The tough parts. They come in waves. They come randomly. They come expectedly.

Dr. Jennifer Hartwell stood in the operating room over his body. A man brought into IU Health Methodist Hospital with devastating injuries, multiple horrific injuries. It had been a crushing motorcycle accident.

There was no saving him. No surgeon could have. His injuries were not survivable.

“And yet I had him in the operating room and I felt horrible when I couldn’t save him,” says Dr. Hartwell, a trauma surgeon inside one of the busiest Level I trauma centers in the nation. “Those are bad because those stick with you.”

The tough parts, though, sometimes turn to wonderful. Being a trauma surgeon is a string of highs and lows. Victories and defeats. One can change to the next in a moment.

But in the end, what stands out are the people that Dr. Hartwell cares for. Many getting better. Some taking their last breaths before her eyes. Others brought in without a chance of survival, yet she gives every last ounce of strength she has to bring them back.

“There are those patients who really stick out. I can remember their names. I can remember their injuries. I can picture them,” says Dr. Hartwell, who came to Methodist a year and a half ago. “And sometimes, the cases just pierce your soul.”

***

Trauma is the glamorous made-for-TV part of medicine. It’s the stuff filled with drama, blood and sweat.

Dr. Hartwell sees it all. The gunshot victims and stabbings. But those make up just 10 percent of trauma cases at Methodist.

Most of her patients average 45 years old. Many are elderly. The most common cause of trauma is from falls, followed by motor vehicle accidents. 

When she’s on call, Dr. Hartwell will touch 20 patients in one shift. In a year, she sees more than 600. Often, she gets to deliver amazing news to families. Often, she doesn’t.

“The worst part of my job is having to go and tell a family bad news,” says Dr. Hartwell, a married mother of four.

After all, how do you walk up to a mother and tell her that her son has died? How do you tell a husband that his wife may not make it through the night?

Dr. Hartwell has settled on doing this part of the job her own way. She always asks a chaplain to join her. She takes a few minutes to get presentable. That might mean taking off her surgery cap or getting a drink of water. It may mean changing scrubs if they are soiled from the operation.

“Then I take a deep breath,” she says. “And I say a little prayer.”

She asks only key family members be present, perhaps the parents or a spouse and a close support person. And she starts each conversation the same way: “Hi, I’m Dr. Hartwell. I’m the one who has been taking care of your loved one. Tell me what you already know.”

Sometimes, the families just have a sense. They know it’s bad. Other times, the families know nothing. They’ve just been told that their loved one has been in a car accident and taken to Methodist.

“I let them tell me and I go from there,” she says. “And I usually try to be very brief and I usually say just a couple words letting them know what happened.”

And if she has to give the impossible news that a patient has died, “I say, ‘We did everything we possibly could but he has died.’”

“I force myself to say the word ‘died’ because in that moment people don’t process ‘passed away’ or ‘we lost him,’” Dr. Hartwell says. “As hard as it is to say that, I’ve learned that I need to be succinct but truthful and accurate and say those words.”

Death. It’s a part of life for a trauma surgeon. How Dr. Hartwell goes from stopping the gush of blood on a patient and watching tragedy unfold to living a normal life outside the hospital with her husband and four children is unthinkable.

Finding the space between the two extremes of emotions is key, she says. The space between getting too emotionally involved and becoming numb to it all.

“For me, it’s a combination of making sure my head and my body and my heart are in the right space,” she says. “Which is why I am a diligent reader, runner and writer. That gets me in my right space.”

And Dr. Hartwell is deliberate about leaving work when she goes home. And being focused on patients when at work. Of course, it’s never perfect.

“Sometimes, we hit the mark,” she says. “And sometimes we don’t.”

***

Born in Troy, Ohio, a small town just north of Dayton, Dr. Hartwell grew up thinking she wanted to be a teacher.

No one else in her family had a medical background, except her grandmother, who was a nurse and met Dr. Hartwell’s grandfather taking care of him during World War II.

Both of her parents were counselors. Her dad, now retired, was a licensed professional clinical counselor who ran the counseling center at their church as well as the outreach and non-profit ministries.

