Celebrating GeriPal’s 200th with Leaders in Geriatrics and Palliative Care

Eric: Welcome to the 200th GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Anne: This is Anne Kelly.

Lynn: And this is Lynn Flint.

Eric: And Alex, how’s this going to go today?

Alex: We have a number of special guests who are joining us today from all around the country, and we are going to be asking them, when you think about hospice and palliative care, name something you’re grateful for and something you’re hopeful for.

Lynn: I just want to highlight, if you ever tune into the video version of this podcast, today is the day to see Alex’s shirt. I love it.

Eric: Alex is wearing a Hawaiian shirt in GeriPal lettering or, a GeriPal shirt in Hawaiian style.

Alex: It’s endearing in the same way that ugly Christmas sweaters are endearing.

Anne: Yes. If this were any other day, we would be sitting down questioning your style choice for today.[laughter]

Eric: Yeah, I see Christian Sinclair, he is dressed up to the nines for this podcast.[laughter]

Anne: Nice tie.

Eric: But he is missing the GeriPal Hawaiian shirt, which is odd.

Christian Sincl…: I don’t get into a suit very often, but I’ll do it for you. [laughter]

Lynn: Wow.

Christian Sincl…: I’m at an end of life symposium for city of hope, so …

Eric: All right, we see people coming in, Alex, and we should probably start. But before we start, we always do a song. And this is important. Alex Smith, what is the song request that you have today? Because aren’t you the one who decided the song?

Alex: We’re doing What a Wonderful World, and it’s actually a request from William Dale, who I think will be joining us at some point today.

Eric: Okay.

Alex: (singing)

Eric: That was awesome. We’ve got a lot to cover in this episode. We’re going to do what you’re hopeful for and what you’re grateful for in geriatrics and palliative care.

Alex: And we have an exclusion. You cannot say GeriPal.

Eric: You get negative points.

Alex: Yeah.

Eric: Anne is keeping track of points.

Anne: I’m good at that. [laughter]

Eric: And feel free, we have people coming in and out of this podcast, join in the discussion, and we’ll have some special questions that pop up first. All right. So …

Alex: Let’s start it off. So we’re going to ask you to introduce yourself and then say, when you think about hospice and palliative care, name something you’re grateful for and something you’re hopeful for. And we may occasionally get special questions. Anne, Lynn, you want to introduce those special questions?

Anne: We are celebrating a very important GeriPal milestone with this 200th episode, so Lynn and I have prepared some very thoughtful bonus questions in keeping with that theme. So stick around, we will pop in with bonus questions along the way.

Alex: Yes, so you may get a random bonus question.

Lynn: We’ll surprise you, yes.

Alex: So let’s start with Helen Fernandez. And Helen Fernandez, please introduce yourself and tell us, when you think about hospice and palliative care, name something you’re grateful for and something you’re hopeful for.

Helen Fernandez: Excellent. Thank you, guys. Helen Fernandez, vice chair of education in the Brookdale Department of Geriatrics and Palliative Care at Mount Sinai. And saying hello to my Mount Sinai West Coast campus.

Helen Fernandez: I am grateful for all of you, for these colleagues who are so supportive, who brighten my world, who are an important part of my story, who have walked this journey with me. And in the vein of this community, I hope, I am hopeful that we will see each other, hug each other once again.

Eric: Hey Helen, when do you think that’s going to happen? Let’s put on your prognostic forecasting. You have to tell us when we’re going to be able to hug again.

Helen Fernandez: Less than six months. [laughter]

Lynn: 200 days.

Helen Fernandez: Less than six months.

Lynn: Less than six months?

Eric: We do have some in-person national meetings coming up.

Helen Fernandez: That’s right.

Eric: So either in Nashville or Orlando for HBMHES, that’s exciting.

Helen Fernandez: That is, I was going to say pub crawl. That was what I was looking forward to.

Alex: Thank you so much, Helen. We’re going go to Mary Lynn McPherson here and we’re going to ask you the same question. When you think about hospice and palliative care, name something you’re grateful for and something you’re hopeful for.

Mary Lynn Mc Ph…: Excellent. Well, thank you for inviting me. I’m Mary Lynn McPherson, I’m a professor at the University of Maryland Baltimore. And I think when I look at the whole world of education and medical practice, everybody gives lip service to interprofessional education and practice. But you know what? I am grateful for how well we rock it out. I think we are the model of excellence for the rest of the world, whether it is formalized education through a degree program or didactics that I see through fellowships and residencies, whether it’s a physician, a pharmacist, a social worker, an advanced practice nurse, certainly your podcast is an example of an interprofessional education. And practice certainly. I literally think that we wrote the book on that. We don’t just talk the talk, we walk the walk, and my hope for the future is that it’s catching and they follow our path.

Eric: Mary Lynn, you have a first in the kind educational thing going on right now. You want one sentence on that?

