From the President

Vision, Principles, and Ebola

President James Wagner

Since late July, when Emory University was asked to receive and care for two medical missionaries who had contracted the Ebola virus in Liberia, I have been asked often what role the Emory trustees or I played in deciding that we should accept these patients at our hospital. After all, this was wholly unfamiliar territory we were being invited to enter: there had never been a known Ebola patient in the Western Hemisphere. Beyond the extreme caution and strict protocols required to care for the patients and ensure the safety of our health care workers and the community, there was the possibility of negative public reaction and understandable fear about possible risks. How was the leadership of Emory weighing these issues?

My consistent reply, probably disappointing to many, is that I’m proud to say that the leadership of the university played virtually no immediate role in saying yes to the request. Naturally the leadership of Emory Healthcare, our university-owned system of hospitals and clinics, was fully engaged, and faculty-physicians as well as nursing administrators were involved in preparations. But when the mission, guiding principles, and ethical standards of a university are widely understood and adopted throughout the institution, presidents and trustees do not need to weigh in on every matter of importance.

Emory’s mission is to create, preserve, teach, and apply knowledge in the service of humanity. Fulfilling that mission happens most effectively when everyone, from the chair of the board to the assistant professor, and from the staff nurse to the department secretary, understands that all of us are working together with these aims in mind. In that sense, the teams making decisions about these two special patients were one Emory, acting on a deeply held and broadly understood commitment to Emory’s mission.

Of course we had to keep trustees informed of developments along the way. Our first rule in trustee communication is, “No surprises.” Trustees should learn the news about their university from the university, not from the media or elsewhere. In this case, we could anticipate some of the questions our trustees might hear from friends and colleagues, and we could answer them ahead of time to help in those conversations. What are the risks for the caregivers and for the surrounding population? What are the foreseeable outcomes for the patients? How many more patients are likely to need our care? What are the financial costs to the university, and what are the reputational liabilities if something disastrous occurs? During the weeks following the admission of those first two patients, we maintained regular updates to our board to supplement the massive wave of news reports and social media generated by the patients’ treatment and progress.

None of this is to say that our trustees were merely passive spectators who had no role in rising to the challenge presented to us. I would argue that, in fact, Emory could not have met this challenge without the vision, foresight, and aspiration of generations of trustees past. As an example, I could simply point to the presence of the US Centers for Disease Control and Prevention (CDC) adjacent to Emory’s main campus. It was the vision of Emory trustees and others some sixty years ago that made it possible for the university to convey the land for that federal agency, keeping it in Atlanta and bringing it close enough to the university for significant partnerships to bloom.

Owing to the CDC’s presence, we have had in place for more than a decade a special isolation unit in Emory University Hospital, just in the event that CDC workers might contract highly infectious diseases. This isolation unit is the scene of frequent drills to prepare for a host of emergencies—such as the need to care for Ebola patients. Rarely needed for actual use, the unit is an unprofitable enterprise in terms of a bottom line. The trustees understand this to be part of our mission to discover new ways of treatment, teach new methods of care, and apply that knowledge in the service of humanity.

In more general terms, the board’s fiduciary role in guiding a university requires that trustees insist on a vision for the institution and hold the members of the university community—including themselves—accountable for achieving it. As a community of privileged people, a university bears a burden of responsibility. The events of this summer that thrust Emory into the spotlight and under the global media microscope are, to my thinking, an example of shouldering that burden. We could have chosen not to assume the responsibility for these patients. Instead, while exercising appropriate caution, we chose to try to rise to the vision that the Emory community had adopted.

In the end, our physicians, nurses, staff, and communications professionals not only earned the gratitude of the patients and their families. They also demonstrated the power for positive transformation that is inherent in research universities, transformation that we trust, in this case, will help lead to the control of this dreadful disease.

This text originally appeared in the November/December 2014 issue of Trusteeship magazine.

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