Editor’s Corner: New World. New Ways. Same Resolve.

First off, I would like to wish you all well and offer you a warm e-embrace on behalf of the LipidSpin team. I would also like to apologize for the delay in releasing this issue featuring the SWLA; we’ve been a bit distracted by a global health crisis and our schedule got pushed back.

It is hard to believe our last gathering was the Clinical Lipid Update in Denver. I distinctly remember using the “fist bump” greeting during pre-meeting courses, which then gave way to real handshakes and then hugs as the meeting began in earnest — I was so naive pre-COVID19. The taxi driver told me he had already noticed that the airport crowd was starting to thin out by the time we were heading back to our respective homes, and within one week, we all learned what it meant to “shelter in place” and to “social distance.”

The outbreak in Wuhan had already begun, but seemed far away initially. Then we started to hear about Italy, Iran, Turkey, and then the Washington state outbreak, then New York City. Friends and family started fleeing Europe, and some brought the virus with them. Others left safe environs just to step right into the fray, and it did not take long before the travel questions seemed entirely irrelevant.

It has been a whirlwind since then. Most of us have never personally experienced a ‘shutdown’ like this. If we were born in the right place/time, we have not lived through war in our backyard, a cholera outbreak in the camp where we live, or oppressive governments that literally peek through your windows. Some of us have lost loved ones recently, and have not had the right opportunity or freedom to mourn. Some of us are fearful for the economic challenges thrust upon us by the virus. And most of us have more mundane concerns.

We are stuck at home, unless we have to work on the frontlines of the disease. We are stuck at home with clean water from our taps (mostly), working electricity 24/7, cable internet and entertainment access. We are stuck at home with short supplies of toilet paper and cleaning supplies and there are long lines at the grocery store, but we come home with full bags of fresh food. Our trauma is the physical isolation, the disruption of normalcy, and the roulette of living in a pandemic.

It has been a horror show for some of our colleagues. We have seen our hospitals empty out to make way for infected patients. Our senior citizens, our weak and sick, and particularly our patients with cardiometabolic diseases have been hit hard; and so have our colleagues on the frontlines. Nurses, physicians, assistants, and orderlies have succumbed to the disease. The ICU staff is in a constant rolling turnover and they are getting tired. PPE is in short supply and staff have learned to be creative to manage. They have also banded together and this week we were regaled with signs of hope and joy as staff create honor guards for discharged survivors.

I have been fortunate to be able to focus on academic pursuits during this crisis. I do Official Publication of the National Lipid Association 3 Discuss this article at lipid.org/lipidspin Editor’s Corner: New World. New Ways. Same Resolve. DANIEL E. SOFFER MD, FACP, FNLA Editor, LipidSpin Clinical Associate Professor of Medicine University of Pennsylvania Internal Medicine and Preventive Cardiology University of Pennsylvania Health System Philadelphia, PA Diplomate, American Board of Clinical Lipidology not work in hospitals anymore (not since 2005), and I no longer worry about being deployed to the ICU as Philadelphia seems to have reached a plateau and the health system administration does not really want an out-of-practice physician getting in the way of good care. Our office volume is way down, but I feel blessed to be supported by a large health system that buffers the economic stress for me. I know those of you in private practice do not have that luxury and that you are faced with the solution of seeing more patients at a time when it is not safe for them. I struggled with wondering if I am doing enough. Should I volunteer to work in the hospital, the urgent care center, the PPE production line? A colleague suggested that our job is to keep people out of the hospital, and that simple statement gives me purpose.

In the meantime, I have retreated to what I do best. I ‘see’ patients, I edit papers, I create presentations, and I prepare to teach a course for the home-bound medical students. This is where I have found comfort and the needed distraction from the worry.

I have also found what others have found: time. The commute is shorter everyday, and my first appointment moved back to a luxurious 9am since tele-visits do not have to work around normal work and business schedules. That means I have time to do extended exercise in the morning, make my lunch every day, and even take a walk in the evening with my wife. And to be quite honest, we really do prefer this simpler life. There are fewer obligatory evening meetings, no weekend work travel, or even weekend sports schedules. I like this pace of life. I am better rested, fitter, able to get through my to-do list.

I know the June Scientific Sessions was moved to December, but my internal ‘NLA clock’ leaves me anticipating the meeting. And LipidSpin continues. It took us longer than necessary to wrap up this edition, but we got there, and the next edition is moving forward at the same time. It is not the same as a face-to-face meeting, but LipidSpin can be a surrogate for now.

It makes sense to have moved the 2020 Scientific Sessions to December, but I will miss all of you as we roll into June. It is the communion of the NLA that is our greatest strength. We all tend to practice in the islands of our home institutions and private practices. It is the coming together three times per year though that reminds us we are not alone in our field. We see our friends and colleagues who all speak the same language of lipids, and we are energized by those meetings. I still get excited to see the red cover of the JCL and even though I have read, re-read, and re-reread the articles in LipidSpin by the time it arrives in the mail, I still love to pick it up and hold it in my hands. These journals remind me of my connection to all of you. They provide us superb science, guidance, a chance for mentorship, leadership, and a chance to cherish the process. We learn from each other, we share what we know, we make ourselves better, and we go out and teach to the community, and we heal others.

We will have to adjust to the changing world, but I know that we will be able to redefine ourselves in this challenge. The NLA has always been the ‘go-to’ organization for all things lipid and we will continue to be that organization. However, we may have to maintain our strength and voice from a distance for now.

So, once again, thank you to all of you who are managing the madness in the ICU’s. For all of you who are struggling to stay afloat right now, don’t forget that you have your NLA peeps to lean on. We mourn with all of you who have lost loved ones. And for those who need the warm embrace of a colleague from afar, know that we will be together again soon.