Archive for June, 2020

 

Jun 26 2020

Life in the Time of Corona(virus) – Day 103

by at 7:30 am

The weird paradox continues. Our inpatient burden of COVID-19 patients continues to drop both here and throughout the MedStar Health system. I do see masks around town, though some people don’t use them. Obviously, I don’t agree with those who choose to not wear masks. However, I simply cannot fathom people who scream that their sacred rights are impinged upon if mask-wearing is public policy based upon sound science. Frankly, I think those people are selfish and foolish, perhaps catastrophically so.

Some of the most obnoxious dissenters are in Florida, which keeps racing towards a health care apocalypse, followed by a number of other states. A few simple acts of leadership at the state and national levels could have prevented or limited behaviors that can only accelerate the disaster. Not only would such leadership have been effective, it would have been broadly accepted.

This is not a debate about religion, freedom or elections when lives hang in the balance. It is about the explicit and implicit social contracts that make societies work. Be free, but not if your exercise of freedom causes harm to others. It’s not so complicated. Too many innocents are being led to slaughter by false prophets.

Meanwhile, life continues. Ken, Sarah and their kids seem very happy in their new home. Harriet and I will be celebrating two residency program graduations — simultaneously — for our son David (at a socially distanced dinner) and our daughter-in-law Sarah (by Zoom). This is one moment when the Zoomiverse comes in handy.

Work continues too. There was a wonderful meeting on Wednesday evening, highlighting fantastic translational science by David Perlin and colleagues in New Jersey, with vibrant participation by clinical investigators. We came away with wonderful ideas for future investigator-initiated clinical trials. On Thursday we were treated to a Cancer Data meeting presentation by recent recruit Joyce Slingerland, who gave a wonderful seminar about her work to untangle the influence of obesity on ER+ breast cancer. This was the last Data Meeting for the academic year; I don’t know about you, but I will miss the opportunity to come together for scientific feasts.

It has been a crazy few months, as we deal with coronavirus, economic challenges, health care delivery paradigm shifts, Instacart, reruns of old football games, Doordash, educational and research obstacles, racism, life and working (really hard) from home. And we thought this year would be all about the presidential election! It’s time for a breather. I am going to take a blog break until after the July 4 holiday weekend. It will be a bit of a working vacation, and I will try to hold my Zoom calls to no more than five hours per day. Some vacation!

Stay safe, and be well.

Lou

One response so far | Categories: Uncategorized

Jun 24 2020

Life in the Time of Corona(virus) – Day 101

by at 7:30 am

Lots going on so far this week. The request forms for research resumption are available via GMS, and I have submitted our own lab’s request and am busily reviewing a large number of requests from Lombardi PIs. We don’t yet have a “go live” date, as we await formal submission of the University’s plans for research resumption to the DC government. However, I don’t think it will be much longer. Coronavirus-based hospitalizations have not surged over the past week, so I hope this means the District will be favorably inclined to accept a responsibly executed plan.

In the meantime, please remember that this initial re-entry will be what restaurateurs would call a “soft opening,” with no more than 25% building occupancy at any one time, and careful adherence to physical distancing principles. Labs that ignore or flaunt the rules will risk contracture or temporary closure; we are obligated to be quite serious about the rules of re-engagement.

Today was very bittersweet for Harriet and me. Our son Ken, daughter-in-law Sarah and their children, Ella, Eli and Isabel, moved back to the Philadelphia suburbs, where Sarah will start her dermatology career. We are thrilled for her and for them, but having them nearby for the past three years has been an undiluted joy. We will miss them, but look forward to many chances to be with them in the future. Apparently, we have our own bedroom in their new house. Our son David, daughter-in-law Kelly and granddaughter Clara decamp for Manhattan next month for his one-year spine surgery fellowship; happily, they’ll be returning to DC after that. Friday night will be bizarre; we have to attend a small, physically distant goodbye dinner for Dave from his orthopedics program in Baltimore, while simultaneously attending Sarah’s goodbye party (a Zoom event) from her dermatology residency program at Georgetown. Poor Elana and Ben and their kids Isaac and Aviva will bear the brunt of our grandparental attention in Baltimore over the next year. Lucky us!

Amidst all the news emanating from the political sphere over that past few days, I can’t shake my concerns regarding the pause in granting H-1B visas. These visas have been incredibly important to both medicine and research over the past 30 years. Countless gifted, driven and effective physicians and scientists with H-1B visas have helped drive innovations in science and medicine, and many chose to stay in our country, infusing it with the hybrid vigor that is one of the core elements, if not the actual secret sauce, of our country’s durable greatness.

