A Thanksgiving Update from Dr. Smith: 11/26/20

Dear Colleagues,

I hope everyone in the Department is enjoying a safe, healthy, and festive Thanksgiving. This is no ordinary Thanksgiving, of course. When I peek at the data through the fingers covering my eyes, I can no longer deny that we are seeing a regional resurgence of the Coronavirus. Over several weeks the slope of the new-case curve is unequivocally positive but nothing approaching what we experienced in March. Admissions in general and admissions to our ICUs are following a similar slope. Pressure on capacity is related more to pre-Covid levels of normal activity than to Covid cases.  A meticulous plan for staffing redeployments if our surge accelerates has been developed by NYP and CU, a process in which our own Beth Hochman is critically involved.  We are not close to a level that would impact non-urgent surgery.

I refuse to share dry turkey breast with Cassandra. I prefer sweet potatoes with Pollyanna; judge me if you wish. Personally—and not pretending to speak for NYP or Columbia—I think we should tell ourselves this is a busy flu season, except that flu = Covid. I may be proven wrong if we don’t see a shoulder on the new-case curve fairly soon. I will not be proven wrong in believing that all of you will handle whatever comes, shoulder or not.

My Thanksgiving message would ignore a rare gem of optimism if I failed to mention that we have not one, but at least three vaccines poised for release. All three appear highly effective based on preliminary data, as anyone with eyes and ears already knows. Having seen how effectively our institutions scrambled their flight decks in the spring, you won’t be surprised to hear that thoughtful and thorough plans for institutional distribution of vaccines are well underway. If and when my subcategory leaves basecamp, I want to lead the climb. I hope my family and friends, and everyone else I care about, will have preceded me to the summit in safety.

There has been no shortage of irony in 2020, and the history of our Thanksgiving holiday offers its own. Without repeating many well-known historical details, I’ll mention that the Pilgrims had the opportunity to occupy a choice site in Plymouth only because it had been vacated by the Patuxet tribe, all but one of whom had died in an epidemic over the previous several years. Not a pandemic, but one of those tragic European imports that decimated native populations. Not that it was easy for the colonists, half of whom died in the first winter.

The sole Patuxet survivor had been kidnapped before the epidemic by an English “explorer” in 1614, sold briefly into slavery in Spain, then spent several freed years in England before returning in 1619, to find his village empty. He was Tisquantum (“Squanto”), who was a pivotal diplomat and Outward Bound instructor to the wilderness-naïve Pilgrims. Among other gifts, he showed them how to fertilize corn seeds with a fish or two. As we grapple with rationing of scarce resources and disparities in access to care, is there a metaphor here? All of those fish, ground up and spread evenly over Plymouth, would do nothing for anyone. Even the Pokanokets had competing demands for a limited fish supply. A few fish, focused, founded a great nation.

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