Mary Lynn Mc Ph…: Absolutely. We’re super duper excited that we have our PhD in palliative care, first in the United States, joining our master of science and our graduate certificate. And we have a lot of interest, and I’m very grateful for every one’s support.

Eric: When does that start?

Mary Lynn Mc Ph…: It started this past fall. We have our first cohort of 10 people and they are crushing it.

Eric: Nice.

Mary Lynn Mc Ph…: Yes.

Alex: Great. Thank you so much, Mary Lynn.

Mary Lynn Mc Ph…: Thank you.

Alex: Next we’re going to go to Christian Sinclair, who’s looking sharp today.

Anne: Dapper.

Christian Sincl…: Thank you very much.

Alex: Good stuff. Tell us something about hospice and palliative that you’re grateful for and something you’re hopeful for.

Christian Sincl…: Yeah, so first of all, congratulations, you guys. It’s not what I’m thankful or hopeful for, but just congratulations on just crushing it and keeping at it with the podcast. It’s excellent.

Eric: You’re getting real close to losing some points there, Christian.

Christian Sincl…: No, no, no, I’m not-

Eric: You’ve got to step it up with us.

Christian Sincl…: Had to wear this shirt at a national meeting. I’m a outpatient palliative care doc at the University of Kansas in Kansas City, Kansas. And what I am grateful for is, in our field that we have really strong peer to peer mentors. And whether they call them friendtorships, pocket mentors, whether it’s a Twitter DM group or a Discord group or a group text, I know I’m part of a few of them and I talk to other colleagues and they’re a part of them. And if you’re hearing this and you don’t have one, we are a great field. You’ll find, just ask around and you can build your own peer to peer network that’s just in your pocket, on your phone all the time. So really grateful for that. And hopeful, I’m really hopeful that palliative care truly becomes upstream and we do so much more in the next five years in outpatient and community based palliative care. There’s so much potential there. And I see a great kinship between geriatrics and palliative care to work and learn from each other. So that’s what I’m hopeful for.

Anne: Well, thank you, Christian. And this is Anne again, chiming in to tell you, you are lucky enough to receive our first bonus question of the day. So don’t go anywhere.

Christian Sincl…: Okay.

Anne: Christian, if you could only eat one thing for 200 days, what would it be?

Christian Sincl…: Oh, gosh.

Christian Sincl…: I’d have to say a really good breakfast burrito.

Lynn: There you go.

Alex: That’s what I’d have as well.

Anne: A little versatility, even though you’d have the same one.

Lynn: That’s a lot of burritos.

Anne: Yeah.

Alex: Excellent. Thank you, Christian. Next up we’re going to have Haider Warraich. Haider, please introduce yourself and tell us something that you’re grateful for and something you’re hopeful for in hospice and palliative care.

Haider Warraich: Hi everyone, thanks for inviting me. My name is Haider Warraich, and I am a cardiologist and heart failure specialist at VA Boston and Brigham and Women’s, who is really passionate about and interested in palliative care. There’s so much I’m grateful for in geriatrics and palliative care. I love the collaborative nature of this field. I love how this field is, even though it really goes to the heart of medicine and focuses on so much of why we all became doctors, just talking to patients and communicating, but is always pushing the envelope and really challenging not just established notions, but also using technology to get ahead and reach patients where they’re at.

Haider Warraich: And what I really love about this field as well is that when I’m amongst cardiologists, I’m often ironically called the touchy-feely cardiologist. I’m just a cardiologist, which is great. And what I’m hopeful for in 2021 is really getting, is hopefully turning the corner on this pandemic so that I can start meeting people in person, seeing our patients, seeing their loved ones more. I think that’s something that I’ve really missed these few years and I would love to be able to put that behind us, hopefully.

Alex: Thank you so much, Haider. Next we have James Tulsky. James, please introduce yourself and tell us something you’re hopeful for, something you’re grateful for about hospice and palliative care or geriatrics.

James Tulsky: So thank you so much, and I think it’s just wonderful you guys are doing this particular program on your 200th anniversary. So congratulations. So what I am grateful for is that we have been mainstreamed. I have felt that more so in the past year than ever before. And I don’t think, we’re just, we really are like everybody else. We’re not like everybody else, but increasingly we are accepted like everybody else. It’s no longer a weird thing for a resident to consider going into fellowship in our field. It is no longer something that we, at least in our community, that we have to justify to the hospital. I mean, you still have to argue for positions and things, but the notion that we should exist is just accepted. Some of this unfortunately came because of the pandemic and I think people picked up on our value in that environment, but whatever it is, I’m grateful for it because it feels really, really different.

James Tulsky: And as far as what I’m hopeful for, so like everybody else has already said, I’m absolutely hopeful that we turn the corner on this pandemic. It’s hard not to make that your number one, two, and three and four hope. And as far as timetable, I don’t know, but I really believe by the end of the calendar year we might be there. Do you know we’re pushing into our second year, or the end of our second year? It’s just crazy.

