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 was going on. And that's been a number of times where burnout has hit me. It's been not being burned out by what I was doing, but the way it was being dealt with or the people I had to report to, or the lack of an understanding or even an appreciation of what you have to deal with. So my real plan for retiring was to be this coming June. Seeing I first started May 5 of 1972, I wanted to get my 50 years in and say I've been a working respiratory therapist for 50 years, but I kept my license active, so I will still be a respiratory therapist for 50 years anyway. I just won't be working in a hospital. And that's something that when you deal with problems with burnout or problems with feeling that sometimes you just have to do something instead of just sitting back and being upset about it or feeling like you have no control.

Doctor JB  [00:13:49]:

And so was that what was happening when you stopped working in April or last April? Were you having feelings of burnout?

RT Ron Jacobs [00:13:57]:

Well, that's exactly why the neonatologists and the people in the NICU were very supportive, because we were dealing with some good things. So the nursing staff and the physicians in the NICU were actually really great. So when I escaped the office and went to work down there, I felt great. But there was always the phone call of, did you do this? Did you do that? Ten minutes ago? You should have done this. Did you do it? Yeah. It was the fact that now there was a supervisory structure that was total micromanagement and focusing on the wrong things. My wife had retired in February, and yes, I would have liked to continue to work, but she said the same thing. She goes, you're coming home, you're upset. All you do is complain about your supervisor, and then you're okay because you only work three days a week. Although during COVID we were working four or five hour shifts a week. But you're great on the days you're not working, but then the day before you go to work or the night before you go to work, you're already look like you're getting stressed. And I wouldn't sleep well the night before work because unless it was a weekend, and I knew that the supervisor wouldn't be there, and then I still might get called, but I knew supervisor wouldn't be there. It was a problem. So it pushed me to say, I either live with this and the unhealthy aspects of it, or I do what's right. For me, there are two things that make me sad about burnout. One is when people don't think they have any control. And two is when they've made a career choice that unfortunately wasn't a career choice. It was a job choice. To me, healthcare has to be a career and a profession. It can't be a job. And I've looked at it all along as the people that I see suffering the most are the ones that think it's just a job and have no other outlet.

Doctor JB  [00:16:35]:

That's interesting. I'm curious to know if you could explore that a little bit more. How can you tell apart somebody who views it as a career versus as a job?

RT Ron Jacobs [00:16:44]:

Well, one of the things is involvement in a professional organization. If it's your career, it's lifelong learning. If it's your career and your profession, not only do you want to be involved in maybe online, maybe go to even local conferences for more than just the fact that you need it for continuing education in Respiratory therapy. In New York State, you need 30 hours of continuing education every three years to keep your license, which not a lot of states do, although in respiratory therapy, a lot of states have continuing ed requirements because the actual therapist helped to write the laws. And we understood how important continuing ed was, not only to keep you current, but for networking and to keep you involved with people who are still enthusiastic about their profession. So if you've got people that are talking about, I want to do the online continuing ad because it's cheaper and I can get away with it and I just need to get my hours. People who don't see any use for learning, don't see any real use for being involved with the profession. And in fact, people that called me respond or respiratory geek because I loved what I did. But it's hard because a lot of times you're pushed into healthcare careers by the fact that, you know, it's a job that you're always going to have the opportunity to work. And in this day and age well, even years ago, but in this day and age, making sure you have a job when there are layoffs in industry. Half of my students that came into the respiratory therapy program in the last ten years or eight years of it were laid off from some form of industry and needed to come up with a second career. When my wife and I moved Tel Paso, every single hospital in the city wanted to hire her, because nurses are nurses. You can go to any city in the country and you can get hired. Respiratory therapists aren't quite as good as that, but still, pretty much they are. And especially now, you can be a traveler. People went into healthcare for job security and not for the fact that they really wanted to be in health care. So that can also lead to burnout if you're doing something not because you really wanted to do it, but you're doing it for other reasons. And I don't care what job you're in, whether it's healthcare, whether it's managing a supermarket, whether it's working at Lowe's or managing Lowe's, if you're doing it just because you need work, you're going to be more prone to being burned out than if you're doing it because it's something you really want to do. Now, along my path, I didn't always get what I wanted. When I moved El Paso, I was moving there to work at a certain hospital. I had already been offered a job, and I was told that I told them I'd be coming in June after I graduated from respiratory school. And I got there in June. They had called me in May and asked me if I could get there in May. I said no. I haven't graduated yet. I got there in June, and he tells me, I'm sorry, I don't have a job for you anymore.

Doctor JB  [00:20:41]:

Wow.

