WELCOME ALL OF YOU FOR THE VIVEK
MURTHY DISTINGUISHED LECTURE
SERIES ON PUBLIC HEALTH
LEADERSHIP.
THIS LECTURE SERIES IS IN
CELEBRATION OF THE ASIAN
AMERICAN AND NATIVE HAWAIIAN
PACIFIC ISLANDER HERITAGE MONTH
FROM NATIONAL INSTITUTES OF
HEALTH, NIH, AND FEDERAL ASIAN
AMERICAN COUNCIL, AND IN
COLLABORATION WITH THE HHS
OFFICE OF EQUAL OPPORTUNITY
INCLUSION AND OTHER AGENCIES,
FDA, CDC, HRSA, SAMHSA, PAPOC.
MY NAME IS RINA DAS, I AM THE
CURRENT PRESIDENT OF THE CHAPTER
AND THE DIVISION DIRECTOR OF THE
INTEGRATIVE, BIOLOGICAL AND
BEHAVIORAL SCIENCES AT NATIONAL
INSTITUTE ON MINORITY HEALTH AND
HEALTH DISPARITIES.
WE KNOW THE HEALTH OF POPULATION
IN THE WORLD IS ULTIMATELY
DEPENDENT A GREAT DEAL UPON THE
SUCCESSES OF OUR PUBLIC HEALTH
RESPONSES, OUR PUBLIC HEALTH
LEADERS AND AT THE LOCAL, STATE,
AND NATIONAL LEVELS.
SO TODAY'S EVENT IS INCREDIBLY
MEANINGFUL FOR THE AANHPI
COMMUNITY.
WE HAVE THE U.S. SURGEON GENERAL
DR. VIVEK MURTHY AND DR. DAVE
CHOKSHI TO CREATE LEADERS TO
INSPIRE OUR NEXT GENERATION.
TO START THIS EVENT, IT IS MY
GREAT PLEASURE TO INTRODUCE DR.
SOUZAM WHO WILL PROVIDE SOME
WELCOME REMARKS.
>> THANK YOU AND WELCOME,
EVERYONE, THIS BEAUTIFUL SPRING
AFTERNOON.
SPRING, WITH ALL THE HOPE AND
PROMISE IT BRINGS TO OUR WORLD.
WE CELEBRATE THE GREAT PRIDE
ASIAN AMERICAN, NATIVE HAWAIIAN
AND PACIFIC ISLANDER ON OUR
CAMPUS.
THIS MONTH HAS BEEN CELEBRATORY.
I HAVE LEARNED SO MUCH FROM
LISTENING TO THE SYMPOSIUM ON
THE CHALLENGES WE FACE AS A
COMMUNITY ON THIS CAMPUS AND IN
THE WORLD IN GENERAL.
FOR ME ON A PERSONAL LEVEL TO BE
WELCOMING TWO DISTINGUISHED
FELLOW COUNTRYMEN.
IT IS A THRILL.
AND ON A PROFESSIONAL LEVEL AND
PERSONAL LEVEL TO KNOW YOU COME
FORTH WITH BIG MINDS, BIG
MESSAGES, AND OF COURSE A BIG
HEART AND I'M THRILLED TO BE
ABLE TO SAY A FEW WORDS.
HONORING AND CELEBRATING THE
VIVEK H. MURTHY DISTINGUISHED
LECTURE SERIES AS A MEANS TO
HIGHLIGHT SERVICE TO THE
COMMUNITY AND PUBLIC HEALTH
LEADERSHIP.
SO TODAY WE HAVE DR. MURTHY
RECOGNIZING DR. CHOKSHI'S LONG
TIME.
EVERYTHING YOU SAY ON PUBLIC
HEALTH LEADERSHIP, ON MENTAL
HEALTH, HOW TO COMBAT THE
EPIDEMIC YOU DEFINED OF SOCIAL
ISOLATION.
BUILDING TRUST AND COMMUNITY AND
RESILIENCE TO ADDRESS HEALTH
INEQUITIES.
EVERYONE ONE OF THESE POINTS IS
GOING TO MEAN A LOT TO US.
WE WILL FOLLOW UP WITH
DISCUSSIONS AND ACTIONS AFTER WE
ARE THROUGH THIS AFTERNOON.
