The 10 minute drive to work was routine. It was one of those amazing September mornings where, no matter your age, your work responsibilities, or your lifestyle, you had to be in awe over the beauty and brilliance of the nearly cloudless, luminescent blue sky. It was warm, sunny, and what could only be described as a perfect morning. In fact, every time I experience those same stunning atmospheric conditions of that Western Pennsylvania morning, a tinge of telltale PTSD chemistry runs through both my connecting neurons and my bloodstream because what unfolded not two hours later  evolved into an emotional catastrophe for our country.

The very nature of my position as the CEO of a hospital often revolves around one’s ability to cope with tragedy, heartbreak, and trauma.In fact, having spent the previous five years at the Level 1 Trauma center, communicating and dealing with tragedy had somehow become, at a certain level, just part of the job. That morning, however, was different. It was a virtual body blow to the soul on every level.

My 8AM meeting with a former Mossad agent and a U.S. Ranger was a discussion of the possibility of utilizing our sophisticated proteomics and genomic analytical equipment from the DoD funded research institute that was a part of our health system in detecting the presence of anthrax.  It was a topic that I had hoped would never need to be broached in little Windber, Pennsylvania, but world matters, terrorism, and various political miss-steps had gotten us to this point in our international relationships.

In the middle of this meeting, my assistant politely interrupted our meeting to suggest I step into the administrative conference room to watch the television that had been tuned into the Today Show. As I stood to walk there, my cell phone rang.

It was my wife who said, “Are you watching this?”

My response was, “What?”

To which she replied, “A plane just hit the twin towers.”

“I’m on my way to the TV right now,” I replied.

And as I entered the small conference room, plane number 2 hit the second building. No one was really sure what was happening at that time, but that second plane did not seem like the first hit was a fluke. We watched for a few minutes more and then returned to the meeting where we continued our previous anthrax discussion.

Several minutes later, I received a call from the Trauma Center that they had just been notified that a plane with 157 passengers on board had reported a bomb on board and were headed toward the Johnstown airport. The caller suggested that I put our hospital on full trauma alert. My mind immediately sorted through those numbers and realized that at least 100 of those potential patients could not be cared for immediately in the three local hospitals due to staffing and capacity issues. I called an immediate full-alert which meant getting extra gurneys, calling in off-duty emergency room physicians, and preparing for a full disaster response.

A few minutes later when people described my complexion as a dull shade of gray, I received another call, and that call was more stark. Cancel the trauma alert, the plane has crashed near Shanksville, your paramedics will be needed onsite. By then, the word of the attack on the Pentagon, the World Trade Center and what some referred to as Fort Murtha because there were so many DoD funded plants operating in this area had painted a picture of warfare, and we were told there were approximately 1200 unaccounted for airplanes in the sky of the United States and we should be on the lookout for stolen ambulances and other emergency vehicles potentially containing terrorists.

Our paramedics were deployed and spent the day at the site of the crash. When they returned, they told me the following, “We have bad news and worse news. Everyone on that plane was killed, and no one there took precautions in the event there was anthrax or any other potentially lethal substance on board that flight. We could all be dead by the end of this week.”

Ironically, by the end of the week, the hospital was filled with sneezing, coughing employees who had either psychologically manifested an anthrax infection or had not taken proper precautions against a common cold.  And that was the beginning.

A few weeks later I received the call from then County Coroner, Wallace Miller, asking about out capacity to house the remains of the victims found at the site in our minus 180C freezers at the research institute. Obviously, we were ready and willing to accommodate his request, but those remains were sent to the Bethesda area where all other victims remains were being held and genetically analyzed.

Our involvement with those first responders continued with the help of our in-house psychologist who was made available to them over the next several months. Since then, life has not been nor will it ever be the same for the United States of America. Our perceived impermeable status would forever be history.

