Practicing (Episode 2): Brad Wiggins and Dr. Steve Morris
Real teams are the antidote to the chaos of modern medicine. Real teams know each other, feel loyalty to one another, trust one another, and would not want to disappoint one another (Tom Lee, NEJM Catalyst 2016). Practicing are conversations between real team members about why the work matters. Our goal is to preserve and share the stories of the teams at 泫圖弝け of Utah 泫圖弝け Care.
By Brad Wiggins and Steve Morris | 9 minutes
DRAW TO BURN CARE
Dr. Steve Morris , MD, and Brad Wiggins , RN, lead the intermountain wests only burn center at the 泫圖弝け of Utah. They have worked together for over 25 years, sharing a passion and commitment for the mission of caring for burn patients. Chrissy Daniels and Mari Ransco learn about their unique and enduring connection.
START WITH "WHY"
1. HOW DID YOU GET STARTED IN YOUR LINE OF WORK?
[Brad:] Thats a complicated question. My work in the burn unit was really unexpected. Ive been in the hospital for 29 years. I started in the storeroom in high school. I can honestly thank my mom and Lynda Faldmo (former nurse manager of the burn center and director of risk management). My mom knew I was done working in the storeroom at 19, and she had a conversation with Lynda in the hallway one day. They were talking about kids and life, and she said Brad is looking for something new. I was hired as an 'equipment technician.' Seemed like I was going to clean equipment, but found out really quickly that it was another name for nurses aide.
At that point, I wanted to be an air force pilot. I was in ROTC here at Utah, but I very quickly fell in love with the idea of caring for burn patients. I would come home from flying and working on my private pilots license, and my girlfriend at the time would say, you know when you come home from the burn unit youre totally excited and lit up. You come from flying and you basically say, it was ok. Having a mom and a grandma as a nurse, there was no way I wanted to be nurse. But the burn unit changed that for me. I really quickly discovered how much you could make a difference in someones life.
[Steve:] The first time I ever thought about burns as a disease or injury was the week before I started medical school. I was single, I had just finished my degree in chemistry. From the time I was very young, I always knew I wanted to do medicine. I saw a physician as someone like Marcus Welby; then I entered medical school. The first time I was in the medical center as a pre-med (I had gone up there many times as the son of a hospital pharmacist), I was with my mother, and we saw this burn patient and of course my mother recoiled. I ended up taking care of burn patients when I was a medical student and as an intern.
I was drawn to burn care; here was a patient who otherwise would have died; who might never live a real life because of what had happened. And because of the strength they have in them, and you can see it, they become a person again. They get back to living, they get back to running, laughing, crying, teasing, whatever.that is what just drew me to burns. And of course when I realized how much I liked critical care, and I liked operating, all of that came together for me. It just felt right.
When I was a second year resident, one night I was post-oping patients, and another doctor,, said what are you doing Morris? You ever think to take care of burns? I said well, Ive thought about it. He said think real hard. That moment in time tripped a number of gates open and pretty soon I was an attending. Jeff ended up being my partner for 25 years, and Brad and I started working together.
BUILDING A TEAM BEYOND JUST CRITICAL CARE
2. THE BURN UNIT YOU'VE CREATED HAS THE MOST MATURE, TEAM-BASED CARE OF ANY CONDITION THAT WE CARE FOR IN THE HOSPITAL. YOU WENT BEYOND CRITICAL CARE AND STARTED LOOKING AT THE PATIENT FROM BEFORE THEY COME TO YOU TO LONG AFTER THEY LEAVE YOU. HOW DID THAT COME ABOUT?
[Steve:] My original mentor, Glenn Warden, was a real iconoclast. He had a vision; he was a pugnacious guy and a lot of people didnt like him. But he cared about the patient. He was really hard to work for, but he had human concern. I never thought of this before, but that human concern sparked something in me. I realized that a surgeon cant do this (take care of burns), a nurse cant do this, a social worker cant do this, a psychologist cant do this, a mother or father cant do this; this is something that can be done by all of us together. The whole is much greater than the parts, and Glenn Warden saw that. He did some things that would really shock you sometimes, but he did it because of the patients welfare and he inspired others to do the same.
