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Emergency NYC: A new Netflix series featuring Northwell · 20-Minute Health Talk

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We're not just COVID doctors and COVID nurses and we're not just
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healthcare heroes.
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You know, we didn't just show up, you know, in March of 2020.
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This is something we do every day.
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The different pieces of the puzzle in Emergency NYC are reflective of that
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from the helicopters to the ambulance driver, to the nursing, and
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obviously to us as surgeons.
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And I think we can all celebrate this show as a reflection of what we
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do individually, what we do as a healthcare system, and what we do as
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a healthcare provider for the greater good.
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Welcome to 20-Minute Health Talk.
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I'm Sandra Lindsay.
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Today we are speaking with two of the stars of the Netflix docuseries
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Emergency NYC, which is out today.
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I gotta say, there's a lot of buzz around this exciting show, which is
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actually a spinoff of the critically acclaimed series Lenox Hill.
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Both are created by Ulari films and both follow the lives of a cast of
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healthcare providers.
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Like one of our guests today, Dr.
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David Langer, he's the chair of neurosurgery at Lenox Hill Hospital
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and vice president of neurosurgery for Northwell Health's Western
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region.
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I visited Dr.
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Langer at his office on Manhattan's Upper East Side to talk about the
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show, his own experience becoming a patient himself following a
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serious spinal cord injury, and what people can expect from Emergency
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NYC.
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We were also joined by one of his patients, Julian Primiano, whose
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dramatic story is captured in this new series.
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Talking to them, I felt like I was right there with them in the
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documentary and I think that's what people are going to take from
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this.
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Again, this binge worthy series is out today and I encourage you to
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check it out.
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But before you do, here is our conversation with Dr.
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David Langer and Julian Primiano.
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Dr.
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Langer and Julian, thanks for joining me today.
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Your stories in Emergency NYC were just so powerful and I am
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encouraging everyone to go out now and stream Emergency NYC.
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All episodes are on Netflix and ready to go.
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Dr.
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Langer, what are you most excited for the public to see when they
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watch Emergency NYC?
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Yeah, I think the series is much more bigger.
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It's a reflection of the disparate parts of not just a hospital or
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patient experience.
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This is a very broad look at lots of different
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pieces of a large health care system in the greatest city in the
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world.
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And I think there's a couple of things in the trailer about the sirens
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are the soundtrack of the city best line.
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Best line that I think is really true, that a siren means that
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somebody's struggling.
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I think it's as tough as it is to sometimes when that thing goes by,
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here's one now, you know, as I reflect on that, and I think that to
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me, that's what the show does.
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A siren is the first step.
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It's a call for help.
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And then that's when that switch gets flicked and initiates a series
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of dominoes that hopefully results in a great outcome like Julian had.
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And so I think perhaps that's the gift the show is trying to portray.
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It's up to the public whether there's something to that or not.
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I think it will, but I think that's what I'm most excited about.
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Part of your story, Dr.
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Langer, involves Julian, who is joining us today to share her story.
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Julian, how did you get connected with Dr.
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Langer?
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I was connected via the emergency room, so I had come straight here.
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Well, what brought you to the emergency room?
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I was having symptoms of faintness.
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I was drooling from the left side of my mouth.
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I was having no expression on the left side of my face.
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I just wasn't feeling myself.
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I would want to sleep until 01:00 in the afternoon when I wake up
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every day at six, and I knew something was wrong.
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I waited a long time.
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I hid my symptoms for about a month because I was too nervous to kind
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of speak up and said I had a problem and we could have had a major
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problem.
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And then a few days before I came to the emergency room, I had taken a
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photo and I had sent that photo to my mom.
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My husband and I were at a wedding, and my face looked very concerning
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to her.
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So she said, please, when you get back into the city, go to the
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emergency room.
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We found out that Lenox Hill was with Northwell, and so we came up
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here at 09:00 on a Sunday, and they admitted me to the ICU
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immediately.
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And the next morning I was with Dr.
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Langer and Dr.