Alex: Great.

James Tulsky: But the other thing I was going to say is I’m really hopeful that we are taking a new step in equity in palliative care. And that’s something I feel this next year will really be bringing to us. It’s already started, I feel like it’s even bringing more. I think all of our departments, divisions, sections, programs are attentive to this. I think it’s already being reflected in panels and discussions. And the part that I’m hopeful for is that not only will we change who we are as a community and that we look a little bit more like America, but that also we are going to be able to reach out even better to patients and to a broader group of patients. And that’s something that I’m very hopeful about.

Anne: Okay, don’t go anywhere. You are the lucky winner of the second bonus question.

James Tulsky: It’s just like being on Jeopardy, I hate this.

Eric: That’s actually where it came from. [laughter]

Alex: You called it.

Anne: These are just as hard-hitting questions as well.

Lynn: That’s right, that’s right.

Anne: So if you had to sit down and binge watch a television show for 200 episodes in a row, what show would you watch? You could repeat episodes.

James Tulsky: Sopranos.

Anne: Oh, wow. Quick answer. Thank you.

James Tulsky: I know it’s murder and unethics and all sorts of horrible things, but it’s … [laughter]

Anne: But it makes for great TV. [laughter]

Lynn: Yeah, it’s a good show.

Eric: I have a 13-year-old son, so that’s a literal question that we do. Because we just watch the Simpsons every day going through all the different episodes.

Lynn: Yeah.

Alex: And there are probably 1,000 episodes.

Eric: Oh, there are so many episodes.

Alex: Thank you so much, James. Next we’re going to go to Nancy Lundebjerg. Nancy, please introduce yourself, tell us something, we heard a lot about hospice and palliative care. Let’s hear about something you’re grateful for in geriatrics and something you’re hopeful for in geriatrics, if you could.

Nancy Lundebjer…: Oh, Alex, I prepared something being grateful for both geriatrics and palliative care.

Alex: That’s fine, go for it.

Nancy Lundebjer…: So you’re going to have to suffer with that. I’m Nancy Lundebjerg. I’m the CEO of the American Geriatrics Society. And before I became CEO, actually benefited from both geriatrics and palliative care in my own life as a family caregiver. So very early in the 1990s I was introduced to both fields. So I’m glad that some of you now think that you’re mainstream. You actually may have been very mainstream at that point in time, at least coming to the attention of me. I am very grateful for the strong partnership with the American Academy of Hospice and Palliative Medicine in moving our shared agenda and ideals forward. In particular I think that we strengthen and support each other as we work to change the viewpoint of other academies and other organizations in healthcare, and have really appreciated having that partnership.

Nancy Lundebjer…: Something that I’m hopeful for, like everyone else I’m very hopeful that we’ll be meeting face to face in both Nashville and Orlando. I know they’re not everyone’s top destination, but I have a feeling that there’s so much pent-up travel demand that you all attend these two meetings. And then in 2022 I really look forward to the continued growth in the geriatrics and palliative care pathway that has been championed by Helen Fernandez and Lynn Flint and is really their brainchild, and could not think of a better way to create future leaders who have had two full years of training in both geriatrics and palliative care and to continue the great work that we’re able to do together.

Alex: Terrific answer, Nancy. Do we have a bonus question for Nancy?

Anne: I’m sure we can find one.

Lynn: Oh, yes.

Anne: Stick around, Nancy. Okay, Nancy. If right now you reached down and found $200 in your pocket, how you spend it?

Nancy Lundebjer…: I would send it to the GeriPal podcast for funding.

Anne: Correct.

Eric: There was only one correct answer, and it was press the donate button on GeriPal.org. [Laughter]

Anne: You nailed that bonus question, Nancy. [laughter]

Alex: That was funny. Next we’re going to go to Allison Kestenbaum. Chaplain, please introduce yourself, Allison, and tell us something in geriatrics and palliative care that you’re grateful for and hopeful for.

Allison Kestenb…: Yeah, well, I’m so excited to be with you all. I’m Allison Kestenbaum, I’m a board certified chaplain and chaplain supervisor and palliative care chaplain at UC San Diego Health. And yeah, I get to teach spiritual caregivers about how to do spiritual care in palliative care.

Eric: Okay, tell us something that you’re, wait, grateful or hopeful for first? Grateful for.

Allison Kestenb…: Yeah, I am grateful for our tribe of palliative care. I had the opportunity this year with CAPSI to help facilitate the sessions for palliative caregivers of all backgrounds and disciplines to hop on and have essentially conversation sessions about the challenges of our work. And it was just amazing, every single one got to do this every month, just seeing people who did not ever know each other, had no previous contact, just come together and open their souls and understand and see each other. These people have different kinds of support in their life, but to be seen by other palliative care tribe members was incredible. And then just to see some of the connections that have come on with that. Yeah, so it’s just really great to be able to see that and to see that today too. We all come together and we kind of know each other and know what we’re trying to work toward. So I’m very grateful for that.

