Nemours Children’s Health pediatric psychologist Erica Sood, PhD joins us during Episode 31 to talk about her work improving the emotional health of children with chronic health conditions and her research into the care of moms, dads, and other family members following a prenatal diagnosis of congenital heart disease.
We also talk with Zachary Boynton, MD, Co-Chief Resident at Nemours Children’s Hospital, Florida, on heart health in high school athletes and the effectiveness of including an electrocardiogram in a student-athlete’s pre-participation health screening.
This episode was recorded at the 8th World Congress of Pediatric Cardiology and Cardiac Surgery in Washington, DC.
Carol Vassar, producer and host
Guests:
Erica Sood, PhD, Pediatric Psychologist, Nemours Children’s Cardiac Center, Delaware Valley
Zachary Boynton, MD, Co-Chief Resident, Nemours Children’s Hospital, Florida
TRANSCRIPT
CAROL VASSAR: Welcome to Well Beyond Medicine, the Nemours Children’s Health podcast. Each week, we’ll explore anything and everything related to the 80% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar. And now that you’re here, let’s go.
[THEME SONG] Let’s go, oh, oh. Well beyond medicine.
CAROL VASSAR: The list of presenters at the eighth World Congress of Pediatric Cardiology and Cardiac Surgery is an impressive one and included more than a few Nemours researchers and clinicians. Today, we hear from two of them. Pediatric psychologist Dr. Erica Sood joins us again in this episode to talk about her work improving the emotional health of children with chronic health conditions and her research into the care of moms, dads, and other family members following a prenatal diagnosis of congenital heart disease.
First, though, we talk with Dr. Zachary Boynton. Dr. Boynton is co-chief resident at Nemours Children’s Health Florida. His research presented at the World Congress centers on heart health in high school athletes and the effectiveness of including an electrocardiogram or ECG in a student athlete’s pre-participation health screening. It isn’t happening everywhere yet, but it is required in Orange County, Florida, where Nemours Children’s Hospital is located. But let’s back up and learn how cardiac health is traditionally screened for high school athletes. Here’s Dr. Zachary Boynton.
ZACHARY BOYNTON: So the American Academy of Pediatrics, the American Heart Association, and the American Academy of Family Physicians have come out and published guidelines, which is essentially a series of questions and then a physical exam that your primary care providers will do in order to screen the athletes.
The questions really are focusing on family history, and then symptoms that people have had, or young athletes have had during sports. Things like, have you ever felt lightheaded, or have you ever passed out during exercise? Have you ever had chest tightness or chest pain during exercise? Have you ever had palpitations or feeling like your heart is fluttering during exercise?
And then the family history aspect is, do you have any family history of unexplained death or sudden cardiac death in a family member younger than 35 years old? Does anyone have an implantable cardio defibrillator under the age of 35 in your family? Or is there any genetic cardiac diseases that run in your family? Things like hypertrophic cardiomyopathy, Marfan syndrome, things like that?
CAROL VASSAR: So how helpful are the sports exams in spotting at-risk kids for ongoing or imminent cardiac issues pre-ECG?
ZACHARY BOYNTON: So I did some looking before coming here today, and I haven’t found any studies that publish how good is this screening at finding cardiovascular disease in children. It was first introduced in 1996 by the American Heart Association, and the American Academy of Pediatrics formally recommended that we do this, but I haven’t found any studies or don’t know of any studies that say 8% of kids get caught or 2% of kids or anything like that.
CAROL VASSAR: So adding in the ECG has its benefits. Let’s talk about that. It’s an electrocardiogram. How is that done, what is it, and why do you think it’s important to the pre-participation sports screening?
ZACHARY BOYNTON: So ECGs look at the electrical activity in some of the structures of your heart. You stick 12 stickers that have little wires that are attached to these stickers on your chest. It takes about 20 to 30 seconds to actually get the ECG done, and then your pediatric cardiologist will read it and see if there’s any abnormalities. The benefit of it is it’s a further look or just more information that we have on the heart health of these athletes. Sudden cardiac arrest is the number one killer in young athletes, and in 80% of those athletes that have sudden cardiac arrest, they have no symptoms prior to the actual arrest where their heart stops.
CAROL VASSAR: I think we have to be clear. This is not common that the heart stops in a teenage young man or young woman. Talk about that.
