The Many Legacies Of Dr. Bruce Ribner

Hello, and welcome to "Transmission Interrupted."

My name is Jill Morgan.

I'm a nurse here at Emory University Hospital Atlanta, and I am very pleased

today to join a group of physicians that I know very well, a team of

infectious disease physicians here at Emory to really honor Dr. Bruce Ribner.

We are very grateful for his legacy here in Atlanta.

So I'll get to those introductions in just a second.

For those of you not yet familiar with NETEC, our mission is to set the gold

standard for special pathogen preparedness and response across health systems in

the U.S. with the goals of driving best practices and closing knowledge gaps

and developing innovative resources.

NETEC works alongside and in cooperation with the CDC and is

funded by ASPR, the Administration for Strategic Preparedness and Response.

So I want to introduce friends of mine, near and dear.

So first I want to start with Dr. Colleen Kraft.

She is an infectious disease physician and a clinical microbiologist

here at Emory University Hospital.

Dr. Jay Varkey, who is a former hospital epidemiologist here at Emory.

He's also the chief quality officer for Emory University Hospital and Emory

University Orthopedic and Spine Hospital.

And Dr. Aneesh Mehta, who is also an infectious disease physician

here at Emory and is now the chief of infectious diseases here

at Emory University Hospital.

And the reason these three are here is that they were a team of incredible

physicians who cared for our Ebola patient and Lassa fever patients

in this arena for a long time.

It was quite a group back then, and we'll we're gonna share a few of those stories.

But I really wanna welcome you guys to "Transmission Interrupted" with me, to

talk about one more member of the team who now has passed away, Dr. Bruce Ribner.

So welcome to "Transmission Interrupted."

I'd like to start with how you guys met Dr. Ribner, when you first met him,

Because, of course, I met him as a nurse, and he was somebody who was running this

team already when I came on board.

But I know you have a longer history with him than I did.

So, Aneesh, why don't we start with you and then Jay. I'll

go to you, and then Colleen.

Thanks, Jill, and it's really a happy and sad occasion being

here to talk about Bruce Ribner.

So I met Dr. Ribner when I was a senior medical student.

I was visiting from Oklahoma, and did an away rotation at Emory because this was

one of the places that I really wanted to come, and I knew I was interested

in infectious disease, so I signed up to do that elective here at Emory.

And just by happenstance got assigned to a month where Dr. Ribner was rotating,

and just had him as my attending.

I still remember some really great moments where he was teaching us about

the time course of HIV, and that was, you know, I still have, like, notes

from that little lecture, and he had this train going off the cliff to

demonstrate how the CD4 count dropped off once the viral load hit a certain

amount of time for a certain duration.

And so, I also remember being intimidated by Dr. Ribner, because he's very

senior, very astute and erudite.

And also had a very sharp sense of humor, which definitely caught me a couple of times

as a medical student, as a resident, as a fellow, and also as a colleague of his.

And then I got to match here at Emory as an internal medicine resident and also had

Dr. Ribner as my attending when I did a infectious disease rotation as a resident.

And then, of course, as a fellow in infectious diseases here, I got

to spend a lot of time with Bruce as an attending, as an advisor.

And, yeah, just enjoyed all of those moments.

To be honest, I knew much about Bruce as an infectious disease physician

and educator, and as the hospital epidemiologist here at Emory.

I did not really know about the Serious Communicable Diseases program that he

built until I became faculty, or I was becoming faculty, and he's like, "Oh,

you seem to have a strong interest in viral immunology and viruses."

And I said, "Yeah, that's what I love." And he's like, "Well, we could use

some of that talent on this team." I was like, "What are you talking

about?" And so that I think, right, just as I was finalizing what I was

gonna be doing as a faculty member, he offered for me to join the team.

And I learned a lot about it.

And I'll give one final introduction to Bruce.

So one of my first experiences as a faculty member with Bruce is

he called a surprise drill in the SCDU, my first week as being an

attending physician on service.

Totally caught me by surprise.

I didn't really know all the protocols as well as I should have.