SO I WANT TO INTRODUCE A VERY
SPECIAL PERSON TO ME, MONICA
WEBB HOOPER, MOST OF YOU KNOW,
WHO WILL DO THE HARD WORK OF
MODERATING THE SESSION.
IT SHOULDN'T BE HARD, IT SHOULD
BE FUN.
INTRODUCING OUR TWO SPEAKERS IN
MORE DETAIL AND GENERATING A SET
OF QUESTIONS AND ANSWERS IN A
VERY LIVELY DISCUSSION.
WELCOME, MONICA, AND WELCOME DR.
MURTHY AND CHOKSHI FOR BEING
HERE.
>> I'M HONORED TO MODERATE THE
THIRD YEAR OF THIS EVENT.
THE FORMAT OF THE VIVEK H.
MURTHY DISTINGUISHED LECTURE
SERIES FOR PUBLIC HEALTH
LEADERSHIP IS A CONVERSATION OR
A FIRESIDE CHAT RATHER THAN A
LECTURE OR A FORMAL
PRESENTATION.
TODAY WE HAVE THE PRIVILEGE OF
HEARING FROM TWO ILLUSTRIOUS
INDIVIDUALS.
FIRESIDE CHATS ARE GREAT TO HAVE
A CONVERSATION TO LEARN ABOUT
THESE DISTINGUISHED INDIVIDUALS,
TO HEAR THEIR PERSONAL
REFLECTIONS AND HOPEFULLY WE
WILL HAVE TIME TO INCORPORATE A
FEW QUESTIONS FROM THE AUDIENCE
TOWARD THE END.
ALLOW ME TO START BY INTRODUCING
AND SHARING A LITTLE BIT MORE,
JUST A SMALL SELECTION OF OUR
TWO GUESTS TODAY.
NOT ONLY JUST IMPRESSIVE, BUT
HISTORIC CAREERS.
SO DR. MURTHY IS THE 21st
SURGEON GENERAL OF THE UNITED
STATES.
AS A RETURNING ROLE.
PREVIOUSLY SERVING AS THE 19th
SURGEON GENERAL.
AS THE NATION'S DOCTOR, THE
SURGEON GENERAL'S MISSION IS TO
RESTORE TRUST BY RELYING ON THE
BEST SCIENTIFIC INFORMATION
AVAILABLE, PROVIDING CLEAR
CONSISTENT GUIDANCE AND
RESOURCES FOR THE PUBLIC AND
ENSURING THAT WE REACH OUR MOST
VULNERABLE COMMUNITIES.
AS THE VICE ADMIRAL OF THE U.S.
PUBLIC HEALTH SERVICE, DR.
MURTHY COMMANDED 6,000 DEDICATED
PUBLIC HEALTH OFFICERS SERVING
THE MOST UNDERSERVED AND
VULNERABLE POPULATIONS DMES CAN
-- DOMESTICALLY AND
INTERNATIONALLY.
HE HAS A PODS THERE CAST.
THE FIRST SURGEON GENERAL OF
INDIAN DESCENT, DR. MURTHY WAS
RAISED IN MIAMI WHICH IS MY
HOMETOWN.
WHO LIVES WITH HIS WIFE IN
WASHINGTON, D.C. AND THEIR
CHILDREN.
OUR HONOREE IS DR. DAVE CHOKSHI,
A CLINICAL PROFESSOR AT NEW YORK
UNIVERSITY AND PRIMARY CARE
INTERNIST AT BELLEVUE HOSPITAL
IN NEW YORK CITY.
PREVIOUSLY HE SERVED AS THE 43rd
COMMISSIONER AT THE NEW YORK
CITY DEPARTMENT OF HEALTH AND
MENTAL HYGIENE AND THE FIRST
HEALTH COMMISSIONER OF ASIAN
DESCENT.
HE SUCCESSFULLY LED NEW YORK
CITY'S COVID-19 PANDEMIC
RESPONSE INCORPORATING A
CAMPAIGN TO VACCINATE 6 MILLION
NEW YORKERS AND ENSURE ACCESS TO
TREATMENT.
HE SERVED AS A PRINCIPLE PUBLIC
SPOKESPERSON FOR NAVIGATING THE
COMPLEXITIES OF SCHOOL AND
BUSINESS REOPENINGS.
