Author, poet, and philosopher Noah benShea interviews Dr. Sam Weinstein, CEO of SpecialtyCare, former director of Pediatric Cardiothoracic Surgery, and Surgical Director of Cardiac Transplantation and Mechanical Assistance at The Children’s Hospital at Montefiore. Their conversation is both touching and profound as they discuss the importance of perseverance and the human element in healthcare that can be so important to patients and their families.

 


 

Below is the transcript of the conversation:

Noah benShea:             It’s great to see you again, and I had a question for you just as we sit in this conversation. Would it be okay if I call you Dr. Sam?

Sam Weinstein:            Absolutely.

Noah benShea:             Would that be all right?

Sam Weinstein:            No problem.

Noah benShea:             I know you’re a family man, and when your kids were little and they said to you, “Dad, I know you’re a doctor, but what do you do?” What did you tell them?

Sam Weinstein:            Well, my kids thought Sam Weinstein MD. meant Sam Weinstein my dad. Basically, I’ve had a few different jobs as a physician, but my last stint, 16 years clinical as an associate professor of cardiac surgery, I was a pediatric heart surgeon. So I would tell them I fixed little kids’ hearts.

Noah benShea:             Yeah. Not a bad answer. I fix little kids’ hearts. But I think to them, oftentimes, what they like … They like the MD, my dad.

Sam Weinstein:            They still do.

Noah benShea:             When you were a young man and starting to witness some … I’m sure you studied under some great physicians and healers and met some fabulous nurses. Was there one in particular who you witnessed, conducted themself in some manner that really drew your attention and said, “I like that spirit in that person”?

Sam Weinstein:            Sure. There was one time that it struck me, the human side of a physician, who was really well-known for his expertise in mechanical assist devices, almost the opposite. He was very technically driven, and this was in the early days of mechanical assist devices when they may not have lasted terribly long. They created a lot of patient complications, and sometimes the devices themselves would fail. When that would happen, the patients would not survive.

There was one time where I was on the floor in a patient’s ward room with this surgeon and a team full of people when the machine was failing, a left ventricular assist device, and the patient who had really had a tough time had recognized along with all of us that the machine was not gonna be able to keep going. The look on her face was staunch. At that time, we had really nothing else to offer.

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So the attending physician, a cardiac surgeon, sat down on the edge of the bed, and he just stroked her hair for the nine to 10 to 11 minutes, ’til things were over. And she relaxed. And she closed her eyes. And it was all that he had left, but at that moment, it was everything.

Noah benShea:             Sometimes in our life caring is all we’ve got left, and it’s just … No one loses the impact in the sense of the impact of caring … Caring is healing.

Sam Weinstein:            He got, even though he was a master at working with machines, that, at that moment, all he had left to offer was himself and just some mild human contact and utter small reassurances to her. I’ve never forgotten it, and when given the opportunity, I’ve tried to emulate that behavior.

Noah benShea:             I think a lot of people think of physicians and nurses that have this kind of distant concern so you don’t get too caught up emotionally, but there’s a huge requirement for healers to reach into themselves to find some place where they can find some aspect that can do beyond all of the training they’ve had, what it requires. That’s always most amazing to me because it seems to run against what people think is the personality of someone in this position.

Sam Weinstein:            I think so. I think everyone handles it a little differently. I think some disconnect ’cause they’re not comfortable with the emotional side. I think those who are more comfortable can display that, but it’s tough today, especially when you’re a surgeon and in an operating room. You have to have some sort of disconnection when you’re actually operating on a patient. When that ends and where it ends can be challenging for people. Does it end at the door? Does it end upstairs? Does it end when you go home? Not all patients and physicians understand that.

Noah benShea:             And at different times in your life, the old Heraclitus, “No man puts his foot in the same river twice. Not the same river, not the same man,” so where you are in your own evolution in the sense of evolving as a physician as a healer.

Sam Weinstein:            Everybody’s a little bit different. I remember the physician who treated my grandfather after he passed told my father, “Everybody that passes takes a little piece of me, and if I was not all in it at the end with the conversations, it’s not ’cause I didn’t love your father. It’s because when I see what’s coming, I have to protect myself. I’m not telling you it’s right. I’m just telling you it’s what I do.”

We, as a group, understand what the physicians go through. We understand not just the stress of dealing with the patients, but the stress of the procedure, how the hospital is demanding, how the state and regulatory agencies are demanding. We need to be there for them, to take care of them, to make sure that they have all the tools to be comfortable and successful.

Noah benShea:             To that end, here you are with a number of major success behind you in your life. Here you are now, the CEO of Specialty Care. Why now? Why this? What are you hoping to bring together here that is yet the next stage in the evolution of, if you’ll excuse my expression, the great Dr. Sam? What is the next step in the evolution of this? Help us understand a bit, will you?

