Who is Angela?

Angela Mills, MD is the newly appointed J. E. Beaumont Professor and Chair of the Department of Emergency Medicine at Columbia University College of Physicians and Surgeons.   As well, she is the Chief of Emergency Services for the west campus of New York-Presbyterian in New York City.

Angela grew up in Nazareth, PA and is a first-generation college graduate and physician. She spent much of her professional life at the Hospital of the University of Pennsylvania and Perelman School of Medicine: residency, chief residency, and junior and mid-career faculty appointments. She advanced academically to Professor of Emergency Medicine in 2017, while serving in the roles of Medical Director and Vice Chair of Clinical Operations.

The inaugural Chair of the newly formed Department of Emergency Medicine, Angela joined Columbia this January 2018.

What is Angela’s vision for the department?

Angela wishes to deliver the highest quality patient-centered care. This requires an environment producing practice-changing research. This requires training the next generation of scholars and leaders in emergency medicine. She is committed to serving the New York-Presbyterian health system communities locally and globally.

Value enhancement is a top priority. Thus, Angela’s vision is that value enhancement efforts (short term change adds long term benefit) will focus on the three mission areas of clinical excellence, research and education. She believes the vision can be accomplished through two overarching goals: 1. Delivering superb patient care and 2. The recruitment, career development and retention of outstanding faculty.

What is Angela’s message in her TEDx talk?

Right when Angela arrived to Columbia, the Columbia University TEDx organizers selected her as one of their keynote speakers. Angela’s message was clear:

When a patient presents to us with addiction, mental health illness, or interpersonal violence, they don’t just need medical help, they need patient-centered care. We need a healthcare system where patient needs are more effectively addressed, where patients have timely access to care, where mental health issues are not stigmatized, where addiction is treated with innovation and compassion, where gun violence is recognized as a public health issue, and where we fund violence research.

 She illustrated her message through two impactful patient care stories:

“Karen was a young woman who was abused as a teenager.  She suffered from depression and self-medicated with alcohol and opioids. At first she took prescription opioids, but as her tolerance grew, so did the cost of getting high.

Eventually she migrated from the white pills of Percocet to the white powder of heroin.

She sold her body to pay for her addiction and often came to the ER after being beaten by a ‘client’. I personally took care of her twice in the ER, and I know others cared for her as well.  Karen was sad and hopeless and had tried to commit suicide multiple times. I did the best I could.  I showed her empathy, I consulted our social worker, I had our psychiatrist see her, but deep down I knew that just wasn’t enough. And though I don’t know what ultimately happened to Karen, I’ve seen enough patients like her to know that the outcome can’t have been good.”

“Steven was a 19-year-old Black male who was brought in from the back of a police car after being shot multiple times in his chest and abdomen. Despite Steven being dark-skinned, he was white as a ghost. He had lost a lot of blood and was in shock. Almost immediately after his arrival in the ER, Steven’s heart stopped beating. As doctors, we did what we are trained to do. We gave him blood, we cracked his chest open.  We used every tool in our tool box to save him.  The bright red blood poured out of Steven’s body and despite our best efforts, he died. In the moment when we pronounced him dead, the controlled chaos of the emergency department came to a halt. The loud bustling room turned eerily quiet. That transition — from working so hard to save a life to the stillness of pronouncing death —  is one of the hardest moments for me as a physician. And then Steven’s mother arrived. The sound of her screams echoing through the department still sends shivers down my spine. Steven’s death was a tragedy, not only because he was a victim of gun violence, but because that night was not Steven’s first time being shot. Steven had come to our ER a year earlier with a gunshot wound in his lower leg. But it was only a flesh wound. He had no broken bones and didn’t need surgery, and so he wasn’t admitted to the hospital.  We just treated him and sent him home. And we know how that ended.”

As a take-home message, Angela emphasized that the EDs are not failing patients. Our society is failing its citizens. It’s not good for our country, that loses the benefits and contributions of citizens who want to be healthy. It’s not good for anyone. As a human being and as a mother herself, she requested that we take care of ourselves and that we all take care of each other.

Watch the full TEDx talk here!