864: Chicago Hope

Announcer

A quick warning, there are curse words that are unbeeped in today's episode of the show. If you prefer a beeped version, you can find that at our website, thisamericanlife.org.

Ira Glass

From WBEZ Chicago, it's This American Life. I'm Ira Glass. A couple of years ago, one of our producers put together this story that just got too big for our show. It couldn't be contained in an hour or two hours. And so it spun out into its own podcast series called The Retrievals. It was a big hit. Maybe you heard it. Our coworkers at Serial at The New York Times produced it.

Anyway, now that producer, Susan Burton, is back with a story that is just as compelling. And they have released it as season two of The Retrievals. At first, I heard drafts of this months ago. And I am very excited that we can present one of the episodes for you today. I have to say, one of the things that I really like about this story is that by the end, it turns out to be surprisingly hopeful.

She also invented this way to tell a radio story I have never heard anybody try. I hope you like it. I think you'll like it. The story takes place in a hospital's labor and delivery unit. And there's some description in here of medical procedures. And things don't go well. Just a heads-up. Here's Susan.

Susan Burton

6:00 AM in Chicago. Of course, the shot starts at the lake. Camera pans over the water and the magnificent buildings rise from the shoreline, twinkling in the dawn light. We continue across the city, still bird's-eye view, over the grid, over the elevated tracks and wide highways, coming to rest in a western suburb.

Drop down to a brick bungalow where, inside, a woman, late 30s, moves softly past the bedrooms where her children sleep and steps out the front door to meet the morning. Wind chill of 20 below. She hurries to a minivan. And as she pulls away from the curb, we see the streets frosted with salt, the moon shining high and hard. And we see her work ID where she keeps it on the center console. The words "BOARD CERTIFIED RN" and her name in all caps.

This is Mindy Figueroa. Mindy says she was made to be a nurse.

Susan Burton

Mindy was the first one in her family to go to college. Her parents came to this country undocumented, from Mexico, worked factory jobs, earned citizenship. Mindy paid her way through school, got her degree, started out at a small hospital, and after a few years, transferred up to a big one-- UI Health at the University of Illinois at Chicago.

She works on the labor and delivery floor, with patients about to have babies.

Susan Burton

We watch this happen, Mindy stepping cheerfully into a labor room, her face framed by two neat braids. And then we carousel through shots of Mindy at work-- Mindy strapping a fetal monitor to a patient's belly, Mindy at the nursing station holding a plastic pillow up like show and tell, her colleagues doubled over in laughter, Mindy, her face grave, bursting through the door of the OR.

Mindy loves the intimacy of labor and delivery. And that adrenaline, that switch from, it's calm to now it's time to run.

Susan Burton

This story is going to be about one of those deliveries that Mindy watched, one that changed things for her and for her hospital. There are more than 2,000 deliveries a year at UIC. It's a public hospital, not a fancy one. And it's located right in the middle of the city, in the medical district.

Establishing shot of the hulking building, dawn breaking open the sky above. A humble hospital in Chicago, a hard-working nurse, a delivery with stakes-- how could we not tell this like a medical drama? A medical drama, its emphasis is on the world inside the hospital, on the heart and the heroism of the people who work there, on their relationships with one another, on how their interactions with patients are shaped by their own stories.

But what happens in a hospital also reverberates outside. And on this show, we're going to see that too. Because this delivery that Mindy watches, it doesn't just change things at UIC. It could change things for the entire country.

And now let's pull back, get the whole hospital in the frame, and end the opening credit sequence with this image, this boxy building on the subzero morning. But we know that behind that imposing facade, it's warm. We're already invested in the human drama inside. Black screen.

Ira Glass

Susan Burton's story continues. Stay with us.

Ira Glass

It's This American Life. Susan Burton picks up where she left off.

Susan Burton

The action of the episode begins with Mindy in a nearly empty elevator. Closer to 7:00 AM, change of shift, you can barely fit, it's sardines. But Mindy's early today. She's almost always early. She's the one who will have cleaned the break room by the time her coworkers arrive.

