Archive for July, 2020

 

Jul 31 2020

Life in the Time of Corona(virus) – Day 138

by at 7:30 am

If you were one of the many hundreds of attendees at Thursday’s research resumption meeting, you know the plans. There will be a gradual reopening, and its success will depend upon our collective responsible behavior. For now, all didactic learning will be virtual. Coronavirus marches on, even as an elected member of the House of Representative wonders if his case of COVID-19 was caused when he was forced to wear a mask. I guess he just does not want to be confused by the facts. It’s no wonder that the pandemic is thriving in our country, where foolish thinking has led to inadequate, uncoordinated action by the federal government and given license to undisciplined, irresponsible personal behaviors.

Speaking of collective responsibility, I took a brief midday break after seeing a few patients using the TeleHealth platform and watched part of the deeply moving funeral of John Lewis. Three living former presidents attended and spoke. Former President Carter could not be there but sent beautiful prepared remarks. One president apparently chose to not be there to celebrate the life of this remarkable man. The speeches were eloquent, but the most powerful and moving statements were from Rep. Lewis himself, who arranged for his self-written eulogy to be published today in the New York Times, timed to coincide with his funeral. Even though he is gone, the memory of his example and the majesty of his words live on, and it may well be that history remembers him with greater attention and appreciation than all of those presidents. He made me reflect on the American form of apartheid, increasingly revealed to be the will of a savage minority hell-bent on preserving power and money at all costs — just as in the waning days of minority rule in South Africa. How fitting then that former President Obama gave the eulogy that I believe John Lewis would have wanted — reminding us of our collective responsibility to preserve democracy by assuring that every citizen has a right to vote, and here I quote Lewis, “The vote is the most powerful nonviolent change agent you have in a democratic society. You must use it because it is not guaranteed. You can lose it.”

Collective responsibility to assure a fairer society that reflects American ideals starts with the ballot box, but it does not end there. I think of our little part of the world — education, research, health, community — and know that we can and must do a better job in all of those dimensions. How can we better attract, nurture and celebrate underserved minorities in our schools, labs and clinics? How can we best assure access of all people to quality health care that focuses on healthy behaviors, disease prevention, early intervention and effective, affordable therapies? What can we do to help our racially, ethnically, economically diverse communities join together — not by pureeing them into a bland melting pot, but rather by creating a cultural bouillabaisse where each community is distinctive, yet connected and interdependent with other ingredients in the delicious broth that can be the America of the future — one joined by a commonly held belief in freedom, democracy, equal opportunity and justice for all? As a great university, Georgetown has both the opportunity and responsibility to be a transformative player in this process, and it has accepted these challenges unhesitatingly. And, as long as I have the privilege of directing Lombardi, I commit my effort to help bring this about, because it is the right and just path.

Have a wonderful weekend. Stay safe and be well.

Lou

 

 


The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

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Jul 27 2020

Life in the Time of Corona(virus) – Day 134

by at 7:30 am

Baseball is back. I am watching the Phillies, who remind me that the time off did not necessarily make things better. They still do not have enough pitching to succeed, and seemingly never fail to fail when it matters at the plate. Oh well. Basketball is coming back. The Sixers, the enigma of the NBA, will go only as far as the fragile health of their keystone player, Joel Embiid. So, I don’t expect much. NFL training camps open soon; the Eagles will be OK, but only if there is a season. Apologies to Todd Waldman, but I don’t really follow ice hockey. It is undeniably fun to have some live sports to watch, even though the crowd noise is piped in, the stands are devoid of people and some seats are occupied by eerie cardboard cutouts of human facsimiles. Surprisingly, it all seems a bit trivial to me — perhaps a pleasant temporary diversion, but nothing more. Real life is so much more important. Those of you who know me well will recognize a seismic change in my outlook. Perhaps this is reversible, but I hope I don’t fully return to “normal” and will continue to find pleasure in other activities and diversions that I have pursued during the pandemic.

Seasons will restart (i.e., the NBA) or start (the other sports), but the only one I see being sustainable is the NBA, which has been placed into a hermetically sealed bubble in Disney World, located in the middle of a pandemic hotspot. We’ll see how that works out. I keep thinking of the eerie and terrific TV series “Wayward Pines,” where, through a massive deceit in a post-apocalyptic world, a shard of human civilization existed in a heavily guarded encampment, surrounded by unfathomably awful carnivorous humanoids that had devolved from human origins. Eventually, the bad guys broke in, and it got pretty ugly. So, the NBA resumption could work, but it will be dicey. As for baseball and football, there are no hermetically sealed bubbles for those sports; I will be surprised if their seasons are able to proceed to their conclusions without further interruption.