This terribly shortsighted decision will have little impact on employment figures in this time of COVID, but anything that blunts the possibility of transformative change takes us in the wrong direction. To my many immigrant colleagues and friends, I urge you to stay the course, for this misbegotten policy, and the attitudes that underlie it, are not reflective of the America I know and cherish, and that needs you.

Stay safe and be well.

Lou

No responses yet | Categories: Uncategorized

Jun 22 2020

Life in the Time of Corona(virus) – Day 99

by at 7:00 am

So much for quiet weekends. I write this blog late on Saturday evening, amidst political and social turmoil supercharged by a large indoor political rally that flies in the face of public health guidelines and common sense, in a city beset with an increasing coronavirus burden. I just hope this does not become another Charlottesville, and also that Tulsa, which once boasted a thriving economic district known as “Black Wall Street,” does not become another New York, at least in the pandemic sense. I, for one, have had my fill of super-spreaders.

I am writing today because my Friday blog was canceled in recognition of the university’s first annual remembrance of Juneteenth. I am not writing on Sunday because that is Father’s Day, and we are driving up to Philadelphia to see my dad. He has been hanging in there, though I would not characterize him as having rallied. We are grateful for the opportunity to be with him. Our physically distanced visit will be preceded by a stop in Baltimore for an outdoor breakfast with Elana and her family, and followed by a physically distant visit with David, Kelly and Clara, whom we have not visited with since early March. Today, we sat on the deck with Ken and his family, who move to the Philadelphia area on Wednesday. No hugs — not yet. But the people we love always look better in three dimensions.

Hugs will come. There has been a continuing drop in the number of hospitalized patients in our local hospitals, meaning that the first stage of relaxation of physical distancing did not increase our community’s infection rate. As we head into the next phase, beginning on Monday, I hope this encouraging trend continues. In today’s message from Georgetown’s executive vice presidents it seems we still have a bit of work to do before we relax our internal guidelines, but hopefully we are not too far away.

Stay safe and be well.

Lou

No responses yet | Categories: Uncategorized

Jun 17 2020

Life in the Time of Corona(virus) – Day 94

by at 7:30 am

As we navigate the anxious monotony of life in the time of coronavirus, the big news this week for Georgetown (so far) is that we are planning for resumption of research, contingent upon approval of Georgetown University’s plans by the District of Columbia. Becca Riggins has been a key member of the task force dedicated to research resumption, and she has kindly shared the following information with me for distribution. Thanks, Becca, for your fabulous work on our behalf!


Research Restarting Plans

As we heard at Monday’s Restarting Research Town Hall, each PI will be expected to submit a plan for resuming research in accordance with the guidelines outlined in the document: “Restarting Research Activities at Georgetown: a phased approach” shared with the research community on June 11.

Within a week, we anticipate a portal to go live in GMS where this plan must be submitted.  We are providing you with this link to the draft questions so that you can begin preparing now.

When the online form in GMS is completed, it will be submitted to your Department Chair. Final approval of plans will be made by the Dean, in consultation with the Chair and other authorities.

Please note — approval of your research resumption plan does not constitute permission to restart or increase your research activities until formal DC government approval to do so has been granted.


 

There is light at the end of the tunnel. Please remember to stay safe and be well so you can enjoy what happens next.

Lou

No responses yet | Categories: Uncategorized

Jun 15 2020

Life in the Time of Corona(virus) – Day 92

by at 7:30 am

Greetings on a beautiful Sunday morning. I don’t know how you feel, but it seems odd to have a relatively quiet weekend. I am grateful for the reprieve, which I imagine will be temporary. However, the existential challenges of this moment have not changed. I can’t decide if enjoying a beautiful weekend is a good thing that is necessary for our communal mental health, or if this represents a looming complacency that could have terrible long-term implications.

Another defenseless black man was killed by a police officer in Atlanta a few days ago; this happens with mind-numbing frequency. The act had immediate, swift consequences. That represents a form of progress, and we have to start somewhere, but if you’ll forgive me an oncologic analogy, addressing police violence is akin to treating a cancer patient with narcotics to relieve unbearable pain. The pain medicines help and they are necessary, but they do not eliminate the root cause of the malignancy. Dr. King would be proud that the protests have continued, appear sustainable as a movement and are nonviolent. However, I believe he would only be satisfied if the recognition of this violence becomes a catalyst for change, not only in policing, but also in moving closer to a time of color-blind access to accomplishment, safety and justice.

