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Faces of Neurosurgery

The Global Impact of the COVID-19 Pandemic on Neurosurgical Practice (Part II)

By AANS Spotlight, COVID-19, Faces of Neurosurgery, HealthNo Comments

The American Association of Neurological Surgeons (AANS) and the Journal of Neurosurgery Publishing Group are pleased to announce the publication of eleven new editorials on the impact of the COVID-19 pandemic on neurosurgical practice. The series kicked off last week with three editorials and an introduction on the subject, which were published in the Journal of Neurosurgery and the Journal of Neurosurgery: Pediatrics.

Last week we heard from neurosurgeons in the United States, Canada, Italy and China on the impact of the pandemic on neurosurgical practice. This week’s installment adds editorials from the U.S., Republic of Korea and Singapore.

The editorials cover a wide variety of important areas demonstrating the impact of COVID-19 on the practice and training of neurosurgeons. Although other fields of medicine more readily come to mind when considering the battle against the virus known as SARS-CoV-2, neurosurgical practice has also had to adapt swiftly in response to the COVID-19 pandemic.

The following articles cover neurosurgeons’ experiences and lessons learned thus far during the COVID-19 pandemic:

Join us in reading these free articles.

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.

April 17, 2020
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The Global Impact of COVID-19 on Neurosurgical Practice

By AANS Spotlight, COVID-19, Faces of Neurosurgery, HealthNo Comments

The COVID-19 pandemic has significantly impacted medical practice across the globe. The effects are most notable in the fields of infectious disease, virology, emergency and critical care medicine, and epidemiology. Other medical specialties, including neurosurgery, however, are also impacted.

To highlight the effect of the pandemic on the neurosurgery practice, the Journal of Neurosurgery Publishing Group (JNSPG), the scholarly journal division of the American Association of Neurological Surgeons, is releasing a series of editorials on the impact of the COVID-19 pandemic on the practice of neurosurgery.

Douglas S. Kondziolka, MD, FAANS; William T. Couldwell, MD, PhD, FAANS; and James T. Rutka, MD, PhD, FAANS, introduce the series and highlight the impact the pandemic has had on neurosurgical practice. Three editorials are available, and additional papers on this topic will appear each Friday, so be sure to check back weekly.

Yirui Sun, MD, PhD, and Ying Mao, MD, PhD, provide an update on the pandemic in China. They speak of colleagues lost and the efforts of neurosurgeons to treat emergency cases regardless of the viral status of their patients. The authors also discuss how COVID-19 has given them “pause to reinforce [their] skillsets and redesign [their] mindsets to perform roles not only as neurosurgeons but also as executive officers.”

Marco Cenzato, MD, and colleagues speak from the Lombardy region of Italy. They describe a reorganization of neurosurgical facilities to expand the number of ICUs available to COVID-19 patients. Fifteen neurosurgical departments were temporarily consolidated into three locations, with neurosurgeons and patients shifted as well. As a result, “opening the hospital doors to neurosurgeons coming from other institutions has offered an unprecedented opportunity of collaboration and integration of teams.”

Leaders of the American Society of Pediatric Neurosurgeons address current management of COVID-19 in the pediatric neurosurgery community and provide recommendations on the preparation and response to the pandemic. Crucial areas addressed in their recommendations include children’s hospitals as a whole, operating rooms, pediatric neurosurgery clinical teams, and patients. Serious illness remains relatively rare among children with COVID-19. Nevertheless, the authors warn against complacency and stress the need for urgency in preparation and response to the pandemic.

Neurosurgeries must be prioritized, delaying less urgent cases so that increased hospital facilities and equipment can be made available for patients with COVID-19.

The COVID-19 pandemic has wreaked havoc in the lives of people across the world. The numbers of cases and deaths from the disease continue to climb at a rapid pace. Many deaths have occurred among health care workers. On both a personal and professional level, the JNSPG editors acknowledge, with sadness, the passing of fellow neurosurgeon James T. Goodrich, MD, Chief of Pediatric Neurosurgery, Montefiore Medical Center, New York City, from complications related to COVID-19 on March 30, 2020.