Alex: And what are you looking forward to?

Allison Kestenb…: More of the same, that we can have some of these connections that we’ve all made virtually. I guess that’s one of the side effects of what we’ve been going through the last couple of years. There are some people who I feel so close to from the palliative care community that I met over Zoom in the last year and a half and I’ve never met in person. So I’m looking forward to some of those connections deepening, maybe it’s in person but maybe in other ways. So just looking forward to that in the future.

Alex: Thank you, Allison. Next we’re going to go to Kimberly Curseen. Kimberly, please introduce yourself. When you think about geriatrics and palliative care, name something you’re grateful for and something you’re hopeful for.

Kim Curseen: Okay, hi. Hi, I’m Kimberly Curseen, I’m director of outpatient supportive care for Emory Healthcare. They gave me a hat, so I’m grateful for that. What am I grateful for? I think I’m very grateful for all of our hospice nurses and CNAs. So we spent so much time talking and praising people who are on the front lines. And that was so well deserved, but my girls and brothers and sisters were behind enemy lines, and they still went in those houses when they didn’t have PPE. And I remember being down here in Georgia when they were trying to buy it off of Amazon and trading with each other, and it was extraordinary. And they still kept those referrals going at great risk to themselves. So I just want the whole world to recognize how often they were left out of the conversation and how much in danger they were and how much was expected of them. So I’m super, super proud to be part of this community and rely on them heavily.

Kim Curseen: What I’m most grateful for, there’s so many things to be grateful for. I am grateful that our field is starting to do some self-examination and ask ourselves some really difficult questions. Just like James said, wanting our field to look like the people that we serve. And are we equitable? Asking questions about the things that we’re doing, and I’m super hoping that we will continue to really investigate what it means to practice palliative care upstream and what does that mean, and put some, we have a beautiful house, but we’ve got to put some bones and some furniture in our house, so we know what we’re doing as we’re bringing these bright young minds into the field. So I’m super hopeful for that, and hopeful and grateful to see so many people who come to us saying, “Hey, Kim, I want to do outpatient palliative care.” I’m like, “What?” So that is something, they’re like, “I don’t want to be in the hospital. I want to be here with you.” So that has been awesome and heartwarming. And then I’m grateful for all you guys.

Anne: Okay. Kimberly, you too get a bonus question.

Anne: If you had to listen to the same song 200 times in a row, what song would that be?

Kim Curseen: If I had to listen to the same song …

Alex: I think there are some songs I’ve listened to 200 times in a row.

Kim Curseen: I know, I’m trying-

Alex: For instance, this podcast.

Kim Curseen: Gosh, this has to be … Oh man, I don’t have enough medication in me to actually tell you guys the truth. [laughter] I’m trying to think of something.

Alex: Oh, come on.

Kim Curseen: Oh, you know, my parents were children of the ’60s and ’70s and parts of their brains are still there, so it’s probably Fleetwood Mac’s Seven Wonders.

Eric: Alex, can you give us … No, Alex …

Kim Curseen: You don’t have to, Alex, you don’t have to. That’s my mama’s fault. You don’t have to.

Alex: Kim, can you sing a line of it for us?

Kim Curseen: As much as I adore you, I will not for dignity and for the sake of your podcast.

Lynn: Maybe on the 300th episode?

Kim Curseen: Yeah, on the 300th episode after the pub crawl, then you get a whole different Kimberly.

Lynn: This is being recorded.

Alex: Right, right. Thank you so much, Kimberly. Let’s go from one hat to another. William Dale, I see you wearing a holiday hat.

William Dale: Hi.

Alex: William, when you think about geriatrics and palliative care, name something you’re grateful for and something you’re hopeful for. And also, congratulations on the two major publications about the importance of geriatric assessment in oncology in Lancet and General Oncology. Great work.

William Dale: Thank you, thank you. Yeah, years of work coming together for a couple weeks. Very nice. Thank you. My hat is totally my assistant. I wear hats with my mask so people can see me on campus. So I love to have it available. Thanks for inviting me to this party and for looking at those papers. We’re very happy about those papers. I will take a chance to say we got a big grant because of those papers just now. So we got a $4 million grant last week from Rising Tide, so very happy about that. Let’s see. I’m grateful, honestly, for my colleagues. I have had the best colleagues, especially in the geri onc world. I’ll separate them out. So I will call out especially Supriya Mohili and Heidi Klepin, two of the strongest women I work with. And I have been privileged to work with strong women for so much of my career, and I’m grateful for all of them. It’s made my life much, much better. Supriya led one of those studies, of course, and Heidi’s our colleague in crime.

