Welcome from the Chair
Dr. John Sweeney
When SARS-CoV-2 first appeared in China, it was half a world away and easy to relegate to being out of sight, out of mind. Of course, that ended quickly, and by March 2020 the pandemic began changing everything everywhere. "Unprecedented" became one of the words for the season.
For me, the truth of the pandemic arrived when one of Emory University Hospital's first COVID-19 patients was intubated. Almost immediately, I was entrusted with convening a multidisciplinary group to recommend adjustments to the perioperative arena in response to this new threat. After considering both the short supply of PPE and the limitations of COVID testing, we endorsed such measures as pausing elective procedures.
All of us in Emory Surgery had a pivot moment when we saw what lay ahead. We began revising our routines and recalibrating our systems so we could continue delivering the care our patients required while trying to keep everyone safe. As we devised measures to handle the curveballs that kept coming our way, we found that some of our solutions could remain relevant after the virus.
An early challenge for surgeons was rethinking our use of anesthesia. After learning that general anesthesia could create aerosolized COVID particles in the operating room, we designed new protocols for protecting the surgical team during intubation and/or extubation, one of which was pre-procedure patient testing. As a PPE conservation solution and to save time, many of us started using local anesthesia combined with IV sedation for certain procedures because it worked just as well as general anesthesia. Many of us will probably continue to do so beyond the virus.
This type of flexibility is thoroughly in evidence throughout our ORs, clinics, and offices. Reliable systems may move these processes along, but our people have been the final drivers of our success. After witnessing the ability of the department's faculty, staff, and trainees to maintain our clinical, research, and academic commitments during these extraordinary times, I have never been more proud to be part of the Emory Surgery team.
John F. Sweeney, MD
Joseph Brown Whitehead Professor and Chair, Department of Surgery, Emory University School of Medicine