April 10, 2020
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The Coronavirus Disease 2019 Global Pandemic: A Neurosurgical Treatment Algorithm

By CNS Spotlight, COVID-19, Faces of Neurosurgery, HealthNo Comments

The COVID-19 pandemic is disrupting neurosurgical care at medical centers throughout the United States. Institutional and governmental recommendations are not specific to neurosurgery. Protocols are urgently needed to help neurosurgeons triage cases based on acuity, and also to minimize the risk of infection for both patients and peri-operative medical staff. In many academic tertiary care hospitals, there is limited personal protective equipment and staffing shortages.

Given that there is insufficient data to create formal guidelines, physicians from the University of California San Francisco (UCSF) Department of Neurological Surgery and Department of Anesthesia have presented their institutional neurosurgical treatment algorithm during the California COVID-19 shelter in place order. The UCSF protocols are based on outbreak “surge levels,” and using these levels to guide operating room utilization based on the acuity of neurosurgical cases. The protocols and checklists from UCSF, which are published online in Neurosurgery — the official journal of the Congress of Neurological Surgeons (CNS) —  offer some guidance to neurosurgeons in other centers.

Click here to read “Letter: The Coronavirus Disease 2019 Global Pandemic: A Neurosurgical Treatment Algorithm.”

The CNS also offers a related webinar presentation, “UCSF’s Experience with COVID-19 in the Midst of the California Shelter-in-place Order.”  Click here to view the webinar.

John F. Burke MD, PhD
Resident, Neurological Surgery
University of California San Francisco
San Francisco, California

 

 

Praveen V. Mummaneni, MD
Professor, Neurological Surgery
University of California San Francisco
San Francisco, California

April 3, 2020
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AANS Neurosurgeon Spotlight: Winter 2020 – The Mind of a Neurosurgeon Part III

By AANS Spotlight, Career, Faces of Neurosurgery, Food for thoughtNo Comments

From training appraisal to relocation, authors explore the neurosurgeon perspective in AANS Neurosurgeon’s The Mind of a Neurosurgeon. Prominent neurosurgeons discuss their unique experiences in a field in which few have the opportunity to work and thrive.

Changing Gears: Mid-Career Relocation as a Catalyst for Better Patient Care
Daniel Orringer, MD, FAANS

  • Inspirational leadership; state-of-the-art facilities; a cumbersome electronic medical record; affiliation with a top-notch medical school; and a culture and history of excellence.
  • Navigating geographic change – from Ann Arbor to New York.
  • Navigating institutional change – evaluating essential components of a routine.
  • A new team – leading with the patients’ interest in mind.

The Mindful Neurosurgeon and the Art of Doing What’s Right
Edward C. Benzel, MD, FAANS

  • The desire for personal gratification, professional advancement and monetary gain can lead one to their neurosurgical calling.
  • The mindful neurosurgeon does not look at a job from the perspective of the job being a commodity generator, but from the perspective of the job as a calling.
  • Good leaders are selfless guides, reflective and empathetic.
  • The truly mindful neurosurgeon values doing what is right over all else.

Building the Neurosurgical Mind: Critical Appraisal in Neurosurgical Training
Beverly C. Walters, MD

  • Neurosurgical training goals focus on specialty knowledge acquisition, development of technical skills involving eye-hand coordination, learning how to collect important patient data and enhancement of critical thinking ability.
  • Look at the structure of research that tries to promote changes in practice to develop skills in evaluation of data and to be able to decide, factually, whether the ideas are worthy of inclusion in clinical practice – or, more importantly, if they are not worthy.
  • This basic concept of understanding the successes and failures of clinical research in our specialty and development of the ability to use data in the treatment of patients became known at the end of the twentieth century as evidence-based medicine.

Read More from The Mind of a Neurosurgeon.

February 6, 2020
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