ZACHARY BOYNTON: No. Sudden cardiac arrest– I think the incidence, depending on what you’re looking at and what area and what population is, is about 1 in 40,000 to 1 in 80,000 people will have this happen to them. So, it’s certainly not common. But if it is detectable or preventable, then that’s certainly something we should be looking into and figuring out how to keep our kids as healthy and as active as we possibly can.
CAROL VASSAR: Now, you’ve been researching this, and this is what you’re presenting on. You’re the lead author on this study, I understand.
ZACHARY BOYNTON: Correct.
CAROL VASSAR: And you’ve been researching occult cardiovascular disease detected during the pre-participation sports ECG screenings. What did you find?
ZACHARY BOYNTON: So ECGs are not mandatory, are not part of the nationally– or not part of the screening process for every high school athlete for high school sports physicals. But in May of 2021, Orange County School District mandated this so that all high school athletes in Orange County School District had to have an ECG done.
CAROL VASSAR: And that’s Orange County, Florida, which is where Nemours Children’s Health is located, our hospital.
ZACHARY BOYNTON: Correct. It’s in Orlando. It’s the ninth largest school district in the entire United States, so for May ’21 to May of 2022, we did 11,547 ECGs on high school athletes. About 2.7% of those, or 310 of those, were found to be abnormal, and so those kids required follow-up with a pediatric cardiologist. So, of those 310, we had 105 follow up with Nemours Children’s Hospital.
We don’t get the entire catchment like maybe we would in Delaware because there’s three children’s hospitals in Orlando. And so, of those 105 that followed up with us, 15 of them were found to have a potentially life-threatening cardiac disease. Twelve of them had something called Wolff-Parkinson-White syndrome, and then three of them had some form of cardiomyopathy.
CAROL VASSAR: So it sounds like it saved lives.
ZACHARY BOYNTON: Yeah, absolutely.
CAROL VASSAR: The abnormalities that you find in the ECG– are they congenital, are they acquired conditions? And if they’re congenital, how were they missed?
ZACHARY BOYNTON: So, depending on what you’re finding, they can either be acquired or have some sort of genetic component. That’s part of the reason why the American Heart Association and the AAP– the American Academy of Pediatrics ask those questions about family heart history. And sometimes you have a defect in a gene that builds a protein or a muscle in your heart that takes 15, 18, 22 years to actually show a manifestation or actually affect the strength of your heart muscle.
So unless we’re doing genetic screening on every baby that’s born in this country where you have a very significant family history where your uncle died at 22 and we know why, it’s just not something we’re looking for, or we would see until kids start to have either symptoms or we start to do these screenings in the teenage years.
CAROL VASSAR: Nothing we can put in the newborn screening, or that doesn’t really apply?
ZACHARY BOYNTON: You could. I think there’s so many different kinds of genes that affect these things and so many different heart conditions that can predispose a young athlete to sudden cardiac arrest that you’d have to be sequencing the whole genome at this point to really identify all of these things.
CAROL VASSAR: Which might not be the most efficient way of going about that.
ZACHARY BOYNTON: 100%.
CAROL VASSAR: Now, the ECGs for every athlete– is that every year? Is it once in their career? How does that work?
ZACHARY BOYNTON: So right now, it’s every athlete. It can be the football player, the kid in the marching band, the kid on the soccer team. And at this point, it’s only one time during their high school athletic career. So even if you play three sports in three different seasons, you only need one ECG screening the entire time you’re in high school.
CAROL VASSAR: Let’s talk about bringing this to the federal level. How far away are we to having this nationwide?
ZACHARY BOYNTON: It’s tough to say. I think in the world of pediatric cardiology, it’s a controversial kind of thing, more so from the manpower that it takes to do all of these screenings. 11,500 ECGs is not a small number. It’s not something that’s done quickly. It took a lot of dedication and a lot of altruism from people who volunteered their time to do these screenings and a lot of time from the physicians who are reading these screenings. So that’s really where the controversy kicks in, so it’s tough to say where we’re at from a national mandate.
It’s one thing to do in one school district, but it looks very different on a national scale. But I think if we can save one life if we can prevent one kid from having to go through that awful experience of sudden cardiac arrest, have that family not have to go through that torture, not have that community witness somebody collapsing on the field, that’s incredible.
There was a student, a high school football player in a pre-season game in Miami-Dade County down in Miami, who collapsed on the side of the field and had to be resuscitated in front of fans, family, other students, other faculty members, and I just can’t imagine how horrific that experience must have been for that entire community.
