As the coronavirus (COVID-19) continues its spread across the world, the medical community is closely monitoring events, regularly updating policies and protocols, and enacting preparedness plans in response to the ever-changing information and in collaboration with local health agencies.
The effects on physicians and other health care professionals, as well as hospitals and health systems, are deep and broad—from rescheduled elective surgeries and routine appointments to an influx of patients to limited availability of certain medical supplies and drugs. Cardiothoracic surgeons are among those who are navigating the growing impact of COVID-19 and embracing the changes, which are happening by the minute.
Dr. Vinod H. Thourani describes how the coronavirus pandemic is affecting cardiothoracic surgeons and their patients and how the specialty is uniquely equipped to handle the high-intensity work of actively managing COVID-19 patients.
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By Dr. Vinod H. Thourani
In my wildest dreams, I would not believe that I would be asked to write a blog article on a virus that has inflicted its wrath on the world. Quite honestly, when I first heard about this virus, I was not worried. In my naïve world, I thought this was just another saga of over-dramatized news.
As we now are in the 7th week of this pandemic, boy was I wrong! I am awestruck at how we as a household, as a hospital, as a city, as a nation, and as a human species have come together to fight a common enemy. In this article, I reflect on day-to-day activities as a cardiac surgeon and intensivist during this pandemic.
With decades of training and background, cardiothoracic surgeons are unique in that we are capable of managing every aspect of critically ill patients. My colleague, Peter W. Barrett, MD, MS, was already running an extremely busy ECMO and high-risk cardiac surgical unit prior to the pandemic, which prepared our team for the needs and stresses of COVID-19. Moreover, he has spent countless hours cannulating patients for ECMO support, airway and ventilator management, daily bronchoscopies—all skills at which cardiothoracic surgeons excel! We were born for this high-intensity work.
During this pandemic, we’ve gone back to the fundamentals to understand the basic pathophysiology of this virus. In order to help COVID-19 patients, Peter is managing them from head to toe. Just as we would with the toughest postoperative patients, we have employed extremely active management of these patients.
Peter has reassured our CVICU nursing and operating room staff that we are all in this together. Cardiothoracic surgeons are inherently seen as leaders of the wards, operating suites, and intensive care units, but during this pandemic, we must equally show our humanistic and collaborative sides. From time to time, Peter has gone beyond the traditional doctor role and directly helped nurses with caring for these difficult patients. He has encouraged our environmental support staff and thanked them for the work they are doing in the ICU. He has had to take a crash course on virology while also reading the rapidly emerging COVID literature in order to help our hospital staff decipher and interpret the litany of studies and, most importantly, decide which treatments to use for our patients.
In addition to the COVID-19 patients, there are patients at home who are waiting with fear and trepidation because their elective surgeries were canceled or postponed. It’s important to reassure these patients that they won’t have to suffer with chest pain or shortness of breath too much longer. Let your patients know that when the time comes for their surgeries, your physicians and hospital systems will be ready, and the staff will deliver the outstanding care they expect. Assure them that we will work through these unprecedented times with humility, grace, and the utmost respect for each other.
On a personal note, remember and count your blessings as you reconnect and deepen family bonds. Pick up those hobbies you set aside. Remember—to be entrusted with the care of a fellow human being in his/her most vulnerable time is a blessing, an honor, and a privilege that few people have.
You have a lot to offer; do the right thing. And most importantly, don’t forget to smell the roses.
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Dr. Thourani is available to discuss the changing roles of cardiothoracic surgeons on the front lines of the COVID-19 crisis.
Dr. Barrett is available to discuss the importance of ECMO in treating COVID-19 patients.
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Vinod H. Thourani, MD, is the Bernie Marcus Chair of Cardiovascular Surgery for Piedmont Healthcare and the Marcus Heart Valve Center. He previously served as Chairman of the Department of Cardiac Surgery at MedStar Health and Professor of Surgery at Georgetown University. Dr. Thourani specializes in valve surgery, specifically in minimally invasive and transcatheter aortic and mitral valve surgery.
Peter W. Barrett, MD, MS, is the Director of Cardiovascular Critical Care and Director of ECMO Services at Piedmont Healthcare. He also is the Director of the CVICU at Piedmont Atlanta Hospital.
The opinions expressed in this article are those of the author and do not necessarily reflect the views of The Society of Thoracic Surgeons.
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