Emory Malone, Reflection
Emory Malone is a Ph.D. candidate and graduate research assistant at UAMS.
People’s Choice Award
Take a Bow
By Andrew Oh
Before walking out of the patient’s room, I bowed and spread my hands out, signifying respect and a thankfulness for one’s presence in our culture. He began to tear up – although I had been waiting for my first Samoan patient, he had been waiting much longer for his first Samoan provider.
“Keep going.”
I smiled.
Andrew Oh is a medical student from Seattle who wrote this piece after a shift in the Emergency Department.
Poor Outcomes
by Angela Townsend
It’s not that the cats and diabetics will die. It’s just that they are at risk of poor outcomes.
The elderly cat with eyes like Al Pacino is not a finalist for the Cute Overload calendar. There is a hard kink in his tail from a door that closed too quickly. He is the newest resident of New York Animal Care and Control.
If you pet him, he will not bite you, only exude shame in all directions. If you pet him, you will feel overripe peaches under his skin, lipomas that will not kill him, although they may contribute to a poor outcome.
If you show him to potential adopters, they will avert their eyes. They were looking for something younger, more yielding. Look! An orange kitten! They will not think of Al again. They will not ask about his outcome.
It’s not that the weird sanctuary plucks “death row” cats. They hate that term. They bristle like ferals when Facebook shrieks it in all caps. The weird sanctuary simply has an eye for animals at risk of poor outcomes, the old and the uncertain and the unconventionally attractive. The weird sanctuary is addicted to the unreasonable. They leave fishy thumbprints on recipe cards for unauthorized redemption. They overlook the adorable in favor of Al.
The diabetic volunteer does not understand why the word “diabetic” is passe. Nowadays folks ask if she prefers “person with diabetes,” but Clara doesn’t mind the adjective. She snickers that her pancreas is as good as a potato, while preventing her from properly enjoying potatoes. The bum! Diabetics are more likely to have poor outcomes if they get sick, so Clara takes zinc and gets vaccinated.
Clara came to the weird sanctuary when her cat Bean was diagnosed with diabetes. She says God has a sense of humor, but she doesn’t always “get it.” The weird sanctuary wrapped her in silly spaghetti arms. They taught her how to give insulin injections. They promised Bean would get with the program. They were right. She was hooked.
It’s not that Clara felt lost before, but she hopes you’ll understand how the weird sanctuary is better than church. If they take a cat like Al, they won’t mind when she has nothing to say, she just needs to sit on the floor in the Senior Cat Room for a while. If they take a cat like Al, they’ll ask how she’s feeling and wait. When they look her in the eye, they won’t twitch off if she doesn’t say “awesome!”
Nobody needs to say what would have happened to Al at the public shelter. The weird sanctuary writes good newsletters. Donors take the staff by the sleeves and make them promise they’ll never sell the sadness, not even if it works. The weird sanctuary is happy to promise. Death does not need a press secretary. When the light is strong, everyone knows it could have been otherwise. They will focus on the revolution. They will spin the sun like a lottery wheel until it lands on life. They will accept all of Al and all the animals he invites to the dance floor.
Nobody needs to ask what Clara would be doing if she wasn’t scraping litter boxes and brushing calicos. Clara is more interested in tomorrow. Her hemoglobin A1c is not great, and her thyroid has been heckling her, but many creatures are besotted with her. She will wear her weird sanctuary T-shirt to the grocery store and testify to what happens when weak things get crowns. Clara tries to explain, but the words get syrupy, and finally she says you just need to come and see for yourself.
It’s not that the cats and diabetics would have died somewhere else, but we don’t need to speculate about other outcomes. There is a weird sanctuary, and it stages many coups.
Angela Townsend is the Development Director at a cat sanctuary, where she bears witness to mercy for all beings. She has an M.Div. from Princeton Seminary and B.A. from Vassar College.
Angie has lived with Type 1 diabetes for 34 years, laughs with her poet mother every morning, and delights in the moon. She lives in Bucks County, Pennsylvania with two shaggy seraphs disguised as cats.