And I still remember Bruce sitting behind me with a piece of paper,

writing down all the things that I had opportunities to improve upon.

And so, but yeah, he continued to be an educator, a trainer, a mentor, and

and colleague, right up until the time that he was not with us anymore.

I'm glad you mentioned that he was a little intimidating

to you because certainly, as a nurse, he just had the aura of sort

of old-school medicine, right?

Always with the tie, usually with some sort of pathogen on his tie, right?

I mean, not a spill, but actually, the pattern on his tie, suit, lab coat.

And he was an intimidating presence.

So, I'm glad it wasn't just me.

Jay Varkey, how did you get to know Bruce?

Jill, first thanks for inviting us.

Pleasure to be here with you, and certainly with my friends and

colleagues, Dr. Craft and Dr. Mehta.

So I was finishing up my fellowship at Duke.

I was applying for faculty jobs, and I'd gotten some interest in terms of…

stewardship, and there was a position to be the medical director of antibiotic

stewardship at Emory University Hospital.

So I came here to interview, and Bruce might have been maybe my third or fourth

person I was interviewing with that day.

Which meant that I got to go to his office, which I realized turned into

a whole side quest to my interview day because I, I got introduced for the first

time to floor 7B, which is actually in the attic of the old university hospital.

There's actually no public elevator that goes up there, and I ended up

actually taking the elevator to the sixth floor, and I found a random stairwell.

It looked like I was about to get lost.

I walked into an area with a bunch of contractors.

It looked like it was, in fact, an attic.

And then I actually found that Bruce's office was right there,

and he was genuinely shocked that I actually found his spot.

And for the next hour or so, I interviewed with him through a small window of two

giant stacks of journals and papers.

So I sort of sat like this and talked with him.

And little did I know that not only would I end up seeing Bruce almost

every day for the next several years after I joined faculty, but that I would

actually become his office neighbor, because my first spot was actually

right across the hall from him.

And I bring this up because, similar to what Aneesh said, Bruce

definitely had a wry sense of humor.

I had been advised, and I had been asked on my interview day

whether I had any interest in hospital epidemiology, and I did.

And to that end, I had actually, when I was… When I joined, I

said if there was an opportunity to join as an assistant hospital

epidemiologist, I'd really be honored.

I had heard after the fact, and I teased Bruce about it when he was retiring,

that, I think, when Bruce found that out, I remember him saying something

to the effect of, "I don't remember asking for an assistant." which is

totally legit because he actually made the job look really, really easy.

He could answer in a cool, calm, and almost detached way, stuff that

would immediately make me sweat.

There's an outbreak of tuberculosis," and he would just very simply just

ask like three very straightforward questions to ground everyone.

And to that end, I learned a ton from him, all the way until he retired.

In fact, I learned so much that, that even though he didn't ask for an assistant,

it was an honor to take over his role as hospital epidemiologist when he

gravitated to his leadership role in NETEC

Yeah.

I think that's absolutely right.

I remember during a press conference when somebody had asked a question

that he considered just, like, not very well stated or not very well

presented, and he said, "Well,

I think what you meant to ask was…" And I was like, " Oh, no.

He went there.

"I mean, and it was just so perfect.

Yeah.

He, he definitely was, if you were on the right side of his humor,

was great, and if you weren't, you definitely squirmed a little bit.

Yeah.

You squirm, but sometimes it was even funnier.

Oh, yeah.

Yeah.

No, it's true.

He was never, it was never of evil intent or mean in any way.

It was just that he was so smart and so, yeah.

Colleen, tell me about your relationship with Dr. Ribner.

Yeah.

I mean, he is a very interesting guy.

an infectious disease fellow.

And I had been rounding, you know, it was the winter month, so I had,

like, a kid at home from daycare.

My husband was also sick from the kid.

The kid had yet another thing.

I was pregnant.

I had pneumonia.

Was trying to round with him, and he finally looked at me and was like,

"Colleen, just go home and come back when everybody's feeling better." And

I was sort of ashamed because I felt like, you know, "Don't you need me?