It is wonderful to see people up and around, eating outside in restaurants and going to the beach. However, SARS-CoV-2 continues its grim march through the United States, having left a trail of destruction through our region, and is now attacking Florida, Texas, Arizona and many other states with renewed vigor. In some states, like Florida, premature relaxation of social distancing led to a surge of cases, and our friends in Tampa have returned to sheltering at home. Don’t be surprised if we have to do the same thing in a few weeks. This is not over.

Cancer is not over either. About 4,800 Americans will have died of cancer in the time that elapsed between my Friday blog and today. And in May, we lost a mutual friend to cancer. As a guest blogger here, Allan Butler moved so many of us with his piece about the cancer treatment experience at the hospital during the time of COVID-19 back in April. His courage was on full display through his artful words. We wish his family the very best.

I can’t wait to get back to that fight full-time, and look forward to our Monday noon meeting regarding research resumption at GUMC.

Stay safe and be well.

Lou

No responses yet | Categories: Uncategorized

Jun 12 2020

Life in the Time of Corona(virus) – Day 89

by at 8:38 am

Inpatient numbers of COVID-19 patients continue to decline here at MedStar Georgetown, but in other parts of the country the news is not so good. The tide continues to rise in Texas and elsewhere. This virus is going to be with us for a long time. I know that we all want to believe that the worst of this first wave is behind us and we can begin to resume normal life. However, there is talk of going back into lockdown in several cities in our heartland, and I know from my former graduate student Reham Ajina that surges in cases in Saudi Arabia have precipitated new restrictions. So, before you fire up the grill this weekend, please resist the urge to have a party. There will be time for that at some point.

For that reason, today’s Partners in Research session could not be more timely. The first virtual meeting of this longstanding series, the focus is — wait for it — COVID-19. I will be moderating a virtual panel discussing the GUMC research response to the pandemic. Our panelists include Moshe Levi, Mike Atkins and Rebecca Katz. It should be a fascinating hour, and we expect a lot of questions from our virtual attendees.

I plan to write three blogs per week moving forward — by now you have surely read enough from me.

Stay safe and be well.

Lou

No responses yet | Categories: Uncategorized

Jun 11 2020

Life in the Time of Corona(virus) – Day 88

by at 10:00 am

It is hard to know the direction of this pandemic. Hospitalizations in our area continue to decline, even as they rise elsewhere in the United States. Washington is gradually opening up, and outdoor seating restaurants are sprouting up on closed streets in Bethesda. Many of us worry about a coming surge following Memorial Day activities, the recent protests in our region and the relaxation of social distancing. Nobody quite knows what to do, so it is good to be careful.

In that spirit, we have received the most welcome news that it is time to begin planning for a gradual, measured reopening of GUMC research labs. We will learn more about what that means and how to proceed at a GUMC Town Hall on Monday, June 15, from noon to 1 p.m. I encourage everyone to attend that virtual meeting (which you can join via this Zoom link).

It is good to know there is movement, but please remember that this particular freedom will carry with it a great deal of responsibility to remain attentive to basic principles that will protect all of us.

I also want to note that Tuesday was a day for many of us to consider the ugly toll of racism in our country as members of the scientific community. Let’s resolve to make every day one where there is just a bit more sensitivity and action to reduce discrimination in all its forms. We can do this, and we can lead the way.

Stay safe and be well.

Lou

No responses yet | Categories: Uncategorized

Jun 10 2020

Life in the Time of Corona(virus) – Day 87

by at 7:30 am

He couldn’t breathe. One of the 491 Americans who died from COVID-19 on Monday, June 8 did so in an ICU, lying prone, surrounded by strangers, all of whom had tried so hard to save his life. Nobody who loved him could be with him when he needed them most. He died alone.

He couldn’t breathe. This man was held down on a pavement by people sworn to protect him, while one of them forced the breath of life out of his inert body. In the background were horrified strangers, many of whom pleaded for his life, even when he could not. Nobody who loved him even knew he was being murdered. He died alone.

You might think I have created an analogy of convenience, but bear with me here. Certainly, death from COVID-19 occurs despite astonishing benevolence, while this murder provides a textbook example of malevolence. But, in many ways the root causes are not so different.

