Latest / Here to Serve - A United Regional Podcast / Alan Coleman, Trauma/Acute Care Surgery Medical Director
Transcript
- United Regional: Welcome to Here to Serve, a Unite a Regional podcast. I'm your host, Ryan Graves. My favorite part of being the Director of Patient Experience at Unite a Regional is the incredible people that I meet and work with on a daily basis. And I want you to meet them too. Join us to meet the people behind the badge and to highlight those who are here to serve. All right, Dr. Coleman, welcome to the Here to Serve podcast. I'm excited for this one. Thanks for having me. Yeah. Well, ⁓ tell us who you are and what you do at Unite a Regional. Hi, guys. My name is Alan Coleman. I am the one of the acute care and trauma surgeons at the hospital. I am also serving the roles of, amongst other things, trauma medical director and wound care medical director. Okay. And I also shout out to Berg Bernat, but I'm also the Berg Bernat Fire Department medical director. Oh, that's cool. didn't know that. Yeah, there's a couple other little titles here and there. Those are kind of the... the big ones. ⁓ So trauma first. So for you not a regional trauma medical director and wound care. Correct. Medical director. I didn't I didn't I didn't know about the Wink. I knew that you were trauma. I was going to ask you for a fun fact. But the Burke Burnett PD, I mean, that fire department, that's pretty good. They get a fun fact. I am there a ton of fun facts about me because just a fun fact. Okay, give me some more. I know I get now I got to know give me some more fun facts. No, people that work with you may not know necessarily. Let's see. I I am half Filipino. Okay. So my mom's from the Philippines. Okay. I have multiple tattoos. Okay. And so that's kind of a What's your favorite? My favorite tattoo. So I have these sleeves that I just did on my arms ⁓ that were probably consecutive the last two years. ⁓ And those are my favorite right now because they're one of the newest. I've kind of helped design those. And that's cool. They represent both sides of my ethnicity. OK. So this side, which is my dominant side, is representing my African background. And then the left side represents my Filipino background. OK. That's really cool. Yeah. And so I was really happy about these. Man, anything else? Other fun facts? I could do this all day. This is the stuff I'm into. I used to break dance in high school. All right, well now we're going to have, we don't have space in here, but we're definitely going to have to have a demo break dance. Okay. Like just for fun competition. me a little bit. can do something like at least one move, right? That's awesome. Fantastic. Fantastic. I think I know one break dance move. ⁓ I may have to show you. I'll show you and you can give me some tips on it. That's awesome. So let me ask you this, talking about your background a little bit. I'm always fascinated how people end up where they are in the roles they are in the location they are, you know, it's it's always fascinating to me. So let me ask you this, did little Dr. Komen know he wanted to be a surgeon and how did that happen? How did you, how did you become a surgeon? So little dr. Coleman did not know anything about doing anything other than watching cartoons on Saturday morning and so So I so my background Is I was raised in Dallas Born and raised in Dallas. I had a kind of a poor background. My parents were divorced At an early age, I guess I was about middle school elementary middle school And so I grew up in that kind of austere environment and because of that, especially with being African American, I kind of gravitated towards professions of respect and authority, high in the socioeconomic hierarchy. And that's probably the, I guess, for lack of better term, the more superficial reasons to become a physician, but nonetheless important and highly respected. And then as I grew up and I realized how well I did academically as that was kind of the bigger focus in my life in order to kind of remove myself from any other social situations in my life. And I learned a lot from my mother about work ethic and grinding and staying focused and kind of ignoring negative things. And so I did really well, graduated pretty reasonably high in my high school class. And by then I had done some medical experiences that put me on that track. I was a big science nerd. my degree is in biology. And I still do quite a bit. Like when we go on a trip, we're always doing something nature-y. Okay. Yeah. I still really am into that type of stuff. And then ultimately gravitated towards medicine. I didn't really have an idea of what type of medicine I wanted to do, but being of a shorter stature, I thought I would... relate more to pediatrics. Less intimidating. Yeah, okay. Yeah. Yeah. So I went that track for a while. ⁓ I ultimately got accepted to medical school at Texas Tech University in Lubbock and went through my first two years, which is just school. School textbooks. And then during one of those summers, I actually worked with a pediatrician. in that community and realize I just did not want to do pediatrics. I just didn't like the turnover for how often and how many times you had to see a patient. then the, ⁓ especially with