At UIC, your coworkers have your back. Mindy could say this about all of the nurses on her crew. One of those nurses is Clara Hochhauser. We see her emerging from the locker room in gray scrubs and a scrub coat. Not everyone wears a scrub coat, but Clara does because it has better pockets and because it covers her tattoos.

Clara has large, wise eyes, as if she sees more than other people. She's a natural at nursing, but it wasn't obvious that it was where she would wind up.

Susan Burton

One day, Clara got a massage, and then she became a massage therapist. And she found the clients she liked best were the pregnant clients. So then she decided to become a midwife. But after finishing her degree, she just wanted to start working. And as a nurse, she could do that sooner. She started as a mother-baby nurse and eventually switched to labor and delivery.

She never thought she would have her own kids.

Susan Burton

And then Clara got divorced from her wife. She met a guy. They got married. Suddenly, Clara understood she didn't have to be, as she puts it, a perfect, magical, special person to have children. She was 40. With her husband, Clay, she did IVF, and soon she was pregnant with twins.

Susan Burton

Clara would go home with her babies. That's not where this story is going. She would also be delivering at UIC herself. On a medical drama, when the healthcare provider becomes the patient, it's a twist. But this isn't a twist. It's our premise. We don't know how this matters yet, but it will. It matters that this patient is not a visitor, that she's not someone who leaves, but someone who stays.

A twin pregnancy at age 40-- there was definitely a chance that Clara would need a C-section, but she wanted to avoid it.

Susan Burton

Clara also wanted to avoid delivering in the operating room. Typically, if you're having twins, you can labor in a labor room, but you have to deliver in the operating room, even if you're delivering vaginally. It's a safety thing, just be in the right room if something goes wrong. But Clara really did not want this.

One of the things Clara did want was for Mindy, her coworker, to take pictures of the birth.

Susan Burton

Mindy's always taken pictures. Back in college with the little cameras you'd hang on your wrist. Eventually she got a camera with a big lens that attached and taught herself how to use it from YouTube.

Susan Burton

On April 19, 2022, Clara arrived at the hospital for a scheduled induction, which is when you get drugs to start your labor. Now, we flashback to see her on that day. She and her husband, Clay, are crossing the street from the staff garage.

Clara's purposeful, leading the way. Clay's just passed the bar, is going into criminal defense, did an internship advocating for victims of police brutality. It matters that you know something about Clay so that he's a little more than just the cut-out husband, more than just the husband watching the main event.

At the employee entrance, Clara badges in.

Susan Burton

On the fourth floor, Clara enters her labor room, Room 5, the best one. That's where they try to put you if you're a staff member. Her co-workers have decorated it for her. She changes into a gown, climbs into bed. Clay sets a Bluetooth Speaker on the windowsill, opens his phone, starts the playlist. "Push It," it's on everyone's playlist. The Beach Boys' "Don't Worry Baby."

And so far, Clara's not worried. Even when she receives the drugs to start her labor, everything feels surprisingly OK. By around lunchtime the next day, she's in some pain from her contractions and is debating whether it's time to go for an epidural.

Susan Burton

Heather Nixon, the head of obstetric anesthesia at UIC, charismatic, assertive, boss lady, but not bossy. Let's actually meet Heather on the way into the room. Let's watch her leaving her office downstairs on the anesthesia floor.

Heather's office-- mini fridge, on top of it a framed photo of four women dressed up for girls' night, a black leather couch with a hot pink pillow where lots of times Heather spends the night. Heather is 51, with two daughters in college. But she's the one with the energy of a college kid-- can sleep anywhere, pop up bright-eyed at weird hours.

Susan Burton

Heather has lived in Chicago for 30 years, came to the city straight after finishing college. She knew she wanted to be a doctor, but she had to pay off student loans first. So she worked as a shot girl in a bar off Rush Street, T-shirt tied up, abdomen showing.