COVID-19 was destined to spread, and it was going to kill. But consider this: Mitigation strategies are estimated to have prevented 60 million cases, and by extension perhaps 1.2 million deaths (2% of the cases). How many more deaths might have been prevented with more effective, coordinated governmental action? Early action, better social distancing, more masks, more PPE, widespread testing, aggressive drug and vaccine development — all of these were possible, and any would have helped. This was a failure of leadership, grounded in the principle that government is the enemy of the people. However, Lincoln said it best: Government is of the people, by the people and for the people. It does not exist just for the benefit of rich white men.

Over the past 40 years the political battleground has sadly morphed from a debate between big vs. small government to one of small vs. no government. COVID-19 has taught us that small government is bad, and no government is cataclysmically horrible. The people did not want this to happen, but our national political leaders did not care, or did not want to care — at least not enough. We cannot bring back the lives of those we’ve lost, but with effective government we can do something about the next big challenge we face — be it infectious, environmental or military. The great thing is that we — each of us — can do something about this problem by having a heart-to-heart with our hearts, and then voting as if our lives depend on it. Because they do.

The murder of George Floyd was the product of cynical malevolence that has infected society and all of its sacred institutions, with the possible exception of the military. On balance, too many people have either liked it this way or have ignored the uncomfortable truths of institutionalized racial intolerance. There were consequences. We got the government we deserved, one that is paralyzed by rancor and animated by the devils of our worst selves. This animus permeates everything from police precincts to school boards, all the way to the halls of Congress and the West Wing, and then back again. This societal cancer was not invented in 2016; it is the predictable product of 400 years of systemic dehumanization of our fellow countrymen and citizens.

But we are having a moment — a special moment — when the people of this country are sensitized to the evils of intolerance and are open to change. We need a government that embraces this moment, sustains it and catalyzes urgently needed change. There has never been a better moment to have that heart-to-heart with your heart. Vote, and when you do, remember George Floyd, who was solemnly laid to his untimely final rest today. Honor his memory and his sacrifice by doing what you can to bend that arc of history more fully, and in the direction of justice.

Stay safe and be well.

Lou

No responses yet | Categories: Uncategorized

Jun 09 2020

Life in the Time of Corona(virus) – Day 86

by at 8:47 am

I am taking a blog break today. Stay safe and be well!
Lou

No responses yet | Categories: Uncategorized

Jun 08 2020

Life in the Time of Corona(virus) – Day 85

by at 9:19 am

In the past two weeks, bright light has shined on racial injustice in the United States as never before. Earlier generations relied upon word of mouth, books, magazines and newspapers. Photography captured moments frozen in time. More recently, newsreels, radio and TV gave injustices more physical immediacy, but it was too easy to sweep under the rug the barbaric behaviors that society preferred to keep hidden. There have been so many murders, and many more lesser, but abhorrent, acts of intolerance. Add to those atrocities the countless unrevealed acts of domestic abuse, and non-domestic abuse of women and children. But something has changed, and there is no putting this genie back in the bottle.

At first, body cams revealed acts of police brutality. But, the transformative change has been the increasing use of cell phone cameras, which provide instantaneous, indisputable documentation that can be disseminated broadly. Two brutal murders, one by vigilantes, another by a police officer, have galvanized society. Here in our region, an enraged adult abused a few teenagers on a bike path, with the whole ugly scene captured in living color by another teenager. Two outrageous acts, and one that was simply boorish; all now live forever on the internet, and thus in our memories and consciences. Each one of us would do well to imagine that everything we do — be it in our public or private lives — is apt to be posted somewhere, and that we are accountable for our behaviors. This loss of privacy is more than a bit chilling to contemplate, but if acts of racism, “Me Too” behaviors and violence are increasingly subject to essentially contemporaneous public review, it is likely that we will be increasingly obligated to listen to the calls of our better angels. That will be a good thing.

Racism is aptly termed the original sin of America, and despite its unbearable and seemingly intractable legacy, a few cell phone videos have galvanized our nation. This gives me hope. Our country has faced pandemics before, but the immediacy and impact of coronavirus, amplified through social media platforms using cell phone videos, similarly galvanized our society as never before. Prevention and curative therapies are on the not-too-distant horizon. We in medicine have roles to play in these healing processes, and it is not just through scientific inquiry and the provision of medical care. I am so proud of Georgetown’s participation in #WhiteCoatsForBlackLives this past Friday.

We can and must confront and address racism in all its forms, and we will overcome coronavirus. We also will beat cancer, of course. None of these challenges are easy, but they all demand that we be at our very best.

Be safe and stay well.

Lou

No responses yet | Categories: Uncategorized

Next »