pediatrics, there's a lot of viruses. And so you don't know specifically what's helping them. They just get better. They're Do you have kids? I do have two boys. Okay, two boys. How old are they? ⁓ 13 and He ones about to turn 13 and then ones about to turn 17. Okay. Hey, you're better than me When that people ask you my kids age and like yes, no, I have three and they like they keep changing I don't know their birthdays are coming up. So it's what I have to figure about so to finish the medicine thing, so actually Decided against that and then started doing surgery rotations and absolutely fell in love with the Hands-on approach the immediate outcome of surgery. ⁓ then I found out about pediatric surgery. And so I kind of gravitated towards that. I could still work with little people, I can do surgery. And so I went down this long track of doing stuff for pediatric surgery. It's actually one of the most competitive specialties of surgery. In fact, there's probably, at least back then, were twice. at least twice as many applicants as there were programs across the US and including Canada. Wow. And so you had to jump through a lot of hoops in order to get into that fellowship. You had to shake hands, you had to network, you had to to the right places, you had to do the right things. And so you had to at least do all these things to make yourself equivalent to everyone else and then go beyond that. And so I actually did, so I did my general surgery residency at Texas Tech, I stayed there in Lubbock, and then broke up that residency and did two years in Cincinnati. But up to this point, you're Texas guy. Correct, born and bred. But you left Texas for Cincinnati. I loved Cincinnati ⁓ and still love Cincinnati because my youngest son is actually born in Cincinnati. There's a story behind that if you want to hear about it. But ⁓ did two years of there where I did. ⁓ fetal surgery medicine. Okay. So I work with high-risk obstetrics and pediatric surgeons that did pre-born surgeries on fetuses. Oh, wow. Yes. so, and then I did an ECMO fellowship with them. Wow. And did a bunch of research. And so then I came back and then ended up not matching the first year in pediatric surgery fellowship. So how old are you at this point? I am... So I graduated high school in 2001 and then four years of college. So 18, 22, and then another five years of residency. Pushing 30 then? Yes. Okay. And so then I went and did a surgical critical care fellowship in Columbus, Ohio. So we went back to Ohio, just a different part. and I did it at Nationwide Children's and Ohio State University. So they have a combined program that allows you to do adult surgical critical care. It's just that it's focused at the children's hospital because these people want to do pediatric surgery. Halfway through that or a third of way through that, I realized I didn't want to keep doing all this reapplication process and had fallen in love with critical care. So ⁓ Texas Tech's general surgery program is very... ⁓ heavy end critical care medicine because they have a burn center, they have a big surgical ICU. And so I ended up falling in love with that while I was finishing up my general surgery residency. So I thought, why not do something that could work dual purpose? If I don't want to do the pediatric surgery route, then I'll get into critical care without losing any steps. And so I approached ⁓ my program director at that time, probably three months or so in, and told them the news and everybody... wants to keep you in their track. Of course. They invested in you, but they're very supportive. Everybody wants you to do well in life in general. Sure. ⁓ And so he actually adjusted my rotations to where I did quite a bit of it at the Ohio State University. So I did a lot more adult critical care there than typical and then ultimately ended up in Wichita Falls. Yeah. Well, man, we're glad you're here. How long have you been here? So going on nine years. Nine years. That's awesome. I knew you'd been here for quite some time and we're sure glad to have you. I hear, you know, I'll tell you right now, my role as patient experience, director of patient experience, if there's concerns ⁓ about someone, I know I hear them regularly. And so it's a good thing when your name doesn't come across in my office often, only in a good way. Like we hear good things about you from patients and from our staff always are supportive and are thankful for you to be here. I have a... a very different track in life, but we have one thing that definitely overlapped. And that was, thought I'm an RN and I thought for sure I wanted to be a pediatric RN. When I started, I I really, that's cause I did a lot of youth work growing up and I love, I love, I've got three kids. I love working with kids and I just find it so rewarding. And so I was like a youth pastor at my church. And so I'm like, cause I'm becoming a nurse. I'm like, clearly pediatrics is the path for me. And one rotation through acute pediatric unit. And I'm like, no. That's I'm out because I couldn't first of all I couldn't handle I'm a baby when it comes to this So seeing kids suffering like I did not handle that well and it is a big deal. It's a it's yeah, and was like, nope That's not for me. And so I went