COVID-19 Update from Dr. Smith: 4/8/20

Each day during the COVID-19 crisis, Dr. Craig Smith, Chair of the Department of Surgery, sends an update to faculty and staff about pandemic response and priorities. Stay up to date with us.

Dear Colleagues,

The Governor, the Mayor, and all the rest of us are holding our breath in hope that NYC is peaking. At NYP, today and yesterday there were more discharges than admissions. Hosanna! Let’s review some of the things your Department has been doing. First, some context, for those who might not know: serious viral pneumonia is customarily treated by pulmonologists and medically-trained intensivists in a medical ICU. When it became obvious that MICU capacity would be quickly overwhelmed by COVID-19, surgeons and anesthesiologists idled by cancellation of elective surgery volunteered in droves to staff ICUs in converted ORs and on step-down floors. Our ORICU teams are treating almost 80 patients in settings not designed for this purpose, in a triumph of motivation over infrastructure. These volunteers weren’t deterred by risk to their own health or by unfamiliarity with treating terribly challenging viral pneumonias. Words can’t adequately express how proud our ICU teams should be of what they’re contributing.

Today, quite a number of our non-physician employees have volunteered for work transporting patients, for which there is serious acute need. At this point in time, patient transport primarily involves moving COVID-19 patients being admitted through the ED to a Milstein unit. The transporter is provided with full PPE, and few specific skills are required. The infectious risk is much lower than working as an MD or nurse in the ICU or ED, but higher than office work with minimal patient contact. It might not be obvious that an empathetic transporter has a precious opportunity to humanize the transport experience. Our COVID-19 patients are legitimately terrified of dying, and they won’t see their families again until discharge; try to imagine how that feels. The transporter can put a sympathetic human face on Charon, ferrying a frightened patient across the river Styx.

Transport is just one reminder that every contribution matters. Consider this admirably prideful Tweet from “Jester D” on March 14: “I’m a garbageman. I can’t work from home and my job is an essential city service that must get done….Doctors and nurses are going to keep doctoring and nurse-ering. Us garbagemen are gonna keep collecting the garbage.” Indeed, it must get done. Singer-songwriter John Prine died of COVID-19 yesterday, at age 73. He worked a day job as a mail carrier in Chicago for five years early in his career. John Prine wrote songs for common people… “The scientific nature of the ordinary man / Is to go out and do the best you can.”

Craig R. Smith, MD
Chair, Department of Surgery
Surgeon-in-Chief, NYP/CUIMC

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