I think we're live. Well, hello, and welcome you all to this wonderful Luminary Lounge. I should probably say good morning, good evening, good afternoon, because I know you all are tuned in from different parts of the world. I have the distinct honor and pleasure of welcoming a very special guest today, Dr. Heather Lee Bailey. Welcome, Heather. Thank you for your time with us today. Oh, it's my pleasure to be here and in such unusual circumstances. Absolutely. So I'm gonna give you all a brief background on Dr. Bailey, although I know that most of you all in the audience today have known her, have probably met her during her time as the SCCM president, have interacted with her at some level and know of her and have probably worked or collaborated with her at some point in your career. So Dr. Bailey completed her medical school at the University of Medicine and Dentistry of New Jersey in Newark, New Jersey. Now this place is known as Rutgers, but back then it was still known as the University of Medicine and Dentistry of New Jersey. She then undertook a residency in emergency medicine at the Medical College of Pennsylvania in Philadelphia and then joined on as their faculty. After a fellowship in critical care, she served as the department director of critical care education and their associate residency program director for nearly a decade. Dr. Bailey is currently faculty in the Department of Emergency Medicine at the Durham VA Medical Center in Durham, North Carolina. So her career has been deeply rooted in education, trainee development and mentorship. In fact, mentorship is a focus that she has brought to her roles at the Society of Critical Care Medicine. And in fact, her dedication and expertise has been recognized nationally and internationally for all of these mentorship, education and trainee development. Her career interests are management of injury and critical illness. And in fact, they have taken her globally. She was a key developer in the comprehensive trauma life support all the way out in India as part of her work with the International Trauma, Anesthesia and Critical Care Society. I can go on and on about her, but this is about you and I today and our opportunity to ask her questions. I will like to tell you all a little bit about her journey with the SCCM. This being the 50th year anniversary of the SCCM, Dr. Bailey has been involved with the society for 20 plus years. And she's fulfilled a different number of roles, starting as a leader in her chapter society. She was the chapter president of the Pennsylvania chapter from 2003 to 2005. And then she was awarded the Dr. Joseph and Ray Brown Award for her chapter level contributions in 2008. She was then subsequently elected to the council of the SCCM and got an SCCM. And then we know that that career trajectory took her onward and upward. And her path of volunteerism, mentorship and leadership made her the first emergency medicine trained president of the Society of Critical Care Medicine in 2019. Heather, that was a fairly concise introduction from my perspective. But, you know, this is a fascinating story. And I'd like to open up today by just asking you your story in your own words. I mean, there's a lot of big highlights here, work with chapter societies, the first ER president of the SCCM. How would you like to tell the audience about your story? I mean, there's more to it than this and we'd love to hear it in your own words. Well, Ashish, thank you for the kind and lengthy introduction. And it's really been an unforeseen and mostly enjoyable journey. And I never anticipated 25, almost 25 years ago when I joined the society, that this is where that path would take me. In fact, when I joined the society, there was no subspecialty of emergency medicine critical care. The term emergency medicine intensivist didn't exist. I mean, as we all know, just this past year, Webster's finally put the term intensivist appropriately so in the dictionary. And so now the entire world knows what an intensivist is. But when I joined the society, there was no such thing as emergency medicine as a pathway to critical care. Dr. Martin talked this morning about our founders and coming together in 1968 at a meeting in Atlantic City. And they had the foresight to make us multi-professional and recognize the importance of team involvement. But what he didn't talk about, there's only so much time you have in a presidential address is the fact that they also realized the importance of the continuum of care. And that it doesn't matter where the patient is in the hospital, the patient needs the right care at the right time. And that if you wait until the patient arrives in the intensive care unit, the opportunity is generally lost. And there's a wonderful quote from Dr. Saffer that talks about care in the ICU becomes expensive terminal care if pre to the ICU is not addressed. And I think that is so key. So even 50 years ago, our founders realized the importance of it. And when I joined the society, even though EM critical care wasn't a true entity, there was an emergency medicine section. So our founders did have that vision truly from the beginning. And when I joined, there was a very small number of us. You could count, I think on our two hands, the number of us in the room. And we were small, but enthusiastic. And we were determined because we felt that along with our founders, that we had an important contribution to the care of the critically ill and injured patient. And it really started from there with enthusiastic individuals who saw that there was another way to do things. Yeah, so that's a fascinating story, but going back again, were there certain individuals, was there things that happened during that journey during emergency medicine training or even before that in medical school that told you that critical care is going to be your calling? When did that calling come to you that really told you that it's not just emergency medicine, it's going to be critical care as a subspecialty of emergency medicine for you? So that absolutely started in residency. I had the fortunate opportunity to attend residency at the Medical College of Pennsylvania, who was chaired by Dr. David Wagner. MCP was the