back to ⁓ other areas, but ⁓ I always thought that that's what I wanted to do It sounded good in theory until I was actually there No, no, not not for me. I have a special respect for the people that feel like it's like man and everybody has ⁓ different callings, but it's a different thing for sure. So let me ask you about ⁓ trauma specifically. A trauma surgeon ⁓ is, and you do many things beyond that, of course, but I would like to ask, what does that path require ⁓ to be a trauma surgeon? Personally, temperamentally, do you kind of see, ⁓ as you work with other trauma surgeons, do you see certain personality types drawn to this? I'm just fascinated by that. So most general surgeons are very well trained in trauma ⁓ surgery in general. So nowadays, it's not just trauma, it's acute care surgery as well. So what they tag is acute care surgery. And so what that basically means is all of the sick patients that come through the hospital, ⁓ not just your traumas, your gunshots, stabs, falls. ⁓ that also includes people that are sick from some organ in their body trying to kill them. And so there's their appendix, their colon ruptures, their gallbladder is sick, and so they ⁓ call us. And so it has transitioned that way. used to be all general surgeons do this as part of their call responsibilities. ⁓ Over the last five to 10 years, it has become, ⁓ there's been an emphasis on work-life balance and things like that. so, gone are the days of significant 24 hour, three times in a row, three nights in a row call ⁓ in exchange for this specialized group of physicians or surgeons that deal wholly with this. ⁓ And it has been significant for work-life balance for all surgeons in general, not just... the trauma acute care surgeon, but the general surgeons as well. And it has improved outcomes across the board because now you have somebody dedicated to this specific disease process in this acute phase of their, and their process. so that's kind of where it is. ⁓ Most of the, and as far as training, like I said, most general surgeons have the background in the training and can probably just go into the field and that role and responsibility. right from the get-go, and then that just kinda on-the-job training where you start to focus on it, you get more more comfortable with that route and start doing that on a regular basis. From the standpoint of additional training, you can do a surgical critical care fellowship, and that has an additional focus in intensive ICU patients. And then you can have a two-year fellowship that has a an acute care surgery or trauma operative year, and then that focuses on you getting more specific operative experience, because the majority of your surgical critical care fellowship, ALS, and the ICU taking care of those patients, not necessarily ⁓ having to focus on the surgery of those patients. And so that's the training for it. ⁓ And then as far as ⁓ personality, I would say most of These people are ⁓ highly analytical ⁓ and not averse to unpredictability. ⁓ So those are kind of the two things that probably stand apart from other surgeons that have routine elective practices where they can schedule a surgeon, know what they're getting for the most part, and then have a game plan going into it. we have a few hours to make a game plan and then figure out what we're dealing with in the operation. so, and the same disease does not present the same way in every person and also does not physically manifest the same way. And so you're constantly having to make adjustments or have a much broader skillset for dealing with all sorts of things that may happen during a surgery or whatever you may encounter. So unpredictability is one thing some surgeons can't handle. And then just the analytical thinking and the improvisation that somewhat come with this. I wonder about, you said something earlier that really clicked with me is your mom. Sounds like an awesome lady, by the way. Is she around here? She lives in Dallas. Dallas, OK. She is an awesome lady. Yeah, she sounds awesome. Shout out to mom. If she's ever here, I want to meet her. But so we have two viewers at least my mom will watch this and your mom will watch it involved. But ⁓ yeah, she's over here. I definitely want to meet mom. But ⁓ you said she taught you to focus and ignore the distractions. Do you I can only imagine right in in all surgical situations, but especially the high stakes. I mean, that's got to be a huge skill set is the ability to focus and and put other things out of your mind. Sure. I ⁓ and Yes, absolutely. It's a skill set that comes with it, but I think everybody has the ability to focus. Even the ADHD, they have the ability to focus. It's just what do you feel like you can easily focus on? And so whether that's being able to play the same video game for hours at a time, even though there's constantly dynamic things and changes, you're still able to focus on that. You can still focus. And so my hyper focus is the ability to be able to shut out things and then concentrate on taking care of this patient and figuring it out. Now you tend to figure out things that help you focus more and kind of drown out some of the distractions and things like that. like for me, ⁓ one of the things I routinely do that