Don't… You know, do I have to be here!

I'm an ID fellow." And he just showed me that, you know, he

could still do all the work.

And honestly, that has made me wanna be I mean, since that moment, I

have wanted to be that way as well.

So yes, I'm rounding in the hospital.

Yes, I have a team, but I've always really aspired to be able to handle

everything myself, just because I think that was something that he showed me.

But now, I think, the other cool thing for me is that around that time

as well, his wife Barb also worked at the Glen Memorial preschool, and so

my kids were also cared for by her at different times in their growing up.

So that was also very special.

They had three boys.

We have, we have three boys.

I mean, they still have three boys.

So, but just as, you know, his self-reliance, and I like what both

Jay and Aneesh said, his mastery of the situation is something that I still aspire

to because I still don't always have that.

But your memory of him during that press conference, just like managing those

questions, I will never forget that.

That is one of my top highlights of Bruce Ribner, especially when they

asked why we didn't tell anybody that we sent Nancy Rebel home.

That was my favorite answer from him.

And, you know, I'm not gonna say it perfectly, but he essentially said,

"I don't usually tell the press when I discharge patients from the

hospital." It was like so awesome

Yes.

Yes.

Yeah, he sort of invented the, the-- not invented, but he, he certainly perfected

that almost mic-drop kind of thing.

Like, there is no comeback to that.

You're just left hanging by that. I am of an older vintage than y'all,

and so Dr. Ribner and I were of a similar, I don't know, not age

really, but I think just upbringing in medicine that was more old-school.

So, you know, I come from a very conservative family and then grew up

in, from my nursing career, in some more rural places that I think were, there was

a time for casualness, but also in the hospital, you called people Dr. Ribner.

I, I never called him Bruce Ribner.

I, I called him Dr. Ribner always, and then he, in return

just called me Nurse Morgan.

I mean, it was Nurse Morgan all the time.

And so it was not a formality because he put himself on any high horse.

It was just sort of that was how we were both brought up in; I

think, in our healthcare careers.

But one of the things that I found most valuable. I know I've heard several of

you talk about over the years was the real equality of the team we had during

our care of Ebola patients, and I think that he was inspirational in that.

And it was something that I appreciated and have continued to value through

the rest of my career because you realize how, unfortunately, it's

still sort of a rare thing to feel like you're really treated as an

equal no matter what your ranking is.

So, you know, you each met him at a different point in your career, and yet

I think you would probably say that your acceptance into Dr. Ribner's circle, and

and how he treated you was essentially the same because it was just, you know, show

me what you're worth and do your job and we're all in this together kind of thing.

And I was really grateful to feel like no matter who you

were on our team, he listened

I think that's spot on, Jill.

I was just gonna briefly add to that, and this is gonna sound odd, but I think in

that same role modeling of equal voices on a team, the other thing, and I, I won't

speak for Colleen and Aneesh on this, but the other thing that I appreciate,

I think kind of goes hand-in-hand with that is also sort of the freedom to not

necessarily fail, but sometimes flail.

So you asked about- you made a good comment that, you know, we worked with

him at different points in our career.

I think Bruce recognized that a lot of what we do, not just

in medicine, but especially in infectious diseases, is very gray.

There's not a lot of black and white.

And to that end, sometimes you actually have to have some freedom to do

something where it might be a little bit different than what somebody else may do.

And I think Bruce was particularly skilled in allowing that in, in a

very… as long as you could rationalize why you were doing it, and as long as

he reiterated the fact that he would steer you in the right direction if it

saw you were going off on a tangent.

That was something that was actually really quite motivating

and inspiring, in a way

And I will say I do not have the patience for that all

the time for those who are junior And so I, I just like, as we're kind

of reflecting on him, I'm really grateful that he showed us so much.

I mean, he always was, to me, a little bit of a walking contradiction.

Like he had this flat hierarchy, but he could also just raise up and be the boss,

which is appropriate in a lot of the circumstances that we found ourselves.