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Boockvar.
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Then what happened?
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What did Dr Langer say to you?
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What was going on? Down in the emergency room,
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after they took the CT scan, they had told me that I had a mass in my
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brain on the right side.
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It was quite large.
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And then after that, we found out more with the angiogram the
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following morning.
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And then Dr. Langer and Dr. Boockvar2 were able to tell me exactly what it
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was.
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It was a cavernous malformation.
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Not to be immediately concerned, but it was definitely something that
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would need to be eradicated within a month or so.
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So, Dr Langer, what is a cavernous malformation? A cavernous
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malformation is basically a kind of
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tumor.
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I mean, not cancer, but a tumor.
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It's like a mass that's made up of blood vessel tissue.
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It doesn't have a direct blood supply.
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It's sort of like a mulberry with, like, little or BlackBerry.
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It has little tiny little pork parts to it, little cells of tissue, of
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a vascular tissue.
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They bleed, they rupture or ooze, and then they enlarge, and they can
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be very chronic.
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And she had quite a large one with a lot of what's basically what's
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called mass effect, because the size of the mass was putting pressure
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on her motor areas of the right side of her brain, which resulted in
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this kind of drooling.
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This is primarily in her facial area.
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So these can present with seizures.
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They can present with mass effect like Julian had.
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They can present with bad headaches.
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Depending on their location, and based on the size of this and the
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degree of neurological deficit she was having and her age and her
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medical health, we felt that it was relatively urgent to remove this
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so as to avoid any kind of progressive neurological deficit and
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recurrent bleeding and massive and pressure on the brain.
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Is this very common?
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Not particularly.
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I mean, probably less than 1% of people have, and they can run in
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families.
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They can be familial.
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But Jullian's isn't one of those types.
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People with familial ones with multiple cavernous malformation, she
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really just had one.
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In young patients, they're one of the more common causes of a
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neurological complaint because young patients don't have as high of an
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instance of things like regular stroke or some of the other causes of
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acute neurological deficits.
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So, as a group, cavernous malformations will be a higher percentage in
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young people of those that can cause the kind of symptoms that Julian
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had.
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So you're admitted you come to the Ed.
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What thoughts were going through your head then?
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For the first second, I was terrified.
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I just couldn't believe what had happened.
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Your life is moving so fluidly, and then all of a sudden stops.
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Stops.
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Everything stops.
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So my parents had to change their life.
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Everyone in my life changed their lives for me, and they really showed
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up.
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And I had to show up for myself and for them and stay positive,
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because just as hard as it is for the patient and for myself,
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it's tenfold for the family members.
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So I just knew I needed to go into positivity mode immediately, and
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that's exactly what I did.
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So, Dr.
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Langer, tell us about Julian's surgery.
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Well first of all, I think initially when we came in, we should
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know what she had.
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This could have been a cancer.
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It could have been a tumor.
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It could have been a bunch of bad stuff.
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Once we knew this was really a benign problem, certainly we could tell
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her a good story.
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We gave her some options, like we could wait this out and see if it
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happens again.
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But because of the size of it, I think we were concerned that if it
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bled again, that it could be even worse.
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Because it wasn't an area where she was going to suddenly we didn't
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think she would suddenly die from it or become really sick.
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So that's kind of the nature of these things.
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But, you know, I think, again, her husband was a doctor.
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We could I could have a very frank discussion with him.
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Yeah, I was well, again, my husband being a doctor, he was very
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adamant about the sooner, the better.
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My parents were a little apprehensive.
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Of course, it's brain surgery.
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It's scary.
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It's things you see in the movies.
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It's definitely, you know, Dr.
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Langer does it every day, but the normal, average, everyday person
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does not.
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You see them on Netflix.
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You see the brain surgery on Netflix?
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Yeah.
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Yeah, you see it on TV.
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So my parents were very apprehensive.
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But they trusted my husband, they trusted me, and they trusted the
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doctors.
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So they said, whatever you feel comfortable with, we'll move forward
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with that.
