Prepared to Lead

On March 8, a month after Meg Rush, MD, MMHC, was named President of Monroe Carell Jr. Children’s Hospital at Vanderbilt, the first adult case of the novel coronavirus, COVID-19, was diagnosed in Nashville, Tennessee.

While the virus primarily affects adults in both infections rates and severity of illness, Children’s Hospital, which stands as part of a large Level 1 trauma center at Vanderbilt University Medical Center, sprang into action to prepare, plan and support its colleagues in adult health care.

For many, beginning an important institutional leadership role that can shape a hospital and its programs for decades, there can be a settling in period over the first 100 days. Rush had just 30 days before she, Children’s Hospital and teams across the Medical Center were thrust into the worst international pandemic humans have seen since the Spanish flu in 1918. There’s no handbook, or a crystal ball, on how to lead during a pandemic.

What she possesses, however, is experience, drawing from 36 years in health care at Vanderbilt, first as a resident, then as a researcher, clinician and administrative leader; her ability to connect and communicate with people; and perhaps most importantly, the influence of her family roots, particularly her dad.

“I went into medicine to serve people. I have a deep emotional intelligence and I want to connect with people. I get a lot of that from my dad,” Rush said. “I want the people who work in Children’s Hospital to feel like I care about them, because I do. I am not this abstract person. I want people to have some insight into who I am.”

Leaning in

Rush, an Ohio native, hadn’t originally planned to study medicine. Marine Biology, or something in the sciences, was her intended major, she admits. During an annual family summer trip to Michigan with her mom, dad and two brothers, before her sophomore year of college at DePauw University, her dad, Richard Goettle, asked why she was “dancing around” the subject of going into medicine.

“‘Why aren’t you embracing medical school? What’s holding you back?’ my dad asked. My first response was that there weren’t many women that go to medical school and have a family, and I had hoped to do that someday,” Rush said.

“You’ll figure that out as you go,” her dad told her.

So, she leaned in, restructuring her junior year of college to put herself in a medical environment. She did a rotation in genetics at Indiana University Medical Center at Riley Children’s. That solidified her path in medicine, though not to pediatrics — yet.

At the University of Cincinnati College of Medicine, she was drawn to children, but a difficult pediatrics rotation during RSV and rotavirus seasons made her unsure it was her career path. A career as an obstetrician-gynecologist also wasn’t a fit for her, though she gravitated toward the newborns. Still she wavered.

Following a rotation with a cornea specialist, she decided to pursue an ophthalmology residency, which she jokes is ironic because she doesn’t like her eyes touched. Her school dean warned that she and her then husband, Charles Rush, MD, an OB-GYN, would have a tough time getting a couples match for residency in the same city with ophthalmology as her choice.

Again, she pivoted, finally settling on pediatrics. They matched at Vanderbilt University Medical Center (VUMC), their first choice, in 1984.

Soup to nuts

Rush arrived at VUMC as a motivated resident who began to find her passion in neonatology, caring for the hospital’s tiniest patients. At the time, pediatric care was delivered on three inpatient floors within the adult hospital at Vanderbilt.

She stayed at Vanderbilt for her fellowship in neonatal-perinatal medicine under the leadership of Mildred Stahlman, MD, the pioneer of the modern neonatal intensive care. Rush quickly knew she had found her home at Vanderbilt and Nashville. She joined the faculty in 1990, also giving birth to her first daughter, Katie, that year. Three years later, her younger daughter, Libby, was born.

In her early years at Vanderbilt, Rush established herself as a basic science researcher, studying the role of vitamin A in lung repair following injury that occurs with mechanical ventilation as well as in early embryonic lung development. Her work was significantly influenced by the guidance of two mentors, Stahlman, and the late Tom Hazinski, MD, former chief of the Division of Pediatric Pulmonary Medicine.

This research experience facilitated her role with the Institutional Review Board, helping restructure the institution’s policies and direction in human subjects research, particularly as it pertained to children. (Her connection to research is never far even in her role as President. She keeps photos of her research slides in her desk drawer.)

At every step, Rush accepted opportunities presented to her, diving in to learn all aspects of each new role — no matter how daunting — and always pursuing excellence along the way. Over the years, she has served as program director for the Fellowship in Neonatal-Perinatal Medicine, associate director of Pediatric Transport, medical director of Neonatal Transport and co-chair of the Ethics Committee.

“Every chapter of my career has given me experience and leadership skills, soup to nuts, about how everything runs in this hospital,” Rush said.

Continuing as an emerging senior administrative leader, she was named chief of staff of Children’s in 2007. A year later she was named a “Woman to Watch in Medicine” by Nashville Medical News.

She subsequently added the responsibilities of executive medical director in 2012. She has led the development of program strategies for the hospital’s business enterprise — on and off campus — served as a representative from administration to the hospital’s medical staff and led vital quality and safety initiatives. In 2014, she earned her Master of Management in Healthcare from Vanderbilt’s Owen Graduate School of Management.

In her administrative role, she has been an integral part of the Children’s Hospital leadership team responsible for overseeing a multiyear, multiphase expansion that began with a 33-bed, 30,000-square-foot expansion in 2012, and that continues today with the current four-floor, 160,000-square-foot expansion atop the existing pediatric facility. Well-respected at Children’s Hospital as well as with community pediatricians and organizations, Rush is a fervent advocate of quality, compassionate care for children and families.

Her appointment as President in February came at a pivotal time for Children’s Hospital as it continues to advance the size and scope of its clinical and surgical programs for children within the hospital as well as offsite to bring care closer to where families live. Also, at the start of COVID-19 in March, Children’s Hospital opened its second expansion unit on the 11th floor.

‘Tacking’

When COVID-19 hit Nashville, changing the way Children’s Hospital and the larger VUMC community would operate, Rush pulled everything she knew from her career and personal influences into her leadership role.

“As COVID has evolved, we have acted on the best information we have. We’ve made decisions with all that we know at the time, pulling back when we needed to,” Rush said.

Many of her influences are also reflected in her weekly, and sometimes twice weekly, communication messages to faculty, staff and trainees. She has provided assurance amid the messiness of the moment and has kept people informed. She’s also introduced people to who she is, to her love of quotes, to her devotion to her daughters and their virtual dinners and her desire to connect with employees.

In one communication, she even employed her summer sailing experience with her dad, noting that the pandemic is much like trying to sail without much wind, a tactic known as tacking. It means to zigzag to move forward, which can sometimes be inefficient and frustrating and requires real-time decision-making.

“Tacking requires patience and positivity to ensure one makes the most of each maneuver on the water. To me, tacking is a great metaphor for where we find ourselves today — navigating the uncertain winds of a pandemic,” she wrote.

Years ago, Rush’s dad told her to exemplify for others a balance between personal and professional life. She has done that, dedicating herself to a career in medicine, to her community and to her daughters, Katie, now 29, and Libby, 26.

She is fully committed to her next chapter at Children’s Hospital.

“I have grown just like Children’s Hospital has grown. I know how this place is put together, and I know its success is dependent on different areas and the collective work of teams,” Rush said. “Our commitment is to patients first. But we are also committed to the faculty and staff here to make it a positive place for people to come to work every day. I want people to feel a connection to the mission we have — to provide excellent clinical care and support of children who come to us for their health needs. This is a really special place. Being connected to the mission we carry out every day makes it more than just a place you come to work — it is a place of hope. I am truly honored to serve in this role and lead this great collective team.”

— by Christina Echegaray

Hope – Summer/Fall 2020