Anesthesia itself came as a surprise to Heather. It wasn't a specialty she'd ever thought she'd want to do. But she had a mentor who made her fall in love with it. This is the case for a lot of anesthesiologists. There's a common misconception that this is the doctor who just puts you to sleep. But there's a lot more to it than that. The surgeon has their head down in the surgical field. The anesthesiologist is watching over all of you.

When Heather discovered the subspecialty of obstetric anesthesia, she had a feeling like, OB, this is my tribe. These are my people.

Susan Burton

Many OB anesthesiologists proudly identify the same way. They like awake patients, not sleeping patients. Now we catch back up to the action. And we see Heather enter Clara's room and begin arranging her equipment on a tray. Clara sits erect on the bed, waiting, bed pumped up high, her feet dangling.

She'd asked for Heather to do her epidural like, hey, Nixon you gonna be around? Heather was happy to do it. She does this for all her providers delivering if she can. Not that a resident couldn't do it, but you want to take ownership if, god forbid, something goes wrong. Close on Heather's gloved fingers touching Clara's spine.

Now we're going to watch Heather actually do this procedure. We're going to be talking a lot about procedures on this show, and viewers need to be grounded in them. And does anyone really know what an epidural is, besides the thing you can get for pain when you're having a baby?

Now we see Clara take an anxious peek over her shoulder and Heather telling her, no, no, I'll talk you through it. You'd think nurses and OBs, they'd be the most relaxed about the epidural, but they're just as nervous as anyone. From her tray, Heather picks up something that looks like a swizzle stick, like what you use to stir a cocktail.

This is actually a large, hollow needle, and its placement in Clara's back, this might cause someone to turn from the screen for just a second. So I'll tell you what Heather's doing. She's inching that needle into Clara's back a little deeper, a little more, until the tip enters what's called the epidural space. Heather finds that space by feel. There's a ligament she's looking for.

Susan Burton

Now, Heather threads a thin plastic tube, a catheter, you know this word, through the large, hollow needle until the plastic tube is inside the epidural space as well. We could go one level deeper with the science, explain that the epidural space is not really a space at all, just potential space. But I won't get into this. Just nod to it so that doctors watching can be like, on this show, they know what they're talking about.

Now, Heather slides the needle off the plastic tube, which stays in Clara's back. Anesthetic drugs will be delivered through the tube, bathing the nerves near her spinal cord. Clara is relieved when the procedure is over.

Clara's epidural is topped up with more drugs. And that does the trick. She's more comfortable right away. A couple hours later, at 11 o'clock, Heather signs out to the anesthesiologist on the overnight shift and fills him in on Clara.

Susan Burton

We see Heather get in her car, drive away from the hospital.

Clara had been comfortable when Heather left. But several hours later, she's having the same pain again. And other things are going wrong, too. Her labor is stalling. Her blood sugar is climbing. So are the babies' heart rates. Clara knows she's headed for a C-section, but she requests one last half hour laboring on her hands and knees just to see if that will help.

Now we see the room, dark, except for the lights of the monitors, Clara on all fours in the hospital bed. Close of her forearms, we briefly glimpsed the tattoos. We remember for a moment that Clara has stripped a layer off for us. There's a lot of vulnerability in what she's allowing us to see. The only other person in the room is Clay.

That was another thing Clara had requested, just please, everyone clear out and give me one more try. But the try doesn't work, and there's no more time to waste. The nurses unplug Clara from her monitors and push her cumbersome bed down the hall to the OR.

Susan Burton

Mindy was at home, asleep, but she got right out of bed and grabbed her camera bag. We see her, strap over her shoulder, hurrying down the bungalow's front steps and into her minivan.

Susan Burton

Up on the fourth floor, Mindy takes a plastic-wrapped surgical suit from a closet and pulls the coverall on over her clothes. Then she turns toward Clara's OR.

Ira Glass

Coming up, the failures in Clara's surgery and where those lead. That's in a minute from Chicago Public Radio, when our program continues.

