Dr David Heller of Portsmouth tells stories of 33 years in the emergency room

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I recently met Dr David Heller for a high-profile conversation about his life and career on the sea coast. The interview has been edited and condensed for clarity.

Donnermeyer: Start me off with a funny story.

Heller: Well… my wife Colleen who is a nurse and I were flying home from vacation. An announcement came through the intercom. “Is there a doctor on board? I raised my hand during the last vestiges of my vacation. It looks like there was some distress with the woman sitting right behind me, could I please help? I questioned the woman. “I’m fine,” she insisted. Apparently her seatmate thought she was having some sort of episode. I felt his heartbeat, spoke to him, and walked over to the captain’s cabin to get the diagnosis. “She looks good. Just tired. “

– Sorry, said the captain. “I’ve already made the decision to make an emergency landing, and we’re headed down.”

“What !? She says she’s okay, and she looks good to me! At this point, I realize that I would be seriously delayed and arrive home with hours to spare before go to my 7am shift at PRH (Portsmouth Regional Hospital).

“The decision has been made and I cannot change course now,” said the captain casually.

The plane diverted to Chicago. Doctors came on board to get the perfectly healthy woman off the plane. My thanks were a lot of dirty looks! I guess it’s funny when you think about it.

Dr David Heller

Donnermeyer: Thank you !, a little lightness for a difficult job. Can you describe a typical day in the emergency room?

Heller: Emergencies are a fascinating place where people from all walks of life come for help. Some patients have minor problems that they think could be major. Others have truly life-threatening emergencies. It takes a highly skilled and efficient team to deal with what is called “organized chaos”. Part of the appeal of working in an emergency room is that each shift is different, unpredictable, challenging, and an opportunity to help others.

Donnermeyer: What do you think is the most unusual thing that you have seen?

Heller: Well we see a lot of crazy things in the ER. I guess I would say I’ve been ‘fishing’ for all kinds of things stuck in all kinds of holes over the years. Once, when I was struggling to retrieve an electric vibrator from my rectum, I paused for a second where I thought “if my MOTHER has any idea what I’m doing now!” I was careful to laugh only to myself, realizing that it was probably the most embarrassing day in this patient’s life!

Dr Heller in DMAT

Donnermeyer: What does emergency staffing generally look like?

Heller: Emergency personnel are constantly evolving. There is always an emergency doctor in the emergency room 24/7. Depending on the time of day, there might be two docs and two PAs (medical assistants). People stay late when necessary. There are several nurses, technicians and an emergency unit coordinator. There are also radiology technicians, laboratory staff, a psychological counselor, admissions officers, a triage nurse. Many people!

Donnermeyer: I know it sounds silly because an emergency is an emergency, but if you think you have to go to the ER and can wait, what is the slowest time of the day?

Heller: Historically, between 7 a.m. and 9 a.m. has been the slowest period. However, nowadays there is no such thing as slow time.

Portsmouth Regional Hospital Emergency Department, 5/02.

Donnermeyer: In the aftermath of the opioid crisis, how are emergency departments handling pain medication prescriptions?

Heller: Drug addiction is a huge problem. ERs try to be “opioid light,” which means opiates are prescribed very judiciously. There is a prescription monitoring program in New Hampshire and 47 other states where we can see if a patient has been prescribed controlled substances by another supplier and when they were prescribed. Emergencies do not treat chronic pain. Patients with chronic pain should be managed by their own doctor or pain specialist. This policy has dramatically reduced the number of controlled substances prescribed by emergency physicians. “

Donnermeyer: I believe you were in charge of emergencies that horrific night in 2012 during the drug raid in Greenland, New Hampshire, when the chief of police was killed and other law enforcement officials were killed. been shot and brought en masse to your emergency room, overwhelming your staff with desperate patients all immediately. I learned that it was such an amazing night that the hospital management closed the hospital for the first time in history and ordered ambulances to take patients to other hospitals. I was told that the law enforcement brothers and even the governor’s office all flooded the ER that night.

