By Hana Nobleza, MD; Deepa Maliayandi, MD; and Diana Greene-Chandos, MD, FNCS
We have all seen our lives changed by the global COVID-19 pandemic since the first reported case of COVID-19 on Dec. 31, 2020. The mission of Women in Neurocritical Care (WINCC) continued to be strengthened during these times. In this pandemic, we saw the rise of neurocritical care not only directly tackling COVID-19 but also getting involved in social activism, continued friendship, international collaboration, and improving diversity, equity and inclusion. This article will serve to celebrate the recent accomplishments of WINCC, discuss our events at the recent virtual Annual Meeting and share our new evolution into a group that aims to grow diversity as a whole within NCS.
We have seen multiple representatives of WINCC show the world how WINCC is contributing to fighting the COVID-19 pandemic as featured in multiple media outlets. Dr. Chou was featured on CNN to discuss how the pandemic has impacted our care for our patients. Dr. Alexandra Reynolds and her group were featured in AP News to discuss her findings of the role of transcranial dopplers and “bubble physiology” and COVID-19. Drs. Aarti Sarwal, Neha S. Dangayach and Sherry Chou were featured in The Daily Beast to discuss the potential link between Guillain-Barré Syndrome and COVID-19. The Neurocritical Care Society’s GCS COVID Consortium led by Dr. Sherry Chou was also featured by U.S. News and World Report. Dr. Elissa Fory and colleagues described the first case of necrotizing encephalitis in a COVID-19 patient. Dr. Sara Hocker was featured in KARE11 news regarding strokes and COVID-19. Dr. Navaz Karanjia discussed how COVID-19 can affect the brain in a podcast featured in KPBS News. A project that was started by a group of WINCC, neuroendovascular surgery fellow, neurology resident and neuro-ICU nurse was featured by Fox54 News showing the strength our camaraderie despite the distance between us.
Dr. Diana Greene-Chandos and multiple women in the Women’s Neurology Group published a nationwide survey on neurologists’ practice pattern changes in the time of COVID-19 in the Neurology Journal, and a group of The Ohio State University neurointensivists, including six WINCC members (Drs. Kamdar, Mainali, Lee, Hinduja, Greene-Chandos and Strohm) published in the Journal of Stroke and Cerebrovascular Diseases on stroke practice changes in the COVID-19 pandemic.
These are just a few examples of how WINCC pushed science and understanding of the pandemic, as well as promoting wellness and camaraderie during these difficult times. WINCC also recognizes that we have the obligation to the Society as well. And one of our strong advocates for social activism, Dr. Marin Darsie, was shown in PBS Wisconsin News discussing the impact of an in-person election and the pandemic. WINCC is carrying its mission forward both nationally and globally.
As WINCC continues to celebrate its members, we wanted to acknowledge Dr. Diana Greene-Chandos. Under her leadership, WINCC has created multiple initiatives that have brought change in NCS and the field. She has been an exemplary role model for women neurointensivists. Along with other senior women neurointensivists, she paved the way for NCS’ increased recognition of the need for diversity, which fueled junior members of the subspecialty. In the recent virtual Annual Meeting, she hosted Dr. Chere Chase-Gregory as the Keynote Speaker for the annual WINCC reception. Dr. Gregory and Dr. Greene-Chandos have a long history together, as they were co-fellows at Johns Hopkins 19 years ago (along with Dr. Robert Stevens) and ultimately worked together as attending neurointensivists and vascular neurologists at Novant Health’s Forsyth Medical Center, seeing each other through many of the highs and lows that life can bring while building and growing a practice, unit and stroke program.
Dr. Gregory is now a Senior Vice President and the Chief Health Equity Officer of Novant Health. She spoke about her life as an African American woman and how she approached each segment of her life, education, clinical training, leadership roles and her career in the C-suite of a large health care system. It was an incredibly inspiring talk and to many NCS members, it was described as one of the best lectures they have heard on diversity in medicine and on leadership. Dr. Gregory is a true trailblazer and if you missed the presentation at the meeting, please give yourself an hour to listen.
