Allina Health president and chief executive Dr. Penny Wheeler delivers the commencement address at the University of Minnesota School of Public Health with several mentions of the Backyard Initiative.
©Ë'University of Minnesota School of Public Health
By Dr. Penny Wheeler
The following is a transcript of Allina Health president and chief executive officer Dr. Penny Wheeler”'s University of Minnesota School of Public Health Commencement speech. The speech was delivered on May 18, 2015 and contains several references to the Backyard Initiative. View a video of the speech.
The last time I was on stage in this grand auditorium, I was 10 years old and playing the piano, and I was scared to death. Needless to say, I have changed and aged since. This historic hall has also grown up since then as well, so I hope I hit fewer clinkers today and can improve on my previous Northrup Auditorium performance. To do so is immensely important, as you are all so worthy of honor. I couldn”'t be prouder than to be a “Triple Gopher” by background and to be partnering with you, all of you, now and into the future to improve the lives of those we collectively serve.
We share something very precious together. Together, we share a noble mission. As Teddy Roosevelt said, “Far and away the best prize life has to offer is the chance to work hard at work worth doing.” My then 8-year-old daughter, Olivia, once paraphrased this by saying to a friend, “
My mom used to be a doctor, now she just does something about improving people”'s lives.”
Together, we have a tremendous opportunity to positively affect people”'s lives in unprecedented ways through the connection between health care and public health. The lives of so many and the health of our broader communities depend on the convergence of our worlds. And we can”'t let this brilliant opportunity pass. We simply can”'t!
Through my remarks, on this very big day for us all, I want to give you an understanding, from my perspective, as to:
- why individual and community stories can and need to be positively re-written,
- how we can do so together at this unique time, and
- what this transformation demands of your talents and your character to change health for the better.
Let me bring in some of the stories””stories that keep us awake, stories that don”'t need to take the tough and tragic turns they have taken.
One such story burned into my memory banks is that of Marletta. Marletta was a kind and loving woman who had a tough lot in life. A single mother of a three-year-old son, Marletta had not graduated from high school, lived on less than a livable wage, and was challenged physically by severe obesity and diabetes. I met her on a night when we would struggle to save her life.
She came to the ER at 27-weeks pregnant with abdominal pain and a bulge in her abdomen that was considered to be a weakening in her abdominal wall””a hernia. She had had only one care visit during her pregnancy. When she went to the OR, what was thought to be a hernia turned out to be something rare and frightening. Marletta had a condition that was a surgical and obstetrical nightmare””a placenta percreta. This rare condition occurs when the placenta grows through the thick wall of the uterus and invades other tissue. In Marletta”'s case, it had grown all the way through the wall of her bladder. This dire emergency often results in severe and uncontrollable bleeding and irreparable damage to the affected organs.
We delivered her premature infant girl and then worked through the night to repair the severe damage, while feverously trying to keep up with her severe blood loss. After operating into the wee small hours of the morning, transfusing her with 23 units of blood, and holding a vigil for five days in the ICU, Marletta took a turn for the better. She still had challenges, but miraculously survived. Her wound got infected and broke down due to her size and a diabetic-related infection. The gaping wound had to slowly heal on its own, and she would be in the hospital three more weeks before she was well enough to go home. Her infant survived the ordeal as well.
Unfortunately, after nearly losing her life, Marletta”'s life got harder. While she earnestly held down her cleaning job and cared kindly and diligently for her two children, her boyfriend was cocaine addicted and abusive. Five years after being a near medical miracle, they fought over his drug use, and he strangled her to death.
How might Marletta”'s life had been different if we partnered with all our assets to serve her in better ways?
What if she had been supported to finish her education?
What if she had access to health screenings that led her to a stress and weight management program and diabetic care or had been offered these at her prenatal visit?
What if a community health worker had been accessible in her neighborhood?
What if she had been enrolled in a WIC Program after she recovered from her surgery and received that support?
What if she had someone to whom she could turn when her boyfriend was using and abusing?
What if, in the words of the Robert Wood Johnson Foundation, Marletta was surrounded by a culture of “health”?
What if she had choices? Would her two children still have had their mother?
