 Everybody welcome back to Zang on the front lines. I'm Morgan Hutchinson. And I'm Matt Fields and we are two emergency physicians who also love to get nerdy about design and really think about how we can redesign our healthcare system to make it better, especially in this time of this pandemic. If you miss anything of our previous episodes, please feel free to check them out at healthdesignlab.com slash D-O-T-F-L. We had an awesome first few weeks and this week we have some very exciting news. I'd like to turn it over to co-authors of Health Design Thinking and good friends of this show, Ellen Lupton and Bon Coot. I'm Ellen Lupton and I'm a curator at Cooper Hewitt Smithsonian Design Museum and a long time collaborator with Bon Coot in the Health Design Lab. And we did this book together which is actually an ongoing project. We're already working on the second edition. So Cooper Hewitt is really excited, Bon, that we are part of your team kind of behind the scenes here on designing on the frontline, contributing to your program and following along and being inspired. It's really great. Thanks for including us. And part of our inspiration for design on the front lines is the book that Ellen and I wrote and we're excited about this intersection between design and healthcare, design and medicine. And we just wanted to create a casual layback Friday afternoon experience or Friday night experience for those of you in Europe or Friday early afternoon experience for those of you on the West Coast where we bring a group of like-minded folks who wanna explore this area and get some inspiration on how we can apply design and how we can apply methods and healthcare to practically create some solutions to the current pandemic that we are all experiencing. So thank you for being here. Thanks for the Cooper Hewitt folks. Special shout out to Pam Horn from the Cooper Hewitt and there's some of you here who have contributed to the book. So thank you for joining us. Pam, Ellen, we're so excited to have you guys. Everybody from Cooper Hewitt, thank you for joining us this week. I'd like to also give a shout out to our team at the Health Design Lab, Rob, Christy, Mary Ellen, Michelle, everybody who's working behind the scenes to make this awesome. Rob, let's turn it over to you for our music update. Yeah, so I am your friendly producer and Zoom bouncer. Should our meeting be invaded by Zoom bombers, I will quickly eject them. This week, our intro music was brought to you by, let me just share my screen real quick. Okay, so that was brought to you by the COVID-19 playlist. This is a pretty sweet playlist if you guys are hanging out and you're looking for some music to go with your vibe. The COVID-19 playlist is actually shared with me by Julianne Villa, she's a great person on Twitter, eat patient, do what I like to talk with down then. And that song was Agoraphobia by Dear Hunter. I just, I like having more of a chill vibe on Friday. So we're gonna go with that. So here it is, it's the COVID-19 playlist. Very good, I suggest it. This is Julianne, she's cool, follow her too. And we'll turn it back to you, Morgan. Thank you so much, Rob. We appreciate you as our producer and as our music guy, but more than anything, as our Zoom bouncer. Everybody else from Health Design Lab, thank you so much. And we appreciate having us here. Today we've got four exciting speakers we are about to introduce. We have two breakout rooms and so it's gonna be a busy hour. Yeah, awesome. First I would like to introduce, first I'd like to remind you to use the chat box, introduce yourself, let us know where you're from and keep your video on. We wanna see your faces, we want this to be interactive. But most importantly, it's Friday, it's five o'clock. Join us for an optional drink. I'm again drinking bourbon today. This time I switched over to a little higher quality, the Jefferson Reserves Twin Oak Cask. Yeah, I can see your jealousy bond. What are you, Morgan, what are you drinking? So I was inspired by our speakers last week from San Francisco, I actually had two speakers from San Francisco, so I'm drinking a Napa Pino. Love it. I think we should probably introduce our speakers though, maybe. I think we should. So this week we have some great guests. We have Eden Liu, Mike Natter, Trish Hemwood and Effie Keen as our guests. So let's get to it. Everyone, please turn your videos on. And again, if they remind you that and right after our first speaker, we're gonna be going into a breakout, so get ready for that. Thanks so much. So Trish and Effie, thank you guys so much for being on the show. We've been trying to get you guys on since the beginning. Trish, Hemwood and Effie Keen are two emergency doctors that we know well. They are leaders in the fight against the pandemic COVID-19 and they have been working day in, day out to make our hospital a safer place for doctors, patients, for everybody and not just our hospital, but the whole enterprise. Trish is a director of Global Strategic Partners at Thomas Jefferson University Hospital and thank you guys so much for joining us today. I will hand it over to you. Thanks Morgan, thanks for having us. I'm just gonna start with a couple of sides for perspective and I guess by way of background about me, I'm usually working in the global health sphere and or in a global disaster environment. And so it's been a really interesting experience for me obviously to have this global disaster come here to our normal home clinical environment. I'm just gonna share my screen and give you guys a few thoughts. You're able to see there? Okay. Yep, we can see it. Let