Courtesy of Yale New Haven Health System
Balancing intensive patient care with demanding research projects has always been intrinsic to the lives of intensive care physician-researchers. But against the backdrop of a relentless pandemic, 2020 has seen an intensification of the challenges that accompany this dual role.
Strenuous hours in the hospital, time spent away from loved ones, and uncertainty about the future are just some of the many challenges healthcare professionals face. But despite those hurdles, by the end of 2020, Yale’s Lung Department had published 232 research papers, surpassing 134 publications last year – all while staffing the medical intensive care unit and caring for COVID patients. -19. According to the chief of the department of pulmonology, intensive care and sleep medicine, Naftali Kaminski, as days turned to nights at the CIAU, many articles were written at dawn.
“There were articles coming out of our section that I literally know people wrote between 11pm and 3am,” Kaminski told The News.
Ensuring that no one is left behind is essential for the success of the department, he said. Kaminski explained that everyone was keenly aware that if they had time to research it was only because someone else was on COVID-19 wards treating their patients.
Keeping the spirit of collaboration alive – whether working together on research projects, sharing credit for different papers, or simply letting each other know they had friends among their colleagues – fueled the sense of camaraderie. of the department and strengthened what was already a strong emotional support network.
Maor Sauler, assistant professor of pulmonary medicine and intensive care physician at Yale Hospital New Haven – who currently divides his time between pulmonary clinics, MICU teams and laboratory research – expressed gratitude to his colleagues .
“When everyone was at home we could go to work and spend time with great colleagues and do the things we were trained to do,” Sauler said. “In a lot of ways, it allowed us to sort of shoulder the burden of all the patients and all the illnesses that we have had to deal with.”
When summer arrived and the rates of COVID-19 cases started to drop, it gave many a reinvigorated focus on their research, Sauler said. With more time to work on their projects and fewer critical patients in the ICU, it was easier for them to pick up where they left off.
Kaminski noted that at one point it almost seemed like people were having a “second honeymoon” with their research careers. But many early-career scientists were also worried about what the time they had spent outside the lab might mean for their tenure.
“Research can’t stop, clinical work can’t stop, and we’ll always find a way to make it work,” Clemente Britto-Leon, assistant professor of pulmonary medicine and treating physician, told News intensive YNHH. “But there are tradeoffs that need to be made, maybe there are a few more hours you need to materialize in the middle of the day for that to happen.”
For Britto-Leon – who has also worked at the CIAU, seen patients at the CF clinic, researched and treated post-COVID-19 patients – these trade-offs ranged from lack of quality time with his family to the inability to pursue some of his favorite hobbies including bird watching and visiting art museums.
Nevertheless, despite these difficulties, his motivation to help his patients and to continue his research supported him and his colleagues.
“It’s kind of in our nature, in the medical field, to help in any way we can, so a lot of people wanted to contribute,” Sauler said.
But beyond contributing to the overall knowledge of science, Britto-Leon pointed out, research often lays the foundations for the medical practice of physician-researchers.
While the coronavirus has sparked many scientific unknowns, due to the way it has assaulted the respiratory system, pulmonologists have been able to refer to their experience with acute lung injury and disease to anchor their understanding of COVID-19. Ultimately, much of the research they had conducted long before the pandemic began helped guide how they approached COVID-19 patients.
“Sometimes I stop to think about how informed my clinical practice is by my knowledge of the basic mechanisms of inflammation, injury and repair, and how this translates into the way I care for my patients. “said Britto-Leon. “And the opposite is also true, I tap into my translational research for many of the questions I find in clinical practice. It makes me a better doctor.
He said his experience studying cystic fibrosis, for example, had prepared him to look for markers of inflammation and understand how they might affect the lungs in the context of COVID-19.
Likewise, Sauler explained that the years he spent studying cellular responses to stress in acute and chronic lung disease informed his perspective on the devastating effects of COVID-19 on the respiratory system.
“In a lot of ways, we just did the job we’ve always done to try to understand the mechanisms of acute and chronic lung injury,” Sauler said.
Another key factor that enabled the department to pursue its research projects was the funding provided by the office of Yale School of Medicine Dean Nancy Brown to early-career scientists. In a statement to the News, Brown wrote that YSM management wanted the funding “to serve as a catalyst for increased mentorship during this difficult time.”
Both Sauler and Britto-Leon stressed the importance of the grant to maintain their respective research projects and were both grateful to have received this support. Kaminski also stressed that this had a positive impact on the general morale of the ministry.
However, Britto-Leon stressed that because the pandemic gives more visibility to the struggles that physician-scientists must grapple with even outside of international health crises, he hopes this will reinforce the need to always support those in the early stages. of their career.
“Even in large academic institutions like Yale, we still face a lot of challenges,” said Britto-Leon. “We cannot prioritize our clinical activities over our research activities as they are both essential pillars of everything we do and everything we are. Sometimes we find it difficult to balance the demands of our academic lives with our clinical activities and our personal lives.
Total research funding at the Yale School of Medicine increased from $ 612.9 million in 2010 to $ 671.2 million in 2019.
Maria Fernanda Pacheco | [email protected]