1. Facing Death and Seeing Miracles | Crooked Media
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June 12, 2020
Unholier Than Thou
1. Facing Death and Seeing Miracles

In This Episode

Phil introduces the podcast by talking about one of the reasons he began re-evaluating his relationship with God: finding love. He’ll talk to his fiancé, Dr. Darien Sutton, who happens to be an emergency room doctor, battling on the front lines of the COVID outbreak, while still maintaining a strong belief in the power of faith and the situations where he’s witnessed miracles.





Phillip Picardi: Welcome to the first episode of Unholier Than Thou. I’m Phillip Picardi, your host. You might know me from my work at Teen Vogue, where I was the Chief Content Officer. Or more recently, you may know me from being the Editor in Chief of Out Magazine, where I covered all things LGBTQ. Right now, you may be just as surprised as I am to hear that I am hosting a podcast that is about faith and spirituality. I actually wanted to create Unholier Than Thou because I myself was having a crisis of faith. I was, and have always been a proud homosexual. Even when I was a kid, I was probably one of the gayest people you could ever meet. And I basically always wore who I was immediately on my sleeve. And for any kid, that’s probably a good thing. Right? But for my family, it was a little bit more complicated. My dad was and is extremely Catholic, and it was a complicated upbringing. When I eventually came out of the closet, I remember telling my dad that I was no longer going to get confirmed. And for those of you who don’t know, confirmation is something that you do as a teenager in the Catholic faith, were you basically declare that you are committing yourself to the faith. And I knew that I could not in good faith declare myself or declare any allegiance to Pope John Paul the second, because he was homophobic and in fact, because the entire Catholic Church is homophobic. So I walked away from the faith. And so that kind of brings me to today. You know, I have had the same relationship with God for the past 15 years that I did when I was 14. And that is that I don’t know who God. What I do know is that I am a newly-engaged man. And I know that before I get married, I want to figure this shit out, and reassess my values and what I stood for. And when I thought a lot about that, I realized that I had to go all the way back to the beginning to figure out how I could move forward. So for today, it feels logical that we interviewed the person who for me has most embodied what God means, and that’s my fiancee. And I know that that sounds maybe a little bit trite and maybe a little gross, but bear with me. I have not been religious. I have not prayed. I have not done anything spiritual for basically the past 15 years, give or take. And one of the things that I realized when I was thinking about my relationship with God was that love in and of itself feels like a spiritual process or a spiritual journey. And love, like religion, requires devotion and discipline and understanding and sympathy and empathy. And so when I think about love and when I think about the bond that I share with my fiancée, I realized that in essence, I have been a part of a really important spiritual journey for the past five years. And maybe this is the closest thing I’ve got to God in my life. So I want to talk today to my fiancée, Darien, who is going to share a little bit about his own faith journey and how he approaches God, and especially his being an essential worker in the midst of a global pandemic. We’ve had a lot of conversations about what God looks like and what miracles look like in this moment.


[news clip] We need more. Those are the words constantly being touted by health care professionals at the front lines here and across the globe. Joining us now is Dr. Darien Sutton, who’s an emergency room physician here in New York City. Doctor, thanks so much for joining us.


[clip of Dr. Darien Sutton] Hi. Good evening. How are you?


[news clip] I am well, handing in there . . .


Dr. Darien Sutton-Ramsey: My name is Dr. Darin Sutton-Ramsey and I am an emergency doctor, physician who happens to be the fiancée of Philip Picardi.


Phillip Picardi: Can you try that again? But not in slow motion like you’ve just suffered a stroke.


Dr. Darien Sutton-Ramsey: [laughs] That’s not what a stroke would look like. So my name is Dr. Darien, Dr. Darien Sutton-Ramsey. I’m an E.R. doctor who happens to be your fiancée.


Phillip Picardi: Um, it’s funny because when I first started dating you, I was very uncomfortable with the way that you constantly invoke God in casual speech.


Dr. Darien Sutton-Ramsey: Absolutely.


Phillip Picardi: You love saying things like: look at God, thank God for this beautiful day. I was surprised to find out that you, a person of science, that you actually have a very steadfast belief in God.


Dr. Darien Sutton-Ramsey: Yeah, because I remember when I got accepted to medical school and my dad said: you are going to see God even more. I remember that and I didn’t understand it until I got into the hospital and realized that I saw the work of God in the art of science every day.