Her mom started out as a home economics teacher, but then got a master’s degree and was a guidance counselor for a career technical center.

The family jokes that Dr. Hartwell’s younger brother, a police officer, and she, a trauma surgeon, certainly veered from their parents’ jobs in “feelings.”

But one summer before college, Dr. Hartwell became mesmerized with a documentary on PBS. It was called “M.D. – The Making of A Doctor.” The series followed seven people through Harvard Medical School.

“That just captured me big time,” Dr. Hartwell says. “And I said, ‘That’s what I want to do.’”

So she switched her major from education to zoology, the closest thing to a pre-med degree that Miami University had, and soaked in all she could studying life systems.  

After college graduation, she put her medical school on hold to follow her husband, Scott, who was in the military, to Fort Campbell in Kentucky. She taught middle and high school science – and loved it. But not enough to deter her from her “Making of a Doctor” dreams. 

When the couple moved back to Ohio, Dr. Hartwell made it happen. She went to medical school at Wright State University, and then did five years of general surgery training at University of Illinois at Chicago.

It was there, in her third year of residency, when she discovered that trauma was where she wanted to be. She had seen surgical oncology and vascular surgery and all the other specialties. When she went through trauma, she thought, “These are my people.”

“I just really like the team aspect of taking care of trauma patients. I like the immediate gratification of taking care of trauma patients,” Dr. Hartwell says. “They are sick and injured and you can take them from being super, super sick to really turning the corner and making them better really fast.”

***

Trauma takes a certain type of person. “But isn’t it great everyone is different and likes different things?” Dr. Hartwell says.

For Dr. Hartwell, who before coming to Methodist was at Grant Medical Center in Columbus, the adrenaline rush and fast-paced world of trauma draws her in.

“We see a patient and within the first two minutes I’ve got to decide, ‘Should we give them blood? Do they need to go to the operating room? What cat scans do I need? Do I need cat scans at all?’” says Dr. Hartwell, who did a 1-year fellowship in Memphis at University of Tennessee Health Science Center.  “I have to make very quick decisions.”

It’s all about taking in the big picture and asking, “What is most important now?” she says.

And even as Dr. Hartwell sees the tough parts and the great parts and the devastating cases that pierce her soul, she always comes to the same conclusion.

“I’m so thankful for my job,” Dr. Hartwell says. “I’ve got the greatest job in the world.”

More on Dr. Hartwell

Personal: She married Scott, a financial and risk analyst, right out of college. Before medical school, Dr. Hartwell had her first son, Jack, now 17. During medical school, she had daughter Allie, now 14. As a third year resident, she had Ben, now 9, and as a senior surgical resident, she had Sam, now 8. 

Balancing it all: “People always want to talk about work life balance and I don’t really believe in work life balance. I just believe in life,” she says. “This is my life. The two of us, we have two careers and four kids and we just make it work. All throughout my education and training and to this day, my husband deserves all the credit for making this happen. He’s amazing and a super dad.”

Outside of Methodist: Dr. Hartwell is an avid runner and just finished her first marathon. She loves to cook and try new recipes and all her disposable income goes to travel. She journals and does devotion each morning and writes a blog traumamom4.com, the musings of being a mom, a surgeon and a runner. At night, she reads mostly nonfiction but will throw in fiction every now and then for “brain candy.”

Her research interest: Nutrition support for trauma patients, specifically critically ill patients getting nutrition through a feeding tube. “Patients who are really injured, they need more calories and more protein to heal,” she says. “If we aren’t super diligent about putting the feeding tube in and calculating what calories and protein they need and getting it to them, then they fall behind really fast. Nutrition matters a lot.”

Professional involvement: Dr. Hartwell is part of the Eastern Association for the Surgery of Trauma (EAST), Western Trauma Association (WTA), The American Association for the Surgery of Trauma (AAST), American College of Surgeons, Society of Critical Care Medicine (SCCM) and the American Society for Parenteral and Enteral Nutrition (ASPEN).

— By Dana Benbow, Senior Journalist at IU Health.

   Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.

When the National Football League championship game pits the top team of the American Football Conference against the National Football Conference titleholder, players have about three hours to capture the victory.  But when teams of nurses face off for the Critical Care Bowl they have just 30 seconds to deliver their answers.

Nearly 30 IU Health nurses joined in the recent competition sponsored by the Central Indiana Chapter of the American Association of Critical Care Nurses (CIC-AACN). The Jeopardy-style contest challenged the skill and analytic of new RNs and veterans.

“The competition was fierce. There were 14 teams and lots of friends and family members turned up to cheer on their favorite nurses,” said Mandy Dees, manager of nursing education, University Hospital.  The AACN is a non-profit organization made up of 200 chapters throughout the United States dedicated to providing professional and personal support to acute and critical care nurses in an effort to provide the best possible patient care.

While many competition teams practice for the big football game, the critical care practice is done during around-the-clock bedside care, said Dees. Teams chose questions from six categories – ranging from not so difficult (100 points) to very-difficult (500 points) questions. And just like the NFL championship game, this contest begins with a coin toss to determine who picks the first question.

The teams are quizzed in categories that include cardiovascular, pulmonary, endocrinology, hematology, and renal topics.

Here are some sample questions:

“Peaked P waves are associated with what electrolyte imbalance?”
Answer: Hypokalemia

“In order for a stroke victim to receive reperfusion therapy, how long from the onset of symptoms must a patient be diagnosed and treated?”
Answer: 3-4.5 hours

“What is a patient with a large crush type traumatic injury at risk for?”
Answer: Myoglobinuria, Rhabdomyolysis

IU Health Methodist team members represented Cardiac Medical Critical Care, Cardiovascular Critical Care, Adult Critical Care, and Multispecialty Critical Care. IU Health University teams represented Medical Intensive Care, Transplant and ICU.

After a tough battle, the Cardiac Medical Critical Care team emerged as the champions using the name, “Code Blue Commanders.” IU Health teams also captured second and third places.

Team members included:

Champions, Code Blue Commanders. – Nicole Wallace, Melissa Johnson, Nick Keesler, Carli Chandler, Kate Stephens and Ashley Nestra

Second place, Rapid Infusers – Sarah Wheeler, Brandi Kopsas-Kingsley, Zach Derringer, Emily Lucas and Kim Servas

Third place, Maxed out on Pressors – Kami Biggerstaff, Ali Heda, Alex Monnin, Sam Bonvillian, Jackie Smith, Katelyn Mathison.

“We’re a very competitive unit and the final round was close between the two teams. IU Health didn’t win last year so it was good to bring the win home,” said Nicole Wallace. It was her third year of participating in the competition.

“These nurses are the best of the best when it comes to critical care and taking care of patients,” said Dees. “For all their efforts, they didn’t get a big trophy but they got to be part of a winning team and have the bragging rights for a year.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at T.J. Banes or on Twitter @tjbanes.

A colorful painting is displayed just inside the entrance to the Cancer Resource Center. Across the top are the words: “Enjoy Every Day.” A patient created the artwork, and Lindsay Syswerda has adopted the words.

“I look at our mission in as to help others enjoy every day because you’re never guaranteed tomorrow. So it’s important to find happiness in everything you have,” said Syswerda, who obtained her Bachelors Degree in public health promotion & education from Central Michigan University.

Syswerda moved to Indianapolis from Grand Rapids with her husband Curtis who is pursuing a degree in energy engineering at IUPUI. Prior to joining IU Health Syswerda worked for a Michigan health system in events and relationship building and has also worked with volunteer programs in an adult cancer service line.

One of her first goals is to beef up the volunteer program and provide meaningful experiences for volunteers with the Cancer Resource Center. “A lot of people want to give back. This volunteer role is ideal for cancer survivors or caregivers as well as retirees and individuals who enjoy interacting and helping others,” said Syswerda.

The Cancer Resource Center provides information for classes/events, educational resources, support groups, and other resources at IU Health Simon Cancer Center and within the community.

