A record snowfall in northern Iowa in February 2003 led to ice jams that blocked the Mississippi and Missouri Rivers, producing a historic environmental crisis. Superimposed on the snow and ice melt were rains that dropped five to seven inches daily into early July. The resulting Great Flood of 1993 was one of the costliest in American history, abruptly halting water purification in greater Des Moines and leaving a quarter million people without potable water supplies.
As Chief of Staff and administrative leader of renal dialysis services at a large metropolitan health system, I was called to help develop strategies to meet the health care needs of the community, including provision of fresh water for the life-saving dialysis machines serving a large group of hemodialysis patients. Entering the Board Room, I found a frenzy of activity and ideas both big and small being tossed out by every member of our leadership team. Catching the eye of our CEO, I was asked if I could take “the dialysis issue” off her plate of immediate concerns, and I began planning immediately for a disaster response. I harkened back to my residency training in code management when I distilled all actions into three simple phrases:
- “When you arrive at the code, make sure to check your own pulse first.” An evolving crisis can lead the entire team into a harried and ineffective response. By making sure that you calm yourself first, you are better able to make sound decisions.
- “In a crisis, team members are looking for someone who appears to be in charge – they’re looking for a leader. Be the leader.” Many times, we find ourselves part of a wild and hectic crisis and no one seems to want to stand up and set the course of action. Speaking clearly, providing evidence-based approaches, and being transparent with the team helps to instill confidence that no task is too great.
- “Prioritize the most important actions first and show people that you really care.” Nero fiddled while Rome burned, and many leaders tend to address issues of lesser importance first rather than prioritizing action on the issues that really matter. Just as with the “ABCs of resuscitation,” crisis management leaders need to intervene on issues that will have maximal impact in the shortest amount of time. Caring for and about your team during these fast-moving and impactful times is key, and being able to triage a wide array of tasks is an essential trait.
The End of the Story
My personal mission has always been to help those most in need; addressing crises is a simple extension of a sense of caring that has been with me since childhood. Helping to create a solution for a displaced group of patients on hemodialysis helped satisfy my personal drive to be of use to my community. Working with an outstanding team of health care workers, a solution was only as far away as how we might completely and creatively provide services for our community. Phone calls to a neighboring medical clinic led to an offer to convert the clinic into a dialysis-ready site that could use portable dialysis machines to meet the needs of our patients. A local bus company donated drivers, buses, and fuel to transport shifts of patients 25 miles each way for treatments that continued off site for nearly two weeks. Staff car-pooled and worked painstakingly long hours to meet our patients’ needs, while a spirit of “let’s make the most of this and have a little fun” began to shine through each of the very human interactions developing between our new “patient and staff family.” Caring was palpable, and we began to witness the best of the human condition shining through.
The lessons learned and relationship bonds formed during the crisis of the Great Flood of 1993 are as applicable today as they were when none of us could be certain of the fate of the dialysis facility and its patients. We still come to work trying to be the best we can be, and the ways in which our communities pull together define the current state and the future for us all. The “Greatest Generation” understood what it meant to pull together, and we must all face the inevitable crises that will come our way with the same fortitude and grace as was shown to us during the trying times of America’s past.
One final thought as you live out your personal missions to help those most in need in your community: “Be good to yourself—don’t expect perfection while you are trying to deliver the very best you have to offer.” If we all lift just a little bit together, and if we all give up just a little for the good of our communities, we will make it through this crisis, and we will be better human beings that are better connected to each other and to our communities. Just move forward every day, with one foot in front of the next, and focus on being the best version of yourself as you serve your fellow citizens and neighbors.
Written by Dr. Ken Anderson, DO. Dr. Anderson is a graduate of Des Moines University College of Osteopathic Medicine. Dr. Anderson has a background in nephrology and as a transplant physician and completed his nephrology training at Los Angeles County + USC Medical Center. He held residencies and became chief resident at both Iowa Lutheran Hospital and Yale University-Norwalk Hospital, and has been a member of the National Colorectal Cancer Roundtable Advisory Council, the American College of Surgeons’ Coalition for Quality in Geriatric Surgery, and the Global Scientific Committee of the International Hospital Federation.