{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/x34mk67g12/manifest","type":"Manifest","label":{"en":["Dr. Yajaira Johnson Esparza"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Description"]},"value":{"en":["\u003cp\u003eIn this oral history, Dr. Yajaira Johnson Esparza reflects on her experiences as a behavioral health consultant at Robert B. Green Family Health Center during the COVID-19 pandemic. She discusses caring for a medically and socially complex patient population, the rapid transition to telehealth, and efforts to reduce barriers to care through integrated behavioral health services. Dr. Johnson Esparza also describes the anxiety and uncertainty experienced by patients and providers, the impact of the pandemic on vulnerable communities, and the importance of teamwork, adaptability, and resident dedication in maintaining patient care during a public health crisis.\u003c/p\u003e (summary)"]}},{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Date"]},"value":{"en":["2025-06-27 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["interview"]}},{"label":{"en":["Agent"]},"value":{"en":["Dr. Alexis Ramos (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["video"]}},{"label":{"en":["Keyword"]},"value":{"en":["family medicine","San Antonio","Texas","Covid-19","pandemic"]}},{"label":{"en":["Subject"]},"value":{"en":["Yajaira Johnson Esparza (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["english (primary)"]}}],"summary":{"en":["\u003cp\u003eIn this oral history, Dr. Yajaira Johnson Esparza reflects on her experiences as a behavioral health consultant at Robert B. Green Family Health Center during the COVID-19 pandemic. She discusses caring for a medically and socially complex patient population, the rapid transition to telehealth, and efforts to reduce barriers to care through integrated behavioral health services. Dr. Johnson Esparza also describes the anxiety and uncertainty experienced by patients and providers, the impact of the pandemic on vulnerable communities, and the importance of teamwork, adaptability, and resident dedication in maintaining patient care during a public health crisis.\u003c/p\u003e"]},"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/313/294/small/JohnsonEsparza.mp4_1782763337.jpg?1782763346","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294","type":"Canvas","label":{"en":["Media File 1 of 1 - Johnson_Esparza.mp4"]},"duration":1343.1418,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/313/294/small/JohnsonEsparza.mp4_1782763337.jpg?1782763346","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/313/294/original/Johnson_Esparza.mp4?1782763320","type":"Video","format":"video/mp4","duration":1343.1418,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048","type":"AnnotationPage","label":{"en":["Interview with Yajaira Johnson Esparza [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Transcribed by Corynne McEachern on 09/10/2025\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=0.0,0.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): My name is Alexis Ramos. I will be conducting the interview. And you're Yajaira Johnson Esparza. Corynne McEachern is here as well. And then today's date is June 27th, and we are at the Robert B. Green, 903 W. Martin Street, downtown. And is it okay if we continue with this interview?\n\n(","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=0.0,24.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Yes.\n\n(","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=24.0,24.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Okay, great. So go ahead and describe your current title.\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=24.0,31.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/5","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I am an associate professor in the Department of Family Community Medicine. I'm also a behavioral health consultant here at our residency clinic.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=31.0,42.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/6","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Amazing. Okay. And do you want to go ahead and describe a typical day in the clinic for you prior to 2020, before COVID?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=42.0,51.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/7","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Well, I started here September 2019, so I've only been a few months in my role, but a typical day in the clinic, to be honest, looks very similar to what a typical day in the clinic look like, looks like for me now. I have my scheduled patients in the morning, the afternoon, but throughout the day, I will also be available for the residents and the faculty and work with their patients whenever something comes up during their visit available for them. So it's hectic in a wonderful way. There's not a lot of downtime, rapid pace, and that's the way it continues to be now. That's the way it was then.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=51.0,93.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/8","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): So can you describe the population that you serve at the Robert B. Green?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=93.0,100.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/9","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): We serve a socially and medically complex population. We, of course, as you know, are in one of the most impoverished zip codes in the county, so we're working with patients who are dealing with multiple stressors, social determinants of health, and multiple psychosocial stressors as well. So very fortunate to serve this population. It's also a population that requires a lot of work, a lot of collaboration, a lot of hands-on.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=100.0,133.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/10","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Okay. So no title change, is that correct? So during the 2020 COVID Pandemic, you were still working under the same title?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=133.0,143.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/11","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I was an assistant Professor back then. I also – now I'm also – I didn't mention this. I'm sorry. I'm now the director of behavioral health education in the residency, which I wasn't back then.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=143.0,157.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/12","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Gotcha. And so what setting did you spend most of your time during the pandemic? Inpatient, outpatient, telemed?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=157.0,165.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/13","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Most of our time, my time was outpatient here. Actually, my time at the hospital decreased during COVID. The behavioral health faculty were not in the hospital as frequently as we were prior to COVID, so there was a little bit of a drop there for obvious reasons. Most of my time was spent inpatient. As soon as we were able to get patients back into the clinic, we started coming to the clinic. So there was a bit of time that we were doing telehealth, and between the behavioral health faculty, we would alternate who would be in clinic, who would be doing telehealth, just so that there was always some kind of presence in the clinic.