“We are looking for volunteers to help connect patients, families and caregivers to local community resources to assist them during their cancer journey,” said Syswerda.  Cancer Resource Center volunteers are trained by IU Health Simon Cancer Center as well as the five partner agencies: Leukemia & Lymphoma Society, American Cancer Society, Susan G. Komen, The Little Red Door and Cancer Support Community.

In her new role Syswerda will also oversee the activities of the CompleteLife Program that provides such services as yoga, massage, art and music therapy to patients, family members and IU Health team members. A cosmetologist is also part of the Cancer Resource Center and provides cancer patients with haircuts and wig fittings.

“The CompleteLife program has some wonderful experts in their fields and I want to support that and find ways we can enhance that,” said Syswerda.

Some of the upcoming activities include: Lunchtime music, family and friends caregiver support (both on Thursdays); and the First Monday Cancer Support Group (October 2). The wig bank is open twice a week, a caregiver massage chair is available on Tuesdays, and “Creating Hope,” a watercolor workshop is offered on Thursdays. A complete list of events can be found here.

“I really believe that it’s our mission to help others find some joy in their lives every day during one of the toughest times – whether that’s through yoga, music, art or some other holistic approach,” said Syswerda.

Here are a few more things about Syswerda:

• Her creative outlet is floral arranging. She enjoys working with wedding parties to design and create bouquets okc for the special day.
• She doesn’t consider herself “outdoorsy” although she does enjoy kayaking and biking.
• She took a yoga class in college that started her love for the relaxation technique.
• She loves arts and crafts and at one time thought she might become an interior designer.

— By T.J. Banes, Associate Senior Journalist at IU Health.
Reach Banes via email at T.J. Banes or on Twitter @tjbanes.

There are, of course, the prescriptions that get filled — an average of 780 a day.

Do a little math and that’s a mind-boggling number in a week, let alone a month or a year. And that alone is remarkable.

But inside the bustling IU Health Methodist Retail Pharmacy there is so much more going on, things most people would never fathom.

All the staff is trained on identifying signs of domestic violence. More than once, they have helped get a victim to safety.

The pharmacy is taking major strides to slash hospital readmission rates with a discharge program that’s had amazing success rates.

And workers make personal calls to nearly 1,000 patients every month – HIV and transplant  – to make sure they have their prescriptions and are getting refills of their life-saving medicine.

“The retail pharmacy does a lot of different things. We have a lot of different programs,” says Cindy Miller, RPh, who has been manager of the Methodist pharmacy for 12 years. “I enjoy the variety of starting new programs and seeing how they can help patients and drawing out the strengths in our staff because the staff is really why all of our programs are successful.”

The staff. Behind the counters, among all those bottles and boxes of pills and medicine, is an army of workers. The Methodist pharmacy employs about 36 – ranging from pharmacists and certified pharmacy techs to social workers and social work assistants.

There is also a robot in the pharmacy, which joined the team about six years ago. She/he fills 40 percent of the prescriptions and labels the bottles.  

Miller has worked at the pharmacy, which opened 30 years ago, for 21 of those years. She’s seen its name change six different times. At one point, it was called the Methodist Prescription Center. At another, Indiana Home Care.

As manager for the past 12 years, Miller has worked to transform its mission. We asked her to tell us more about all that goes on inside this pharmacy inside the hospital.

Robust discharge program

When a patient is ready to leave Methodist, a pharmacy tech goes to that patient’s room to enroll them to get prescriptions filled.

Miller and her staff want to make sure patients leave with their medicine. They troubleshoot prescriptions, making sure they are written correctly, that they are covered by insurance and that the patient has the money to pay for it.

When the prescriptions are ready, a pharmacist will call the patient in the room to go over cost and do counseling. The pharmacy tech will then deliver it to the room.

The program started in 2008 and Miller has been tracking its success, which has been tremendous.

Over the last 18 months, the readmission rate for patients who left with their medicine was 4.23 percent less than those who don’t leave with their medicine.

“That’s huge,” Miller says. “It’s eye opening.”