And so I think that that was always fascinating to me that, you know, Jill,

for patients with Ebola Virus Disease was I got to sort of spend a little bit

of time, I know you wouldn't say much, in the shoes of nurses, like in

their hierarchy and how they function.

But Bruce already knew all that.

Like, he already, he got that.

He, he walked that, but you wouldn't necessarily… Like he knew it,

but he didn't always, I feel like show it, if that makes sense.

okay.

Yeah, I think, just to build on both of those, both Jay and

Colleen, what you guys just said.

So just going back to that first moment, in the SCDU for me, during

that drill, I mean, he was taking notes, and I do remember that after

the fact, but he ga- he did not, and I would not have been able to do this.

I didn't-- He never stepped in and said, "Aneesh, you should think about

doing it this way." And that's how he was as a teacher and a mentor.

He would give you that flexibility to find your way.

But as you mentioned, Colleen, like if it was, like, important, if this was

gonna hurt somebody, then he clearly knew what the right thing was to

do, and he would step up and say it.

But up until that point, he gave you the freedom to learn in your own way.

and it's something that I've tried to emulate in my career,

but I still haven't gotten there.

It's just that immense patience that is built on this confidence of

intellectual power that, that was just impressive to watch, from Bruce.

So yeah, just still trying to emulate that.

Yeah.

I mean, I think it is a powerful thing to be where the buck stops,

and yet give that, as you all have said, that flexibility to

other professionals to get there.

But knowing that you have that backstop, that there is this person

who has this enormous intellectual capacity, who understood things you

were probably not gonna understand, who had your back in that way.

And I think that that's, that's a very powerful thing.

I mean, I, I'm certainly grateful I didn't ever have to deal with the press, right?

I mean, I think he, he protected certainly the rest of us from ever

having to do those kinds of things.

And that can be a double-edged sword, right?

If somebody wants to have those experiences.

But I think that, I mean, to me it was, as you sort of said, a

walking contradiction in some ways.

I wanna actually kind of riff on that because, as several of us have talked

before, when we went to the services after Dr. Ribner's death, we got to

see some of the great, great images that his family had put together.

And as has been mentioned, Bruce's wife Barb was there, and his sons and

grandchildren, and seeing this person that I only knew in a suit and tie and a

starched white jacket, like holding his sons as babies, and camping and hiking

and doing all these other things that were just- he just looked so, I mean,

like comfortable and normal, if you will.

And I didn't know him that way.

I only knew him this very, sort of, I don't know, a little

bit uptight kind of persona.

So I'm, I was really grateful to get that glimpse of a very rich life.

So I'd like to hear from you guys what, what you knew that that people

would be surprised about, or that, you know, you got to see in Bruce

perhaps that other people didn't.

Yeah, I had a very similar experience, Jill, at the

Shiva, which was an honor to be at.

I mean, I knew Bruce for 23 years.

And really, you know, the past 12 or 13 years, like very, very closely.

And you know, he- I knew well, like his sort of medical pedigree, like

where he had trained and the different institutions that he had led and, you

know, from, coming from MUSC to Emory and how he built the program at Emory

for hospital epi and then built the program for our biocontainment care.

And I knew a lot about his family.

He like shared a lot about Barb and his three boys and fun things that

they were doing, their accomplishments.

But Bruce, like in all those years, like, I don't remember him

telling stories about the cool things that he did outside of work.

And that's what I think, you know, you were commenting on, and we saw in the

pictures, but also the stories that his boys told about him, his sons told about

him during that, like this rich human being that Bruce Ribner was that we

didn't always get to experience because, you know, we were focused on our work

and his contributions to our work.

I wish I had known more about those things, and I'd love to have those

conversations, but it was really nice to see, as we all talked about

earlier, that Bruce Ribner was far more than the man we knew at work.

He, just rich, had a really, really rich life beyond the confines of our hospital.

To build on that, I think… I forgot which one of us mentioned the idea

of Bruce being a bit of a contradiction, but I, I think Aneesh said it well.