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=165.0,207.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/14","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Got you. Okay. And so what do you remember about those first few weeks in clinic? What were you seeing or hearing from your patients or coworkers?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=207.0,218.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/15","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): They were quite sparse. We didn't have a lot of coworkers in the clinic. Obviously there were, and actually to be honest, it took a while before behavioral health faculty came on board. I think initially it was Dr. Ogbeide who was doing most of the in-person vague memories. And then eventually she came up with a schedule where we would rotate who would come into the clinic, who would be doing telemed. So because there were so many folks outside doing telemed there, you didn't have many coworkers the way that you do right now. But I think there was a lot of anxiety. I think our patients were anxious about coming in. Some patients did ask for telemed, but I still feel like many of our patients preferred to come in person. Even with that anxiety, that just meant that we would try to catch 'em during their medical visits and try to limit additional visits. So really shooting for that warm handoff so that we're not having to ask someone who is already anxious about COVID and with good reason, someone who's immunocompromised or whatever else, trying to keep 'em from having to come in. But definitely anxiety, anxiety for assess well, thinking like, oh my God, did I wear the right mask? Should I have had a, I already forgot N95 instead of this basic mask. Oh my gosh, I forgot my face shield. So you had a lot of that worry. You also had all of discomfort wearing all these things in an outpatient setting, which of course is very frustrating. You also had some patients who maybe were not thrilled about the fact that we're having to wear masks and you're also dealing with them being upset. So I dunno if I'm answering your question, but I think I'm a little bit all over the place, but there's a lot of that, I think, going on a lot of anxiety and some frustrations with guidelines that we had to keep.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=218.0,333.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/16","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Yeah, absoluletly. Did patients in this area experience the pandemic differently than other areas, do you think?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=333.0,340.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/17","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I think so. And I think we have seen a lot of the data that has shown that community members living in areas that are more impoverished, impoverished, of course, had less access to the vaccinations. They were also the patients who were perhaps a little bit more at risk given obviously the medical complexities, but also the kind of jobs that they had requiring them to constantly be at their jobs. And so I think that the interaction of all those factors, obviously, I think made it a little bit more challenging for our population.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=340.0,375.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/18","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Absolutely. So what health disparities, if any, did you witness being exacerbated by the pandemic?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=375.0,381.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/19","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Okay. So I mentioned earlier the fact that we work with a very medically complex population. Many of our patients are already dealing with disproportionate rates of chronic conditions like diabetes, like chronic kidney disease, dealing with the consequences of these diseases as well. So when they're not able to access care with the same frequency, or whether when there are any breaks in their care, whether it's because we can't get 'em to the referrals or whatever it is, I think we increase the prevalence of these conditions, but also the exacerbation of these conditions. So I think they're already dealing with these disparities and these inequities, and when something like COVID comes on board that then impacts how care is delivered, when it's delivered, how well it's delivered, I think you inevitably increase some of those disparities, not to mention the impact that has on their ability to manage stressors and their mental health.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=381.0,449.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/20","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Absolutely. And so how did you or your team handle those health disparities exacerbated by the pandemic?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=449.0,458.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/21","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Part of it is kind of what we already do. We try to make sure that when we know we have a patient who is dealing with multiple barriers to care, whether it's transportation, whatever those barriers are, we try to meet the patient where they're at here in the clinic. So if we knew that patients were coming in and we knew that the likelihood of them coming back for another visit to come see us is a pretty low likelihood, we would do our best to catch 'em in that visit. And this happened even with telemed, right? When I was at home, I'd be standing in front of my computer waiting for the physicians, the faculty or the residents to reach out to me to let me know that a patient that they're seeing needs me to give them a call and have a visit with them in that moment. Or I'd be reaching out to the resident or the faculty to let them know, Hey, you have a patient coming in who you're not seeing who you're speaking with about this one condition. I want to check in with them afterwards. So we try to have these visits. I say we try because we still do this, try to have those visits during our medical appointment to try to minimize those barriers that inevitably exacerbate or sorry, widen that disparity.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=458.0,532.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/22","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Absolutely. And then you've touched on it a little bit, but any other innovative strategies employed to manage the limited resources and ensure continued patient care?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=532.0,549.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/23","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I think the accessibility is the biggest thing. I think, like I said, even during telemed, I think we could have taken the, when we were doing more of the telemed, I think we could have taken the approach of saying, well just wait until they reach out to me. But no, we still decided that we had to be proactive, so we would still scrub the schedule. We still try kind of what we do when we're in person. We still try to see who are the patients that need our help, because I mean, we recognize when the physicians are having this telemed visit, they're also having to balance the technology and whatever else that maybe they're not thinking about getting the patient connected to the behavioral health consultant. So I think we, even in that context where it's a little bit more challenging, we still made an effort to be pretty proactive.