We are starved for normalcy, even if the forms are altered and slightly perverse in their execution. Professional sports, which are limited in scope but not in resources, are struggling to move forward. Lots of other “normal” activities — restaurants, bars, beaches, work, public transit, school — are struggling too, with varied levels of success. I suspect we will experience a lot of “one step forward, two steps back” scenarios as we yo-yo between relaxation and tightening of social distance guidelines over the next year or so. As Georgetown joins that struggle, I hope all of us do our parts to keep each other safe so we can do our work. While others “play ball,” let’s “work to end cancer now.” It’s never been more important to act smart.

Stay safe and be well.

Lou

 

 


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Jul 24 2020

Life in the Time of Corona(virus) – Day 131

by at 7:30 am

I am writing this blog entry on Thursday morning, before heading out to see patients. So far this week, I have ventured outside only once, to briefly visit a patient in the hospital. The stifling heat and tropical storms kept me inside by choice. Thankfully, we have a treadmill at home so I was able to get in my usual amount of exercise.

Regarding the pandemic, there is so much to discuss, but it feels repetitive to me. We know what we have to do. However, as we adjust to what might be a pretty long haul, even as we dip our toes into modified ways to do research here at Georgetown, I can’t help but think about the challenges of educating our youngsters. Our kids are grappling, like everyone else with school-age children, with dilemmas related to schools that will likely have little or no in-person instruction through the end of 2020, despite the exhortations of some political leaders. The risks of infection cannot be trifled with under any circumstances. Oh, but the consequences. Who stays home? Who takes on teaching responsibilities? How do people pay for child care, or in-home instruction? How do people keep their jobs if they have to stay home? How do businesses and, for that matter, higher education and research universities operate when much of the workforce cannot pay the necessary attention to the work that needs to be done because of the critically important work that must be done at home?

I certainly do not have the answers. However, I have been wondering; if there was any segment of society where vigorous virus testing could and should be done, it would be in schools and child care facilities to assure those environments are as safe as possible for the children, their families and the educators, staff and caregivers. Perhaps we could then have less disruption in our children’s education and social development, with the derivative benefit of allowing their parents to make their other contributions to society (and not pull out their hair!). The rest of us could muddle through using social distancing, PPE, and the like until testing was more broadly available. It would be expensive, but consider the alternative costs.

With the imminent start of this school year unlike any other, what I suggest is probably not practical. But, I want everyone at Lombardi grappling with these challenges to know that I am awed and frankly humbled by your contributions to our mission through your work in the face of so many unprecedented challenges.

Have a great weekend. Stay safe and be well.

Lou

 


The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

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Jul 20 2020

Life in the Time of Corona(virus) – Day 127

by at 6:30 am

Greetings on Sunday morning. Yesterday, a long travel day, started with a drive to visit Ken, Sarah and their kids and see their new house in the Philadelphia suburbs. Then, we caravanned up to Yardley to spend a few hours with my father. After an early dinner, we drove home. Audiobooks make long drives bearable; we are listening to Dan Silva’s “The Order” right now, and so far it is an engrossing listen. We are still careful about physical distancing, but perhaps a bit less crazy in its implementation — I did not wear gloves to pump gas at a rest stop on I-95, though I did wear a mask and cleaned my hands when I was done. I guess that represents progress.

The Sunday morning news programs are remembering the late John Lewis, an icon of the Civil Rights movement, with reverence and great appreciation. What a brave, principled man. He resolutely got himself into “good trouble,” important trouble, time and time again, and made this country a better place. His work is not done, but he shined a light on the path forward. Billy clubs could not kill him, but pancreatic cancer did. It is a reminder of the important cancer research that remains to be done.

I had the unbelievable privilege of meeting him in 2012. One of my patients, a prominent congressman, had died of metastatic colon cancer, I was invited to attend his funeral in Newark, N.J., along with his surgeon, Lynt Johnson, who was the chair of the MGUH Department of Surgery at the time. We attended a reception prior to the funeral, and Rep. Lewis and other members of the Black Congressional Caucus were there as well. Lynt introduced me to this icon, and we spoke for about 10 minutes, in a conversation that ranged from the cancer care of underserved minorities to Dr. Martin Luther King Jr.’s “Letter from a Birmingham Jail.” The man radiated intelligence and deep, ethical goodness.

