Hot Spot

Alex Jahangir

Description

When Nashville identified its first case of coronavirus in March 2020, the city was between Public Health Department directors and as unprepared as the rest of the world for what was to come. Dr. Alex Jahangir, a trauma surgeon acting at that time as chair of the Metro Nashville Board of Health, unexpectedly found himself head of the city's COVID-19 Task Force and responsible for leading it through uncharted waters.

What followed was a year of unprecedented challenge and scrutiny. Jahangir, who immigrated to the US from Iran at age six, grew up in Nashville. He thought he knew the city well. But the pandemic laid bare ethnic, racial, and cultural tensions that daily threatened to derail what should have been a collective effort to keep residents healthy and safe.

Hot Spot is Jahangir's narrative of the first year of COVID, derived from his op notes (the journal-like entries surgeons often keep following operations) and expanded to include his personal reflections and a glimpse into the inner sanctums of city and state governance in crisis.
I am an orthopaedic trauma surgeon. I specialize in intimate disasters defined by blood and broken bodies. Show me somebody whose every bone is shattered and I will know what to do. Show me somebody whose life is draining away, and I will remain calm, reminding myself of a saying in trauma surgery: all bleeding stops. I have spent years training—and training others—not just to fix, but to heal: to help people move past shock and damage and reenter their lives again.  
 
In 2020, I became both doctor and patient. I was shown a city whose every norm was shattered by the worst health crisis of our time. By virtue of fate and circumstance, that city—Nashville, Tennessee, where I had immigrated from Iran as a six-year-old child—looked to me to decide what to do. I didn’t know. I lived in that city with my wife and young children, my parents, grandmother, extended family, colleagues, and friends. Nashville was part of me and I was part of Nashville. I was shattered too.  
 
In this we were all the same. Leaders of nations, leaders of states and cities, leaders of companies and congregations and schools, parents of children, essential workers, rich and poor, young and old, solitary souls living in cavernous houses and generations crammed together in tiny apartments. In the early days of the pandemic, we were all stunned and scared by what we didn’t know.  
 
My hometown asked me to help figure it out. Given my position in March 2020 as the chair of the Metro Nashville Board of Health, the mayor asked me to lead the Metro Coronavirus Task Force, later known as the COVID-19 Task Force. Like everyone working with me, I was initially at a loss. But I was able to join with some of the best minds and hearts I have ever met, and together we did the best we could.  
 
We needed to move mountains, and some days we did. We were able to accomplish things on behalf of Nashvillians that—sometimes mere hours before—had seemed impossible. On these good days, I felt myself part of something larger, more powerful, and more consequential than anything I’d ever experienced. I walked in the clouds with my compatriots, both humbled and proud to be a human being and an American—living in a country with a singular capacity for ingenuity and innovation.  
 
On other days we failed to move anything in the right direction, much less mountains. On these days I cursed my feet of clay and my limits, particularly my naivete and ignorance of the interdependent and complex systems that make our cities work. I also sometimes found myself helpless as competing interests attacked each other and attacked me, or as selfishness and fear overcame our better natures, or worst of all, as politics rather than people’s needs drove decisions.  
 
On the bad days, I was filled with sorrow, frustration—and something more, something unfamiliar. I had known sorrow and frustration. I had known failure. I had struggled to save people’s lives and lost them when their injuries proved too much to overcome. But I had never known anger like the anger I felt when people who had the power to help solve the massive problems of the pandemic refused to do so, preferring to duck and posture and blame and lie, then leave local officials and volunteers like me to deal with the fallout.  
 
It was weird to be Nashville’s hero on the good days and Nashville’s villain on the bad ones. I wondered how a guy like me—a classic striver who grew up trying to make good on my opportunities—wound up becoming either one.  
 
 
Foreword by Dr. James E. K. Hildreth
Introduction
Surge 1: March 8, 2020–May 31, 2020
Surge 2: June 1, 2020–September 30, 2020
Surge 3: October 1, 2020–March 7, 2021
Epilogue: Surge 4
Notes

Sujets

• Public Health
• health
• Medical
• Médecine
• América
• Trump
• Hildreth
• Council
• American
• Caldwell
• March
• Coronavirus
• Swann
• Joe Biden
• Guimbarde (instrument)