William Dale: Hopeful, I’m hopeful that my kids are going to be in a world that’s better, different, with the arc of justice moved a little closer to where it ought to be. And I’m thrilled for that. And that my son especially, up at Berkeley, enjoying his life there makes me hopeful. And my other one is a little bit facetious. But the other day in discussions with an insurance company, they said they had a CARG billing code. I’d never heard of a CARG billing code as someone who’s led CARG for quite a while now. So my hope is that there will be a CARG billing code so that geriatric assessment for cancer patients will be something we can financially count on. So those are my grateful and hopeful.

Eric: I just want to clarify for our listeners, what does CARG stand for, C-A-R-G?

William Dale: Yes. Yeah, C-A-R-G is the Cancer and Aging Research Group started by Arti Hurria over a decade ago, and has now grown from 10 members to 467 members as of last week. So kudos to our community.

Eric: Yeah.

Alex: Thank you, William. Terrific. We’re going to move to Christine Ritchie next. Christine, please introduce yourself and tell us, when you think about geriatrics and palliative care, something you’re grateful for and something you’re hopeful for. Oh, I can already see Lynn and Anne starting to …

Eric: That means you’ve got the bonus question coming,

Lynn: Something’s coming, Christine.

Christine Ritch…: Oh, dear. Oh, no, I was hoping for no bonus question. But anyway, so yeah, I’m Christine Richie and I’m in geriatrics and palliative care. And in terms of what I’m grateful for, I’m grateful for so many things. I’m grateful for vaccines and COVID tests, which enable us to stay connected with each other. And I’m also very grateful to what Kim mentioned, which is this uncovering of all the injustice that we … Actually it’s always been there, but we have not chosen to look, that COVID has given us the opportunity to go deeper on and look further in. And that brings me to what I’m hopeful for. And you would be disappointed if I didn’t at least tell you bit of a poem. So my hope is going to be a poem, or part of a poem because a poem is too long.

Alex: Cover your ears. Eric’s not a poem person.

Christine Ritch…: Yeah, sorry, Eric.

Alex: Everytime we get a GeriPal podcast about great poetry it’s consistently refused. Please read your poem, Christine. [laughter]

Christine Ritch…: Now, Eric, just cover your ears for now. This is from-

Eric: Earmuffs, earmuffs.

Christine Ritch…: This is from [inaudible] of Troy. History says don’t hope on this side of the grave, but then once in a lifetime the longed-for tidal wave of justice can rise up, and hope and history rhyme. So hope for a great sea change on the far side of revenge. Believe that a further shore is reachable from here. Believe in miracles and cures and healing wells. Call the miracle self-healing, the utter self- revealing double take of feeling. If there’s fire on the mountain or lightning in storm and if God speaks from the sky, that means that someone is hearing the outcry and the birth cry of new life at its term. It means once in a lifetime that justice can rise up, and hope and history rhyme.

Anne: Thank you, Christine. And as promised, you get our next bonus question.

Christine Ritch…: Excellent.

Anne: Christine, I’m going to personalize this question for you a little bit, because if I remember correctly, I think you’re someone who enjoys cooking. And I was going to ask, if you had to cook the same recipe 200 times, what would you be cooking?

Christine Ritch…: What a great question. Probably cinnamon rolls.

Anne: Oh. We’ll be there.

Alex: I’m there.

Anne: They’re good.

Alex: Thank you so much, Christine. Next we’re going to go to Sean Morrison. Sean, please introduce yourself and tell us, when you think about geriatrics and palliative care, something you’re grateful for and something you’re hopeful for. Are you going to say you’re grateful for advanced care planning? I couldn’t resist.

Eric: If our mics weren’t attached, that would be a drop right there.

Sean Morrison: Well, I was going to congratulate you guys on 200 episodes, but that’s not going to happen. I’m Sean Morrison, I’m chair of geriatrics and palliative medicine at Mount Sinai in New York, and I also direct the National Palliative Care Research Center. I’m grateful for the community and what this community of healthcare professionals has done over the past 20 to 30 years. And very grateful that there is a next generation that is brighter, smarter, more ambitious than all of us old folks who are ready to take over the field. And I am very grateful for that, because I can then retire. And I am very hopeful that our fields will move beyond what James Tulsky said as mainstream to really insert into the genome of American medicine over the next five years. And that not only will we be mainstream, but we will be indispensable, and indispensable for every American, not just those who have access to healthcare right now in 2021. And again, I will congratulate you guys on your 200th episode, and hopefully you will be planning for the future.

Alex: Thank you, Sean. Thank you, appreciate all your support over the years. We’d like to next welcome Wendy-Jo Toyama.

Wendy-Jo Toyama: I’m the CEO for the American Academy of Hospice and Palliative Medicine. So thanks for having me on, and congratulations, it’s great to be here.

