Marc Goldfarb, RN, BSN, CNOR, was inspired to take portraits of his masked and shielded colleagues in the spring. “As nurses were asked to remain flexible and provide care in different settings, we began to lean on each other for support,” Goldfarb said. “I found myself working alongside a lot of familiar faces, only the expressions had changed. I didn’t see fear. I saw concern. I didn’t see hopelessness, I saw bravery. I never saw weakness, I saw strength. And more than anything else, I noticed camaraderie.”
We called it “Flu Forward.” Two years ago in the pages of this magazine, we looked back 100 years to the 1918 flu pandemic and speculated on whether such a disease could strike again. Our experts’ chorus: It wasn’t a question of if humanity would face another great global pandemic, but when.
The answer to that question came sooner than many of us would have expected with COVID-19. And this issue serves, in a few ways, as an elaboration of that answer.
We have also broadened our scope as we grapple with what a contemporary pandemic means in our lives and work in academic medicine. Our story about the 1918 flu implicitly posed a third question after “if” and “when” the next global pandemic would strike: How would we deal with it? The answers we delved into two years ago proved prescient to the approaches now undertaken here and around the world—public health surveillance, novel treatment strategies, and rapidly deployed, fresh approaches to vaccines including RNA-based and DNA-based vaccines pioneered at Penn Medicine. Our cover story in this issue offers glimpses of this full-force effort underway at our institution since the spring, including the immediate clinical response, support for the workforce, and planning for a changed future.
Before COVID struck, we had already embarked on another 100-year look back for this issue, timed to the centennial of women’s suffrage in the United States, with profiles of Penn medical alumnae from each decade from 1920 to the present. As the reality of 2020 unfolded, we reshaped the story’s direction. Our 1920 graduates, including Julia Morgan, MD, were conscripted to treat influenza patients while still in medical school in 1918. Our 2020 graduates were kept away from their clinical duties at the spring peak of COVID, before the start of residency this summer put them back on the front lines at hospitals across the country. Not only do we now highlight the transformation of the landscape for women in medicine, but also what changed in the space of a century bracketed by two global pandemics.
Back in 2018, there were other “how” questions we didn’t think to ask about a deadly modern global pandemic. How would it change us, our fears, our focus? How would we face it, and what strengths would we lean on to survive and help those in our care? Many of the stories in these pages—cover to cover—now answer that question and show how COVID-19 has driven our focus on what matters most. That includes public health, surviving the pandemic; creativity, whether in finding unexpected sources of PPE or in using artistic expression to cope with hardship; and justice, driving out longstanding inequities. It includes caring for our colleagues, for our loved ones, and for ourselves. It includes being there to extend a helping hand—even if virtually, from a physical distance—as we all strive to get through this.
And sometimes the answer to “how” is evident even without words, but with a feeling of compassion, support and camaraderie as we’ve supported one another in different ways than before. It was 5:30 on a chilly morning in April when Colleen Kelly, RN, BSN, CNOR, paused before starting her shift outside the entrance of the Hospital of the University of Pennsylvania to allow a colleague to take her photo—the photo now on this issue’s cover. Moments later, patients saw the warmth of Kelly’s kind eyes to calm their fears as they arrived for surgeries that couldn’t be delayed, even in the earliest peak of the pandemic when many non-emergency procedures were put on hold. At the time, visitation restrictions to protect our patients and staff meant they were unable to have a loved one with them—no family member could hold their hand. Kelly, a 19-year Penn Medicine employee, was redeployed to welcome patients to help them feel at ease as they came through the door.
“It felt rewarding to help patients and their families, to help them feel a little better about the situation,” Kelly told me recently. She’s now back at the Perelman Center aiding in outpatient surgeries again, where her patients are allowed to bring a visitor and things are mostly back to normal, albeit with masks and shields. It’s a changed world, but Kelly’s expression remains kind—and reminds us that the way we’ll get through this is by looking out for each other, together.