Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

The Nameless Land

This novel, The Nameless Land, works to highlight the activists, marginalized, and minorities that have succumbed to the deadly system of the corrupt elite and resort to revolutionary tactics and violence to take down the system. The story is set in the fictional territories of Aurum, Opus, and the Nameless Land, which creates a strict, discriminatory, sectarian system as the core of Aurum’s laws. My inspiration comes from real-life experience during the Lebanese revolution that started on October 17th, 2019. Aurum is the perfect description of Lebanon’s corrupt government with nepotism, power, and theft being the underlying qualities a politician needs to thrive and become wealthy. Lebanon has faced thirty years of the same politicians stealing electricity, selling donations for their own gains, diverting public funds to their own bank accounts, and risking the lives of their own citizens. The corrupt ministers in this book were modelled after the politicians and certain events were pulled from the protests on the streets of Beirut. This has been a long-running project since my very first semester at NAU, which started as a short story in 2016, and there is still so much potential to expand it in many ways. Being an international student, this program was my reason for leaving home. My goal was to put myself in an environment where I had no experience, no friends, and no one by my side in the very beginning. Of course, that changed when I met all my professors and classmates. I believe my character, Keyani Canmore, is the fictional creation of my experiences. My entire MFA revolved around this story and, learning more about writing for activism that I plan on taking back with me to Beirut, in hopes of creating some real change from the acceptance of LGBTQIA+ related literature in university curriculums, the implementation of a “write as you are” literature magazine, and, most importantly, inspire people to fight hard against corrupt systems. This novel fits into the Young Adult genre, specifically categorized as dystopian fiction. I have pulled inspiration from similar subjects such as The Hunger Games, The Red Queen, and The City of Brass. The authors S.A. Chakraborty, Suzanne Collins, and Victoria Aveyard have thoroughly motivated me to follow this genre. Their books combine corrupt systems with revolutionaries that shift the dynamics of entire regions. I would also add Snowpiercer, based on the French graphic novel Le Transperceneige by Jacques Lob, Benjamin Legrand, and Jean-Marc Rochette. This is the voice I felt most at home with because it always links back to my time protesting in the streets, knocking back teargas canisters, and running from the police who wanted to arrest peaceful protesters. I imagine my novels are more cinematic with my descriptions and giving background details only if it comes naturally or through dialogue. My tone and writing style in this are focused on that, showing the readers the world through Keyani Canmore’s eyes and trying to make it seem like a movie through words. I have been dreaming big with what I intend to accomplish with this project. My novel does not end with this thesis. I plan on honing the story, expanding it where it needs to be expanded, and take as much time as possible for me to perfect it. I am hoping to find an agent that deals with this genre and publish the book to a wide audience. This subject has been part of my life, since I was born. It has become a part of my personality and is shaping my decisions to come in the future, which is one of the many reasons I hold this story in such high regard. I want this story out there as the entire world is starting to wake up to corrupt governments and systemic racism. Now is the perfect time to write about revolutionaries