me get up to that. All right, so this is one of my interesting thoughts. So I usually do a lot of work in Rwanda and this is a comment from one of the former ministers of health in Rwanda about how global responses to pandemic are only as strong as the weakest country and pandemics are just outbreaks mishandled. And I think unfortunately in the United States in particular we find ourselves in this situation of a challenging handling of the pandemic which has led to I think our significant concerns about volumes and the ways that we have to design the environment that we're taking care of patients. I'm used to taking care of patients in a little bit of a different environment. And I think really the intersection in terms of healthcare and design in this situation is really all about change and the Delta. So for me, my whole world over the last three months has been defined by I think this symbol. Every day volumes going up and down. What are the case numbers? What is the Delta in terms of cases? But then also thinking about how do we change the way that we take care of patients or workflows, the environment in which we work. And I think it's not an easy consideration. Let me see if I'm having some technical. Sometimes you have to use your mouse to advance the slides and not the arrows. Okay, perfect. So I'm used to working I think in a little bit more of a low resource context with a little bit less of the built environment considerations and more of a situation where you need to build it. So this is a post earthquake and Haiti, one of the field hospitals and triage and sort of emergency departments and ICU is where I was running. So again, this was an area in a field. We put up tents and created all the workflows in that kind of consideration. I also worked in a couple of different Ebola treatment units in the context of the Ebola outbreak in West Africa in 2014 and 2015. And this is an image similarly of actually what was a former leper colony, a sort of empty hilltop that ended up getting cleared to establish our Ebola treatment unit, which ended up taking care of a high volume of patients in that environment. But it was also a different consideration because we didn't have to work around existing structures. We just essentially built what we needed to on the right side of the back right side you end up seeing that can be suspect word where patients enter Ebola treatment units are all about flow and or managing infectious disease or kind of highly contagious pathogens. It's really all about how we move people in and out. And to me, that's all about designing the care environment. So we really thought a lot about suspect and confirmed word for those patients and really thinking about how we set up that flow in an open space consideration. We were blessed with some pretty amazing sunsets in that space as well, but you can see we just created this all out of nothing. These are some of the workflow areas. And then here we come to COVID-19 and it's a really different consideration thinking about managing a global disaster at home and the different things that we need to set up in those considerations, particularly thinking about existing structures and existing workflows that then we have to work around. I think as we started, we were working on some of our mobile testing, access to testing and the contagion consideration was major. We started this early mobile testing site. And again, this was an existing parking lot. So that was a little bit easier to think about how we were going to design that space. It was a bit of an open consideration once we found it. We shout out obviously to the design team and the co-lab trailer who ended up playing a pivotal part in our walk-up site in that area as we kind of designed workflows for both drive-up and walk-ups. I think the city aspect of the considerations around surge planning for us were really major and how do we get people in on foot and how do we manage volumes in a really fixed environment? We evolved those structures over time in terms of weather and other considerations that we came upon in the mobile testing environment, but then thinking about where we were gonna manage patients because of some of these flow considerations and working around existing structures was a really big challenge for us. So this is our valet area for the emergency department at Jefferson. And we had to think of this is the only space. You can see the ceiling there actually was a major consideration and the type and size of a tent that we could fit in that space and trying to work through, okay, where's the drive-in? Where are we redirecting traffic? Where can people enter and exit? Matt, shout out to Matt who helped us with one of these additional design, thinking through the workspace. How do we make sure we have patients six feet apart? And then as we thought about actually operationalizing these, it became more significant working on flow. We ended up working with some of our architecture colleagues that I work with in the global space actually to think about the patient flow in and out, who were the existing workflows of patients that were coming into the department and how do we think about similar that one-way traffic? We don't want suspect patients kind of coming by other patients coming into the emergency department. And so I really in this role had to put on the, I think design thinking hat with a lot of my colleagues to try to work through some of these considerations. As we were seeing things evolve in the region, particularly the New York caseload and wondering how we were gonna manage potential major surges. We