Personal touch

Every month, Miller’s staff makes phone calls to nearly 1,000 patients — more than 400 transplant patients and about 450 HIV patients.

The goal is to touch base and make sure they are taking their prescriptions or refilling them.

And when a transplant patient or patient on a ventricular assist device leaves the hospital, a pharmacist is sent up to consult with the patients on the medicine they will need outside of the hospital.

Miller’s next goal? To get patients with chronic obstructive pulmonary disease (COPD) on a similar program.

Social spectrum

Most people don’t think about social workers in the pharmacy, but they play a big role. They help patients qualify for financial assistance programs to cover the cost of their prescriptions.

Pharmacy staff members are trained on identifying victims of domestic violence. If they notice something with a customer that raises a red flag, they will ask that person if they’d like to talk to a pharmacy social worker.

Since that program has been in place, Miller has seen several domestic violence victims brought to safety.

More About Miller

Personal: Miller was raised in Beverly Shores, Ind., and started dating her husband, Jeff, when she was 15. They have been married 34 years, live in Indianapolis, love to travel and have three grown children, Joy, Jeremy and Patti. They also have three grandchildren, two girls and a boy. 

Road to pharmacy: She thought she wanted to be a physical therapist, but her taste for pharmacy came as a sophomore in high school. She loved chemistry and her chemistry teacher, whose son was a pharmacist. She knew from then on, a pharmacist she would be.

Education: Miller went to Purdue University for pharmacy school, then completed a post-graduate residency in hospital administration at Brigham And Women’s Hospital in Boston.

Full circle: After she finished her residency, she was hired at International Health Services in Boston where she developed a database tracking diagnosis and the difference in length of stay based on drug use, very similar to the discharge program at Methodist.

Landing at Methodist: The couple moved back to Indiana in 1988 and Miller worked at an independent pharmacy before coming to Methodist in 1996. She worked as a pharmacist before taking the role as manager 12 years ago.

— By Dana Benbow, Senior Journalist at IU Health.
 
   Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.

Fall is often when people begin thinking about health benefits and insurance coverage for the coming year. Many employers conduct open enrollment in the fall, which may result in new considerations and the possibility of changes in health coverage, especially if your employer is switching insurance carriers or offering new health plans. When it comes to maintaining good health, here are some things to keep in mind as you make choices during open enrollment:

Aim to establish an ongoing relationship with a primary care provider. Long-term physician-patient relationships allow doctors to get to know their patients and learn their medical history. While it’s not always possible to maintain such a relationship due to insurance changes and life circumstances, continuity of care provides significant benefits for patients.

When reviewing your health insurance options each year, check to make sure your primary care doctor is included in your plan. If you need to find a new doctor, plan to schedule an appointment with your current physician before the end of the coverage year to help ensure a smooth transition. Your current doctor may be able to recommend other providers and will help transfer your medical records. If you’re taking prescription medications, it’s important to work with your current doctor to ensure you have refills to meet your needs until you find a new physician.

Review the preventive care coverage included in your plan. The Affordable Care Act requires that preventive health services be covered at no additional cost in all health insurance plans. These services, which include immunizations and health screenings are based on age and gender. Take time to review your health plan to understand what preventive care services are offered and then work with your primary care provider to develop a preventive care plan that’s right for you.

Learn about your prescription drug plan and work with your doctor. Some health insurance plans offer incentives for 90-day prescriptions. If you’re taking maintenance medications for a chronic condition, such as heart disease or high blood pressure, ask your doctor if a longer-term prescription is possible to save you money.

Know where you need to go for lab and imaging services. Some health plans require you to use certain labs and radiology centers. If you’re able to choose, you may want to find facilities that are close to your home or work. If you’re selecting a new primary care doctor for insurance reasons, you may want to see if these services are offered on-site for added convenience.

With today’s technology, we can learn about anything—any time—using devices that fit in the palms of our hands. And while “Googling” can be helpful in gathering information, there are things you should consider when looking for medical information online.