probably very few people even even notice is I chew gum during a case. And it just kind of lets me relieve tension in my head. makes sense. Yeah, so it does that. But yeah, I think everybody has the ability to focus. It's just truly what is allowed. And that, ultimately, I think if people would realize what their hyper focus is or what comes natural to them, would help them in their career decisions. it make you so much more successful if you figured out what made you take first. are nailing I totally agree. That was actually the line of questioning I wanted to ask you was I'm fascinated by high performance things, right? And the ability I've noticed in myself when I find things that I can truly just like shut everything else out and focus on. That's when I can perform my best. And so I've heard, I've heard some surgeons say, and I've not talked to a lot, but I've heard some surgeons say like, man, when I'm in surgery, that's like one of the few times in life that everything else goes away. Stakes are so high. I am flow state locked in. ⁓ sure. Is that is that would you agree with that? Yeah, absolutely. So there are times and most surgeons will kind of comment on this periodically where you are you realize nothing else going on the surgery. But when you're done, you realize how tense you were, like how long your knees were or how tense your shoulders are and are your ergonomics and things like that. And you want to make corrections later on. But You never realize it. You're so focused on whatever is happening in that procedure and it going right. ⁓ But a lot of surgeons ⁓ distract themselves, you know, doing like there's music in the background. They already try to have a conversation. They try to lighten the mood to kind of ⁓ affect the surgery and things like that. And I tend to try to do that as well. But yeah, you tend to notice a lot of things just because of how focused and the moment you are. Yeah. Well, the stakes are so high. absolutely. And I don't beg my next question, which is when you're, you know, doing something that is so high stakes, it requires such a lock in. Do you find in other areas of your life? I don't know how to say this without it sounding bad. I don't mean it bad, but is it hard to maybe find meaning sometimes and other things that aren't as high stakes? Do you run across that at all? No, I. Let's see how would I word this? So you. Because that is so natural. you tend to gravitate towards those same things. ⁓ And that can affect your personal life. So, and this is kind of a ⁓ running gag, I guess, with my wife. She is a nurse, a background nurse. So she was a postpartum nurse when we were in medical school. I had the privilege of meeting her the other day. Her office is right around the corner from me. Yes, she was out, started working at the hospital. But she was ⁓ a postpartum nurse ⁓ and she was working. and through med school and things like that. And then she became a stay at home mom and then she went back to as needed school nursing. And now she works kind of at the hospital doing administrative stuff. ⁓ And it was kind of this during probably a more contentious parts of our relationship that ⁓ the, I would come home and I would meet like something down or ask for something down. was like. when I just write an order for it. So there would just be go. It didn't go well. I think a pan flew at me or something like that. But but you go home and you still have the same mentality of all the hierarchy of order in the hospital. And then you go home and you have kids that absolutely do not listen to you. Yeah, you're you're you're nothing is orderly. So you end up having that ⁓ be your less desirable situation and you either start having us like spend all this time doing more things at the hospital or gravitating back towards that which is natural and comfortable and convenient. And so then you stop dealing with the things that are important at home or trying to make the adjustments that are necessary to build a. ⁓ good relationship or have a strong relationship with your children and things like that. You do notice that stuff ultimately. I think that has been kind one of those things over 20 years of marriage and raising two kids that we have continued to work on and things like that. That's awesome. Well, just seeing that, acknowledging it, figuring out how to work through it, I mean, that's huge because man, I mean, I've seen it. ⁓ I've been... and at United Rangers for 20 years and about, I don't know, 17 of those I've been working closely with providers. And usually when things start going wrong with the provider, my first question is, what's going on at home? Almost every time because it's like, what's going on at home? Because this came out of nowhere, providers are humans. When your life's falling apart at home, it falls apart at work too. And so it's a huge part of success is like, man, I gotta be on point, not just here, but at home. I can't help but think of... there's an old Will Ferrell SNL skit where he's sitting around the table and his kids are like giving him grief about something and he's like, I'm a big deal. I drive a Dodge Stratus, you know, and he's like, I'm respected at work and his kids are like rolling their eyes. Anyway, I digress. Let me