were even going into spaces like our parking garages trying to determine how we would repurpose them. This was an example of an amazing repurposing that we were thinking of as a model in a lot of groups that were using kind of garages or underground structures to create surge capacity. We were in a lucky situation where we were actually able to move this show inside. And that's where I'll let Effie kind of take over and talk a little bit about responding within the existing structures in our emergency department. All right. So hi guys, I'm Effie. Gonna share my screen as well. I just have some pictures to share with you guys. So this is our current, I think current iteration of our sort of process map for where patients go through the ER, how their triage, where we send the people who are PUIs or people under investigation for COVID-19 versus where we send the people who are in the ER for other reasons. This is one of many iterations of this. So this is just a screenshot of my computer and every single file, except for a couple of pictures that you see is a different version of this process map and all of these were made within two weeks. Every day, the tests that were available to us changed. The timeline for how quickly they came back changed. The number of patients changed. The locations we were putting them changed and the volume changed. So with that many degrees of change every day, some of these I made actually before we knew what was going to happen or any kind of contingency scenario that we could think of. So I have, I mean, more than this, I have, I think, 20 or 30 of these just on my computer waiting. Similarly, at the beginning, we worked with our design team to make this chat bot to interface with the public and help people assess their own risk of having COVID or how sick they were and whether or not they needed to come to the emergency room. It was a really great effort and people loved it and it got used by, you know, over a thousand people just within the first week or two but it was almost immediately obsolete as soon as we posted it because the testing criteria and the tests available changed so quickly at the beginning. And it was really not until the last couple of weeks where we really got to a steady state. Sort of on the interior side in the ER, we had to divide the ER into a co-ordered area for possible COVID cases and then another area that was relatively clean, I guess initially we were calling them hot and cold zone, but then we had a concern that people would think that the cold zone didn't have any risk of having any COVID patients. But then it became hot zone and less hot, low risk, you know, hot zone and not as hot zone because really with this type of illness, it could be anywhere. So we made these signs to put out front, to divert EMS to a different door when they were coming through with suspected COVID patients and kind of divided the ER with barriers to try and keep a certain area, I guess a little cleaner or a little safer. With that, we kind of had to do really rapid training of our entire staff on different PPE. So we had videos and protocols and reminders and science posted on how to use the PAPRs and how to use N95s, that appropriate donning and doffing, kind of trying to deal with the difficulty of training a very large group of people to do something that's technically rather complicated with all of the donning and doffing and making sure you're doing it completely without actually being able to gather those people in a space and teach them and observe them doing it because they look the same together. This is just a picture of our PAPR hood storage room. This room for as long as I've been at Jefferson has been completely empty and is now completely full of PAPR hoods and everyone who's been there can get kind of actually a haunting image of this time with all of the supplies that we're using to keep ourselves safe and how quickly everyone learned. Along with that, there was a lot of discussion about PPE in just treating patients and also PPE and protective strategies when doing high-risk procedures in the emergency department and the highest procedure of all that we do is intubation where you're physically in very, very proximity to a patient's airway. So we built this airway cart with all of the supplies and then we made these roles that contain very easily and rapidly accessible all of the supplies that we may need so that when a patient comes in and they're extremely ill and need to be intubated quickly, you can get all of your protective equipment on and not have to waste time finding all of the appropriate equipment because you know that it's all right there. So this is just one of those seemingly small innovations that actually made a real difference and how quickly we're able to provide critical care in the safest way possible just by having everything easily available. The other big consideration aside from you know preparing the inside and surge spaces for where we were going to treat patients is the other surge plans for staffing. This was something that me and Morgan and Jen White and Trish and several other people worked out very early on in the outbreak and it's almost a little chilling. It's just our surge plan for what happens if different numbers of emergency physicians get sick and can't work and who would have to staff the emergency department so we could continue to provide care to patients even if you know many or even most of us were sick and unable to work. Fortunately, we didn't ever have to use any of this really. We stayed in level one throughout this outbreak so far. You know, nobody