Hey Rox,

Western PA Guide to Good Health Summer Edition
Suicide, Social Media Addiction, Mental Health Issues Result of Covid Isolation and Stress
By Nick Jacobs
As we as a society examine the negative impact of the past 15-plus months, one group that needs specific atten- tion is our young people.
A recent article in Becker’s Hospital Review helped sound the alarm as hospitals are inundated with kids attempting suicide. As stated by Jena Hausmann, CEO of Children’s Hospital Aurora, Colorado, her pediatric emergency and inpatient units are being “overrun with kids attempting sui- cide and suffering from other forms of major mental health illness.”
If that’s not a societal and cultural statement, nothing ever will be. The article went on to explain there has been an increase of 90 percent in the demand for behavioral health treatment.
The combination of isolation and stress from the COVID pandemic has contributed to this phenomenon and turned what would have been low- level anxiety and depression into suicide attempts. The chief medical offi- cer of this Aurora-based Children’s Hospital went on to explain that the top reason for emergency room visits over the past several weeks has been sui- cide attempts. He went on to explain, “The kids have run out of resilience – their tanks are empty.”
One of my long-time physician friends, Dr. Scott Shannon, a pediatric psychiatrist from Colorado, says, “We need to take action. Physical inac- tivity, deteriorating diet, lack of adequate sleep, and fraying of family rela- tionships are similar threats pounding our kids. This has been a long train coming.
“We tend to ignore the issues of children and women in our culture and this is an example of that and what denial and avoidance brings when a syn- ergistic crisis arrives to stress an unprepared, poorly funded and non-func-
tional system.”
Nor is this challenge limited to Colorado.
Not long after my contact with Dr. Shannon, another close friend and
pediatrician, Dr. Matt Masiello, called me from Massachusetts where he said the challenges are similarly alarming. He indicated that young patients are sometimes kept in holding situations for days at a time before they can find psychiatric beds.
I then spoke with a local administrator from Southwestern PA and was informed they are seeing a situation that is also approaching the emergency level with the primary challenge of finding appropriate facilities and pro- fessionals to help these kids.
We have all become critically aware of the challenges this pandemic has created when it comes to the lack of socialization, required home school- ing, and the loss of significant activities such as dances, sporting events, and recognition and celebratory ceremonies. Besides that, if you’re a teenager challenged by living with parents who are insensitive, abusive, or just stressed from attempting to deal with the pressures of working all day from home, the level of isolation experienced can be overwhelming.
Beyond these first, most obvious causes feeding this wildfire of psychi- atric challenges among our young people, can we point a finger at anything else? Maybe we should look at the addictive nature of social media as another potential contributor.
To quote a friend and Ph.D. Psychologist Gregory Rys, “Media is now deliberately designed to be addictive. Especially since we have entered the age of instant feedback via phone, table, PC, internet, and cable TV.
“Marketers are deliberately using principles of neuroeconomics and learning theory to economic decision making and consumerism at a macro and micro level. Social media platforms know how to effectively utilize these principles for advertising.
“Once you have someone addicted to a device and platform you can shape their emotional state and influence their behavior. There is a newly emerging disorder that psychologists are treating. It is called Social Media Addiction, and just like other addictions, you can use the addiction to weaponize its users. And it occurs on a daily basis: to suppress facts or to invent them. And the addicts will believe what they are told as long as the drug keeps being delivered.
“The ironic thing is, most of us don’t believe these principles apply to us, just other more gullible people. That is exactly where the architects of social media drugs want us.”
Of course, you don’t have to be a physician, a scientist, or a behavioral health professional to realize we are in a time of significant turmoil where the primary societal infrastructure has been significantly disrupted, and it is time for serious change. Otherwise, we risk losing a whole generation to the residue impacts of the COVID-19 pandemic.
If that happens, we effectively can say goodbye to any chance we have of ever returning to “normal” – whatever that is.
> Nick Jacobs is a partner with SMR, LLC, a senior leadership healthcare consulting firm. He was a founding member of the Academy of Integrative Health and Medicine, former board member of the American Board of Integrative Holistic Medicine. A former hospital CEO and founder of two
genetic research institutes, Jacobs maintains a website, Healinghospitals.co

As we celebrate Memorial Day 2021, let me challenge you to consider what more this holiday may represent and further challenge you to look at things just a little differently than we have since the inception of this day of remembrance. This year our Memorial Day, our lives, our country, and our world position, vision, and influence has been forever changed.

