In this issue, we grapple with what a contemporary global pandemic means in our lives and work in academic medicine, and with the question of how it changes things. These stories 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 each other and the compassion that shines on the faces of those around us, even through masks and shields that protect us.