Eric: So Wendy, one thing that you are grateful for in either geriatrics or palliative care. I’m guessing you’re going to be taking the palliative care part of that.

Wendy-Jo Toyama: Well, actually what I’m going to talk about is just the folks who are in this field. Among my association colleagues I have shared that I feel so fortunate to be working with leaders and members who make space for grace and check in with how people are doing as we’re moving through this really disruptive period with the pandemic and racial reckoning. And it is just, it’s very, very special. And I don’t need to tell all of you that, you know that. I just feel like I’m really honored to be able to support all of you and help, hopefully we help make it easier for you to do the sacred work that you all do. So yeah, it’s been, I just feel honored.

Alex: And when you think about the next year, if you had one hope, what would that be?

Wendy-Jo Toyama: Oh, well, you know my answer, right? I am very hopeful that for those who can join us in Nashville, that it is a joyful gathering of the profession. And for those who are not ready or for whatever reason can’t, that they feel like they can connect through the virtual option. We recently did an in-person board meeting. I’m probably one of those whose bubbles is a little smaller than the rest of you. And it was joyful to be together. And I was at Foley, Sean, thank you, it was joyful to just … There are people I didn’t realize I didn’t know how tall they were and I hadn’t met, because I felt like I had. So I think for me the answer has just got to be that we all find a way to make the connections with each other in 2022, whether it’s at our assembly or elsewhere.

Eric: And speaking of connections, Wendy, on Thursday night in Nashville we’re going to have our annual pallimed, GeriPal party, location TBD.

Wendy-Jo Toyama: Okay.

Eric: But it’s a great time to get connected with everybody. So if anybody’s listening and going to Nashville, jump on.

Lynn: Outdoors.

Eric: Outdoors.

Alex: Outdoors, with some sort of heat lamps or fire tables.

Eric: And maybe, I’m just going to throw it out there, maybe there are some igloos involved, but that is …

Lynn: That’s right.

Alex: Thank you, Wendy-Jo. We’re going to turn now to Rachelle Bernacki. Rachelle, please introduce yourself. Tell us, when you think about geriatrics and palliative care, name something you’re grateful for and something you are hopeful for.

Rachelle Bernac…: So I’m so happy to be here, it makes me really happy to see all of your faces. I have had the great fortune to work in surgery the last couple years, and that has been tons of fun. So I’m grateful to my teams, R Cooper and Amy Bulger and Lynne O’Mara. And we are working with American College of Surgeons to implement geriatric and palliative standards in surgery. And it is cool and I think sort of the next frontier, and I’m just grateful to be able to muck about in this new space and try to figure out what what’s right and what’s not right, and I love it. And the Hartford Foundation, the Hillman Foundation are funding us, so we’re really delighted. So that’s me.

Alex: Great. Tell us something that you’re hopeful for about the next year.

Rachelle Bernac…: So I’m hopeful that we don’t get to omega on the variants. I guess another more serious message is, I loved Vivek Murphy’s attention to burnout and his really, he did just a lovely little segment on Twitter, which was fantastic. And I think it really makes a difference. We really need to watch out for each other and pay attention to people’s burnout and mental health and take care of each other to get through this next part. Because I feel like we’re in the 75th percent, like when I rode my bike cross country, that last section was the hardest. And this is going to be hard and we’re going to have to all hold hands and drag each other across the finish line.

Eric: Wait, you rode a bike across country? Like literally?

Rachelle Bernac…: I did.

Lynn: Dropped that in.

Eric: Or is that just a figurative comment?

Rachelle Bernac…: Oh no, I literally did it, Seattle to Washington DC.

Eric: Wow.

Rachelle Bernac…: And Ohio was the hardest part. And it not because of Ohio, just because it was almost done. So I think we’re, I guess I’m an optimist, I think we’re almost there and we’re just going to need to just buck up and do it. And I have been so amazed by everyone from nurses, TAs, everyone has just really come up, stepped up to the plate during this last two years to really give it their all. And when I think about it, I’m just really amazed.

Alex: And I just want to say on the Vivek Murphy note, we’ve been trying to get him on the podcast. He hasn’t said no, but he hasn’t said yes either. So anybody out there, if you’re listening to this and you see Vivek, please tell him, “You need to get on the GeriPal podcast.”

Rachelle Bernac…: Oh, I like that.

Lynn: Vivek, you were my resident in residency.

Eric: Oh, really?

Lynn: Yeah.

Eric: He was your resident?

Lynn: He was my resident.

Eric: You’ve got an in.

Lynn: Yeah, I was your intern.[laughter]

Rachelle Bernac…: Maybe we can start a Twitter campaign or something. I think you can get him.

Lynn: Yeah, maybe.

Eric: You can say, “If you don’t, I’m going to go back into my evaluations and rate you lower from that.”