first full emergency medicine residency, first full three years. And Dr. Wagner is considered the grandfather of emergency medicine, one of the founders of my primary specialty. But he also, along with the founders of SCCM, had the vision that emergency medicine was a continuum of care and it just didn't stop in the emergency department and that you needed to continue critical care resuscitation throughout the patient's stay. And so even long before I joined my residency, the MCP residents ran an ICU, first at West Park in Philadelphia. And then when I had started my residency, we were at Misericordia in West Philadelphia. And it was staffed essentially by emergency medicine residents with some of the Misericordia house staff as well. But the attending staff was our emergency medicine faculty. Now we had the unique opportunity that we had several faculty who were IM trained and had done critical care and then had grandfathered into emergency medicine. So these were the faculty that led our program in the ICU. And during my three years of residency, I did nine months of critical care time, many of which were at the Misericordia ICU, but also SICU and PICU as well, and some CCU. So it really showed me that resuscitation needs to continue and the importance of taking continued care of the patient. And the physiology is just fascinating and you can see what happens. And what fascinated me is if you did or did not do the right thing for the patient in the emergency department, how that then affected their ongoing course in the ICU. So it really was a bit of serendipity. I was fortunate that I was able to go to MCP, which was a fabulous training program. And I learned just amazing care of patients and medicine there because Philadelphia is a very busy place to be a physician. And I trained in a time prior to any kind of hours rules. So for many of the rotations, especially in the ICU, we essentially lived mostly in the hospital. So it really gave us, I think, a good appreciation. And I saw what the possibility was. I didn't know that it was gonna go anywhere, but that's really where my interest developed. And then I was fortunate that our now immediate past president, Dr. Lou Kaplan, was a resident and then junior faculty with me at MCP. And we had the same interest and MCP was a relatively small, but robust hospital. And so we worked together all the time and joined SCCM at the same time and had a lot of collaborative projects. So I think the combination of training at MCP, Dr. Wagner's vision, and then all the time that I spent doing critical care as a resident, and then with Lou Kaplan's guidance, we kind of found this path together. So wait, Dr. Kaplan was a co-resident? He was a chief when I was a junior resident and then we were junior faculty together. Wow. Surgeons, they take a lot longer and he also did some research time. He will joke about that as well. But yeah, so we crossed a little bit of time in residency and then as junior faculty. Well, isn't it? I mean, I'm sure some of your MCP faculty have run into the two of you and have looked at the two of you and said, like, how great is it for that program to have trained two people at almost the same time who ended up in similar roles for the SCCM? I mean, I'm sure there's this feeling of pride at the Medical College of Pennsylvania. Well, considering that MCP is now closed and has been closed for a while, but I think that those who are out there, yes, we have heard comments. In fact, after Dr. Kaplan's presidential address last year, we were met backstage by one of his former mentors and the lead of his research lab, Dr. Glenn Whitman. So we had a nice reunion and conversation about just that fact that it was really extraordinary that we were in the same place together. Wow. You know, I picked up a few things from that story, but you said something about resident work hours, and you know I'm going to ask you that question. I mean, then and now, do you think that we're doing the right thing for our trainees by restricting work hours, especially in critical care, where, like you said, you live in the ICU to really learn and experience critical care medicine, but for us, we make our residents go home when the sun goes down. Is that the right approach? So I think it's a different approach. I mean, I don't know that the way that we did it was certainly not the best way, I think, for our physical and mental health, because we really were pushed to the brink. I think the good thing about the way we trained when we did was we saw a phenomenal number of patients, and you were at the bedside taking care of that patient if they were unstable. You did not leave because your time was up, but I also think it took a toll on us personally, physically, emotionally, so I can't say that either way is the best way. You know, now I think our residents can get frustrated and challenged with the fact that, you know, they need to go because of the hour rule, and it's changed medicine a little bit. I think that individuals, it's almost like a bank job, right? It's not necessarily nine to five, but, you know, you're there for the hours, and it takes away, I think, a little bit of the personal responsibility and ownership, but I don't know that we've come up with the best way for medical training. I think there's advantages to both, and I think there's challenges with both, but I'm very grateful that I trained when I did because I think it really helps cement the need to know what you need to know because otherwise someone's gonna die. Right, right, absolutely. I mean, you know, we moved with the times, and I'm sure that, you know, 20 years from now, there will be further variations to the way we train, and hopefully, you know, it'll all be good. So again, you know, a great point, but let me take a little detour here and also ask you about multidisciplinary critical care. Now, as you and I know, you know, so I'm anesthesia-critical care trained. You are ER-critical care trained. You know, I face the same dilemma. Sometimes I introduce myself to the world, and I say I'm an anesthesiologist who does critical care, and people look at me. In fact, jokingly, some non-medical people have asked me, what is your role in the