Celebrating even in the midst of uncertainty

Record-breaking and unprecedented seems to start every sentence these days and for good reason. This week we witnessed record-breaking turnout in our general elections in the country, our state, and even in Johnson County. Yesterday the United States also broke records for new COVID-19 infections (exceeding 120,000 in one day), and sadly our own state of Iowa exceeded its record for COVID-19 hospitalizations yesterday. Records often are meant to be celebrated but these records have left us in a place of uncertainty. As many of you know University of Iowa Health Care has experienced increased demand on our services in the face of the accelerating pandemic in our state. As a result, the hospital has implemented surge planning, details of which have been shared with all of you. These changes will have significant impact on many aspects of the clinical operations within the department, will involve redeployment of staff to meet pressing needs, for example in the Influenza-like Illness (ILI) Clinic, opening new ICU beds, and modifying our ambulatory clinics. The next few months will be challenging for all of us. I am confident that the members of our department will once again rise to the challenge. Our resiliency will be taxed, but I believe in our mutual commitment to support each other, reflecting the strong culture of collegiality and solidarity that characterizes our department. 

It is important for the department to know how you are doing and what we can do to support you during these challenging times. I know that our Chief Residents are already mobilizing to monitor our trainees for signs of burnout, but I would encourage all of us to look out for signs of stress in our colleagues and to offer a helpful hand. I convey my deep and sustained gratitude to each of you for the sacrifices you have made and are continuing to make as we adapt to the present crisis, as you help us plan our next steps, and as you continue to provide extraordinary care for the Iowans who depend on us with their lives. Please make sure that as the political winds shift and blow around us in the coming weeks, coupled with the activities that we must adopt to prevent acquiring COVID-19 in the community, that you are finding the shelter and restorative rest that you need to carry on with our immensely critical work.

Despite the ever-present challenges, it is important for us to celebrate the good things that happen in our lives and of course in our department. About ten years ago, an annual departmental tradition of recognizing excellence in clinical care was expanded to include all members of the University of Iowa Physicians group, which took ownership and transformed them into the UIP Clinical Awards. Six categories honor consulting providers, health care leaders, effective teams, quality achievements, patient satisfaction, and overall outstanding effort. As with any set of awards, a measure of subjectivity and timing is as much at play as demonstrated skills. This is the problem when you work in a place filled with the very best in our profession! That said, it was gratifying to see our department so heavily represented in this year’s slate of awardees. COVID-19 has challenged us all as a health care system and individually. Each of us has had to discover and are still being asked to discover wells of fortitude and grace to navigate this crisis. It is no surprise, therefore, that the majority of these awards recognize the creativity and resourcefulness in our institution’s response to the pandemic. Whether it is Dr. Katie Imborek’s leadership in establishing the ILI Clinic or the Home Treatment Team’s innovative approaches for managing symptomatic COVID-19-positive patients in their homes, the UIP Clinical Awards reflect the strengths of our institution in this challenging period. Congratulations to all the winners this year and the nearly 20 nominees from within our department. You are inspirations to us all.

What also remains noteworthy about this unusual year is that amid great upheaval, we continue to achieve great successes. In any another year these would be the headlines, in-depth stories about new treatment methods or bench discoveries giving us greater understanding of complex systems. COVID-19 and our responses to it dominate, as they should, but I am grateful that we are still able to note some of the comparatively more common, but still no less celebration-worthy, achievements, particularly of some of our more junior faculty. In just a few short months since arriving here, Dr. Elissa Faro, a medical anthropologist, has already tapped into resources that exist right here on campus. With a pilot grant from UI’s International Programs, Dr. Faro will begin to assess the effectiveness of a mobile app on mother and child wellness in Togo. Two new career development awards from the American Heart Association will also fuel research and early-stage faculty development in our department. The first, to Dr. Nirav Dhanesha, a member of the Chauhan Lab, should produce new insights into the mechanisms between obesity and deep vein thrombosis. Another CDA has been awarded to Dr. Quixia Li, a member of the Irani Lab, which will allow her to examine endothelial Sirtuin1’s regulation of metabolism. Last week also saw the publication of a multidisciplinary, multi-institutional effort led by Drs. Mohamad Mokadem and Kamal Rahmouni in Cell Reports. Their study shows that energy expenditure after bariatric surgery activates endocannibinoid receptor-1 in the sympathetic nervous system and leads to “browning” of mesenteric fat. This work advances our understanding of how weight loss surgery may increase basal metabolic rates, which may contribute to its efficacy as a therapeutic approach. I hope you will take a moment to reflect on the exceptional community of caregivers, researchers, and educators in our department. Reflect on our achievements and draw strength from each other as we face the immediate challenges ahead.  

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