"This Is What We Do. We Take Care of Sick Patients."

Michelle Baron is a top infectious disease expert and fearless protector

By Katie Kerwin McCrimmon

(October 2020) A veteran nurse was so afraid when the new coronavirus arrived in Colorado that she considered quitting her hospital job.
Then, she watched virtual town halls that featured Michelle Barron, MD, the lead infectious disease expert in Colorado, and the nurse’s perspective changed. Barron has worked around the clock with fellow leaders since early January to safeguard patients and more than 24,000 employees at 13 hospitals.

Even as Barron has faced the most overwhelming challenge of her career, she has displayed her typical sunny attitude. She calmly reassures staff members – again and again demonstrating how to properly wear masks and other personal protective equipment, or PPE. She’s become a bit of a hospital and media celebrity, known for wearing fun shoes and joking about her curly hair that can have a mind of its own as Barron straps on N-95 masks or face shields.

Her message always has been comforting and clear: “This is what we do. We take care of sick patients. We know how to do this.”

Since early January, Barron has served as one of UCHealth’s chief architects for handling the pandemic, a “thinker-in-chief” of sorts.
But she also wanted to see how policies she helped create were working and her infectious disease colleagues were exhausted from tending to so many critically ill patients. So Barron recently rounded on two separate weekend shifts at her home base: UCHealth University of Colorado Hospital.

There, in one of the COVID-19 units, Barron met the veteran nurse, who like so many other staff members, had been afraid to treat patients with the new virus.

The nurse greeted Dr. Barron like she was a rock star: “I know you. You’re the town hall lady!”

Barron grinned.

The nurse confided that she almost left her job, then thanks to Barron, found the courage to carry on.

“I’m still here,” she proudly proclaimed.

“That so made my day,” Barron said.

Throughout the crisis, Barron has been both fearless and self-effacing: the infectious disease expert with the infectious personality.
None of that is a surprise to the people who know Barron. All of her life, she has plunged straight into challenges, armed with a powerful intellect, confidence, and a big heart.

A sheriff of sorts, like her dad

Barron stands just 5-feet 2½-inches tall (yes, she counts the half inch), but don’t underestimate how tough she is when it comes to fighting a pandemic.

Barron’s dad was a deputy sheriff in Texas and his daughter is now a sheriff of sorts for UCHealth. Her bad guy these days is a virus that jumped from an animal to humans in China late in 2019. Since then, Barron has been closely tracking her enemy, while also making life and death calls and keeping her community safe.

Barron grew up in the Mexican border town of Laredo, Texas, and always has been fearless. Along with her little brother and their male cousin next door, Barron loved climbing trees, staring down snakes, finding bugs, and shooting tin cans with BB guns.
While she tore around town with the boys, Barron also loved ballet. And these days, Barron’s known for her eclectic shoe collection. Depending on her mood, she might blaze through the hospital halls in bright cherry red Doc Martens, strappy sandals, or leopard-print boots.

Barron has always straddled two worlds. Her mom’s family came from Monterrey, Mexico. Her maternal grandfather taught her to ride horses and shoot a rifle at age 6. Her mom’s mom taught her how to make spicy roasted chile salsa and homemade tortillas. Her dad was from a big family in the Texas town of Corsicana. That side of the family spoke with a Texas twang and told rich stories. Barron grew up speaking both English and Spanish, and while no one on either side of the family was a doctor, Barron announced to the world at age 4 that she planned to become a ballerina-doctor or maybe an astronaut doctor.

Fortunately for patients and medical providers in Colorado, the doctor part stuck.

While doing her medical training, Barron cared for AIDS patients before experts had good treatments or knew fully how HIV spread. She saw the stigma that her patients faced from getting a sexually transmitted virus and decided to become a specialist in infectious diseases. She came to Colorado to do her fellowship in 1999 and has been here ever since.