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And I'm so glad that we did it when we did.
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Definitely no regrets.
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So, Julian, you have a master's degree in opera performance from the
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Manhattan School of Music.
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Were you performing before your diagnosis?
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Yes, I was.
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I was performing a lot, actually, as a soloist, soprano, classically
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trained.
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Also do musical theater as well, but mostly opera.
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Well, I can't wait to hear you someday.
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What was life like before your diagnosis, your recovery, and what is
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life like for you now?
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So before, very energetic.
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Like I said, I'd wake up, big routine, go to the gym, go about my day,
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go to work.
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But then during the diagnosis, I was in the hospital for a while, and
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I was home.
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I had some seizures following the procedure, which was expected, and I
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was home for about four months.
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I had to have someone stay with me, which was my mother at the time.
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She stayed with me all day long.
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My husband would leave to go to work around 05:00 a.m..
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She would come down from her apartment at that time.
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We would have breakfast together.
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We would go about the day together.
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And then my husband would come home.
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And then it was his turn to look after me.
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And we started small.
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We would go on.
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Like I said, I love to walk New York.
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I walk all over all the time.
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And I couldn't do that anymore.
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So two blocks here and there was a huge feat for me during that time.
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Why is that?
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Were you weak?
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Weak on a lot of medication.
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That must have been very scary.
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Were you scared?
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Terrifying, yes.
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So what is life like for you now?
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What are you doing?
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What are you up? Now
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it's wonderful.
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I feel so much better.
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You look fantastic.
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Thank you.
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And like I said, coming off the medication and working with my
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epileptologist to figure out when is the right time to make the
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changes, I've just been seeing so much improvement in my day to day
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neurological, how I go about my day.
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Her post up course is difficult.
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and bright and has all this stuff going for, and all of a sudden she's
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on all these epilepsy meds that weren't all working.
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They basically slow your brain down.
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She was struggling with the speech and just doing simple things.
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And we knew that there's something that we could cure, was curative
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and would leave her to live to have babies and get married to her
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handsome husband and do the things that she wanted to do.
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And that was, I think, the most important thing she had to understand.
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But the fact is, it how to come out because we didn't want her to suffer
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from irreversible neurological deficit.
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You always want the best outcome for your patients, and I knew we did
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the right thing.
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But the fact that she wasn't feeling great and was just so taken down
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by the seizures was rough.
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And that's why it's so great seeing her like this.
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Obviously, you know Julian's case and story better than anyone.
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Having brought her from diagnosis to surgery to now being with us
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today, is there a particular moment captured in the show that stands
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out from Julian's story?
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I mean, frankly, the scene that I find the most, that resonates with me most in
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Julian's story was when I went to see her husband in the waiting room,
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that's the hardest part, seeing him there and knowing how much he
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loved her.
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And then his emotions.
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Those are the things that are the most satisfying in what we do
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sometimes.
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All the mechanics and all that, it's great to do really cool stuff.
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I wear my heart on my sleeve, obviously, and I'm an emotional person,
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which some neurosurgeons aren't, to be quite frank.
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And sometimes you're being that way isn't necessarily a good thing
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because we struggle with such difficult problems.
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But these are very dramatic times sometimes in our business.
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And so when you go out there with a good news, that's great.
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And that's something that I think, for me, resonated the
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most for me, that came in the show for sure.
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It's been a year since you've seen Dr.
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Langer and vice versa.
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What is it like?
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It feels like yesterday for me.
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We spent a lot of time together.
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He was very just I mean, every day at the end, after, he
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would do his rounding after his surgery days, he was there at like,
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07:00, which was never really the best time for me because that's when
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I would take my medication.
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So I would be very loopy.
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And usually when I would see him, I would see three of him, and he was
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just great.
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He would make me laugh quick 15 minutes of his time.
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It really just means the world.
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Dr.
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Langer, what is it like seeing Julian after over a year?
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Well, one of the best things about our business is that the nurses
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always miss out on, honestly, is we see people at their worst and they
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come back to us.