SO IN 2021, UNDER DR. CHOKSHI'S
LEADERSHIP, THERE WAS A RELEASE
OF -- HIS PROGRAM OF RESEARCH
FOCUSES ON VARIOUS FACETS OF
PUBLIC HEALTH MEDICINE.
HE HAS PUBLISHED IN HIGH IMPACT
PEER REVIEW JOURNEYS ON THE
IMPACT OF INCOME INEQUALITY ON
HEALTH INEQUITIES, RACISM AS A
FACTOR THAT REDUCES QUALITY OF
PARTIAL CARE, MOUNTING
CHALLENGES TO HEALTH ACCESS TO
IMMIGRANTS AND THE HARMFUL
HEALTH IMPACT OF COVID-19
MISINFORMATION.
I SHOULD NOTE DR. CHOKSHI IS
DEEPLY COMMITTED TO HEALTH
EQUITY AS HIS RESEARCH AND
PRACTICE INDICATES.
HE ADVOCATED FOR SAFETY NET
PROVIDERS, NOT JUST A LIFELINE
FOR PEOPLE WHO LACK INSURANCE,
BUT ADDRESSING THE NEEDS TO EARN
THE TRUST OF HISTORICALLY
DISENFRANCHISED COMMUNITIES WHO
MAY HAVE EXPERIENCED
MISTREATMENT.
AS A FINAL NOTE BEFORE HIS
POSITION AT NEW YORK UNIVERSITY
AND NEW YORK CITY DEPARTMENT OF
HEALTH AND MENTAL HYGIENE, DR.
CHOKSHI WAS THE PRINCIPLE HEALTH
ADVISER IN THE OFFICE OF THE
SECRETARY AND APPOINTED BY
PRESIDENT OBAMA TO THE
PREVENTION, PROMOTION AND HEALTH
IN 2016.
I COULD GO ON.
I WILL STOP THERE.
WE ARE CELEBRATED
>> WE WILL START WITH YOUR
HISTORIC CAREER PATH INCLUDING
WHAT MOTIVATED YOU TO SEEK
PUBLIC SERVICE AS PART OF YOR
JOURNEY.
THANK YOU SO MUCH, DR. WEBB
HOOPER.
I WANT TO CALL YOU MONICA
BECAUSE I WANT TO CALL VIVEK
VIVEK.
I'M PROUD TO BE PART OF THIS
AMAZING AMERICAN TO CELEBRATE
ASIAN AMERICAN, NATIVE HAWAIIAN
AND PACIFIC ISLANDER.
THANKS FOR OPENING UP WITH A
CHANCE TO SHARE THINGS THAT ARE
PERSONAL.
I WILL START BY SAYING I
CONSIDER MYSELF A PUBLIC SERVANT
EVEN BEFORE I WAS A DOCTOR.
AND THAT'S BECAUSE I HAD A FEW
EXPERIENCES EARLY IN MY CAREER
THAT PROPELLED ME ON THIS PATH
AND REALLY INSPIRED ME,
PARTICULARLY BECAUSE OF THE
PEOPLE, THE LEADERS THAT I MET
WHO I THOUGHT WERE TRYING TO
SHAPE A BETTER WORLD FOR ALL OF
US.
SO I'LL JUST SHARE A LITTLE BIT
ABOUT TWO OF THOSE EXPERIENCES.
THE FIRST WAS AT THE TURN OF THE
CENTURY, WHEN WE WERE IN THE
THROES OF ANOTHER PANDEMIC, THE
HIV/AIDS PANDEMIC.
I REMEMBER GOING TO PLACES LIKE
INDIA WHERE ALL OF MY EXTENDED
FAMILY LIVE OR SUB-SAHARAN
AFRICA OR EAST ASIA, THESE
ANTI-RETRO VIRALS THAT CHANGED
THE HIV/AIDS IN THE UNITED
STATES WERE NOT ACTUALLY GETTING
TO THE PLACES WHERE THEY WERE
MOST NEEDED.
AND THIS WAS SOMETHING THAT WAS
VERY DISMAYING TO ME AS A YOUNG,
IDEALISTIC PERSON, PARTICULARLY
SOMEONE WHO BELIEVED SO STRONGLY
IN THE POWER OF SCIENCE AND
INNOVATION TO HAVE CREATED THESE
MEDICINES IN THE FIRST PLACE.