Alex: Ouch.

Eric: You’ll never be surgeon general.

Anne: Rochelle, don’t go anywhere yet, because you get a bonus question.

Rachelle Bernac…: Okay. I’m a little worried about it, but I think I can handle it.

Anne: Okay. I think you can. If you had to watch the same movie 200 times in a row, what movie would that be?

Rachelle Bernac…: Oh, gosh. So something, either the Sound of Music, which I probably have about 200 times, or The Princess Bride.

Alex: Great choices.

Anne: Excellent.

Rachelle Bernac…: Yeah.

Anne: Thank you.

Rachelle Bernac…: That was an easy one. Thank you.

Anne: Good, worked out well.

Rachelle Bernac…: Great.

Alex: We’re going to turn now to Chris Langston. Chris, thank you so much for joining us, and thank you to Archstone Foundation for funding this podcast. We’re going to ask you to introduce yourself and then answer a question. When you think about geriatrics and palliative care, name something you’re grateful for and something you’re hopeful for.

Christopher Lan…: Thank you so much, Alex and Eric. I really appreciate all of your work this year and every year. And if anybody hasn’t, they should be sure to donate to the GeriPal podcast. I think the monthly subscription approach is highly valued, very valuable. It actually took, this was a good question, it took me a long time to think of anything to be grateful about. This has been a very bad year for older adults, which is the point of geriatrics and palliative care. I think that what I realized I am grateful for is the way that many geriatricians and other specialists in the field of care of older adults have rallied around particularly the most vulnerable nursing home residents and really worked very hard, pushed themselves, I think, much, much further than I would have ever expected to engage in policy and to speak out and do things that I think will hopefully ensure that people living in nursing homes are safer than they have been at the beginning of the pandemic.

Alex: Yeah.

Christopher Lan…: And you know, hope is not a plan. I don’t really do hope, but I don’t do gratitude either, so that’s okay. 2022, I’m not hoping, I’m scheming for the California Master Plan for Aging to actually have some positive impact and to do some things that are good for the geriatric workforce and good for the benefits and services to older adults, to try to get the infrastructure of both community based and healthcare organizations to work better in the service of the needs of older adults and their caregivers. So that’s my hope, my scheme, I prefer scheme to hope.

Christopher Lan…: I’m in the middle of the Archstone Christmas party.

Eric: I like the Hawaiian shirt, Chris. Is that in honor of Alex right there? Because Alex has this beautiful GeriPal shirt on. I’m sure it’s going to be catching on soon.

Christopher Lan…: Very nice, Alex. And are you able to play again so soon? I heard in one of the previous podcasts you’d hurt yourself.

Alex: Yeah, I did break my clavicle, but I had surgery, so shorter time to recovery. So I’m back back playing a little ukulele and some easy guitar.

Christopher Lan…: Oh, right, the miracle of surgical recovery. How about that? Cool.

Eric: Do we have a special question for Chris? Okay, go for it.

Anne: Yes, we do. Stick around for this bonus question. If you could be gifted 200 of the same item, what would it be?

Lynn: We’re scratching the bottom of the barrel here.

Christopher Lan…: Well, until two years ago I would have said video cameras so that I could give them to all my grantees and we could video chat. And then all of a sudden that happened all by itself, so I don’t need them any more. So it’s very clear, Nancy, you know what I need 200 of, and that is Geriatrics At Your Fingertips so that I could just send them to everybody I know.

Anne: Perfect, thank you.

Eric: Chris, you also mentioned in the chat something about a surgical verification program. And I see Bernacki right there too, she was just talking about that. What is geriatric surgical verification?

Christopher Lan…: Well, I just have to say I love Clearco, and that’s pretty much the end of it. So really was very, very fortunate to have the opportunity to support Cliff and his work at the American College of Surgeons around quality care, he has a big mandate around quality surgical care, but he wanted to build up their geriatric qualification program. They are able to give appropriately benchmarked information on outcomes of surgical procedures, things that are really meaningful and that engage surgical teams. And then also to create a package of, let’s say evidence informed things that you can do to have better outcomes, from the preoperative to operative to the postoperative to discharge, things that will improve outcomes. And he’s been rolling this out. COVID clearly has distracted a great deal, and Nancy reminds me that Cliff was one of the first Janigan scholars from the surgical specialties to be nurtured in their geriatric careers.

Christopher Lan…: And in addition to the ACS poobah of quality, he’s a surgeon at UCLA and was a mentee of Bob Brook. I think that says … Yeah, the Rand guy. Anyway, so has built this program and Hartford is continuing to support it and help it roll out. And someday I hope that Archstone will be able to do something like that too.

Alex: Great. Nancy, I saw you unmute yourself when Chris said something about Geriatrics At Your Fingertips. Did you have something you wanted to say?

