The Ten-Minute Interview with…Everet B. Taylor, MA, RCIS

I am a health services manager with over 20 years experience in the fields of invasive and noninvasive cardiovascular services. I received my initial cardiovascular training in both invasive and noninvasive studies from the Army, and traditional education from Wayland Baptist University and Webster University. I served with the United States Army for 23 years until recently, and today, I work with the Kaiser Permanente team at Sunnyside Medical Center at Clackamas in Oregon, as manager of three departments that include three cardiovascular laboratories (with an additional two under construction). Why did you choose to work in the invasive cardiology field? At the time I joined the invasive field, I was in the service and our Army hospital was experiencing a severe shortage of quality cardiovascular professionals with knowledge and stamina to care for our very ill patients. The interventionalist who was the chief of cardiology service directed me to work full time in the cardiac cath lab. Once I started, I began to realize that there was so much to learn and do for the benefit of our patients that I submerged myself into every aspect of the cardiovascular (CV) lab. Can you describe your role in the CV lab? In my role as the cardiovascular lab, CVPR, MPU manager, I am tasked with establishing a model invasive cardiology program for our organization that should be second to none in the region where we operate. What is the biggest challenge you see regarding your role? The biggest challenge that I face is managing change; changes such as those that are occurring within our CV environments, and my being able to translate them and then effectively communicate those changes to the staff while continuing to provide the highest standards of care for our patients. What motivates you to continue your involvement with the cath lab? Each day I am motivated to know that our teams in the invasive labs have the potential to positively impact the lives of our patients and their family members. What is the most unusual case you have ever been involved with? I remember a time when I was working at one of our medical centers in Texas and I was on call. We had just received a male patient less than 40 years old into our lab. He arrived at the hospital by ambulance. We were told our patient had been having episodes of crushing chest pains that went away with nitro. The decision was made that when the patient arrived at the hospital, the transport crew would take our patient directly to the cath lab. We wasted no time in starting. Within ten minutes, we had images and located the offending lesion. Our interventionalist performed an angioplasty. After the first balloon inflation, we took a picture, looked at the result and saw the artery was wide open. While we were watching the angiogram playback and the hemodynamic screen, the patient went straight into v-tach and within seconds went into v-fib. Everyone reacted. As the circulator during that case, I went straight for the defibrillator, selected 200 joules, charged it, cleared the patient and discharged it. As you would imagine, nothing happened — no change. I repeated this two more times (and each time I increased the joules to 300 and then to 360), and like the first, nothing happened. We began working the patient as a code, and we did this for a while (it seemed like forever). We did CPR, gave meds and I attempted to defibrillate our patient nine times. Each time our effort met with no success to convert our patient. We began to feel defeated, and our interventionalists was prepared to call to end the code when I felt I needed to make one final, desperate attempt at saving this patient’s life. I reached over to the defibrillator for what I remember as the tenth time, and charged it at 360 joules. At that time, I could hear someone asking what I was doing and I somehow did not answer. I remember asking everyone to stand clear, and then I pushed the discharge button one more time. With my eyes glued to the monitor, I saw one blip — QRS — and I heard a beep from our defibrillator monitor’s audio, then I saw a PQRST complex and then more organized PQRSTs followed in a regular pattern. I then grabbed the patient’s arm and felt pulses that matched the screen, and I held his hand until the patient began to breathe and come around. When the patient was stable, we went back, took more pictures of the patient’s coronary anatomy and found that his arteries were still widely patent. Our patient was sent to our ICU and released from the hospital a couple days later. He showed no significant signs from the episode. This was simply very bizarre. When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high? To stay focused, I exercise by running. Running helps me to clear my head, especially when I am feeling the stresses brought on by work. Are you involved with the SICP or any other cardiovascular societies? Yes, I am an active member of SICP, and a current active RCIS with CCI, and I support the Army’s cardiovascular program. Are there websites or texts that you would recommend to other cardiovascular labs? I read Cath Lab Digest to stay grounded, and from a physician support perspective I often read information that I receive from Transcatheter Therapeutics (TCT), which I find to be very informative. I try, when possible, to attend the annual TCT Symposium presented by the Cardiovascular Research Foundation. Attending TCT is valuable to me. While there I am able to look at and listen to the results of ongoing research studies that affect our approach, products that we use, statistics about our patients’ outcomes and an overall look at trends in our business. TCT is a good source of information that allows me to plan ahead. Do you remember participating in your first invasive procedure? I do remember my first invasive procedure. It was supposed to be a simple left heart study and I was assigned to sit, learn and assist a seasoned monitor tech. I was excited, nervous and scared. Soon after the case started, the monitor tech was called away to take supplies into the OR and did not return until the case had ended. Recording the case was left to me, and I felt overwhelmed, as I was left alone to record everything that was done during the case on an E for M hemodynamic monitoring system and on the case log. Unable to keep up, I had the (yards of) pressure recording mixed up, and an incomplete case log at the end that took all of us hours at the end of the day to make sense of. If you could send a message back to yourself at the beginning of your cardiovascular career, what advice would you give? My advice would be to not become complacent. Learn as much as you can about the invasive lab environment and get comfortable with it, as the technology, the equipment and almost all the approaches that you see and do will be continually changing. Where do you hope to be in your career when it is time to retire? I would like to end my career in education and cardiovascular service consulting when my time comes for retirement. Has anyone in particular been helpful to you in your growth as a cardiovascular professional? Looking back at my path in the invasive lab, I feel that credit is due to many individuals that I have worked with over the years. However, Dr. Roger Belbel, who was the chief of cardiology services when I was first was directed to go and work in the invasive lab, is to be credited for having the foresight to select me to join the cath lab team. Another person of significance was Mr. Antonio Perez (now deceased) at William Beaumont Army Medical Center in El Paso, Texas. Where do you think the invasive cardiovascular field is headed in the future? I feel invasive cardiology is headed towards becoming the first option for patients that would normally be referred to surgery as the only option for a variety of cardiovascular problems. Invasive cardiology continues to evolve from just being the gold standard for diagnosing coronary, valvular and heart diseases. With notable advances, and evolving transcatheter technologies for the invasive labs, I see a very bright future for invasive cardiology. Everet Taylor can be reached at Everet.B.Taylor@kp.org

NULL