THEY WERE SET TO HAVE A
SO-CALLED LAZARUS EFFECT IN
TERMS OF BRINGING PEOPLE BACK
FROM THE BRINK OF DEATH AND YET,
WE AS A SOCIETY COULDN'T FIGURE
OUT HOW TO GET THEM TO THE
PLACES WHERE THEY WERE MOST
NEEDED.
AND SO MY LESSON FROM THAT
EXPERIENCE WAS THAT SCIENCE AND
INNOVATION ARE NOT ENOUGH.
AND IT IS REALLY ABOUT ACCESS
AND SOLVING A DIFFERENT TYPE OF
PROBLEM, A HUMAN PROBLEM, TO GET
THEM WHERE THEY WERE MOST
NEEDED.
AND THEN THE SECOND EXPERIENCE
WAS WHERE I WAS -- WHERE I GREW
UP IN LOUISIANA, WHICH WAS HIT
BY THE NATURAL DISASTER
HURRICANE KATRINA IN 2005.
MY FIRST EXPERIENCE IN PUBLIC
HEALTH WAS AT THE HEALTH
DEPARTMENT BOTH BEFORE AND AFTER
HURRICANE KATRINA.
I SAW IN A VERY VISCERAL WAY HOW
DISASTERS, WHETHER IT IS A
PANDEMIC OR A HURRICANE, HOW
THEY MOST AFFECTED PEOPLE WHO
WERE ALREADY LIVING ON THE
MARGINS.
AND CAUSED THOSE PEOPLE TO BE
FURTHER MARGINALIZED.
I SAW THIS WITH MY FAMILY
MEMBERS, WITH MY FRIENDS, THE
PEOPLE WHO I HAD GROWN UP WITH
DURING HURRICANE KATRINA.
FOR BOTH OF THOSE EXPERIENCES IT
WAS VERY CLEAR TO ME THAT
GOVERNMENT WAS A POTENTIAL FORCE
FOR GOOD.
DON'T GET ME WRONG.
I SAW WAYS IN WHICH GOVERNMENT
DROPPED THE BALL AND WAS NOT
ABLE TO DELIVER ON ITS PROMISE,
BUT IT WAS VERY CLEAR TO ME TO
TAKE ON THOSE ISSUES AROUND
MOVING FROM INNOVATION TO ACCESS
AS WELL AS ADDRESSING EQUITY,
PARTICULARLY FOR PEOPLE WHO ARE
ALREADY LIVING ON THE MARGINS,
THAT PUBLIC SERVICE WOULD BE A
BIG PART OF THAT.
AND THE LAST THING I WILL SAY TO
FAST FORWARD TO MORE OF THE
PRESENT DAY, IS THAT WHEN I HAD
THE PRIVILEGE OF SERVING AS NEW
YORK CITY'S HEALTH COMMISSIONER,
I LOVED THE FEELING OF GETTING
UP EVERY MORNING AND KNOWING
WITH CRYSTAL CLEAR CONVICTION
WHAT MY PURPOSE WAS.
AND MY PURPOSE WAS SIMPLY TO TRY
TO SAVE LIVES AND PREVENT
SUFFERING EACH DAY.
AND I DON'T THINK THERE ARE TOO
MANY JOBS WHERE YOU GET TO DO
THAT, WHERE YOU KNOW THAT
ULTIMATELY, YOU KNOW, WLFR IT'S
E-MAILS AND MEETINGS AND POWER
POINTS AND ALL OF THE OTHER
THINGS WE DO IN OUR DAY-TO-DAY
OF WORK, THAT ULTIMATELY THEY
HAVE TO SERVE THIS NOBLE PURPOSE
AND FOR ME THAT WAS SO
MOTIVATING AND CONTINUES TO BE.
>> THANK YOU SO MUCH FOR SHARING
THAT.
IT IS REALLY FANTASTIC.
I THINK YOU SAID A LOT THAT
REALLY RESONATES WITH MANY OF US
AND I CAN APPRECIATE HEARING
ABOUT THOSE TWO KIND OF KEY
AREAS AND PAST EVENTS THAT
REALLY INSPIRED YOU IN YOUR
CAREER.