For much of her career at University of Colorado Hospital, Barron has served as medical director of infection control and prevention. She’s also a professor at the University of Colorado School of Medicine on the Anschutz Medical Campus.

She has tangled with some tough diseases in the past, including the H1N1 flu pandemic in 2009 and Ebola in 2015.

But in early January of this year, Barron learned about a new virus that would become the biggest foe of her career. And she had the foresight to see it coming long before the illness it caused even had a name.

A prescient early warning 

michelle barron 300On Jan. 8, Barron sent a prophetic email to her emergency preparedness colleagues. In her typical friendly, but firm manner, she alerted them to a virus that was sickening people thousands of miles away.

“Hello. Happy New Year! Never a dull day in infection prevention,” Barron wrote. “There is a severe respiratory disease due to a novel coronavirus that is causing an outbreak in the Wuhan province of China.”

Barron and her team had been preparing for possible pandemics for years. Maybe this new illness in China would turn out to be nothing. But Barron didn’t want to take any chances. She knew that another deadly coronavirus, later dubbed Severe Acute Respiratory Syndrome or SARS, had started in exactly the same way.

In the weeks that followed, as the virus spread from China, to other parts of Asia, Europe and ultimately to Barron’s doorstep, her early January warning and immediate action proved prescient and critical.

While coping with the pandemic, Barron has kept twin missions top of mind: providing extraordinary care to patients while protecting caregivers. The pandemic is far from over, but early results show that Coloradans have benefited from Barron’s leadership.

Across the U.S., COVID-19 has claimed the lives of more than 195,000 people. Each loss has been tragic, but thanks to Barron and other leaders, UCHealth medical providers have been able to send many COVID-19 patients home. Nearly nine out of 10 patients hospitalized with COVID-19 at UCHealth facilities have survived.

Barron’s colleagues credit her with a pivotal role in these positive outcomes.

“She clearly is the pre-eminent infectious disease practitioner in Colorado,” said Nancy Madinger, MD, who selected Barron for her fellowship back in 1999, helped train her, and is now a close friend.

Since coming to Colorado, Barron has continued to treat AIDS patients and new illnesses keep her detective skills sharp.

“Infectious disease is not a static field. There’s always a new challenge. We’re very lucky to have someone who has gone through so many iterations of new diseases and who has the knowledge and temperament to manage a crisis,” said Madinger, director of the University of Colorado Clinical Microbiology Laboratory and a professor at the University of Colorado School of Medicine.

Of course, Barron is the first to credit her team and the stellar people who have helped fight the pandemic in Colorado: from medical supply managers to nurses to lab managers, ICU doctors, pulmonary specialists, respiratory therapists, cleaning crews, chaplains, and so many others.

Still, Madinger said Barron deserves a great deal of credit since she’s such an excellent leader.

“If she were in the military, she’d be a general,” Madinger said.

Of course, Barron would score more style points than most generals. She’d be friendlier and she’d make fun of herself more. One of her favorite stories is about the time she was leading a brigade of fellow doctors and students around the old Veterans Administration hospital in Denver when she opened a door and led the team straight into a janitor’s closet.

“Never follow me!”

In reality, people love following her. While she may not have the best sense of direction, she has a way of sniffing out danger and keeping people safe. Barron likes the sheriff comparison.

“I’m a law-and-order type of girl,” Barron said. “I’m also crazy empathetic, but infection prevention is black and white. We follow rules. My job is to keep you from getting into trouble.”

Fearless from the start

These days, it’s funny that Barron’s job is to be a rule follower. When she was little, Michelle Angelique Barron, or Shell or Shelley for short, was a bit of a handful. Her mother used to say that she was climbing before she could walk.

Barron loved growing up in Laredo. It felt like everyone was related to everyone. Back then, it was easy to head across the border to shop or see relatives. These days, it breaks Barron’s heart that the drug cartels have brought violence to her once peaceful city and region.

As a child, Barron had the run of town. She has a sister who is two years older, but Barron and her brother, who is just 11 months younger, considered their sister boring and found their own fun.

