Six Degrees of Separation

by Scott A. Meyers, Executive Vice President
February 16, 2009

The concept has been around believe it or not since 1929. That is the concept that anyone on earth is separated by no more than five other people from any other person on earth. Take for example Hu Jintao, General Secretary of the Communist Party of China. If you know someone, who knows someone, who knows someone, who knows someone, who knows someone, who knows Mr. Hu, then you are separated by six degrees! The 1994 trivia game “Six Degrees of Kevin Bacon” is probably more familiar to many of you. About the same time the game came out, Kevin Bacon stated during an interview prior to the premiere of the movie The River Wild that at that point in his career he had worked with everyone in Hollywood or someone who had worked with them.

I’m here to state that in health care the degrees of separation are probably less than six between any health care worker in the world and yourself. That can be good or bad, depending on your behavior and beliefs. I have two short stories to share that will illustrate each.

This past December, a colleague of mine was on a local bus in Orlando, FL, headed to Universal Studios for some vacation fun just prior to the ASHP Midyear Clinical Meeting. As she sat with her husband anticipating a fun filled day of rides and entertainment, she overheard (she described the conversation as excessively loud and inappropriate) two individuals discussing their pending graduation from a Big 10 University College of Pharmacy. They unfortunately were speaking very disparagingly about a couple of the faculty members at the college of pharmacy! This colleague happened to have been a graduate of the school in question – a graduate that was planning on attending the school’s reception at the Midyear Meeting just a few days later!

To her credit and before the students could hang themselves any further, she turned to her husband in an equally loud but calm voice and stated, “It sure is amazing how small the pharmacy world is, don’t you think?” That and a brief glance to each of the young men were all that it took to end the conversation! Unfortunately, the damage could have already been done for these two bozos! My colleague never made it to the reception because of logistical issues, but it would have been fun to see the looks on the faces of these soon-to-be pharmacists as she spoke with the Dean right in front of them! Knowing her way of dealing with issues, she probably would not have told the story but rather nodded towards them while talking to the Dean about a completely different topic. As my father says, “if you don’t have anything good to say about someone, don’t say anything!” Always wise words.

On the other hand, less than six degrees of separation can work to your advantage if you know how to use them. A few days ago, I received a call no parent ever wants to get. It was from the U.S. Consulate in Chengdu, China. For those who do not know, my 27-year old son Tanner is teaching English at a University in Ganzho (pronounced gan-jo), China and has been off work during all of January and most of February because of the Chinese New Year! Being young, single, and adventurous, he and three friends (Matt, his wife Nora and Chris) had traveled to far western China and the Tiger Leaping Gorge in the Yunnan province. Tiger Leaping Gorge is the deepest gorge in China – not quite the Grand Canyon, but nothing to be trifled with. The caller identified themselves as the “on call” person for the consulate and that there had been an accident. “Tanner is fine” came very quickly after, but I knew what the next sentence would be. “One of his friends has been badly injured, and you need to call Tanner immediately!” My heart sank. I knew it would be Matt, his good friend from Rockford!

The frantic call back to my son revealed that Matt had fallen into a 15-20 foot deep ravine while sliding down the slope of the gorge. He had a fractured skull and broken neck. They were at the nearest hospital after a harrowing rescue involving two Chinese farmers, a mule and a two hour ambulance ride. Matt was in surgery to stop the bleeding, but the hospital could do nothing to fix his broken neck! When Tanner asked one of the police from nearby Shangri-La, “What happens when a Chinese person breaks their neck here?” His two word answer was matter of fact and shocking to my son, “They die.”

The good news is that the U.S. Consulate staff came through by reaching SOS International, and after a day of paperwork, swooped in like “knights in shining armor” as Tanner e-mailed and airlifted Matt, Nora and Tanner to Hong Kong Baptist Hospital. To make a long story short (I know, too late), Matt had a very lengthy but successful surgery to stabilize his neck (C-1 fractures are very scary), relieve the pressure on his swollen brain and reconstruct one eye orbit within 36 hours of arriving in Hong Kong. He hopes to be headed home in mid-February with a full recovery anticipated sometime this summer!

Here’s where the six degrees or less comes in. What would you do if a family member or close friend were injured or ill in a foreign land, and the only people there with them had no health care background? If you’re like me, you’d want to find someone on the ground there that could help them make good health care decisions, find appropriate resources and just make sure they were cared for in the best possible manner.

I immediately made some calls. First was to Henri Manasse, Executive Vice President of ASHP, deeply involved with the International Federation of Pharmacists (FIP) and a good friend. Henri was in a meeting but his office manager asked if Bill Zellmer might be able to help. Knowing Bill well too, I said sure. Bill did not have any contacts in that area of the world but offered to search his FIP contacts for assistance. I thanked him but said I would wait to see if Henri could help but still keep him in mind. When Henri called shortly after, his response was the same, but he offered the name of a UIC faculty member who I have known through the Dean’s Advisory Committee on a very limited basis. This faculty member works with pharmacists in Hong Kong and other areas of Asia for the College of Pharmacy. So I had a potential source that might bring me to within one or two more degrees of my goal. Later that same night I spoke with Stan Kent, Assistant Vice President of Pharmacy Services for Northshore Health-System in Evanston and Andy Donnelly, Director of Pharmacy Services at the University of Illinois Medical Center in Chicago. Both have spoken extensively in Asia, and my hope was that they had spoken in Hong Kong. Andy also suggested the faculty member from UIC. This confirmed my source should it be needed.

Fortunately, for Matt, Matt’s parents (who arrived in Hong Kong only hours after Matt did), Matt’s wife Nora, and Tanner, English is well spoken in Hong Kong and every situation was resolved with a “best case” scenario! Knowing that one call could start a chain that could connect me directly to someone in that institution with whom I could speak about the situation was comforting.

I am extremely lucky with regard to the degrees of separation I enjoy. My job has created many of the relationships that get me closer than most to folks all around the world. However, here’s the important lesson. You know me. Not that it will get you into the movies free, but ICHP members should always remember that if you have a question, and you don’t know where to go, give me a call. I may not know either, but I know people who will, or I know people who know people. Again, not because I’m special or talented or whatever, but because I’m in a job that requires me to develop relationships with people who really know people.

I guess I do have one more brief example of how I can help, and many of the pharmacy directors around Illinois have used this option. If you have a question regarding the Illinois Pharmacy Practice Act and/or Rules, but you don’t want to ask someone at the State for fear that an inspector of some sort may show up shortly after you ask, I can help. I frequently call Dr. Yash Amin, Pharmacy Coordinator for the Department of Financial and Professional Regulations with questions on behalf of an ICHP member. He is always very helpful, and while I don’t usually get a response in writing, I get something useful to take back to whoever asked the question. In the old days (Ed Duffy days - Dr. Amin’s predecessor), I would lay the question out as a hypothetical hospital would like to do this or that, and Ed would laugh and tell me to tell the hypothetical pharmacy director that he or she could or couldn’t do whatever it was they wanted to do. In fact, after a few years of working with Ed on a variety of issues, whenever I would call, he would start the conversation by asking if this was another hypothetical hospital question! In these cases, you may only have one degree of separation for the solution to a troubling issue!

Health care is a small world. Pharmacy is even smaller! Remember the rule of six degrees of separation but know that you may in fact be much closer to solving problems, finding the right people, or gaining a sense of peace than you ever thought!

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