I mean, on one side we knew him as Dr. Ribner, you know, EH Hospital

epidemiologist or SCDU medical director.

And then you're right, in celebration of his life with his family, I, for

the first time was looking at him on a, he, I, he seemed like the Dos Equis

most interesting man in the world.

It was just, it was fascinating.

And I wouldn't say Bruce was guarded per se.

I just think it was his general reserved personality.

He wasn't particularly effusive in terms of talking about these kinds of personal

details, even after coming off of a, yeah, a camping trip or a vacation.

He'd talk about it at a high level, but it was, I, I think, and in

some sense, this is just how he was, he clearly role-modeled the value of

family to him outside of the hospital.

And I'll give one tangible example to it.

And it was, you know, as I mentioned, he, he was my office neighbor.

So, there was a period of time where I would usually drive with

my small children at the time, from Atlanta to Austin, Texas.

And he always thought that was funny, but I, because he's

like, "Ah, it's a long ways."

But he told me for like two years in a row, and then it took

me a while to realize that this was clearly a place he had found.

He kept telling me about this restaurant, and I found out later it was in San

Antonio, that was basically pirate-themed, and the whole thing is on a pirate ship.

And he- that's the first time I had seen him kind of go in

that detail about something.

And again, I worked with Bruce for a long time.

I wasn't expecting the one restaurant recommendation he'd give me would

be a pirate ship in San Antonio.

But it clearly was something that resonated with him, and it was

because he was with his family.

And this was at the same time when he had covered the

traditional Christmas holidays for a lot of us for well over 20 years.

And even when I think a couple of us, you know, volunteered,

he- I think he shooed me off.

He's like, "No, no, you, you be with your family." And, and it, it was just,

it was a, it was kind of a… It was a role modeling a priority of family or

having a life outside of the hospital.

I think all of us saw that; that really had a significant impact on me.

Yeah.

I'm not gonna be able to picture him in a pirate ship-themed restaurant.

Not,

no way.

Yeah.

But you should

because he, he also did a lot of crew and rowing and sailing.

And so that was something that I kind of only learned later 'cause I'd visited

his townhouse, when they moved away from their Fair Oaks home to their townhouse.

They had this huge paddle, or I, I think,

you know, like his… Their cruises going to Antarctica, I think, like you're saying,

Jay, all these, like, really… But a lot of them were water-based because he kind of

had this love, and I think had been on crew or something in college or grad school.

So, it was really interesting and I thought, you know… I, I'd looked

through all their memory books of all these trips, and I knew Barb quite well

and… But I was still also stumped by some of the things that he would tell me.

When we were having our boys, he said, you know, our boys are pretty close

together in age, but he said that he, you know, they'd had their boys five

years apart, so one and then five years and then another one in five years.

And he kept saying, and I loved, I, I can imagine him saying this.

He said, "By that time they were a big helper," and it was that same kind

of a thing; he was just a good helper by the time the next baby came along.

And I did sort of see that, like fatherly, grandfatherly, and

I think great-grandfatherly.

I think they have; he has great-grandkids as well.

And so, you, you'd get these little glimpses into that.

And I think even the story that was told of how much he was a sympathetic,

empathetic father figure to his boys at the shiva, also resonated

because he was sort of like that to us, we just didn't notice.

Like, we didn't realize.

But especially during that time that we all worked together for a lot

I think now we see because we're having to deal with it ourselves.

You know, the things that he kind of took care of or made decisions on for

us or, you know, to, in order to sort of shield us from these, these kinds of

things that would've really, I think, Jay, I like your phrase, made us sweat.

Like, it would've really been hard for us to manage being away from our families to

care for these patients, to then try to make sure we're doing a high reliability,

taking care of ourselves, you know, getting pressure from all different sides.

He was really the one that filtered all of that, and I think I didn't realize

until much later how much he really was sort of watching out and, you know,

he is giving us opportunities, giving us some of the positive things, but

he was kind of taking a lot of the heavier stuff on himself, for sure.

Yeah.

