Ross Perfetti

ROSS PERFETTI, then a graduate student at University of Pennsylvania, Philadelphia, Pennsylvania, was approved funding in October 2022 to aid research on “A Syndrome of Care: Naming the Harms of Medical Progress,” supervised by Dr. Adriana Petryna. Intensive Care Units (ICUs) provide life-saving treatments to critically ill patients. At the same time, practices such as mechanical ventilation and heavy sedation can cause long-term emotional, physical, and cognitive impairments for patients. Accumulating research on these negative outcomes demonstrates a dual effect of biomedical progress and the harms incurred by high-tech healthcare. The emergent category of “Post-Intensive Care Syndrome” describes these adverse biological effects as well as social pathologies, such as disruptions in memory and feelings of isolation among survivors. The criteria of this syndrome are continually revised in medical literature and clinical settings, yet the classification remains nebulous as the complex social formations of “ICU survivorship” can evade categorization. How do clinicians and researchers make sense of medical harm that includes both biological and social effects? The grantee conducted 18 months of ethnographic research among ICU clinicians, patients, and families in clinics, homes, and rehabilitation centers. In doing so, the project examined how clinicians grapple with the multifaceted biological and social aspects of ICU survivorship and how classification shapes opportunities for accountability. This research illuminated how complex ethical formations, or what the grantee calls “syndromes of care,” emerge at the frontiers of innovation and edges of medical knowledge.