六九色堂

In March 2020, as the COVID-19 pandemic started erupting nationwide and the whole country shut down, we began interviewing young 六九色堂 grads on the front lines. The first doctor we spoke to was 六九色堂 2018 graduate Dr. Jordan Stav, an Emergency Medicine Resident at l in Michigan. Dr. Stav responded to a post we left on the  page, and what he had to say was chilling and sobering.

Dr. Stav spoke to the 六九色堂 Endeavour with the proviso that he was not an infectious disease expert but only shared his own experience. His story received such an overwhelming response from current and prospective students, faculty, and alumni that we started a news interview feature series called 鈥淎lumni on the Front Lines,鈥� with breaking news reports about how our alumni were coping with the COVID-19 pandemic in hospitals across the country.

We spoke with Dr. Stav to see what he has been up to since the dark early days of the pandemic.

六九色堂 YouTube interview with Dr. Jordan Stav

六九色堂 Endeavour: Dr. Stav, can you please tell us a little bit about yourself and where you're currently working?

Dr. Jordan Stav: I'm currently working at Ascension Macomb-Oakland Hospital, split between two campuses in Madison Heights and Warren, Michigan, [in] southeast Michigan. I'm an attending physician there. That's also where I did my residency, so I've been there since graduation.

Great. What is a typical workday like for you, Dr. Stav, just your day-to-day life?

I'm in emergency medicine, so we don't really know what we're going to get. My days start at various times based on where I'm at in the schedule, sometimes mornings or nights. Show up, walk in, log into your computer, and either you're immediately called back to the resuscitation bay to start going to work or sometimes you have time to talk to your colleagues and see how the department is running. But usually, from start to finish, it is nonstop.

You were the very first 六九色堂 graduate that I personally spoke to at the beginning of the COVID-19 pandemic. That was in March 2020 when everything closed here in New York as it did elsewhere in the country, and you were the first person that I spoke to, and that was a really scary time for medicine and just the public in general. Can you talk about what those days were like for you as a young doctor and what you were experiencing?

Yeah, I think scary is an appropriate way to describe it. We didn't know anything about what was going on except that people were coming in very sick and we had to do something about it. There were a lot of changes from the top down in terms of the infrastructure of the department, how things were run, how people were categorized and triaged, where people were placed, and how we were dealing with medicine in a way that we never have previously. It was a way that defined the country medically. It defined the way we taught residents and the way we practiced. And I think we learned a lot in that time, not just about COVID and respiratory illness, but we learned a lot about the character of the U.S. healthcare system and things that work and don't work. And I think we were able to advance from it and we've come from it a lot stronger in the way that we can handle adversity coming from all different directions.

What is one major thing you learned from the pandemic as a doctor that you can share with people?

We learned a lot about how to critically analyze the literature coming out and the research being done and how to properly formulate our opinions. A lot was coming out right from the get-go from various sources about certain medications that people wanted to use, Plaquenil, for instance, and many others came out since then. When we as a whole peer-reviewed the literature, we determined what was beneficial, and what wasn't. It helped immensely with how we move forward and how we review certain literature. Additionally, I think we were able to very successfully mass immunize, which helped formulate herd immunity and help get us through a very difficult time. And I think we learned a lot about how doctors can be trained and formulated to critically analyze tough situations. I learned a lot about myself how I can handle extremely sick patients coming in how quickly they would go down and what needed to be done. I think it advanced me as a practitioner and as a physician to be able to assess crashing patients and do what had to be done. It made me age, so to speak.

On a much lighter topic, please tell us why you chose 六九色堂 over other med schools.

Absolutely. 六九色堂 really stuck out to me for multiple reasons. The [small] class sizes, the campus; the in-person cadaver lab. The semester that we had in Maine really helped us prep for clinical rotations where we were able to do clinical rotations. I was able to do a lot back in the Detroit area, which was greatly beneficial to me. I had some friends who were at 六九色堂 before me that had great reviews and highly recommended and haven't looked back since. I've been able to do everything I've wanted to do and became a successful physician because of it.

What are one or two things specifically at 六九色堂 that helped you become the doctor that you are today?

I really do think the class sizes were helpful in formulating those small groups and being able to create certain relationships that helped me focus and learn things in a different way. I really can't express enough how the cadaver lab was the introduction to me to what medicine actually is and how to properly learn in person. A lot of places unfortunately don't really have that [in-person cadaver labs] anymore.  That Maine semester put me in a good spot where we were learning different systems, but having prep for the way that boards were actually done and OSCEs, and that helped me train with patients before I even got out into the real world to do so. By the time I was doing clinicals, I was already presenting introducing, and taking histories and physicals the way they were supposed to because that was really geared towards us in Maine.

