The day began like any other for Dawn Rudolph, president and CEO of Saint Thomas Hospital in Nashville. She had a raft of meetings with various groups and a full calendar, as usual. All that changed within hours as the scope of a public health crisis that she had never seen became clear.
St. Thomas's emergency room is where the contamination of compounded steroid drug from a Massachusetts pharmacy was first suspected. That contamination, as has become clear over the past few weeks, can be deadly.
The fungus found in vials of an injectable steroid drug used to treat back pain caused some patients to develop an extremely rare version of fungal meningitis, and sick people are still being discovered. More than 17,000 doses of the steroid were shipped to clinics in 23 states. At least 15 people have died in six states. And at least 203 people have been sickened.
But none of that was clear at first.
Similar to military leaders operating in the so-called "fog of war," at the beginning, Saint Thomas had nothing to rely on other than their internal expertise and a surge plan developed for natural and public health disasters.
The hospital's first steps came from those drills, Rudolph says. "Once we knew it was happening, the general medical staff was informed, and we provided them with talking points," she says.
This was an effort of the communications department, not only to inform the public, but to inform the medical and hospital staff of the scope and nature of the problem as they currently understood it, she says. That was important when rumors took flight in the early stages of the crisis, even among family of caregivers at the hospital.