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Middle Seat Hump Syndrome

By Michael Ross, Founding Partner, ROAMcare


You need to be of a certain age to remember summer vacations in the family car with enough family that it fills all the seats, three across, and the middle seat makes the leg room on a coach class flight look generous, for there, right where your feet want to be, is "the hump," the growth in the floorboard that rises nearly to seat level, allowing whatever it is that transfers the up and downs of the engine to the round and round of the rear wheels to make its way from the motor to the where the rubber meets the road? From that spot in the middle, you can see the windows but everything going by just outside them is a blur.

I am of that age and have been on those vacations and I got that middle seat. For a while there were just two of us in the back and we would each get out own window seats with clear views to the outside. On the inside there was plenty of room between us for the picnic basket and cooler that were only opened at planned stops along the way. Then the third one came along. At first, it wasn't such a big deal as she started out in the baby seat in the middle. After she outgrew that seat and moved to the actual car seat, she still had short toddler length legs and the hump was not an impediment to her comfort. Eventually though, she grew and with that, so did the complaining. "I don't want to sit on the hump!" And the compromise order that came from the front was, "Take turns." From then on, whenever the car stopped, the back seat crowd shuffled and everyone got a turn being uncomfortable for a while.

That's a little like what's has been going on in the country. The effects of COVID-19 on our jobs is the middle seat hump and we’ve all had our turns on the hump. We may have had our hours reduced, or our workdays compressed. Inventory may have been harder to get, conferences have been cancelled, and continuing education shifted to online when it was available at all. Access to certain areas in the hospital or nursing home were limited and outpatient pharmacies’ days shortened. Several times it appeared to be lessening and some consideration was given to easing restrictions, but the ride wasn’t over yet. It slowed enough just to open the door, let everybody get out for a quick stretch, and then it was back into the back seat, somebody different now on the hump.




The ride may be coming to an end for our country. The number of vaccinated people continues to rise. New case appear to be decreasing and restrictions are easing. The stops are longer and time to stretch is longer. Just like coming to the end of the ride after sitting in the middle back seat over the hump, though maybe a little stiff and maybe a little sore, you climbed out of the car, got out and appreciate the freedom that came with being able to move around. That’s where we are now. We may be a little worse for the wear after a ride we have been on for so long, but we see the stops are getting longer and we are going to climb back out into the world and feel the freedom that comes with being able to move around.


Middle seat hump syndrome was never that horrible and may have been the inspiration for some future engineer to design SUVs with higher cabins that cleared all those mechanical doodads or to shift the driving wheels to the front and obviate the need for a hump running down the middle of the car’s interior. Along those same lines it could be that some of the adjustments we made during our times of distance operations, remote learning, and limited staffing can translate to more efficient operations, easier to manage continuing education choices, and a greater focus on what’s important in our jobs.


Someday you may get to say, “You need to be of a certain age to remember the summers when vacations didn’t happen, and we all could see of the outside was the world going by in a blur. We were all just waiting to get out and when we did we all we able to focus better and we felt the freedom that comes with just being able to move around.”



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