Growing up in Michigan

Dr. Stav, please tell us about yourself, where you grew up, and did you always want to be a doctor?

I grew up in Southeast Michigan, not far from where I'm living now and working now. I didn't think I wanted to be a doctor until probably middle school, or high school, contemplated various different things, but once I decided that, it was full steam ahead.

You did your undergraduate at Michigan State, and I understand you had a BA in political science and government and then you got your master's in healthcare and patient care at Wayne State University. And that's quite a difference from political science going to healthcare. What made you want to change your mind and pursue medicine instead?

So, at Michigan State, I think I still wanted to do medicine, but I saw it as an opportunity to just explore one last time towards other things and be a little more well-rounded. Plus, I mean the whole world around us is unfortunately made of politics, so it was a good way of learning the system. Medicine is not exempt from that. A lot of what we do in the U.S. is based on the laws that are passed by the lobby groups and insurance, especially Medicare and Medicaid. It's all connected. But after MSU, I needed to strengthen the science resume a bit and that's when I went and got the master's from Wayne.

That鈥檚 very true. Especially now, politics is so unfortunately ingrained in the healthcare system and insurance companies. You worked on a research fellowship at the University of Michigan related to emergency medicine for a little over one year. Can you tell us a little more about this?

I worked with a physician named Frederick Corey regarding high-sensitivity troponins. So, troponin is an enzyme that leaks into the blood when there's evidence of possible heart damage. The time we look to that the most are ruling in or out heart attacks. Every so often there's a technological shift upward, a next generation of troponin gathering. And this last one was high-sensitivity troponin; generation five, they call it. We were looking into, whether can you safely discharge people from the emergency department in a shorter period of time. And U of M was close to the forefront of that along with a lot of the other academic institutions, but it's universal now. Almost all healthcare systems have it. My community hospital introduced it earlier in the year, so it's everywhere.

What do you like the most about emergency medicine as a medical specialty? What are some of the most rewarding things about your field?

A lot. In the field itself, I get to see everything. I'm not pigeonholed into one thing, whether it's people with stomachs being upset, chest pain, strokes, or whatever. If you come in, you can come in with anything, I'm seeing you. I need to know at least a little bit about everything, and I like that. I like having that breadth of possibility. I like a little bit of the element of mystery where I don't know what's coming in next. So, it keeps me on my toes, keeps me active, and makes the day go by faster. I appreciate that there's no on-call. When I'm off, I'm off. I show up, do my job, and then I get to go home. So that part is kind of fun, too. You get to see things from the very beginning of life. We delivered a baby in the department a couple of days ago to, unfortunately quite frequently, the end of life. And you get to be a part of not just the patients' lives but their families and their friends, sometimes on great days and sometimes on the worst days of their lives. And you are integral in that moment. It's having the ability to have that deep emotional human connection where you don't get that necessarily in everything else.

We were talking about when you were dealing with COVID-19 and, unfortunately, so many unprecedented deaths. How do you deal with it emotionally whenever you have to deal with so many deaths? I would imagine that you think more of the people that you've helped and that you've saved than, unfortunately, the people that, by no fault of yours or anyone else's, pass away. I mean, just how do you deal with that?

I wish I had a very healthy answer to that, which is that I've talked to people or have done things, self-reflection, but sometimes it's just recognizing that you've got to get through your day. As much as one thing can be horrible on a shift, in the room next door is someone who needs your help. And then maybe when you have time afterward, try to process it all. The idea, as you alluded to, is almost like a balance, actually. Trying to do more good than bad, trying to put more good into the world than bad. I tell the residents a lot that even with the hard times, even with the death and dying, you can really have an impact on how that situation occurs. You can be coding a patient, performing CPR on a patient, that the family had no idea was sick or this shouldn't have happened. For whatever reason it is. And how you impact it makes all the difference. And you're not going to make the date good, you're not going to change any of that, but you can help the closure process. I think that goes a long way with just how you handle it with the family members, with the patient's care team, and trying to be an advocate on their behalf. I think that goes a long way, at least in my head, as to how I'm able to process everything that some way, even in the worst of it, I'm helping somewhere along.

I was interviewing another emergency medicine doctor recently also from Michigan. One of the things he said is that working in the ER, of course, you do see a lot of trauma, you see a lot of car accidents or bad situations. But what he said鈥攁nd I'm just curious if you feel the same way鈥攜ou mentioned people that were very sick, that their families weren't aware of it. I don't know if yours is a medically underserved area, but do you see a lot of people that maybe have late-stage diabetes or something that they weren't going getting regular primary care where it could have been prevented had they the doctor more often? Maybe they didn't have the insurance. Do you often see things that are preventable where it gets really bad where somebody finally goes to the hospital and you have to maybe even find people that don't have a regular doctor? Do you encounter that at all?

