Brandon, 41, already relied on his dad for all of his daily needs, ranging from setting up the lift to move him from bed to his wheelchair to scrubbing him down in the shower and pouring his morning coffee into a cup with a straw. That was the way it had been since Brandon broke his neck in a vehicle accident almost nine years earlier, and they made it work, with a hefty dose of gallows humor to keep from screaming.

Monty Patterson trusted the doctors at knew what they were doing, but opening someone’s skull always carries the risk of doing further damage. What would happen if Brandon lost control of the limited muscles he could use in his arms or his ability to speak?

“I said, ‘If you’re just doing this so you can play video games, I’m gonna smack you,'” Monty said in an interview at in Aurora while Brandon was hooked up to a computer tracking his brain activity. “He said, ‘No, I’m doing this so I can play video games and further science.'”

Brain-computer interfaces that allow people to control artificial limbs using their minds exist at the boundary of science and science fiction. As is, a paralyzed person who has had the surgery and undergone the lengthy process of training the program can control objects on a screen and complete some movements with a robotic arm. But a system that would allow patients to regain the full abilities they had before their injuries, while possible, remains only a hope.

Brandon Patterson, who is paralyzed from the chest down and has limited use of his arms, was the into a part of his brain involved in decision-making during a surgery in February.

The researchers working with him aim to determine whether putting electrodes there, rather than in areas specific to movement, will produce better control of screens or artificial limbs. They are also investigating whether they can send signals the other way, to produce semi-natural sensations in limbs that can’t communicate with the brain.

Dr. Daniel Kramer implanted six arrays of electrodes, which resemble patches of tiny needles, to pick up signals from the surface of Patterson’s brain. A computer then has to learn how to decode what the electric signals in the brain mean, because two people thinking about the same action produce different patterns.

“Each brain is totally different,” said Kramer, an assistant professor of neuroscience at CU’s and a neurosurgeon at University of Colorado Hospital.

The current setups are good at moving a robotic arm in the right direction, but don’t always know when to stop: something like a toddler who knocks over the toy they want to grab, Kramer said. Putting the electrodes in a part of the brain involved in higher processing might improve that, he said.

If a computer could send signals back, the brain could judge whether it needs to tighten or loosen the grip of a robotic arm, in the same way that a person using their natural hand finds the balance where they don’t crush or drop the thing they’re holding, Kramer said.

“There’s lots of things that go into making a hand movement correct for an object,” he said.

Private companies and researchers are working on parallel tracks with the technology, with the businesses trying to prove their products help patients enough that the should approve them, Kramer said. At universities, they’re more focused on learning about how the technology and the brain work together, which could lay the groundwork for future advances, he said.

Kramer made clear that he couldn’t guarantee any benefits and that the goal of the research was to improve the technology for future patients, Patterson said. He doesn’t have any robotic devices or a computer capable of linking to his brain at home, so he only uses the technology during sessions with the research team.

“If I see some things now, fine, that’s cool, but it’s not for me,” he said.

Patterson’s wildest dream for the brain-computer interface is to someday be able to drive his wheelchair with his mind, like Professor X in the X-Men comics. But being able to use a computer more easily would also be a significant improvement, he said.

He currently uses a combination of voice controls and a stylus that attaches to his hand like a brass knuckle, allowing him to peck at a screen. Neither was enough to succeed with Microsoft Excel and pass the statistics class he took as part of his psychology major at , he said.

On a Friday in April, researchers hooked Patterson up to a computer, plugging wires into ports sticking out of his scalp like a stegosaurus’ back. He didn’t have on the decorative metal spikes he sometimes attaches to them when going out.

“If I’m going to get looked at funny because I’ve got spikes, I’m going to make it as punk rock as possible,” he said.

Set-up complete, the researchers assigned Patterson mental tasks, such as visualizing putting his fingers through the holes of a pair of scissors or holding a cup. Just thinking about the tasks didn’t produce a significant reaction that they could detect, but holding up the scissors as a visual aid and asking him to pretend he wanted to drink from the imaginary cup got the signals firing.

Later, they set up something that looked like a 1980s computer game, with a green disk sliding on top of gray disks in a circle around it. The researchers were moving the green disk at that point while telling Patterson to imagine sending it in the right direction, Kramer said. Eventually, once the computer learns to decode his brain’s patterns, he’ll be able to move the virtual disk with his thoughts.

When he tried again, about two weeks later, Patterson could move the disk without as much support from the computer. He couldn’t budge it when asked to imagine he was playing air hockey, but a prompt to think about how the Jedi move things with their minds in the “Star Wars” movies clicked.

“The Force is strong with me,” he joked later.

People can somewhat understand the challenges of not being able to use his arms fully or his legs at all, but having quadriplegia brings a whole different set of challenges that a brain-computer interface probably can’t solve, said Tammy Neuman, Monty’s partner and Brandon’s co-caregiver.

Patterson — who lives with his father and Neuman in Elbert, about 50 miles southeast of Denver — had to relearn how to cough because his diaphragm no longer contracted and figure out what he could do with limited control of his arms. His biceps still work, but his triceps don’t, and his fingers usually stay curled under.

“Life with a quadriplegic is always about overcoming,” she said.

On top of that, the stillness can lead to blood clots, including one that went into his lungs and landed him in the hospital, Patterson said. Pressure sores from sitting or lying too long in one position are a constant threat.