This was more than a chance to have an actual conversation with a living chapter of the definitive American History book. President Obama was correct: the arc of history bends toward justice. In my view, this arc is a current that energizes rather than electrocutes those who come into contact with it. It does not dissipate, but gains strength as it is transmitted, not via the air like a virus, but through the heart. John Lewis was a guardian of that arc, and he generously distributed its current. Like so many he touched in his life, he passed a tiny bit to me (call it inspiration, if you prefer) as we talked. I hope I can strengthen and distribute that energy through the work I do and life I lead. It would be a fitting tribute to a life well-lived by a great man.

Stay safe and be well.

Lou

 


The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

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Jul 17 2020

Life in the Time of Corona(virus) – Day 124

by at 8:30 am

I am in the middle of a NIH study section meeting, reviewing cancer-focused immunology and immunotherapy grants; interestingly, the number of applications being evaluated is quite high — apparently part of a COVID inspired burst of grant-writing around the country. After a 10-hour marathon, I am a bit fried right now, and we face an additional eight hours of grant reviews tomorrow. I have been asked to write first drafts of the resumes and summaries of discussion for each of the discussed grants. That leaves no time for checking emails or the news (come on, you know you do that at least a little bit when you are at study section!), but it concentrates my attention wonderfully, and I have learned a lot. The level of innovation and technological virtuosity have never been higher. It’s a jungle out there!

Here at Georgetown we are juggling our academic lives with plans to reopen research and education. There are a lot of moving parts, and I have received many anxious inquiries from our scientists, wondering when they or their staff will be granted access to resume on-campus research activities. Please remember that the first group getting tested for COVID-19, and hence the first to be cleared to return, is composed of people who have had access to campus. The rest of us will follow, hopefully in short order. I know it’s hard, but please be patient. It is actually a lot easier to shut things down than it is to open them up again in an environment where caution is required.

Meanwhile, coronavirus continues to ignore politics and do what it does best: infect people, especially those who don’t take adequate precautions. It doesn’t care about age, race, gender or political affiliations. The homeless are no more susceptible than governors or athletes. Anyone can get infected, though these variables can matter when it comes to outcomes. So far, our region has not had the soaring infection rates seen in states like Florida, Georgia, Texas, Arizona and California. Masks and social distancing work, it seems. Our inpatient numbers at MGUH continue to be low, fortunately. Tony Fauci was, is and will be right about what needs to be done to contain this pandemic. In a just world, he would be celebrated, not reviled. I guess a Nobel Prize is not a possibility, since what he has accomplished is not discovery science, but a grateful nation should find a way to offer him its thanks.

I hope you have a great weekend. Stay safe and be well.

Lou

 

 


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Jul 13 2020

Life in the Time of Corona(virus) – Day 120

by at 7:30 am

On Saturday night, I sat on a lounge chair on our deck, watching the sky darken over the ocean as the sun set behind us. I explained to our grandchildren Ella and Eli, who were watching along with me, how the light of the setting sun made the cumulus clouds above shine brightly as darker, wispy clouds passed under them. The sea glowed pink, and as night approached the horizon line thickened, like the outlines of shapes painted by Wayne Thibaud. Then, there was a cloudless night sky, dark over the ocean, illuminated by countless stars. Magic.

When I was a boy, we lived in a garden apartment complex, with a large central green space. On summer days I would lie on the ground, watching the clouds roll by, or watching the night sky, overwhelmed by the infinity of it all. I felt insignificant, awed, filled with wonderment at the majesty of the universe, and I considered myself lucky to be alive at that moment. The thought of death filled me with dread. It was so overwhelming that I more or less decided to table those thoughts, as I felt I could never understand “why,” but might one day gain insights into the “whats” and “hows” of existence. I still feel that way.