Heller: For reasons of confidentiality I cannot go into details, but I will say this … our work with the Emergency Preparedness Committee paid off that night, allowing the hospital to be better prepared. for incidents causing multiple victims such as the shooting in Greenland … and most recently in the face of the COVID pandemic.

Donnermeyer: Can you explain the emergency preparedness committee? I believe you were instrumental in its creation and have continued to serve as the Medical Director of the Portsmouth Regional Hospital Committee for 15 years now.

Heller: When I arrived at Seacoast in 1988, the 911 dispatch system was almost non-existent and in need of improvement. I became chairman of the NH 911 committee. This committee designed the improved 911 system in NH and then introduced a bill to the legislature to pass the 911 law in NH. The implementation took several years, with many field issues, renaming of duplicate street names etc.

Then, after the events of September 11 and Hurricane Katrina, I felt that emergency preparedness was of the utmost importance in the hospital and in the community and I became chair of this committee. Many in the hospital jokingly call us “the end of the world committee.”

Donnermeyer: It seems to me that 33 years as an emergency doctor is a long passage?

Heller: The average ER doc has an ER “shelf life” of 8 years. It is a very stressful job that requires decisive thinking. There is rarely any downtime during work. There’s even a phone in the ER bathroom so you can be called while doing “your business.” You have to work a high percentage of nights, weekends and holidays. Night shifts returning to day shifts are becoming increasingly difficult. There is a high percentage of prosecutions. The ability to multitask is essential and becomes more and more difficult as we get older.

Donnermeyer: In 2019, when you started reducing your duties at the Portsmouth ER, you signed up to work in India as a medical missionary with an organization called “Me to We” outside of Canada. Your wife Colleen might also serve with her nursing skills. Can you explain how medical care in India differs from our care in the United States?

Heller: In India, we were seeing patients for whom the nearest hospital was at 2:30 am on almost impassable roads. Getting regular health care or follow-up care was almost impossible for these people. The patients we have seen have had difficult lives. Most appeared to be 20 years older than they were. Some of our care was frustrating … for example, we diagnosed a probably metastatic breast cancer in a 50 year old woman. She had no way of getting to the hospital for a biopsy, surgery, and possible cancer treatment. No service was available to help him. His fate would be to see the cancer progress until his death. Very sad.

Donnermeyer: I understand that you deploy in hurricanes, floods and other catastrophic events as part of the New Hampshire Disaster Medical Assistance Team (DMAT)?

Heller: Every state has a DMAT and some of the larger states have multiple DMATs. DMATS members are temporary federal employees who can be deployed in the event of a disaster. Last August, I was deployed to work at a New Orleans children’s hospital that was inundated with children with COVID. I returned to Louisiana in September with DMAT after Hurricane Ida, and ended up being the chief medical officer of a 250-bed special medical needs shelter at the New Orleans Convention Center.

Donnermeyer: Take us a look inside this COVID children’s hospital if you can.

Heller: After Hurricane Ida decimated southern Louisiana, we set up a 250-bed shelter at the New Orleans Convention Center to care for patients who were too fragile or sick for regular shelter … intensive therapy. It has been a great experience for me as Chief Medical Officer to work collaboratively with federal, state and local disaster responders.

Donnermeyer: One last good story?

Heller: Well … we were heading home from a more recent vacation. Then the intercom asks “Is there a dentist on board?” I continued to read my magazine. No one has come forward. Colleen’s nurse forced her to beg me to answer. “I really am not a DENTIST! ” I insisted. “But there is no one else!” she appealed. We both reflected on the nature of the emergency and whether I might be qualified to help, but the calls eventually ceased and our plane landed at the agreed time to the original destination. I still wonder what a dentist could have done at 30,000 feet!

Shari Donnermeyer has been a Seacoast resident since 1987. Her career has always been in local media; Radio WHEB, Comcast (now Effectv) and Seacoast Media Group. She is currently working with a national research and consultancy company in the local media space. Shari has served on the board of directors of the Prescott Parks Arts Festival and president of the Portsmouth Chamber of Commerce. She is the mother of two grown children who both made it into the Portsmouth school system and now both live in Denver, Colorado. Write to him at [email protected]


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