And one advantage, of course, of having Dr. Ribner as a shield, if

you will, against some of those slings and arrows was that because he had

that persona and because he had the the knowledge to back it up, people

didn't question- like, when you come across as that kind of expert, people

don't poke you quite so much, right?

Because they, they, "Oh, well, well, this person clearly knows what they're talking

about." And, and that's sort of something that I think many of us struggle with,

no matter how long we've been doing our jobs or how confident we feel in it.

Somebody asks you a question, and you're like, "Huh, did I, did I say, misspeak?

Did I, d- is there something about that I don't know?" And he just,

like… It was not bluff and bluster.

It was just that he had a command of a topic that, and, and that was it.

His knowledge was encyclopedic.

Yeah,

I, I have-- Aneesh and Colleen have heard me say this before,

but, you know, the ID rounding room was again right next to my office, and

Bruce did a lot of clinical service.

He saw a lot of patients.

And so oftentimes I could hear him teaching next door.

And every once in a while I'd hear him say something, and just in the back of my mind

I'm like, "I don't think that's right."

And I was at my computer, so I'd, I'd actually look it up, and it always was,

you know, like to a T. It, it was-- I always wanted to kind of catch him

and be like, oh, you know, 'cause I-- he had no compunction about catching

us when we make those mistakes and giving us the exact citation in

a way that we would never forget.

So I always wanted to do that.

I can't think of one time I actually did.

Yeah

I remember when he said I was there when he talked to one of

our patient's families and said that he had Ebola encephalitis, and I thought

I was gonna fall over because I was like, "What are you talking about?"

But he was absolutely correct, and I- it just hadn't-- I don't know if

we just hadn't talked about it as a group, or it hadn't dawned on me.

Like, I kind of still feel to this day like I must have missed something.

But he, I mean, he was so-- he knew what was going on at all

the time, especially clinically.

Yeah, Corrie, I remember that specific conversation, so

well because it was emblematic of his, like, deep knowledge and precision

in application of that knowledge.

Because I was going around and around with the family about how this could be

toxic metabolic, all these other things.

And we had all talk…

And, and, and Bruce was like, "It could be all those things, but to be

honest, I, I believe this could be Ebola virus-induced encephalitis." And

we had no way to prove that until that patient needed an MRI of the brain,

and it was clearly demonstrated there.

And I remember being, like, talking to all of you guys afterwards.

I was like, "What is Bruce talking about?

Tox- you know, the encephalitis from Ebola.

That hasn't been described.

Like, do you guys know? And yeah, we- after that MRI, it was

like, oh yeah, he was 100% right.

I didn't know what I was talking about.

So

Just the way he went about telling the

family too was also very Bruce.

He was very matter of fact and, and we were-- I mean, I, I don't guess

I was there in the room.

I was stunned.

I think I probably had a hard time, you know, like softening that.

But, you know, I was like, "Maybe we should have talked about this

altogether and like come up with more."

But I mean, it was the appropriate conversation.

It was the right tone.

He's, you know, he is, he usually has a lot of-- he's

listening as well as speaking.

But yeah, it was, it was amazing to be around that.

Yeah, and he knew exactly how those parents of our

patient needed to hear that information, which I clearly was struggling with,

and he just, like, said it, right?

You said matter-of-fact, with confidence, but with calm, and that's exactly

what they needed in that moment.

So yeah, it's impressive

So I want to, w- just wrap up this wonderful conversation

with you guys to ask what you think from your perspective, personally,

Dr. Ribner's legacy is to you.

And then I don't-- I, you know, obviously we know, and, and, and I probably should

have stated at the outset that Dr. Ribner, as we've mentioned, started a lot

of things, but specifically related to this podcast and this work that we do with

NETEC and, with preparedness nationally, is that Dr. Ribner put into place the

biocontainment unit at Emory University Hospital as the occupational health

That was all because of this one man.

Now, obviously it took a team of people to put that together, but it was his vision.

I, my own personal legacy about him is w- honestly, his willingness to pivot

when it was needed, whether that's what was happening with the patient in

the room, whether that was happening with how we were handling something.