Phillip Picardi: How?


Dr. Darien Sutton-Ramsey: It was really honestly, anything. It was the idea of understanding what a miracle is and seeing it happen every day, I think that when I walked into the hospital and I realized I was becoming a physician, I knew or I learned in that time that miracles were not that big, extravagant things that you see publicized on TV. They weren’t the kind that you see in movies. You know, they were the small, minute things that happened in every day that just blessed you in ways that you didn’t know you needed.


Phillip Picardi: There was a story that you told me recently that I actually wrote about.


Dr. Darien Sutton-Ramsey: OK.


Phillip Picardi: Where a, you know, like when you get to the E.R., right—like tell me if I’m saying this right, you basically have like a board of people that you need to see as the attending physician, right?


Dr. Darien Sutton-Ramsey: Before you get to the doctor.


Phillip Picardi: Yeah.


Dr. Darien Sutton-Ramsey: Yes.


Phillip Picardi: So one of the patients that you were, that was next on your list.


Dr. Darien Sutton-Ramsey: Yeah.


Phillip Picardi: Had been seen already by your team.


Dr. Darien Sutton-Ramsey: Yes.


Phillip Picardi: And he was a Black man who presented with chest pain after a run, I believe, if memory serves me, correct.


Dr. Darien Sutton-Ramsey: Yep. Yep, you’re correct.


Phillip Picardi: And they warned you that even though he seemed completely fine, he, his wife was in the room and she was, quote unquote “extremely agitated.”.


Dr. Darien Sutton-Ramsey: Yeah.


Phillip Picardi: And you basically got into the room, and you told me that you did not see an agitated woman. Who did you see?


Dr. Darien Sutton-Ramsey: No, I saw a Black woman that was frustrated and scared. So to help people understand before, I mean, anyone who’s been to an emergency room gets it. Like you walk in, you talk to someone, that usually is someone that’s like a start nurse. And then you talk to a triage nurse who helps you [under] gets to your symptoms. And then you talk to, you know, people who help take your information, and then you get to the ER and you speak to the team nurse, and then you speak to the, the resident, if you’re in a hospital that has residents, or the physician assistant or the nurse practitioner—all of these people will create notes when they’re interacting with you and they give me their perception while I’m treating patients who are already in the ER. And that way, if anyone is in extremis or in distress, they’ll let me know a little bit earlier. But that’s the path of happening. That’s the path that happens. So I happen to be working and I remember getting a note that this man was coming in and he was relatively young, like old enough to have children like graduating high school. So I remember getting that information and then seeing his vitals and all these numbers. Nothing was alarming and so I remember allowing the team to continue to work on him. While I took care of other patients who were really, really sick. And right before I was going to see him, someone tapped me on my shoulder. And I remember the nurse going, you know, his wife is here. If you could see him sooner than later, that’d be helpful because she is angry. Just want to warn you. And I remember thinking, like, OK, I mean, I get that all the time, people, the ER is a scary place. So I remember walking into the room and I didn’t see anyone angry at all. I saw someone that could probably be like at my summer family cookout. So it was just like someone who I felt very comfortable with and I think, I felt when I walked in the room a sigh of just like relief, like, oh, my gosh, someone who’s going to hear me. And I sat down and everyone always thinks that I sit down because, like, I’m establishing peace and rapport. I’m just tired—so I sat down and we had a conversation and she sat and she told me, she said, listen, no one is understanding me. He was out for a run. He came back home. He was sweating profusely and that’s not normal. He said he had chest pain ripping to his back, and at a moment he passed out onto the couch. And it wasn’t the kind of pass out where he was just tired. It was like he definitely passed out. And he’s trying to tell you that he’s OK, but something is wrong. And then she was like, also she, she leaned in, she was like: we got a divorce, I don’t even like this guy. And I was like: oh, OK. And I remember looking at him and he was basically like: I feel fine. He was like: I want to go to bed. And then she said a buzz word. If anyone is in medicine that’s listening, that is really textbook and classic chest pain: rip into your back is a specific diagnosis called an aortic dissection. Your aorta is the biggest artery that’s in your body, it’s the first artery that leaves your heart and then it separates into all the smaller arteries that supply your body with blood. And when that rips, if you can imagine, that is your lifeline. And so if that ruptures or breaks or clots, it stops everything. And so I walked over to the CT, I spoke to the technician and I said, I don’t ever do this, I rarely do this, but I’d like to use my privilege as a physician and move this person to next up. But personally, I didn’t have much of a concern that this gentleman was going to have a diagnosis. I was just getting this done because I was trying to appease this, my aunt, you know, because she basically was like, you better get in there and do some shit. And I felt like it was my aunt telling me, like, do it now. You know? And so, and I had a lot of respect for this person who I’d never known because this is my aunt. And I remember sitting with the resident and then talking to her and then sitting down. I remember like going getting on the phone, someone has asked me another question and someone who I thought was the radiologist came like running out, who had saw the image as soon as the image got produced on the screen and said, this is an emergency, I’ve never seen this before, but I know that this is wrong. And he said, Dr. Sutton, can you just look at this real quick? And I said, sure, what’s going on? He said, just just like, look at it. And he was like, panting and I looked at it and I saw his aorta on the screen and it was actively dissecting or ripping. And I said, oh, my God, this man has an aortic dissection. We need to get this man to the operating room now. And I went back to him and he was completely feeling like, you know, I have a little pain, but I’m OK. But that was in hindsight because he wasn’t exerting himself, he wasn’t increasing his own blood pressure. He ended up going to the operating room. It was I remember it was 11:59 at night. I was going home. I was going home. I admitted him. Call the surgeon. The surgeon came in. Everyone came in. We were all having a discussion about his management, controlling his blood pressure, his heart rate, getting him optimized to go to the operating room. He had never had a surgery in his life. And now he’s going to go to have a surgery which could end his life. And I kept following him and he ended up walking out of the ER.