In a recent article by Margaret Renkl in the New York Times, she explored the failure of our nation to meet the challenge of a different type of patriotism, patriotism to care for and defend our fellow man for the good of the country.

Not unlike what we did to preserve our nation, our belief system, and our future in times of war, in 2020 we had the opportunity to show a type of patriotism, human caring, and common good that would serve to present an example of what should and could be a positive pathway for life in America for generations to come.

She described the COVID pandemic as “the moral equivalent of war” where we were engaged in a battle to save lives, a battle that was not brought on by an actual war but by a pandemic that did not care about any individual human being.

In her opinion piece she alluded to the politicizing of this pandemic by our political leaders and by, as she described them, “craven commentators” who encouraged Americans to refuse to do anything to stop the spread of this disease because they should see themselves as patriots. As she stated, these self-proclaimed patriots continued to have social gatherings, would not stay at home, wear face masks, and now are rejecting the vaccine, a decision which could allow the virus to continue to mutate to the point of no return.

She stressed the fact that, excluding the Civil War, with one estimate as high as 900,000 COVID-lives lost, more Americans have died from COVID-19 than in all of the other wars we have ever fought as a country. We were engaged in a literal war, fighting for our lives against a virus, and the result was aptly described as a national calamity, an invasion of “a destructive and unstoppable force” that could have been met ever so much more humanely and intelligently than it was.

Our handling of the COVID-19 virus truly could have been a time for us all to come together on behalf of our fellow citizens, and to demonstrate our ability to sacrifice on behalf of others. But we did not, and now it is time to mourn the immeasurable losses caused by this war on our health, and as she described it, not mourning just for life but also for “security, camaraderie, and the capacity for hope.”

When we consider all of the teachers, healthcare workers, first responders, and essential workers who lost their lives due to the daily sacrifices they made to protect, feed, educate, and help their fellow man, we see true patriotism. Then you can add to that the millions more of us who were compliant and took whatever measures necessary to protect our most vulnerable citizens from this disease. It is that knowledge that makes us even more aware of the chasm that exists between our fellow citizens who did not and who would not even consider changing their behavior in even the tiniest ways to protect or help their fellow man.

Maybe, as the author suggested, we need a new kind of Memorial Day to commemorate those who did the right thing by working collectively to protect and defend our neighbors, friends, and strangers but also to remember all of those whose lives were lost because of those shellfish decisions by others. The fact that our idea of national service has become so self-centered, so politicized, so cold and heartless, demonstrates where we currently are as human beings in a society that is struggling to remain a nation.

As she stated, “There is more to mourn today than I ever understood before.”

The title of this missive would suggest that the Covid-19 nightmare is over.  Not at all.   Here is a statistical update.  Worldwide, as of March 1, 2021, there have been 2,650,000 deaths and 120,000,000 cases. In the United States, there have been 534,000 deaths and 2,940,000 cases.  To put this in perspective, in the six years of World War II, the United States lost 407,316 U.S. servicemen and women.

The coronavirus has been an unbelievable disaster throughout the world, but the American citizens have borne a disproportionate share of the pain.  Why?

There are probably many reasons, but two come to mind:

Citizen Response:  I have family members who say they would rather have the disease than the vaccine.  That is a quaint position.  The only problem with this position is that one of the side effects of the coronavirus is death.  Several days ago, I watched my beloved Pittsburgh Pirates in a Spring Training game at LECOM Field in Bradenton,  The television camera drifted into the outfield and focused on a bar and grill above the centerfield wall.   There were 25 patrons enjoying the game.  Only three were wearing essential protective masks.   What were they thinking about?  The coronavirus and the more recent variants are so lethal, particularly in Florida.   I love a good baseball game, but not enough to put my life and the lives of others in danger under the current circumstances.