Something as comparatively minor as a full bladder or bowel can trigger a because his body senses something is wrong below his spinal injury and doesn’t know how to manage it.

“I say I’m on 13 of my nine lives,” Patterson said.

Kids and teens who previously felt fine are seeking outpatient help, existing outpatients need more support and the number of young people showing up in mental health crisis is growing.

Typically, emergency department visits for mental health reasons are about 20% higher in April at than the annual average, though last year, that gap narrowed to 12%, said Dr. Lauren Eckhart, director of patient care services for the hospital’s Pediatric Mental Health Institute.

“This is something that we talk about a lot every time April rolls around,” she said.

Rates of depression and anxiety among youths peaked during the pandemic, following gradual increases over the previous decade. Since then, fewer students are reporting distress, but the most recent found about 1 in 4 high school students still said they felt sad enough that they stopped doing normal activities.

Not all parts of the country seem to have the same pattern, although the data points to school breaks as relative lulls. Nationwide, mental health emergencies among youths peak a few weeks after school begins in the fall, and then again in the spring, with dips around Thanksgiving and Christmas, said Dr. Jennifer Hoffman, an attending physician at Lurie Children’s Hospital of Chicago.

The pattern could reflect that schools are one of the major places that identify students’ mental health concerns, as well as the accumulation of academic and social stressors, she said.

Most Colorado schools end classes in May, meaning that, in April, time is running short for students who are trying to raise their grades, and even those who are doing well face a crunch of tests and project deadlines, Eckhart said.

In addition, subsets of students are dealing with standardized testing, transitions to new schools or high-stakes social events such as prom, she said.

“All our kids are coming in with more stress,” she said.

That rings true to Ayush Vispute, a junior at Rampart High School in Colorado Springs. His friends and classmates are dealing with Advanced Placement course exams and the SAT or ACT. And although most teachers and parents want to help, he hasn’t seen specific programs to counter the stress.

One of the most helpful things is studying as a group, even when that isn’t the most efficient way to review the material, he said.

“Working in solidarity can be the best way to work through stressful times,” he said.

Outpatient providers also see a seasonal effect.

Calls to Wellpower’s access center seeking help for children and teens increased 25% from February to March this year, and appear on track to rise again in April, said Dr. Casey Wolf, the Denver mental health center’s medical director and a child and adolescent psychiatrist. Existing patients also struggle as the end of the school year nears, she said.

“This time of year, I just come to work knowing that nobody is doing well,” she said.

Young people who are already dealing with some level of anxiety or depression need more support when their academic or social stress increases, Wolf said. On top of that, many struggle to adjust to Daylight Saving Time and sleep less, which interferes with their ability to manage their moods and focus in class, she said.

“They’re going to bed even later, but school starts at the same time,” she said. “When people don’t get enough sleep, they don’t think as well.”

In addition to bringing end-of-school stress, something about spring itself seems to trigger distress for a subset of people, said Dr. Ruth Gerson, director of child and adolescent psychiatry at New York University-Brooklyn.

Scientists aren’t certain why that is, with theories including an increase in allergens, different viruses circulating and increased temperature and daylight hours, she said.

“We think that some people are more vulnerable to whatever these triggers are,” she said.

In adults, suicide rates tend to increase in spring and summer, although the data from UCHealth’s screening offered to all patients suggest the number of people at potentially high risk doesn’t change nearly as much from season to season, said Robert Albrecht, behavioral health supervisor for the emergency department team at University of Colorado Hospital.

Longer days can increase symptoms for people with , and for some people with severe depression, the change of seasons can give them just enough energy to make or carry out a suicide plan, he said.

“It’s a little counterintuitive,” he said.

In addition, people may expect to feel better when winter is over and have a hard time coping when they don’t, Albrecht said. And, of course, warmer weather tends to bring an increase in social events, which add stress for some people, he said.

Working with a mental health provider can help people identify their seasonal and situational triggers and come up with a plan to manage them, Albrecht said. That could include medication, therapy and lifestyle changes such as planning exercise and regular social interactions, he said.

One of the biggest things parents can do to protect their children is to prioritize sleep, including by limiting screen time, Gerson said. They can also help young people prepare for stressful events like finals, college applications and social events by asking them to anticipate how they’ll feel if they succeed or fail, and helping brainstorm ways to respond if something doesn’t go their way, she said.

If they have a plan developed before their emotions are running high, they’ll be better able to understand that disappointment or the feeling of being trapped will pass – and will know their parents believe in their resilience, Gerson said.

“They’ll have thought about what can I do, who can I talk to,” she said.

And, of course, parents need to be willing to ask uncomfortable questions if they see their child is really struggling, Gerson said. Kids are already aware of suicide, and asking them about it won’t give them the idea, she said.

“We’ll let them know that we’re not scared of the hardest thoughts and feelings they’re having” by discussing them directly, she said.

Ideally, parents and youths will start working together as early as January to plan for how they’ll manage increasing stress in the spring, Wolf said. Schools also may be able to help if parents explain their child’s needs and what kind of support could help, she said.

Although spring may be a particularly stressful time that lands someone in a crisis center or emergency room, most people in that situation need ongoing support to manage their underlying mental health concerns, Wolf said.

“When the acute crisis might pass … there’s still the depression or the anxiety, or what I most often see is a combination of both,” she said.

