From the Editor-in-Chief: Bigger Questions of Systems, Viruses, and the Lives of Real People

https://doi.org/10.37765/ajmc.2020.43656In the early days of AIDS, I trained as a medical student in a ward filled with patients struggling to survive complications of the illness. At that time, a large share of patients succumbed to their first episode of Pneumocystis pneumonia, and here were dozens of people struggling through this infection. So many frightened people, so many gaunt faces searching for hope.

In what could have been a center of despair, one patient, a professional singer, decided to fight back. Each morning, despite fatigue and shortness of breath, he stepped into the corridor and began to sing. At first the notes were tentative, interrupted by fits of coughing. As the days passed, however, his voice grew stronger, and the notes turned into increasingly beautiful arias. The beauty of the voice mesmerized and inspired us. This community, assembled through the cruel human toll of an invisible foe, was forged together through courage, gifted to us by one man’s willingness to fi ght back. Thirty-three years later, I can still hear his voice.

In both that pandemic and the one that we now face, our extraordinary systems of technology and knowledge have proven vulnerable to the smallest of things. Once again, we face an invisible, seemingly implacable foe that has upended our sense of normalcy. We should not resign ourselves to an inevitable fate, nor should we minimize the challenges of the road ahead.

As a hematologist, I have learned to appreciate that distinct moment in caring for patients and families, shortly after the word “cancer” is first spoken, that is both a time of extraordinary vulnerability and a turning point: It is the time when the will to transcend that word and its implications is mobilized in earnest.

We are at that moment in this pandemic. Clinicians, clinics, and hospitals have mobilized to ensure that patients receive the support and care that they require. In such a diffi cult time, it is extraordinary to see again and again how acts of compassion and courage can have such immense power. For those who are most vulnerable to the eff ects of the coronavirus 2019 (COVID-19), particularly those with cancer, hospitals and clinicians have worked to create safe havens where patients can continue to receive lifesaving care. As we learn more about this virus, with a flood of knowledge coming on a daily (sometimes hourly) basis, our ability to respond continues to evolve.

While this response is built upon a foundation of science and technology, the way forward ultimately requires that we navigate the human dimensions of this pandemic. Social distancing, masks, and a profound revisioning of our daily routines are as fundamental to transcending this virus as are much-needed advances in science and technology.

As I recall the early days of the HIV/AIDS pandemic, what stands out most is its profound human cost and the courage of those who helped our society transcend it. We are in the midst of a time in which the human toll of COVID-19 and the enormity of the path ahead are clear. As we develop the science and therapeutics necessary to combat this foe more eff ectively, we need to remember that success requires understanding and navigating the humanity at the heart of our systems of care. This battle is not going to be won fully in a laboratory—rather, it must be realized in the lives of real people.