Informations

• Publié par: Vanderbilt University Press
• Date de parution: 15 septembre 2022
• Nombre de lectures: 0
• EAN13: 9780826505088
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Hot Spot
Hot Spot
A Doctor’s Diary from the Pandemic
Dr. Alex Jahangir
with Katie Seigenthaler
VANDERBILT UNIVERSITY PRESS
Nashville, Tennessee
Copyright 2022 Vanderbilt University Press
All rights reserved
First printing 2022
Library of Congress Cataloging-in-Publication Data on file.
Record available at https://lccn.loc.gov/2022002696
ISBN 978-0-8265-0506-4 (paperback)
ISBN 978-0-8265-0508-8 (epub)
ISBN 978-0-8265-0509-5 (PDF)
For Helen, Layla, Kate, and Elise .
Thank you for your steadfast love
and support, the foundation for everything
I do and the north star for how to do it .
CONTENTS
Acknowledgments
Foreword by Dr. James E. K. Hildreth
Introduction
SURGE 1: March 8, 2020–May 31, 2020
SURGE 2: June 1, 2020–September 30, 2020
SURGE 3: October 1, 2020–March 7, 2021
EPILOGUE: Surge 4
Notes
ACKNOWLEDGMENTS
As I think about all of those who did their part to help our city during the first year of the pandemic, or helped me personally, I realize it may be impossible to give everyone the acknowledgment they deserve. But I’m going to give it a try—and ask forgiveness in advance from anyone I’ve inadvertently overlooked.
My deepest gratitude and thanks go out to:
First and always, my family. Helen, Layla, Kate, and Elise, as well as Padar, Maman, and Maman Doctor, are the heart of this narrative. But I am part of a much larger clan. All of my aunts, uncles, and cousins encouraged this effort. I am especially indebted to my brother, Eiman, and my sister-in-law, Amber Solivan. They were always there to support Helen and the girls during times when my responsibilities to the city and my patients took me away for too long, and their son, Darius, is like a brother to Layla, Kate, and Elise.
The people of Nashville. It never ceased to amaze me that, despite it all, most Nashvillians continued to rally round and support each other. They certainly supported me. Many times, strangers stopped me to say hello and provide words of encouragement when they saw me out in public. They lifted me up on my darkest days, and I will never forget them.
Nashville mayor John Cooper, who placed his trust in me and gave me the opportunity to serve, as well as his extraordinary staff. These stellar individuals include deputy mayors Brenda Haywood and Bill Phillips; staff members Fabian Bende, John Buntin, Ben Eagles, Mary Falls, Robert Fisher, Mike Jameson, Katie Lentile, Chris Song, and Kristen Wilson; and Metro’s legal department, specifically Bob Cooper and Derrick Smith, whom I relied upon continually for advice.
Vice mayor Jim Shulman and the members of Metro Council. They consistently prioritized the needs and requests of Nashville’s Metro Coronavirus Task Force (later known as the COVID-19 Task Force) even as they made clear the issues of most concern to their constituents across the city.
The women and men of the Metropolitan Public Health Department. Their unselfish commitment to their responsibilities unquestionably saved countless lives during the first twelve months of the pandemic, and still does today. Dr. Gill Wright and Tina Lester led the department through the most challenging time in its history; Brian Todd and Matt Peters ensured accurate and up-to-date information was always available to the public; and Hugh Atkins, Rachel Franklin, Josh Love, Katie Schlotman, Tom Sharp, Dr. Joanna Shaw-KaiKai, James Tabor, Laura Varnier, Leslie Waller, and Hannah Wilson were constant sources of support for me during the timeframe covered by this narrative.
Chiefs William Swann and Jay Servais, and the men and women of the Nashville Fire Department and the Office of Emergency Management. They always answer the call to keep our city safe, and I am particularly grateful for the support the Task Force received from Kelly Caffery, Kendra Loney, Heidi Mariscal, Joseph Pleasant, and Rodonna Robinson.
Dr. James Hildreth, Patrick Johnson, and the professionals at Meharry Medical College. The college’s contribution to pandemic mitigation was incalculable, and Amber DuVentre, Dr. Cherae Farmer-Dixon, Dr. Julie Gray, and Dr. Theodora Pinnock represent so many Meharrians who fulfill Meharry’s mission to serve the underserved.
The many leaders of Nashville’s healthcare systems—Ascension/St. Thomas, HCA/Tristar, Nashville General Hospital, and Vanderbilt University Medical Center (VUMC). They cultivated and continue to maintain unprecedented partnerships to ensure everyone in our region receives the care they require no matter the course of the pandemic. They include Tim Adams, Dr. Jeffrey Balser, Dr. Deann Bullock, Mitch Edgeworth, Chad Fitzgerald, Dr. Edmund Jackson, Dr. Greg James, Lindsay Miller, Dr. John Morris, Dr. Wright Pinson, Heather Rohan, Dr. Stephan Russ, Fahad Tahir, Dr. Tama Van Decar, Dr. Joseph Webb, and Dr. Brian Wilcox.
