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ACADEMIA Letters Narrating the COVID-19 Pandemic by Medical Drama: the Case of Grey’s Anatomy Valentina Possenti Debora Serra Introduction The coronavirus disease 2019 (COVID-19) spreading has caused a worldwide pandemic and, since the very beginning, has been affecting the whole community globally as per multiple life issues strictly concerning not only the health-related domain, but also the economic, social and cultural dimensions. To name some, people living in all areas of the globe have been suffering from several effects of this huge public health emergency, such as economic and working worsening conditions, a compromised emotional status and reduced access to care, as well as increased contagion risk perception (WHOb, 2020). Some evidence show that researchers employ science fiction and fantasy in public engagement, advocacy and education as significant sources of insights to identify public interests, inspire policies, and influence future science. These uses of science fiction as a supposed source to reflect public interests are undermined if the intended audience or beneficiaries of research interpret the examples employed by researchers differently (Menadue et al., 2020). During 2020, many shows and film productions shut down. Among them, Grey’s Anatomy had to stop before completing Season 16 with 21 episodes, instead of 24. Then, the show came back on screen with Season 17 in November 2020, both in the USA and in Italy. Even with a downsized schedule from 25 to 16 episodes due to the difficult filming in pandemic time, the seventeenth season started narrating the COVID-19 pandemic at the Grey Sloan Memorial Hospital, by interweaving it with the long-lasting plot (Studarus, 2020). So far, Academia Letters, December 2021 ©2021 by the authors — Open Access — Distributed under CC BY 4.0 Corresponding Author: Valentina Possenti, valentina.possenti@iss.it Citation: Possenti, V., Serra, D. (2021). Narrating the COVID-19 Pandemic by Medical Drama: the Case of Grey’s Anatomy. Academia Letters, Article 4456. https://doi.org/10.20935/AL4456. 1 Grey’s Anatomy is a long-run television series, with a universal popularity (consistently a ‘top 10’ television show in the USA and in other countries as well), and its setting in a busy urban tertiary-care teaching hospital. The fictional hospital is located in Seattle, whereas filming taking place in Los Angeles previously (Serrone et al., 2018), the actual set is in the State of Washington (Studarus, 2020). Materials and Methods We analysed the episodes of Season 17 from n. 1 to 6, broadcast from November to December 2020 in the USA with a quite same timing in Italy, too. Using the word search function, we carried out a content analysis to the six episodes’ scripts to observe the storytelling cases about COVID-19 pandemic, both as per hospitalized patients or as if the disease affected some of the main characters (e.g., Meredith Grey or Tom Koracick). We ran the textual analysis independently by a generalist software rather than specific tools, because the actual focus was to detect associations to public health issues involved by the epidemic. Our intent was exploring feelings, myths and legends on risk perception drivers as well as main worries and fears in the general population by analysing recurring topics, expressions or wording in such a popular show. Results We analysed the COVID-19 storytelling in Grey’s Anatomy 17x1-6 as follows by the frequency of the mostly recurring terms. We explored four macro topic areas: 1) COVID-related outcomes; 2) diagnostics or non-pharmacological interventions; 3) risk perception; 4) people ethnicity. As expected, COVID/COVID-19 and pandemic as well are the mostly recurring terms, with great peaks in the middle episodes [n. 3 and 4]. A few times other COVID-related terms occurred, as disease standing alone or the more jargon illness, or words indicating presence or absence of symptoms, and relating to therapy or treatments. A concept we found expressed many times is all around death and patients’ loss. About diagnostics or preventive measures, facemask use and testing were the main drivers. Sense of fear or being scared is the absolute indicator for risk perception, whereas as per individuals’ ethnicity black people are the most recalled, in opposition to whites. Chinese ethnicity is mentioned just once in the first episode and Asians four times in the fourth; on the contrary, China, Latin, Caucasian, and African are terms never occurring. We found three macro topic categories with recurring related expressions. In the first group, as per COVID-associated outcomes we observed a set of issues on how the pandemic affects public health globally, such as: occurrence of the Academia Letters, December 2021 ©2021 by the authors — Open Access — Distributed under CC BY 4.0 Corresponding Author: Valentina Possenti, valentina.possenti@iss.it Citation: Possenti, V., Serra, D. (2021). Narrating the COVID-19 Pandemic by Medical Drama: the Case of Grey’s Anatomy. Academia Letters, Article 4456. https://doi.org/10.20935/AL4456. 