DR. MURTHY, AS YOU REFLECT ON
THIS QUESTION ABOUT YOUR OWN
PATH, COULD YOU SHARE ANY KEY
CAREER CHALLENGES, MAYBE, THAT
YOU HAVE HAD TO OVERCOME THUS
FAR AS A PUBLIC HEALTH LEADER IN
ADDITION TO ANY OTHER ASPECTS OF
YOUR JOURNEY.
>> WELL, THANK YOU, MONICA, FOR
THAT QUESTION.
I'M JUST SO GRATEFUL TO DAVE
ALSO FOR BEING HERE AND JOINING
US.
JUST TO SAY TO BEGIN ALSO THAT
DAVE IS SOMEBODY I HAVE SEEN AND
GOTTEN TO KNOW AND BEEN
PRIVILEGED TO BE FRIENDS WITH
OVER THE YEARS.
I HAD A CHANCE TO WORK WITH
DAVE, IN FACT, WHEN WE WERE BOTH
TRAINING IN RESIDENCY AT BRIGHAM
WOMEN'S HOSPITAL IN BOSTON.
I THINK ONE OF THE THINGS I
ADMIRE SO MUCH ABOUT HIM WHICH
IS WHY I'M SO GRATEFUL HE
ACCEPTED OUR INVITATION TO JOIN
US TODAY, THAT SPIRIT OF SERVICE
HE SPOKE ABOUT HAS BEEN A
THROUGH LINE THROUGH HIS WORK.
HE IS A GREAT EXAMPLE OF HOW YOU
CAN SERVE IN SO MANY CAPACITIES,
WHETHER YOU ARE THE COMMISSIONER
OF HEALTH FOR THE NATION'S
LARGEST CITY, WHETHER YOU ARE
SITTING AT THE BEDSIDE, AS I
WATCHED HIM DO, TAKING CARE OF
PATIENTS SOME OF THEIR DARKEST
HOURS OR WHETHER YOU ARE A
STUDENT FIGHTING AND WORKING
HARD TO GET ACCESS TO ESSENTIAL
MEDICINES TO PEOPLE AROUND THE
WORLD WHICH IS WHAT HE DID AS A
STUDENT AT DUKE UNIVERSITY AND
YEARS AFTER IN MEDICAL SCHOOL.
HE IS A WONDERFUL ROLE MODEL FOR
ME.
THE ABILITY TO SERVE IS AN
IDENTITY WE CAN BRING IN OUR
LIFE.
A VERY IMPORTANT LESSON FOR ME
TO REMEMBER AND US TO SHARE WITH
OUR LISTENERS AND VIEWERS TODAY,
ESPECIALLY GIVEN WE HAVE SO MUCH
NEED IN OUR COUNTRY RIGHT NOW
WHEN IT COMES TO HEALTH.
WE NEED PEOPLE TO SERVE IN ALL
WAYS POSSIBLE.
FOR ME, YOU ASKED ABOUT
HARDSHIPS OR CHALLENGES ON MY
CAREER PATH.
YOU KNOW, I THINK ONE OF THE
CHALLENGES I HAVE FACED IS AN
INTERNAL ONE OF OVER VARIOUS
TIMES IN MY CAREER I DIDN'T HAVE
CLARITY OF WHAT I SHOULD DO IN
ORDER TO ULTIMATELY FIND A SENSE
OF REAL MEANING AND CONTRIBUTING
THE WAY I COULD BEST.
YOU KNOW, THIS WAS REALLY A
CHALLENGE FOR ME PARTICULARLY
DURING MY RESIDENCY TRAINING THE
YEARS AFTER WHERE I WAS DOING A
LOT OF SEARCHING.
IT WAS A CHALLENGE AFTER MY
FIRST STINT AS SURGEON GENERAL
WHERE I WASN'T QUITE SURE WHAT
THE BEST WAY WAS FOR ME TO
CONTINUE CONTRIBUTING.
I SUSPECT THAT MANY OF US HAVE
PERIODS IN OUR LIFE WHERE WE ARE
NOT SURE OF WHAT WE WANT TO DO
OR HOW WE WANT TO CONTRIBUTE.