really knows what's going to happen next but we spent a lot of time working out plans for worst case scenarios at the beginning. And similarly we- I just want to tell you we have about one more minute left. This is my last slide. Cool. So this is our final surge plan of what to do when despite all of this preparation, all of the surge staffing planning, all of the surge spaces, the tents in the garage and the interior space, what to do when all of that is full and we still have more patients coming in. So another thing which never happened. So this was our planning for how we could provide care for patients at home when we couldn't admit them to the hospital because the hospital was small. A small and less extreme version of this has now been deployed where we're able to discharge some patients with pulse oxides and some monitoring equipment at home but we really never got beyond phase one with this either. We just have all of these surge plans and we may continue designing if there's another surge in the future. Did I fall out yet? That is awesome. Thank you Trish and Effie. You guys have really done so much to make the emergency department a safer place and I really appreciate it. I know my colleagues, Bon and Morgan and all of us really do. We actually were just all in the emergency department this morning. Bon and Morgan believe it or not, were at the overnight and I came in for the morning shift. I actually am just, I'm actually in a hotel right now because I just checked in because I'm doing a run of shifts. I still have some marks on my face for my shift this morning. And sadly, COVID is not gone. On my shift today, I had a number of sick COVID patients and a lot of us kind of Memorial Day weekend saw everybody at the beach, thought maybe it was over and yeah, fortunately I hate to be like Debbie Downer but I wanted to get the message out there that it's still not gone. It's still here and that's why all of this thinking and designing and strategizing and sharing and collaborating is really important. So thank you guys so much. I actually do have some good news though. On my way home, I stopped and I was able to acquire a Boudino, D'Afghano coffee or Afigeno coffee. I know I've been going on about this for the last three weeks. So everybody, I want you guys to know I finally acquired it. And I'm so happy for you, Matt. I knew them like, you know, like I said last week I've been hearing about this every day so this is like a big moment. Yeah, yeah, it's everything I hoped it could be. So I'm going to be enjoying that. And I think we're going to go ahead and take a time, move on and jump into breakout rooms. So everybody, video's got to be on. So please turn it on and this is where we get to really chat one on one with people and meet new people and make some connections. So Rob, take us to the breakouts. All right, here we go. One, two, three. All right. Wow. Welcome back everybody. That was amazing. Great break out room. Yeah. I met some really cool people. That was fun. Morgan, did you? Absolutely, totally. Like, well, Chrissy Shine was in my breakout room. So I mean, they even have to go beyond that. But yeah, Kevin and Bobby it was like a really good conversation about what's going on and COVID and kind of addressing some of other things that we haven't had a chance to talk about yet on the show, but we are looking forward to. Yeah. It was great. Some folks got kicked. Sorry to the folks who got kicked out at the beginning of the breakout rooms. I don't know why Zoom likes to do that, but welcome back. We missed you. Yeah, Zoom bugs and glitches and we're all trying to get through those in this pandemic. So all right, we're gonna jump to our next guest. So speaking of the importance of design, our next guest is Eden Lu. She is a designer from Texas with a broad body of work consisting of graphic design, UX, UI, packaging, furniture, architecture, exhibition design and design strategy. She does it all. She's a great friend of the lab and has collaborated on a lot of cool projects with us. Eden, happy to have you with us. Thank you. I'm gonna share my screen and see if this works. Yeah, so do you guys see my screen or do you just see like the keynote? It looks good. We see your screen. If you have played it, it'll be good, yeah. Cool, okay, cool, yeah. So thanks for having me, you guys. I love working with a health design lab on all kinds of projects. And so I'm happy to be here sharing what I've been doing as a graphic designer. So for the past month, I've been working with this group called Last Mile PPE, which is this national group of volunteers that helps source and deliver PPE directly to frontline healthcare workers who feel like they don't have adequate supplies coming from their own facilities. And this all started with this tech ethnographer. Yeah, I don't even know what that is, but her name is Trisha Wang and she had lived in Wuhan years ago and noticed that their communities had these hyper-local groups that were formed to help each other out with like medicine and supplies. And so in times like these, when we can't rely on top-down measures to help us, it becomes the role of the community to just help each other out. So in Brooklyn, she joined a WhatsApp group to see how this community could get started in her own area in Brooklyn. And it always starts with a single need, somebody needed masks, but then somebody else has masks and somebody else is generous enough to deliver those masks. And it just keeps going, right? Like more people needed more masks for their teams and people knew how to source hundreds or thousands of