"I realized that a surgeon cant do this (take care of burns), a nurse cant do this, a social worker cant do this, a psychologist cant do this, a mother or father cant do this; this is something that can be done by all of us together. The whole is much greater than the parts."
We were, and still are, in a silo because of that在ut people get that spark. I did, Brad did, Lynda did, many people have; those that can see it stay. Those that can only see the wounds and the pain and the horrible twist of fate that caused the patient to be here; those that can only see that dont last that long. There is a real culling process that goes on. We see people who are only here for 4 months, a year, and then they cant do it - unless that light turns on. I guess that was what happened to me, and its never gone out.
3. HOW DO YOU THINK YOUR TEAM WOULD DESCRIBE WHAT THE BURN UNIT IS ABOUT? WHAT WORDS DESCRIBE THE BURN UNIT?
[Brad:] Passion. We have instilled passion in our team to believe that you can pull someone back from the worst injury of their life. That you can give them hope. Commitment. A drive for success. Those are things that Dr. Morris and I both had instilled in us from early in our careers. Burn patients bring that out of you.
The humanistic side ultimately is that you believe youre going to be able to get them back on their feet again. On the hardest of hardest days, they come out of the fire and they come out of their challenges with amazing success stories and they go on to lead amazing lives. Not everyone, but a high percentage. We have very little death. We help people overcome something that from a public perspective is viewed as horrific, traumatizing and ultimately destroying of someones self-worth and together we prove them otherwise. Were going to be here with you, cry with you, hold your hand, sometimes hurt you, but we push really hard for those things.
[Steve:] I think these relationships arent intentionally created. Of course, we know we have to work together as a team, but they happen because of the circumstances that we work under. Usually they happen not because of something youve said, but the relationships happen because were working at the bedside together and we look over at each other. I look into Brads eyes. Or Randys eyes. Or Sue Hills eyes. Or any of these people that Ive worked with for decades, and there is that understanding. I remember, (I had no idea I would get emotional), one time we had a little 10 month old 泫圖弝け who had an absolutely horrific burn on her upper extremity, and it was making her sick and we had to amputate. I was in the operating room with Randy. We completed the amputation, I looked at Randy, and there was communication without a word.
I consider Randy, Brad, and others, not necessarily the greatest friends but perhaps the most magnanimous and wonderful people. They work in the burn unit for a number of reasons. When things are hard, people will often say how can you do this? I say, I had no idea I could take it, I bet you didnt have any idea either. But because we can, we must. These patients cant help themselves, they need help from someone else. Those people that can do it, must do it. It goes far beyond a job.
One time we were in a staff meeting, and I cant remember what Jeff Saffle was talking about, but he was coming down on someone because they werent doing something they were supposed to. I looked over and said to Jeff, remember this is a job. If looks could kill, I would have been dead, because the look Jeff gave me meant this is not just a job, this is a mission. Its almost like entering a religious order. It goes far beyond pay, it goes beyond the job, and its one of the most remarkable contracts. Its a relationship that physicians, residents, nurses, case managers and so many others have with the patient. You set aside your own desires and wishes.
[Brad:] Dr. Morris and my relationship is exactly as hes defined it. Weve spent incredible amounts of time together, trying to save someones life. Weve been successful and we havent. Those moments that weve shared together over the last 25 years define us daily in how we approach the rest of the team, and in what we expect out of the commitment to the patient. It is something we both expect. We expect the rest of the team to focus and commit to taking someones life and turning it around.
"The relationships happen because were working at the bedside together. I look into Brads eyes. Or Randys eyes. Or Sues eyes. Or any of these people that Ive worked with for decades, and there is that understanding."
There are endless moments when Ive looked across the bed at Steve, in the middle of the procedure. We dont have to say anything; were both feeling the intensity of the situation. We understand the impact its having on us as professionals, and how much its grabbing a hold of our hearts. When youve worked with someone as long as we have, you can love each other. We do love each other, we have a significant relationship that way. That is unique. Thats the piece that keeps us.