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=549.0,596.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/24","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Excellent. Okay. And then any changes from that period that have stayed in place? It sounds like yes.\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=596.0,602.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/25","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Yeah, it's funny. Like I mentioned, I think we continue to do things in a very similar way, the way that, and I think as a whole, as the clinic, we continue to strive to provide care in a very similar way to what we were doing back then. I think if anything, we have the ability to do more telehealth. On the behavioral end, what I've noticed is that patients don't typically prefer telehealth. They typically prefer to come in. So although we have that option, uhm it's very few the times that I ever have to do telehealth with patients because I think they appreciate coming in in person. I think they it is important to meet with their clinicians, their physicians, their behavioral health consultants in person. So even though we do have that now, which is, I think, a COVID leftover, I don't know what the word would be, it’s not something that we rely on – at least on my end as a behavioral consultant, not something I rely on as much because patients prefer to see us in the flesh.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=602.0,673.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/26","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Agree. Okay. And if you feel comfortable, can you describe a moment that felt especially overwhelming or powerful during that time?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=673.0,675.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/27","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I think overwhelming can be positive or negative. I'll go with overwhelming personally, to be so new in the clinic, to be so new in the role and also in the role in academic medicine where I hadn't been before, where you're still trying to get a lay of the culture, understand what it means to be an educator in academic medicine, all of a sudden everything shifts and you're at home. So I think personally it was, I think my feeling of being overwhelmed is similar to what many people had where I was just talking to one of my colleagues today where I'm trying to conduct a telemed visit and they're banging on my door because my kids need something. And that's really hard because you're trying to be so present for the patient, and at the same time you have somebody in your household who is banging on the door needing something. Patients were incredibly gracious, think, when they said – they would say things like, “Oh, of course. Don't– don't worry about it. I can't even hear it that much.” I'm like, “I think you can, and you're – you're just being kind because it's loud.” But that was – that was hard. And I think being away from your coworkers, being away from this community that you were looking forward to building, I think was a little bit challenging feeling like you were missing out on making some of those important connections, which I think inevitably help our patient population as well. So I think that was overwhelming. I do have to say that there was a lot of support, from our behavioral health lead, Dr. Ogbeide, to make sure that we had frequent check-ins as a team, as the behavioral health team checking in, making sure that we kept tabs on each other and knew that we were doing okay. So I think that was helpful as well. As far as what felt powerful, I think, uhm, it was wonderful to see how our residents really handled the situation. They, our residents, had to obviously, many of them had to be deployed to the hospital and had to always be gowned up. And, there were a couple times when I was able to be at the hospital, and I would see the residents gowned up, and they would have a smile on their face going in. Right? And to see them, it kinda brings, like it gives me a little bit of chills to think about it because to see – to see these these physicians who are at the very beginning of their training trying – and I'm refer… I'm, I'm thinking a lot about, like, our, our younger trainees who had just come in – being so willing to go in there and no ifs, ands, or buts. They were just ready to do it. I think that was very powerful, and that really, I think, made – made it a little worthwhile to see that.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=675.0,845.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/28","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Okay. Did this experience shape the way you practice medicine now, do you think?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=845.0,857.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/29","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I don't know. I feel like, if anything, I think it was an excellent reminder. Excellence is not the word, but it was a big reminder of how vulnerable our communities are to system level issues and how something like a pandemic can really not exacerbate well, yes, exacerbate, but also highlight the things that have been there, the things that many of us knew, the things that the literature tells us are impacting our patients day in and day out. So I think if anything, an event like this really forces you to always be mindful of the multiple barriers that are impacting our patients' lives, the systemic level issues that are getting in the way. And I think it, I don't know, magnifies the vulnerability of our system. I think that, I don't know if, I guess maybe that changes the way I practice now. Maybe I try to stay more tuned into those issues.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=857.0,924.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/30","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I think that's an excellent segue. Do you think that the system is better prepared now to handle an event like this?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=924.0,946.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/31","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): By the system, do you, I'm – I'm wondering. Do you mean, like, us as a program, like – like us? Or do you mean the hospital? Or do you mean, like, the larger system across the country?\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=946.0,946.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/32","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I mean, you can answer all three, but I was leaning more towards our residency system.\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=946.0,956.