masks and more volunteers were like, I can bike, I have a car, I'll drive supplies to hospitals. And so they really rapidly, like within days, needed to organize into this grassroots network. And they needed to start fundraising. And so they started reaching out to other GoFundMe's in New York City about like, hey, let's pull together our fundraising so that we can buy bigger supplies. And they got this data wrangler named Betsy Bentley who created this amazing air table form and really robust form to get healthcare workers to sign up and tell them about their needs. And then they even have like an entire group of verification callers who would call every single request to talk to the healthcare worker about what do you need, where are you, how do we get this to you and how many masks are you getting per week? And then they also started writing all of these policies, right? How do we know that the PPE we're sourcing is good and valid? How are we going to manage this entire team? How are we going to function as a team? And then they had like tons and tons of bikers who were up to the challenge of like going around to, they had these dispatchers who like sort of allocate, like, okay, we need somebody to pick up this PPE from this warehouse and we're going to deliver it to this team at this hospital so it's like a crazy, crazy supply chain that was created. So within two weeks, they had delivered 40,000 masks around New York City and at this two week mark, this is kind of where I came in. I was not part of any of that and I was just a graphic designer at home being like, how can I help? And one of my friends working in this group, her name was Shin, she said, hey, our organization needs a logo. So I was like, that's the least I can do, right? I can help make a logo. So I came up with this symbol of like, they're the final leg of the supply chain. They're overcoming barriers. They're actually on the road. And after I made a logo within like 20 hours, it was a really, really quick sprint and like all their brand assets, I was like, well, how else can I help? I saw that they had all of these crazy documents because it's a grassroots, like everything's always changing and their structure is always changing. So I was like, wow, that's a lot of documents and new volunteers were coming in and getting faced with this. And so it was a problem that they couldn't retain volunteers because it's just like, this is overwhelming. So I started doing really small things like let's just make a guide and open source guide directory. This is the least I can do. They started making crazy, crazy system maps and it's always changing, right? Because you're always adding like a new partner and new thread or a new role. And so I was like, well, okay, we'll try to like, how can I visually clean this up so that somebody new coming in on the team can kind of understand the big picture quickly and then get to their role and get something done. And then we got other designers to come in and help us too. We got a web designer named Chloe Chang, Mark Nakamura and Wang Zhenghong, they helped create these brand assets that are traditional like branding elements, right? We got an amazing illustrator to sort of really humanize this brand that was coming forth. And now, today, I don't even know how much PPE we've been able to deliver and supply, but it's spread all over this local group and in New York, it's this national. We have this national team like supplying and sourcing a lot of PPE and then sort of distributing out to all of the areas in need. So kind of came up with three takeaways for this from my perspective. Sometimes I think graphic design is like being a design janitor. You know, at Double Take Labs, which is my company, we always say that design can help break down barriers to complex concepts. And so I saw this as like a way for me to just, you know, help them clean up something, help make sure that everybody has the information and they can access that information really quickly, whether they're an internal volunteer or they're a healthcare worker just trying to find a way to get more supplies. You know, as a graphic designer, I love data visualization. There are data visualization by Georgia Lupi and data lands. If you don't know them, you should look into them. They're amazing designers that just take data and really tell human stories through it. And as much as I wanna be like beautifully flashy with data as well, we do everything off Google Slides and Google Sheets. And so really trying to figure out like what, how do I use this tool to be just as effective with the data that we're taking from the request form? So we're just trying to be really simple and really open source so that everybody on the team can use these and they can tell these stories like simply and beautifully. And finally, kind of what I saw as a role for graphic designers and visual designers is that we're making these tools to support others. I love working with everyone that I've met for like just a month online virtually because they're so excited and that's kind of what keeps me going is like if I can just help them make a presentation that can get more money from like a fundraiser or just make a chart that helps like 100 more people better understand what their process is, what their needs are, what their problems are then that could be something great. So yeah, that's all I have. Thank you so much, Eden. That was amazing. We've been really excited to have you on the show. Graphic designers are like design generators. That is like such a good line. I mean, that might be the best line so far from our