RT Ron Jacobs [00:20:43]:

And I'm going and he goes, wait a minute. Why have a friend that is the director of a different hospital? Maybe he has a job available. Well, the hospital I wanted to work at had a NICU, so that was one of the reasons I had picked that. But it turned out that the hospital that his friend was the director at had a smaller NICU. Level two wasn't as good, but he hired me over the phone.

Doctor JB  [00:21:15]:

Wow.

RT Ron Jacobs [00:21:16]:

Yeah. Wow. So you can do two things. You can be upset about the fact that you didn't get the job you wanted, or you can focus on making the best of where you're now going to be. And that's the same thing people have to understand and do is you're not always going to get or have the direction you thought you were going to go in. You're not always going to get the job you really wanted. You might get a different job, but then if you focus on doing the best you can and making it the best you can, you don't know what's going to happen. Within six months, because of other issues going on. He promoted me to the first supervisor for their NICU because they were going from a level two, which handled sick but not acutely ill babies, to level three, which handled the most premium, the sickest of all babies, and he needed a supervisor for it. And because I did everything I could do there, I got that job. And that opened it up for Erie County Medical Center to keep my promise to my wife to move back to Buffalo if the right job ever came up.

Doctor JB  [00:22:40]:

Wow. Working in a NICU just sounds very challenging because here you have this newborn baby that the parents were looking so forward to taking them home. And for whatever reason, they're born early, they're not able to go home, and they are cling for their lives, and they're so small and they're so frail. So how did you cope with that?

RT Ron Jacobs [00:23:09]:

It's interesting because it was my first love, surprisingly. I was in my respiratory school and there was a three week rotation at the children's hospital. And the first day I stepped into the NICU in my clinical rotation, I fell in love with it. I think part of it is you like the excitement of having to think on your feet and of the challenges day to day, and the focus of these babies are going to be here whether you are or you're not. It's not like you can change what the reason they're in the NICU is, but you can be part of giving them the best chance to survive. So those become the focus of all the NICU nurses, too. I mean, yes, we get horribly depressed when bad things happen, but the focus of people working in the NICU is, look at what we're going to do to give this baby the best chance they ever had. I remember shortly after starting at even now, the NICU. When I moved back to Buffalo at Sisters, we had a set of triplets, and I came home from work, and my son was standing in the kitchen and I pulled out a five pound bag of hot dogs, and I just tossed him a five pound bag and he caught it. I said, what you caught weighed more than the three babies combined that I just delivered today and we're going to try and keep alive. So that's the challenge. So how do you deal with it? You get depressed when you get home, you figure out ways to focus. And now this day and age of debriefing and discussing and not coming home and having it all inside you where you're worried, could I have done something better? Could I have done something more? Unfortunately, too many health care people, and I was one of them for a number of years, self medicated with alcohol or drugs or something that would take away the feeling when they got home. And the only difference is that doesn't let you focus on the right things to do.

Doctor JB  [00:25:42]:

Hold on 1 second. 1 second for me, getting hot. I was like, I need to get some air. Okay.

RT Ron Jacobs [00:27:00]:

Yes, down here. I'm in my basement, and I have a space heater, which I turned off now. But sometimes when I'm down here using the computer to play computer games with my brother, I have to wear a jacket. That's not my issue.

Doctor JB  [00:27:19]:

I was asking you, how did you guys cope with it?

RT Ron Jacobs [00:27:24]:

