Editor’s Note: Since the onset of the COVID-19 pandemic, neurosurgeons have helped bring aid and comfort to neurosurgical patients and those suffering from the novel coronavirus. Today, on Memorial Day, we wish to salute the efforts of the men and women serving in our U.S. Military, who, too, have provided comfort and mercy during this national emergency. On this day and always, you have our unwavering gratitude for your dedication and service.
I’ve been asked to comment about my experience mobilized in the military reserve in response to the COVID-19 pandemic. I do so without named authorship secondary to the fact that the mission is ongoing, and the focus should be on a genuinely profound group effort.
Bluntly, the United States military responded in a big way with a large and immediate tri-service response. It’s truly been incredible to see, and it’s been an honor to play a very small part. Nearly 1,600 U.S. Navy Selected Reserve Sailors have deployed globally to fight COVID-19.
The U.S. Navy has developed a neurosurgery presence on both the United States Naval Ship (USNS) Comfort and the USNS Mercy. The USNS Comfort has aided the effort in New York City while the USNS Mercy has helped in Los Angeles. Both undertook evolving missions to best help the civilian hospitals. The mission morphed as necessary from off-loading non-COVID-19 patients, to acting as a trauma and emergency surgery center, to ultimately focusing on treating COVID-19 patients. The leadership has been adaptive to the needs of the community. There are a lot of good people who are doing very impactful things with both missions. Navy Reserve neurosurgeons aided in neurosurgical coverage and general surgical call responsibilities on each of the ships with excellent mentorship from their active-duty counterparts as well as the Navy Reserve neurosurgery specialty leader.
The United States Army has also helped create a field hospital at the Javits Center with an ideal maximum capacity of up to 2,500 beds. This was mostly to off-load more stable patients with COVID-19, but the facility also had intensive care unit (ICU) capabilities. The Navy Reserve Expeditionary Medical Force Bethesda supported the medical relief efforts at the Javits Federal Medical Station with a top to bottom 400 sailor hospital staff unit. There was no neurosurgery occurring at the Javits Center, as the focus was on COVID-19. Other similar sites throughout the U.S. were also established.
Other Navy Reserve doctors and nurses are embedded into the New York City public city hospitals that have been decimated with COVID-19. Navy Reserve doctors and nurses are joining their civilian counterparts in treating COVID-19 patients in hospitals where they are most needed. Many are acting in new and expanded roles due to the dramatically increased ICU needs. The shortage does not call for additional neurosurgeons to perform neurosurgery but for additional coverage in overflowing ICUs. These are very sick patients, and neurosurgeons have a tremendous possibility to do some good within this structure. As our medical critical care colleagues take a pounding, neurosurgeons are very comfortable in the ICU, in treating critical patients, in dealing with mortality and in leading large health care teams to make pragmatic, direct and impactful decisions. Indeed, the Joint Section on Neurotrauma and Critical Care of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) issued guidelines to help neurosurgeons managing COVID-19 ICUs. The Navy has been tremendous in organizing teams across multiple specialties to do just that work.
Neurosurgeons who no longer desire the ICU could also consider joining their hospital’s prone team to help flip acute respiratory distress syndrome (ARDS) type patients with COVID-19 throughout the hospital. These teams generally travel from unit to unit to supine and prone the sickest of the respiratory patients in the hospital. Anesthesiologists head these teams due to airway concerns, but they also include orthopaedic, spine and other surgical specialists comfortable in positioning complex patients. It is truly a service that makes a tangible difference when managing these patients within the ICU.
It goes without saying that service in the Navy Reserve rests upon the service of others. Colleagues back home have taken additional emergency call, increased their workload and served the local community in similar ways. Even more so, spouses have to work overtime at home, especially those with small children and those juggling their own virtual careers. Multiple people have come together in numerous ways to serve the people of New York City. And, the welcome in New York City has been one of deep gratitude both inside and outside the hospital.
The objective impact of the Navy Medical Response Team will be measured in patients treated, intubations and central lines. However, the subjective impact has been even more important. The military members here have truly made a difference fighting an invisible enemy.
*This is the author’s opinion only and in no way reflects the thoughts or opinions of anyone else in the United States Navy. It does not represent the official policy of the United States Navy, the Department of Defense or the United States Government.
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.