All the time. And I think that's universal. In the vast majority of emergency departments, I think you'll find that with exceptions to nicer suburban areas where everyone's insured and taking care of themselves. But the vast majority of emergency departments you'll see... I mean, we see both. We see things that are not preventable and have just gone down a certain path and are unfortunate in their own right. And then you see the preventable things and whether or not it's because of a delay in care, inability to access care, denial, whatever it may be, it's an unfortunate social side of it that's very difficult and often frustrating. But in the end, all we can do is, first and foremost, stabilize, and do what's best in the moment. And then if the patient is inevitably being discharged because they don't require admission, just try your best. The hospital usually provides decent resources for this with referral lines and providing primary care and there are clinics and there are free clinics, and brochures that we give out. We try our best, but in the end, things happen the way they do. For whatever reason, people have trouble getting access to transportation or funding, or whatever it may be. But that is an unfortunate part of the healthcare system.

Are there any new cutting-edge treatments or medications specifically in emergency medicine that you'd like to discuss that are relatively new鈥攁nything that's come out that's really helped make it easier to care for people? 

In emergency medicine, we're at the forefront of acute care, so we do get to be at the front of these trials to see what's going on. Sometimes it's not always the introduction of new things, but determining what isn't helpful, that we're doing things that are harmful and we can stop doing. And right now, we're getting away from certain things called targeted temperature management. We're going more so towards strokes something called thrombectomy where they go in and retrieve the clot. We're doing the same thing in pulmonary embolisms, so blood clots in the lungs, as opposed to giving what we call a Tenecteplase or tPA, which is a medication that used to go in there and dissolve it, but also would cause a lot of side effects. So, we're leading in that direction now for thrombectomy, which is pretty cool. And we're working in conjunction with our neuro and our vascular teams and cardiovascular teams to push more and more towards pulling clots out, which sounds cake, but it's actually far more beneficial to the patients.

I think that's kind of cool that we're getting more on board with that. And in terms of medications, there's just new anti-coagulation reversal agents. There are new medications we're using for asthmatics. I mean it's nonstop, but I think thrombectomy is really at the forefront. I think that's pretty cool right now.

Advice for current & prospective students

What advice would you give to current and prospective students considering a career in emergency medicine? I know you said that at one point people thought it was going down, and I would imagine that especially with the advent of COVID-19 was such a national, if not international, emergency. What would you say to somebody who is possibly thinking about going into this specialty of medicine as a career? What would your advice be?

Don't listen to anything except for what you're feeling. If you walk into something and you feel at home, that's what's worth following because that's what you're going to have to get up and do every day for the rest of your life. If you are able to walk into a place and it excites you and you know that you're going to go home and read about something or you think you're going to make an impact, then that's what you need to really follow. That's what you need to go into.

Now I welcome anyone to talk to me about emergency medicine. The problem was that there was an article that came out a couple of years ago and it was subsequent to Covid where volumes were down and there were too many emergency physicians. There wouldn't be enough spots. I haven't seen anything like that. Our volumes are through the roof right now and I'm busy. But I'm happy and I love walking into the department every day, and I'm tired when I leave, but I feel accomplished. I think that's the kind of day you're looking for. If you can do that, then you can really find something where you're not long-term fatigued by it. You still enjoy the art of medicine and the learning of medicine.

Is there anything else that you'd like to add about emergency medicine as a specialty?

Emergency medicine is a great field. There was a lot of talk not too long ago about a drop-off in it, and that's not what I'm seeing at all. Volumes are higher than ever. I love what I do, it's fast-paced, walk in, walk out, and it's nothing but fun and a good time for me. So, I recommend anyone who's interested, please reach out. I'd love to talk to you about it. It's an unbelievable field.

As far as 六九色堂, it was everything I needed and got me to where I needed to be.  I wouldn't be the physician I am today without the school I went to. I'm very appreciative.

What would you like to say to the 六九色堂 alumni out there as a fellow alumnus, just in general, anything that you'd like to say to the alumni, a shout-out, or any ideas on how we could make the Alumni Association better?

Everyone just keep up the great work and I miss a lot of people out there. I mean I'm still seeing a lot of 六九色堂. We've been getting residents coming through the hospital. I'll let them know that I'm from the same spot they're living in. Yeah, I mean I don't know if Michigan itself is. I would imagine so, but I mean I did the vast majority of mine there.

We have a lot of 六九色堂 grads working in Michigan. 

It's always great to see someone else that came from the school and see how everyone's doing and doing what they need to.

Email Dr. Jordan Stav at jstav89@gmail.com

Top photo: Dr. Jordan Stav. Photo courtesy of Dr. Stav