SOMETIMES THERE CAN BE -- THAT
CAN BE HARD FOR A LOT OF
REASONS, BUT ONE OF THEM IS SO
MANY TIMES OUR IDENTITY AND OUR
SENSE OF PURPOSE IS VERY DEEPLY
TIED TO OUR WORK, EVERYONE
THOUGH WE HAVE OTHER ROLES WE
PLAY AS A PARENT, PERHAPS, AS A
SON OR DAUGHTER, AS A FRIEND.
BUT SOMETIMES WHEN WE ARE NOT
QUITE SURE WHAT TO DO CAN REALLY
CHALLENGE OUR FUNDAMENTAL SENSE
OF IDENTITY.
I WENT THROUGH PERIODS IN MY
LIFE WHERE I EXPERIENCED THAT
AND STRUGGLED WITH THAT.
WHAT REALLY HELPED ME DURING
THOSE TIMES WAS, ONE, TAKING
SOME TIME TO GET MORE AND MORE
CLEAR ABOUT WHAT I CARED ABOUT
AND WHO I WAS AND LETTING THE
NOISE SETTLE AROUND ME, WHICH IS
MUCH EASIER SAID THAN DONE.
THE OTHER THING THAT HELPED ME
WAS HAVING ANCHORS AND
SPECIFICALLY FRIENDS WHO CAN
REMIND ME OF WHAT MATTERS TO ME.
WHO COULD TELL ME IF I WAS
TRYING TO SOUND EXCITED ABOUT A
JOB WHEREAS I REALLY WASN'T
EXCITED ABOUT IT.
I REMEMBER A PARTICULAR MOMENT
WHEN I WAS THINKING ABOUT A JOB,
I REMEMBER AFTER MY FIRST STINT
AS SURGEON GENERAL WHERE I
WASN'T QUITE SURE IF I SHOULD
TAKE IT, BUT IT FELT LIKE A JOB
THAT WOULD GIVE ME A SENSE OF
IDENTITY AND CLARITY AND
PURPOSE.
I CALLED UP DAVE AND ONE OF OUR
OTHER FRIENDS AND SAID, THIS
OPPORTUNITY CAME UP.
I THINK IT SOUNDS LIKE IT COULD
BE GOOD.
AT THE END OF THAT, MY
PRESENTATION, IF YOU WILL, OF
THE IDEA, DAVE AND OUR OTHER
FRIEND SAID YOU KNOW WHAT?
YOU ARE SAYING ALL THE RIGHT
THINGS, BUT YOU DON'T SOUND
EXCITED.
WE ARE NOT SURE IT RESONATES
WITH YOU.
THE TRUTH IS IN THE END THEY
WERE RIGHT.
THE BEST PART OF THAT JOB WOULD
HAVE BEEN GETTING IT, NOT DOING
IT.
THAT IS A CRITICAL DISTINCTION.
SO ANYWAY, THE PEOPLE HAVE
REALLY BEEN SO CRITICAL FOR ME
IN NAVIGATING THOSE DIFFICULT
MOMENTS.
I WOULD SAY THAT THE LAST THING
OF CHALLENGES AND HARDSHIPS,
THIS IS GOING TO SEEM LIKE A
FAIRLY ROUTINE ONE BUT ALL OF US
HAVE EXPERIENCED.
ALL OF OUR JOBS HAVE TAXES, IF
YOU WILL.
I THINK AS A TAX OF THE STUFF
YOU DON'T REALLY WANT TO DO BUT
YOU DO SO YOU CAN DO THE STUFF
YOU WANT TO DO THAT MAKES YOUR
HEART SING AND MAKE YOU FEEL
EXCITED AND ENGAGED.
THAT'S OKAY.
NOT EVERY PART OF YOUR JOB CAN
EXCITE YOU 100%.
BUT SOMETIMES I THINK I FOUND
THAT ONE OF THE CHALLENGES OVER
THE YEARS, YOU KNOW, ESPECIALLY
WHEN I WAS OUT OF TRAINING, I
WAS FIGURING OUT HOW DO I MANAGE
THOSE CHALLENGING PARTS OF THE
JOB AND STAY FOCUSED ON THE
PARTS THAT ARE REALLY EXCITING.
ONE OF THE THINGS I FOUND LIKE
IN MY FIRST STINT AS SURGEON
GENERAL TO DO THAT I NEEDED TO
GET CLOSE TO THE PEOPLE I WAS
TRYING TO SERVE.