Angie loves life dearly.
Beet
By Bryan Clifton
As we enter Spring and get ready for backyard gardening season, I was reminded of this photo I took of my farmer friend Ricky B, working the family farm. There’s nothing like a fresh & gritty backyard beet!
Bryan Clifton is the senior photographer at UAMS. His photo and video work has supported a range of local and international entities including Heifer International, Bloomberg Philanthropies, Root Capital, Counterpart International, USDA, USAID, Sustainable Harvest Coffee Importers, Arkansas Children’s Hospital, UAMS (University of Arkansas for Medical Sciences), University of Arkansas Extension, The Clinton Foundation, Equator Coffee, Green Mountain Coffee Roasters (Keurig Green Mountain), Peet’s Coffee, Allied Cycle Works, Arkansas Sustainable Livestock Cooperative, Grass Roots Cooperative/CSA, AARP, ACDI/VOCA, Men’s Journal , Marketplace.org (NPR) and others.
Pen and Ink Drawings
By Elizabeth Hartzell
Each original drawing features an organ paired with a plant and/or herb that some consider beneficial.
Elizabeth Hartzell is a painter, illustrator, and dancer based in Austin, Texas. She is the recipient of the Emerging Arts Leader’s professional development grant and TBX Honorary Scholarship Awardee. Hailing from Little Rock, Arkansas, Elizabeth studied both studio art and dance at the University of Arkansas at Little Rock. Her style of painting originated in college when studying the impressionist Mary Cassatte. Continuing to push further into abstraction, she found her figures floating in colorful worlds that stir the imagination. During her last years of college, she focused primarily on dancing but when her husband and father were not able to work due to illness, she started a fundraiser to help her family get by. In exchange for donations, she offered drawings and paintings. Painting and drawing became a part of her everyday routine, as well as, a type of therapy to cope with her situation. Elizabeth’s style transformed by drawing inspiration from her commissions, long walks in nature, dance, and meditation. She’s greatly inspired by the colors of sunsets, wildflowers, and moonlight.
The First Move and Second Location of the Medical School
By Timothy G. Nutt
Out of the four previous locations of the UAMS College of Medicine, the site at Second and Sherman streets from 1890-1912 is the least known and discussed. However, this second building allowed the school to not only admit more students but provided much needed and improved facilities. The former Sperindio Hotel, which had housed the medical school since its founding in 1879, had served its purpose.
By the end of its first decade, medical school enrollment had increased so much that the aging facility had little room to accommodate the student population. Whereas enrollment for the 1879-1880 period—the school’s first academic year—was twenty, the beginning of the 1890-1891 school year saw 90 students enrolled. In addition to the cramped space, the former hotel needed repairs from years of deferred maintenance. While the Sperindio Hotel, located on Second Street between Louisiana and Main streets, was not the best-suited for a medical school, it nevertheless served well as an educational space. It was not conducive, though, to clinical practice. Because of this, students practiced their skills in the Fones Brothers Warehouse, located directly across the alley from school. This arrangement no longer was feasible, so the proprietors of the medical school (the eight original founders) began to look for another location.
In early 1890, the proprietors of the medical school began to look for other locations and they quietly sold the medical school building. With the attendance increasing each year, the eight founders saw a big return on their original investment of $5,000, since all the profits of the school went back to them. It would not be until 1911 that the medical school ceased to be a proprietary school and became an official division of the University of Arkansas.
The investors purchased property on the northeast corner of Second and Sherman streets for $2,000 and begun construction of the new medical school. When completed at a cost of $15,000 (over $500,000 in today’s money), the building was three stories high and measured 150 feet long by 150 feet wide. The building had amenities that the former building did not, such as a lecture hall and amphitheater. The building was completed before the beginning of the 1890-1891 school year. A few years later, the city hospital, known as the Logan H. Roots Memorial Hospital, opened next door, which provided clinical opportunities for the students. A private hospital, known through the years as the “University Hospital” and “Maternity Hospital”, also was constructed nearby. Beginning in 1892, the first floor of the medical school was converted to the Isaac Folsom Clinic, a free facility for indigent patients. Folsom, a prominent doctor from Lonoke, bequeathed part of his estate to the school to provide health care to the indigent residents of Little Rock. Later, in 1916, a larger Isaac Folsom Clinic was built directly behind the medical school building. By that time, though, the school had moved once again—this time to the former State Capitol (Old State House).