Ira Glass

It's This American Life. I'm Ira Glass. Today's show-- "Chicago Hope." We're hearing a story from the new season of The Retrievals podcast. Susan Burton takes up where she left off.

Susan Burton

When Mindy arrives, Clara is still being prepped for surgery. She's flat on her back in the OR, which is obviously not where she wanted to be. The L&D operating rooms at UIC are relatively small, out of another era. Mint green tiles on the walls, like you're stepping into the showers at a YWCA. Harsh light.

But Clara is calm. We see her now through Mindy's viewfinder, her eyes closed, the expression on her face. My god, it's the embodiment of a word whose use is rarely earned-- beatific.

Susan Burton

Surgery's getting closer now. There are poles on either side of Clara's bed, and soon a giant piece of medical paper will be stretched between the poles, blocking Clara's view of her abdomen. This paper is called the drape, and it both protects the surgical field from contamination and protects the patient from the sight of her open body.

The anesthesiologist has added more drugs to Clara's epidural, making it strong enough to get her through the surgery. Now the doctors need to test to see if the anesthesia is working. Tight on the skin test, it's so weirdly basic-- the anesthesiologist poking Clara with a broken tongue depressor. Another doctor does something more severe-- clamping Clara's belly hard with a surgical instrument. Clara feels none of it. And that means they're ready to go.

There's a decision to make about the C-section, how much of this procedure to show. Like Mindy said, how graphic are we doing? We're not going for gore on this series, for showing open bodies for the kick of it. But we do want visceral, all the meanings of that word.

Viscera, literally, that's what's inside a patient's abdomen. But also how that word is applied to art. Art that's visceral-- it's of the body, it attends to the body. Hopefully, it makes you feel something in your body. A visceral aesthetic, muscular, close to the bone. Raw but not sensational, not shying away.

OK, enough self-regard, enough theory. What does this mean in practice? Now the surgeon calls out, incision, and then cuts into Clara's abdomen, just above the pubic bone. We're not seeing the scalpel in her flesh, OK, but just know that this kind of cut is called a bikini incision. Bikini sounds tiny, but this cut is big. Once Clara's abdomen is open, the surgeon needs to reach the uterus.

The uterus is behind a pair of muscles. Now we see, actually see, the surgeon and the OB resident position themselves on either side of Clara and pull. These two women in scrubs pull so hard to separate this muscle that their bodies lean back, like in tug of war. This is a very physical surgery. When Clara is a nurse in a C-section, she either covers her eyes or looks away for this part.

But of course, today Clara is the patient. We go behind the drape now, tight on her face, but something's different, radically different. It was just moments ago that she was beatific, but now her mouth is tight.

Susan Burton

A few years earlier, Clara had had a panic attack during another surgery at UIC, an eye surgery, cataracts, weird to have them at such a young age. In the surgery, a different kind of paper drape had been unfolded over Clara's whole body, like a death shroud, so that she was entirely covered in blue paper except for a hole over one eye.

And then she'd heard the doctor say, you need to give her something else, she's hyperventilating. All through her pregnancy, she'd been worried that if she needed a C-section, she would have a panic attack again.

Susan Burton

Clara's anesthesia is not working. She is now in the middle of major abdominal surgery, and she can feel that surgery. Clara knew this could happen. She had seen this happen. Intraoperative pain during cesarean-- healthcare providers know about it. Patients don't.

When Clara herself first started working on L&D, and patients in labor would tell her, for my last baby, I had a C-section, and I felt everything, Clara would think to herself, that can't be true, there's no way. Who would do that? And then she saw it happen. And now it is happening to her.

Visceral, that key word, what Clara is feeling is visceral pain, meaning pain that originates inside her abdomen. When the doctors did the skin test, Clara didn't feel it, right? She was numb. But sometimes a cesarean patient is numb when you test her skin. And when you open her up, you find she's not. There are a lot of reasons for this, but in the moment, the reason for the pain doesn't totally matter. What matters is that you treat it.