Phillip Picardi: That’s amazing.


Dr. Darien Sutton-Ramsey: Yeah, I’m sorry. That was a long story, but it’s one of the most profound stories in my clinical career. I think when I think about things that changed my life.


Phillip Picardi: When you think about that moment, obviously there are factors at play that are important to talk about. The first is systemic racism and how it manifests itself in the health care system.


Dr. Darien Sutton-Ramsey: Absolutely.


Phillip Picardi: But then when you walked in didn’t you feel, or did you feel like if you weren’t there, this could have gone a very different way?


Dr. Darien Sutton-Ramsey: It’s very possible, because to be honest with you, he had nothing on paper that would have caused concern. And by that, I mean some patients have abnormal vital signs, but they look OK. He was the kind of patient that had normal vital signs, otherwise normal labs that initially had returned and a normal presentation that would have allowed me to say this person is low risk. He has no reason to have this type of emergency. He can go home.


Phillip Picardi: Mm Hmm. In that way, do you feel like there was a reason that you were the doctor to meet with that patient that day?


Dr. Darien Sutton-Ramsey: Certainly this is what we’re talking about today, right? It’s like the idea of what God is to me, nudging you, putting you in places and not telling you why. And that’s what that was.


Phillip Picardi: Sometimes it feels like you are surrounded by tragedy, and right now, obviously, it’s a global pandemic and people are dying at rates that are completely unnecessary based on irresponsibility at the federal level.


Dr. Darien Sutton-Ramsey: Yeah.


Phillip Picardi: With all of that in mind, like especially with how you keep saying that you try to find reasons or you try to find ways that God is present in the emergency room, I just wonder, how could it ever be possible to find God in what is happening right now?


Dr. Darien Sutton-Ramsey: So it’s hard, right? Because in one instance, you want to have faith. You want to believe that there’s a higher power, but then you see so much death and illness. When you look at places that are in dire conditions and you wonder where is God in those moments? And I still wonder. I look at the numbers that come in and watch the trucks full of Black and brown bodies, and I say, where is God? You know? I am not going to be shy. My faith is, is I feel like I stumble with my faith every day. But God is his hope inside of me, I think, I’d have to say. I don’t, I don’t, it’s difficult, I don’t feel like God is there or has the ability to lead everything, and I feel kind of like sacrilegious saying that, you know, and scared of saying that, but I, I feel like God is able to nudge in and place, but not necessarily able to change—I don’t know, I, I don’t know enough about God still.


