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Rhodes T, Ruiz Osorio MP, Maldonado Martinez A, Restrepo Henao A, Lancaster K. Exhausting care: On the collateral realities of caring in the early days of the Covid-19 pandemic. Soc Sci Med 2024; 343:116617. [PMID: 38277763 DOI: 10.1016/j.socscimed.2024.116617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/28/2024]
Abstract
We explore care as a site of multiplicity and tension. Working with the qualitative interview accounts of nineteen health care workers in Colombia, we trace a narrative of 'exhausting care' in the early days of the Covid-19 pandemic. Accounts relate exhausting care to working without break in response to extraordinary demand, heightened contagion concern, the pressures of caring in the face of anticipated death, and efforts to carry on caring in the face of constraint. We bring together the work of John Law (2010, 2011) on 'collateral realities' with Lauren Berlant's (2011) thesis of 'cruel optimism' to explore care as a site of practice in which the promise of the good can also become materialised as harm, given structural conditions. Through the reflexive narrative of 'carrying on' in the face of being 'worn down' by care, a narrative which runs through health care worker accounts, we draw attention to the collateral realities of exhausting care as personal and political, at once a practice of endurance and extraction. We argue that the exhausting care that relates to the extraordinariness of the Covid-19 pandemic also resides in the ordinariness, and slower violence, of the everyday. The cruel optimism of care is a relation in which the labour of care reproduces a harmful situation.
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Affiliation(s)
- Tim Rhodes
- London School of Hygiene and Tropical Medicine, London, UK.
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Harrison M, Lancaster K, Rhodes T. The fluid hospital: On the making of care environments in COVID-19. Health Place 2023; 83:103107. [PMID: 37683402 DOI: 10.1016/j.healthplace.2023.103107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023]
Abstract
This paper explores the boundary-making practices enacted by the hospital. Taking a hospital in Sydney, Australia, as our case, we investigate how the hospital holds together as a care environment through the coordinating movements of many materials, spaces, bodies, technologies, and affects. Drawing on interviews with hospital healthcare workers involved in care, research, and management related to COVID-19, we examine the multiplying effects of these movements to trace the ways in which the hospital is (re)made in relation with pandemic assemblages. We accentuate the material affordances of care environments and how care is adapted through the reshaping of the spaces and flows of the hospital. Through this, we highlight how care providers can work with the fluidity of the hospital, including through reorganizing routines and spaces of care, engaging with communication technologies to enact care at many scales, and remaking mundane materials as medical objects in the evolving care environment.
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Affiliation(s)
- Mia Harrison
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia.
| | - Kari Lancaster
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Tim Rhodes
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia; London School of Hygiene & Tropical Medicine, London, UK
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Broom A, Williams Veazey L, Kenny K, Harper I, Peterie M, Page A, Cort N, Durling J, Lipp ES, Tan AC, Walsh KM, Hanks BA, Johnson M, Van Swearingen AE, Anders CK, Ashley DM, Khasraw M. The Enduring Effects of COVID for Cancer Care: Learning from Real-Life Clinical Practice. Clin Cancer Res 2023; 29:1670-1677. [PMID: 36920243 PMCID: PMC10150237 DOI: 10.1158/1078-0432.ccr-23-0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/10/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023]
Abstract
For three years, COVID-19 has circulated among our communities and around the world, fundamentally changing social interactions, health care systems, and service delivery. For people living with (and receiving treatment for) cancer, pandemic conditions presented significant additional hurdles in an already unstable and shifting environment, including disrupted personal contact with care providers, interrupted access to clinical trials, distanced therapeutic encounters, multiple immune vulnerabilities, and new forms of financial precarity. In a 2020 perspective in this journal, we examined how COVID-19 was reshaping cancer care in the early stages of the pandemic and how these changes might endure into the future. Three years later, and in light of a series of interviews with patients and their caregivers from the United States and Australia conducted during the pandemic, we return to consider the potential legacy effects of the pandemic on cancer care. While some challenges to care provision and survivorship were unforeseen, others accentuated and amplified existing problems experienced by patients, caregivers, and health care providers. Both are likely to have enduring effects in the "post-pandemic" world, raising the importance of focusing on lessons that can be learned for the future.
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Affiliation(s)
- Alex Broom
- Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Leah Williams Veazey
- Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Katherine Kenny
- Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Imogen Harper
- Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Michelle Peterie
- Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Alexander Page
- Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicole Cort
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Jennifer Durling
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Eric S. Lipp
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
- The Preston Robert Tisch Brain Tumor Center, Duke University, Durham, North Carolina
| | - Aaron C. Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Kyle M. Walsh
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
- The Preston Robert Tisch Brain Tumor Center, Duke University, Durham, North Carolina
| | - Brent A. Hanks
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Margaret Johnson
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
- The Preston Robert Tisch Brain Tumor Center, Duke University, Durham, North Carolina
| | | | - Carey K. Anders
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - David M. Ashley
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
- The Preston Robert Tisch Brain Tumor Center, Duke University, Durham, North Carolina
| | - Mustafa Khasraw
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
- The Preston Robert Tisch Brain Tumor Center, Duke University, Durham, North Carolina
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