Seek out reliable health websites. The Internet can be a valuable resource, but it’s also full of reports, posts and websites that are inaccurate or misleading. To find the most reliable medical information, stick to websites curated by respected national organizations, hospitals and academic medical centers. The Centers for Disease Control and Prevention website, cdc.gov, is a recognized resource, as is familydoctor.org., which is sponsored by the American Academy of Family Physicians. One way to determine if a website is reliable is to take note of the number of advertisements that appear on the site. It’s best to avoid websites that display too many ads, which could signal editorial bias.

Understand the role of “community forums.” Health-related community forums often found on Facebook and other social networking sites are usually not approved or fact checked by doctors or medical experts. Typically, individuals post opinions and their personal experiences in forums, which should not be considered reliable medical information.   

Confirm online findings with your primary care doctor. While it’s understandable to be curious about your health, especially if you are experiencing new symptoms, it’s important to talk with your doctor about information you find online. Symptoms can result from a variety of illnesses, conditions or circumstances, and your doctor is most qualified to assess your symptoms and provide a diagnosis. Knowing you and your medical history, your physician can determine if the information you find online is relevant to you.

Internet-based research is often most helpful after you’ve talked with your doctor about your situation. He or she can then direct you to reputable online resources to learn more about your condition and ways that you can effectively manage your health.

Are you in a walking routine? Maybe you have created a great habit of walking outdoors everyday on your lunch break or parking further away? As a registered dietitian and nutritionist, I work with bariatric patients at Indiana University Health to help them lose weight in preparation for surgery. In addition to being followed by a team, patients also receive individualized nutrition counseling post-operatively. We work together to identify barriers and solutions throughout their weight loss journey, which often includes exercise.

I also help people reach their health and fitness goals as a certified personal trainer and group fitness instructor. I love being able to help people integrate nutrition, fitness, and wellness to eat better, move better, and feel better doing it.

Don’t let the cold weather be a barrier to your healthy habits. Follow these tips below to help keep you active and fit through the fall and winter months.

• Dress Appropriately: Bring a jacket to work and dress in layers if you plan to take your workout outdoors. Dressing appropriately for the temperatures can make a huge difference in the comfort of your workout. If you get too hot, you can always remove a layer.
• Fix Your Feet: Consider keeping an extra pair of gym shoes in your office. Proper footwear can be the difference in foot or knee pain that inhibits you from long walks. Consider checking out your local running store for a free assessment to help find the right type of shoe for you.
• Plan Ahead: Be sure to check the temperature the night before or day of your planned activity. This can help you not only choose proper clothing, but also proper gear such as a hat, gloves, or scarf.
• Always Have a Plan B: Raining outside? Plan to take extra stairs at work, walk laps at your local mall or high school, or pace the isles at the grocery store (avoiding the free samples of course!).
• Join a gym or recreation center: Many companies have a fitness facility on site. It is common to find gyms at an affordable price, and often insurance companies may have incentives for increasing activity. Some programs, like the YMCA, even offer financial assistance if needed.
• Home Workouts: Search on YouTube or websites like ACEFitness.org or ACSM.org for free exercise routines you can do at home with little to no equipment. Always practice proper form and technique to ensure safety.

— By Katie Hake, RD
   IU Health North

Recent data supports that lung screening can detect early stage lung cancers before they become incurable. Find out if you’re a candidate for screening. 

Why screening is so important.

Usually symptoms of lung cancer don’t appear until the disease is already at an advanced non-curable stage. However, in 2011 the New England Journal of Medicine published results from the National Lung Screening Trial that found that screening decreased lung-specific cancer mortality by 20 percent among high-risk patients. Based on that data and a recommendation by the U.S. Preventive Services Task Force, private insurance providers, as well as Medicare, will now cover the cost of lung screening.

Eligibility requirements for screening.

Screening is for high-risk patients who are aged 55 to 77, have a 30-pack year history of smoking (a pack a day for 30 years or two packs a day for 15), and currently smoke or have quit within the last 15 years. Patients must also be relatively healthy enough to undergo treatment that might include surgery, radiation therapy, chemotherapy, or a combination thereof. 