The babies, we missed the delivery, but we see them now at the edge of the room in newborn warmers. And we understand they are healthy, that they are OK. But Clara is not. We see Clara punching the drape, as if trying to hit the OBs. What are the OBs doing on the other side of the drape? What are they understanding? What are they feeling? Why are they ordering Mindy to tell Clara's husband everything is all right?

We don't know the answers to these questions yet. We're on the side of the drape with Clara and the anesthesiologist, who's giving her supplemental drugs-- fentanyl, ketamine. Is he doing the right thing, giving her those drugs? We don't know this yet, either. But the feeling we convey now is that something is wrong, very wrong.

What's going on inside for Clara is that all these drugs have her hallucinating. Is this the kind of show where we do a magical realism thing of inhabiting her consciousness? I mean, it could be, yes, why not use it this way? Why not use it to show what Clara is seeing?

A story I heard-- I'll say this fast-- a mother is given ketamine during her C-section. Her baby is born and the nurse brings her the baby. And the patient says, this is a lovely baby, but this is not my baby. My baby does not have two heads. I heard this story from a doctor. It happened while she was still a resident.

And she told me that after that woman, she never used ketamine for a cesarean patient again. What Clara is seeing, we see now, colors and shapes. If you're a certain kind of person, you might be fine looking at an open abdomen but freaked out looking at hallucinations. Clara feels unable to communicate.

Susan Burton

The cautery instrument is called the Bovie. It stanches bleeding. And the red hot pain of it is something Clara remembers precisely. Something that years later, would wake her up in the middle of the night. The sear of that instrument, Clara, exclaiming, ow, and a doctor saying, we'll move to the other side. What?

There's still a lot of surgery left after the delivery. And now we're going to see a part I know some people might not want to see. Brace for it. I'm giving you the warning. The doctor is lifting Clara's uterus out of her body and resting it on her abdomen. It's like a giant, shiny Easter egg. The uterus has been exteriorized. That's what this is called.

And the reason we're seeing this is-- please remember that Clara can feel this, can feel her organ being lifted out of her body. Oh, and at some point during all of this, Clara starts throwing up. Now, the surgeon sticks a good portion of her forearm into Clara's body. What we see in the shot is just the arm disappearing into the abdomen. She's using a pad of gauze to check for internal bleeding.

Again, the point is, Clara is feeling this. Now we hear her scream, "Why are you doing this? Make it stop." And now we do, as if on her command, we leave the surgery. We need to get out of this OR where bad things are happening and we don't understand why. Outside of the operating room, an obstetric anesthesiologist named Cory is arriving for his 7:00 AM shift.

Cory, we're not going to meet Cory as a main character. Maybe he's someone who will be developed later in another episode. He's trim and boyishly handsome. We watch as several nurses urge him toward the OR. Cory, you need to get in there now. Cory pushes open the door and enters the room just as the surgeons are putting the final stitches in Clara's skin.

Susan Burton

Cory, Clara knows him, trusts him, unlike the other anesthesiologist. She had no idea who that guy was. We see some relief in Clara's face and we see Cory holding back tears. And even though there's no resolution or total explanation, at least we know that Clara is being cared for. Cory wheels Clara to the recovery room, the PACU, and as soon as she's settled, Cory goes down the hall and calls his boss-- Heather.

Susan Burton

Heather was at home. She'd been at the hospital so long the night before that she got the day off. Cory told her about Clara.

Susan Burton

Heather is mad because she's in charge here. And she's an anesthesiologist. The thing the anesthesiologist is in the room to do is manage pain. Cutting someone's body open and then operating when they can feel it, that is not supposed to happen. That's something from history or from war.

But in the United States, it happens 100,000 times a year. That's the best estimate of how many patients have significant pain during cesarean. Not all of these patients feel the exact same intensity of pain, or at the same parts of the surgery, or for the same length of time, but the pain they feel is significant. Most people don't know about this. Until recently, I didn't.