The exceptional professionals with the State of Tennessee. In addition to my trusted counterpart Commissioner Lisa Piercey, MD, these include Brigadier General Scott Brower, Diane Dubinski, Dr. John Dunn, Dr. Mary-Margaret Fill, Dr. Michelle Fiscus, Dr. Tim Jones, Dr. Morgan McDonald, Dr. Jill Obremskey, Dr. Paul Petersen, Patrick Sheehan, and Mario Vigil. All were critical to the Task Force’s capacity to serve Middle Tennesseans.
The stellar educators who lead our region’s public and independent schools. In particular, Dr. Adrienne Battle, Hank Clay, Todd Dickson, Dr. Vince Durnan, Bradford Gioia, and Rebecca Hammel brought extraordinary creativity and problem-solving skills to the task of educating Nashville’s children regardless of the unprecedented challenges the pandemic posed.
My colleagues at VUMC. I could never have taken on my additional responsibilities to the city without the support of my Department of Orthopaedic Surgery colleagues, outstanding professionals and even better people. In addition to our department chair, Dr. Rick Wright, this includes my partners in the Division of Orthopaedic Trauma, Drs. Robert Boyce, Phil Mitchell, William Obremskey, Manny Sethi, and Daniel Stinner; as well as our team of advanced practice providers, Greer Henry, Melissa Lasater, and Meghan Rees. I also leaned heavily on the following colleagues to inform the Task Force’s response: Dr. David Aronoff, Dr. Karen Bloch, Dr. Melinda Buntin, Dr. Kathryn Edwards, Dr. John Graves, Dr. Marie Griffin, Dr. Kris Rehm, Dr. Kim Sandler, Matthew Scanlan, Dr. William Shaffner, Dr. Tom Talbot, Dr. Lisa Weavind, Dr. Consuelo Wilkins, and Dr. Patty Wright.
The public relations professionals at FINN Partners. Prior to the pandemic, I had never spoken at a press conference and had very little media and communication experience, skills that were crucial to an effective pandemic response. The team at FINN taught me how to clearly and thoroughly explain the Task Force’s decisions to the public, especially in the midst of crises. The team’s leaders were Amy Seigenthaler, John Seigenthaler, and Pat Warner, with crucial support from Abby Brown and Kate Raley McIlroy.
Butch Spyridon of the Nashville Convention and Visitors Corp, a model for me of civic dedication and diplomacy, as well as compassionate commitment to the city’s first responders and healthcare workers; Lisa Quigley of Tusk Philanthropies, one of the most intelligent and talented people I know and a font of consistent wisdom whenever I need advice; and Senator Bill Frist, who represented Tennessee in the US Senate from 1995 to 2007, and whose mentorship and friendship were unexpected benefits of taking on the Task Force role as he provided insight and advice that made for better policy at every turn.
My co-author Katie Seigenthaler. She took an idea that initially was a composition book full of scribbled daily notes and helped me develop it into a cohesive story of my experiences leading Nashville’s pandemic response from March 8, 2020, to March 7, 2021. And we had a great time in the process. Hers is one of the most cherished friendships of many I developed during one of the most consequential times of all our lives.
FOREWORD
Dr. James E. K. Hildreth
Many of us were intimately involved with Nashville’s Metro Coronavirus Task Force as the city battled the pandemic’s first devastating surges. We still are. The Task Force remains in place. It will remain in place as long as the pandemic persists in its disruptive course across our communities and our lives.
But a distinctive character of openness and action has defined Nashville’s pandemic response because Dr. Alex Jahangir is at its helm. Immediately after the city’s department of public health confirmed the first case of COVID-19, Dr. Jahangir jumped into the fray in his capacity as chair of the department’s volunteer board by putting pen to paper to sketch out a citywide pandemic plan. It was a decision both unsolicited and essential. It led Nashville mayor John Cooper to ask him to be the face of the response, a position guaranteed to open every aspect of his life to scrutiny. Nonetheless, he poured all of his considerable energy and intelligence into the awesome responsibility—not by dictating or commandeering, but by reaching out across his vast network to pull in any individual or institution he could think of capable of contributing to the protection of a city under siege.
One of the first people he reached out to was me. This is not an insignificant thing. Only in hindsight was I was an obvious ally and advisor. Trained at Harvard University, Oxford University, and Johns Hopkins School of Medicine in biomedical research and infectious disease, I am a veteran of the HIV/AIDS epidemic, the last great health crisis to sweep the globe. I am also the president and CEO of Meharry Medical College, a Historically Black Medical School and Academic Health Sciences Center based in Nashville that has for generations trained doctors to serve the most vulnerable among us—those who are often disproportionately impacted by societal health crises such as viruses run amok.
But we who are