COVID-19 Update from Dr. Smith: 5/12/20

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,

In 1977 Peter Medawar, a 1960 Nobel Prize winner, defined a virus as “simply a piece of bad news wrapped up in protein.” 42 years later the bad news was the novel Coronavirus SARS-CoV-2. It was having its way with us 59 days ago, when I wrote my first Update to the Department of Surgery. We were shutting down ORs and research labs. The scarcity of PPE was frightening. Information was a salad of confusing rumors, rambling emails, and pronouncements from multiple sources. I attempted to write a simplifying summary. I wrote another, then another. I sensed that people sharing such universal dislocation needed morale as much as information. I grew tired of using the phrases “fingers crossed” and “when the dust settles.” Near the beginning of Groundhog Day, the Bill Murray character says “Well, what if there is no tomorrow? There wasn’t one today.” March was tomorrow-less. New cases were doubling fast, and we could only guess when we would bend the curve. Extraordinary individual effort and motivation carried us. April was equally exhausting but less terrifying as the curve bent and plateaued. Past-peak feels more like navigating home to harbor down the backside of the hurricane.

As we’re constantly reminded, our home harbor will have changed, in the new-normal. Did you know that the magnetic North Pole has emigrated from Canada to Siberia? The position of the magnetic North Pole is determined by iron and nickel flux in earth’s molten core, and is subject to a tug-of-war between two strong foci, one in Siberia and one in Canada. It has been moving steadily towards the Siberian focus for years.  The pace accelerated in the 1990s. Like any other tourist it crossed the international date line in 2017. To keep systems like GPS aligned a major update was required in 2019, just in time for SARS-CoV-2 to navigate around the world.

Drive an arrow through the center of rotation of the earth from south to north, and it will emerge in the Arctic Ocean, about 300 miles from the vagrant magnetic North Pole. The arrow will point at the North Star (Polaris, formerly a-Ursae Minoris) at the end of the handle of the Little Dipper, 133 parsecs away. The earth wobbles on its axis, like a spinning top, a movement called “precession.” That causes the arrow to inscribe a circle through the universe over time, pointing at different stars. At the time of the Pyramids, Polaris was Thuban, in the constellation Draco (the Dragon). About 14,000 years from now Polaris will be Vega, the fifth-brightest star visible from earth. In 26,000 years a-Ursae Minoris will wear the Polaris crown again. True north becomes new north.

At Bill Murray’s epiphany in Groundhog Day, he says “Do you know what today is? Today is tomorrow. It happened!” We have made the turn to the execution phase, on the return path to new-normal. It carries a different kind of excitement. Our Marshall Plan. With the terror diluted, people seem happier and the crisis feels less compelling, but fear is still there. Fear of future surges, fear of economic struggle, and fear of the unknown, because “normal” is gone. In the execution phase people like me begin returning to their accustomed roles as elements of production, treating diseases pushed aside by Covid-19. It’s uplifting to be back in the OR today doing heart surgery again. The pole star I’ve followed through 59 Updates is moving. I feel my motivation leaning away from filling a void toward meeting an expectation. Perhaps that’s my void, that provokes a performance that’s a tiny bit too self-conscious, and takes me closer to the fine line between full of knowledge and full of myself. Whatever, it’s time for a pause. The new-normal will not include Updates every day. “No man ever steps in the same river twice, for it is not the same river, and he is not the same man.” Mush on, Heraclitus!

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

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