Goodbye 2020 and New Year’s Resolutions
The year 2020 was defined by the pandemic, injustice, and politics. For me the year included denial about the pandemic, fear when the pandemic hit, pain when George Floyd died, and hope following the election and release of the COVID-19 vaccine. At the end of the year the PCICS 2020 meeting brought our community together virtually. Nikhil Chanani and Lindsey Justice are to be commended for the elaborate contemporary program that had state of the art presentations from diverse speakers.
For me the highlights of the meeting were the sessions on COVID-19 and Equity, Diversity and Inclusion. In the COVID-19 session Lorenzo Grazioli spoke of the devastation of his hospital in Italy by COVID-19 and how the ICU team was able to expand bed capacity by doubling patient rooms, innovate, triage, educate to take the best care of patients possible. Eva Cheung described her experience in assembling a multidisciplinary team to develop an individualized treatment algorithm for multisystem inflammatory syndrome in children in New York City. Gil Wernovsky discussed how the Congenital Heart Academy kept our congenital heart disease community connected throughout the world with webinars. Lara Shekerdemian’s talk showed us what exceptional leadership looks like with her account of the challenges faced by leaders during the pandemic included efforts to keep the team connected, ensuring the mental health of providers, showing vulnerability, and how overcommunication is never a bad thing.
The Equity, Diversity and Inclusion session highlighted inequities in our workforce and care of our patients. Sarah Teele described implicit bias with an excellent peanut butter and jelly metaphor, and emphasized that acknowledging these unconscious associations that are made early in life is imperative. Kiona Allen’s talk included building inclusive teams, making the CICU environment accessible to people of all racial and ethnic backgrounds and less “Eurocentric”. Keila Lopez gave an excellent review of the history of racism and bias in medicine in the United States, and reiterated the importance of not attributing racial and ethnic disparities in congenital heart disease outcomes to genetic differences but rather to social determinants of health. This session was the perfect segue to Priyanka Saha’s outstanding abstract presentation from the Pediatric Health Information System database that described racial disparities in children who had congenital heart surgery. Compared to white children, black children were less likely to receive reintervention and more likely to die in the hospital.
These data suggest that there may be racial variation in our medical decision making. For our new year’s resolution let us pledge that we each take a long hard look at ourselves and see if we treat our black and other minority patients differently. Let us pledge as nurses, nurse practitioners, physician assistants, current and future cardiac intensivists to advocate for our minority patients who are lingering in the ICU postoperatively with residual disease, in need of a catheterization or reoperation after surgery, ECMO or a transplant.
Lastly, has the pandemic of 2020 changed our meetings forever? The virtual format allowed us to meet and I hope that future meetings will be “hybrid” by including a virtual option for attendance. I can’t wait to go back to a live PCICS meeting, from the black, white and grey of the East Coast winter to life in technicolor in Miami. I can’t wait to see you all in that large meeting room, in the poster sessions, on the patios and bars of the Lowe’s hotel where we network, hug, laugh, and share our stories, to next time in Miami.
Maryam Y. Naim, M.D., M.S.C.E.
Pediatric Cardiac Intensivist
The Cardiac Center, Children’s Hospital of Philadelphia
Departments of Anesthesiology and Critical Care Medicine and Pediatrics
Perelman School of Medicine at the University of Pennsylvania