Right step for SMH board

As it happened this past Nov. 29, this was an odd coincidence: Two of Sarasota’s most important public boards met for the first time with their newly elected conservative board members. And, as it happened, each of their meetings was scheduled to address a highly volatile issue that was the underlying influence that drove the new board members’ elections.

For the Sarasota School Board, that issue, broadly speaking, was the spread of woke-ism in the schools. But it coalesced — however right or wrong — into holding one man accountable, whether to keep or dismiss Superintendent Brennan Asplen.

For the Sarasota Public Hospital Board, the issue focused on a higher scale — life and death: how Sarasota Memorial Hospital treated COVID-19 patients during the past two years.

Both meetings and topics were important. For sure, having the right leader as CEO of public schools is paramount for the community’s future — educating our children to be productive citizens. 

But over time, the hospital board meeting has the potential to serve as a historic moment for the future of Sarasota Memorial, as well as for hospitals around the region and nation. Handled correctly — as the meeting was, the board’s charge to the hospital’s quality committee to provide a transparent review of how SMH handled COVID-19 patients can produce two invaluable outcomes:

• An honest assessment of why COVID patients were treated the way they were.
• What not to do and what to do when the inevitable next pandemic strikes. What did the hospital learn?

It starts with “why?” 

That is always the question to be answered. That’s what many of the speakers at the hospital board meeting wanted to know: Why? 

Why were their loved ones given the drug Remdesivir, a drug the World Health Organization declared that hospitals should no longer dispense because of the deaths and harm it caused. “I need to better understand why my mother received it,” Jenny Naylor  told the hospital board.

Her father wanted to know why his request for Ivermectin for his wife was refused. “What right does Sarasota Memorial have to deny my request?” he asked the board.

Many family members of deceased COVID-19 patients wanted to know why they couldn’t be at their loved one’s bedside before they died. 

Dr. Kenneth Hurwitz, director of critical care medicine at the hospital, like all the speakers, had five minutes to explain the hows and whys of the Sarasota Memorial clinical staff during the pandemic.

In his remarks, you can hear that the hospital staff did its best and more. “The nurses, therapists, physicians and support staff all pitched in by working longer hours and extra shifts, and especially before the availability of the vaccines, they did so at great risk — personal risk to themselves and to their families,” Hurwitz said.

“We met regularly with our nursing and respiratory therapy leadership, with our infection control staff, our clinical pharmacists and physician colleagues in infectious disease and other specialists,” he said. “We were aided in the evaluation of literature by our academic colleagues from the Florida State University residency program here at SMH. We monitored the national recommendations, and we applied those that were appropriate to local use.

“Our goal,” he said, “has always been to treat patients based on up-to-date, respected, published, peer-reviewed, evidence-based medicine.” 

When you absorb the comments of Hurwitz, other physicians and SMH staffers who spoke, you can picture a cloud of strain and stress permeating the hospital at the height of the pandemic and a degree of uncertainty, doubt and second-guessing because of all of the competing information flooding the internet and media.

If you were in the shoes of the hospital CEO or the chief of medicine, you can presume much of the decision making had to revolve around managing risk. The inclination would be strong and compelling to go with the protocols that were coming from the so-called experts in Washington — Dr. Anthony Fauci and the Centers for Disease Control. There was the expectation of trust.

But take Ivermectin. Fauci dissed it as quackery and never acknowledged its efficacy. What’s more, we’re now learning Fauci and his cohorts influenced social media to tar and censor from their sites world-renown physicians and researchers who had reputable data that challenged the Washington orthodoxy, that Ivermectin and other treatments indeed worked.

One of the speakers at the hospital board meeting condemned what came out of Washington as “government overreach.” Add to that the public factors of fear and, over time, distrust of government.

Put all this together, and it’s not off base to compare the pandemic to the fog of war. Plans are foiled. Surprises occur. 

After the board heard from 33 speakers, roughly half of them sharing emotional, gut-wrenching stories, Dr. James Fiorica, chief of the system’s medical staff, noted: “This has been the most difficult two-and-a-half years in my history in Sarasota.”  

No doubt this period will stand forever in history as a benchmark for the hospital system. And not just for SMH. What occurred at SMH also occurred at the more than 6,000 other hospitals across America. 

If this were post-war, our military leaders would do what they always do: Conduct detailed post-mortems. And to its credit, and as it should, the new hospital board, has ordered its quality committee to take the first step: “after-action reviews” of how and why patients were treated the way they were and a thorough, transparent assessment — “what did we do well, what did we do badly, what lessons did we learn, what things would we do differently, how can we better prepared for a future pandemic,” according to Board Chair Tramm Hudson.

As Jenny Naylor, daughter of a deceased patient, admonished: “Please do the research and ask the really challenging questions. … For my mother and for all others who seemingly died as a result of these protocols, I beg you to do your job.”

New Board Member Bridget Fiorucci cast the reviews in a broader context — that Sarasota Memorial can set the example for hospitals across the country. By doing its reviews, “We can be the change that everyone else needs in other healthcare systems.”