Phillip Picardi: OK, let’s take a break right now and come back right after this.


[ad break].


Phillip Picardi: Picking up our conversation with Dr. Darien in this part of the interview, I asked him about an unusual practice he adopted in the E.R.


Phillip Picardi: One of the things that you talk about is how you specifically adapted a policy that you implement when somebody dies in the emergency room.


Dr. Darien Sutton-Ramsey: Yeah, every time I declare someone dead, I have a moment of silence. I say that person’s name and then I usually say this person was probably someone’s son, was someone’s son, someone’s daughter, someone’s sibling, someone’s cousin, and someone’s friend, and today their life is ended. And then I asked my team to take a moment of silence.


Phillip Picardi: Why did you start doing that?


Dr. Darien Sutton-Ramsey: I started doing that because in my senior last year of training as emergency doctor, a new Dr. Shannon McNamara came into the room while we were resuscitating someone who was going to die, and I remember the patient dying and then I remember her—what we normally do at a death, honestly, is it’s really sad, we disperse, and we go and treat our own individual patients and we leave that patient there for the,  for the team, whoever is the primary team, to bag the patient, identify the patient, contact the family. It’s just whoever the primary person is, that’s their job. And then everyone else, we kind of leave. And there’s no moment of just being like, OK, there’s no moment of, you know, honoring, and she took this moment to honor. And it struck me so hard to realize that all the deaths that I had seen before her, I’d never done that. And I said and I vowed at that moment that when I was going to be an attending, I’m fully adopting that skill because I think that that’s necessary.


Phillip Picardi: So now in coronavirus, with the death obviously being everywhere.


Dr. Darien Sutton-Ramsey: Yeah.


Phillip Picardi: And patients being crowded into hospital rooms, patients dying in front of each other, I’m sure. Some hospitals have patients dying in the hallways, in the parking lots, right?


Dr. Darien Sutton-Ramsey: Yep.


Phillip Picardi: Do you still believe that? Do you still feel God when people are dying?


Dr. Darien Sutton-Ramsey: God’s presence is definitely diluted, because it’s happening so much that I definitely don’t feel God in the way that I felt before this all started.


Phillip Picardi: And where do you think you look to find God now?


Dr. Darien Sutton-Ramsey: I try to, you know, when the first time when I realized God was still here is when during the thick of the pandemic, when we were, I was declaring so many people dead that I was waiting on the phone to speak to the medical examiner to declare the death, and normally it would take like ten minutes and it would take an hour, because so many of us were calling in to report our deaths. And I remember ending the shift and walking outside and seeing tree buds, like when I was a kid, I used to walk to school and look up, and when I knew it was spring was when I would see the tree buds on the trees. And that was a moment where I knew change was coming. And it was such a moment of like death and darkness and I remember walking out of the hospital at the end of a night shift in the morning and seeing these first signs of spring. And then I felt like I was like, I’m here.


Phillip Picardi: You often say that working in medicine, you have no choice but to believe in miracles.


Dr. Darien Sutton-Ramsey: Mm hmm.


Phillip Picardi: Why do you say that?


Dr. Darien Sutton-Ramsey: Because honestly, sometimes many times you just can’t explain why something worked. And in medicine, we try to say, oh, this A went to B and then B went to C and then led, and in every single step. But every single day where there’s something that’s going on and we can’t fully explain it. And I think there are miracles inside of those moments.


Phillip Picardi: You mentioned that it’s harder to find God in this moment of coronavirus, but there was a story that you told pretty recently about this one patient who, from my understanding, one of the weird things about coronavirus is that it can be quite volatile.


Dr. Darien Sutton-Ramsey: Mm hmm.


Phillip Picardi: And once it gets bad, there’s often no coming back from it.


Dr. Darien Sutton-Ramsey: Mm hmm.


Phillip Picardi: And the tricky thing about the way people die with coronavirus is that because it’s a respiratory illness, it deprives the brain of oxygen, which means that patients are very much out of it when they pass.


Dr. Darien Sutton-Ramsey: Yeah.


Phillip Picardi: And then you said that there was this one patient who somehow got his faculties back and it was enough for him to be able for one of your colleagues to get him on Facetime with his family so that he could say goodbye to them. Do you remember that story?


