From the Dean: And we’re off!

Welcome to 2023! I trust that you had a pleasant and enjoyable New Year. Susan and I had a wonderful few days away with our children, their spouses, and grandkids. But it is good to be back and part of the exciting things that are happening at your UND School of Medicine and Health Sciences. First up on the docket will be our testimony before the North Dakota Legislature regarding our budget proposal. The North Dakota legislature convened on Tuesday of this week and, by law, has 80 working days to complete its business. During that time, the legislature appropriates dollars from the general fund and other sources to support a wide variety of operations (with the concurrence of Governor Burgum, who is the signatory on bills passed by the legislature). As you may know, especially from prior columns, the School gets about a third of its revenue from state appropriations; we are very grateful for this extraordinary support, and my main focus when I testify next week will be to show the legislature what we do with this financial support in the realms of education, discovery, and service. It actually is a pretty convincing and straightforward story because of the fantastic efforts and outcomes achieved by our faculty, staff, and especially students. I will post my presentation slides to our website next week after my testimony, but if you’d like to watch the proceedings live, click on https://video.ndlegis.gov/ and scroll to find the Jan. 11 hearings for the House Appropriations Committee – Education and Environment Division. We present from 9:30 a.m. until 10:15 a.m. on Wednesday, Jan. 11, right after the UND presentation that is scheduled from 8:30 a.m. until we start at 9:30 a.m. President Armacost will be the main presenter for UND, as I will be for the School, but both of us will be assisted by others in the organization. Namil Choi, our Associate Dean for Administration & Finance/Chief Operating Officer, will accompany me to Bismarck and be available to answer questions from the members and provide context for our budget requests.

Part of our presentation will address our hot-off-the-presses Seventh Biennial Report on Health Issues for the State of North Dakota, which you too can read online here. Many thanks to Mandi Peterson and her Healthcare Workforce Group on this latest report, which we’re required by the state legislature to develop in advance of legislative years. As the Report notes, the pandemic has exacerbated “burnout” across health professions in the state, resulting in early retirements and resignations among some providers – thus a greater shortage overall – at the same time as it increased workloads for those physicians, nurses, and therapists who remained in their professions. But our state also improved in some measures, relative to previous reports. For example, the percentage of North Dakotans who report smoking, binge drinking, and drinking and driving are all down relative to 2019, according to the Report. This is all good news and will help our state improve overall cardiovascular health generally at the same time as it helps us combat the pandemic’s deleterious effect on our population’s wellbeing.

Speaking of cardiology, I thought I would offer a few thoughts wearing my cardiologist’s hat regarding the collapse of Damar Hamlin in a recent NFL football game. I only know what has been reported in the news media, so my comments are pure speculation. But many years ago I was peripherally involved in what appears to be a similar case, where an apparently healthy athlete was hit in the chest and suffered a cardiac arrest. While rare, any number of apparently similar cases have occurred over the years. Called commotio cordis, the “attack” appears to be due to the induction of a very unstable heart rhythm (ventricular tachycardia or fibrillation) by a thump to the chest at the very instant that the heart, during its normal cycle, is vulnerable to the extra beat that the chest trauma can induce. Typically, there is no apparent underlying heart disease, and survivors can lead subsequent normal lives. The key to survival, though, is the application of an external electrical shock to the chest wall and thus the heart by an automated external defibrillator (AED) as quickly as possible. As you might know, we have two AEDs available in the SMHS building: one on the first floor by the Simulation Center and one on the third floor by room E310.  I’ll discuss all of this in a little more depth in next week’s column, in addition to discussing what preparations and precautions we take at UND to deal with this very rare but obviously very serious possibility for activities involving our student athletes.

Until then, though, welcome back and stay warm.

Joshua Wynne, MD, MBA, MPH
Vice President for Health Affairs, UND
Dean, UND School of Medicine & Health Sciences