show. It was really interesting to hear about that and that's what we've seen. I mean, what you are talking about, designers like stepping up to volunteer to time, volunteer to effort, volunteer their creative abilities has been like such a huge game changer for us. And so I think that's just, I mean, I think that's why we have this show and so it's really cool to hear from you. Yeah, thank you for having me. Yeah, no, and I completely agree. And oftentimes I feel that as a physician, I'm in the position of trying to present information and I've already learned so much from some of the projects we worked with you on how poorly I present information, especially to different audiences. And so I think it's really great to know you and connect with you to learn how to do that better. So thank you so much. I think we're gonna go ahead and jump into, I think we're a little like where time is going fast because this is just such an awesome group. And so I'm gonna jump into our next guest who is Mike Natter. And Mike is an artist and a physician and he was a medical student at Jefferson where I am proud to say I commissioned him to do some artwork for an event I held before he was mike.natter on Instagram with 100,000 followers. So hopefully that makes me rich one day and I reap those rewards of having that vision. But he's created tons of impactful art pre and post COVID that has influenced people inside and outside of medicine and he is just a really cool guy and somebody that I think everybody should know. So Mike, great to have you with us. Tell us about yourself. Matt, thank you so much. I'm truly honored to be here. As Matt was saying, so I went to Jefferson, I was really fortunate to get into Jefferson. My background's in art. So I went to art school, I ended up doing a post-back pre-med program. My childhood diagnosis of type one diabetes kind of led me to medicine overall. And when I was at Jefferson, I felt a little bit ashamed of my background. I kind of hit the fact that I was an art kid. I felt horrible imposter syndrome. I didn't think I belonged. But it was really my artistic background and my observation and my skills as being able to really observe and see and kind of use what I saw as the visual language. I was literally translating medical concepts that were very difficult to digest into my own visual language to help me really understand. And I was really fortunate that places like Jefferson really accepted that and championed that. And I was able to kind of work with Rob and Bon and the help design lab and kind of see that really kind of take shape as I was starting to graduate. I'm now currently in my last year of the digital medicine residency at NYU. So I've very much been kind of in the front lines of seeing really horrible stuff unfold. And I really truly believe that it's in times like this, in times like crises where there is no chapter in the textbook of how to treat this illness. There is no playbook. No one's done this before. We're creative types, designers, graphic designers. All of the creative types are the ones that are able to think outside the box. They're able to see the problem and then utilize a creative approach to do so. The way that I kind of look at my art overall is I think art in general is kind of for me is falls into three categories. It's really hard. It's just communication. At the end of the day, art is a really unique way to communicate. And I was really blown away by everyone who spoke so far but Eden's work is really phenomenal. I love the phrase that she uses as janitor. But I don't want that term just makes it, it takes it down. It's so much more than that. Like you're able to use your art and your design to clean things up, to make things communicate so well. So I would use it more as your designer, that that in and of itself is really phenomenal. So for me, art is communication. Art's also didactic. So I use art to teach myself medicine but then I also was using it to teach, right now I teach medical students, I teach my patients, I teach my co-residents, I teach my interns. And by drawing, it's the actual process and not so much the product. So I always tell my colleagues that aren't so good at art and can't draw as well. To really go for it because it's that pathway you take in your brain, that process you use that helps you really understand the material. And it also creates a rapport with whoever you're trying to teach to. So whether that be a patient or your medical student or whoever it may be, I think there's something to be said about that process you take. And then art is also as catharsis. So what I'm really here to talk about today is kind of what I've been doing for my own catharsis in trying to find the words that don't exist for what it's like to be on the front lines, to see this horror unfolding in front of us. I am technically not that inclined. And so I sent over for my illustrations over to Bonn and I'm hoping we'll be able to share the screen. I'm gonna share the screen, is that cool? Okay, of course. Just tell me when to go. Mike, you sent it too, but also a technical one. I know. Let's see if this works. All right. Can you guys see that? Yeah. All right, cool. Yes. Bonn saved my butt so many times I can't tell you. There was more time I'll tell you other stories. I love Bonn. You're amazing, Bonn, thank you. So what I started to do was I was working these crazy hours in the hospital and I was seeing some horrible stuff and I didn't have words to really express what I was going through. I was exhausted and I just didn't know how to kind of encapsulate it and to compartmentalize and