This would not be the first time that Dr. Evalina Burger has hung out a sign that says “Medical Help Available.’’
Caring for people during crisis is ordinary for Burger, an orthopedic surgeon at UCHealth University of Colorado Hospital. She has repaired blast injuries for refugees fleeing war in Angola, performed the first surgeries for those maimed during Hurricane Katrina and now, during the global pandemic, she is in the operating room doing spine surgeries for those at risk of paralysis or deadly infections.
In recent days, she and all UCHealth hospitals resumed medically necessary surgeries for people who needed help but had to wait until a surge in COVID-19 patients passed. Burger and teams of physicians and medical experts are taking every precaution to keep all patients safe from the novel coronavirus.
As one of the world’s experts on spinal surgery, Dr. Burger is no stranger to adversity. A native of South Africa, she chairs the Department of Orthopedics at the University of Colorado School of Medicine. In her early years, she volunteered to serve in the medical corps for the South African military and led a surgery unit there at a time when very few women were even performing surgery.
“I held the rank of captain,’’ she said. “At that time, we were providing humanitarian help to Angola. I was taught to speak Portuguese fluently so I could communicate with patients flowing out of Angola.
“I worked with multiple amputees, those injured from land mines and machete injuries. And that is what turned my desire toward orthopedics,’’ she said. “I started to enjoy all of these surgeries that we did to save limbs; replant toes to work as thumbs and all of the scary stuff that you do in a war zone. That was the beginning of my career.’’
Burger was certified to practice medicine in 1984, and then earned certification as an orthopedic surgeon in 1993. She was recruited to the United States as an associate professor at Louisiana State University Health Science Center. She built an adult spine program there and then Hurricane Katrina walloped New Orleans, the worst hurricane ever in the United States.
She has not forgotten the day the city ordered that residents evacuate the city by zip code.
“So we packed up our car and spent hours on the road. It was eerie to see highways going only in one direction, with lanes and lanes of cars,’’ she said. “As we were driving by cars, you could see that they had their livelihood in the car – the dogs, the cats, the chickens on the roof rack. It was weird, it was very weird.’’
She sent her parents, who had been visiting from South Africa, back home. She and her husband, son and two dogs packed their truck and drove to Los Angeles because her son, at the time a child actor, had business there.
Burger then packed up the truck and drove to the Super Dome in Houston to pick up her administrative assistant, who had sought refuge there, and the two drove back to New Orleans, which was under water.
“I stayed with kind people who had a house on top of their barn,’’ she said. “And I took a pontoon boat over the river. I was 96 miles from the hospital, and I was one of 36 doctors who returned to the city and work out of the Kenner Hospital very early.’’
Upon arrival, she and other doctors cleared the building of mud and rocks. Since all channels of communication had been silenced, Burger had only one way to let people know that the hospital was open. She placed a cardboard sign outside of the hospital: “Medical care available.’
“There were no phones, no pharmacy, no blood bank, but I was able to perform the first surgery. We had to take care of very significant injuries. We had people cutting themselves with chain saws, and shooting themselves in the hand with nail guns. We had teenagers playing ‘chicken’ on the freeway and we didn’t have a blood bank.”
“It was very taxing, but my previous military experience served me well during that time.’’
Now, in the throes of a worldwide pandemic, Dr. Burger is unfazed. She’s been in the operating room frequently in March and April because some patients risked paralysis and death from serious infections without intervention.
Since November of 2018, she has led the CU School of Medicine’s Department of Orthopedics. She has been an active investigator and educator working to find new metal-alloy compositions to improve orthopedic implants. She has helped to implement the use of new spinal rods that result in more than 90% fewer fractures in patients. These rods are each individually designed for each patient specifically.
On March 13, 2020 – Friday the 13th – the day the United States began to reckon with the grave threat of an invisible virus, when word that surgeries would be postponed in hospitals across the country, Burger knew she was living in another extraordinary time, not a war or a hurricane, but a pandemic.
In the following days, she picked up the telephone and personally called each of her patients. She was sorry to inform them, she told them, that their surgeries would have to be postponed for safety reasons. She would reschedule as soon as she possibly could.
In the next few days she and other surgeons didn’t have to clean buildings of muck from a hurricane, but they quickly drafted plans to ensure that all patients entering UCHealth surgical suites during the pandemic were safe.
“We are rolling out very slowly, we have enough PPE (Personal Protective Equipment) to protect both of our patients and our providers. We are practicing social distancing, that means we won’t have as many rooms open, that means we won’t have as many patients lined up and waiting for surgery,’’ she said.
Every patient scheduled for surgery will be tested for COVID-19. When surgery is completed, every room will be terminally cleaned,
“It will be completely sanitized, and we are taking other precautions. When we intubate patients, no one will be in the room for the first 15 minutes except for the anesthesiologist in a full suit. That way, we limit exposure,’’ she said.
After surgery, patients will be cared for in private rooms and patients will be watched over via telehealth and remote monitoring, which means contact with patients are limited to only needed interactions – a practice in place before COVID-19.
“We are making sure that when we are doing surgery, we’re doing surgery that is medically necessary and we are not doing surgeries that would involve a patient going to a skilled nursing facility afterwards, because that is where we are seeing the biggest outbreaks. We are going to start on surgeries for our patients that are medically necessary and patients are healthy enough to have a short hospital stay and go home.’’
“We have been providing excellent care for our patients, we’ve been using telehealth and making sure taking care of everyone during this period of uncertainty,’’ she said.
In the coming days, as surgery suites begin to slowly come back on line in UCHealth hospitals across the Front Range, doctors will have everything they need to help people and keep them safe. They’ll have PPE, sanitized rooms, a blood bank, a pharmacy and the ability to widely communicate – everything at the ready.
In this crisis, and others, Dr. Evalina Burger will be there, too. Rest assured.