Expenses grew faster than payments in 2022 and 2023, narrowing hospitals’ margins on patient care, while a stock market downturn cut into the value of their investments. In 2024, the trend reversed, according to the new reports, with insurance payments growing slightly faster than the cost of providing care.

Still, Colorado hospitals say their finances aren’t on a solid footing as the next challenge looms: Medicaid work requirements will kick in Jan. 1, and people who lose coverage will almost certainly become uninsured. Medicaid doesn’t cover most hospitals’ full costs, but they collect little or nothing from patients without insurance.

The state’s hospitals made about $101.6 million on patient care in 2024, up from $11 million in 2023, according to the .

That translates to roughly $99 in profit per patient in 2024 — up from $11 per patient in 2023, but far from the pre-pandemic level of $1,367 per patient in 2019.

Counting investment income, hospitals came out ahead by about $1.9 billion in 2024, with most of the profit going to large facilities. Total profits were about $407 million higher than in 2023, but still about $381 million below 2019 levels.

The releases two legislatively mandated reports, which lag by one year, on hospital systems’ finances each January. A third report, on , lags two years, so the data only covered 2023.

The overall profits conceal significant variation.

Out of 85 facilities reporting data, 22 lost money overall, down from 32 in 2023, according to the . Overall profit margins ranged from a high of 33% at in Fort Collins to a low of -182% at , which opened in Colorado Springs that year.

Smaller and independent hospitals were more likely to lose money.

Hospitals didn’t perform as well without investment income included, however.

When looking at patient care and related operations, 45 hospitals lost money, and only 28 made 4% or more, which the considers a sustainable profit margin.

Which method generates a better picture of hospital finances is a perennial bone of contention. State officials describe reserves and investments as important for understanding facilities’ total wealth, while the hospital association likens them to retirement accounts that no one wants to tap for daily expenses.

Kim Bimestefer, executive director of the Department of Health Care Policy and Financing, described 2024 as a time of stabilization for hospitals, because payments started growing faster than expenses for the first time since 2021. Both have roughly doubled over the last decade, she said.

“At the other side paying all of this are consumers and employers, so we’ve got to recognize the sustainability of that, how do we work together to get it down, but also recognize where the hospitals are struggling,” she said.

Complete data from 2025 isn’t yet available, but the numbers from the first nine months of the year suggest hospitals continued “treading water” last year, said Tom Rennell, senior vice president of financial policy and data analytics at the hospital association.

Inflation remains high and the cost of uncompensated care is increasing, so 2024 was a challenging year, he said.

“Everyone’s just kind of hanging in there,” Rennell said.

Uncompensated care, which is the sum of charity care hospitals provide and bills they can’t collect, increased by about $171.7 million, or close to one-third, from 2023 to 2024.

The department attributed the increase to the end of the COVID-19 public health emergency, when states had to start verifying Medicaid eligibility again and recipients lost coverage. The Census Bureau estimated the uninsured rate in Colorado rose from 6.7% in 2023 to 7.9% in 2024.

, the city’s safety-net hospital, provided $174.7 million in uncompensated care, or about one-quarter of all unpaid services in the state, followed by , in Aurora, at $76.1 million and , in Colorado Springs, at $24.4 million.

The cost of uncompensated care will almost certainly increase in the coming years.

Medicaid work requirements under H.R. 1 — known as the “big beautiful bill” — will take effect in January 2027, and people who can’t navigate the process won’t have another option for health insurance, said Jennifer Tolbert, deputy director of the Medicaid and uninsured program at , a nonprofit that does health policy research, polling and journalism.

States will have some control over the resources they put into finding data so that fewer people have to file their work hours manually, but an increase in the number of uninsured people is inevitable, she said.

“Regardless of how much data-matching states are able to do, people are going to fall through the cracks,” Tolbert said.

Donna Lynne, CEO of Denver Health, said the state’s plans to hold Medicaid rates flat for the next few years, combined with cuts under H.R. 1, will force difficult choices in hospitals that serve large numbers of low-income people.

Colorado faces a budget gap approaching $1 billion, and Medicaid accounts for one-third of state spending.

“We’re not crying wolf. The bottom is going to fall out,” she said during a on Feb. 11. Denver Health lost about $20.5 million on patient care and related services in 2024, and had a 0.2% profit margin with investments.

The coming increase in the uninsured rate means that hospitals will need to do more to help patients navigate the Medicaid enrollment process and to provide the assistance their communities need most, said Sophia Hennessy, policy and research lead coordinator at the .

Federal law requires nonprofit hospitals, which are exempt from most taxes, to spend money on “community benefit,” which can include free care, health-promotion programs and medical research, among other things.

The state’s community benefit report showed nonprofit hospitals spent about $1.4 billion on community benefits, exceeding the value of their tax exemptions.

Training and recruiting providers, mostly at the and , accounted for the largest share, followed by charity care and unspecified other programs.

“Hospitals are, net, doing strong, and we want to see more of an investment in Coloradans,” Hennessy said.

Rennell disagreed that hospitals’ overall position is strong. Most are financially shaky and expect the situation to get worse as more patients lose their insurance next year, which could force some to close or reduce services, he said.

“Our hospitals are taking that seriously, yet feeling the road ahead is going to bring difficult choices,” he said.