CAROL VASSAR: Was he OK?
ZACHARY BOYNTON: Yeah. He was resuscitated. But if we can prevent that with a 20-second EKG, then I think all of this work is worth it.
CAROL VASSAR: Absolutely. If I was one of those hundred-plus families that found out my child has an issue, what can families do then? What are the next steps, and how do you go about supporting families as they move forward in this new journey?
ZACHARY BOYNTON: So if you have an abnormal screening, you’re called and told that you need to set up an appointment with a pediatric cardiologist. And so, really, the ECG is very much a screening tool. It’s not a diagnostic tool. So once they come in and see the cardiologist, they may undergo more testing– things like an echocardiogram, which is an ultrasound of the heart to look at the actual structure of it. It may be something like a stress test where you’d get on a treadmill and you run for 10 minutes, and we see does your ECG change as your heart starts to beat more quickly.
It really is just helping the families of get in touch with more resources and more support in finding more answers of why this is an abnormal thing. It’s very possible that the abnormality is benign and it’s unsignificant and that you just need an extra appointment to get a clean bill of health, but I think the peace of mind that that’s providing to families is certainly worth it.
CAROL VASSAR: In terms of research moving forward by you, what do you plan on pursuing?
ZACHARY BOYNTON: So the next stage of this trial is to try to reach out and work with Orlando Health and AdventHealth in Orlando, Florida, to see if we can get the data from patients that had abnormal screenings that potentially would have gone and been evaluated or worked up by their team. So that’s the next phase of this trial. And then again, just continuing to look at the ECGs and the numbers and the data that comes out of the subsequent years as ECGs continue to be mandated in Orange County school district.
CAROL VASSAR: Do you see this as longitudinal?
ZACHARY BOYNTON: Yeah, absolutely. The mandate– you only have to get one ECG in your high school career, so I don’t think we’ll have quite the volume of 11,000 that we did in the first year when we were capturing all high school athletes. But certainly, the data is going to continue to be there, and the kids who are identified to have significant disease are going to be followed up in clinic and continue to be watched closely by our team. So, that certainly is the longitudinal aspect of it.
CAROL VASSAR: Let me ask about families. Are they bought into this? Do they see benefit in the ECG for their teen athletes?
ZACHARY BOYNTON: I don’t do a ton of the actual screening stuff. I’ve gone to a few of them just to get an idea of the process from the athlete coming in to do the screening to the tail end, where we’re collecting the data after they see the cardiologist. But just the few discussions I’ve had with families– they’re thrilled about this. This is a minute of their time to have that peace of mind or one more piece of data, one more reassurance that their kid is safe when they’re on the field playing sports or when they’re on a jog at 6:00 in the morning in their neighborhood.
CAROL VASSAR: Do you think that’s why they’re bought in because it could save their child’s life?
ZACHARY BOYNTON: I think so. I don’t have children, but being a pediatrician, parents have an unbelievable protective instinct that I think, unless you have children, you don’t fully understand. And every parent on this planet would do anything in their power to ensure that their child is healthy and safe. And so if that’s a one-minute appointment at their local high school to get the screening done, then they’re all for it.
CAROL VASSAR: Dr. Zachary Boynton is the co-chief resident at Nemours Children’s Hospital, Florida. He’s currently applying across the nation for a fellowship in pediatric cardiology.
[MUSIC PLAYING]
Pediatric psychologist Dr. Erica Sood works closely with the pediatric cardiology team at Nemours Children’s Health, Delaware. Her job is to take care of the psychosocial health of patients and their families, and it is the family on which she focused when presenting at the World Congress.
ERICA SOOD: Supporting families is so important. When we think about the health and well-being of children with cardiac conditions and other chronic illnesses, they’re spending the vast majority of their time outside of the clinic setting, outside of the hospital, at home with their families, with their parents. And by supporting parents and families, we are, in essence, supporting the children themselves, and we’re helping the parents to be able to provide the support to their children.
CAROL VASSAR: And one of the things that you are presenting on here is how to support families who find themselves in the situation of a prenatal diagnosis of a cardiac concern. I can only imagine. I have three healthy adult children. I am fortunate. But I can only imagine what it must be like to be in that position. What immediate support can you and your team provide to not just parents but grandparents, other caregivers in that family unit?