“I was basically a boy growing up,” Barron said. “We would look for space aliens and play with snakes and lizards. None of that bothers me. I loved digging in the dirt, fishing, and finding worms.”

Her mom’s dad had been in a weapons instructor in the U.S. Army and took his granddaughter under his wing.

“He taught us how to shoot in case we’d ever want to go hunting,” Barron said.

The concept of killing a creature didn’t sit well with Barron, but she was a pretty good shot.

“I was probably 6 or 7 the first time I held a rifle. We had BB guns and pellet guns. Grandpa would let us use his rifle. It had a good kick. He’d stand behind us to help steady the gun. We’d shoot tin cans.”

Later, her grandfather had high hopes that Barron would join the military. He wanted her to attend West Point, and thanks to his service, he had the connections to help her get an appointment to the elite service academy.

But Barron had plans of her own.

“I never would have survived in the military. I was like, ‘Hell no.’”

An older boy from her high school had attended Yale University. He shared his experiences with Barron and encouraged her to apply to the revered Ivy League institution.

“I wanted to go to the best school I could. I dreamed big,” she said.

Barron was an excellent student and chose Yale, a decision which her grandfather jokingly bemoaned in his heavy Spanish accent.
“I am so proud of my granddaughter, I wanted her to go to West Point. Instead she went to ‘Jale,’” he told his friends, pronouncing the “y” in Yale with a Spanish “j” sound.

Barron eventually bought him a cap with Yale written on it so that people would know she wasn’t actually in jail.

He also tried to give Barron a pistol with a pink holster to take to college.

“I was mortified. I gave it back to him,” Barron said.

How can we fix the immune system so people don’t die of things that live in the environment?

AIDS patients inspired a calling 

Despite a bit of culture shock and bitterly cold winters, Barron thrived at Yale.

She met friends for life soon after arriving and loved her professors.

“Yale is really diverse. Laredo was probably 98 percent Hispanic. So meeting people from different backgrounds was a really cool thing,” Barron said.

Barron never strayed from her mission to become a doctor. She majored in biology and volunteered in a hospital where she loved bonding with patients.

“I was working in a rehab unit. There was an 80-something-year-old reverend who had had a stroke, was blind in one eye, and had trouble walking,” Barron recalled.

Time and again, she visited with the man and the two had great discussions about religion and philosophy.

“I love the amazing stories I get to hear from patients. I draw energy from people,” Barron said.

She graduated from Yale in 1992 and returned to Texas for medical school at University of Texas Southwestern Medical Center in Dallas.

As a third-year medical student, Barron worked on a ward full of AIDS patients. Doctors only recently had discovered that an old cancer drug called azidothymidine or AZT could help AIDS patients, but much like COVID-19, there was a lot of fear.

“I had all these patients who were dying from infectious diseases that normally would not kill you,” Barron said.

She became fascinated with how the immune system works. She also was eager to help people who were suffering from both physical ailments and discrimination.

Many of her patients were gay men who had never come out to their families. Some had no visitors. Others told loved ones they had cancer.

“There was such a stigma,” Barron said.

She decided to dedicate herself to combating infectious diseases.

“I found my calling,” Barron said.

“How can we fix the immune system so people don’t die of things that live in the environment?”

A dangerous new virus

When the first known cases of the coronavirus arrived in Colorado, UCHealth leaders immediately set up command centers to streamline the health system’s response.

Barron and her right-hand woman, Larissa Pisney, MD, a fellow infectious disease specialist, assistant professor of medicine at CU School of Medicine, and associate director of Infection Prevention and Control at University of Colorado Hospital, served as key architects for new policies that UCHealth leaders had to create on the fly.

Where should patients go if they thought they had COVID-19? Who should treat them? What medications could doctors and nurses use to treat patients? How would doctors and nurses stay safe? Could UCHealth continue to offer other services and non-emergency surgeries? Could UCHealth shift some patient visits to virtual visits instead? Question after question arose and Barron, Pisney, and others had to develop answers fast.