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And it never ceases to amaze me of how much improvement you can see in
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people when you see a patient who's recovered her energy
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is back.
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That brightness is in her eyes.
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I can see now she's back.
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And I didn't necessarily see that a year ago.
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And in fact, she grew her hair longer, and you can see that it's hard
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to even recognize her, given where she was.
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So that's really the gift that we get.
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And that's the reason why I went to nurse surgery in the first place.
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And so seeing her over there was like, whoa, you look great.
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That's a big difference.
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The creators of the show, Ruthie Schatz and Addie Barash of Ulari
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Films, spoke to E.
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News about why a show like this is important, and I want to get your
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reactions to what they said, because I thought it was interesting.
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We wanted to portray the vital importance of each individual while
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revealing the complexity of the healthcare system and its many moving
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parts.
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Their raw acts of humanity are usually only witnessed during the most
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fragile moments of a person's life, but are necessary for all to see.
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Dr.
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Langer, why do you think a show like this is important?
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Well, I think that, first of all, taking care of people is a team
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effort.
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And I'm lucky enough to be working with a nursing staff and a group of
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people that's committed to making people better, whether it's
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neurosurgery or spine surgery or what have you.
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I think that the show is emblematic of that.
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We see in Julian's case, a very simple problem that to her and
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her family, she's the most important thing on Earth, and she comes
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here asking for help.
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And then we provide a structure and a group of people that's committed
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to that.
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The moving parts from the neurologists and the PA's and the nurses to
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the OR staff and the techs and then the ICU staff, and then, again,
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nursing all the way through.
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Obviously, my own story plays a big role personally, which is very
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different.
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Having been on sort of both sides as doctor and patient was really
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sort of interesting.
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The fact that these people are filming my life when I have a spinal
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cord injury, so that's really crazy.
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Wow.
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I understand you were in a skiing accident that left you paralyzed.
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Initially, when this happened,
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the whole idea of breaking your neck and being quadriplegic and
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then sort of coming back while the cameras are around, maybe one of my
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closest friends I'm not a particularly religious person, and one of my
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closest friends is very Catholic.
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And he told me, he said something like, you must have had an angel on
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your shoulder.
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And I think that there was an element of trust and something just this
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happens for a reason.
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It must have happened for a reason.
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And this is going in the right direction.
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And the fact that we can tell a story like that, especially with the
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public sort of knowing me from the prior show, there
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clearly was that was part of it.
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I can't explain it necessarily, and the way it worked out, obviously,
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is truly extraordinary.
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But there was this incredible difference between kind of being a
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patient and being a physician.
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The difference of that, it was just wild.
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And it ended up carrying a significant place in the show and in my
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life, to have that forever is really a privilege, and I'm humbled by
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the whole thing.
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Well, I'm happy that you did well.
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You are doing well.
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You look almost as great as Julian.
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So, Julian, this series is out in the public for people to see.
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What do you hope people take away from this?
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What do you want them to know about cavernous malformation, your
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story?
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What do you want them to take away from this?
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Well, first and foremost, I want them to take away from watching the
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series that any hospital system is,
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I mean, it's amazing,
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these people work so hard every single day.
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I think the nursing staff at this hospital is some of the best I've
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ever seen in my family.
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They just rave reviews.
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And then next for my story, I think, don't be nervous to say
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something.
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Get to a hospital if you need to, because there's people like Dr.
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Langer.
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They're ready and willing to help you.
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So I worked in the ICU for over 20 years here, so I know the nursing
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team, and I know that we have some of the best nurses at Northwell,
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but also here at Lennox Hill.
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I'll come back someday.
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Julian, Dr.
20:15
Langer, thank you so much for being our guest here on 20-Minute
20:19
Health Talk.
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Your stories were so powerful, and I know that it will resonate with
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so many people out there.
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And if you think their stories are dramatic listening to the
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podcast, wait until you see it on netflix emergency NYC.
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All episodes are out now.
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Until next time, I am Sandra Lindsay.
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Thank you for listening.