Letter from the Chair

Members of the Surgical Nursing Team, such as Colleen LaBuhn, APN and Viktoriya Kagan, APN pictured here, had to work creatively to manage the care of patients who had been isolated due to Covid-19.

2020 has been an uncommon year. The COVID-19 pandemic upended virtually every aspect of our lives as individuals and collectively as a society. And yet, through it all, the Department of Surgery at the University of Chicago Medicine persevered in expertly balancing the tripartite mission of clinical care, education and research, and leading the way through the most uncommon and unusual of circumstances. We innovated and adapted to new ways of delivering surgical services amidst a pandemic, and we rapidly reorganized our training programs. Our research teams pivoted to address critical new scientific questions in the wake of a new highly infectious disease, and our scholarly contributions helped shape the response of the surgical community to the pandemic. The stories in this annual report reflect the many ways in which our surgeons and scientists have stood together to provide exceptional care throughout this extraordinary time.

Early in the pandemic, as “elective” surgical procedures were halted as part of the early public health response, our perioperative team developed an approach to ethically triage medically necessary, time-sensitive surgery reflecting resource availability as well as patient and provider risk. A rapid publication in the Journal of the American College of Surgeons (first-authored by Vivek N. Prachand, MD, Professor of Surgery, and based on a framework he conceived) was widely disseminated and adopted by centers across the country and internationally. It was endorsed not only by organizations such as the American College of Surgeons, the American Hospital Association and others, but also informed Governor J. B. Pritzker’s directives to restore surgical services as Illinois emerged from the first wave. A number of other scholarly contributions from our department (including several initiated by our residents) concerning patient safety, informed consent, health equity, clinical trials and the use of laparoscopy shaped opinions in the broader surgical community during the early days of the pandemic.

The stories of our patients and our care teams during the pandemic were extraordinary. For example, in April, our extracorporeal membrane oxygenation (ECMO) team stepped in to care for a patient who was diagnosed with COVID-19 just 10 days after a heart transplant. Unable to visit him in person in the COVID-19 ward, they worked with the translation team to use iPads to communicate with the patient, using every available technology to reassure him that he was not alone, despite being in isolation. Similarly, our thoracic team intervened in the treatment of a patient with COVID-19 who had received a lung transplant a year earlier; the patient was able to take advantage of convalescent plasma as part of a clinical trial led by our newest Thoracic Surgery faculty member, Maria Lucia Madariaga, MD, Assistant Professor of Surgery. Innovations in care delivery rapidly emerged during the pandemic, especially those incorporating telemedicine. Jessica J. Kandel, MD, Mary Campau Ryerson Professor of Surgery, found that the new telemedicine platforms developed during the pandemic helped jump-start a multidisciplinary clinic for patients with pediatric vascular anomalies, allowing the team to overcome the scheduling challenges involved in arranging consecutive appointments for patients with surgeons, dermatologists, child-life therapists and anesthesiologists.

COVID-19 dramatically exacerbated the impact of endemic structural racism and barriers in access to healthcare resources in our community. The pandemic disproportionately affected Black, African American and Latinx communities with higher rates of asthma, hypertension and diabetes, factors that render COVID-19 more deadly. During the height of the pandemic in Chicago, the trauma service at the University of Chicago Medicine continued unabated to battle the visible virus of violence. Unfortunately, COVID-19 exacerbated adverse social conditions and heightened intentional violence. The trauma service stepped forward to address the more than 40 percent increase in violent trauma from April to August. To provide compassionate care and improve communication, we implemented an iPad-assisted program with the violence recovery program. We applaud the efforts of Drs. Bendix, Cone, Hampton, Prakash, Williams, Zakrison, Wilson and Rogers in conjunction with the residents and advanced practice providers on the trauma service.

2020 was also a year of social unrest. In the aftermath of recent national events that put a spotlight on police brutality, discrimination and violence against minority populations, our department redoubled efforts to confront systemic racism and bias. The Diversity, Equity and Inclusion Steering Committee was created under the leadership of vascular surgeon Chelsea Dorsey, MD, Assistant Professor of Surgery, in a newly created role as Director of Diversity, Equity and Inclusion for the Department of Surgery. We have dedicated ourselves to addressing and eliminating discrimination in all forms within our department through continuous self-assessment, targeted programming, advocacy and creation of an increasingly diverse and culturally competent workforce. A recent article from Medicine on the Midway, republished here, highlights some of the established and emerging women leaders in our department.

I hope these stories provide insight into our world as we find it now and highlight what makes the Department of Surgery at UChicago Medicine “uncommon.”