These inaccuracies are easily disproven by publicly available data, and we believe it����ap important to set the record straight.

UCHealth does more than any health system in Colorado to care for Medicaid patients, and we are proud to do so.

Last year, UCHealth served 30% of all hospitalized Medicaid patients in Colorado, twice as many as any other provider. At our flagship facility, University of Colorado Hospital, we cared for almost 18,000 hospitalized Medicaid patients and provided over $280 million in uncompensated care, more than any other hospital in the state. This is not just a statistic; it reflects our deep commitment to ensuring access to care for those who need it most.

In fiscal year 2025 alone, UCHealth provided approximately $670 million in uncompensated care – an amount that has been growing as more Coloradans become uninsured or need assistance with their health care bills. Unlike some hospitals that receive financial support from local cities, counties, or taxpayers, UCHealth received no such funding last year. Every dollar we earn is reinvested in Colorado – supporting patients, employees and communities across our state.

We agree that health care affordability and insurance premium increases are a real concern for Coloradans, especially as premiums are expected to double for those who buy their insurance from the exchange.

UCHealth is dedicated to making health care accessible and affordable. We provide free care for anyone whose household income is below 250% of the federal poverty guidelines – about $80,000 per year for a family of four – and significant discounts for those earning up to 400% of the guidelines – $128,000 for a family of four. These programs ensure that hundreds of thousands of Coloradans receive the care they need, regardless of their ability to pay.

We also support rural hospitals across Colorado by offering low-cost IT services, advanced medical records and accepting thousands of patient transfers from hospitals unable to provide a higher level of care. These partnerships help stabilize rural health care and keep care local whenever possible.

Despite our total expenses increasing by 9.3% last year, UCHealth’s average reimbursement rate rose by only 2.0%. This gap underscores the financial pressures facing health systems and how providers are working to minimize price increases for patients.

UCHealth is proud to be a Colorado-based nonprofit health system and one of the state’s largest employers. All revenue stays in Colorado and is reinvested to support patients, employees, and communities. Our mission is clear: to improve lives and provide exceptional care for all Coloradans.

The editorial places undue emphasis on investment income, which is highly volatile and includes unrealized gains. Just as a household would not base its monthly budget on the performance of a retirement account, it would be irresponsible for a health care provider to rely on long-term investments to fund operations. These gains can disappear overnight. This volatility is precisely why investment gains or losses should not be used as a measure of financial stability. UCHealth’s financial reserve, which is typical for a system of our size, enables us to care for patients during times of uncertainty, including pandemics, federal government shutdowns that delay or stop payments to hospitals, or dramatic increases in expenses.

The appropriate metric for measuring a hospital’s stability is operating margin. UCHealth’s operating margin last year was 3.5%, a level that provides stability but little excess. This modest margin allows us to maintain high-quality services, invest in technology, provide updated equipment for our patients and recruit top clinicians, all while navigating rising costs and reimbursement challenges.

We welcome thoughtful dialogue about health care costs and access. But that conversation must be grounded in facts. UCHealth’s record speaks for itself: unparalleled service to Medicaid patients, hundreds of millions in uncompensated care, more than $1 billion in total community benefits, and a steadfast commitment to affordability and community health. These are the values that guide us, and they deserve to be recognized accurately.

Elizabeth B. Concordia is the president and CEO of UCHealth.

To send a letter to the editor about this article, submit online or check out our guidelines for how to submit by email or mail.

Not all of the responsibility for this failed system falls on hospitals, but Colorado’s non-profit health care providers are uniquely positioned to be able to help during this difficult time if they embrace the charitable nature of their business.

According to The Denver Post����ap award-winning health reporter Meg Wingerter, most Colorado hospitals saw a profit in 2024. But the most profitable hospitals tried to argue that their profits were untouchable because the money came not from patient care but from returns on investments — we assume that means the trusts and foundations that help support the hospital saw impressive investment gains that were reinvested into the market rather than realized and withdrawn.

UCHealth — a network of non-profit hospitals and clinics across the state affiliated with the University of Colorado — reported a $1.2 billion profit. HCA Health One, the state’s only for-profit hospital network, reported $616.8 million in profit, and CommonSpirit Health reported $22.2 million.

A spokesman for UCHealth said most of the profit came from returns on investments in the stock market, rather than from the 4% return on investment it makes from patient care and hospital operations. However, given that UCHealth is a tax-exempt system required to spend money on charitable activities, we do not think it����ap unreasonable for the system to be expected to return some of that profit to its patients in the form of out-of-pocket discounts before deductibles are met.

Most hospitals already write off a huge amount of uncompensated care, and that charitable gift to the poor who are truly unable to pay and have no insurance counts toward their required charitable activities.

But we also know that hospitals like UCHealth are not spending as much of their revenue proportionally on charity care as other organizations. UCHealth does deserve credit for serving the most number of Medicaid patients and having the highest uncompensated care. But when compared to the system’s size of operations, the distinction for taking on “the largest proportion of charity care costs within the state” rests with Denver Health. Colorado’s “has the largest value for charity care costs with $88.1 million. This is three-fold more than the next largest figure of UC Health University of Colorado Hospital’s of $24 million.”

Meanwhile, Allan Baumgarten, a researcher who compiles data annually about health care in a handful of states, reported that HMOs in Colorado reported a combined net profit of $89.1 million. Yes, that seems paltry compared to the hospital profits, but remember that health insurance doesn’t actually produce anything; it is a middleman, pass-through business operation designed solely to reduce the risk of those it insures.