ask you a couple more questions. We're already running out of time and I got so many questions to ask you, it's a bummer, but. We can do a part two. Yeah, for sure, we'll do part two. What's the, and I think I probably know, but I wanna ask, what's the hardest part of the role? Like the hardest part of what you do? I think it goes back to just balancing. So you want to do all the things that, so my, I love the patient care aspect of this. And I think if I find it the, the easiest, the most natural, the least stressful, as crazy as that sounds, as opposed to my administrative roles. That's not the normal for me. I feel like people have given me these roles or offered me these roles because they see something in me that... ⁓ translates to taking on a leadership role. But that's not the most natural for me. It's the curse of doing a good job. You do a good job, they go, hey, what's that? That's probably the more difficult part of my job in my life. then the other part of that is I love the patient care aspect of my life. And so I tend to have that as a high priority. And that sometimes can affect your personal life. And unfortunately I have my wife who has been through me through all through medical school, residency, and so she has a understanding of how my personal is and how I prioritize how I take care of my patients and has been ⁓ absolutely the most wonderful person in supporting me through that and ⁓ know, all of the household stuff and raising children wonderfully and to contributing members of society. blessing. Yeah, absolutely. It has made my life so much better and in turn affected and improved all of the things I do from a professional standpoint. All right. So shout out to Karen. Yeah, shout out. Shout out to the wife. Absolutely. ⁓ So that's the maybe the worst or the hardest part. What's the most exciting part? Like the thing that gets you fired up the most, makes you happy? Patient outcomes, ⁓ I guess in the general sense of the words, ⁓ because I take care of really sick patients and just being able to have a direct impact in how they heal, how they recover ⁓ is what allows me to continue to move forward ⁓ and make the exhaustion, the stress work. Yeah, worth it. In fact, being in Wishtoff Falls, which is a smaller community where you tend to run into the same patients or the families that you see or take care of on a regular basis, it was invigorating. We were just at an event last night and someone came over and they said, actually two people that night I had taken care of or they knew somebody I had taken care of and one had a really bad skin reaction after service. She's still internally grateful and she expressed that. And then one person came over and said, ⁓ you took care of the ex-wife, family, friend of this, and so far removed, but they told me how she was doing and expressed how wonderfully she had appreciative of me and things like that. And that's motivating. Yeah, it's gotta feel good. Yeah, absolutely. It makes me say I did a good job despite how much, how long the recovery was, how critical they were that they... were still so grateful in that they had at least a reasonable outcome. And so that's exciting. That's awesome. I can't imagine. people have this funny thing that I'll say funny. It's probably not funny, but I have something I say. People are like, hey, how's your day going? I'm like, you know, just saving lives. And I'm just being silly. mean, I'm a part of an organization that saves lives. And maybe I've done CPR and saved a life or two in the last 20 years. But that's pretty rare. It's more metaphorical when I say saving lives. ⁓ But you know, you can actually say no, I actually saved somebody's life today and then that person comes up to you and says you saved my life. I think that's like probably like the male fantasy right there. It's like somebody walks up in public and goes that guy saved me. Like that's pretty cool, man. It's be rewarding. It is absolutely rewarding. And I want to also give a shout out to everybody that helps me do that. Yeah. Because and I'll liken it to ⁓ pre-hospital medical services. So EMS. that save lives with very little things. And they bring them to the hospital alive, as opposed to with very little things in the most austere environments, in a ditch, with no lighting, whatever it is. And they get to the hospital and I'm able to continue that process with the help of everybody around me. I can't do the surgery without the anesthesiologist, the whole anesthesia team, the person handing me the instruments. a person running to get more stuff for me than a circulating nurse, the people that are taking care of the patient afterwards or before. And so it really is an organization saving lives. And I think that that doesn't go, that goes unheard quite a bit. Yeah, that's definitely one of my kind of core beliefs and phrases I say all the time is we win or lose together. Like it's the power of the team. Johnny Roberts was on here a few months ago and And I was asking him about his job and his favorite parts and those things. And, one of the things he said is he realized very early on the power of teams. If you can put a good team together, like you can do anything. It's like you can literally get anything done. If you can put