At the height of the pandemic, emergency physician and Belmont resident Carl Dahlberg found himself working at an emergency department in Texas.
“There were an enormous number of people on the vents down there with COVID-19,” he recalled. “If you were on the vent at that time, you were very likely only to come off it when you died.”
That translated into a lot of difficult conversations about death with the families of the patients he was caring for.
“The little things matter so much when you have someone dying,” he said. “I would sit there and I would see these people watching their loved one taking maybe their last few breaths, except what they were really doing is watching the monitor go beep beep beep.”
In those moments, Dahlberg encouraged nurses in the room to turn off the monitor “so [families] could be with their loved ones in their final moments.”
“Little touches like that in health care just add the humanity that we all need,” he said. “I’ve been there, and I’ve tried to add that humanity for people.”
Over the last 20 years, Dahlberg has practiced medicine in emergency departments all over Massachusetts — as far west as the Berkshires, he said. Currently, he’s helping out at understaffed hospitals in southern New Hampshire.
“I tend to help out where I’m needed,” he said.
That became true again this fall when HCA Healthcare put out a call for physicians to make their way to Asheville, North Carolina, where Hurricane Helene had recently wreaked havoc on the land and caused the deaths of more than 200 people.
For Dahlberg, with years of experience in emergency departments across the country — including stints of disaster relief — it was like nothing he had ever experienced. The longtime Belmont resident went south on Oct. 2 and returned home on Oct. 7.
“This was mainly a disruption-of-resources-problem,” he recalled. “For a few days, [the hospital] was overwhelmed with patients. It was a mix; some were injured and some were disrupted and homeless. Between those two scales, there were people with chronic disease that weren’t being managed.”
There were also behavioral health problems, he said, and people in addiction recovery “whose methadone clinic just got washed down the gully.”
In addition to all that, they were without running water, power was mainly supplied by generators, and transportation was an issue.
“It’s everything you see in emergency medicine, just made more acute around this disaster,” he said.
Circuitous Route
Dahlberg’s career didn’t begin in medicine. In fact, he started out working in information technology.
“It wasn’t until my 20s, when I was working in the financial industry doing IT, in the Chicago markets … that I said ‘There’s a trillion dollars changing hands every day, and I just don’t care. … If we’re all thrown back into the Stone Age, I want to be able to help people with real problems, not make money.’”
So, he went to medical school and found a particular interest in emergency medicine, he said.
“I think I have a willingness to pitch in without complete information and sort of be willing to help,” he said. “Some other physicians, they talk. I like to act and do.”
Dr. Rick Kulkarni, a friend and former colleague, said, unlike Dahlberg, most doctors end up working at one hospital as salaried physicians or employees.
“A small percentage of doctors do more of what I’ll term as firefighting work, meaning they’ll go from one hospital to another, wherever there’s a need. Those doctors, I feel, are a different breed because it takes confidence and courage to go from one hospital to another. Each hospital has its own culture; it’s hard to drop in in the middle of a department … Carl has been doing that for a long time,” Kulkarni said.
Even amongst those doctors, he said, there are few who do what Dahlberg does.
“A very small percentage do what he does, which is to go out and help out in areas that really need help the most,” said Kulkarni, an emergency room physician who worked in emergency departments with Dahlberg for over a decade.
A New Focus
Though Dahlberg still practices clinically, his focus has shifted.
“I had been asking around to try and figure out ways a physician with a bunch of real-world experience can contribute to improving the health care system,” he said. “I started realizing that the system is really flawed, and U.S. health care spends a ton of money and gets very little results for it.”
So, he went back to school. This time, for a Master of Business Administration at Massachusetts Institute of Technology Sloan School of Management. Since he graduated in 2017, he said, he’s been coaching early-stage startups at MIT and Harvard University.
“Carl is extremely forward-thinking,” said Dr. Anthony Dowidowicz. “He’s very very dedicated to patient care on an individual basis but like all of us, as he’s gone forward in his career, he has a much broader vision. At a certain point in your career you stop thinking about each individual patient and start thinking more about the collective good.”
Dahlberg remains connected to MIT through the MIT Sloan Physicians Group, which was founded initially by Dowidowicz as a networking group, and later expanded with the help of Dahlberg and Dr. Andrea Doria. Dowidowicz said he met Dahlberg while working on a project together in Boston at a hotel purchased by the city to provide a safe space to use for people with substance use issues. Emergency physicians were hired to oversee the initiative.
“For me, it went too far past some moral lines that I really couldn’t participate in after a few months,” Dowidowicz recalled. “Carl and I really bonded over what our ethical boundaries were and what we should and shouldn’t be doing with our medical licenses … I really connected with Carl because of the depth of those conversations. … I came to have a great deal of respect for Carl at that point.”
In addition to his work with the startups and the physicians group — which hosts meetings twice per year and other small activities in between, as well as provides mentoring to new doctors — Dahlberg said he’s also working with a nurse to start a longevity medicine practice.
Though his background and decades of experience are in emergency rooms across the country, Dahlberg can’t be so easily characterized as a scientifically-minded person.
“Carl is a pretty multifaceted guy,” Kuklarni said.
In addition to being an entrepreneur, he’s a beekeeper and an artist. After years of woodworking, he also happens to do a little blacksmithing on the side.
“I’ve been studying blacksmithing,” Dahlberg said. “I just love to make stuff. I made most of the furniture in my home. Now I’m trying to figure out who needs metal.”