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Ready to Return to the “Old Normal”

By Warren C. Hammert, MD

Today is Sunday, April 12.  It is remarkable how life has changed over the last month.  At the University of Rochester, in Rochester, NY, we are now 4 weeks into the “shutdown.” We are only performing urgent and emergent surgery and seeing “needed” patients in the office. Trauma has been slower overall, with most injuries being amenable to WALANT in our procedure room.  I have done several finger fracture pinnings and tendon repairs and patients have generally been happy they can avoid going to the hospital.  Office days include acute trauma follow up appointments and patients that had surgery immediately PC (Pre COVID).  We have transitioned to telephone and now video visits via zoom for most office visits.  Our residents are working strictly in the hospital, but still doing orthopaedics.   They are in teams, working one week and off the following two, aligned with the faculty that cover trauma call. Since our hand surgeons are not often at the hospital and spread out in terms of office locations, we are all still working in some capacity, but have several tiers of “disaster plans” if it gets bad.  I have seen a lot of variation in terms of concern about the virus, potential repurposing of our physicians and advance practice providers, the loss of revenue for the medical center, and how that will affect us individually.  We seem to be prepared as a medical center and are fortunate to be in a better situation than those in NYC and other areas.  We have enough PPE and ventilators currently and based on projected curves, should continue to be ok. 

This week, I have one surgical case – distal radius fracture tomorrow.  I have office Tuesday, Wednesday AM, and Friday, with mostly video and telephone visits.   Like most academic institutions, we have transitioned our resident and fellow conferences to video using zoom (I wish I would have bought their stock two months ago).  While we always used Hand.e (disclosure is I am the editor of Hand.e) in preparation for conferences, the addition of Hand 50 has been great as it gives our residents and fellow the opportunity to hear perspectives from others around the country. We are also collaborating with other institutions to collectively improve the fellows didactic experience given the change in their operative experience. 

I have been fairly productive with the additional time – I have been able to get some of my academic projects done during the day rather than at night, I have been able to exercise more consistently, but am eating much more as well.  I have been able to sleep more and spend more time with my wife.  I bought an apple watch so we can have competitions to see who moves the most each day.  

I am ready to return to the “old normal”, but for us, I think we are still at minimum, 6 weeks away.  I think there will be some good that will come from this crisis.  I think we are learning about remote education and can hopefully use this as a means to improve education for our fellows and residents.     

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