Doctor JB [00:00:03]: Hi, everyone. Welcome back to the Hope for Med podcast. I am your host, Dr. J B, and today's featured guest is Ron Jacobs. He is a respiratory therapist who recently retired after over 49 years in the profession. During his career, he worked as a staff therapist, a supervisor, a department head, an educator, and had a long standing involvement in the AARC, the national professional organization for respiratory therapy. Welcome to the show. RT Ron Jacobs [00:00:35]: Hi, nice to be here. Doctor JB [00:00:38]: So, Ron, I love starting this show, learning more about you and your background. So could we start from the beginning? Can you please share with my audience your origin story? RT Ron Jacobs [00:00:50]: Okay. It actually started out pretty nondescript because it was not a career choice. I was in high school. I always knew I was either going to be a scientist or a physician because that was the direction I wanted to be in. And I was thinking about medicine and healthcare. I was actually in my freshman year of college, dating a girl whose father was a surgeon. And I asked her about being an orderly, and he said, Why don't you try to be an inhalation therapist? You don't have to go to school for it. The hospital can train you, and you can see a lot of what doctors do without having to get the education certification or even a license. And luckily, through connections with my dad, I got hired at 18 at a small community hospital in Buffalo, who was just expanding to the night to the evening shift. Back in 1972, it was called Inhalation Therapy. It wasn't even thought of as a profession that might exist ten years from when I went into it, so hence, my parents were not really happy with that. But I did it as a summer job and as a semester break job. It helped me pay for college. I did my bachelor's in chemistry, and because I had thought about healthcare, I minored in psychology so that I could understand a little more about the human aspect, because when it comes to medicine, you've got to have compassion and humanity to go with it, or at least I always felt that way, and, of course, humor. So when I graduated from college, I went back to Buffalo, moved back to Buffalo, and started working at that same hospital full time while I was in graduate school. And by now, the field had been called Respiratory Therapy. So for those of you that didn't know inhalation Therapy, in about 75, the name changed to Respiratory Therapy somewhere along the way after I met my wife there. But somewhere along the way, we were talking about medical school because I was in graduate school. And she realized I hated my research because part of my research in graduate school involved killing animals, even though they were mice and rats. I don't like killing anything. I mean, I don't even like killing a fly. I'm not really good at that. So she suggested I drop out of graduate school and go to the community college in the area, get my degree in respiratory therapy so I could make a career of it. And after discussion about being a physician, she said she didn't want to be married to a doctor because she wanted to be married to someone who would have a life and be part of the life of her kids. She knew me. I would be the kind of doctor that would work 20 hours a day, seven days a week. I would have gone into neonatology or intensivist for ICU, something where you're constantly on call and you constantly have to be available. So that would have been me. So I thought about it, and I decided to follow her recommendation, got my degree and started my career there, which probably worked out very nicely. I mean, we left Buffalo. I ended up at a hospital where I became their supervisor for their NICU, because I always love babies. That's where I got my supervisory experience, or initial supervisory experience. A job opened up back in Buffalo at our major trauma center, where back in the 80s, they were hiring the very first respiratory therapist to run the respiratory therapy program. I applied for it and we got the job and we moved back to Buffalo and they took over as a department head. All of this and in the background all of this time, I had been a member of the American Association for Respiratory Care, and that's our national professional organization. But I bring that up because I'll talk about it later. But it's really important for people to stay focused regardless of what's going on in their job and regardless of what's going on at the particular facility they work at. From there, the medical director I worked for at Erie County Medical Center, which was the hospital, got me hired at the University of Buffalo as a clinical instructor of medicine. I always liked teaching. Even in my undergraduate degree I would do presentations. I actually got to be one of the small group presenters for a course where there'd be a major lecture twice a week and then break into small groups. So education was something I really liked doing. I love teaching, and now to become a clinical instructor of medicine for the University of Buffalo was great. So that was the beginning of my official education or my official teaching from there when things changed. And that's where burnout gets in. Sometimes you don't have control over burnout, it's controlled by your environment. Occasionally things change as far as the administration at the hospital, but at that same time an opening came up at Genesee Community College for a director for the respiratory therapy program, and I was able to get that job. So now I became a full time educator and really loved that. Did that for about twelve years and got tired of driving almost an hour back and forth to work. And again administration changed. So the people that hired me and I developed the program with them in their positions, the president of the college, vice president of the college, and my dean, all changed to a different group of people that we didn't have the same philosophic points of view. And I also really missed full time patient care. That's always been my love. So I then left the college after twelve years at the college and started working full time at a hospital in Buffalo, where I was spending half my time in NICU and half my time with adults, mostly in ICU. And because some of the physicians that I had taught when I was a clinical instructor of medicine back in the 80s were now attendings at this hospital, they asked me to start giving classes to residents there, even though it was unofficial, because I didn't have a position, any kind of educational position. But then I was able to do some teaching in the process. So I kind of did everything I wanted to do as an end to my career. And I'm still a respiratory therapist, so I will be a respiratory therapist for the rest of my life. I just may not be working in a hospital doing it. It's the profession I love. So that's my 49 years. Although it went pretty quick, I'm sure. Doctor JB [00:08:31]: It flew by in the blink of an eye. And what's interesting is sometimes when you were in the hospital, the day may not be going by so fast. RT Ron Jacobs [00:08:44]: No, especially in a few different periods of time throughout my career. In the early days when I was working in El Paso and became the supervisor of the NICU, there might be as we were developing our NICU, there might be days where it just dragged, and you were busy pretty much from the minute you got into the unit till the minute you left. When I took over supervisor, I actually then would have to, at times, send lunches to the staff that was up there, because they wouldn't have any time to leave the NICU because of the demands. Surprisingly, those days, even though they were extremely busy, went quick. The days that dragged, which I hated the most, were the days where it was really slow. I mean, if there was nothing going on, or very little going on, that was horrible. I like being really busy, but not crazy busy, if you can understand the difference. And crazy busy, you always feel like you're leaving something out, or you're not doing the best job you can because you're too busy running around like a chicken with your head cut off. Doctor JB [00:10:02]: You feel overwhelmed. RT Ron Jacobs [00:10:04]: Yes, it is. And you don't really get any recognition for crazy busy, but really busy, you can stay focused, you can keep yourself going in the right direction, and you can keep busy. Other times when days kind of really dragged were I was at a trauma center in the early days of adult respiratory distress syndrome, which for people that aren't in health care, that's when because of whatever injury they have, their lungs just shut down and they have to go on ventilators. And in the early days of it, we had very little idea of how to effectively treat it. So then not only would the days be busy, but they would also be so frustrating because you didn't know what to do. Those kind of days were really difficult to deal with, similar to what happened with COVID And that almost became to a lot of the staff their first experience with all of a sudden dealing with a disease process that even though you tried your best, you really didn't know the best thing to do for it and you didn't know how to make it better. And you were just spinning your wheels and watching people die and scratching your head and just feeling bad. Doctor JB [00:11:36]: So when did you retire? RT Ron Jacobs [00:11:40]: Actually, last April. So I retired after about a year and a half of the COVID issue, but that wasn't the reason I retired. I would have loved to keep working, and especially seeing we were seeming to get a handle on not only how to manage the most difficult of the patients with pneumonia due to COVID, but also how to deal with even the simpler cases. My difficulty was working in an environment where supervision and management were not supportive. They were not advocates for what you were doing or what