Former Administration: I have no interest in politicizing this missive.  The fact is that the Former President had advanced knowledge that the coronavirus was coming to the United States and that it was lethal. In an interview which appears in Bob Woodward’s second book about President Trump, he is quoted as saying “I did not want to reveal this information to the American People because I did not want to set off a panic.”  

 Later, various arbitrary dates were selected when the disease would simply disappear.   It was also suggested we might inject into our bodies various chemical or biological agents.    

Where did the coronavirus come from?  The first known infections from SARS-CoV-2 were discovered in Wuhan, China.   Because many of the early infected patients were workers at the Huanan Seafood Market, it has been suggested that the virus might have originated from the market.  However, additional research revealed that the disease may have been introduced into the Huanan Seafood Market by anyone from any country.  The actual genesis of the coronavirus remains a mystery, but there is no proof the disease was manufactured as a biological weapon.

 Covid-19 or the coronavirus has inflicted incalculable mass destruction to the world economy, over $17T in the United States alone as well as extraordinary devastation to public health and citizen safety.

 We are now in a race to develop effective and safe vaccines for the mutations that are occurring in South America, South Africa, England, California, and other geographic areas as we work to immunize all willing citizens.   Why is this so important?   We only need to look back to the Flu of 1918 and 1920.   One pig in Iowa may have been responsible for 50,000,000 world-wide deaths.  In the United States, 20-30 percent of all citizens contracted the disease and 690,000 U.S. citizens died.  The only way America could achieve herd immunity was by so many of its citizens contracting the disease and surviving, and even then mask-wearing and social distancing was controversial. 

 Immunization for Covid-19 offers the hope that we might achieve herd immunity before the end of 2021.  It is by no means certain. 

I’ve been trying to get my head around mass-shootings for a long time. With more than 100 gun-related deaths every day in this country, and even when our children are being shot in their classrooms, we are still a country divided over the majority of gun laws.

In spite of the fact that 33 percent of mass shooters were individuals who were legally prohibited from owning or possessing a firearm, many of us remain steadfastly resolved that no gun law is a good gun law. Some believe politicians want to take away all of their guns and restricting gun rights in any way is not only unacceptable, it is un-American.

Well, guess what, I have no plans to say anything about the increased numbers of deaths that have occurred since military-style weapons and high-capacity magazines were legalized, and I’m not going to talk about the fact that 54 percent of mass shooting incidents were domestically related.  I’m also going to carefully avoid the data point that a large of number of the shooters are mentally ill young, white men.

Why? You might ask. Well, it’s because I have a bigger fish to fry. Actually, it’s not even a fish.  It’s a freakin’ whale.  We’re going once again to discuss masks. I know. Not again.

In my research I came across the description of the mind-set of those individuals who seek personal autonomy at all costs, those people who argue in favor of total civil liberties and a reduction or elimination of the power of the state. The magic phrase that seems to have recently been cut out of their philosophical conviction is a restricting clause that says, “Unless it damages or interferes with the public good, or the benefit or well-being of the public.”

That’s the whale, the elephant in the middle of the room, or the Babe Ruth candy bar in the swimming pool. “Unless it interferes with the public good.”

Here’s a question for you. Why is it a problem to drive impaired? Why is it illegal to yell fire in an auditorium where there is no fire?  I think I know. It’s because it interferes with the public good. Any one of those things could result in someone else being negatively impacted because of a decision to drive drunk or cause a panic in a crowded room.

If you live in Pennsylvania and want to ride your motorcycle without a helmet, the state says that’s okay, but if you are severely injured and live, there’s a chance the state might have to provide medical care, financial support, and public assistance for you for the rest of your life. In other words, if you do it only to you, the state will pay for that, but don’t do it to other people, the public good.