2 newly generated rules and operational protocols due to epidemic emergency; above all at the beginning, lack of Personal Protective Equipment (PPE) supplies; uncertainty about therapies and treatments. On the other hand, we have the health professionals’ perspective: diffuse burnout or hard feelings affecting emotional state of surgeons, as for instance ways to communicate severe health outcomes to patients and their relatives. The second group is about social issues such as health inequalities, stigmatization processes and individuals struggling with challenges to the private life (e.g., living apart from their families, not in the condition to hug and have physical contacts with family members). Other relevant tracks in these six episodes concern mental health and human traffic. Discussion and Conclusions Grey’s Anatomy is a widely popular medical drama that even in the past has been the subject of scientific papers published internationally (Torgerson, 2020; Serrone et al., 2018; Hallam, 2009). Since the fall 2020, it has been offering a prompt and multidimensional narration of the COVID-19 emergency. As expected, the hospital setting has served as the main contextual driver to clinical issues, such as hospitalization procedures or pertaining the professional performances delivered by the high-level surgeons. They, in fact, do not cope easily with “losing patients” and do not get used to the high speed of death toll due to the pandemic. In Grey’s Anatomy, the entire storytelling is centered on all surgery fields and death or patients’ loss are highly estimated since the first Season in 2005, as it is considered an assessment indicator of the surgeons’ performance (Serrone et al., 2018). By the story structure in its seventeenth Season, Grey’s Anatomy has also been telling to what extent the COVID-19 has generated ‘alone’ effects within the broad healthcare sector. Examples of that are the delay to other non-urgent surgery or treatments, because the response to the pandemic has become the first and only issue that matters (PASSI and PASSI d’Argento National Working Group, 2020). We observed that despite health professionals having been recognized globally as “heroes” since the very beginning of the pandemic, this specific term does not occur anytime in the episodes of the show (Cox, 2020). Or in the same way, another stylistic choice is not focusing on nurses. We detected a high-level attention to social issues (ASSET, 2015; Possenti, 2018) such as stigmatisation processes (WHOa, 2020): characters never used the word “Chinese” to indicate the virus, although President Trump named it (Gladstone, 2020). In the same way, the screen players chose not to give importance to the fear against Chinese people. Patients showing stigma against Chinese health personnel occur only twice, in the first and the fourth episodes and, in both cases, the momentum ends immediately. Academia Letters, December 2021 ©2021 by the authors — Open Access — Distributed under CC BY 4.0 Corresponding Author: Valentina Possenti, valentina.possenti@iss.it Citation: Possenti, V., Serra, D. (2021). Narrating the COVID-19 Pandemic by Medical Drama: the Case of Grey’s Anatomy. Academia Letters, Article 4456. https://doi.org/10.20935/AL4456. 3 Apparently, the pandemic emergency looks like it is affecting all individuals in the same way, but it is not at all (Stokes et al., 2020; Killerby et al., 2020; Gold et al., 2020; PriceHaygood et al., 2020; Millet et al., 2020). The COVID-19 occurrence serves as a further case to enhance inequalities in health as well as more in general (US HHS, 2020). As Torgerson describes (2020), Grey’s Anatomy always deals with social topics and one of the most is about blacks vs white people. This feature is not missing in the pandemic scenario, but is even greatly addressed. For instance, one of the main concern the medical doctors talk about is how much medicine and diagnosis capacity are centered on white patients, or again the big attention paid to the Afro Americans and the black community overall. During the episodes from third to sixth, in fact, Dr. Pierce, Dr. Bailey, Dr. Weber and Dr. Jackson (all play actors are black) speak about the big incidence of COVID between black community with a special attention to life conditions and bias, the socalled social determinants of health that have historically prevented people of color belonging to racial and ethnic minority groups from having fair opportunities for economic, physical, and emotional health (US HHS, 2020). There is already increasing evidence for disproportionate COVID-19 effects on some of those population groups (Stokes et al., 2020; Killerby et al., 2020; Gold et al., 2020; Price-Haygood et al., 2020; Millet et al., 2020), because poverty and healthcare access affecting these individuals are strongly associated with wide-ranged health outcomes and risk factors (US HHS, 2020). Such a high degree of attention to the real world has been possible thanks to the medical advisors, like Linda Klein (who can also be seen on screen as Nurse Linda), and meetings between the writers and real COVID doctors, about their experience fighting the virus (Studarus, 2020). The producers have included all real-life things that occurred since the beginning of the epidemic and the narration reflects the actual timing. For instance, the adoption of the