The medical school stayed at the Second and Sherman location until 1912. The building, though, continued to be utilized for lectures. The move in 1890 to larger facilities cemented the stability of the medical school, which had been in question for many years after its establishment in 1879. The move to the Second and Sherman building also showed that the medical school would continually expand its services in caring for the city’s—and later the state’s—citizens. That mission continues to the present.
Timothy G. Nutt is the Director of the UAMS Historical Research Center.
Conversations at UAMS: Erin Gray
Erin Gray is the Assistant Vice Chancellor and Clinical Liaison for Environmental Services (EVS), Nutritional Services, and Institutional Support Services which falls under Campus Operations. She has been with UAMS for close to 15 years and has been in her current role for over two years.
Interview by Brittany Tian and Claire Gist Bradberry
Guest Editor: Adam Williams
We would love to hear more about your role at UAMS because it seems very important, but I think it’s something that people might not be familiar with.
I have close to a 800 employees in my divisions. My areas cover the EVS (Environmental Services) group, Transport group, Hospitality staff, Occupational Health and Safety staff, patient food, retail, and special programs including our employee-student food pantry. Basically, many of the things that keep the wheels moving in the hospital; that’s what Campus Operations does.
People don’t think about it a lot, but when you are looking at turning over a bed or turning over a room, my teams are on those calls, and we are a pretty critical part in keeping patient flow moving. From the time I started this role, my goal has been for us to be invisible. I want my teams to be so good at their jobs that nobody ever sees us, kind of like Disney.
We also contribute a lot to the front lines of safety. Cleanliness in hospitals is safety. That means all the high touch points have been taken care of, it means that there have been contact precautions in the room. We do extra assessments of any high touch point spaces to make sure that they’re safe for the next patient. We are part of the frontline team that comes in, not only to make sure that rooms are clean, but so that we prevent infections or other unsafe working conditions.
When I started in my current role, patient satisfaction ratings were in the 20th percentile and now we’re in the 75th and 80th percentile. We have come a long way. We value our team members, and we want to make sure that they know that they do things that nobody else can do. We want people to recognize that we are an important part of the system.
Patient food is a huge part of what we do. Not only do we feed patients in the hospital, we also and prepare and deliver food to the Orthopaedic and Spine Hospital three times a day. Our kitchen is responsible for feeding all the children at the Child Development Center as well.
We maintain seven different retail spaces across the various UAMS campuses. Patient transport and our hospitality group (behind the Info desk, handling wheelchairs, and driving patient carts) is a part of our Campus Operations team.
Our Occupational Health and Safety Department handles all lab safety and waste stream disposal – all the things nobody wants to think about at a hospital/medical school/research facility. OH&S keeps us safe and regulates those areas. Finally, we oversee all the disposal of waste through the Department of Environmental Quality.
It is a big, big job! It’s a lot of different areas and moving pieces. There is a lot of firefighting, but we have gotten good at preventing forest fires. That was one of my goals with this job: to be less firefighter and more Smokey the Bear, and we have made progress there. I really enjoy it. It’s never the same day twice, but it’s a very rewarding job.
What would you say has been the most rewarding project for you or your biggest accomplishment in your current role here at UAMS?
We’ve had a lot of big wins, but I’d have to say it is probably the opening of the Orthopaedic and Spine Hospital.
Opening the Orthopaedic and Spine Hospital was a real challenge for all the groups that I manage. The timeline changed. We had to pull all of that together and make sure that patients were fed when there was not a kitchen there. We had to reconfigure to plan for that. We had to make sure that all the permits were timely obtained to be able to run all that equipment. We had to make sure the patient rooms were clean and ready.