People ask how can you do burn care? Its this conversation, its this moment. Its the survivors coming back thanking us, its the graduation card, 5 years later, the marriage announcement, the baby announcement. They consider themselves family, that doesnt go away. We chase that every day in the changing healthcare environment, trying to maintain something that grabbed ahold of us, and in a difficult time of healthcare challenges, we are lucky to have been here and to influence those around us to make impactful change.
This last year for us, weve added a lot of new team members to the burn center. We are creating the future of the burn center. Weve welcomed many, many people into burn care, and in 15 years, some of them will still be here. We know that. We carry that message forward of compassionate, dedicated care to people who need it.
"When things are hard, I say, I didnt know I could work here, and I bet you didnt know you could work here. I bet you didnt know you could take it. But because we can, we must. These patients cant help themselves, they need help from someone else. Those people that can do it, must do it. It goes far beyond a job."
A PARTNERSHIP OF MUTUAL RESPECT AND ADMIRATION
4. BRAD, WHAT'S THE ONE THING YOU WANT STEVE TO KNOW, AND STEVE, WHAT'S THE ONE THING YOU WANT BRAD TO KNOW?
[Brad:] Thats a challenging question for any partners. Over the years, weve had chances to talk about the successful moments weve had. Weve even had time to talk about the challenges. Hes a brother in arms to me. He is somebody that carries the same torch as me. We share a vision of all of those things weve talked about here.
At the end of the day, the thing Id want Steve to know is I care for you immensely, Im proud of your dedication. Youre more dedicated than any physician Ive ever worked with. Your commitment and your focus to go into a patients room, and connect with that family, and to believe youll do everything in your power to save their life, is untouchable to anything Ive ever seen. Thats the standout piece for me. When someone says tell me about Dr. Morris, its the unwavering love for everyone you care for. Its unique and special. We have a lot of national exposure to burn care as well, and its something that is unique on a national level. We have something thats personal, a personal commitment to each other. I love Steve very much for that.
[Steve:] Our careers have been very parallel. We started out very young, and we had the fun of watching our leaders struggle with the burn center (before we became the leaders), and the learning experience of going through it. Ive seen Brad change a lot. Its almost like a personal relationship in that we are so different.
I feel that we complement each otherlike a hand in glove. We dont always see eye to eye, but when we dont, we have each others back. I am so grateful that you know I have your back, and I know you have my back. We disagree only because were different, yet were so much the same.
You are absolutely immovable. If you look at him, if you talk to him, you know one thingwhen Brad has his mind set on something, you may as well get out of the way, turn around and go the same direction. That is something that has never changed, from the moment you were young. Your determination, your commitment to doing the right thing, your integrity, your moral uprightness, and your absolutely immovability in moving forward. I dont think Ive ever told you this, but this is what draws me to you, and this is what makes me respect you so much. Im so proud to be your partner.
MORE THOUGHTS FROM THE TEAM
After hearing Dr. Morris story, we talked with Randy Leiphardt. Leiphardt is a surgical technician and has worked in Utahs burn center since 1984. Leiphardt reflected on working with the same passionate people for 33 years.
"The burn unit is a special place. Im very loyal to Dr. Morris. I met Dr. Morris in 1989. He is caring, that has always impressed me. Brad and Dr. Morris care as much for the staff as for the patients."
ON WHY HE HAS STAYED IN THE BURN CENTER
"When you work with people for a long time, you become loyal to each other. You have a lot of respect for each other. You may not always agree, but the respect is there. As a surgical technician, its unique to be in a place where they respect and care about what I think. I wouldnt get that at other places."
ON LOYALTY
"Loyalty is a two way street. Brad and Dr. Morris would never ask you to something that they wouldnt do themselves. There is no double standard. Brad came from working in distro (storeroom), and has seen all those different levels. He has experience to be a good leader because he knows where were coming from and he can say, I hear you, but we need to get the job done. Brad and Dr. Morris are both honest. You respect the leaders that are willing to get down in the trenches with you and do it, and Brad and Dr. Morris are those leaders."
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