I learned of it from listeners to season one of this podcast. It doesn't matter if you haven't heard season one. The details are less important than the common experience it described-- pain a doctor didn't listen to, pain a doctor didn't adequately treat. That experience resonated with many listeners, and hundreds of them, mostly women, began writing to me with their own stories.

One afternoon, I opened a note that was unlike any I'd received so far. "I had a C-section," the email began, "where anesthesia was not properly administered. I remember telling them I could feel the cutting, the moving of my organs, the burning, shocking, brutal pain, and being told that wasn't possible and that I would just have to tough it out."

To me, this listener's experience seemed so out of range that it might be singular. Then I opened two more of these notes. Soon I understood this was a subject that would come up again and again.

C-sections are the most frequently performed surgery in the world. In the US, there are 1.2 million of them a year. So 100,000 patients a year feeling pain during cesarean, that's 8%. Some people say the rate is even higher. There's no other surgery where this happens, no other major surgery where it would be acceptable for 8% of patients to feel that surgery.

8% is a brand new number from a recently completed study. It didn't replace an old number. It's the first number of its kind. Until now, nobody had ever done a study like this, asking thousands of patients in the US and Canada whether they felt pain during their C-sections.

But now the study has been done by doctors who recognize that this is a problem and that putting a number to it is a step toward solving it. And this is what this story is about. Not just that there's a problem with severe pain, but that people are trying to solve it.

As soon as I finished season one of The Retrievals, people began asking me, what are the solutions to fixing this problem in medicine of dismissing women's pain? I was surprised the first time I got this question about solutions. Obviously, I should not have been surprised. But I didn't have a bullet point list. How to shift an entire culture, how to listen to women patients-- these are really complicated issues.

And solutions had not been the focus of my reporting. I looked at what went wrong. Exploring what went wrong doesn't automatically translate to solutions on how to make it right. But this question made me curious. Well, what are the solutions? It turned out that a bunch of people interested in pain during cesarean were thinking about the same thing.

So here we go, a case study in solving one of medicine's most persistent problems, listening to women patients and adequately treating their pain, told through the experiences of four women-- Clara, Heather, Mindy, and Susanna, who run up against this problem and take it on, with efforts that touch both individual patients and entire countries. How do they do this? What can they change? And what does it cost them?

Back at the hospital, Clara has been moved from the PACU to a bed. It isn't long before she hears from Heather.

Susan Burton

And now we see Clara in her bed, and we follow her gaze out of the window, out of the hospital, down to the street, where we pause for a second over Mindy's minivan, an orange parking ticket on the windshield. And then we continue across the city, arcing back over the same elevated tracks and wide highways we traversed earlier, only now it's dusk instead of dawn.

And when we get to the lake, we turn around so that we can see the sunset over those magnificent buildings, their windows fiery with the day's last light. And we hold that shot as the music swells and the credits roll.

Ira Glass

Susan Burton. OK, so that was the opening episode of season two of her podcast, The Retrievals. And I kind of said this at the top of the show. As the story unfolds in later episodes of the podcast, it does this thing that I think almost never happens in a big investigative story. It becomes surprisingly hopeful. Doctors take a look at the problem that Susan is documenting, and then they act the way that you would hope that doctors would act. They take it seriously.

People step forward to try to change things. One of them is the head of obstetric anesthesia from this first episode, Heather Nixon. I'm going to play you a clip from the second episode so you can hear what I'm talking about. It's interesting. By sheer coincidence, Heather Nixon had been scheduled to give a speech on pain during cesareans at a major medical conference before she saw how the anesthesia in Clara's C-section went wrong.

And so she had been planning on doing a speech focusing on technical tips. But now she rethought this. She decided to do something much more participatory than a typical medical conference speech. And when the day of the speech came, she began her talk by telling the assembled doctors the story of Clara's cesarean, how Clara felt, what was happening during her surgery, and really what that did to Clara in the aftermath.

And then, the action turns, the story turns to one of a number of very insidery, almost behind-the-scenes moments where doctors are trying to be honest with each other and with themselves about their own failures and how to fix them. OK, here's a bit of that.

