QI
Editorial
How Can You Talk About Anything Else Quantum Change In The Year Of COVID-19
In the last three months I have had three good friends die, two of COVID-19, one in Memphis, the other in Seattle; the third friend, also in Memphis, admitted in congestive heart failure, died not of COVID-19, but of hospital acquired sepsis. Three good friends. That’s natural, friends dying as they grow older, but it is sobering. And that’s not to mention the COVID-19 deaths that our hospital colleagues have seen, nor fellow physician colleagues who have contracted and died of it. To say this is the year of epidemic, then pandemic, then endemic; the year of torn social fabric; the year of sobering recognition of the fragility of humankind; the year of reckoning; each would state the obvious. I am brought to the idea of Quantum Change, not as in Quantum physics, but as in the term coined in 1994 by Psychologist William Miller, the idea of “long-lasting…profound realizations that can happen quickly…that fundamentally alter a person’s sense of values, perspective on life, how they view themselves in the world.” The idea applies to an individual, but surely applies collectively to us all. No doubt there will be profound changes in the marketplace, in how business is conducted, changes that may have happened anyway, but are now accelerated. No doubt there will be profound change in how physicians diagnose, treat, control infections. Advances in surgery and medicine were often born of necessity, out of crisis, and the same is happening now, particularly in re-thinking the damage caused by our own immune systems, now targeting a different pathway of treating infection. Early in sepsis the treatment target is the inciting organism, but now focus has shifted to our dysfunctional immune system. Paul Thomas, immunologist at St. Jude Children’s Research Hospital, is looking at the role of interferons and interleukin-10. Monoclonal antibodies, all the rage in oncology, are now investigated for their potential role treating infection, including hospital acquired. It is too late for my friends, but we will get through this, new treatment, new understanding, new prevention. But will we come to that Quantum Change, all of us, that we really need? Thomas C. Gettelfinger, M.D. 3
