Author: George Weiner
Date: 2020-12-01 11:08:56

It’s Thanksgiving morning and I am sitting quietly at our kitchen table while my wife Teresa bakes some bread. That is about the only thing usual about the holiday this year. No big turkey. No happy sounds from children and grandchildren running about. We will be Zooming with the family shortly which is better than nothing, but certainly not the same as reading a book with a grandchild on your lap in front of the fireplace. Nevertheless, we, like everyone else, are doing what we can to make the best of the current circumstances and look forward to the day, hopefully in the not too distant future, when we can be together again in person.

Since the beginning of the pandemic, we have all adjusted our personal lives to a new reality (I avoid the term “new normal” because this is anything but normal). I have been thinking about how I will remember this period from a professional point of view based on three general principles.

• We have had to develop novel and creative approaches to assure strong collaboration during these stressful times.
• We are doing so in physical isolation, but this does not mean we are each operating independently – In fact, in many ways, we are working together to a greater degree than ever before.
• Our mission of reducing the burden of cancer through the interdependent missions of research, education and clinical care, is unchanged and as important as ever.

The following are vignettes related to how these principles has impacted on each of our missions during the pandemic. I suspect these will stay with me when the happy time comes and we no longer need to don a mask every time we step out the door.

Mission – Research

In September, we completed the intense process that comes around every 5 years of renewing our status as a National Cancer Institute (NCI) designated comprehensive cancer center. Normally, the final step in the review is a site visit here a group of 15-20 cancer research experts from around the country come to Iowa City for three days to assess the research contributions being made by the cancer center. They also review our impact on the community and other aspects of our cancer-focused efforts. Because of the pandemic, our NCI site visit this cycle was held virtually. We presented our research contributions, our impact on the people of Iowa and other essential characteristics of an NCI designated comprehensive cancer center including interdisciplinary coordination and organizational activities. After each presentation, we answered questions from the reviewers, most of whom were participating from the comfort of their own homes. Thankfully, the technical aspects of the virtual site visit worked well. On the other hand, the hallmark of our cancer center is teamwork, and this is difficult to convey over a computer screen. The amount of work that went into preparing for the virtual site visit was enormous, with contributions made by many researchers, administrators, staff and technical teams who worked for many months to assure the review went well. We will hear about the formal results in the next few months. This effort required a remarkable display of creativity and collaboration on the part of a large number of dedicated people, working closely together despite physical distancing, during a very stressful time. That said, I certainly hope we never have to do a site visit virtually again!

Mission – Education

One of the primary goals of an academic cancer center is to train the next generation of cancer clinicians and researchers. Our approach to such education has been changed, but not halted, by the pandemic. I continue to have weekly meetings with my research group by Zoom. In fact, my clinical research colleagues are more likely to participate virtually in these meetings now since they can do so from their offices or clinic and don’t have to walk to the other side of the medical center. I continue to meet weekly with graduate students in my laboratory. This has worked fairly well. It has become a standing joke that just about every Zoom meeting starts with a graduate student asking me to “enable screen sharing” so we can review their data and plans together. Grand rounds and other conferences including tumor board discussions are held virtually as well.  Not ideal but it works. As we all have gotten used to virtual conferences, we realized such meetings don’t need to be limited to a single institution. Holden suggested and organized the first Big Ten Cancer Research Consortium Grand Rounds that is a virtual meeting now held monthly. Typical attendance over the past few months has included around 100 researchers from multiple institutions. New collaborations between cancer centers in the Big Ten are starting to emerge from these discussions. Hopefully Big Ten Cancer Research Consortium Grand Rounds will continue post-pandemic and be seen as a silver lining that emerged from this very difficult time.

Mission – Clinical Care

A few weeks ago, I served as the attending physician on the malignant hematology service where most of our patients are being treated for leukemia. I worked with a fantastic team that was flexible and thoughtful about how to best care for patients despite the pandemic. We all wore personal protective equipment at all times and modified traditional rounds to minimize exposure for both patients and health care providers. In normal times, an important part of such rounds is talking with loved ones at the bedside to discuss results and plans. Given the pandemic restrictions on visitors in the hospital, these conversations had to take place by phone or video conference. I struggled with how to do this most effectively. While talking with patient family members by videoconference from the hospital room allowed us to do so together, I found having such videoconferences with family from my office had some advantages. It allowed me to take off my mask which helped with interpersonal interactions.

The pandemic has changed how we do things. Some changes, such new ways to communicate and collaborate on research and education, have added value and will stay with us post-pandemic. Others, such new approaches to communicating with patient’s loved-ones because of restrictions on visitors, will gladly go away. The pandemic has impacted how we do what we do, but not why we do what we do. For that, I am extraordinarily thankful.