Ironically, HMOs are covering less and less risk. The high deductible plan ensures that unless an illness or injury requires thousands of dollars in care during a single calendar year, the insurer won’t have to cover any of the costs. And, the deductible resets Jan. 1 every year, meaning that patients can nearly meet their deductible — of say $5,000 — only to have it reset in the new year. A patient could spend $10,000 before their insurance company picks up a dime of the cost for their care.

Meanwhile, non-profit organizations are clearly misunderstanding their mission.

Obviously, we want UCHealth’s investments to grow, and not all of the gains should be realized in a single year. The hospital system is also aggressively growing and . Given the quality of care we know UCHealth provides, that is great news.

But hospitals need to be much more transparent about how much of their profits are being poured into growth and increased profitability, and how much is going to actual charitable work, like reductions in costs for low-income and middle-class patients who face crippling deductibles.

Yes, USHealth is a teaching hospital, and we know that much of its charitable work goes toward preparing the next generation of doctors and nurses. There is a shortage of health care providers in America, so we are not suggesting this work stop.

But a balance is needed when the hospital system reports $1.2 billion in profit in a single year.

Greater transparency from the state-affiliated system, and from all the nonprofit hospitals enjoying tax-exempt status, would go a long way to alleviate the bad taste patients have in their mouth when their care is completed and the bill arrives.

To send a letter to the editor about this article, submit online or check out our guidelines for how to submit by email or mail.

UCHealth, which owns the 700-bed hospital in Aurora, postponed non-emergency surgeries for a week in July following those shortages. At the time, the confirmed it was investigating a complaint involving the hospital, but didn’t say what it was about.  

Newly released reports from that investigation show that when a state inspector visited the hospital on July 14, they discovered 17 stainless steel carts strewn across the sterilization department in such a way that it was difficult to walk through the area.

Each cart held between 11 and 30 contaminated surgical instrument sets, according to investigation reports released by the state health department.

“Surgical instruments were grossly soiled with dried blood and tissue,” the inspector wrote about a kidney transplant tray on one of the steel carts.

Officials at the state health agency were so concerned about what they found during their investigation that they declared “an immediate jeopardy,” which is issued when a problem has caused — or is likely to cause — serious harm, injury or death to a resident or patient.

The health department required UCHealth to develop a plan to correct the violations, and the hospital is now in compliance, so the agency won’t take further action, Department of Public Health and Environment spokeswoman Alexandrea Kallin said in an email Thursday.

“We postponed some elective procedures to ensure patient safety and worked closely with CDPHE to implement changes to return (the sterilization department) to full capacity,” UCHealth spokeswoman Kelli Christensen said in a statement. “It is important to clarify that used surgical instruments awaiting the decontamination process are often stored in various non-patient-facing areas. At no point during this situation were patients at risk.”

The state’s investigation — the results of which were — found University of Colorado Hospital failed to put in place measures to mitigate staffing shortages before opening four new operating rooms in June, which led to an increase in the number of surgical instruments needing to be cleaned.

The sterilization department required 85.2 employees after the rooms opened, 20 more than previously required, according to the reports.

“Upon request, the facility was unable to provide evidence (that sterilization department) staffing levels had been increased to meet the post-expansion requirement,” the inspector wrote.

An administrator told state officials that hospital leaders knew of the staffing shortages before opening the additional operating rooms, but the facility struggled to hire and keep employees because the salaries UCHealth pays are below market rate, according to the reports.

Another employee told the state inspector that staffing levels had dropped in the sterilization department over the past year, but the hospital prohibited hiring replacements, according to the reports.

Employees told state officials that because of the shortages, surgical instruments were not cleaned in a timely manner and often remained unprocessed overnight — and sometimes for up to six days because staff couldn’t keep up with the volume, according to the reports.

One employee told the inspector that employees were trained to spray surgical equipment every 72 hours to prevent “bioburden” from hardening and making it difficult to properly sterilize the equipment, according to the reports.

The inspector found that between April and July, anywhere between 100 to more than 500 surgical instrument sets remained unprocessed, depending on the day.

The state reports said the hospital postponed non-emergency surgeries so staff could clean surgical instruments and implement a system to manage case volumes.

“Throughout this situation, patient safety remained our top priority,” UCHealth’s Christensen said. “We have not identified any health-care-associated infections linked to the (sterilization department) staffing issue.”

The hospital’s sterilization department now has 140 full-time employees, she said.

UCHealth’s decision to postpone surgeries whiles staff addressed the sterilization problem stands out from other hospitals that have found themselves in similar situations.

Colorado cited at least 16 hospitals for sterilization problems between 2019 and 2024 — most of which occurred because employees made mistakes that could have contaminated instruments — and saw hospitals continue to provide surgeries even as the facilities retrained employees on sterilization techniques.

Last year, the Rocky Mountain Regional VA Medical Center in Aurora also paused surgeries after discovering a mysterious residue on medical equipment.

Poorly sterilized surgical equipment can lead to infections, including death, such as those linked to a breach at Denver’s Porter Adventist Hospital in 2018.