Nancy Lundebjer…: If Chris sends me a chat, I’ll send him 200 copies of Geriatrics At Your Fingertips.

Anne: That’s what the 200th episode is all about. Ask and you shall receive.

Christopher Lan…: What about a book discount?

Lynn: Do you need a breakout room?

Nancy Lundebjer…: So just as background for this, Chris actually funded me to give Geriatrics At Your Fingertips away to medical schools, residency programs, and I don’t know, untold numbers of places. And we still think there might be boxes of 2003 Geriatrics At Your Fingertips in lockers at certain medical schools. So maybe I’ll go hunt those down, Chris.

Alex: That’s great. Thank you so much to all of our guests. We’re going to go around the room now, and we’re each going to say one thing that we are grateful for and one thing that we’re hopeful for in geriatrics and palliative care. And we’re going to start with Eric.

Eric: So I am going to do opposite. I’m going to start off with what I’m hopeful for. I am very hopeful for this year’s annual meetings, both AHPM and AGS. People coming together, people being able to hug. I’m also hopeful that at some point I’m going to be able to take off these masks in group meetings like this so we can actually have live in-person podcasts. And what I am most grateful for in the last year was COVID vaccinations. My COVID anniversary, vaccination, not my COVID anniversary but COVID vaccination anniversary is on the 23rd, right before Christmas Eve. And just a big shout-out is that you can actually donate online to the WHO initiative to make sure that everybody has access to COVID vaccines. That was my anniversary gift to myself, is donating. So we make sure that everybody has similar access, no matter where you live on this world. So that’s where I’m at.

Alex: Great. I’ll go next. And I’m going to say, I’m a clinician researcher so I spend most of my time doing research. And I’m just so grateful for my mentees because they just fill me with energy and ideas and hope for the future, quite frankly. And they have such a diverse array of interests, and it just is a joy and inspiring to think about their future and potential. And it helps me think about such a broad range of ideas and issues, as I’ve talked about previously on this podcast.

Alex: What I’m hopeful for in the coming year, I’m going to stick with the research theme here, is that funding opportunities continue, particularly for the junior investigators and somewhat for the mid-career. I worry about them. I worry about them at this time. It’s hard out there, right? And it’s hard for everybody. It’s hard for the clinicians. We’ve had a lot of shout-outs for the clinicians. I also worry about the researchers. And I know there are a lot of researchers who are struggling in a lot of ways right now. And so I’m hopeful that funding and support will continue for them throughout the next year. I’m going to pass it on to Anne now.

Anne: Lynn and I, when we were thinking about today’s episode, we realized that what we are grateful for and what we are hoping for had a lot of shared overlap. So I’m going to let Lynn take the first part.

Lynn: Okay. So I have to say, I think it was Kimberly who talked about caregivers. And that was really what was on my mind when thinking about what I’m most grateful for over the past couple of years. And I don’t think I could really say it better than she did. It was just, there’s all these people in homes, in nursing homes, in all different kinds of settings, who just continued going to their job even when it was really dangerous and uncertain and scary. And we all just really relied on them in so many different ways. And I’m just so grateful when I reflect back for all of their hard work, and I’ll pass it to Anne for what you’re hoping for.

Anne: Yeah, and because with that gratitude I think we just, we were thinking together about just the unsung heroism that caregivers provide for folks every day, and hoping that in the time ahead there is increased recognition, increased compensation, increased opportunities to help people sustain the really amazing caregiving work that they’re doing day to day. So hoping for that.

Eric: Well, I also want to do a shout-out that, for all of our listeners, whether or not you’re on podcasts or YouTube, check out the GeriPal tweet that’s associated with us and put in that reply part what you’re hopeful for and what you’re grateful for. We’d love to see what you guys are thinking. You could also go to our YouTube site and put it in our comments as well. But before we leave this, we’ve got a little bit more from Alex on the ukelele.

Alex: A little more Wonderful World. (singing)

Eric: Thank you, Alex. Thank you everybody for joining us for this podcast, all of our special guests today, and all of our listeners. We really appreciate your continued support. For those who have donated to the GeriPal podcast, I’ve got to say I was expecting like maybe $20, mostly of that coming from Alex’s mom. [laughter]

Alex: I didn’t donate, she did.[laughter]

Lynn: I just want to say that I am hoping for more top 40 from Alex…

Eric: Oh yeah, a little pop music there?

Anne: Yeah, a little more pop, yeah.

Alex: Oh, no. I see many torture sessions coming. [laughter]

Anne: I have lots of ideas.

Eric: A very big thank you, Archstone, for your continued support. I also want a big shout-out for AGS and AHPM. I want a future podcast with Nancy and Wendy on, and we can talk about the future of our national…what’s the word I’m looking for? Organizations.

Alex: Professions, yeah.

Anne: Landscape.

Eric: Yeah. And with that, good night, everybody.