When I left active duty in the Navy in 1988 and came to Boise one of the first people I met was “Gil” Gilbertson who was the CEO of St. Luke’s. Gil was a great man. Unfortunately, he has passed. We could certainly use his wisdom today. At a very difficult time in our community in the early 70s Gil took out a second mortgage on his own home—as did a group of physicians in the community, to secure funds to keep St. Luke’s up and running. My how times of changed. How many CEOs or physicians in our community would today take such a risk? It requires a deep commitment to not only the enterprise (hospital), but to one’s calling and profession and to one’s community. 50 years ago, this was common. There were no “bailouts” or CARES ACT Funds or $450million Federal cash infusions to secure assets or companies in tough times. Other enterprises in our community required placing personal assets at risk in tough times. MK, Hewitt Packard, and Albertson’s before these companies grew into worldwide operations that became the backbone of the Boise economy were bailed out privately during their incubations. One of the problems with always having and economic backstop in life is that capital is not deployed in the most efficacious fashion and labor is not appropriately allocated.
What we have seen in Idaho and across the USA is that a top down “command and control” economic and governance system is not nimble enough to react to a changing battlefield. A public health strategy emanating from the Halls of Washington or Boise that is not attuned to the needs of individuals and the unique circumstances of time, place, and demographics doesn’t work. On the other hand the clinical side of taking care of Covid patients has been a great victory for medical practitioners—doctors, nurses, and technicians, who have used the internet to circumvent the medical academic hierarchy that has before now controlled the dissemination of information in the sciences. The NIH/CDC, and publications like the Lancet and New England Journal of Medicine have been behind the curve from the beginning. Clinicians like Dr. Paul Marik from Eastern Virginia Medical school who first described strategies for the treatment of cytokine storm 10 years ago (he was a Nobel Prize finalist) could only get his strategies promulgated by social media and e-mails. The Mayo clinic, Stanford University, Harvard and many other institutions followed his lead and outcomes in ICUs and hospitals have improved dramatically—many of those strategies are being deployed by Idaho doctors.
I believe Idaho doctors like Dr’s Christy Hahn, Jim Souza, and Ryan Cole have served the public and their profession well. What I am concerned about is that when there have been differences in opinion—especially on the public health questions, people with impeccable professional credentials have been vilified—mostly by politicians, those in the media and those representing the health care industry’s best interests. Even a former Idaho Attorney General and Supreme Court Justice—Mr. (Dr.) Jim Jones has opined that those with a different opinion or point of view have not been true to the Hippocratic oath or to the ethics of their profession. A call for disciplinary action by the State Board of Medicine has been brought forth by more than one of these experts.
If there was one opportunity that could have truly made a difference that was not leveraged by the politicians and many in the medical elite, it was that the people really in the know were not represented on either the Governor’s Advisory Board or on the District Health Boards. ICU and ER nurses were at the front of the battle, yet we had hospital association lobbyists and administrators calling all the shots. Who would know better about the status of available ICU beds, staffing decisions—some made prior to the pandemic that are now impacting our ability to care for sick patients—nurses and technicians working on the front lines. This valuable source of intelligence and advice is only now being taken advantage of.
Several articles have appeared in the press the past few days that concern me. One from the Capital Sun written by Audrey Dutton was an interview with Chris Roth the CEO of St. Luke’s who offered early on in the article:
“Sadly, we’ve had individuals who have been used by other groups, or other causes, like the ‘health freedom’ group. We’ve had some of our own people who have been put in front of the camera, and frankly they’re just getting used for somebody else’s cause” ALIBIES DESTROY CHARACTER. There is no such organization as the “health freedom group.” The people who he is referring to are nurses who have worked on the front lines since the beginning of the pandemic. He does not have to agree with them, but he should at least respect their contributions and their right to speak freely. By creating such a straw man argument, he violates the simplest rule of debate—“what is true of the part is not true of the whole.”
He also opined: “I think that the people who are intentionally spreading misinformation, for their own personal gain, are going to be held accountable. It’s a matter of time. And that’s probably all I have to say about those types of individuals.” Was that threat that people who disagree with him will have actions taken against their licenses or credentials? Shame on him for even thinking that. Many of these people have impeccable credentials and are held in highest esteem by their colleagues. Their opinions may be different than his, they might even prove to be correct—or wrong, but they are far better informed and have a far more disciplined approach to and for the scientific method than he does. Gil Gilbertson understood this and that is why he was so respected by the medical community.
And let’s not forget that throughout history dogma in the name of science has many times proven to be wrong. Does Mr. Roth not recall the house arrest of Galileo Galli for believing that Copernicus was right—the earth does revolve around the sun and not vice versa? Should doctors and people with a contra opinion about Covid-19 mitigation strategy be placed under house arrest? Who does he think he is—Pope Urban the VIII?
There is a statement by Mr. Roth in the article that I agree with 100%: “Everything’s political right now. But these health districts, particularly Central District Health, it’s all about politics and not about public health. And, you know, we’ll see what happens in the next election. People are going to have to choose whether and how those changes.”
I couldn’t agree with him more. I also believe that the personal attacks on honorable professional people—doctors and nurses, are a form of “gas lighting”. By creating a faux class of “heretics” it takes the focus off the problem at hand. The problem is that the “backstop’ for making bad decisions—clinical, administrative, and public health—lots of free money, has made those people making those decisions less accountable.
The time for an out brief is months off. Bad decisions were inevitable because the planning, positioning and execution of a plan against an efficient enemy was difficult. We should do better next time if those who fight the battles are given a voice in the planning.
We need more Gil Gilbertsons. He understood that very basic concept. “Keep your eye on the ball” Do your job and don’t alibi.