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How creating a board game helped a Boston ICU doctor grapple with the trauma of COVID-19

Lakshman Swamy hopes that this board game will help people celebrate and trust healthcare workers and their work.

The board game, Critical Care, explores the world of ICU medicine in 250 playing cards, from the medicine used to the procedures patients undergo. Vince Chan, MD

In March of 2020, when hospital beds were being converted into ICU beds to prepare for COVID-19 patients, those working in hospitals thought they were ready. But what hit them was a new reality that no one was prepared for: Hospitals were inundated by the sickest of patients suffering from a virus doctors still knew very little about.

One of the doctors at the frontlines was Lakshman Swamy, who at the time was a senior fellow at the Boston Medical Center in the ICU.

For Swamy and many others, the ICU quickly became overwhelming with the sheer number of patients, combined with the need to keep up with reading the research, listening to discussions on COVID-19, and warning people to stay home to stop the spread. ICU mortality rates shot up, and it became a sterile and lonely place due to the lack of family members allowed to be present with the patients, Swamy said.

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To escape the grueling days of working in an ICU during a pandemic, Swamy found refuge in a unique place. He began squeezing in hours at night reimagining the ICU before the pandemic, and creating a board game based off of his recreation of the ICU.

“It was kind of a private journaling experience for me at first, where I just started to kind of put this whole ICU together on paper that I missed, frankly,” Swamy told Boston.com. 

The board game, Critical Care, explores the world of ICU medicine in 250 playing cards, from the medicines used to the procedures patients undergo. The game has easy-to-understand descriptions embedded on the cards for the players to read and learn from. Concepts of social justice are also woven into the cards. 

Critical Care is a one- to four-player game that allows players to think critically about how they can best help and treat their patients. They are also faced with challenges, such as dealing with infections or being short-staffed, aimed to mimic the issues that doctors and nurses face daily in the ICU.

Swamy hopes that this board game will help people celebrate and trust healthcare workers and their work, especially as they grapple with the increase in the delta variant the past few months. The other goal he hopes to achieve with this game is to educate people with words that are typically used in hospitals. 

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During the initial stages of the pandemic, Swamy realized that there was a burden for medical experts and healthcare workers to communicate messages clearly to the public to keep them safe from the virus. Even now, he says, there are issues with misinformation that get in the way of people understanding how serious the virus is and the importance of getting the vaccine. 

The game contains 250 playing cards and has easy-to-understand descriptions of medical procedure. – Vince Chan, MD

“We wanted to democratize the language of the intensive care unit and medicine in the hospital in general,” Swamy said. “It’s [historically] patriarchal, you know, it’s a huge barrier there of access, it’s not equitable.” 

To bring the board game together, Swamy assembled a group of diverse individuals, including a game designer, an author and clinical researcher, an ICU survivor, and a pulmonary and critical care fellow. The team, who never met in person due to COVID-19, came together to bring Swamy’s vision of the board game to life. 

“I would say that outside of having actually held the box in my hand and feeling that this game is real, the thing I’m most proud of is the team that we put together,” Swamy said.

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Omari Akil, the designer of the game and a professional game designer and content creator, worked to make the board game more “fun,” Swamy said. Swamy also worked on the content with Sara L. Merwin, the author of The Informed Patient: A Complete Guide to a Hospital Stay, to ensure the cards had patient-friendly language and were patient-centered. 

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Swamy focused on bringing together a diverse group, not just in the racial sense but also in terms of varied perspectives. He was inspired by the ICU, where there is a diverse staff treating diverse patients.

“I wanted to embody the game and the team of the game and everything with that same concept of representation,” Swamy said. “And so it was really important to me to intentionally seek that out in the people I was going to work with.” 

After designing the game, the team raised money to help fund the first printed editions of Critical Care in just eight hours on Kickstarter. Swamy recently watched two people play the initial version of his game for the first time, and saw his vision in action: Even those without medical knowledge can be immersed in the game, he said.

“I’m hoping that this really encourages a whole new kind of generation of people to be interested in healthcare in a time when it’s hard to see that as something attractive,” Swamy said. 

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