In addition, there is a retail space there that we had to create with a new menu and staff and get that off the ground. So, if I’m thinking about probably the biggest thing that we have done with all my groups, that would be the biggest accomplishment of this organization during my tenure.
It was a monumental effort to the point of us being there in the wee hours of the morning and putting the finishing touches on the rooms to make sure they were ready to go. It was a real team effort and a proud moment to get the doors open there. And it’s remained a challenging space, but I’m proud that everybody came together to make that happen.
What have been some of the big changes you have seen during your 15 years at UAMS?
The one thing that is constant about UAMS is change. It has changed so much over the years. I was first hired as the Director of Volunteer Services. I moved from that role to Director of Patient Experience. Moving to the operations side was a pretty big shift for me. As the hospital’s focus shifted to patient experience, it impacted how I viewed my role and everything I do. That vantage point of balancing the needs of the institution while striving to keep patients happy and well cared for is part of why I was hired to be in this operational role.
When I moved to this role, I wanted to make sure we didn’t lose focus on the patient experience side when we’re handling operations. How are patients affected when something is not clean or broken? How does that make patients feel? How does that make families feel? Do I feel safe here? How do we do a better job of making sure that our patients are eating and getting the nutrition that they need?
Those type of questions have been at the forefront of my mind, and that’s been a change since when I first joined UAMS.
Additionally, Covid changed everything. Many of my exceptional employees who never seem to struggle, were really challenged during Covid. Everybody was a little road weary, right? We were all trying to do more with less and trying to be better with less. While everything was overwhelming and scary, being here at UAMS, the hub for healthcare for our state, I think it made us realize how dependent we are on each other – as employees, as families, as UAMS teams, and as a state.
I still walk in here and feel like it is home. There are people that I’ve walked in the doors with that are here today that were with me 15 years ago and in the trenches with me during Covid in 2020. The commitment to serve everyone is the thing that has stood the test of time, and I hope we always stay true to that commitment. It’s more challenging during times like Covid, serving everyone and treating every patient that walks in the door. But it is part of what has hooked me in and keeps me here at UAMS because I think it’s critically important.
Did you always know that you wanted to work to help people?
I have. Before UAMS, I worked in nonprofit management. I was an executive director for a nonprofit agency that specialized in auditory verbal therapy. So, in a way I was already connected to healthcare, certainly already in the nonprofit realm.
But I have also always been really interested in the operational side, and it was my boss when I was the Director of Patient Experience who said I really think that you would be good at operations.
I think all my past experiences have brought me to where I am, and I really love operations. I love being able to solve problems. I love being able to work with my team, and I always have been more a coach leader [editor’s note: a coach leadership style focuses on developing team members as individuals through one-on-one communication, empowering them, and fostering a sense of ownership and accountability].
For me, if UAMS has a flood or we are getting behind on workflow, it’s important to me that my employees see that I can and will jump in and help them. I want them to know that I am there with them; that we are all part of this team; and sometimes we get asked to do really impossible things.
So it is very meaningful, I think, for my team to see me being willing to strap on a hairnet – which is not my favorite thing by the way, nobody looks good in a hairnet – but I think that’s really important for them to see, and all of the work that I’ve done previously, has prepared me to be that type of leader.
Do you have any tips for being in a leadership role and how you think someone else can improve being a leader?
I think, especially in a hospital environment, it is so important to remember that there’s rarely anything that you do as a leader that’s not going to impact somebody else.
When you’re making decisions it’s always better to bring everybody to the table. It’s much better to do that than to get halfway down the road in the project and realize you have not thought about nursing, or you have not thought about the physician side of it, or you have not thought about EVS.
It is important to make sure that you are not just making decisions about yourself and your team but thinking about the campus-wide impact and who to engage with to get the best outcome.
Is there anything else you would like us to know about your work?
Another tip I would give for the clinical side is to not forget about the operations people. They are really important. They are entry-level people. They make $15 an hour. But, for the most part, the people on my team take a lot of pride in their work. Their work is important to them, and it puts food on their table. They want to feel like they are part of a team. They do not want to mess up, and they want to be appreciated for what they do.