ICU? Do you just put them to sleep and wake them up, or do you actually practice critical care, right? So I'm glad that we're focusing on the word intensivist because that's how it should be. Now, why is it that our model in the U.S. is still slightly segregated in terms of, you know, you're either a pulmonologist who does critical care or you're a medical doctor who does critical, whereas you go to Europe and you go to Australia, the specialty of intensive care medicine has developed as a single, standalone specialty. Do you think we should be leaning towards that approach, or are we sort of good for what we're doing right now? So I think there's some good in both. I think one of the issues is that we all do have multiple backgrounds, and that's how medicine in the United States has evolved. We started with different specialties and then developed subspecialties, and it was relatively quickly realized that many of the subspecialties were shared, right? Surgeons are in the ICU, anesthesiologists are in the ICU, pulmonary critical care is in the ICU, pediatrics. All of these different specialties take care of critically ill and injured patients in the ICU. You know, I certainly know of the care and the training in Europe and in Australia, and I think the focus starts earlier. I think that, you know, they're guided during their initial medical school training to go down this pathway. We have not, up until relatively recently, focused on the knowledge of critical care and the critical care as a specialty in our medical students. So our medical students many times get to residency and then find out about critical care. I know that when I was a student, granted it was several decades ago, you know, critical care wasn't discussed. And even on my ICU rotation as a student, you really didn't understand what there was to the specialty and the subspecialty. So like I said, that's why I really discovered it in residency. And I think it has to do with the focus of training. Now, perhaps with what we've all endured in the last year, where everyone has needed to learn some aspect of critical care to help out with the crisis, that the focus will shift. So 20 years from now, perhaps it will be a unified specialty that starts from the get-go in medical school. And I think only time is gonna tell us, but I think the focus now after this past year that we've had, I think there will probably be some interest in that. All right, so we've got a bunch of questions from our audience here. So this is going to get really interesting now. And one of the questions that caught my eye was your collaboration with Lou Kaplan. So Beth Taylor asks, what types of projects during your collaboration with Lou Kaplan sort of helped you bridge the gap between the emergency, the medicine department and the ICU in terms of patient flow and communication? Did you actually do some projects with him back then? Absolutely, very early on in our career. And it was an interesting time at MCP because MCP was challenged with many bankruptcies and hospital buyouts. So it was an interesting time to be just attempting to survive in Madison. But we did some acid-base research. We looked at using APRB and ventilators. And so we did several different projects. We looked at this monitoring in the emergency department and in the ICU. So we had quite a little variation of things that we focused on. He had gone to Pittsburgh and done his critical care fellowship at Pittsburgh and come back with all of these great and interesting new concepts that we tried out in Philadelphia. Yeah, so it looks like you've got these stories about collaborative critical care that obviously resonate well with us. Did that actually start early on? Looks like it started early on in your career. Did that help you as you went through this leadership process with the state chapters, local chapters? Did that sort of collaborative openness help you progress through the different chapters? Absolutely. So we had submitted a couple of abstracts to our local, the Pennsylvania chapter. Pennsylvania has been a longstanding chapter. In fact, chapters really started with them, with Joseph and Ray Brown formed the Pennsylvania chapter. And that's who the chapters award is actually named after them, sponsored by the Pennsylvania chapter. And so what we had submitted some abstracts there and done some presentations there. And the Pennsylvania chapter is a very enthusiastic, very involved chapter that has a wonderful meeting every year, well, at least up until this past year in Hershey, Pennsylvania. And it really is a great, about 100 or so people, a great place to collaborate with your fellow Pennsylvanians and so we started there and they were looking for help in their executive council. And so we joined that and we participated in the meeting and that was really my start into the beginning steps of leadership was I'd done a bunch of local projects. I'd been on some committees for SCCM, but this leadership pathway opened up in Pennsylvania. And so that is where I got my start. And then for those of you who are familiar with chapters, there is a larger entity in the society, that's the chapter and it's not affiliates anymore, it's chapter and blanking, it was affiliates when I was there and they're responsible for all the chapters and they have a meeting at SCCM every year and where all the chapters get together to discuss projects and there's a leadership structure in that. And then the leadership of the chair of that committee actually gets to sit on council in an ex officio non-voting position. So a little bit of fortuitous and one of the important things is the willingness to raise your hand and say yes when they are looking for people to do work, if you have the ability and your interest and you wanna progress, you must be involved. And the way to get started is in the local committees. And if you have a local chapter, we have either, we had 14, we may now have 15 chapters that are both state and some multi-state and region areas that you can become involved in. And that is how I really got my start and how I was introduced to council because as the chair of chapter and affiliate, you sit on council and I, so I was on council for two years