The has collected dues through payroll deductions since 1987, said co-president Dr. Simone Raiter, a fourth-year resident in interventional radiology. The university abruptly stopped allowing the organization to do that in July, forcing union officers to track down interns, residents and trainees in fellowships to get their banking information, she said.

“This is something that we’ve done for decades. It’s very interesting, the timing,” she said.

The union, which represents about 1,300 young doctors, had gone public in February about its push for collective bargaining with the university. At the time, its leaders said their top priorities were increasing the stipends that doctors in training receive while providing care to patients, along with ensuring the university couldn’t cut the union out of conversations affecting its members.

Under Colorado law, unions can’t force quasi-public employers to recognize them by holding an election in the same way that . That means CU would have to agree to give collective bargaining rights to the Housestaff Association.

The university declined to agree to collective bargaining, and the union alleged in its that CU took steps to retaliate.

In addition to ending payroll deductions, Raiter said, the alleged acts of retaliation included walking away from discussions about a memorandum of understanding that would have formalized the union’s current role, plus canceling meetings at the University of Colorado Hospital and Children’s Hospital Colorado.

Mark Crouch, the chief of staff and associate dean of public relations at the CU medical school, said ending payroll deductions was a “necessary legal change.” The School of Medicine told the union three months in advance so it could come up with an alternative solution, he said.

The decision to stop working on a memorandum of understanding was due to the two sides reaching an impasse, despite good-faith efforts, he said, adding that the school didn’t push any hospitals to exclude the union.

“We simply could not reach an understanding around this one document, but that does not affect our ongoing and frequent collaboration,” he said in a statement.

The school’s leadership and the union continue to meet regularly, Crouch said.

“We remain committed to strengthening our relationship with all residents and fellows,” he said.

The can’t force CU to engage in collective bargaining. But Raiter said she’s hopeful that it will order the university to reinstate the payroll deductions and to continue negotiating a memorandum of understanding so that it can’t chip away at the union’s role during future disagreements.

“The MOU is a great place to start,” she said.

Jerry Morgan stepped in to work the grill in front of the Denver Youth Program’s location on Welton Street on Thursday afternoon, while Felipe Perez headed to talk with the trauma patient. Next time, they’ll switch roles. Both do outreach with young people at risk of becoming victims or perpetrators of violence.

The connection between a cheesy lunch special and preventing violence might not be obvious to everyone, but in a neighborhood where food insecurity is common, a free meal can start a conversation that leads a young person to a positive path, such as the outdoor recreation group or its health care career shadowing option, Morgan said.

“We have to be able to get people the services they need,” he said.

, with about 45% fewer people killed by others in the first six months of 2025 than in the same period of 2024. Data from 30 large cities around the country found an average drop of 17%, .

Preventing violence doesn’t happen without addressing the full picture of someone’s life, said Johnnie Williams, executive director of the Denver Youth Program. If young men can’t get a job to help their families buy food or keep the electricity on, they turn to illicit opportunities, he said.

“Some people deal with that by selling drugs. Some people deal with it by joining gangs,” he said.

At the Denver Youth Program, they can meet some of those needs through programs such as healing circles for young people recovering from trauma and a T-shirt shop that offers a paycheck and job training, Williams said. They also help youth and their families navigate the health care and social services systems.

“It’s everybody’s job” to help steer young people away from violence, he said.

The organization also attempts to deescalate disputes before they end in gunfire, and to intervene after shootings to prevent retaliation. The , or AIM, program sends “credible messengers” to Denver Health, University of Colorado Hospital and other metro hospitals that see significant numbers of patients who survived a gunshot wound.

Credible messengers are community members who build trust with those most likely to be either victims or perpetrators of gun violence, who are disproportionately young men of color. Typically, they were previously involved in violence, and some have spent time in prison.

Perez, who was an AIM client as a young man and now works there as a responder, said seeing someone with similar experiences who isn’t judging them is powerful at a vulnerable moment. It can open people up to receiving mental health care and other help they need to avoid getting hurt again, or harming someone else, he said.

“They see someone that resembles them and they feel safe,” he said.

Studies seem to back up the idea that the days after someone sustains a bullet or stab wound are an effective time to change their direction. A found that over eight years, only about 4% of the 328 people who received services went on to commit a violent crime, and fewer than 2% had another violent injury.

In the second quarter of the year, AIM met with two people injured in community violence — one who had been stabbed and one whom a driver had hit intentionally – and one person with a self-inflicted bullet wound, according to a report it filed as part of a . Data from the summer months isn’t yet available.

Colorado hasn’t set up the grants to prove that a particular group’s efforts averted a certain number of injuries or deaths, but models that worked in other major cities should be helpful in the Denver area, said Dr. Ned Calonge, the state health department’s chief medical officer.

have estimated that violence-interrupting efforts led to about 18% to 56% fewer killings, depending on the neighborhood.

About 90% of the funding for the violence-prevention grants comes from the federal government, so the state may have to get creative to continue them, Calonge said. No single strategy will solve a problem as complex as gun violence, but combining approaches such as credible messenger meetings with interventions like offering trigger locks to parents will lead to progress, he said.

“Making headway is something that����ap going to take a lot of time,” he said. “I think we’re making starts in the right direction.”

Repeated violent injuries are common enough that doctors can think of trauma as a “chronic disease,” said Dr. Shevie Kassai, a trauma surgeon at , formerly known as Medical Center of Aurora. The hospital started working with AIM to connect survivors of shootings and stabbings to behavioral health treatment and other resources, in the hope that they won’t be back, she said.

