The COVID-19 pandemic sometimes feels like a problem we mostly dealt with yesterday, not one we’re still facing today. However, Duke medical anthropologist Harris Solomon had a different story to tell in the Trent Humanities in Medicine Lecture on April 9.
The transformations within Intensive Care Units (ICUs) across the globe, initially sparked by necessity, have morphed into what might be our “next normal,” Solomon said.
During the height of the pandemic, hospitals morphed into war zones where the frontlines became the ICU rooms. Like never before, these rooms became a no-man’s-land that few others would cross. A separation was born.
This separation, however, was beyond a physical space; it was a delineation of roles and responsibilities. Nurses often found themselves acting as intermediaries between the patient and the external healthcare team, prompting a sense of isolation and moral burden. They wrestled with their fears in solitary confinement, while colleagues relayed instructions over walkie-talkies—a stark contrast to the collaborative nature of pre-pandemic medicine. Protocols that were once straightforward now needed a touch of ‘MacGyvering,’ with clinicians making do with what was available.
The rigidity of clinical trials also faced challenges; the blinding of studies was questioned as lifesaving drugs teetered on the edge of accessibility. Solomon gave an example of what this change looked like in real life. A patient was due to be treated, and they said that they didn’t care about the details. Even if it was a placebo, they were fine with it. While he didn’t go into the specifics of what had happened, he used this story to accentuate the disparity between evidence and treatment. People don’t care about the treatment as much as they used to.
“We make decisions like we never did before. We summon the need to accept uncertainty”, Solomon said.
As the crisis was evolving, and the world was recovering from the aftermath of COVID, the fabric of healthcare work found itself to be changed forever. Processes and practices that were once considered to be stable, are now brought under a microscope in a post-pandemic world.
The pandemic has indeed been a catalyst for change, but is this change good? While there is no black-and-white answer, I left the room feeling a bit uncomfortable. Although the pandemic has prompted a reevaluation of the health care system, have we innovated, or have we just found shortcuts?