And then for me, as everybody knows, my favorite topic is PPE.

It happened with our personal protective equipment that we were going to

wear, and he was absolutely willing to say, "If that's what we

need to do, that's what we'll do."

And, and I, I respect that because, again, he did have the gravitas that you

didn't always question things, but it wasn't; it wasn't that he was stuck in

one answer or one way of doing something.

It was because he had just built this, this incredible

foundation of information.

So that's my personal legacy about it.

So, I don't know who wants to go first, but

Yeah, I'll jump in.

So, there are a lot of, I think, legacies that Bruce Ribner has left

on all of us and, and, and on me.

I think, specific to the realm we're talking about, Jill, in biocontainment.

I go back to a story, my own personal story with Bruce that was really

difficult for me at the moment, but now I understand so well why he did it.

So I took a patient that was in airborne isolation out of isolation

a little bit earlier than the protocol dictated, because I felt

like I knew what I was doing, and what was going on with the patient.

And so he called me into his office, and he said, "Let's review Emory Healthcare's

policy on airborne isolation together."

And I talk a lot about this part, right?

Because it was like him pointing out, like the details

and where I went astray.

But I don't talk about, and I should talk more, really, about why

he did it and how he ended it.

And he was talking about, you know, "Aneesh, we could all be right, and we

know we're right, but there's that small margin of error that we all know is human.

And when we make that mistake, that can affect a patient, but it

could also affect our colleagues.

And we need to make sure that we're keeping everyone safe," right?

And I don't talk about that as much as I should, that part of that conversation.

But that was emblematic of why he built the program that, that we all benefit

from and built NETEC, with the other NETEC leaders, back in the day, is

really to make sure that his message, he-we could deliver clinical excellence

while keeping each of us safe, right?

And making sure that we all went back home to our families.

And yeah, that's a legacy that I bring hopefully every day to the

work that we do in biocontainment.

And then the other thing that is just a legacy is being generous.

I think that was all the stories that we've been telling is, is really

a lot about his generosity in making… you know, taking on the hard task as

a leader and giving all the really great stuff to those around us so

that they can build their careers.

And I certainly have benefited from Bruce's generosity as well.

So those are sort of his lasting legacies with me.

Yeah, it's, it's a great question, and I was trying to think

in terms of how to answer it because I think Bruce's legacy is vast and kind

of, like the man, kind of understated.

But I think the point of this is for the four of us who knew him

well to kind of articulate it.

So I, I break it down into a couple of pieces.

I think it's sort of the personal impact, I think his impact on the

hospital where he practiced longest, and then really the nationwide

and international impact as well.

So at a personal level, we touched on it, but again, I think all of us to a

degree, and again, speaking for myself, I think that balance of recognizing and

prioritizing and modeling excellence in medicine, especially infectious

diseases, but still maintaining what is important outside of the hospital,

I think was a personal impact that I think all of us mentioned and have seen.

In terms of legacy of the hospital, and again, I think the longer the four

of us are here, I think there's probably a smaller number of people that remember

just the amount of things Bruce did just because he felt that it was his job.

And these were big deals.

So Aneesh was talking about that focus on public safety.

I mean, Bruce was, and many people have forgotten this, but he was the

gadfly, for lack of a better word, that led to us notifying the public

of a tiny risk, but still an important one for prion-related disease.

And we took a lot of heat for it in terms of the public, but it was

absolutely the right thing to do.

He did the exact same thing in terms of an exposure to tuberculosis because

again, it was the right thing to do.

And by role modeling that, I think that that set a precedent that certainly

impacted the way I thought about things, and I feel I left a legacy

in terms of the way Emory does things.

And then last, and this is hard, just given the fluidity of the current Ebola

outbreak and kind of where we are as a society, but if there's any legacy

that I think is important, that I hope nobody ever forgets is the fact that

we demonstrated, and Bruce demonstrated that our team could safely care for

something that many people find scary.