and I saw how council worked. So it was an interesting and excellent experience. So I highly recommend getting involved in your chapter. Right, no, that's great. But again, there is no, I don't say there is a recipe here, right? State chapter leadership versus getting into the SCCM directly. This is a question more from the youngsters in the audience who are looking at you and saying, how can we be a Heather Lee Bailey tomorrow? Do they have to go through the state chapters? Can they come into the SCCM directly? What's your recommendation? I shouldn't even say this. I mean, there is no competition. These are not too competitive pathways. They're probably synergistic pathways. But what's your thoughts about getting into the SCCM directly versus state chapters? So you can certainly do it either way. There is no set path or blueprint. The one thing that you have to do is participate. I had the opportunity to participate at my local chapter. And so I did because I like to be involved and it was a good organization and I thought I could help and make a difference. So that's the pathway that I chose. But I think I'm probably one of the first to have gone through chapters to get to the leadership position now, but just being involved in the society. Every year we put out a call for committees. Sign up, there's a relatively easy form. You get to pick the top three things that you're interested in. Anticipate that one of the first things you'll be assigned to is some type of writing questions because we need a lot of questions for the question bank because we have so many different educational offerings throughout the year. So we always need new questions. And so that is a good way to get your feet wet. So don't be disappointed when you get assigned to some type of question item writing group because essentially all of us started there. So it is a good way to get your feet wet. And it's important to be able to write a good question that helps you not just with SCCM, but in every stage of your career, especially if you're in academics, you can use that in your main specialty as well. Or I'm also an oral board examiner. I don't do the written questions for emergency medicine, but I am an oral board examinal. But you can help with use that skill elsewhere and you are trained. There is a training program to learn how to write a good question and what makes a good question. And it really is interesting that when you go to take your board certification tests or whatever, MOC or whatever you have to do these days, every specialty is in the process of change. When you read some of these questions, say, oh boy, this is really not a great, a well-written question. So you do learn that skill and that's important, but you certainly don't need to focus and start in chapters. I just recommend chapters because I think it's a great learning opportunity. You get to meet your local people who are across your state or your region. We both now currently belong to Carolina, Virginia. So that's North and South Carolina, Virginia and West Virginia. You're not that far up the road for me right now. And the Carolina, Virginia is another very active chapter. So it gives you the opportunity, especially in times when you can't travel either because of pandemic or finances or whatever it is, you get to do something at your local level. But don't think that this is the only way. I think I'm probably the first to have gotten this pathway. I lost you for a second, Heather. I'm coming back. One second. Sorry. My audio went out for a second. OK. So I think, again, I would strongly encourage anyone who is interested in becoming more involved in SCCM to fill out the application online. It's usually due by the beginning of June. And this way, you will get put on a committee. Most likely, it will be an item writing committee, but it may not be. Almost no one gets to go straight to program. Everybody wants to be on program to help shape the next Congress. And it is an amazing opportunity. And Ashish, I'm sure you can attest to that, because you've been on program now for a little bit. But if you want to get involved, you should start somewhere. And the best way to start is becoming involved. Right. Again, you summarized it really well. The best way to get started is to literally raise your hand and say, I want to be involved. And the society will reward you as you start making those contributions. One of my mentors used to say, don't just show up at an SCCM meeting. Show up and volunteer, and then actually go back and deliver. And once you complete that cycle, you will see that you will progress through the ranks. But anyway, let me talk about your time as the president. There's some questions that I've come through asking you about, what was it like being SCCM president? In fact, from Dr. Lillian Emlert here, what were your favorite parts of being SCCM president? So there was a lot of favorite parts. I was very fortunate that I was finishing my time as presidency as we were just really learning about the COVID and it wasn't yet a pandemic. And the last time I traveled, and I'm sure many of you traveled, was at our Congress last year when Lou became president. And that was actually the last time I was on a plane. So I had the fortunate timing that I did get to travel and represent SCCM all over the world. And it really was an amazing experience. Other societies really are so welcoming. Those that are in developing areas really want to know and learn from SCCM. The majority of them have modeled their societies after ours. They use a great amount of our knowledge content. Many of them do combined FCCS programs, peds, adults, FDM, and all of the other in the House of Fundamentals to help improve the care in their nations and in their areas of the world. And it was also amazing to me that no matter where they were, everyone was having the same challenges, challenges with not enough staffing, not enough intensivists, not enough trained bedside nurses and respiratory therapists, too many patients, not enough time to be able to focus on research, problems with burnout and stress and the ability to deal with everything. We really are one large family across the world. We really have at large the