To the editor of THE EAGLE:

The recent demise of the surgical training program at Berkshire Medical Center has generated surprisingly little discussion in The Berkshire Eagle, and therefore I have decided to offer my two cents worth. BMC has wholeheartedly supported medical education in the past. Will it continue to do so?

My father, Robert J. Tracy, M.D., was one of the founding fathers of the surgical residency program begun in 1962 (along with other BMC surgical giants such as Clem Curd, Gerald Haidak, Ralph Zupanec, Ryder Neary, Ed Galla and Gene Leibowitz.) He considered it the crowning achievement of his life. On many occasions I witnessed him brimming with pride over the successes of its graduates, who often went on to first class fellowships in fields such as cardiovascular surgery, plastics or oncologic surgery. Foreign graduates of the program returned to prestigious positions of medical leadership in their home countries.

The program was clearly a jewel, and it was the highest level of postdoctorate education in the Berkshires, as well as the backbone of quality surgical care at BMC. The program demanded excellence and had a 100 percent surgical boards pass rate. I can just about hear my father rolling over in his grave.

I don’t profess to know at all what went wrong. Maybe it succumbed to the ever-burgeoning medical bureaucracy, or maybe the problem was inept leadership. From my perspective as a Fairview Emergency Room doc, I can tell you that neurosurgical coverage at BMC has been an ongoing program over the last several years.


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It has been inconsistent.

My understanding is that to have a Level II Trauma Center you must have solid 24/7 neurosurgical coverage, and without this designation, you cannot have a surgical program. Here lies an obvious Catch-22. It’s difficult to attract neurosurgeons without a viable program, and you can’t have one without them. The public should be aware that as of Aug. 25, unless new neurosurgeons are recruited, any patient with a neurosurgical emergency -- a hemorrhagic stroke, traumatic brain injury or spinal cord compression -- will have to be transferred out of the county for appropriate care, and precious time may be lost.

So what to do? First, it should be recognized that the loss of the program is every bit as serious as the fall of NARH. Over the long run, it is impossible not to have a degradation of surgical care. The program has provided high quality surgeons who often have elected to stay in the Berkshires, such as Drs. Sadighi, Basile, Veinoglou, DiSienna, Heiseke and Galvez. And without a program you can’t attract other high caliber surgeons. They seek a teaching hospital for the professional enrichment of the educational environment, the availability of first rate surgical assistants, the time-honored desired to teach as they have been taught, a desire to be relieved of middle of the night calls, and finally a desire to be spared the growing tedium of day to day documentation. Although maybe feasible as a short-term remedy, to think that a surgical residency program can be effectively replaced by surgical PAs (with all due respect) or some kind of surgical hospitalist service is untenable.

My unsolicited recommendations are these: The powers that be at BMC should recognize this as the crisis that it is and utilize some of the hospital’s substantial endowment to turn things around fast. Surely, contributors to the endowment did so to assure continuance of the highest quality of care. Hospital administrators should make BMC the most desirable place in the nation to practice neurosurgery, and then recruit three neurosurgeons so that their on call duties are tolerable and the situation is stable.

If there is not enough surgery to support three, the extra time could be used for teaching, attending cutting edge conferences or even doing research. Simultaneously, they should hire a top of the line surgical program director: Parvis Sadighi, if he so desires, or someone else if he doesn’t. (He was brought out of retirement to help manage this problem.) Hopefully, the program can be reborn by 2016.

Resuscitating the surgical residency program will take a huge amount of work and money. But I don’t think it’s an exaggeration to say that the quality and prestige of the institution are at stake. Therefore, I urge BMC to pull out all stops to revive the program right away for the sake of us all.

STEPHEN E. TRACY, M.D.

Lee

The writer is an emergency physician and chronic wound care physician at Fairview Hospital.