preventive measures has dominated the big scene over all the 2020 and the availability ofPPE has been a major issue, when the world was not prepared and filtering face pieces were not a common use good (WHOb, 2020). In all episodes 1-6 we found someone mentioning the wearing a mask issue. There was also the question of how to recreate ethically a COVID situation without drawing resources from facilities still on the frontlines. Back in March, the show donated boxes of gloves and masks to local Los Angeles hospitals when it became clear there simply was not enough PPE. For set decorator, Nicole Cramer (who slyly reveals that during a quarantine plot line, in a series first, Meredith and her sisters will venture into their house’s toy-strewn backyard), it meant looking in less obvious places for set dressing. She reported they knew that the storyline was going to be based in COVID, so she had to research how to get in screening tents and pop up tents and, especially, not taking away them from hospitals in condition of real necessity (Studarus, 2020). Academia Letters, December 2021 ©2021 by the authors — Open Access — Distributed under CC BY 4.0 Corresponding Author: Valentina Possenti, valentina.possenti@iss.it Citation: Possenti, V., Serra, D. (2021). Narrating the COVID-19 Pandemic by Medical Drama: the Case of Grey’s Anatomy. Academia Letters, Article 4456. https://doi.org/10.20935/AL4456. 4 As usual, in Grey’s Anatomy a relevant space for narration is the introspective sphere, sense of desperation and human limitations now as never are on the stage: the novel coronavirus wins (or at least seems to win) everything and everyone. It is cleverer than any surgeon is, faster than any rider is, more pervasive and intrusive than any other aspect of life (Mehta, 2021). In each episode, indeed, medical doctors have to face the huge burden due to the situation, in terms of epidemic spreading but also as per its effects on everyday life. Almost all the medical doctors among the main characters have a breakdown. If it is impossible to explore all the COVID-19 consequences on the real life (WHOb, 2020), in only six episodes Grey’s Anatomy has been capable of speaking about mental health, sexuality, treatments, baby blues and inequalities. Dr. Grey and Dr. Koracick were the two designated to suffer from COVID-19 with the biggest burden on Dr. Grey that went on a vent at the end of the sixth episode. In this part of the show, the same physicians usually going around in the hospital holding the iPads, who have witnessed this kind of anguish again and again, have now contracted the coronavirus and transitioned from caregiver to care-receiver, navigating physical suffering and fear for both themselves and their families. To our knowledge, just in its first six Episodes of 17 Season, Grey’s Anatomy implemented an evidence-based and non-stereotyped communication in public health (Reynolds, 2008; US HHS, 2008), addressing what it is recognized as key factors at international level, both as experimented in pandemic time previously (HEG, 2011; Infanti, 2013; Crosier, 2014, ECDC, 2018) and tackling the socalled “infodemics” condition (The Lancet, 2020; CDC, 2020). In comparison with analysis of communication flows during this public health emergency (Seiter, 2021), the narration under observation resulted actually effective and consistent in capturing the ‘spirit of the place’ (Haukeland, 2017), here intending the most countries in the world living the COVID-19 pandemic within the broader context of the post-trust society (Löfstedt, 2005). We privileged this observation placed in a pre-vaccination context to highlight the most part of health emergency that the COVID-19 has been meaning over the world since the very starting moment. So far, such an observation is missing in literature, but might biased somehow because the Authors may have excluded some terms and, conversely, focused on certain issues. Anyway, basing on a appropriate setting, Grey’s Anatomy has actually achieved the world record to be one of the first medical dramas to have included extensive narrating of the emergency from the COVID-19 epidemic. The true public health message we found in the analysed episodes is that such these hard-won lessons may have the power to change how we build health and care for years to come. Alongside the challenges and traumas experienced during the pandemic, beside high levels of fear among people, these are the reasons for hope, in the way that many international organizations have been claiming in the past decades, demonstrating that to tackle effectively public Academia Letters, December 2021 ©2021 by the authors — Open Access — Distributed under CC BY 4.0 Corresponding Author: Valentina Possenti, valentina.possenti@iss.it Citation: Possenti, V., Serra, D. (2021). Narrating the COVID-19 Pandemic by Medical Drama: the Case of Grey’s Anatomy. Academia Letters, Article 4456. https://doi.org/10.20935/AL4456. 5 health emergencies it is not enough just to bridge the divide between health and social care. 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Narrating the COVID-19 Pandemic by Medical Drama: the Case of Grey’s Anatomy. Academia Letters, Article 4456. https://doi.org/10.20935/AL4456. 9