Wisdom and Tragedy

This article originally appeared in Modern Healthcare under the Commentary title "We've already learned much in this pandemic; our newly acquired wisdom can’t go to waste" and is available in original form here.

From all conceivable angles, the COVID-19 pandemic is a heart-rending global catastrophe unimaginable even in ancient Greek tragedy. The virus itself has already killed countless thousands and infected untold millions. Billions more are bleeding from the lacerations it has ripped through society’s socioeconomic skin.

Despite monumental efforts to blunt the carnage of this tragedy’s first act, the cuts it has left are deep and jagged and will take time to recover. Worse still, before we can fully recover, we must live through COVID-19’s second, third and fourth acts—whatever they may bring—for months and years to come.

Yet the tide of tragedy will retreat. When it does, we will be left with only the wisdom that—in the words of Aeschylus—we’ve earned drop by drop, against our will, through the awful grace of God. Should we fail to capture that wisdom, appreciate it and act upon it, we will doom our grandchildren to reliving the human horror of a violent pandemic in a world caught flat-footed.

So what have we learned?

1. We have learned that war profiteers don’t distinguish between bulletproof vests and N95 masks.
2. We have learned that the Strategic National Stockpile, when faced with a pandemic of international proportions, only lasted a few weeks.
3. We have learned that in the fog of pandemic no one is immune to the reactionary force of fear.
4. We have also learned that it is our response to that fear—individually and collectively—that defines our ability to overcome it and earn either victory or defeat.
5. We have learned that in the absence of strong national coordination, individual states will compete with hospitals, businesses, the federal government, and each other over everything from personal protective equipment to people.
6. We have learned that while viruses have little respect for geography, our pandemic health, much like our population health, remains far too heavily driven by our ZIP code.
7. We have learned that the compassion, perseverance and ingenuity of American citizens are unbounded by social or physical distancing.
8. We have learned that distilleries can make impressive hand sanitizer.
9. We have learned that college engineering labs can 3D-print any kind of face shield a front-line healthcare provider can imagine.
10. We have learned that when the traditional supply chain fails, America finds ways to fill the gaps for those on the front lines.
11. We have learned that seemingly insurmountable problems in the light of day—like providing access to millions of telemedicine visits a week for people across the nation—can somehow be solved in the darkest hours of night.
12. We have learned that while competition drives improvement, competitors become collaborators when faced with crisis and when grounded in the common core value of community service.
13. We have learned that communities care for their front-line healthcare heroes in ways and to a depth that has never been fully publicly expressed.
14. We have learned that when sanded down to its core, healthcare’s most basic, clear, vital construct remains the clinician-patient relationship. And with all the lacquer stripped away, clinicians of all stripes still step up to care for patients.
15. Finally, we have learned that when forced to bear the weight of a fight for our very survival, the pillars of our healthcare system—stressed at the baseline by massive clinical, business and analytic transformation—quickly revert to supporting their most human, most necessary, and most inspiring mission: to care for people in need.

As healthcare leaders, we owe it to our neighbors, friends and families to translate the wisdom we have earned from these painful months into meaningful, sustainable change. Change that will strengthen our national health coordination. Change that will deepen our public and population health infrastructure. Change that will forever banish the long-standing roadblocks to progress torn asunder by the force of this pandemic. Change that will once again stoke the fire that has long burned deep in the hearts of those called to healthcare to serve their fellow humans.

Failure to do so would be tragic.

Dr. Chris DeRienzo is senior vice president of quality and chief medical officer at WakeMed Health & Hospitals, Raleigh, N.C.