And I think it set an important precedent that I hope we don't forget as a society,

that if Americans are serving overseas and get sick, they have a right to

come home and receive the best care.

And I think that that is something that even, you know, politics may

change, society may change, but I hope that that lesson is never lost

because I think it was a critical one.

I should have gone before Jay.

So I would say the thing that I've reflected the most on, 'cause we've

covered some of what I think about is his legacy we've covered already,

is just that vision and deep wisdom and insight to do something on, like

unappreciated for over a decade, and probably even longer than that.

You know, I don't, I don't know as much about his hospital epidemiology journey.

But probably with that, he essentially created civilian biocontainment

units for the whole United States, at least, and maybe farther-reaching.

Most of what exists today, he was involved in at least

giving advice at the beginning.

And also not knowing that would ever come to fruition,

that that wouldn't ever happen.

And even when it did happen, and he's on the front of Time Magazine and all this

stuff, he's a little unbothered by it.

And I, I think, you know, I'm somebody that I think needs a lot of reassurance

and wants to see things happen quickly and soon, and I think he was very

content to do things, again, as we've mentioned, for the right reasons, and

take his time doing it and not necessarily know that it'll ever yield anything.

And that is a very rare, sort of personality trait these days.

I'm glad you went last, Colleen, because I think it really does

tie this up very nicely, that there are people doing things, whether it's vaccine

research, whether it's preparedness in other ways, whether you're working alone

in a lab somewhere and you think, "Is this ever going to make a difference?"

having a sick patient in it.

That did not in any way discourage Dr. Ribner, because I want to make sure I can

explain this, but it didn't matter because the unit was there for the right reason.

The work, the preparedness, everything was there for the right reason.

The parts, the pieces were all there for the right reason.

And I liken it to having smoke detectors in your house or having a fire alarm.

You-- it, it's the right thing to do whether you ever have a

house fire, whether you ever ha- turn on your stove or not, right?

And he understood that, and that gave him that quiet confidence that he

was doing it for the right reason, whether you ever appreciated it or not.

It didn't really matter to him.

Whether it was President Obama saying it, whether it was a patient giving

him thanks, all those things were nice, but he knew his true north.

He knew that what he was doing and what he had put in place

had value and was important.

And so I guess my luxury of doing this podcast is I get to rant a little bit

and I just want to rant to the people that I know right now are working,

whether it's at the CDC or whether you're working on a research project somewhere,

whether you're an infection preventionist in a small hospital and you feel like

you're sort of shouting into the void.

If you're doing important work for the right reason and you've got

your true north, keep going, honey, 'cause that is what it's about.

Whether you're ever recognized, whether it ever gets used, having

those things in place, that's what preparedness is about, so you're not

starting from scratch when the, when the you-know-what literally hits the fan.

So I just think it's an incredible legacy.

You're right.

It's, it's big, and it's wide, and it's deep, and it's all the funny things

that Dr. Bruce Ribner was to us.

And I am, I am very grateful.

It changed the trajectory of my career.

It got me a great relationship with the three of you and with a bunch of other

brilliant infectious disease folks, and I am, I am very, very grateful.

So thank you.

Thank you for sharing your stories about Dr. Bruce Ribner.

Anybody have any last comments they want to get in?

Thanks for doing this, Jill

Yeah.

It's an honor to talk about Bruce

And thanks for looking out for all of us

Yep.

Absolutely.

Absolutely.

All right

That was a lot today.

I, I feel like it was almost a cathartic podcast episode for

me, so I'm, I'm really grateful.

For those of you listening at home, thank you for tuning in to this episode

on the legacy of Dr. Bruce Ribner.

We hope you'll join us for future episodes on a wide range of topics, from healthcare

worker safety, personal protective equipment, of course, and even more

about infectious diseases of all kinds.

If you have any questions for NETEC or ideas for future shows, please feel free

to contact us at info@netec.org or find us on the web at netec.org/podcast, where you

can subscribe to future episodes and find out more information about today's topic.

We'll see you next time on Transmission Interrupted.