The Times They Are a-Changing

By Hannah Hughes, Frank Lyons and Keith Synnott
Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
Corresponding email: [email protected]

Published 10 April 2020

As G.K. Chesterton once proselytised, “health exists for life, and life exists for the love of music and beautiful things”¹. Perhaps he is right on both accounts but unfortunately, for most, these words stir reflection to a time “pre-COVID-19” and are less heartening during the current health-crisis we find ourselves in across the globe. Whilst an inspiring quote like this seeks to give us solace and ownership to our right to health, it does not consider those for whom health is not a given, nor those who find their health further compromised by COVID-19. It does not apply to healthcare workers, who continuously endeavour to maintain their health day-in, day-out in order to return to the front-line and valiantly treat those in need of care, COVID-19 related or otherwise.

Despite the current climate of stringent self-isolation and social distancing, never have we been so connected as a national and international healthcare community. Speaking of his experience in Bergamo, Italy, the Italian intensive care physician Dr Daniele Macchine wisely stated “…there are no more surgeons, urologists, orthopaedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us…”². Pre-COVID-19, the concept of Trauma and Orthopaedic surgeons doffing their scrubs in order to staff a medical ward would ignite a resounding knee-jerk response channelling Father Ted’s immortal protestations of “down with this sort of thing”³. However, we have seen Trauma and Orthopaedic trainees redeployed to medical teams to great effect, decompressing the pressure on medical COVID-19 teams at a time when Trauma and Orthopaedic services have been streamlined in order to facilitate expansion in COVID-19 care provision and to mitigate unessential exposure for patients and physicians. Both national and international surgical training bodies, as well as governmental departments, have published widely on this topic, offering guidance and support for specialists and trainees of all surgical specialities at this time^4-9.

In the words of Queen, when there’s “pressure pushing down on me, pressing down on you”, never has it been so important to foster practices outside the realms of hospital walls and COVID-19 testing centres in order to reduce anxiety and allay COVID-19-related concerns, many of which are outside of our control, whether you are a healthcare worker or not¹⁰. In these times of social distancing, some have turned to physical exercise, some to meditation and many to music. The therapeutic effect of music has been demonstrated to great effect in the literature. Music has been shown to reduce blood pressure, enhance neural network connections and significantly lower levels of inflammatory cytokines and stress hormones¹¹.  It is an effective and readily available method of stress relief and relaxation in our age of technology, internet and applications such as Spotify. Your stress, your song.

In the words of Bob Dylan, “the times they are a changing”¹². Indeed, never have these words rang so true, and never has courage been so necessary. The original definition of the word ‘courage’ comes from the Latin word ‘Cor’, meaning ‘heart’. We have seen the demonstrable galvanisation that national and international surges of courage can have, not only on the front-line of healthcare delivery but in our social-networks, both on and off-line. Millions of homes across the globe are connected by a simple, heartfelt message; “stay safe, stay home”. Socially distance to keep the ones you love close. And change we will. Our collective efforts will facilitate and propel our evolution as a species to overcome this virulent hurdle. The gallant efforts of humanity will be long remembered and forever revered in the post-COVID-19 era, whenever that may come to fruition.

References

1. Chesterton GK. Collected Works of G. K. Chesterton: Ignatius Press; 1990.
2. Seidel J. What life will be like in virus lockdown. The Chornicle. March 11, 2020. Availble at: https://www.thechronicle.com.au/news/what-life-will-be-like-in-virus-lockdown/3966062/.
3. Lowney D. Father Ted: The Passion of Saint Tibulus. Series 1, Episode 3. Ireland, 1995.
4. Health Service Executive (Ireland, 2020). Policy and Procedure: Redeployment of Staff During COVID-19 Infection. Available at: https://www.hse.ie/eng/staff/resources/hrppg/policy-on-redeployment-of-staff-during-covid-19-infection-march-2020.pdf.
5. Department of Health (Ireland, 2020). Ethical Framework for Decision-Making in a Pandemic. Available at: https://assets.gov.ie/72072/989943ddd0774e7aa1c01cc9d428b159.pdf.
6. NHS England (2020). COVID-19: Specialty guides for patient management. Available at: https://www.england.nhs.uk/coronavirus/publication/specialty-guides/.
7. British Orthopaedic Association (2020). Emergency BOAST: Management of patients with urgent orthopaedic conditions and trauma during the coronavirus pandemic. Available at: https://www.boa.ac.uk/resources/covid-19-boasts-combined.html.
8. American College of Surgeons (2020). COVID-19 and Surgery: Resources for the Surgical Community. Available at: http://www.facs.org/covid-19.
9. Royal Australian College of Surgeons. Coronavirus information hub 2020 [April 1, 2020]. Available at: https://www.surgeons.org/media-centre/covid-19-information-hub.
10. Mercury F, May B, Taylor R, Deacon J, Bowie D. Under Pressure. Hot Space, 1981.
11. Simon HB. Music as medicine. Am J Med. 2015;128(2):208-10. 
12. Dylan B. The Times They Are a-Changin'. The Times They Are a-Changin', 1964.