So we coped with it by talking about it, by being open about it, by discussing what we did right, what we did wrong, if anything, what we could have done. Because, as I said, bad things will happen. You have no control. You can do the best you possibly can, and a baby can still die. So as soon as you understand that, you're one step closer to being able to cope with it. If you continually think there's something more I could have done or should have done or you're playing God because you think that regardless of what's going on with this and that's with any patient, actually. But NICU is sometimes even harder. Or the trauma for young people was hard too, but NICU is probably the hardest because this baby didn't even have a life yet. But that's a beginning, knowing that if you did the best you can, you can't prevent bad things from happening. And I would use the quote from Mash, but it was always one I lived by. And that was rule number one is patients die. Rule number two is healthcare professionals can't stop rule number one. So it just is. And humor I hate to say it, but humor and compassion. I had the chance to meet a very famous doctor years ago. In fact, I was speaking at a conference in Cleveland, and Patch Adams was the keynote speaker. And the friend of mine that ran the conference said he's got about an hour and a half before his workshop. Can you take him around and keep him busy for that hour and a half between his keynote address and the workshop? So we sat and we talked. And I had always goofed around and kidded around both with patients whether they were really sick or not really sick family. Because humor, when it came to an emergency situation, professional focus did exactly what I needed to do when it came to real life. Kidding around and a sense of humor I thought was always important. And he really just made me feel good about the fact that other people may not understand it, but sometimes humor can go a long way in healing and especially compassion. But he was somebody that went through medicine when they didn't believe. You should even get to know your patients. You should always have emotional distance and that level of professionality. So I just find that you have to understand your own limitations. You have to ask for help. How do you also cope with it? Well, if you're not sure, you ask for help. So you're not making a mistake when somebody else may have known a little bit more than you did, which is perfectly fine and can help you or help the situation and you can learn from it and you just again, Debrief, talk about it. Don't take it home with you. Don't keep it bottled up. Make sure that you all know. And NICU is a very good environment for it because the neonatologists believe in team approach. When we're in a really bad situation, before they decide to stop, they will typically ask does anybody have any other ideas? Is there something else we're missing? Is there something else you think we should try? So it's not just one person, but it's the group of individuals. I taught neonatal resuscitation. It's a course and a certificate. You have to get similar to ACLs and BLS. It's every two year certification. And that came up as again, one of the most important things is you discuss it because you always want to know what everybody else is thinking. It's also how you avoid burnout too, is not taking it and holding it inside you and going home and living with it. So releasing it, releasing it in a positive way.

Doctor JB  [00:32:17]:

What do you mean by that? Could you give me some examples of a way that would be negative or not so positive versus a positive way?

RT Ron Jacobs [00:32:25]:

Well, one good way is drinking. That's a non positive, negative, horrible way to release it and the reason why or drugs, any self medication, you don't feel it, so you're not agonizing over what happened that day, but it's still inside you. So you think you're releasing it, but you're not. So it's an extremely negative way to try to get through a situation. The positive ways become talking to people. I can't stress that more than anything else you talk, whether it's the debriefing if you can do it at the hospital, whether it's talking to a coworker, whether it's actually getting home and talking to your significant other. I remember before we got into this kind of thought process, I came home one day and I'm sitting there watching TV with my wife and I all of a sudden just start crying. And she looked at me like I was nuts. And that's because if I had come home and talked to her about what had gone on, even though it had been a bad event, but I couldn't. But if I had talked about it, then I wouldn't just sit there and start crying and not be able to do anything about it. I really don't know a better way. And then once you've talked about it, if you all of a sudden come up with or somebody has an idea or you're thinking, well, maybe we saw this event go on, especially in this day and age of Google and the Internet. Let me Google it and see if somebody in Seattle, Washington has dealt with the same problem and maybe did it differently or dealt with it differently. That's the whole good thing about networking. If people did it more often, being involved in your professional organization, because I spoke at national conferences for almost 20 years. I met really enthusiastic professional respiratory therapists and physicians from all over the country. So if anything boggled my mind, I could pick up the phone, or I could do an email, or I had a neonatologist walk into the NICU one day and put a box of a certain type of piece of equipment in front of me that I had been talking to him for six months about. Maybe we should try it. He dropped it in my lap, almost figurative, literally dropped it in my lap, and said, I just got these samples. Do you know what to do with them? I picked up the phone, I called somebody I knew from Children's Hospital in Seattle, Washington. I said, we have this piece of equipment. Do you use them? He goes, yes. They're very easy to use. This is a good way to do it. We tried it on a baby that afternoon. Instead of having to put a tube back in the baby for breathing, it was a different way to keep the baby breathing or help the baby breathe. And it was very simple to do. And I left. I in service, the people, the person was coming in after me, and the next morning I walk in and there's another baby on the same thing. And that's because it works so well with one that now. And it was easy enough to do that. Instead of putting a tube back in this baby where the father accidentally pulled the tube out while he was holding the baby, they said, well, let's try it on this one, because it worked on the other one. And they never put the tube back, that breathing tube back in that baby. We got to the point where it became one of the main ways they call it excavating when they pull the endotrachial tube or the breathing tube out. It became the main way we could excavate these babies a lot sooner when they still needed a lot of help breathing or ventilatory support and be able to do it without the tube in, which resulted in a lot less complications. And how did I know how to do it? I didn't know how to do it. I'm not that smart to know everything. Nobody does. But I had people to call. I had ways to find out, is there a good way to do something?

