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New York, NY – The era of COVID-19 has pushed the envelope in hospitals across the world, challenging care delivery models and allowing one ventilator to ventilate 600 patients at once. At one New York medical center, intense clinical demands and provider fatigue
have inspired one anesthesiologist to push the boundaries of clinical medicine.

Dr. Mac “McGrath” Millerstein, a cardiothoracic anesthesiologist, has intubated countless patients with COVID over the last several weeks. “I’ve intubated four, or maybe it’s been sixty – I’m bad at counting. That’s why we have circulating nurses in the OR.” After
this rash of intubations, he decided to push the envelope with a recent urgent CABG.

“Those OB and regional folks are doing spinals all the time. I haven’t done one in two decades, but how much has changed? If the patient is numb, you shouldn’t really need more than that for a CABG – a spine is still a spine.” Dr. Millerstein taped an endotracheal
tube to the drapes to hide his experimentation from the surgeons, who would’ve immediately thrown a scalpel across the blood-brain barrier had they known.

“The case went perfectly for the first 30 minutes!” said Willing Accomplice, the room’s circulating nurse. “The patient tolerated incision well, was able to hold his breath when directed by the surgeons, and was able to be successfully placed on the heart-lung
machine.” Shortly after, the spinal anesthetic wore off and the patient was quickly placed under general anesthesia. The procedure was completed uneventfully after the surgeon, Dr. Annuloplasty, unscrubbed to sucker punch Dr. Millerstein. Millerstein ducked,
administered intramuscular ketamine to Dr. Annuloplasty, and a major crisis was averted.

“Apart from paralysis as a result of a spinal epidural hematoma, the procedure was a resounding success. Whoever would’ve known you can’t give 30,000 units of heparin right after a spinal? We did it all the time when I was a resident…” said Dr. Millerstein.

The paper was recently submitted to the New England Journal of Medicine for publication, and received a glowingly positive review. “We loved the ingenuity of this case, but we really love that it has COVID in the title,” said Dr. OldWhite Man, the editor-in-chief
of NEJM.

Update
5/25/2020: Dr. Millerstein has resigned his privilidges at Mount St. Presbyterian Israel Methodist Zuckerberg Medical Center as of noon today. Dr. Annuloplasty remains in a ketamine-induced haze in the corner of the operating room.

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