Kassai estimated between half and 60% of her patients who survive “penetrating injuries” — mainly wounds from shootings or stabbings — return with similar injuries. Statewide, only about 2% of people hospitalized with a bullet or knife wound from 2020 to 2024 had a similar injury before, according to the state’s trauma registry. It may have missed people with less-severe injuries, though, because the registry only includes hospitals that can treat more severe trauma.

“All we can do is give patients, give all human beings, the tools to take care of themselves the best they can,” she said.

The only way that any of the efforts work is if people in the community know that someone truly cares about them and is in it for the long haul, said Randall Elliott, a violence intervention specialist who helps calm situations and connect victims and bystanders to mental health support after a shooting.

Services like free lunches and clothing distribution are a vital part of making young people feel they can seek help before a situation escalates, he said.

“It just shows that we’re a positive force in our community and we’re in tune with our community,” he said. “Trust is a rare and priceless jewel.”

The hospital, in Aurora, prioritized emergencies and urgent cases during the shortfall, but is starting to return to a more-normal volume of pre-scheduled procedures, said Dan Weaver, spokesman for , which owns the hospital.

He didn’t specify how many people had to wait for non-emergency procedures, but said some already have new surgery dates scheduled.

“We will be working as quickly as possible to reschedule all elective surgeries and procedures that had been postponed,” he said in a statement. “We sincerely apologize to our patients and thank them for their understanding as we return to normal operations.”

The confirmed it was investigating a complaint involving the University of Colorado Hospital this week, but declined to say whether it had anything to do with instrument sterilization. Once the investigation is over, the state health department .

Sterilizing surgical instruments is a complex process, and technicians must undergo training to ensure they don’t miss a step and leave germs on equipment that will go into a patient’s body. The state cited 16 hospitals for sterilization problems from 2019 to May 2024. In most cases, staff made mistakes that could have contaminated instruments.

The state hasn’t released any information suggesting the University of Colorado Hospital wasn’t following proper sterilization procedures.

Hands that once navigated rock faces that some boulderers could only dream of challenging were now black and smoldering.

Melissa Strong looked at them and yelled at her husband that she didn’t have hands anymore. Doing his best to keep her calm as he raced toward the hospital, Adam assured her that she still did.

Then Melissa’s thoughts went to her passion. “I will never climb again,” she wailed.

Adam didn’t have a response.

And neither did the EMT at the hospital, as Melissa was having her clothes cut off and her body hooked up to IVs.

“I knew the EMT there, and I looked at him and asked the same question: ‘Will I ever climb again?'” Melissa recalled. “And as soon as I said those words, I knew how unfair of a question that was. I followed it up with, ‘You don’t have to answer that.'”

It took weeks in the hospital, months of rehabilitation and a will to keep pushing forward, but Melissa eventually found the answer to that question. She titled “Climbing Through: A Story of Grit, Healing & Second Chance,” which is set to be published by Falcon Guides in 2026.

One of her main takeaways: “We all have some scar tissue we are dealing with.”

‘The most significant moment of my life’

If not for a tripped breaker, Melissa Strong would have died that day in her Estes Park driveway back in 2017.

Strong was burning artistic runnels into wood furniture to be used at the restaurant she planned to open. Employing a technique called Strong rigged a 2,000-volt microwave transformer with mini jumper cables as leads to burn the wood.

But in a moment of distraction, Strong forgot she left the transformer running and grabbed the live leads with both hands. What followed was a life-changing, 20-second-long electrocution that torched her hands.

“I tried to scream, but couldn’t; tried to shake my hands free from the leads, but couldn’t; tried to fall over, but couldn’t,” Strong recalled. “That’s when I said to myself, ‘Oh (expletive), I’m dying.’

“With that thought, everything went black, and I was in a beautiful forest with so many ferns, sunlight coming through. I turned my head and saw a tunnel in the forest. There were these figures floating between me and the tunnel. … When I finally was able to open my eyes, I was face-down, and was looking at the gravel on my driveway. Then, I could finally scream for the first time.”

Strong had been climbing for about two decades at that point, starting with traditional climbing and sport climbing before finding her love for bouldering. She routinely solved difficult bouldering problems, was a volunteer bouldering steward in and ran a guide company with Adam for climbers at Hueco Tanks State Park & Historic Site in El Paso, Texas.

At the burn center in Greeley, the morning after the accident, doctors told Strong that she was going to lose six of her 10 fingers and would only be left with her index fingers and pinkies. That would’ve been a catastrophic outcome for her climbing — not to mention her ability to run a restaurant.

Undaunted, she was transferred to UCHealth University of Colorado Hospital in Aurora, where she met Dr. Ashley Ignatiuk.

A plastic surgeon who specializes in hand reconstruction, Ignatiuk performed an important preliminary test to determine whether he would be able to save Strong’s thumbs. He pricked the tips, and a small amount of blood came out. Strong called it “the most significant moment of my life.”

“If the tissue is completely burnt, then there’s nothing that we can do,” Ignatiuk explained. “But the tips of her thumbs still had a tiny bit of blood supply, which means there were reconstructive options. But not a lot of them, because the whole palm side of her thumbs was completely torched, burnt all the way down to the bone.

