American College of Rheumatology Annual Meeting
American College of Rheumatology Annual Meeting
October 22, 2018
3 min read

Hollywood exec: Make sure your patients know ‘you expect them to fight’

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CHICAGO — Fighting for others is much more powerful than fighting for oneself, according an Emmy award-winning producer who was admitted to George Washington Hospital with an aggressive, rapidly debilitating disease in early 2015.

Three years ago, Jonathan Koch, president and chief creative officer at Los Angeles-based television production company Asylum Entertainment, had been an extremely fit individual who did not smoke or drink alcohol and maintained a healthy diet. However, the sudden onset of rapidly increasing pain and fatigue following a flight to Washington D.C. persuaded Koch to admit himself to George Washington Hospital. Shortly after that, he was placed in the ICU.

Koch was later diagnosed with macrophage activation syndrome, according to Victoria K. Shanmugam, MD, who introduced Koch to the audience at the ACR/ARHP Annual Meeting and was the rheumatologist overseeing his care while at George Washington University.

“When Jonathan woke [from a coma], in addition to telling us how to run the hospital, he demonstrated an unfailing ability to focus on what was next,” Shanmugam said. “Jonathan wanted me to say a few words about why I asked him to speak to you tonight.

“We spend our days as rheumatologists thinking about preserving hand and joint function. Jonathan knows the value of the human hand not just for function but for human connection,” Shanmugam noted. “We spend our days as rheumatologists trying to work in systems that don’t always support what we are trying to do but Jonathan knows how to get things to work even when the challenges seem insurmountable.”

Inspiration through example

She continued, “He inspired everyone in my hospital to try harder every day. The janitors. The people who delivery the food trays. The nurses in the ICU. The physical therapists. The techs who run our hyperbaric oxygen chambers. They all talk about him with awe…I hope this talk gives you similar inspiration.”

Initially, Koch admitted he did not understand what was going on and clashed with his lead physician, Lynn Abell, MD.

“She was my mortal enemy and also, for the most part, saved my life,” he said sharing the most critical moment of his relationship with Abell. “She told me in that moment that ‘you are probably going to die tonight’.”

Koch decided then and there to fight for his daughter.

“The ability to fight for the people that you love is so much more powerful than if you just fight for yourself,” he said. “I committed myself to not dying that day.”

“The damage that people do to themselves for the most part, in my experience, has to do with the way they react to what is going on in their lives — even more so than the very real things that are going on,” Koch said.

Koch had to work hard to get all the health care professionals around him to believe he could fight to survive and eventually get strong enough for a successful hand transplant necessary because of the damage the sepsis caused to his limbs.

Fighting for their lives

A short time before Koch was released from George Washington Hospital, he spoke to Abell who he noted was “so hard. She was so sure of herself. … She knew exactly what I needed to understand my circumstances and be my best in those circumstances and that’s what she did.”

Koch said that day, however, she had tears streaming down her face and Abell said “you changed everything about how I feel about being a doctor. I’ve never seen anyone fight like you fought. You really don’t have any reason that you should still be here and yet here you are.”

Koch said he feels the same way about Abell, Shanmugam and all those who cared for him. He also points to being prepared mentally and physically so when this medical crisis hit him, he could survive.

“The people that you are treating and the people who count on you — there is more in them than you know,” Koch said speaking directly to the rheumatologists and other health care professionals in the audience about their patient population. “There is more capacity for them to fight by your side and feel part of the process.”

Koch said the best way to deal with pain and suffering is to “turn around and look square in its eyes and give it everything you have, every day. I say that not feeling like everybody has exactly the same attitude that I have but that is not important.”

“What is important is that you know what your patients need. That you understand their minds as much as you understand what is wrong with them and you give them the opportunity to see that this isn’t just an appointment; that you expect from them that they will fight.” – by Joan-Marie Stiglich, ELS

Koch J. Resilience: Facing a Health Crisis Head On. Presented at ACR/ARHP Annual Meeting, Oct. 20-24, 2018; Chicago.

Disclosure: Koch reports no relevant disclosures.