Shielding our pulmonary fellows

“Among the aerosol-generating procedures,” an April 27 JAMA editorial cautioned, “performing endotracheal intubation is especially hazardous.” At University of Iowa Health Care, over the last ten months of caring for those individuals with COVID-19 admitted to our Medical Intensive Care Unit and needing intubation, it is safe to say that nearly every one of those procedures has relied on the presence and skill of the physicians in our Pulmonary and Critical Care Fellowship. The successes of our institution, the challenges we have all faced, have been built on the bedrock of risk that our pulmonary fellows have faced, every day. Every member of our department and health care system is deeply grateful for the sacrifices our fellows have made this year.

We cheer on the vaccination celebrations of many who continue to face similar levels of risk in a variety of other situations or those who serve as examples of leadership to reassure a potentially wary public that this vaccine is safe and should be adopted. But the one set of vaccinations that gives us the deepest sigh of relief after a year of holding our breath are those received by this dozen.

As Dale Abel, MD, PhD, wrote recently in a Views from the Chair, every one of our senior (second- and third-year) fellows has been volunteering one extra weekend day to offer relief and assistance in the essential work occurring in our ICUs.

“To be specific,” Jeffrey Wilson, MD, wrote, “the senior fellows have volunteered 1 extra weekend day–per month–in the MICU. Roughly 8 weekend days per month and 8 senior fellows.” Wilson, the program director of the Pulmonary and Critical Care Fellowship, continued:

In my 18 years as program director I have never been more proud of–or inspired by–our fellows. Under incredibly difficult conditions they have each risen to the challenge, without complaint and at significant personal risk to themselves and their loved ones. Twenty years from now when they look back on this our fellows will know they gave their best to help our country weather this storm.

Brian Gehlbach, MD, clinical professor in Pulmonary, Critical Care, and Occupational Medicine, sent the following thoughts:

Our fellows have been on the front lines for 9 months, working 80 hour weeks, volunteering for extra shifts, intubating countless patients with COVID-19 and witnessing many of them die, alone, or with limited family present. Talking to distraught family members on the phone. Worrying about their own health, or that of their families, while wearing PPE continuously for up to 28 hours at a time. They were there at the beginning, when we didn’t have enough surgical masks to wear them for every patient. Our new fellows started in the middle of the pandemic, and we have rarely seen each others’ faces. Nine months and hundred of patients later, they’re still there at the head of the bed, working with our MICU staff to deliver life-saving and compassionate care.
 
In an institution where everyone has stepped up and made tremendous sacrifices, I’m extraordinarily proud of our fellows, who have fought this pandemic day after day and night after night, all while working in the most emotionally demanding environment imaginable. They have helped to return hundreds of patients to their homes and families, and they inspire me to do better. They have skill and knowledge, yes. And our program provides the training. But it’s our fellows’ hearts that have made the difference. 

Their courage and commitment have been inspirations to us all. We cannot thank them enough.

The 2020 Class of Pulmonary and Critical Care Fellows

First-Year Fellows
Miles Hagner, MD
Kimberly Helmkamp, MD
Zack Rich, MD
Luis Vargas Buonfiglio, MD

Second-Year Fellows
Michael Catlin, MD
Bryce Duchman, MD
Peter Szachowicz, MD
Thuong Tran, DO

Third-Year Fellows
Camilo Cano Portillo, MC
Vikas Koppurapu, MBBS
Shweta Kukrety, MBBS (Chief Fellow)
Maksym Puliaiev, MD