Also during the Annual Meeting, WINCC hosted a virtual family night (led by Drs. Marin Darsie and Abby LaNou ) where we watched movies, had a “best pajamas” contest, and our kids got to “meet” one another. Additionally, there was a fantastic cocktail hour for WINCC hosted by IRAAS where we learned to make three new cocktails from a mixologist. It was lots of fun seeing everyone created their masterpieces virtually. Finally, in a new WINCC/INCC tradition, Dr. Greene-Chandos passed the rainbow tiara of leadership to Dr. Deepa Malaiyandi.
The evolution of WINCC to INCC was a gradual one that started with asking broader questions about all under-represented individuals. In 2018, members of WINCC who are also on the research committee, including Drs. Asma Moheet, Susanne Muehlschlegel, Shradda Mainali and Victoria McCredie, began looking at gender parity trends in NCS leadership, awards and grants, and Annual Meeting speakers and moderators. By the summer of 2019, WINCC had created programs to help address disparities for women through the work of Drs. Hana Nobleza (leading the mentoring subsection) and Elissa Fory (leading the families subsection) where women mentorship, career development, speaker’s list and onsite Annual Meeting childcare became realities.
With these successes, the WINCC leadership could not help but feel there were still so many who were left out and left behind. As such, Drs. H.E. Hinson and Deepa Malaiyandi added an Inclusion in Neurocritical Care (INCC) subsection dedicated to DEI initiatives. Serendipitously, the early leaders of the Curing Coma Campaign, along with the NCS Executive Committee and Executive Director, also sought to formalize DEI efforts within the society. Together, they crafted the NCS Diversity Equity and Inclusion Statement, which reads:
“Our goal is to cultivate an environment where everyone is welcomed and included, based on the firm belief that diversity is valuable and fosters innovation that enables us to achieve our mission; to serve our members as well as addressing the needs of an increasingly diverse society. The Neurocritical Care Society strives to support its members in providing high quality and equitable care for the patients and communities we serve. We also aim to support all members in their research, collaboration, training, education, and advocacy efforts.”
Shortly after the DEI statement was finalized, the chaos of the global COVID-19 pandemic hit, throwing a national spotlight on the extreme inequities in society and particularly healthcare. The nation's social reckoning affirmed that NCS simply had to do more. At the request of the NCS officers, Dr. Malaiyandi drafted the INCC Committee Charter proposal with input from Drs. Nerissa Ko, H.E. Hinson, Hana Nobleza, Marin Darsie, and Diana Greene-Chandos, along with the NCS officers, Executive Committee and Executive Director. The proposal was presented to the NCS Board of Directors at this years’ virtual Annual Meeting, and the Committee was approved unanimously!
The INCC founding Chair and Past-Chair will be Drs. Malaiyandi and Greene-Chandos. The structure will involve a leadership committee, subcommittee members, and a general section to ensure that everyone is given a voice. The Leadership Committee will have three subcommittees:
- Women in Neurocritical Care (WINCC) subcommittee
- Sexual and Gender Minorities (SGM) subcommittee
- Underrepresented Ethnicities in Healthcare and Intersectional Concepts (UEHIC) subcommittee
- Liaison with Global Partners Committee to increase inclusion of international members
- Liaison with other societies to serve as a resource and partner to improve their diversity efforts as well
The INCC Committee's charge is to:
- Enhance leadership and research opportunities for individuals underrepresented in neurocritical care
- Develop strategies to expand outreach and explicitly identify qualified individuals of diverse backgrounds to serve and thrive in the Society
- Collect membership diversity demographic data with a goal of 30% complete demographic collection the first year
- Use the above to drive key metrics for underrepresented individuals and establish benchmarks to track year-over-year improvements
- Establish with the NCRC the infrastructure to study disparities in healthcare for underrepresented neurocritically ill patients
INCC will strive to create a DEI model to build and maintain a diverse society in discipline, demographics and years of service. We encourage you to reach out to any of the leadership in INCC or NCS if you want to be involved in this important initiative and committee.