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New York City has been one of the hardest-hit communities in the United States during the pandemic. Doctors from around the world have been volunteering to travel to New York and help out where they can. Pulmonologist Dr. Scott Aberegg from University of Utah Health has just returned home from his voluntary tour in one of Manhattan's intensive care units battling COVID-19 on the frontlines.

"When somebody says they need help, I just go help them," says Dr. Aberegg. He volunteered despite the fear that comes from knowing the high rate of infection facing doctors treating patients suffering from coronavirus.

Dr. Aberegg explains what the situation is like in New York City. From the eeriness of empty streets to the varying degrees of chaos healthcare institutions are facing. He shares his perspective and gratitude for the extraordinary efforts being made from everyone helping out on the frontlines: from the newly retrained ICU nurses to the construction workers making building adaptations necessary to meet the demand and save lives.

In this episode, learn the reality of what the doctors in New York are facing and the bright successes they have achieved. The Secret to Resilience is a Tell Yourself a Good Story

Why do some people seem to recover from adversity better than others? Scot shares an article from Brad Stulberg that claims resilience lies in how we frame events and incorporate those into the story of who we are. Housekeeping

We are nearing 1,000 Facebook followers. Scot and Troy encourage current members to reach out to a friend and encourage them to join the community of men who care about their health. If you have an episode a friend might like, encourage them to subscribe to the podcast at WhoCaresMensHealth.com.

The Who Cares About Men's Health MidMay 5K has been moved to June 12. We encourage anyone who wants to join this virtual race and show support for Mitch as he gets closer to his goal of going from couch to 5K. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot tells us how he responds when he ends up with too much shampoo in his hand. Troy tells a story about why he makes a better ER doc than a mechanic. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

Interviewer: It's time for "ER or Not." That's where I come up with the scenario, give it to Dr. Troy Madsen. You get to play along at home, decide whether or not it's something you'd go to the ER or not for, and Dr. Madsen will give us the definitive answer.

So today, it's more of a general "ER or Not." Like the ABCs of emergencies, how can I decide if something that's happened to me is a reason to go to the ER or not? Do you have some guidelines for us?

Dr. Madsen: Yes, Scot. You know, this is a great time to think about it because, like you said, we really need to think about these resources in the ER and leaving these for the people who really need them right now. So a good rule of thumb is to think ABC. And we'll say ABCD. We're going to add a D as well here. So A is airway, B is breathing, C is circulation, D is disability. So if you're having issues with any of these things, you need to go to the ER.

So A would be airway, your airway is blocked. You're just not getting air in. B is breathing. I'm feeling short of breath. I just can't get a deep breath. You know, I feel like my oxygen levels are low. C is circulation. So that would be your blood pressure. My blood pressure is low, or maybe it's just really, really high and I'm having other symptoms with that. Or I feel like I'm having a heart attack, something that's affecting my body's circulation. Or certainly, if you're bleeding, you know, that's going to be losing blood and affect your circulation. Or D is disability. That would be like a stroke, like I'm disabled. You know, suddenly I can't use my left hand or my face is drooping. So those are absolutely reasons to go to the ER.

But if you don't have those things, there are lots of other resources you can use right now. And I think telemedicine is a great resource right now to call in and talk to someone on the phone, talk to a physician or a health care provider, say, "These are my symptoms." You know, "I'm having this abdominal pain. This is where it hurts. What do you think I should do?" They may say, "Ah, give it 12 hours, see where you are." Or they may say, "Go to the ER." So great time to use other resources. At times, go to the urgent care. I do know urgent cares have been really busy with lots of people with coughs and respiratory symptoms as well. But try to do something besides going to the ER and only go to the ER if you are having those things. Otherwise, start somewhere else first. They'll direct you to the ER if that's where you need to be.

Interviewer: Technology can help individuals with disabilities live a full and rewarding life. That's next on The Scope.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope. The University of Utah Health Sciences Radio.

Interviewer: Dr. Richard Kendall is with the Rehabilitation Center of University of Utah Health Care and we're talking about the Americans with Disabilities Act 25 years later, which really kind of changed a lot of people's thinking about including people with disabilities in life. Tell me about some of the work that you do to include people with disabilities in recreation.