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/33","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I think we learned a lot. I think at first it was very clunky. How do you get this and how do you reach patients in this situation? And I think we were able to overcome a lot of those barriers that I think if we needed, and actually we've seen it, right? I think we've had a couple closures I think related to weather. And those times when we've had to close down because of weather, everything gets activated very quickly. We don't have to cancel patients. We can immediately start switching those visits to telemed visits. So I've often wondered what was it like before COVID hit? And there were weather closures, I'm sure there were weather closures before I came on. It makes me wonder what was it? We just cancel the entire day and that was it. But now I see that we're able to convert those visits as a team very quickly, and everybody knows what to do. They know, contact your MA, reach out to your patient, I know, call my patients. So I think in that regard, I think it prepared us to be able to make those switches much more efficiently.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=956.0,1025.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/34","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): That's a great point. And then if you could tell the public one thing about what it was like to work through the pandemic here, what would it be?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1025.0,1034.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/35","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I kinda mentioned it, like, how the the overwhelming and the, and the powerful question that you asked. Right? It was it was very overwhelming on the personal level. But, also, like I mentioned, I felt like there was a lot of support within the residency. I think faculty supporting faculty, supporting residents, I'm – and I'm sure residents also supporting each other. And I, I think maybe that was perhaps uhm… pause. I lost your question.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1034.0,1071.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/36","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Yep, that’s okay. If you could tell the public one thing about what it was like to work through the pandemic, what would it be?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1071.0,1079.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/37","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Okay. So I mentioned the overwhelming – the, the feeling of being overwhelming. But at the same time, I felt fortunate to have been with the team that I was, was with working through this. I alluded to what was one of the most powerful things about working through it. And I think that's to be part of a team that was able to come together, to be involved in the education of these wonderful residents who just kind of bit the bullet and went after it and made sure that they maintained care or continued to provide the necessary care to our patients. Uhm, that I think was – so I feel two ways, right? I felt overwhelmed, but I also felt very fortunate to have been able to be part of such a wonderful team who continued to be committed to, to their patients. Feeling down, feel starting to feel burned out, but they kept doing it. They kept supporting each other, like, the entire team. So, yeah, kind of two ways about that.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1079.0,1140.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/38","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): And, you know, I think me going to interview other people, that's a pretty common theme. People are saying, you know, terrible, but also very grateful. So two more questions. Working through the pandemic, do you think that it affected you personally at all, in your personal life?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1140.0,1161.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/39","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Yeah. I think for many of us, I think it did. I think it helped me, I think, get closer to some people. I think it helped me appreciate what our patients go through a little bit more. But just through hearing a lot of the things that they were going through, I think many of us grew quite a bit, having experienced the pandemic in that way. I don't know what else to say about that one. I have to think about that one.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1161.0,1200.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/40","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): Did anyone you and your family get COVID?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1200.0,1204.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/41","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): We got COVID once like, way after. But, you know, actually, I remember one.. I was thinking about this earlier today on my drive here. My husband works at the hospital, so, it was hard sometimes because early on in COVID, he'd come home, and it, like, it we… we were like, “please stay away from us.” I think we had a place for him… in the, we had – the office became his room. And, you know, as, as was the case with everybody working in the hospital, they all had, like, an all like, an, an entrance that they would come in through, and, like, there was always some space that was kept, kept between the, the person and the family. And there was some of that, and I think that was hard for us as a family now that I start to think of it. I think it was hard for him. Uhm…just I don't know. You said something that made me kind of think about how that had a, I think, a pretty big impact on us where you're in the same household and you wanna be supportive for each other. And touch is important for that support, right, to be able to hug your dad, hug your partner. Uhm it's hard not to be able to do that, and you just see them walk in, and you're like, “your room is that way.” Please leave your dish, your spoon, and we'll get to it later. Uhm, so that was a bit hard. I don't know what you said that prompted that thought.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1204.0,1289.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/42","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I think I just asked if, “did anyone in your family get COVID?”\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1289.0,1300.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/43","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): That's right. And I was like, oh, so no. Not immediately upfront where we were panicky, not that soon.\n\nRamos (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1300.0,1306.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/44","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): And finally, this interview is being recorded to preserve and documents providers experiences during this unprecedented time. Anything else you want to share?\n\nJohnson- Esparza (","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1306.0,1317.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294/transcript/95048/annotation/45","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"): I'm glad that you're doing this. I asked you earlier what's going to happen with this video, and when you talked about how it becomes part of these archives to document these massive events that have impacted our lives as clinicians, as people, I am just glad that you're doing this, that you're documenting this.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3695/collection_resources/173922/file/313294#t=1317.0,1343.1418"}]}]}]}