Sam Weinstein:            I was looking at a number of different opportunities when I left my clinical practice, and I really feel like specialty care pulled me. When I think about, in my practice, the impact that the technicians and support physicians in the operating room had on me, it was exponential. The physicians who were reading studies while I was taking tumors off the end of the spine of a child helping me keep them out of injury or a profusionist who was there to help me rescue a patient who was in cardiac arrest or a surgical assistant who changed their vacation schedule to help me do a case on a Friday because they knew that I would be more comfortable with them in the room.

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These things are parts of my practice that don’t always get shared with the patients or the families, not even some of the physicians who are in the OR who don’t understand the contribution that these people make, but it’s enormous, and the OR doesn’t run without them. I know that. I love these people for what they’ve done for my patients. I love them for what they’ve done for me, and I feel that it’s my mission to help them be better at what they do, support them to be better at what they wanna do, and make their careers as fulfilling as possible.

Noah benShea:             I think, when I hear you say this, I realize, as a head surgeon, you’re always involved with teamwork, building a team around you. Now, in this role that you’re playing, you’re building a team around you. Is the idea of building camaraderie, is there some magic touch to that, how one builds camaraderie, you think?

Sam Weinstein:            I don’t know about magic touch, but I think attention must be paid to it. So, in my example as a heart surgeon, there might be eight people in the room with you. The patient’s family generally thinks of the surgeon, but there might be two anesthesiologists. There are always two surgeons. There are two profusionists. There are two nurses. There may be cardiologist. There may be other folks in the room. They’re all there to help the patient, but we all need to work together, and some of the days are long. Sometimes they’re not getting the credit for that. Sometimes the outcomes are tough. Sometimes the outcomes are easy, but, again, when you see the look on somebody’s face when they’ve made a contribution that goes, at that moment, unrecognized, at the end, you give ’em an atta boy or an atta girl. The light up, the way they smile when they know that they’ve not only helped the patient, they’ve helped the doctor, you get a double win for that.

Noah benShea:             Oh, I think that that’s exactly what makes you feel you’ve lived a life worthwhile. Yeah.

Sam Weinstein:            You can make the difference on more than one person at a time. There are times when you’re managing the patient, and there are times when you’re managing the team. The team provides such a vital role. They need to be taken care of, and that’s one of the things I always enjoyed when I was a practicing clinician. It’s one of the reasons I wanted to move over to this company, and it’s one of the things I enjoy most about leading here is I get to help thousands of people who touch the lives of hundreds of thousands of patients. That’s really special.

Noah benShea:             Those, in turn, influence lives of over a million people in the last year or so. We were talking about it.

Sam Weinstein:            Right. If you think about touching one life. What circles a person? It’s their family. It’s their community. It could be their children. It could even be future generations. You’re talking about well beyond dozens of people. You think about touching one person, you may have helped 40, 50, or hundreds of people who are all associated with that patient. It has real exponential proportions.

Noah benShea:             Absolutely. We were talking last night. In scripture, it reminds us, when you save one life, it’s as if you saved the whole world. In some level, it really plays that way. The great Arnold Palmer liked to say, “The more I practice, the luckier I get.” I know that a quote from Calvin Coolidge has been something you take to heart that at the end of the day there’s nothing that can replace persistence. You wanna talk a little bit about why this resonates with you and what we’re doing here?

Sam Weinstein:            Sure. Well, it was my mother who was an English teacher who first shared this quote with me, and I’ve had a version of it on my desk since I was in high school. We actually have it on the walls of our company.

Calvin Coolidge had commented that, really, what makes the difference between success and failure is persistence. Talent alone doesn’t get you there. We all know lots of people with talent who can’t work their way through a lot of situations. Genius is not. Unrewarded genius, Calvin Coolidge said, is almost a proverb. It’s really persistence and determination alone that will get your from here to there because it’s not that we’ve failed at anything. It’s that we haven’t figured out yet how to succeed. And you never get there if you don’t persist.

Noah benShea:             There’s … My [inaudible 00:10:59], very few of us are lacking for information. What we’re lacking is the character to act on the information at hand. Right? This is persistence under this quality of character.

Sam Weinstein:            And I tell all the young people in our company that are coming in and people who are interested in training at our company, and, to be honest, anybody who will listen, that this is what makes the difference. We all have access to the same technology. We all can have access to education. What’s gonna separate you from everybody else? It’s really the effort. It’s not that you have to give an effort better than anybody else. You have to give your best effort.

Noah benShea:             Your effort. Yes.

Sam Weinstein:            Right? You don’t have to win. You have to try to win. And what I was saying before is, all you can do is all you can do, but that’s usually more than enough.

Noah benShea:             Yeah. Indeed it is, and it’s one of the shadow qualities that so many people are prepared to give so much less. It’s one of the real coming together qualities of so many people here at Specialty Care because they’re looking to give more. If I might. I think.