Of course there are other stories that keep us awake. I know of John, a victim of inequitable care, who died prematurely of a preventable heart ailment and who his mother described as being “erased” by support services and medical care. Or how about Andy who was 17 years old and had a mental health crisis? With no access to local care (no room in the strained mental health environment) and being shipped to a hospital 120 miles from home, and given no follow-up care, he committed suicide two weeks after discharge.
These stories are heartbreaking, especially when we know that we are interconnected and responsible for each other and each other”'s well-being. We can”'t re-write those of Marletta, John and Andy. But, together, we can support many people we don”'t yet know and enable them to have more choices, lead better lives, and extend their capacity to love and support those around them.
University of Minnesota School of Public Health Dean John Finnegan with Allina Health president and chief executive Dr. Penny Wheeler
©Ë'University of Minnesota School of Public Health
To do so, we have to bring together medical care and public health. We are finally understanding, in my world, that health challenges are not solved by medical systems. In fact, we all know that access to health care is only a small part of a person”'s health. If we don”'t have one foot in health care and a larger foot in the community””working together to create more positive conditions for health””people will suffer. Public health has the data and connections to reveal the problems in the community, and clinicians have the direct patient/community member connections to bring the stories to light and change perspectives, behaviors and policies. Together, we need to collaborate even more, with each other, with other sectors, and with communities themselves to catalyze a big turn toward better health for all.
There are positive examples of change all over our state that we can build on.
At Allina Health, we are privileged to be working in creative partnership with our neighbors in the communities immediately surrounding our headquarters in the old Sears building on Lake Street””now the vibrant Midtown Global Market and The Commons””and our largest hospital, Abbott Northwestern. For the past seven years we have worked on something we call “the Backyard Initiative,” with the School of Public Health. It has evolved into a promising example of community-led change. In fact, those of us at Allina Health had a big lesson to learn from the community at the start. You see, we thought of it as working to improve the health of the people in Allina Health”'s back yard. Pretty soon, though, community leaders straightened us out, by essentially saying “excuse us, Allina Health, but you are in OUR back yard and we are tired of being done to and done for.” Luckily, we listened. Citizens””neighbors””have defined for themselves what is health, zeroed in on social cohesion as a core health strategy, and have formed Citizen Health Action Teams to drive the changes of their choosing and their design. One of the citizen teams is A Partnership of Diabetics, which offers a strong peer support for those with this chronic condition.
I can”'t help but wonder if Marletta had had this community team on her side, whether her story might have taken more positive turns.
It won”'t be easy to get all of this done right so that, ultimately, there are no preventable, tragic stories left to tell. It will be an incredible challenge to change ways of thinking and doing things for the better. There will be whitewater along the way. It will be a character test for us as individuals and as a community. What will it take to relieve this unnecessary suffering? Is it a Sisyphean task to accomplish this?
The task of building a healthier state, nation and world is indeed tremendous, and it will test the character of each of you in the room.
I offer three pieces of advice to help us get there together:
1. Always clarify the intent of change. Why is it important? How will lives be affected for the better? Make it mean something.
2. Drive, don”'t slide. Always bring your best and expect it of those who work with you. Be intolerant of anything that gets in the way of improving a life or lives.
3. Lead with love; make love your legacy. In the end, it is your passionate purpose that will carry you through the whitewater of change and resistance, lead to our collective ability to improve lives in unprecedented ways, and provide congruence between what we value at home, at work and in our communities.
Ultimately, our job together is to relieve suffering and extend hope and possibility. We have a moral imperative to do so and by so doing relieve undue suffering of those whose faces we may not know, but whose lives we have collectively committed to improving. Dr. Don Berwick, a wonderful mentor to so many, said, “ I think health care is more about love than anything else, for if it”'s not one person trying to relieve the suffering of another and that”'s not love, I don”'t know what it is.” Our job is to connect health care and public health to extend that love to the benefit of many. It is a charge and an opportunity for this moment in history, a moment at which health systems like mine finally understand that we are meant to be about more than responding to illness: we are meant to be about health. Let”'s meet at the nexus and profoundly change the health and lives for untold numbers of Marlettas. We need each other, and those individuals we are collectively fortunate enough to serve need you. In this moment, this historic time for what we can do together, the only thing that exceeds my admiration for you is my hope for you. The moment is now, and the moment is yours. Thank you, congratulations, and let”'s do this!