Back to the whale. So, when did it become acceptable to defy “the public well-being” by refusing to wear a mask during a pandemic? When HIV/AIDS was first recognized, people were arrested for spitting on other people and charged with attempted murder, but if you don’t wear a mask, that’s somehow supposed to express your independence, your freedom, your libertarianism?  Instead, it allows COVID and now its mutations to spread. And guess what? That spread has killed nearly 514,000 Americans and continues to kill every day. WTH? Is it machismo? Or machisma?

When did knowingly potentially infecting someone that results in their illness or death become acceptable? When did freedom to kill become part of the public good? What if we just called it what it is, not selfishness or stubbornness, or independence, but attempted murder?

Only about 33,000 people die from guns in the U.S. in a year. That’s 6 percent of those killed by COVID this year. I’m sorry. Logic is not part of either equation, but sociopathic attempted murder might be.

In 1999 as the relatively new CEO of Windber Medial Center, I was invited to have dinner at the home of one of our physicians.

I was seated beside Congressman, John Murtha.  As I began to elaborate on my dreams  for the hospital, Mr. Murtha said, “Nick, why don’t you check to see if you can find someone who will work with Windber from Bethesda or Walter Reed? Then, maybe I can help.”

Although I knew he was a U.S. Representative, I had no idea he oversaw the Appropriations Subcommittee which funded the Department of Defense.

My board chair, Judge David Klementik and I visited the then Bethesda Naval Hospital where the liaison officer we met with diplomatically explained the Navy was not interested in working on research projects.

A few months later, I decided to cold-call the former Walter Reed Hospital. It’s important to interject that I was not a Veteran and had never been there  before.  Consequently, I had no knowledge about protocols, chain-of-command, or even who to contact.

Pre-9-11, things were still pretty informal for visitors at Walter Reed. So, I cautiously walked into the ground floor of the hospital. As I entered the building, the realities of military medicine hit me. The place was packed.

Almost immediately, I saw a white coat in front of me with the letters M.D. embroidered at the end of the name. It was one Colonel David G. McLeod, MD.

Considering how many doctors worked in that building and how many would not have acknowledged me, the next few moments positively changed not only my life but possibly the lives of thousands and maybe someday millions of people forever.

I said, “Hello, doctor, my name is Nick Jacobs, and I am the President of a hospital in South Central Pennsylvania. Our Congressman had recommended that I come to Walter Reed to see if there was anyone here who might be interested in working with us.” 

Dr. McLeod replied, “What’s your Congressman’s name?” I said, “Jack Murtha.” He looked at me and said, “Follow me.”

Little did I know that saying Mr. Murtha’s name would get that type of reaction from the first doctor I ran into at Walter Reed.

Of course, I also did not know this amazing Vietnam War Veteran, attorney, researcher, and physician had founded the Center for Prostate Disease Research at the Uniformed Services University. There was also no way for me to have known that he knew exactly what to do for both Windber and Congressman Murtha.

Most importantly, I didn’t realize he would go on to guide another young physician, Craig Shriver, to assist in forming the Clinical Breast Care Project, a Congressional initiative which would collect over 100,000 plus breast tissue samples used in part by the National Cancer Institute to map the Human Breast Cancer Genome.

It was about a year later when I first met Dr. Shriver. He came to formally ask me what I wanted to do with the grant that our hospital was about to receive for the study of breast cancer. 

Having been a candidate for the CEO position at a research hospital where I had seen my very first genetic analysis laboratory seven-years earlier, I looked at him and said, “I want Windber to partner with Walter Reed to become the genetic breast cancer research center for the Department of Defense.” 

He looked very thoughtfully at me and said, “As long as we’re researching genetics, there’s a new science called proteomics that we should study, too.”  My reply was, “Yes, we should. I don’t really know what either of them are, so you be the doctor, and I’ll be the administrator.”  

It was Dr. McLeod who then helped Dr Shriver operationalize the Clinical Breast Care Project. 

Thank you, Colonel McLeod. “You continue to make lives better every day.”

Discovering knowledge on bookcases

Nick Jacobs

Published Tue Mar 02, 2021 8:23 PM EST