A Memorial Day Update from Dr. Smith

Dear Colleagues,

I cannot adequately describe how rewarding it has been to have so many people email, text, or stop me in the hallways to express their appreciation for my deluge of daily Updates that ended May 12. I can’t attribute such unanticipated resonance to any professional journalistic or author-ly formulas. Or maybe the absence of that cleared the way for something more ripped-out-of-the-thorax. But the daily Updates had to end. I won’t pretend I’m not enjoying the break. After hunching over the keyboard in my Zoom cave it’s a pleasure to straighten up and walk away, before the chair could give me pressure sores. Some people say they’ve concluded from my sign-off that we’re winning the war. I fervently hope that proves true. For their benefit, I should remain silent. I can at least promise there will not be any more daily Updates. Average cardiac operations are lengthy, so restarting our ORs will see to that.

Having stepped out of the river once, where am I? I will try to communicate less frequently without losing relevance and impact, accepting that this part of the journey plays out in lower orbitals. I’ve mentioned previously that climbing down from a peak is hazardous. Stumbles and falls are set up by the waning of adrenal drive that’s been covering fatigue. We have several immediate management challenges. Face-to-face patient encounters will be markedly reduced, replaced by telehealth. Combining that with requirements for a Covid-safe environment forces reconfiguration of office space, and extension of work hours and work days. ORs are already functioning through weekends, and will be indefinitely. Working remotely will decline but may not disappear. Diagnostic evaluations must be completed in the smallest possible number of physical encounters, at CUIMC or at offsite locations in the region. Many of these changes may be permanent, many will be expensive, and our revenue is still far behind. On balance, I believe we will find the Department’s new normal to be far better than the old normal, but it will take time and toil to get there.

Like other restaurants near my home, Underhill’s Crossing has converted to take-out. They included a large, freshly cut daisy in one order. Impossible to let such a brave little emblem wilt and die, so into a vase it went. Two weeks later it’s a perky survivor, thanks to our therapeutic water, its own industrious xylem, and the power of transpiration. Our daisy is not noticeably depressed by the prospect of dying alone in our kitchen as just another pretty thing, with the procreation part of its flower-mission unfulfilled. But who knows? After it’s thrown out, seeds might land somewhere.  Hope dies last if you have the strength for it.

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