If nobody is turning over those rooms, feeding patients, making sure that you have protective equipment, then everything stops. I would really urge you not to forget that, and to get to know those people because they are pretty cool individuals!
I adore my team. I have almost eight hundred people, and I can’t tell you that I know all of them, but I make sure they all know who I am and how to reach me directly. And I do my very best to know a lot about what’s going on in their lives.
They often feel like second-class citizens. I get calls a lot, and one of my least favorite calls is someone saying that I have staff that are just sitting around on their phones when they should be working. Most of the time they are on their break. Our staff doesn’t really have break areas. They are taking a break a lot of times or are waiting on a rideshare.
And I don’t know that people would make those phone calls to department chairs if they saw a doctor sitting on that bench, or a nurse sitting on that bench. So, do not judge a book by its cover. Give them the respect they deserve for a really hard job that not a lot of people would do. They are important people, and they are very important to me.
They also do a really good job, especially if you consider all that they’re up against. So, whatever hospital you are at, be sure you look at those people a little differently because they are part of your team.
I have the best job at UAMS. I really believe that. This is the coolest job to me, because when I call my team, they really want to jump on it and get the work done. They will tell you that we are the front line for safety, and that we have a duty to protect our patients.
Look at the people on my team as your allies and weapons. If you guys ever want to come and meet my team, I would love for you to come and do it. I will strap a hairnet on you, and you are welcome to come and take a tour of the kitchen. If you would ever like to come and meet my team, I would love to introduce you. I am always willing to show people the other side of what it is that we do.
What do you enjoy to in your free time outside of work?
I am an only parent of two amazing kids. I have a 16-year-old son who is addicted to baseball. So, I spend a lot of time on a dirt field. I have an 18-year-old daughter who is about to go off to college. They have completely opposite personalities. And so, my primary role outside of here is just taking care of and enjoying my children. I also have a neurotic dog that I love a lot named Ruthie. She’s really goofy and funny, and I really love her, too.
Life is hectic. Honestly, I haven’t made it to bed before midnight all week. And my day starts about four o’clock in the morning. So, it’s a busy, busy time, but I wouldn’t trade it for anything. So that’s kind of my world right now and that’s enough.
Call and Response
By Katrenia Busch
From my abdomen was speech for thine ear. Twice-born words consumed, out of the pit of my stomach was my tongue of salty sea let loose to walk the path of the moonlight. At the stroke of mid-night, in the midst of dream did the sea waves turn my speech to tune your middle ear.
Katrenia Grace Busch is a seasoned nurse and healthcare administrator. She is also an award-winning poet and freelance journalist whose work has appeared in CBS, NPR, Red Penguin Books, Bloom Magazine and Echoes of the Wild among others.
A Glimpse of the Matrix
By Samuel R. Atcherson
Spotify plays his favorite song.
Through Bluetooth the song is streamed to the external cochlear implant processor.
Through radio the song passes through the skin to the internal cochlear implant receiver.
Through electrical activity the cochlear implant electrodes stimulate the auditory system.
The brain perceives the song.
Never does the song touch air molecules.
Matrix?
Samuel R. Atcherson, Ph.D., FNAP, is a Professor of Audiology and Speech Pathology and Otolaryngology – Head & Neck Surgery at UAMS. He has lifelong hearing loss, is a tinkerer and sound explorer, and often is deep in thought about the miracles and challenges of life.
Fragments of a Journey
By Isabelle Okito
In the quiet of late nights, I juggle
work, motherhood, graduate studies.
Far from home, the weight heavy,
but dreams spark in the distance,
flickering like stars.
One paper, one tear,
one child’s laugh, one task completed,
each step, a triumph.
It’s hard. But it’s possible.
And one day, it will all be worth it.
Isabelle Okito is a devoted mother, and a second year Ph.D. student in Biomedical Informatics at UAMS. She works as a Neurodiagnostic Technologist in the Neurodiagnostic Clinical Lab. Passionate about writing and deeply committed to patient care, she strives to make a meaningful impact in both research and healthcare.