to express myself. So I do what I always do, which is I draw. And I started to draw the images that were kind of burned into my mind, so a lot of those images were really my colleagues, my colleagues who were in their PPE. It's very weird to be a physician who's used to your face-to-face with your patient. Like what we're doing now is very antithetical to our training. Our training is to be at the bedside, our training is to hold their patient stand to learn their story, to examine them, to do physical exams. We are flipping that on its head where we're trying to spend as little time with them in the room as possible because they're so infectious. So we become these faceless kind of astronaut monsters and there is so much empathy and so much humanism behind all of that. And so I was really trying to kind of get that across, that there is this fear and this heroism and this bravery but also this humanism that exists. So this is the first piece that I did that Bonn just put up. This is a piece of a colleague of mine. She's a nurse on one of the COVID ICU units. And what drew me to this image was she had posted this image on her Instagram and her eyes to me really just kind of took hold and told the whole story. And I wanted to use my platform to not really express myself as much as to tell their stories as well. So I asked them to give me an anecdote about what it was like these past few weeks, these past few months. And so I would put their story in my hand right behind the image to kind of help convey that image. And Bonn, you can just go through some more. So then I started to have like depending on what rotation I was on I started to have a little bit more time. So I would take a little bit more time to hatch and really get into these. And again, it's really these, the eyes that would draw me in because the rest of the face is so obscured but the eyes were really telling the entire story. And then I was recognizing when we were being fitted for Pappers and Cappers and N95s and all of these, the PPE. I felt this sense of being called to war. I felt this sense of what it would, I imagined what it was like in the 1940s when you wanted to sign up and go, you know, get fitted for your rifle and go to basic training. It was petrifying, absolutely petrifying. But also it felt like I could finally do some good. I was honored and privileged to have the training to be a physician to actually do some to help. But having that kind of trope of, you know, war and that analogy of war was also very much I felt that very, very heavily. And then I really wanted to, you know honor my classmates and my co-residents. So I wanted to do a piece about them. And so I was juggling between putting a quote of, you know, the Hippocratic Oath behind or I think this one was actually a quote from Churchill and during World War II that I ended up putting in the back there. Oh no. And you might recognize this guy. So Bon has always been just such an inspiration to me and I'm sure to so many others but he very much is the trailblazer and is straddling the two worlds that I am so passionate about which is really art, design, and medicine. And, you know, seeing what he was going through from the designer's perspective but also from an ER physician who are the ER, you know, the ER staff are truly the front lines of this whole war. And so I really wanted to kind of honor him in doing so and he was very, very kind and gave me some quotes and some images to work from. Thanks, dude. That was cool. Yeah, Bon. This is a friend of mine who's an ER nurse here at NYU who herself actually contracted COVID was out for a couple of weeks. And I actually think that is the fear. And I think it was, it was either Trish or Effie was talking about the staffing for what happens if we fall ill? Like what do we do if our staff become sick that we can't help others? And that for me was like the weird trigger. That was the fear of having to take care of my coworkers and seeing people get sick. I think that was of all the things that scared me that was the most fearful. And so seeing her get sick and then get better and come back, I really just wanted to kind of honor her and tell her story with this image here. Again, another nurse was working on the COVID ICU and her story was just kind of unfortunately a little bit more emotional. She was exhausted and she had that same fear that I think we all had and she was much more vocal about that fear. And this is another version in color. And then this is a colleague of mine actually in LA. So this is a first year internal medicine resident who went to NYU medical school. So I became friendly with her before she started. The idea of starting your training as a physician in this time I think is extremely difficult and jarring. And I think there's a level of trauma that it gets sewn into what it's like to be a doctor. And I'm fortunate that I've had my residency. I'm a month away from graduating. I just couldn't imagine starting residency with this kind of pandemic. And then I played with a little bit of graphic medicine or what is known as graphic medicine which is kind of the combination of a graphic novel telling a medicine type narrative. And again, this kind of plays on the tropeism and the analogy of what it's like to go to the war. And at the end of every day, our program director would email us and at the end of each email he would leave a quote or a phrase or something that I was trying to be uplifting. This is the last quote that he had left. And it just was so, it was very touching. It was very, it like rallied the troops and I wanted to kind of capture