As I am writing these lines, June is not over. But, I am in a hurry to write this letter on this sunny and windy Sunday’s evening, because tomorrow I start a 7-day straight NEURO-ICU service. And I don’t foresee I will have time for anything else. The last time I was in the NEURO-ICU, it was in the end of May and it was busy. I estimate that in a week I spent 93 hours in the hospital and probably more than 85 hours in the NEURO-ICU managing patients. You may immediately say “that is excessive, especially when trainees are not allowed to spend 80 hours/week at work and they have uninterrupted sleep during the night (which does not happen when you are an attending). Why are you doing it?”. Well, the answer is simple: because I feel I am doing the right thing and I am enjoying it! I know the same is true for all of you too, although hopefully with much lower in-house effort. In these times of financial constraints and global challenges, hospitals admit sicker patients and manage them with burned-out health providers. Our numbers continue to show attrition and exacerbate the problem we have. And, if this providers shortage is not enough, there are everyday new additional shortages in equipment and medications. We feel this delta between demand and supply increasing or maybe just fluctuating. But what else can we do aside from putting extra hours to help our patients and helping each other? How much this increased clinical effort to maintain quality-service delivery will lead to decreased time or motivation for research and education, it is something to be seen…
The main event this past month was the NCS Board of Directors meeting, held virtually. Sarah Livesay and Mona Kumar presented the NCS Statement on laws that criminalize the provision of healthcare. This is a carefully crafted position statement followed by a clear rationale, that we are hopeful to release this month. Paul Vespa also presented the financial state of the Society: we are strong despite the ongoing challenges from the pandemic, and both the up-to-date numbers and the 3+9 forecast end with a positive net. Moreover, we were pleased to learn that the yearly audit by the independent firm PorteBrown found the 2021 NCS finances in order and as expected – not a surprise! Susan Yeager made me even happier when she presented the Membership numbers: for the first time in our history, the Society had more than 3,000 active members, in fact 3,161! Congratulations to all who have put their blood, toil, tears, and sweat for this Society to be born, survive and grow!
While these new colleagues will start their terms after the Annual Meeting, the new NCS Executive Director will not have to wait so long. After interviews and discussions with our management partner, we reached a unanimous agreement on the person who will replace Sharon Smith-Terry. It is my pleasure to introduce Mindy Saraco to our members! Mindy has more than 20 years of experience in working with nonprofit organizations, such as the American Diabetes Association, the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians, at various roles. Please welcome Mindy, we are very excited having her join NCS!
Marcus Aurelius was one of the greatest Roman emperors. During his times the Roman Empire reached its peak of power. This “philosopher Emperor”, who embraced a Stoic School approach, spent most of his life fighting invading enemies, as depicted in the film “Gladiator”, one of the best films of the last quarter-century. But beyond the Hollywoodian short appearance of the dying Marcus, we do remember him by his writing of Τα εις Εαυτόν “things to myself”, also known as “Meditations”. This masterpiece, written in Greek by a Roman Emperor, is considered one of the most influential philosophical treatises of all times. There are several deeply and emotionally beautiful quotes by someone who was speaking to himself and only to himself. It is there where one can find “Βραχύβιον και ο επαινών και ο επαινούμενος και ο μνημονεύων και ο μνημονευόμενος.” Ephemeral is everyone, both the praiser and the praised, both who remembers and who is remembered and “Μη ως μύρια μέλλων έτη ζην. Το χρεών επήρτηται. Έως ζης, έως έξεστιν, αγαθός γενού.” Do not act as if you are going to live ten thousand years. The inevitable hangs over you. As long as you live, as long as it is still possible, become good. If everything is short-lived, if everything will be lost as a spark in the Cosmic eternity, why are we doing all these everyday tasks, including those grand and heroics? For the praise we will receive? To be remembered by someone somewhere? All will be lost. Why then become good? Most of us may find the answer in religion and the afterlife. Some, such as Marcus Aurelius, will additionally find the answer in the duty of doing the right thing against the reality of the inevitable. The strength one finds by still doing it, knowing that in the stream of time and against the odds, it may not matter. But at the time-point, the “ephemeron”, it does, as we all in the Neuro-ICU know!
Panayiotis (Panos) N. Varelas, MD, PhD, FAAN, FNCSPresident, NCS Board of DirectorsProfessor of Neurology and Chairman, Department of NeurologyAlbany Medical College