same types of problems. And it's interesting how some have been able to solve and others have really struggled through. Some areas of the world are still, I'd say, a bit behind the times with families. Many individuals I talked to were still very upset about the fact that their countries didn't allow families at the bedside. Or if so, for only very short periods of time. And this was in the pre-pandemic time. And they really wanted to know how they could encourage their administration and their governments to allow families to participate in care. That was really a big question that many areas of the world are struggling with. Because families are not allowed at the bedside, which I think, as we've all seen this past year when we've not been able to have families at the bedside, what a difference that has made. Right. So I think it gives you perspective to travel the world as president of the SCCM and understand that other parts of the world are also doing their due diligence. They're trying really hard. They might be better than us at some things. And they might need some help at some things. But I think part of all of this, and I'm going to take another question as I go to our next area, is the first emergency medicine president of the SCCM. It's also a question that I see here. And was that difficult, especially when you traveled the world? Did you get questions about how did that evolve? And were there people who were not used to that concept? So I think early on in my time, that was a much bigger question. The question, really, from emergency, as I got as an emergency medicine intensivist around the world, was not, oh, they've welcomed emergency medicine in, was more the challenge of the hour one bundle. So I spent a lot more time educating the world, so to speak, on that it was the hour one bundle and not the one hour bundle, which is frequently misquoted, and that the goal was to start the bundle within the hour and not complete the bundle within the hour. And so really, people weren't that. They were interested in that I was emergency medicine critical care, but the bigger question that I faced my entire year before and even after has been more focused on the hour one bundle and not so much that emergency medicine should be at the bedside in part of the critical care team. Yeah, and I think you've answered some questions. I mean, Lynn Kelso asks here, what is the best way that critical care and emergency medicine can combine for critical care? And then I had another question coming in that really asked you the challenges of emergency medicine critical care. So anything else you'd like to add to that? So I think it's important to remember that it's part of the continuum. And even though the majority of my colleagues in emergency medicine are not trained in critical care, not doing fellowship in critical care, we do have is our area of expertise is in the acute resuscitation. The challenge, I think, is that those patients who have had their initial resuscitation, but then there's nowhere to go. Even in pre-pandemic times, boarding in the emergency department of all patients, but especially in the critical care patient, has been very challenging because many of those patients are truly in no man's land. Emergency medicine is shift work. So every 8, 10, or 12 hours, the attending is changing out. And not only do you have the patients who are boarding waiting to go to care, you have the new patients that are constantly coming in. And so I think as a specialty, one of the areas that we need to focus on is how do we best manage these patients who are boarding and have nowhere to go? Because multiple studies have shown that those are the individuals who have worse outcomes, both in morbidity and mortality. The longer they spend in the emergency department without a dedicated team, increased risk of pneumonia, and deconditioning, and ultimately death. So this is definitely an area that we need to work on once we get the pandemic straightened out, I think. Right, I'll take a question from Heather Meissen here. And I'm going to reframe it. If Dr. Heather Lee Bailey had a crystal ball and she could look ahead in time and say, what is the future of critical care medicine? What would that crystal ball show her most obviously? And we can say 10, 20, 30, 40, 50 years ahead. What does that crystal ball look like? That's an excellent question. And I really did wish I had a crystal ball because then I'd be able to enlighten all of us as to when we will have the pandemic under control and that we can meet and be together again. But I hope that from what we've learned, especially in the last year, that we really need to focus on what's good for the patient. And that early handoffs, early dedicated teams, making sure that the patient is the focus of the care and that regardless of what specialty, if we remain the same in the United States, having our primary specialty first and then moving on to critical care, I think there's certainly advantages to the way that we do that. You can do a little bit of both because many of us have many different interests. But I think as we go forward, it is going to be probably a bit more like Europe and Australia where critical care becomes its own entity. And people may go straight from medical school into critical care. I do think that the pandemic has highlighted intensive care and the intensive care team. And so regardless if you are a physician, a nurse, an APP, a pharmacist, an RT, that we should take this moment and seize what we've learned and take that information and move forward to what improves all of medical care across all of the subspecialties. And I think the best way to do that is by working together as a team. We've shown that team care, patients do better. Does that also apply to our remote areas, though? I mean, you've mostly worked in urban environments. How about our emergency room providers who work in remote areas? Here's a question, actually, from Adam Holman. He asks, as someone who works in slightly remote areas of health as part of health systems, what is the future over there? He says that he's often the receiver of patients with little resources in the initial hours of a patient's trajectory. He'd