After Covid Took His Father, a Hospital Boss Leans on His Wisdom

“No disrespect, Governor,” he recalls saying. “But I’m really busy.”

Gov. Sisolak cut to the chase: President Trump had just retweeted a post that claimed that the Covid-19 treatment ward Dr. Slonim had spent $11 million to build in the parking garage of Renown’s flagship hospital was a “scam” and a “fake.”

The governor was preparing a statement. He wanted Dr. Slonim to know that all hell was about to break loose.

For many leaders, the Great Pandemic of 2020 has been the mother of all anomalies: a blur of bizarre, impossible and potentially defining decisions, often made in a hurry with no practical frame of reference.

Judging from his 35-page resume, Dr. Slonim, 56 years old, might seem like the rare exception. Before coming to Renown in 2014, he’d practiced medicine for many years and earned a nursing degree and a doctorate in public health. He’d also taught medicine and written more than 60 peer-reviewed articles. It’s unclear how he could have been more prepared to tackle the pandemic.

Long story short: No amount of training could have prepared him.

Tony Slonim grew up in New Jersey, where his father owned a chain of clothing stores. His parents were as baffled as anyone when one day, out of the blue, their 8-year-old son decided he wanted to become a doctor. They watched with delight as he approached guests at dinner parties, offering to take their blood pressure.

Tony was in college when his father, Anthony, was diagnosed with multiple sclerosis. The crisis at home caused his grades to suffer and he was initially rejected by medical schools, not once but twice. In time, he not only earned his medical degree, he achieved a rare feat by becoming board-certified in four different specialties.

At 38, while practicing at the prestigious Children’s National Medical Center in Washington, Dr. Slonim was diagnosed with oral cancer. Beating that disease, he says, gave him the strength and personal courage to aim even higher. He’d always believed that more hospitals ought to be run by physicians, so he moved into administration.

At Renown, Dr. Slonim set out to reposition this locally owned, nonprofit medical center as a resource for making the community it served healthier overall, not just providing medical services. He invested in facilities and outreach, implemented new management practices and promoted a more selfless, compassionate culture. In 2019, Renown posted the highest revenue and net income of his tenure, and Modern Healthcare named him one of the nation’s most influential clinical executives.

In late February, after the novel coronavirus arrived in the U.S., Dr. Slonim began gathering his team to monitor data and make contingency plans. His experience in pediatric intensive-care units had taught him that the trick to managing any serious threat is to “always keep the ball on the other side of the net.”

In March, with the virus still confined to coastal hot spots, he faced his first difficult decision: whether to spend $11 million to convert a hospital parking garage into an overflow ward with hundreds of beds.

He knew the move would expose him to criticism. Renown had plenty of available beds and might never need extras. His decision to cancel elective procedures had already strained the budget.

To make the call, Dr. Slonim had to dig down to something fundamental: the reason he’d wanted to be a doctor in the first place. As a physician-CEO, he says: “When you know the calculus could be life or death, the financial calculus is really subordinate to that. Human life comes first.”

With construction under way, Dr. Slonim’s next dilemma arrived, and there was nothing hypothetical about it. In a predawn phone call, his 79-year-old father in New Jersey told him he was short of breath. Two days later, he was diagnosed with Covid-19.

Dr. Slonim decided not to tell his colleagues. He didn’t want to distract them. His father’s infection, likely by an asymptomatic home health care worker, made him more determined to prepare for the worst. But as his father deteriorated, he felt deeply torn between a son’s impulse to jump in the car immediately and drive east, and a leader’s instinct to stay put. His medical training and personal library of leadership books offered little guidance.

Slowly, he settled on the cold truth: Nobody, not even him, could change his father’s outcome now, but there was a great deal he could do to protect the people of Northern Nevada. He remembered something his father used to say: “It’s not what you do for people when they’re dead, it’s what you do when they’re alive.”

The next two weeks tested his resilience. In stolen moments, he’d call the hospital in New Jersey and ask a nurse to hold the receiver to his father’s ear. Dr. Slonim just talked to his dad for long stretches, with no response. On April 14, he was about to unveil Renown’s new Covid-19 ward to the press when he got the call. His father was gone.

Nevada’s caseload gradually rose through the summer. The parking garage-ward sat empty, but Dr. Slonim kept swatting the tennis ball. To preserve capacity, Renown developed an innovative home-monitoring system for lower-risk Covid-19 patients.

On the day of the infamous tweet, as he weighed his response, Dr. Slonim felt bewildered by the timing. A recent surge had finally pressed the overflow ward into service. It was treating about 40 patients.

As a doctor, he’d learned that in a crisis, it’s important to respond, not react. His first thought was that a tweet is just a tweet. He had important work to do and nothing to gain from wading into politics.

As a leader, however, he knew he had to defend his staff. “They don’t deserve to be called fake,” he told me. “Someone had to have their back.”

What Dr. Slonim didn’t reveal at the time was the extent to which the president’s tweet galled him on a personal level. Years earlier, his late father had operated clothing stores inside

Donald Trump’s

Atlantic City casinos. Now, his father’s former business associate was attacking his effort to address the very thing that claimed his father’s life.

Once again, Dr. Slonim felt deeply divided. And just as before, he began drilling down until he hit something that felt like bedrock. In moments of triumph and defeat, his father had always told him: “Stay humble and keep your head down.”

There would be no barbed tweets or defensive TV segments. Dr. Slonim declined some interviews and kept others short. The harshest term he used for the tweet was “irresponsible.” He used the moment instead to praise, defend and inspire his staff. “Keep your chin up,” he told them on Twitter, “we’ve got this.”

As the pandemic continues to rage on, Dr. Slonim has no plans to pack up his parking garage. Renown says it has treated 370 patients there, and as many as 212 in a week. .

Come what may, the pandemic has already taught Dr. Slonim one valuable lesson: that a genuine crisis, like this one, is something no leader can specifically prepare for. When professional challenges crash into personal struggles, there’s no safety in theoretical constructs. “You could write the best white paper in the world about what to do in a pandemic until you don’t have any more beds,” he says. “And then what?”

Dr. Slonim’s basic prescription for crisis management this: Remember that you’re not omnipotent. You have biases and blind spots. But you’re also a human being with beliefs and values.

When faced with an implausible situation, he says: “There’s something to be said for authenticity.”

—Mr. Walker, a former reporter and editor at The Wall Street Journal, is the author of “The Captain Class: The Hidden Force That Creates the World’s Greatest Teams” (Random House).

Write to Sam Walker at [email protected]