the right group of people with the right mindset, they're aligned on the same goal. Like you can get anything done. So we have what a cool trauma team that we have. ⁓ Shout out to that whole, the whole team is incredible. We'll start naming names because I'll forget somebody, but I want one more quick question. I think we're going to wrap it up right after this. ⁓ But if you could put a billboard up in Wichita Falls with a message from the trauma team. okay. Any message, really, that would ⁓ help the community. What would you like to get out there to everybody? I would just say, come on down, y'all. Yeah. I think Wichita Falls has a lot to offer. ⁓ is just, there's just not been growth. And if the population would go up, then we would be able to support local businesses who have a high turnover just because there's not a dense population to go to those places like in Dallas where you have so many people in this one block that they can support this one business. And there's been a lot of really nice ⁓ small businesses, local businesses just have not been able to survive. ⁓ that would help grow everything, the community. the medical community and then the business side of things. And I think that is probably one of the more desirable things that if you want to continue to be enticing, you need to grow. so, and it's a beautiful environment and I'd like to see that happen just from the long-term standpoint. the hospital's fine. I mean, the resources are excellent and they will grow in turn. So I have nothing that I want. to do for the hospital, wanted to grow the community. I wanted to ask you this and I forgot, we're level two trauma designation, that correct? For anybody that doesn't know what that means, we say that a lot, but I think there's probably a lot of people like, what does that mean? What does that mean and what's the significance for what still falls? So a level two trauma center, and so their designation is level one, level two, level three, are the major designations. Level three just means basically you have a, some regulation to how you're doing your traumas and things like that. Level two is a huge step up. There's all sorts of ⁓ regulations, protocols in place that are ⁓ looked at from a regional level and then ⁓ patient outcomes are monitored a lot closer. Level one is not much different from a level two with the exception of teaching and research. And that does help with patient outcomes, but not to the degree that you necessarily would believe. so level two are just as good as level ones, minus a few specific specialties and then research and residency programs and things like that. And so a level two is pretty significant for this region. And for this region in particular that has a kind of a wide catch with rural areas and places that don't have hospitals or have closing hospitals, then it's significant for us to be able to have this area for that. And the trauma center reaches far and wide. It ⁓ sometimes helps with reimbursement. It increases some of the reimbursement from Medicaid and Medicare, and then also ⁓ increases how much ⁓ the state refunds for like self-pay or non-insured. There's a reimbursement specific because you're a trauma center. But it also provides a service for other places and it builds kind of a foundation for recruiting certain things like an interventional radiologist or something, or orthopedic surgeons and things like that. And so it helps kind of add a foundation to build upon. that would also provide other services for other things to the community and the region. Yeah. Any any PSAs you want to get out there from the trauma standpoint or anything we haven't talked about that you want to cover? So, you know, obviously it's getting warm outside and so motorcycle and ATVs, golf carts, all those certainly be safe, do the right thing, do things. ⁓ without being intoxicated or under an influence. ⁓ Just be safe guys. And then obviously ⁓ swimming and things like that. were to make sure everybody supervised, watch the kiddos, things like that. I can only imagine being the son of ⁓ a trauma surgeon. Like I know every emergency department, ICU and surgeon, all those people, like no motorcycles, no ATVs, helmets. Are you pretty strict on that with your boys or no? So we've never had a trampoline. Okay. I was at the pediatric hospital, I saw some really terrible liver lacerations. And so we've never had a trampoline. We've had a bounce house. That was the to compromise. I won't let my kids really ride with other kids in a golf cart or an ATV. You're saying too much, man. Yeah, absolutely. Well, on this, just you don't know how that other person is going to behave. you can't control that situation. You're not going to prohibit them from doing it. But you can protect your child from doing it, or at least control the environment as much as possible. I'm not a ⁓ restrictive parent by any means, but I do have some things that I'd I know from experience that I try to impart to my kids. it's just, there are other things, other alternatives and things that you can do as well. You can mitigate. Yeah, absolutely. But live life. For sure. YOLO. Yeah, amen to that. ⁓ it's been awesome having you on today, man. Thank you. I look forward to talking to you. was fun.