“We were the problem solvers,” Barron said.

She clicked right into gear. Barron is one of those people who gets calmer when the pressure builds. Back in high school, she was on the debate team and thrived during clutch rounds. She and her debate partner arrived at meets having researched a key public policy issue. But, they wouldn’t know which side of the issue they’d have to argue until a judge flipped a coin. Then, calmly and concisely, they would lay out their case.

During the toughest months of the pandemic, there have been moments when Barron has lost her cool.

“In the midst of this, when I felt the gravity of how bad it was going to be, and we started to see the devastation, that’s when I had my first panic attack,” Barron said.

She thought to herself, “This is not theoretical anymore.”

“People’s lives were impacted by our decisions. We were continually looking at the data and the science,” she said.

But Barron also picked up on the fear that staff members were feeling. And that’s when she urged fellow leaders to start doing virtual town halls to give staff members as much information as possible and to allow them to ask questions and deal with their biggest worries.

“Part of my ability to be calm at work is the medical training I’ve had. You lean into that training,” she said.

On particularly rough days, after meetings that started at 6 a.m. and stretched long into the evening, Barron would get into her car and blast heavy metal music like AC/DC and Guns N’ Roses. The chaos emanating from her speakers helped her release all the tensions she felt.

Among the most wrenching decisions were the ones related to visitors who were desperate to be close to their sick relatives. Even though Barron knew that family members of sick patients would suffer, she and others felt it was necessary to bar nearly all visitors, except for women having babies and people in hospice care.

Once, Barron felt sad for a particular family and considered granting an exception.

Her colleagues reminded her that she had created the rule.

“I know. I know,” she responded.

For the most part, Barron has been optimistic amid the turmoil and one of most satisfying moments came when she met the nurse who had decided to stay in her job after hearing Barron’s words of reassurance. That nurse and many others told Barron they were honored to take care of COVID-19 patients.

“That was my proudest moment,” Barron said. “There was no fear, no anxiety. There was a spirit of cooperation and commitment to patients: ‘Yep. We can do this.’

“You feel so happy and proud of the health care system. Everyone has bonded and gotten through it,” she said.

A big dog’s courage and a ‘chill’ attitude

At home, Barron decompresses by cooking and spending time with her husband, Greg Woskow, who is an engineer, and their dog, Chase.

He’s a mutt: part Labrador and part border collie. On walks, Barron often thinks about how little dogs must be fierce and yappy to protect themselves.

Barron may be just a smidge over 5 feet, but she feels a lot taller.

“I’m not a Chihuahua. I don’t bark at everyone. I must think I’m a big dog. The bigger dogs tend to ignore all the other dogs. They know they’re big, so when they see another dog, they’re like, ‘whatever.’”

“Even though I look like a Chihuahua, I think I’m a Newfoundland. Whatever. Bring it on.”

Well, the world did bring it on. Barron had to face a massive challenge. One colleague asked her how she knew so far in advance that this coronavirus was going to be a tough one.

“I just knew to pay attention,” Barron said. “This smelled and looked so much like the original SARS. It bothered me. With SARS, so much was kept quiet. The medical reports came out much later.”

Ultimately, Barron had to trust her gut.

While the number of COVID-19 patients now has declined throughout Colorado and at UCHealth hospitals, Barron is not letting her guard down. She loves to travel and was supposed to go to Europe later this year. She knows she’ll probably have to postpone big trips until 2021.

“I’m very much an optimist, but we’re not remotely done with this,” Barron said.

She recently told her team they need to start planning for the next wave.

“Everything we did in January, we need to be prepared to do it all over again,” Barron said. “We can’t assume this is going away. We need to be ready.”

This article was originally published in UCHealth Today in June 2020. 
The number of COVID-19 deaths reported in this article has been updated with mid-September data.

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