“With an electrical current, the more resistive the tissue is, the more it heats up. The bone is the most resistant, so it heats up the most and you cook yourself from the inside out. Which is what happened to her hands. But her demeanor and the fact that she was such a fighter made me want to find a solution.”

With the small bit of hope, Strong and Ignatiuk pressed forward. Ignatiuk admits that at the time, he thought there was a 20% chance of saving Strong’s thumbs and zero chance that she would ever climb again.

“Right then, after that tiny pool of blood came from my thumbs, I swore that I would be the best patient in the world if anyone would just try to help me,” Strong said. “And, of course, I thought about climbing the whole time.”

Eight surgeries, skin grafts

While Ignatiuk made a plan, Strong started to get her life back.

About two weeks after the electrocution, she started riding a stationary bike at the hospital. She called on contractors, got business done with the bank and consulted lawyers to make sure her restaurant’s opening stayed on schedule.

Because of Strong’s determination, opened exactly six months after her accident, on Oct. 2, 2017.

“She never faltered on that decision to open the restaurant,” said John Witmer, who co-founded the restaurant with her. “I remember her being very steadfast about continuing on, no matter her injuries and through all the surgeries. She has mental strength beyond almost anyone I know, and a determination that she just won’t quit.”

Ignatiuk conducted eight surgeries plus an array of skin grafts to rebuild Strong’s hands.

One of the procedures, called the , was a novel surgery in which Ignatiuk sewed both of Strong’s thumbs into her opposite forearms. She was stitched that way for three weeks. The surgery enabled blood supply to the thumbs from her forearm tissue, which was eventually incised and left on the thumbs to provide .

Ignatiuk also took tissue from the back of her index fingers for her thumbs, did multiple fusions to get her bones stable again, and grafted thigh skin into her fingers and groin skin onto her palms.

In the end, Strong was left with what she calculates as seven and three-quarters fingers — a much better outcome than what doctors initially predicted. She lost half of her right middle finger and parts of several others, including a shortened left thumb. Neither thumb has tendons and thus cannot bend.

While her thumbs were sewn to her forearms, Strong used the pinkies she had free and her right index finger to continue her restaurant plans and run her guide company. Her friends and fellow climbers were amazed, but not necessarily surprised.

Bronson MacDonald said she knew Strong would figure it out: “That was clear from very early on in her hospital stay.” Another climbing friend, Jackie Hueftle, saw the same resilience.

“She’s a really fierce personality,” Hueftle said. “Melissa, since she first started in the sport, has gone out and tried stuff that was way too hard for her, and just beat (routes) into submission. It’s a different mentality, and we all saw that at the hospital, too.

“… She’s always been determined, and the accident didn’t change that. I felt like, ‘Dang, you should’ve died, and somehow didn’t, and you suffered this life-changing accident for a climber. Yet here you are, just pushing along.'”

Return to the rock

After a six-week hospital stay, Strong’s most challenging days were ahead.

Her fingers were mostly saved, but she had to relearn how to climb, get her strength back and force her way past the mental and physical adversity that accompanied her recovery.

The first step: forgiving herself.

“I was standing next to a pit that could swallow me up,” Strong said. “I was almost ready to jump into the pit and willfully let it swallow me. Because I had no one to blame but myself for this accident. I had to deal with that immediately. So I had to build a safety net over this pit to keep myself from living in despair and from living in anger at myself.”

The second step: touching a climbing hold that Adam installed on the side of their staircase.

Then, she progressed to grabbing a hold with her feet on the ground. Then she took her feet off the ground and pulled herself up on a hold.

The final step was the hardest: actually climbing again. That meant restoring confidence in her hands and upping her pain tolerance and endurance to reach from one hold to another.

“In the couple of years after the accident, it was a tedious, slow and painful comeback — painful emotionally and physically,” Strong said. “The pain was almost unbearable when I first started to truly climb again.”

Strong’s reconstructed hands are no longer calloused. The groin skin grafted to her palm is sensitive and can be easily cut open. But she finally returned to the rock in the spring of 2018, nearly a year after her accident, at the Box Car Boulder in Rocky Mountain National Park’s Wild Basin.

“The main thing was when she did that first climb, it was super easy, but it showed that she could still do it,” Adam Strong said. “It was a V2 traverse, which was one of her old warm-ups. After that, everything else was just building on that.

“She doesn’t climb quite as hard (of routes) as she used to, but she’s still trying her hardest. The numbers are different, but the effort is the same.”

In the years since, the 51-year-old has conquered problems as challenging as V8, which is roughly the mid-point of the bouldering ranking system (V0 to V17). Outside of the sport, Bird & Jim emerged as an Estes Park mainstay, with the business even expanding to a second, adjacent building called the Bird’s Nest, which is a bakery/coffee shop/pizzeria that also functions as a catering and event space.

Yet even though her hands have healed, Strong’s recovery remains an ongoing process.

“Without digits, it’s a constant everyday issue — dropping things, Ziploc bags, buttons, necklaces,” Strong said. “Even climbing, it can still be so frustrating, because there’s so many times (I look at a route) and know if I had my old hands, I could do it.

“But it’s a full-circle feeling, because I get frustrated at all these things, but then I can come around to the fact that I can still try at all these things in life, and I’m still alive. It’s a constant reminder that no matter what the daily frustrations are, the gratefulness outshines them.”