SO THAT MEANT I NEEDED TO GO AND
TRAVEL AND MEET PEOPLE IN
COMMUNITIES WHO ARE RECEIVING
OUR MESSAGES, FOLKS WHO MIGHT
HAVE BEEN READING OUR REPORTS.
FOLKS WHO WERE TRYING TO ENGAGE
IN BROADER INITIATIVES, AROUND
ADDICTION OR E-CIGARETTES.
I FOUND BEING IN COMMUNITIES AND
GETTING CLOSE TO THE PEOPLE WE
WERE TRYING TO SERVE, THAT WAS
SO IMMENSELY CLARIFYING AND
REJUVENATING AND HELPED ME SEE
MORE CLEARLY WHAT WE HAD TO DO
AND CHANGE OUR APPROACH.
IT ALSO JUST GAVE ME A SHOT IN
THE ARM, BY SHOWING ME, HEY,
LOOK, THERE ARE PEOPLE WHO HAVE
REAL NEEDS HERE, WHOSE LIVES WE
COULD MAKE A REAL DIFFERENCE IN
THE WE KEEP AT IT, IF WE KEEP
FOCUSING.
I TRY TO REMEMBER THAT NOW IN
THIS SECOND OPPORTUNITY TO
SERVE.
I TELL MY TEAM THIS OFTEN, WHEN
WE ARE STARTING TO FEEL WE ARE
GETTING A LITTLE BIT CYNICAL OR
FRUSTRATED OR BURNED OUT, THAT
IS A TIME WHERE WE SHOULD THINK
ABOUT HOW WE CAN GET CLOSE AGAIN
TO THE PEOPLE WE ARE SEEKING TO
SERVE.
VISITING THEM OR IN THIS DAY AND
AGE ZOOM CALLS WITH ROUNDTABLES
OF STUDENTS AND CLINICIANS AND
OTHERS SEEKING TO ENGAGE.
LET'S LISTEN, LET'S LEARN, LET'S
STAY CLOSE AND THAT CAN SUSTAIN
US IN 'OUR JOURNEY TO SERVE.
>> THAT'S FANTASTIC ADVICE.
ONE OF THE THINGS THAT STRIKES
ME ABOUT WHAT YOU SHARED, I
THINK IT IS TRUE.
MANY PEOPLE ARE UNCERTAIN ABOUT
THEIR PATH AND THEIR JOURNEY AND
HOW THEY CAN CONTRIBUTE.
IT SHOWS THAT EVERYONE SOMEONE
LIKE YOU WITH THE LEVEL OF
EDUCATION THAT YOU HAVE,
EXPERIENCE, CREDENTIALS, THAT
CAN STILL EXIST.
I REALLY APPRECIATE BECAUSE AT
NIMHD WE ENGAGE DIRECTLY WITH
OUR COMMUNITY MEMBERS AND PEOPLE
WE ARE SERVING THROUGH OUR
SCIENCE AND PRACTICE.
SO I THINK THAT IS REALLY
FANTASTIC.
I DO WANT TO MOVE INTO ANOTHER
TOPIC.
IT IS GREAT TO HAVE SOME
BACKGROUND.
FEEL FREE TO JUMP IN WITH ANY
QUESTIONS OR COMMENTS.
I DO WANT TO TALK A BIT ABOUT
TRUST.
WE KNOW TRUST HAS BEEN PART OF
THE DISCOURSE IN THE PAST THREE
YEARS BECAUSE OF THE COVID-19
PANDEMIC.
THERE ARE DATA THAT INDICATES
LOW LEVELS OF TRUST AND ELEVATED
MISTRUST IN SCIENCE AND PUBLIC
HEALTH EFFORTS RELATED TO THE
COVID-19 EXPERIENCE.
I WOULD REALLY LIKE IF EACH OF
YOU COULD REFLECT ON THIS ISSUE
OF DISTRUST WITHIN SCIENCE,
MEDICINE, AND PUBLIC HEALTH,
SPECIFICALLY THINKING ABOUT THE
PERSPECTIVES AND VIEWS OF ASIAN
AMERICAN, NATIVE HAWAIIAN AND
PACIFIC ISLANDER COMMUNITIES.
SO I WILL DIRECT MY FIRST
QUESTION IN THIS AREA TO DR.
