“Death, be not proud, though some have called thee.
Mighty and dreadful, for thou art not so.”
John Donne

The COVID-19 pandemic is a generational event. It has disrupted every aspect of modern life. Businesses are shuttered. Schools and universities are closed. Social distancing has altered our normal mores for connecting with our neighbors, friends and colleagues. Although many in medicine are dramatically affected by the pandemic as they are on the ‘front lines’ of the crisis, the pandemic has had a ripple effect through the entire health system.

Neurosurgery is no exception. The pandemic has been a significant disruption to the way neurosurgeons interact with and care for their patients. It has been remarkable how the medical community has come together and has been able to pivot on the spot to adjust the way we deliver care to our patients. There certainly is no single best approach, and there’s much to learn from each other.

Over the next several weeks, the Neurosurgery Blog will highlight some of the ways that COVID-19 has affected our practices, our lives and how many in our specialty have responded to the challenge.

We began by highlighting the experience of colleagues from the University of California, San Francisco — who proposed a way to manage neurosurgical cases in The Coronavirus Disease 2019 Global Pandemic: A Neurosurgical Treatment Algorithm. We also shared an overview of The Global Impact of COVID-19 on Neurosurgical Practice, Parts I and II, as recorded by several reports in the Journal of Neurosurgery (JNS). Both the JNS and Neurosurgery will provide weekly COVID-19-related updates from neurosurgeons from across the world.

Neurosurgeons have been personally affected by the virus with results that speak both to the tragedy of the current situation as well as the hope of recovery. Tragically, our specialty lost James T. Goodrich, MD, PhD, from New York City, who died from complications of COVID-19, and we take the opportunity to celebrate his life and achievements.

Neurosurgeons are also playing various clinical roles during this crisis. Aiming to protect patients and create surge capacity, surgeons have been asked to manage their patients and practices by abiding mandatory orders halting elective surgery. Scott A. Meyer, MD, FAANS, will share his experience in “Keeping Neurosurgical Practices Operating During COVID-19 and Beyond,” an issue that is undoubtedly vital for those who practice in solo or small group practices.

Others have been asked to assume alternate roles for their health system as demand requires, which will be discussed by S. Alan Hoffer, MD, FAANS, in “COVID-19 Answering the Call: From Neurosurgeon to Critical Care Physician.” Myron Rolle, MD, will report on “Neurosurgeons on the COVID-19 Frontlines,” based on his experience dealing with one of the epicenters of the outbreak in Boston. Shelly D. Timmons, MD, PhD, FAANS, will be tackling another very tangible aspect of this crisis — the lack of personal protective equipment (PPE) — in “SOS: Send More PPE Now!”

Neurosurgery has also responded by adapting the way we care for and interact with patients and colleagues. These last four weeks have seen an unprecedented expansion of the use of telemedicine at a rate perhaps higher than over the previous decade. Of particular practical interest may be “Telemedicine: During the COVID-19 Pandemic and in a Changing Health Care System” by John K. Ratliff, MD, FAANS, and Clemens M. Schirmer, MD, PhD, FAANS.

COVID-19 has also had a profound effect on medical education on all levels. Face-to-face interaction and departmental teaching and working conferences have been eliminated. The need to keep training going has been a driving force to explore other ways to deliver education. Ashok R. Asthagiri, MD, FAANS, and the CNS education team, will share some lessons and experiences in “Innovations in Continuing Medical Education in a COVID-19 Environment.” In addition to issues related to continuing medical education, we will hear from medical students and residents from two programs in New York — Mount Sinai and the University of Rochester — highlighting how the crisis has affected their training and what the future may hold for those medical students with ambitions to pursue our specialty.

Finally, our former Neurosurgery Blog editor, Deborah L. Benzil, MD, FAANS, also tries to look forward to the end of this crisis and moving forward through her piece “Hope and Recovery, Life After COVID-19.”

We hope to highlight some of the resolve and resilience that neurosurgeons have brought to this crisis in service to our patients. It is too early to tell whether we can simply return to normal or whether a new normal state must be found in the aftermath of the pandemic.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following and using the hashtag #COVID19.

Clemens M. Schirmer, MD, PhD, FAANS, FAHA
Chair, AANS/CNS Communications and Public Relations Committee
Geisinger
Wilkes Barre, P.A.

 

 

Kristopher T. Kimmell, MD, FAANS
Vice-chair, AANS/CNS Communications and Public Relations Committee
Rochester Regional Health
Rochester, N.Y.

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