that sentiment and with some images as well. And then this is a series that I did after coming back from a rough stretch of nights and this idea that we have these routines where we have to decontaminate ourselves. And so when I would get home from the hospital I would take everything off to my front door before I would walk into my tiny apartment. And then you'd wash everything off feeling like you had this invisible enemy on you. And then it was in the shower when I realized that no matter how much you scrub and how much you wash there's an emotional weight that invades and infects you that you really can't get rid of. And so kind of sitting with that in this last image here, the next one that Bob's gonna go to was like this weight that I was kind of trying to unload so that I could fall asleep for the day to then go back to work that night. And it was kind of this spiral of emotion that I was going through to that realization that these seeds of trauma are really so pretty deep. All right, is that the last one? Yeah, so really, really, really appreciate you guys having me. It's truly an honor. And I hope that I was able to give at least a lens of from someone that's not quite a designer not quite an artist and just almost finished with residency and very grateful for that. Mike, we are like so lucky to have you. Thank you so much for coming on. I am a huge fan of your work. I actually have a vintage Mike Natter t-shirt that you made one day back in the day for Ultra Fest. So actually, I'm realizing I should have worn that, but you know, I don't know the grade. But thank you so much. I mean, I think that like as a doctor, one of the things that people are always asking us is what is it like, you know, in COVID? And it's like, it's so hard to describe that in words and you do such a good job of doing that and just an image and people get it. You know, I've actually shared images like that with my family and they like understand in a way that they don't understand when we have conversations. So that's really cool. We're gonna go now into, yes, of course, we're gonna go now into a second chat, second breakout room. We're gonna do five minutes and then we'll come back together to wrap it up. All right, everybody. If you get kicked out, just come back in and I'll put you in a room. So see you soon. Rob, that was not five minutes. I know that was totally like one minute. Was that? That was our guys five minutes. I know. Well, you know, short of making this a two hour session, you know, happy hour is very special and sacred hour long session. I would like to conclude with asking, Christy Schein, do you have... Wait, can I just interrupt real quick? Can I give a shout out to Rebecca Steele? Your baby is so cute. Oh my God. Oh my God. Yeah, okay. Thank you for finding that out. I'm really glad that you did, actually. Can I just give a shout out to our guests from different countries? There's Pascal from Australia. I think it's like seven o'clock in the morning there. Michelle from Dublin, Cassandra, and Marina, both from Mexico, Minka from Winnipeg, Canada. Wait, don't forget the crew from Toronto. Toronto, there's so many Canadians here. Thank you. How about the West Coast, California? Oh, my, my, my, my, my, my, my, my, my, my, my. Totally. Virginia. We've been like so lucky. We've got such a, you know, such a geographically diverse group of people here and it's been really cool to hear from all of you and we've had so many great ideas that we're looking forward to incorporating into the next several weeks of the show. So I think, oh yeah, let's just do one question. So Christy, do you wanna give us one question that you think came up that we could ask the group or to the speakers? Hopefully she didn't get kicked off. Oh, she got kicked off. She might have gotten kicked off. Well, we're gonna end up next week then. All right. Well, then if that's, if she's, Christy, if you- I was just muted. That's all I had on mute, I'm sorry. Thank you for giving me a voice, Rob. So yeah, we had a couple of great questions come up. A lot of the questions sort of spoke to what people's inspirations were for their projects. So one of them came up for Effie in particular. Effie, can you tell us, what was the inspiration for the intubation role that you did? So I think Alana had seen, Alana O'Connell, who's one of our medical education fellows. I don't know one of my co-attendees had seen and Liz Krebs, who's also one of our faculty had seen something relatively similar online from a different university. And then we just kind of adapted it because we just using what we had in the ER. So we pulled some checks out, which are kind of like the sanitary pads that we used for patients and just taped everything to them because it was what we had on hand. If I could also just say that I want to steal that for what we have at NYU because it's brilliant. It's been stolen by several others already. It's absolutely brilliant because we have these clunky orange toolboxes that get there a mess and when we have to two people we're like sifting through these left and right. I think it's brilliant, so we might steal this as well. Awesome. This is our goal is to give you just like little tidbits of excitement. And at the end of the day, when you all tell us, we know I wish I had more time to do this than that. It's one hour and we want to give you as much as we can. And Rob, I see that you are sharing your sound and take it away. Thank you guys. We'll see you next week. And everybody, bring a, have a little toast here. Cheers. Another fun week. All right. Cheers everybody. Have a good weekend.