Doctor JB  [00:37:14]:

That's right. I can agree with you more when you talk about the importance of talking things out in medicine, we all experience so much traumatic experiences throughout our day, and there's a lot of stress that we carry with us, and we need a way to release it. And like you mentioned, some people go to drugs, some people go to alcohol, and some people just keep it bottled inside and try to pretend as if nothing ever happened or just sweep it under the rug and keep going. But my concern with some of those activities is especially the sweeping it under the rug and pretending like nothing ever happened is that one day I was talking to somebody the other day and they said, oh, you're going to have a real bumpy rug. I was like, yes, you will. One day it's going to get so big that it's just going to pop. Right. And it may not even be like a serious situation. It might just be like a little feather that slowly makes its way down and then you lose it. And you're not losing it over that feather. That feather fills just by itself will be nothing. But it's everything that's under that feather. And then what are the consequences if you lose it?

RT Ron Jacobs [00:38:33]:

Yeah, and especially you're right. If you lose it in a situation at work, you lose your focus and it could mean doing something or making a catastrophic mistake. That's right. Or you lose it at home and you take it out on your significant other or your kids or your pet, or you take it out on living beings that are really not even part of the cause. I wonder how many divorces came from the fact that people kept things in and had no release and their relationships just suffered from it. And I agree with you. I think a majority of the time the predisposing event for that total meltdown has nothing to do with what really came up. I mean, you all of a sudden have a meltdown and people are sitting around there, you or your significant other scratching their head, going, what did I do? What even caused this? I didn't do anything today. You mean I gave you peas and you wanted carrots? You know, like so, you know, or that bubble or that that burst could be your own health. I mean, I am sure part of what led to my heart attack was keeping too many things inside for too many years and stress and not being able to deal with the stress.

Doctor JB  [00:40:15]:

Wait, when did this heart attack happen?

RT Ron Jacobs [00:40:18]:

Well, on the 24 march. It'll be 19 years ago. I was only 49 at the time.

Doctor JB  [00:40:24]:

Wait, wow. So you were young?

RT Ron Jacobs [00:40:27]:

Yes, I was young. I was lying in bed, we were watching TV, and it hit me. And the blockage was significant enough that I needed open heart surgery, I needed bypass surgery done. So at 49, I'm having a Cabbage cardio, the coronary artery bypass graph, and usually, at least back when I worked with an open heart team in El Paso, at that point, once you have one of those surgeries done, you're probably limited to about ten to twelve years before they have to do it again, and a number of other things. But I put a lot of it into at that time, not knowing how to handle stress and not knowing how to handle issues with the supervision. Luckily I had left, but it had already left its mark on me.

Doctor JB  [00:41:35]:

So, as your career has gone by, what have you done to handle your stress?

RT Ron Jacobs [00:41:46]:

I know people are going to roll their eyes at this, but meditation works very well, and even if you don't, when you bring up the word meditation, everybody focuses on get the yoga and go to the ashram and swami rami. That's not what you have to do. But meditation becomes a way to focus relaxation. You have to do some type of relaxation exercises again, beginning with the fact that you've got to understand that you can't change things that are out of your control. There's a number of groups that deal with addictions, whether it's alcohol or drug, and they talk about a prayer called the Serenity Prayer. I don't know if you know it or not, but basically one of the things it says is, god, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. So if you can't change something, you have to figure out a way to let it go. Relaxation does it focusing on things outside. Like if it's a work related issue and you're in a position where you can't leave that job, you're already tied to it because of finances, because you've done it for so many years, because you can't figure out a way to get an education to do something else. Then accept the fact that you can't change the environment you're in and come up with things outside of work to focus on that you enjoy. Hobbies. If you can come up with good hobbies or I don't know what, but I know it's getting your focus away from work when you're out of work. Sorry.

Doctor JB  [00:43:51]:

No, go ahead.

RT Ron Jacobs [00:43:53]:

That's it. And not dwelling on, well, that was again why I left the hospital. I loved what I did, I will always love what I did, but I knew I couldn't change it and I was beginning to focus on it when I was home and that was not going to work, so I had to separate myself from it. So it's important because we all have to work for a living. We all don't have the luxury that I had of being able to change where I did something I loved, when where I was doing. It was getting to the point of burning me out because of factors were outside of my control. People don't have that luxury. If you do, good for you. I did. I changed my job in Buffalo to El Paso. I changed my job in El Paso to Buffalo. I changed from the hospital to the college. I went from the college. Some people can do that and they can focus it. But if you can't do that, then look to outside of your work environment to focus your peaceful time, your relaxation time, and try, as bad as it is, try to find friends that aren't just friends from work. Because as much as we all say, oh, we're not going to talk about work, if you're out with your friends from work, work still comes up. It's human nature. So try to come up with things you do that involve people you don't work with, and that gives you a whole different reference.

