the Institute for Family Health, Mount Sinai St. Luke’s, and the Mount Sinai Performing Provider System (MSPPS), a population-health focused, integrated delivery system in Manhattan, Brooklyn, and Queens. Through design and facilitation techniques, stakeholders identified potential challenges, opportunities, and shared value. Stakeholders began strategizing about potential implementation steps.
Lessons from the initiative workshops were captured and generalized in a guide that is now available for implementers to support community health transformation efforts.
The guide is designed for anyone who wants to improve community health through collaboration across health systems and community-based organizations. It will help people build meaningful partnerships, achieve consensus, and scope out a strategy for community health issues. It is meant to be instructive in thoughtfully convening community-based organizations and health care systems to work towards a collaborative goal while building trust. The guide offers exercises, instructions, and tips to help others create a successful collaboration. It is rooted in the Institute’s experiences developing the collaboration and incorporates lessons learned from leading the collaborative. It was developed with support from the Commonwealth Fund.
Experts agree it is clear that systematic change is needed to improve collaboration. It is complicated and will require dedicated involvement from community organizations, health systems, health information technology experts, policy makers, and payers.
As Arthur Gianelli, President of Mount Sinai Saint Luke’s, noted, “The only way to make change is to change policy at the top and piece-by-piece make improvements at the bottom. We look forward to deepening collaborations across health systems and community organizations.”
Saadi Ghatan, MD, and Sadie Gonzalez before her surgery.
Episode 2 of a new Netflixdocu-series titled “Diagnosis” focuses on seven-year-old Sadie Gonzalez from Queens, who suddenly began suffering seizures. Doctors at one New York hospital give her the devastating diagnosis of Rasmussen’s encephalitis and tell her parents the only option is a damaging and irreversible brain surgery that would leave her paralyzed over half her body.
When her parents seek a second opinion at The Mount Sinai Hospital with Saadi Ghatan, MD, director of the Pediatric Neurosurgery Program for the Mount Sinai Health System, and Lara Marcuse, MD, co-director of the Mount Sinai Epilepsy Program and Associate Professor of Neurology at the Icahn School of Medicine at Mount Sinai, they learn there is another option.
Dr. Ghatan, who is also Associate Professor of Neurosurgery and Pediatrics at the Icahn School of Medicine, suggests that a less-invasive surgery is possible—a responsive neurostimulator (RNS) system, a small, implantable neurostimulator connected to tiny wires that are placed in specific seizure onset areas of the brain to deliver electrical stimulation that normalizes the disturbed brain circuitry causing the seizures. He explains that similar to a pacemaker that monitors and responds to heart rhythms, the RNS system will monitor and “learn” her seizure patterns, then deliver electrical stimulation to stop them in their tracks.
Lara Marcuse, MD
The episode follows Sadie’s and her family’s journey through the decision-making process and successful surgery at Mount Sinai.
Although Rasmussen’s encephalitis is an incurable condition and it may be six months to a year before physicians know if the device is successfully helping her, early results look promising.
The seven-part Netflix series is based on the long-running New York Times Magazine column titled “Diagnosis.”Watch the trailer and learn more about the series here. Read more about the series in an article in USA Today.