like to hear your opinion about how we improve the continuum of care in remote areas for critically ill beyond rapid transport and telemedicine. Any messages over there? Well, so first, Adam, thank you very much. Because you are critical in what you do. Because the pandemic has shown that there are areas of the country and the world that really have minimal resources. And in those areas, our patients are doing worse. I do think that there are things that can be done to augment the care. First is getting as much training as you possibly can. Because you are the hands-on, on-the-ground what you do, and your knowledge is going to make the difference between life and death. So I think getting as much knowledge as you can, either through training of fellowship or in things like the fundamentals courses. We are working on a project of what is the next step between for those patients specifically who are boarding either in the emergency department or on the floor in the hospital or in a smaller community hospital. And there's no tertiary or quaternary care center that is available to take the patient. That important 48 hours, what can you do? So we are working on that specifically for those reasons. I think setting up tele-critical care, tele-ICU, is very key. Having some additional eyes, some additional help so they can help guide you. And if it's something that you haven't seen before or are a little unsure how to do, you have an expert who is at least able to put eyes on you and the patient and talk you through what you need to do. Also having good referrals to be able to have a tertiary or quaternary hospital that you can call and say, I have patient X who has this problem. I need to get them to your facility and have a streamlined process where you have done everything that you can to stabilize the patient, but they need more definitive care than you're able to provide. So I think those are the things that we need to focus on. Because, Adam, you're absolutely right that when you are on your own with maybe just a handful of nurses and maybe one respiratory therapist for the entire hospital, it is really a major challenge. And my hat's off to you for working in that environment because our patients need you. Yeah, those are some great points. And I'm going to take a little detour again, go back to your career, because there's a lot of career questions here. Heather Myson is asking about what are some pivotal moments in your career which you felt truly accelerated you to be where you are today? So a few of them I've already mentioned. One was actually through the chapters and working with the Pennsylvania chapter and then volunteering at the chapter and affiliate. And apologies because my brain can't remember what the current term is. I know that David is probably not pleased with that. And then moving up into council. And it really was interesting because this was 15-plus years ago. And there was no emergency medicine or neuroscience dedicated seat on council. It was just the collective seat. And I found it rather striking when I first got there that they'd be talking about different things that they hadn't even considered emergency medicine. So I really think that that was helpful both for me and for the society to take note of emergency medicine. So I think that was one. I think that getting to know the council at that time was also very helpful. I then had gone on to other committees. And I know that because I met people and I'd done the work, I got put on additional committees. And then they, I guess, were focusing on the fact that emergency medicine had not made it onto council, that they put me up for nomination. And so I was initially elected to an at-large member spot. So that, I think, was pivotal. And then going forward, it was a bit of being in the right place at the right time. I really had been fortunate that my career has spanned emergency medicine, critical care, and the focus on the right care right now. So a bit of it is serendipity. A bit of it is hard work and the willingness to say yes. And taking these opportunities that, even though you may not have felt comfortable with, I wanted to pursue and see where it would take me. I really, when I started this, had no idea that I would be in this position. And I've been very grateful and very fortunate that I've been able to follow this journey. And it's taken me to here. Sure. And you also talked a little bit about the role of mentors in your career and mentorship. And it looks like that's been a huge career focus for you yourself. Can you tell us a little bit more? I'm sure there's some inspiring stories over there. Mentors are absolutely key. None of us got to where we are without help. And that, I think, was also pivotal. The fact that Lou and I happened to be residency and junior faculty together and had a common interest, I think, was probably one of the biggest influences of me ending up here. Lou introduced me to SCCM, and we submitted some abstracts that were accepted. And I've been able to attend every SCCM since 1998. Wow. So wait, tell me, your first abstract was accepted at SCCM 1998? Yes. Wow. Wow. Yes. So and then I came to the meeting, and I saw what the meeting has to offer, at least in an in-person meeting. But the virtual meeting seems to be going quite well. And the sessions, the morning session that I listen to in The Futurist is really quite interesting and thought-provoking. So I'm excited for the next two weeks, because this is what we have. I think most of us would rather be in Anaheim. I know certainly those in the Northeast in Chicago with all the snow would probably rather be there. And certainly us with our icy rain, I would much rather be in Anaheim. But we're really, I think, fortunate that we have the technology that we are able to meet in this manner at this time, because I think the conversations are going to be excellent over the next two weeks. And I'm really looking forward to them. Yeah, you bring up a great point. I've always wondered if the same pandemic had hit, say, 20 years ago or 30 years ago, I think things would have been really difficult. So I am thankful to technology. People always say, well, internet is distracting us and this and that. But