Dr. Darien Sutton-Ramsey: Yeah, it was, you know, first off, when people were coming in with respiratory distress, we were just intubated and ventilating everyone. And then the studies came out that we all know about that show that the mortality after we intubated was up to 80, 90%, which is terrifying. And it shaped a lot of the discussions that we started to have with patients before we would do things like intubate them and ventilate them. Something that seemed like it was going to be helpful, hopeful and make them better, now is kind of like this, this death sentence. So it really structured the conversations. And so this man was really having difficulty breathing and he was getting tired of breathing so fast to compensate for his lungs being damaged by COVID-19 and there was a moment where he was just like able to communicate and he was resting, but he wasn’t, he wasn’t actively dying and we were able to get the iPad working and for him to be able to see his family and his mom. And in my mind, it was like not expected that he would wake up and be so aware of his surroundings, but he was in that moment, and he was able to talk to his family. And he didn’t say goodbye because he didn’t know, but he was able to talk to them. And I just thought that was a miracle. Unfortunately, he, so then after that, unfortunately, he succumbed to, he was intubated, he was ventilated, and he was sent to an ICU which involved a very long hospital stay in the ICU. And during that time, the family would, you know, Facetime and try their best to see him. But he wasn’t able to communicate because he was in such a critical state and then he passed away. But I think it was a slight amount of closure to help his family with the fact that he was able to speak to them before he was intubated, that I see miracles in.


Phillip Picardi: Do you think that it’s stories like these or miracles like these that make it possible to go back to work?


Dr. Darien Sutton-Ramsey: For me, like me going back to work? You know, I feel like my relationship with God was really tested during this whole experience. There are moments where I definitely lost my hope and my belief that God was always present when I saw so much death. But then, like I said, there are moments where in many ways I redefined what a miracle was again in this stage of my career. And that provides me hope. And I feel like, although we have seen so much travesty, we’re coming back to a life that is different and has taught us so much from this experience. And now I’m starting now to see God.


Phillip Picardi: Thank you for being here, for taking the time. I really appreciate it.


Dr. Darien Sutton-Ramsey: Look how hard it is for you to say that you appreciate me.


Phillip Picardi: It’s not hard for me to say that I appreciate you. It’s just I feel like I’m being forced to say something and I know how much this is enjoy it.


Dr. Darien Sutton-Ramsey: Listen, I listen to podcasts. I know that this is how it’s supposed to end. You’re supposed to say thank you, I’m amazing. You’re supposed to hug me.


Phillip Picardi: Thank you. I’m amazing.


Dr. Darien Sutton-Ramsey: [laughs] I love you, baby.


Phillip Picardi: I love you, too.


Phillip Picardi: I don’t know who or what God is, or religion, for that matter, or spirituality. But really what I do know is that I’m no longer at the point in my life where I think it’s all a lie. And maybe this pandemic has me going a little nuts and searching for a higher power because there has to be a greater meaning to all of this. Or maybe I’m just going through enough of a crisis that I need to find God to help me through. And whatever it is, I’m OK with, whatever the journey brings. I, this whole show is basically going to be about trying to find spirituality at a time when we need it the most. And we’re going to do so by talking to people who are not your typical religious talking heads, right? We’re going to be talking to feminist astrologers and we’re going to be talking to theologians who are uncovering gospels that show the truth of Mary Magdalene and other religious figures that expose the hypocrisy and truth of the Catholic Church. Or we’re going to be talking to volunteer workers and essential workers who are actually the true embodiment of God in our lives right now. Whoever we are speaking to, I think what I’m hoping is that you will find a way or you will come away from each episode with a different perspective of what faith is and how faith can play a role in your own life. And I think the greatest thing, as I’ve started to do this work, the greatest thing I’ve realized is that faith, even if you are not religious, talking to the faithful and talking about people’s faith helps to expand your imagination of the good in others and of what’s possible. And I think that that’s a really powerful thing for all of us to focus on, especially right now when we’re all living through a time of extreme crisis.


Phillip Picardi: Unholier Than Thou is a product of Crooked Media. Our producer is Stephen Hoffman with production support from Camille Peterson and Alison Falzetta. The theme song is by Taka Yasuzawa and our executive producer is Sara Geismer. Thanks for listening.