Susan Burton

Usually at a medical conference, people are typing on their laptops or holding their phones up to the screen to take pictures of the slides. This room is still

Susan Burton

There are hundreds of people in the room. We watch as half of them raise their hands-- half. Heather had asked how many people in the last month had a patient who had severe pain during their C-section, and half of the doctors raised their hands.

Susan Burton

And it's crazy that we're just beginning to talk about it because it's a known problem, Heather says. She ticks through all the different kinds of knowing. There's medical literature. There's litigation. There's doctors' own experiences in the operating room. So what that means is that there's an active kind of not knowing, and that act of not knowing is as much of a problem as the pain itself.

Susan Burton

Heather's put the questions to the group plainly. How willing they'll be to wrestle with them is anyone's guess. She opens the discussion to the room. The first person to speak is a doctor from New York City named Dan.

Susan Burton

No warm up. No superficial comments before the room really gets going. Dan goes deep straight away. Sometimes I'm scared, he's saying. I'm scared of the biggest thing of all. And in that situation, it seems like the better choice is pain. Heather meets Dan's vulnerability with some of her own.

Susan Burton

From the stage, Heather sees one of the women she trained with in fellowship, giving her a look like, same. People start lining up behind the mics. There's a doctor who practices in New Jersey.

Susan Burton

And there's Zevy.

Susan Burton

The part that spinals and epidurals can fail. When do you tell the patient this thing that you know to be true, but that may sound so alarming to them? These things fail. Wait, what? You're telling me this now?

Susan Burton

We are tight on Andi's face so that you can see she's being self-deprecating, not cocky, gently reminding the group to be alert to their own hubris. Doctors continue to come forward, asking questions, offering tips, letting out frustrations.

Susan Burton

Heather had been worried that there would come a moment like, OK, it's great we're talking about this, but what do we do? Where's the algorithm we follow if a patient is in severe pain? She wasn't sending anyone off with an algorithm to follow because that algorithm didn't exist.

Susan Burton

And it's clear that the audience is eager to come up with solutions.

Susan Burton

There's a lot of crowdsourcing, Heather and others talking about everything from specific doses of medicine to styles of communication. Heather has scoured the medical literature for relevant research on this. But for today, the goal is not to settle on a fix. This is steps to solve a problem. Step one-- talk about the problem. That was what Heather wanted, and apparently it was what the room had wanted too.

Ira Glass

Susan Burton. From there, through the later episodes of this podcast, we hear doctors try to put in place procedures to fix this problem and to change the culture in their operating rooms. It's really something. And one of the key people who makes this happen is somebody who's not even a doctor. That's a whole story in itself. So The Retrievals Season Two. There are four episodes in all from Serial and The New York Times. You can get it wherever you get your podcasts.

Ira Glass

So what you heard today on our show, The Retrievals Season Two, was hosted, written, and reported by Susan Burton, produced by Julie Snyder and Ben Phelan. It was edited by Julie Snyder, with additional editing by Laura Starcheski and Jessica Weisberg and engineered by Phoebe Wang, with original music by Dan Powell, Fritz Myers, and Nick Thornburn.

Special thanks to Elizabeth Livingston, Blair Arthur, Vanessa Lehner, Rachel Roberts, Lynn Holland, Carolina Mendoza, Clara Hochhauser, and Jaime Daly. Our This American Life episode was put together by Miki Meek, Stowe Nelson, and Angela Gervasi. Our website, thisamericanlife.org. If you would like to get lots of bonus content and help us keep our show going, you can become a life partner. Subscribe to our program by going to thisamericanlife.org/lifepartners.

This American Life is delivered to public radio stations by PRX, the Public Radio Exchange. Thanks, as always, to our program's co-founder, Mr. Torey Malatia. He remembers his first monthly paycheck working at a public radio station. I guess it was a long time ago.

Ira Glass

I'm Ira Glass. Back next week with more stories of This American Life.