ERICA SOOD: Absolutely. There’s a lot we can do. I think just helping parents and families to understand that they’re not alone and that what they’re feeling is normal and expected. We can’t take away the shock, the distress, the pain, but we can help them to cope with those feelings, to feel less isolated, to connect with supports that are available, including peer-to-peer support– meeting with other parents who have been through this or hearing about their stories.
We can help them to prepare for some of the stressors that they are very likely to experience after their baby’s birth and help them to develop coping strategies in advance that can be helpful not only during the pregnancy but also after the baby’s birth when their baby’s in the hospital or when they’re parenting their baby at home.
CAROL VASSAR: In that short-term period, what do those supports look like? And also talk about in the long term what they look like.
ERICA SOOD: Sure. So we find that telehealth– and we use the Nemours app– is a very effective way to be able to access and provide support to families after a prenatal diagnosis of congenital heart disease. At that time, they’re not in the hospital. They come in for appointments, but those are long appointments. They’re overwhelming, and that may not be the time when we can really focus on the psychosocial topics. And so instead, being able to provide that support when they’re in their home environment, we’re kind of fitting into their schedule as opposed to the other way around.
So I’ve met with families when they’re caring for their other children when they’re eating dinner, when they’re making dinner. Sometimes, they’re at work, and they’re taking a break from work to meet with me. And I think that’s really a way that we can address some of the barriers to receiving psychological care, especially during such an overwhelming period like when you find out during pregnancy that your baby will be born with a heart condition. And so I think using telehealth, using video appointments, using in-person appointments as well when that is the family’s preference can be a good way to deliver this support.
After the baby’s birth, we need to have psychologists and other mental health providers available in the cardiac center in the hospital so that families don’t have to leave the bedside to access that support. And then, in the long term, we can help to connect families with mental health providers in their community.
And the other thing that’s really important is that it’s not just about mental health providers. So we can provide psychosocial support to families in every clinic visit. We developed a model called Normalize-Ask-Pause-Connect, and that is a model– it’s a straightforward clinical approach for healthcare professionals that don’t have mental health training in how to initiate conversations about emotional health by first normalizing the challenges that many families have, asking with brief open-ended questions how the family’s been doing. Pausing to make sure that we communicate that we really want to know the answer and then connecting them with available resources.
And I hear a lot from parents that when they’re in the hospital during that acute period, they do need that support. Absolutely. But they’re also in a kind of survival mode, and they’re just trying to put one foot in front of the other, and it may not be until weeks or months later, when their child is actually doing well medically, that they finally let their guard down, their emotions wash over them, and they don’t have the supports in place to be able to handle that, and they didn’t expect that to happen.
And so I think by asking about emotional health and normalizing the challenges that can come up at every clinic visit, or many clinic visits or during hospitalizations, we’re giving families the opportunity to understand that it’s normal, it’s OK, this is a safe place to talk about it, and supports are available.
CAROL VASSAR: That’s a really good point, that sometimes the emotion or the emotional issues don’t really rear their heads until months, maybe even years down the line. So that’s actually a very good point. You talked about barriers. What are some of the barriers to delivering psychosocial services to patients and their families?
ERICA SOOD: I think we have to be flexible with scheduling, and that’s something that we really try to do. So, not to say, we have this appointment in two months from now, and it’s at this specific time. Can you make it? I think that’s really not reasonable, especially when we’re working with families of children with chronic illnesses. And so I think trying to be as flexible as possible as we can with scheduling those appointments is really important. I know that’s not always feasible, but that is something that can help.
Being able to deliver the intervention in multiple ways– in person when they’re in the hospital, but also via video appointments or telehealth. I find that stigma used to be a barrier. I do not experience that as a barrier in the same way anymore, and I think there’s two reasons for that. I think one is that as a society, I think there’s much more talk about mental health issues, and so it’s kind of been normalized that it’s very common– and also the need for mental health support. And so I don’t see that reaction that I used to get when I introduced myself as a psychologist. If anything, people are like, oh, thank goodness you’re here. Because maybe they’ve tried to access psychology in the past or mental health services and haven’t been able to.
I think the other thing is that I think we do a really nice job– both at Nemours, but I think at other hospitals as well of integrating the psychological care or the mental health care into the medical care. And so it’s presented as just a standard part of care if your child has a specific condition– in this case, it’s a diagnosis of congenital heart disease– that you’re going to be receiving psychological care, you’re going to be receiving developmental care, and that is just standard for everybody. And so people don’t worry in the way that maybe they used to that they’re being targeted or somebody caught them crying, and now they called the mental health professional.