If you meet these criteria, it’s extremely important to get screened, especially if you’re asymptomatic. Once symptoms appear, the cancer has likely progressed to stage III or stage IV and is potentially incurable.   

Risks of screening.

The only recommended lung screening method is low-dose computed tomography, or LDCT. This emits a low dose of radiation, so there is a small risk involved. However, if you are an asymptomatic heavy smoker, the risk of not getting screened (and being diagnosed with lung cancer at a later stage) will likely outweigh the risk of radiation exposure from the testing.

Another risk is a false sense of security if the test comes back negative. Screening is not a one-and-done. Just like mammography, the first test is a baseline from which to compare future results. You should be screened every year until you turn 78 or have not smoked in more than 15 years.

Finally, the risk of over-diagnosis could result in treatment that’s not needed. To avoid this, get screened at an institution, such as IU Health, that offers a multi-disciplinary approach. Our lung cancer program includes radiologists who specialize in chest LDCT only and who work as a team with thoracic surgeons, pulmonologists, and other lung specialists.

If you’re a heavy smoker, be proactive.

Of course, the best medical advice is to quit smoking. But lung screening can catch cancer at a much earlier stage than at the point symptoms start to appear.

I encourage you to speak with either me or your primary care provider about the benefits and risks of lung cancer screening.

Throwing away empty paper goods; disposing garbage; scouring toilets; mopping floors; stripping sheets – it may not be a job for everyone, but for Qourtney Bush it’s an act of service.

“What I do is janitorial work but cleaning a patient’s room from top to bottom is really a glamorous job because I’ve been in that bed. I’ve been that patient and I know what it’s like to have gloomy days,” said Bush.

As she pushes her utility cart down the hall and rounds the corner of the waiting room on the fourth floor Transplant Unit of IU Health University Hospital, Bush sees someone sitting alone.

“Whenever I see someone sitting there, I just say a little prayer because I know they are anxious and worried,” said Bush, who works a couple weekends a month at the hospital to supplement her income. She also works as a patient service assistant at a local neurology office.

When she’s at University Hospital Bush uses her housekeeping job as a way to connect to others.

“I’ll meet people in the elevator and just start talking. I can listen or I can talk. I’m also a hugger and every opportunity I get, I assure someone they’re in good hands,” said Bush. “When I was here the family members couldn’t always understand the moods. I see family members here stepping out in the hallways confused about why the patient is mad or sad. I can relate. They are hurting. They want to be independent and they don’t want to depend on others. It can hurt your pride. But here I am now.”

***

Her first visit to the transplant unit was one of the most challenging times of Bush’s life. As a teenager, she made a decision to stop taking the life-saving insulin that was prescribed to maintain her blood sugar levels.

“I just thought I was cured. I didn’t want to think otherwise,” said Bush. But over time, negative impacts of diabetes began to take a toll on her body. There were other things going on her life too that wrecked havoc on the Pike High School graduate.

She started writing bad checks and eventually ended up serving time in Rockville Correctional Facility – a penalty that Bush says may have saved her life.

“It was a blessing in disguise because I actually had a medical check up and started taking my medicine again,” said Bush. “Prison turned my life around. I kept doctor appointments and worked to keep my blood sugar levels down.”

She was released in 2006 and even though she was working to take care of her body, the diabetes had damaged blood vessels in her kidneys, causing them to shut down. She began dialysis two years later.

“I didn’t even know about transplants. I didn’t even think it was an option,” said Bush, who credits her nurse practitioner for educating and encouraging her.

“He wanted me to realize I was too young, I needed to get in school, and he told me about transplant,” said Bush. She has completed a number of IUPUI’s Workforce Readiness courses as a pharmacy technician, medical assistant administrator, and patient access specialist. Eventually she wants to work in the hospital full time and start a non-profit that offers community support for prisoners reentering civilian life, and others needing resources for parenting, nutrition, and employment.

Bush begins to cry as she talks about that tough time in her life.