We are infinitesimal components of the universe, each of us a molecule of water in the vast ocean in which we are bathed. We have control over some aspects of our existences, but less than we believe. Somewhere out in that night sky are the remnants of whole worlds that once existed, having vanished — slowly or cataclysmically — and with them perhaps sentient creatures like ourselves. Our planet has endured massive insults, and our species has been ravaged by intermittent catastrophes, such as the Black Plague, which literally devastated humanity. We now know that COVID-19 will take its place in human history as a very significant pandemic, but there is no indication that we are headed towards a Black Plague type of catastrophe. Almost all of us will get through this. However, too many will not.

It could have been so much better. Early action would have helped. This nation defeated Fascism, Communism, battled its way out of the Great Depression, put a man on the moon and created and sustained a new world order following World War II. We could have used our might and ingenuity to create SARS-CoV-2 tests that could be deployed daily, supported by an army of contact tracers and widespread PPE use to allow the nation to stay at work while science developed vaccines and treatments. We could have done this, if only there existed a consensus forged by wise leaders.

Instead, we now face a summer of discontent, followed by an uncertain autumn. We struggle to return to work, to school, to life fully lived. We are tired of this seemingly endless dystopian vacation, grappling with unemployment, inadequate child care resources and the collapse of industries that might never return. Confusion abounds; otherwise sane people throw hissy fits over being asked to wear masks, and there is no end in sight. However, the clouds still drift above, and even a casual examination of the stars at night reminds me that this too shall pass. And, in the end, everything is gonna be alright, though it will never return to the way it was.

We’ll hear more about what lies ahead for Georgetown in terms of returning to our research at a Restarting Research Town Hall set for this Wednesday at 11:00 a.m. Watch your email for joining information.

Stay safe and be well.

Lou

 

 


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Jul 10 2020

Life in the Time of Corona(virus) – Day 117

by at 7:57 am

Where to start? First of all, with my clinic. I had to use my office to pick up my white coat and then, after seeing patients, went back to continue clinic with telehealth patients. The Research Building was deserted. I cannot wait for a time when it is bustling with people. Research resumption and teaching resumption are proving to be daunting challenges, with remarkable complexities. We’ll be learning more about GUMC research resumption plans over the next few days.

In good news, several of our colleagues have received great scores on grant proposals that almost certainly will be funded. There is hope! And Chip Albanese was named an inaugural holder of the Sonneborn Chair for Interdisciplinary Collaboration along with Sarah Stoll (chemistry) and Ed Van Keuren (physics).The William and Karen Sonneborn Chair for Interdisciplinary Collaboration was created for the purpose of incentivizing interdisciplinary collaboration, internally, among Georgetown University faculty, and to expand the ways that students (both undergraduate and graduate) can be meaningfully engaged in their interdisciplinary research. This cross-campus chair exemplifies the potential synergies that can be captured when we leverage the many resources of this university. Congratulations, Chip!

After returning from the beach, I was pleased to see more people wearing masks than before in our neighborhood. That’s good, of course. But just a few miles away, there lies crazy town. Putting aside the political theater of the absurd for the moment, here’s something of grave substance: The U.S. has given notice that it plans to pull out of the World Health Organization. In the midst of a worldwide pandemic that demands coordinated worldwide response. By the country with the most cases and the highest death toll. I cannot begin to articulate the multiple dimensions of this madness.

The WHO is getting a test drive as a political scapegoat for this country’s epic failure to forthrightly address the pandemic. However, the coronavirus is not political, it is just deadly. Managing this medical, scientific and societal crisis as a purely political issue prioritizes power over American lives. Many correctly blame the administration, but I want to take a moment to shine a special light on those cowards on Capitol Hill who have chosen to sit out this moment of supreme moral clarity, allowing the unimaginably poor decision to withdraw from the WHO to proceed without a peep or protest. Most of them know better; hence, they are cowards. We deserve better government and leaders with vision and courage, but can only see that happen if we remember these moments in November.

Stay safe and be well.

Lou

 

 

 

 

 


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Jul 06 2020

Life in the Time of Corona(virus) – Day 113

by at 7:30 am

My blog is back — though I am still at the beach as I write this edition. I hope you enjoyed a safe and happy July 4 holiday. We were with our family — it was so heart-filling — watching the grandchildren splashing in the ocean at the water’s edge was a Hallmark Cards moment for us. We have widened our circle to include our close family — not without trepidation — but are still quite rigorous about physical distancing when we are not on our property. I read with interest that Tony Fauci and other experts do not clean their bags and other shopping items when they carry them into their homes, though all of them are rigorous about hand-washing, and all of them wear masks when physical distance cannot be maintained. I am going to go with their advice. I must say that even though our inpatient COVID-19 inpatient census at Georgetown was down to single digits this past Friday, I am really worried about a “relapse” given what I have seen in the Delaware beach towns.