Sam Weinstein:            Absolutely. And I wanna help them. We wanna help them give more because when you see the look on one of our employees that have not just helped save a patient that day, but have helped the surgeon in the room and knows that that impact is gonna last, not just for days, but literally for generations, and you congratulate them and you let them know that they were a vital member of that team, well, you can just see by the look on their face that that’s something that you hope that they really appreciate. And, actually, you hope that everybody can experience.

Noah benShea:             Yeah. Once people know that they matter, then the world around them matters. Right? Doing this here is how a team matters. That’s the thing that’s amazing here ’cause there’s no I … Like Johnny Wooden, “There’s no I I the word team.” The team matters, and everybody picks up their own self-worth out of being a member of that team.

Sam Weinstein:            We thrive on being vital members of that healthcare team. It’s our missions to help the surgeons in the hospitals to treat those patients as efficiently as they can, efficiently medically and efficiently economically. That’s how we’re trained, and that’s our focus.

Noah benShea:             I think people tend to forget that while the patient is always under a state of tension because of why they’re in that circumstance, the physician also has a state of tension. It’s not a tension that immobilizes the physician or the nurse because they’ve had experience in it, but it’s tension the same way as people get excited before they go on a great … When they’re entertainers, they hone their own edge with the tension. You get better because you wanna make sure you do not make a mistake.

Sam Weinstein:            Well, I think that’s true, and I would add onto that that I like to tell all of our employees, and especially all the new hires, that you don’t really … We do great work. You make your reputation or you make your impact when it’s a difficult situation. I don’t ask or hope for anybody to be in a difficult situation, but when the situation is challenging, that’s when we, Specialty Care, our people, are at their best because that’s when you need to buckle down, think through our training, follow our protocols, communicate intensely, and make sure that we stay in it ’til the end with the surgeon or the neurologist or whoever we’re working with at that moment so that we’re maximally contributing to support what’s happening.

Because when it’s over, you’ve gotta be able to say to yourself, “I’ve done all that I can do”. And all you can do is all you can do. Then, when it’s completed, it’s the responsibility, I think, of the surgeon, and now for me as one of our companies leaders, to let people know that they did a great job. Just ’cause the outcome wasn’t where they wanted it, it doesn’t mean they didn’t have a huge impact. Sometimes they’ll be able to help turn things around, but when you’ve given it everything you’ve got, we all recognize that. If you hang in there professionally, that’s what makes their reputation individually, and I think that’s what makes our reputation as a company.

Noah benShea:             I’m absolutely convinced of it, and I’m convinced that it’s one of those truths that plays on many, many platforms. This great acting coach who taught Marlon Brando said to him, “Play the part, not the result.” Right? Do the work, not the result. Because if you’re playing the result, then you’re playing ahead of yourself, and you’re not in the game.

I have a friend who was a very famous pitcher. I asked him one time, I said, “How did you deal with having 65 million people watching you?” He said, “I never saw 65 million people. I was just playing with the catcher.” Right? You’re staying the game. That’s a challenge.

Sam Weinstein:            That’s exactly right. People like to say you miss 100% of the shots you don’t take. The way I interpret that is, you have no chance of winning if you’re not trying, and you don’t have to win, but you have to try to win all the time.

Noah benShea:             To that point, here you are, achieved a lot of stuff in your life, heading up a great company and what we’re doing and building a fabulous team here. If you were going to tell people what you think is the abiding lesson, right, some message to the next generation … I’m not making you … You’re a younger man than me, so I can ask you this question. If you were giving an abiding lesson to the next generation or people who would come into our field here … When I see people who are committed that their mission statement is to be caring and healing, what would you say to them? What would you say to them is like … “Hi, I’m Dr. Sam. I’ve spent a long time doing this, and I’ve had some achievements, and this is what I’ve learned.”

Sam Weinstein:            Well, I think what I would say is that as technologically advanced as society and healthcare gets, the things that distinguish us as care providers is what we contribute as people. Anybody can look something up on a phone. Anybody can search on the web. That’s not really what makes the difference. What makes the difference is our persistence and our contribution to others and to thinking of the project. Not what it means to us, but what we bring from ourselves to help other people.

There’s no substitute for that. For all the business opportunities, for all the medical opportunities, for all the sophisticated forms of communication, there’s still no substitute, fortunately, for being the room with someone, shaking their hand, laying hands on a patient, or just listening.

Noah benShea:             Of all the things we can make in life, why not make a difference? Dr. Sam, thank you for making a difference. Thank you for making a difference.

Speaker 2:                    Thanks for your time today.

Speaker 1:                    Thanks for listening to Scrubbing In. Please take a second to give us a rating on your podcast app, and subscribe so you won’t miss out on what we have coming up. See you next time.