Doctor JB  [00:45:44]:

Yeah, I mean, I think the community aspect of it is extremely important, and that's why you were part of that respiratory therapy organization for so long, because of the community of really being able to have people who understand your experiences.

RT Ron Jacobs [00:46:07]:

They did. They all had some bad bosses and good bosses, but what we shared was, number one, we didn't work together, so we shared the love for what we did. But I can tell you I was at a national conference, and nine of us hopped that we were in Anaheim. Nine of us hopped on a bus and got this all day bus tour of Los Angeles and Santa Monica, something that had absolutely zero to do with being a respiratory therapist, zero to do with work and really nothing to do with the meetings we were at when we were there for the national conference. So when you're with a group of people that you don't work with, even if they share the same profession, you can still get away from the profession and have fun. But you like each other and respect each other because of what you believe in. But it's not something you have to live with just because you're out and about. Although I did give CPR to a snake, but that's a whole different story. No.

Doctor JB  [00:47:22]:

Yeah, I think that's going to be for another.

RT Ron Jacobs [00:47:26]:

Podcast.

Doctor JB  [00:47:28]:

It's so funny because I had a visual in my head. I was like, oh, my goodness.

RT Ron Jacobs [00:47:34]:

We won't talk about that right now.

Doctor JB  [00:47:40]:

There goes that humor that you mentioned. That's important because that's another form of release. And in the Er, you find that there's a lot of laughter. Sometimes that happens even though we're in the midst of the emergency department. Patients are sick, but you're either going to laugh or you're going to cry. So you have to choose which one I opt for laughing or for laughing? For laughing as often as I possibly can.

RT Ron Jacobs [00:48:06]:

It never hurts. I have gotten in trouble for it occasionally, but that was more in the younger days when people didn't understand it. I do remember one family where unfortunately, I was working with an adult and he was dying of cancer, and I was doing just a breathing treatment with this device we call a nebulizer. And so I was hooking it up, and they go and the daughter goes, what is that? I said it's a nebulizer. And she goes, well, what does it do? And I said, It nebulizes, with this big grin. And she looked at me and she gave me this dirty look and said, I'm not kidding around. I just wanted to know what it did. And so I took her aside and I started talking a little bit and then I brought up a little bit about humor, and I apologized if it bothered her, but the fact that I use humor and that I had met and I brought up meeting Patch Adams, and I left. And I come back in the afternoon for the second treatment, and she's going, he's the guy that knows Patch Adams. He believes in humor. And I was kidding around. Now, I could kid around with her father, and we could tell jokes. And I got him to smile. And she goes, he hasn't smiled in months, ever since he found out. I think if you die with a smile, you're going to die better than if you die with a frown. I don't know yet, but I'm hoping I will.

Doctor JB  [00:49:44]:

I think you need to go into research paper on that and so you can teach. Do you think you're ever going to go back to teaching?

RT Ron Jacobs [00:49:54]:

I am thinking about looking at right now, doing it online. I did when I left the college. I started teaching online in a Bachelor's of Health Science, bachelor's of Respiratory Therapy programs. So I'm thinking about doing that because finding an in person classroom teaching job while being located in Buffalo is not the easiest thing to do. And also my Master's, I have an MBA, so it's not really like I could teach. I don't have a PhD or any type of doctorate, MD or law degree. So it would be hard to teach at a university unless I was teaching in a program that didn't have PhD. So there's no PhD in respiratory therapy. So within a Master's, you can teach at the baccalaureate level and things like that. But I love teaching, but I like the classroom better than online classroom is. So again, you can see the faces. You can feed off people, they can feed off you. But it's still nice to be able to help people grow.

Doctor JB  [00:51:23]:

It's amazing that our time has gone by so fast.

RT Ron Jacobs [00:51:32]:

How am I going to talk for that long?

Doctor JB  [00:51:35]:

And look, you did it. You made it to the end.

RT Ron Jacobs [00:51:38]:

I know. And I still have the future, and I have education, and I haven't talked about a couple other. I still have things on my list, so we'll have to pick them up some other time.

Doctor JB  [00:51:50]:

And our part, too. But in closing, do you have any pearls of wisdom you'd like to leave with? My listener?

RT Ron Jacobs [00:52:01]:

I guess the best thing I could say is find inside yourself a way to make you happy. A way to enjoy your life. You may not enjoy all parts of it, but there's always something in there that you can get joy and comfort from. And as long as you can fall back on those things, it will help you deal with the things that are out of your control.

Doctor JB  [00:52:36]:

Thank you. Thank you.

RT Ron Jacobs [00:52:41]:

You're welcome. Thank you so much. Bye.

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