So I think that has– I do not find stigma to be a barrier in the way that I think people might assume it is, or that it has been in the past, but I think it’s really how we present it. What still is a barrier is insurance. Insurance is absolutely a barrier to psychological services, and I think that is pretty universal. Sometimes there’s carve-outs, and it’s not always– just because an insurance company will cover medical care at a specific institution, they don’t necessarily cover the psychological care. So that can be a challenge.
CAROL VASSAR: So we haven’t quite reached parity there yet, despite the law.
ERICA SOOD: We have not.
CAROL VASSAR: Let’s talk about what parents need versus what siblings need. Siblings need support as well. Talk a little bit about that.
ERICA SOOD: I think it’s hard to generalize about what siblings need because they have a variety of experiences, they’re at a variety of ages and developmental levels. So I would say for younger kids, it can be– working with a child life specialist can be really helpful, or having a child life specialist consult with the parents about how do you explain the heart condition or the illness or what they’re going to see if they visit the hospital in a developmentally appropriate way. How do you help to support sibling understanding without causing traumatic stress symptoms in what they’re going to be seeing or experiencing?
So I think that’s a really helpful resource. I think it depends on the sibling, right? There’s some siblings that might be experiencing anxiety related to their sibling’s condition and may benefit from working with a mental health professional directly. Other siblings may benefit from connecting with other kids who have siblings who have a particular medical illness and, therefore, have similar experiences. But that may not be a direct conversation about their experiences. They might come together and do a craft together, and maybe they weave in some discussion about their shared experiences.
CAROL VASSAR: We’re going to move to another of your presentations where you talk about family-centered care– the importance of it. Have we arrived at family-centered care? Let’s go baseline. Let’s tell folks what is meant by family-centered care.
ERICA SOOD: Family-centered care is providing care in a way that there is a true partnership between parents and family members and the care team, and where the family is really a member of the care team and families’ preferences and expertise and culture is taken into account when delivering care and making decisions.
Have we arrived? I think we’ve made progress for sure. I think we still have a ways to go. At this stage, parents, I think at most children’s hospitals, are invited to participate in rounds. That’s something that wasn’t always the case, and now it is, and that’s wonderful. And it’s hard to believe that ever was not the case, actually.
But there’s a difference between having a parent be present and a parent being a true partner in that discussion, and I think sometimes the parent is a true partner, and sometimes they are just present, and they’re listening, and that may be because the medical team is using a lot of words and phrases that they don’t understand and they don’t know and that are not common in the general language that anybody really knows unless you have medical training. And acronyms. And so we have to make sure that obviously when we’re communicating with parents and trying to partner with parents that we’re using terms that everybody understands.
I think that parents are able to be in, let’s say, the cardiac intensive care unit at all times, right? They’re not being asked to leave at certain times in the way that maybe a decade ago they were. But it’s still too frequent that we see a parent sitting at the bedside on their phone, not sure what they can do to help their child. And so we really need to continue to work on not just providing the care for the baby or for the child with the parent present, but really supporting the parent to be an active member of that care team.
CAROL VASSAR: So it sounds like we’re almost there. Not quite, but almost there. What are some of the barriers that are keeping us from fully achieving family-centered care specific to developmental care for inpatients with congenital heart disease?
ERICA SOOD: There are, I think, a number of barriers. So, one is language barriers. We have parents that are not English-speaking. There’s a lot of informal conversation that happens at the bedside with, let’s say, the bedside nurse that ends up being number one, supportive. Number two, education. And maybe the nurses when they came in, they weren’t expecting to educate the parent, but the conversation started, and it results in support and education. And as a result, that parent may feel more confident in being involved in care.
And I think when there are language barriers, there may be an interpreter or LanguageLine or an iPad interpreter, but that’s not always turned on at a time when the nurse is just coming in to do a quick check or care. I have not done this research, but I be very interested to know the amount of dialogue that occurs in a room where the parent is English-speaking versus when the parent is non-English-speaking. And I think that’s something that is a disparity and that we really need to be thinking about.
Parents aren’t always able to be at the hospital, and there’s a number of reasons for that. Especially during COVID or during flu season when siblings are not allowed in the hospital or in the ICU, it can be very hard for parents to get to the hospital to spend a substantial amount of time there to even get there for education because they have siblings to care for. And they may live at a distance away and the sibling is not allowed in the hospital, and there is no child care option. That is a real barrier, I think, to any type of education and developmental care.