Dr. Kendall: Well, not just including people with disabilities in recreation, but people who have a disability, like everyone else, want to recreate, wants to socialize, wants to get out of their house and out of work and do things that are fun. Our program, here at the University of Utah and TRAILS does just that for people with spinal cord injuries.

Interviewer: And some of the equipment, the technology, and some of the things technology allows people with spinal injuries to do is amazing. Tell me about some of the things you have in your trailers. You have a whole bunch of trailers filled with lots of fun.

Dr. Kendall: Yes. Our program has three trailers full of equipment that are around the valley at any certain time. We have cart skis, we have robotic skis, kayaks that you can operate through sip and puff so really accessible to anyone with any level of any injury.

Interviewer: Let's take a little bit of a turn here and talk about technology and how technology has really changed the game for accessibility and socialization as well. There's something you have that I call robot legs, but you call it something else. Tell me a little bit about the robot legs.

Dr. Kendall: Yeah. The robot legs are exoskeletons, as they're called. They allow individuals with spinal cord injury, and soon strokes, to be able to stand and walk with the use of the robotic arms and crutches. This really is going to open a lot of opportunity for individuals with spinal cord injuries so they can stand, so they can walk, talk to their peers eye to eye. All of those are going to be very important. Technology, in general, is really opening the world and we have Bluetooth controlled prosthetic knees now. People can snowboard, people can walk in them. The technology of carbon fiber allows people to run pretty quickly if you think of Oscar Pistorius. So technology is changing and really is going to open up a lot of access for individuals with a disability.

Interviewer: I'm guessing you're about the same age as I am. When I grew up, I watched "The Six Million Dollar Man." At that point of your life, did you ever dream that that would become reality? I mean, as a physician that's pretty amazing to watch that.

Dr. Kendall: Yeah. It certainly is. While "The Six Million Dollar Man," if you think back in, I think that was the '70s, how much $6 million would have cost. If you think about it now we have neural interphases that people have an electrode put in their brain and can operate robot arms just with their thoughts. So yes, technology is coming to life and I think these are going to be things that as computer and softwares develop further, we're going to see really tremendous growth.

Interviewer: What's on the horizon? What's in the future? What next thing that we can imagine now is going to happen?

Dr. Kendall: Well, the exoskeletons are really in, what I would say is an infant stage at this point. I think that as the computer algorithms develop, you're going to be able these develop where you can stand and walk on their own. I mean, a number of companies have drones that can stand, walk, walk over rocky surfaces with no tethering devices for balance on their own. So I think you're going to see these develop into where somebody can put on the exoskeleton legs and walk even without the use of crutches, and balance, and not fall over.

Interviewer: Will that replace a wheelchair eventually?

Dr. Kendall: For many people, I think it will replace it for many things that they do and I don't think it'll be 100%, but certainly give them accessibility to be up and moving around.

Interviewer: That's incredible. I want to jump back quickly. What's a Bluetooth knee do, by the way?

Dr. Kendall: A Bluetooth knee, basically it's a knee that you can program through your smartphone and tell it to be more rigid or less rigid, depending on what activity you're doing. If you're using it for snowboarding, you can program it so it takes a real big hit and doesn't collapse easily, whereas if you're walking and you want a little more subtle joint play, then you can program for walk mode.

Interviewer: With your interaction with people that use this technology, your patients and what not, tell me the benefit. Tell me a story about how it affects their life.

Dr. Kendall: One of the things that when you see somebody stand and walk, who's been on a wheelchair for a number of years, just the look on their face and really their desire to be able to talk to you while they're standing up, it's really something that is hard to describe. It really brings a whole new phase into their life and gives them hope for the future and further access. Then there's the person who used the sip and puff kayak for the first time, had been living mostly in a nursing home or assisted living facility for many, many years. And he is a ventilator-dependent quadriplegic, can't use his arms or legs, but operated the sip and puff machine very well. The only problem was because he would laugh a number of times, couldn't use the sip and puff]to correctly steer.

Interviewer: Because he was so excited that he was laughing.

Dr. Kendall: He was so excited, he was laughing, being out on the lake in the kayak.

Interviewer: If somebody was interested in learning more about this type of technology to make their life better, what would they do? What would be the first step?

Dr. Kendall: Well, the first step is to go to our website here at the University of Utah Rehabilitation Center and look for theTRAILS program.

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