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When Paul Farmer died in February, it became clear to the world that he had saved millions of lives. He did so by valuing every life equally and refusing to accept constraints. Many of us enter medicine hoping to change the world; Farmer actually did it.

To the extent that Covid vaccine hesitancy reflects deeper, longer-standing fractures in medicine’s relationship with the public, its exploration provides an opportunity to improve patient care in ways that go far beyond the pandemic.

About 27% of Americans say they definitely or probably won’t get a Covid vaccine, even if it’s free and deemed safe by scientists. The behavioral obstacles to widespread vaccination are thus as important to understand as the scientific and logistic hurdles.

Since human behavior — including wearing or shunning masks — will determine the ultimate toll of the Covid-19 pandemic, communication strategies that bridge our partisan divide over science may prove as important as any novel therapeutic.

Our country’s long and troubled history of racism has permeated the physician–patient relationship with mistrust. Now, amid an acute public health crisis that is transforming medicine, perhaps we have an opportunity to reset our priorities to face this deeper, more chronic crisis as well.

For some clinicians, the pandemic offers an opportunity to take on the hero’s role as never before. But those who can’t must confront not only shame and guilt, but also the loss of their primordial story. Who are you, if you can’t be the hero you imagined yourself to be?

As the pandemic focuses medical attention on treating affected patients and protecting others from infection, how do we best care for people with non-Covid disease? Some physicians predict that “the toll on non-Covid patients will be much greater than Covid deaths.”

As the Covid-19 pandemic spreads, we’ll continue to be plagued by resource constraints that will compromise our ability to protect ourselves, our patients, and our communities. But as Washington’s response reminds us, the professional spirit marches on, unconstrained.

Physicians in northern Italy have learned some painful lessons about rationing care during an epidemic. As health care systems work out ethical allocation principles, it seems clear that only with transparency and inclusivity can public trust and cooperation be achieved.

If Roe v. Wade were overturned, morbidity and mortality due to unsafe abortion, including self-induced abortion, would increase, especially among disadvantaged women. We don’t know how many women died from abortion attempts before Roe, but we should recall what we do know about what killed them.