I think parental fear can also get in the way of– this is a very overwhelming experience, and when you see your baby with tubes and lines and monitors and beeping, I think many to talk about, I’m worried I’m going to break my baby. And so we as a care team really need to support the parent in beginning to feel comfortable in providing that care for their babies, and really switching the approach from, here are the things you can’t do, so here are the things you can do. Even when your baby is very sick and attached to a hundred things, here are the things you can do.
CAROL VASSAR: Do you know, of course, without going into any privacy issues– but can you, off the top of your head, give us a patient’s story that sticks with you with regard to either the importance of family-centered care or the importance of just having the family and supporting the family that has the sick child that’s been successful?
ERICA SOOD: So I can talk about a quality improvement project that we have been doing in the Nemours Cardiac Center led by Karli Negrin, who is our feeding therapist. And she has done a terrific job of initiating a– we call it the First Feed Project. So ensuring that parents have the opportunity to be present at their baby’s first feeding experience.
And it seems obvious. Well, of course, the parent should be present at the first feeding experience. But in the medical setting, once that baby is cleared to be fed, oftentimes it’s just a task on the list, and people don’t think about how important that is for that mother or that father to feed their baby for the first time– and then to come into the hospital and find out that your baby was fed and you weren’t even notified.
And so this is something that the team has been working on and has really made great progress in this, and I think it’s something that has really greatly impacted many of our families to have that experience. And again, not just to be present for it, but to be able to actually participate in it, whether the parent is holding the baby, whether the parent is supporting the baby in some way while the speech therapist is feeding the baby, or whether the parent is feeding the baby themselves– making sure that the parent has a really important role.
CAROL VASSAR: And what has been the reaction of parents to that? I would think it would be overwhelmingly positive, but I could be wrong.
ERICA SOOD: No, it is absolutely. And I think it’s overwhelmingly negative when they’re not informed and find out later.
CAROL VASSAR: Anything else you wanted to share about the work that you’re doing, especially with families, which is so very important?
ERICA SOOD: I can talk about another project that we’re doing. We have developed– and this is with one of our cardiac intensivists and our physical therapy and OT teams– holding guidelines to ensure that babies are out of bed in their parents’ arms as soon as they are medically able to be. And at times, there can be inconsistencies in when babies are able to get out of bed based on who the attending is or who the nurse is, or what’s going on in the unit, and the goal behind these guidelines are that this is something that can standardize that so that parents don’t have the experience of coming in one day and being able to hold their baby and then coming in the next day and being told that for whatever reason, their baby can’t be out of bed in their arms. That can be a very upsetting and frustrating experience for parents. So that’s something that we’re really trying to address.
CAROL VASSAR: It may be obvious and an obvious question, but what are the benefits of that?
ERICA SOOD: I think it is obvious. Having your baby in your arms is clearly beneficial, and that’s what your baby’s brain and body expects, right? When you think about a typical healthy baby going home from the hospital, they are expecting to be held by their parents, and so as much as we can try to mimic that normative experience in the ICU and in our cardiac center, the better.
(SINGING) Well beyond medicine.
CAROL VASSAR: Thanks for listening to our conversations recorded at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery in Washington, DC, with me, Carol Vassar, and our guests, Dr. Erica Sood, who you just heard, and Dr. Zachary Boynton. The Well Beyond Medicine podcast truck is coming to Jacksonville on October 5th as we celebrate Well Beyond Medicine Day. That’s your chance to stop by, say hello, and chat on the record on what Well Beyond Medicine means to you.
If Jacksonville is not on your itinerary, visit the podcast website, nemourswellbeyond.org. Leave us a voicemail there with your take on the phrase “well beyond medicine” or your feedback and ideas for upcoming episodes. That’s nemourswellbeyond.org. While you’re there, check out our other episodes and subscribe to the podcast.
Thanks to Che Parker, Susan Masucci, and Cheryl Munn for their production assistance. Join us next time as we head to the city of brotherly love to hear from a Nemours patient and her family about her fight against cancer and Nemours’ new partnership with the Philadelphia Phillies. Until then, remember, together, we can change children’s health for good, well beyond medicine.
[THEME SONG] Let’s go, oh, oh. Well beyond medicine.