it has still kept us together. Well, and not only kept us together, I think it has allowed us to tackle the pandemic in an unprecedented way. I mean, these are unprecedented times, but the ability to share knowledge and information and scientists working together. And it's very fortunate, I think, that Dr. Ciccone, the new president of ESICM, had just left our meeting in Orlando, was home for a day, and the first case appeared in Milan. And the fact that he was able to get on social media and warn the rest of us of what was coming, I think, had made a huge difference in our level of preparedness. I don't think any of us were quite as prepared as we needed to be, but I think we were better prepared because of the knowledge that he shared with the world so we knew what was coming. And I think that is key. I think that has made a big difference in the care of the patients in the pandemic, as individuals have learned throughout this time about when to intubate, other modalities that you can use, the risk of transmission from patient to hospital worker. I think that has all improved our ability to care for the patients and get through this pandemic. Wow, you bring up some great points again, but social media, right? So were you the kind of person who would cringe when people would talk about Twitter and you're in the emergency room, you're trying to teach a trainee and someone's trying to think about Twitter or is distracted because of social media. And here we are, we're so social media dependent and we've sort of fallen in love with it. When you talk about the future of critical care, is social media going to be pretty much a part of what we do? I think it has to be. I have to say that I had never tweeted until I became president. I was my least favorite part of the entire job. I'd much rather have a travel fiasco than have to deal with Twitter. And I was very happy to hand it over to Dr. Kaplan. However, because of the pandemic, I actually, when we were in Congress, I created my own account. And I have to say, it really has been helpful in trying to keep up with what is going on and what is trending and new ways of caring for patients. So even though it is not my favorite, I much prefer in-person conversation and in-person meetings. I think it has made a significant difference in both remaining connected and learning things that we need to learn rather quickly as they come out. So I do think that social media is here to stay. I do wanna just touch back on mentors, especially for those of you who are junior in your career. It is so key to find individuals who have a like mind. They don't certainly need to be from your same specialty. I mean, Lou is a surgeon on emergency medicine, but we had similar interests. And I think finding someone with a similar interest who can help guide you and review things for you and give you suggestions of where you should be focused has really made the biggest difference for me. As I said, hard work, serendipity, but having guidance is key. And I think the other nice thing about the society is that you don't have to wanna be in leadership. You can just wanna come to the society because you like to see your friends and you learn good information. I mean, SCCM is known for our educational material. And I think that's another key reason to be part of the society is you don't need to wanna be in leadership. There's a lot of people who would like to do leadership, but if you just wanna come to participate and be part of the experience, I think that's great as well. And we need everyone's input. That's what makes the society great. This is perfect segue to the next question that I'm seeing here. It comes from someone who was one of my earliest attendings in critical care, who was one of the Congress co-chairs today, Dr. Jose Luis Diaz Gomez. He asks, Dr. Bailey, how do you envision we can embrace our careers after serving as leaders in any capacity? Sort of that connection between our own careers and us serving as leaders within the SCCM. So I know one of the things that we had talked about previous to this is, what is my life planning to be after SCCM? Well, I don't plan to leave SCCM because this is my professional home. And I hope that as a past president that I can continue to contribute. I think there are many things. Some of our presidents have gone back to their primary specialties. Some presidents have retired and then others have been exceedingly active. You look at Dr. Parker and her podcast. I mean, that is just an amazing entity that has been created, that has a wonderful following in SCCM and they're always so informative and so well done. So I think you make of it what you will. I hope my plan is to continue with SCCM because it really is my professional home. You know, emergency medicine, I love my primary specialty. I wouldn't change it at all. And I still, I go to my emergency medicine meetings and I contribute where I can. But SCCM is where really everybody has the same basic thought process and same philosophy. Right, and Beth also, Beth Taylor wants to know what do you do outside of work? You know, we're very interested in knowing what are some hobbies, some, you know, some interesting things you do outside of work. What is Heather Lee Bailey outside of being Dr. Heather Lee Bailey? Oh, I'm an equestrian. I'm an equestrian. I love horses. I have been horse crazy since I was a little kid. My mother and I shared a horse when I was in college and then up until, you know, we had, he was 32 when he died. And my current horse just is about to turn 24. So I've had him for 16 years and hands down, he has been my saving grace during the pandemic. His registered name is Silver Trophy. Silver or hi-ho Silver, because he, even though he's 24, he's going on to, and he has hands down been the silver lining for me of the pandemic. Because I, you know, as president, I wasn't home very much. And so now, even on days that I'm working, if I'm, you know, working in the afternoon, I go to see the horse in the morning. And even if it's not a great day at the barn, it's always a good day to be able to see the horse. And so that has, Silver has hands down been my mental health savior from this pandemic. And he is quite