The big news for our community last week was the planned reopening of research activities at the university, with a target date of July 16. Please submit your plans for reopening if you have not done so, and remember that the rules that have been established were not designed capriciously, and violations of those rules will affect people’s access to our facilities. There can be no science without safety.

In other news of the week, we’ll be heading up to Yardley, Pa., to visit with my father tomorrow; he is continuing his slow, long fade, and I don’t want to miss opportunities to see him. During the six hours of driving this trip entails I will have lots of time to think about two snippets culled from our ongoing culture wars that really bothered me. The first was a video of a face mask mandate counter-protestor, holding a sign stating, “My Freedom Is More Important Than Your Safety.” Really??!! I just cannot wrap my head, or my conscience, around that notion. I know this slogan has been a rallying cry for some people for years. However, as I recall, Jefferson elaborated three core principles: “Life, Liberty and the Pursuit of Happiness” in the Declaration of Independence. Almost 200 years later, when facing the specter of Nazi tyranny, Roosevelt articulated the Four Freedoms: Freedom of Speech, Freedom of Worship, Freedom from Want and Freedom from Fear. Freedom from mask wearing is not mentioned in any of those inspiring concepts that form the essential foundation of the America I cherish. I guess that the freedom to be unspeakably selfish and stupid is implicit in freedom of speech, but taken in their fullest expressions, these principles both reflect and form the foundation of the American experiment. Our core values instruct us to cherish and protect individual freedoms, but to work together to preserve life, reduce fear and pursue the common good. This creates necessary tensions, but Jefferson actually placed Life before Liberty in his text. In that spirit, if some knucklehead refuses to wear a mask in public, that is his or her prerogative. But the common good requires that their access to high-risk common spaces be restricted for public safety. I now will resist the impulse to launch into a tirade against those who spurn facts (i.e., science) to impose their fantasies upon others.

The second snippet was a video of a woman in Missouri at a Black Lives Matter rally, standing on the flatbed of a truck, waving a Confederate flag and screaming at the protestors, with a face contorted by anger, “I will teach my grandkids to hate you!” She has since issued a long and hopefully heartfelt apology, though it must be noted that her outbreak led to the loss of her job and many friends as well. Whether sincere or not, I would prefer that such venom remain unstated, so even an insincere apology represents a small victory. However, in the end we need to create societal norms that, through their repetitive, consistent and prolonged practice, suppress this vitriol until the feelings follow the behavior and fade away to become memories that instruct rather than inspire. Germany, despite some recent relapses, more or less succeeded in suppressing the Nazi impulse after World War II; we can and must do the same with racism. May her grandchildren grow up in a country that embraces and lives the reality of racial tolerance. It will take a lot of work, but it is worth doing.

Lombardi will return to work diminished by the loss of one of our own. Last week we were saddened to learn of the passing of Susan Marx. Susan was an administrative assistant in the Cancer Prevention and Control Program, where she worked for almost 27 years. Colleagues remember being greeted by her smile and a compliment when they entered the office suite at the Harris Building. She loved ushering at the Arena stage, and had a soft spot for children and animals. She also loved learning about the research and teaching we are doing. Beth Peshkin used to hold her evening classes in their suite, where Susan would often stay late and keep an ear on the class presentations. Beth recalls that on many of the mornings-after, Susan would ask lots of spot-on questions as they continued the discussion! CPC faculty are planning ways to honor her memory and will provide further information soon.

Finally, please indulge me for just a few more seconds. June 30 marked the conclusion of Dean Ray Mitchell’s remarkable 20-year tenure as Dean for Medical Education. Many thousands of students, among them my son and daughter-in-law, owe so much to his remarkable vision, warmth and effectiveness as he deftly guided their medical education through turbulent waters and created a full generation of talented, committed physicians who will spend the better part of the next two generations dispensing cura personalis with the compassion, warmth and attention to excellence that personified his values. He is truly a man for others, and we, all of us, are better for his steadfast leadership. Thank you, Ray. Georgetown has big shoes to fill!

Look for my next blog on Friday. Until then, stay safe and be well.

Lou

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