The fight. The battle. The conquest. The opponent. The enemy. The nemesis. Our collective descriptions of our response to COVID-19 are analogous to our descriptions of wartime. We have cast the novel coronavirus as the opposition and ourselves as the mighty conquerors. Reflecting on this portrayal over the past three months – during the final stretch of my medical training before becoming an independent practitioner – I find myself wondering if this monochromatic narrative has actually progressed us towards the ultimate goal of defeating COVID-19. Perhaps my skepticism stems from my own recent experience completing the Interprofessional Applied Practical Teaching and Learning in the Health Professions (INTAPT) course as part of the UofT Clinical Teacher Certificate program just prior to the COVID-19 onslaught. I cannot help but wonder if a shift in attitude towards alliance and partnership rather than resistance and combat is a more productive way of approaching this crisis. I certainly do not intend to make light of the havoc and tragedy that COVID-19 has wreaked on our local and global communities. However, is it not true that better the devil you know than the devil you don’t? In the INTAPT course, I was introduced to various teaching and learning theories that have become embedded in medical education. Notably, Tuckman’s 1965 model of the stages of group development, forming-storming-norming-performing-adjourning, highlights the necessary and inevitable phases in order for a team to grow, face challenges, tackle problems, find solutions, plan work, and deliver results. Perhaps Tuckman’s collaborative approach to building a high-functioning team can be applied to our relationship with COVID-19. The first stage of group development, forming, consists of meek introductions, establishing clear group objectives, and defining individual members’ roles. In this stage, most team members are positive and polite, excited about the task ahead. However, others are anxious as the ultimate team goal remains somewhat vague. As COVID-19 hit our shores during the bleak month of January, it introduced itself timidly and only mildly threatening. With only the odd travel-related case here and there, we greeted the virus cordially and as an unassuming cousin to influenza. Once familiarized, the team then moves into the second stage of group development, storming. In this stage, team members toy with the idea of pushing against the boundaries that were established in the forming stage. This is the stage where many teams fail, and our relationship with COVID-19 seems to be no exception. The novel virus, introduced to us as an unassertive threat, swiftly metamorphosized into an unruly match. It defied our authority with no remorse and proved itself to be a force to be reckoned with. Unfortunately, our collective stress and fear of this uncontainable menace bred internal conflict as public health and authorities at various levels of government failed to traverse this battlefield in union. Gradually, the team moves into the third stage of development – norming. In this stage, members begin to resolve their differences, appreciate each other’s strengths, and cultivate a respectful partnership. As we begin to rise from the ashes of the first wave of this pandemic, we find ourselves in this norming phase. Ultimately, this is a defining moment in our relationship with COVID-19. A true fork in the road. An instance so critical it can and will delineate the outcome of this crisis. An opportunity to define history and lay the blueprints for future generations in times of hardship. We can choose the path of collaboration. As we enter a “new normal” world in the coming weeks and months, we arrive alongside COVID-19, albeit to our chagrin. Rather than focusing on complete eradication (let’s leave that in the trustworthy hands of vaccine developers), perhaps we ought to concentrate our efforts on symbiosis. If we choose this path of alliance, we can progress towards the final two stages of Tuckman’s model – performing and adjourning. In the performing stage, we can harness the pacts made in the norming stage to advance towards our social and economic goals in a manner that is tolerant yet cautious. While we are quite some time away from the coveted adjourning stage where we will finally part ways with COVID-19, a shift in attitude from gory conquest to accepting partnership may allow us to arrive at this final destination with fewer battle wounds. Let’s reintroduce ourselves to the novel coronavirus as cooperative acquaintances willing to live in symbiosis. And, let’s shift this symbiosis from one of predation to one of commensalism. After all, is it not true that better the devil you know than the devil you don’t? Carly Schenker is a family physician. Source