appreciative of the fact that he gets many snacks every day because I'm now here to take care of him. So that is what I love to read. I love music. I read a wide variety of things, but picking one thing, I'm an equestrian. That is what I do. Yeah, it's a clear message in terms of, you know, we've been talking a lot about burnout for critical care providers, not just before the pandemic, but during the pandemic. I guess all of us have, you know, lived through, you know, the death, the despair, the day in and day out seeing these patients not doing well around us. I think you make a great point about having an outlet about just going out and trying to sort of erase that those images from the ICU from your mind and allowing your mind to take a break. And I think important point for all the youngsters here listening into this, right? It is so key. I mean, I'm very blessed in the fact that I live in the woods. So I'm able to be outside even when the weather's not so great. And I have the horse and I cannot imagine how much more stressed that I would be and how mentally not well, if I didn't have those two things. I love to be outside and, you know, I love taking care of my horse and riding my horse. And without that outlet, this would have been an even more difficult, even more difficult time. I just don't even want to think about that. Which is interesting also because you've had a very, very busy and ambitious career. And you think some of us sometimes, you know, when we're on that trajectory, we forget to sort of take care of ourselves, right? Where it says that fine line between ambition and then just saying, okay, this is my time to get away from my work desk or my next paper I have to write to just do something for myself. Oh, absolutely. When I was a resident and junior faculty, no, I didn't really have the time for horses. And I know how much better my life has been now that I have, you know, a horse back in my life. And, you know, the last few years, because of time we haven't competed, but just being able to go out and ride and hack through the woods and, you know, go gallop up a hill is, you know, for me is my mental sanity. Sure. I'm gonna switch gears a little bit to gender inclusion and diversity. You are a true ambassador for the SCCM in terms of all of that. You know, what have been some of the big sort of key moments in your career in terms of gender inclusion and diversity and your message to folks in the audience who come from a diverse background? What does the future look like? Well, I'm hoping that we are working towards a time where it doesn't matter, you know, who you are and what your background is, that if you are the right person for the job, regardless of your gender, regardless of your race, that you are the person who does the job because you are the right person for the job. We want to have equity for everyone, that your background should not, your social background should not make a difference in what you have to contribute to critical care. And I think that we are working towards that. I think SCCM has been a leader in that. You know, Dr. Martin mentioned this morning about our first female president and several of them, our first pharmacist, Judy Jacoby, our first nurse, Maureen Harvey, presidents. And SCCM was actually given accommodation in a JAMA article in 2019 about being one of the societies that was forward-thinking and really on a right trend for leadership of women. In the last 20 years, I am the ninth female in the last 20 years to be president. And we have two more in this upcoming EC council. You will have your second pharmacist, Sandy Cain Gill, and then I believe your fourth nurse, Lauren Source. So I think SCCM has done a very good job in the last 20 years of equity. So I think that's very important. Other specialties, including emergency medicine, we've not been quite as forward, progressive as SCCM has been. Is there something we can do about that? Is that something sort of where we need to go back to medical school and training and change the way things are perceived over there? Or wherein lies the problem, if there is a problem? Well, I think if you just look at the world around and you look at the challenges that are in society, there clearly is still a problem, not just for gender, but for race. So I think it is a society problem that we do need to address. And what I would say is much like after 9-11, we learned the phrase, if you see something, say something. It's really important that if you see unprofessional behavior going on, you need to address it. And you may not be able to address it right at that second. I would hope that you could, but if you are a junior individual, you need to take it to the next level because it should not be tolerated. No one should be harassed. No one should be put down because of their gender or their race. We should all treat each other as equals and with the goal of the care of the patient. We are here for that. We shouldn't leave these petty issues, should not be part of it. So again, if you see something, say something. That would be my message. Because if you don't, then it just continues. Dr. Bailey, we're coming to the end of what has been a wonderful hour of discussion. In fact, I really feel we could have gone on and on and on. If I didn't have this timer that's counting down right now, I truly could have gone on and on. So thank you from me and from the entire SCCM family for your work, your leadership, and what you've given to us. It's an honor and a pleasure to be with you. Last comments from you before we sign off. So I would say thank you, everyone. It has truly been the biggest honor of my professional career. I have enjoyed almost every minute of it. Thank you for your enthusiasm and your participation. And I'm always available if you have any questions or if I can be of assistance. So thank you so much. And I appreciate SCCM and this great honor that they've chosen to give me. Well, again, I hope you enjoy the Congress. See you. ♪♪♪

Dr. Heather Lee Bailey

emergency medicine physician

critical care specialist

medical education

mentorship

Durham VA Medical Center

Society of Critical Care Medicine

early intervention

gender inclusion

patient care