“It was a kidney. That’s big but when I look back . . . it could have been my eyes, a limb, or my heart.” She dabs the tears off her cheeks and mentions the names Dr. William Goggins, Dr. John Powelson, Dr. Tim Taber and nurse Tina Ray – all members of her transplant team. Bush jokingly refers to Ray, who was her transplant coordinator as her “cousin.”

“I still see her and update her on my life,” said Bush of Ray. “That bond we formed is strong. She doesn’t realize the impact that she has.”

Bush was on the transplant list for four years. During that time she underwent bariatric surgery. “I needed to lose weight to prepare my body for the transplant,” said Bush. “I still can’t believe all that I went through. I was incarcerated with people who killed their own family members and yet everything I’ve gone through with my health has been the toughest of all.

“Prison helped me make better choices, but my transplant helped me be more empathetic toward other patients.”

***

As she recently went to work clearing and cleaning an empty room Bush, talked about celebrating this her 40^th birth year.

“I don’t hide who I am. I’m not ashamed because I’m not that same person that I was back in my 20s. I was an only child. I felt entitled. I didn’t want to hear ‘no’ so I wrote bad checks. There was no drug habit, no abuse. I just made unwise decisions.”

She also doesn’t hide her physical scars.

The discolored mark that runs the length of left arm is a reminder of her kidney failure. The mark from the arteriovenous fistula reminds her of years spent on dialysis.

“I used to think this scar was the ugliest in the world. Dialysis was by far one of the most difficult seasons in my life, but now I look at it as a connection to others,” said Bush. “I always use discretion when I talk to patients but I can usually see that they want to engage. It’s like they know I’ve been in their shoes. I won’t turn down an opportunity to help people who worried,” she said.

“Every chance I get I tell people, ‘You are in a great hospital. You are with a great team. You are in the best hands.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at T.J. Banes or on Twitter @tjbanes.

If you look carefully, you’ll glance a glimmer of excitement in Ryan Kitchell’s eyes when he talks about coaching. In corporate life, it’s an attribute that has served the chief administrative officer of IU Health well. One of the most gratifying parts of his job: “I really enjoy helping individuals succeed,” he says.

Kitchell is known for being a thoughtful team builder and coach–on and off the clock. Armed with a whistle and a ball cap, he can often be found on a field, overseeing one of his children’s sports teams. “I love it. I am coaching my 22^nd team this year,” admits the father of four.

Driven to succeed at an early age, the Kokomo native always knew he wanted to carve out a career in finance. Like many Hoosiers after high school, Kitchell enrolled at Indiana University and began to call Bloomington home. “But then I got to the point where I wanted to see what it was all about. At 20, I took an internship on Wall Street. It was eye-opening.”

One thing Kitchell learned: Manhattan wasn’t for him. After his IU graduation, he headed to Chicago. “I was working for Prudential but then headed to Dartmouth for an MBA.” Living on the East Coast was a change. “While it was great to live in a different part of the country for a time,” he says. “Indiana was always home.”

And so the Hoosier headed back, moving from one opportunity to another. Kitchell accepted a corporate treasury role with Eli Lilly before spending several years working with Indiana Governor Mitch Daniels, first as a public finance director and then as director of the Office of Management and Budget.

IU Health came into the picture in 2010. Kitchell joined as treasurer. He then moved to president of IU Health Plans before moving up to chief financial officer—a position he kept for four years.

Today, as IU Health’s executive vice president and chief administrative officer, Kitchell oversees such areas as human resources, government affairs, information services and marketing among others. “This week is actually my seven year anniversary at IU Health,” he says proudly.

Kitchell says he found a calling in healthcare, thanks to a college experience that left him shaken. His best friend and college roommate Bill Keedy was unexpectedly diagnosed with a cancerous brain tumor during their senior year.

“I think of Bill every time I enter Methodist Hospital,” Kitchell says. “I met Bill the first day of my freshman year at IU. Two months before his diagnosis, Bill looked like the healthiest guy in our house. Then, one day, things changed.”

Bill was diagnosed with his tumor right before Thanksgiving, Kitchell recalls. “When Bill was becoming bald and going through chemo, all of us cut off our hair. We all loved him.” Sadly, Bill died before spring break that same year.