CHOKSHI.
THE LEADER IN NEW YORK CITY, THE
EPICENTER OF COVID-19 IN THE
U.S.
CAN YOU SHARE EXPERIENCE AROUND
MANAGING DISTRUST IN SCIENCE AND
MEDICINE?
>> WELL, THANKS, MONICA, FOR
ARTICULATING IT SO BEAUTIFULLY,
WHAT THE CHALLENGES ARE AROUND
TRUST AND DISTRUST.
THERE ARE A COUPLE OF THINGS I
LIKE TO SAY AT THE OUTSET WHEN
WE DIVE INTO THIS TOPIC.
THE FIRST IS TO MAKE SURE WE ARE
ORIENTING AROUND IT IN THE RIGHT
WAY.
BECAUSE FOR ME, THE QUESTION
SHOULD NOT BE POSED AS WHY DOES
X PERSON OR Y GROUP HARBOR
MISTRUST OR DISTRUST?
THE QUESTION PARTICULARLY FOR
THOSE OF US WHO ARE COMMITTED TO
PUBLIC SERVICE, ARE WE WORTHY OF
THE TRUST OF THE PEOPLE WE ARE
AIMING TO SERVE?
IF NOT, WHY MIGHT THAT BE?
AS PART OF THAT WHY, MAKING SURE
WE ARE TAKING AN HISTORICAL LENS
THAT EXTENDS BEYOND THE PRESENT
MOMENT EVEN WHEN WE ARE IN AN
EMERGENCY, A CRISIS LIKE THE
COVID-19 PANDEMIC, AS YOU
ALLUDED TO.
I THOUGHT I WOULD ALSO JUST
SHARE A LITTLE BIT OF SORT OF
WHAT IT FELT LIKE DURING SOME OF
THE TOUGHEST MOMENTS OF
COVID-19.
AND MY MEMORY GOES BACK TO
DECEMBER OF 2020.
THIS WAS RIGHT WHEN THE VACCINES
HAD RECEIVED THEIR FIRST FDA
EMERGENCY USE AUTHORIZATIONS.
AND SO I CONVENED MY CABINET AT
THE HEALTH DEPARTMENT.
THESE ARE ALL OF MY DEPUTY
COMMISSIONERS.
SUCH SEASONED EXPERT PUBLIC
HEALTH PROFESSIONALS WITH
DECADES OF EXPERIENCE AMONG
THEM.
AND SOMETIMES I DO THIS EXERCISE
WHERE I ACTUALLY PASS OUT NOTE
CARDS IN MY CABINET MEETING AND
I ASK PEOPLE TO SUBMIT THEIR
RESPONSES TO ME IN A WRITTEN WAY
TO GET MAYBE A MORE UNVARNISHED
VIEW OF WHAT PEOPLE ARE REALLY
THINKING ABOUT.
AND SO I DECIDED TO POSE THE
QUESTION ONE MORNING AS WE WERE
EMBARKING ON OUR VACCINATION
CAMPAIGN, WHAT EACH OF MY DEPUTY
COMMISSIONERS WAS MOST ANXIOUS
ABOUT WITH RESPECT TO OUR
VACCINATION EFFORTS.
AND I HAVE TO ADMIT THE
RESPONSES THAT I GOT BACK WERE A
BIT SURPRISING TO ME.
OVER 90% OF MY COLLEAGUES, MY
TEAM, WROTE THAT THEIR GREATEST
WORRY WAS SOME VERSION OF
VACCINE CONFIDENCE OR VACCINE
HESITANCY.
AND THE REASON THIS WAS A LITTLE
BIT SURPRISING TO ME IN THE
MOMENT WAS THAT I WAS PERHAPS A
BIT TOO FOCUSED ON OUR NEAR-TERM
CHALLENGES.
YOU KNOW, WORKING THROUGH THE
PRIORITIZATION PROCESS IN TERMS
OF, YOU KNOW, WHO WOULD GET
VACCINATIONS IN WHAT ORDER.
FOR CARRYING AS MUCH SUPPLY.
REMEMBER, WE HAD A VERY LIMITED
AMOUNT OF VACCINE.
PROCURING VACCINE FOR NEW YORK
CITY.
AND THE CAPACITY, THE ACTUAL
CLINICS WHERE WE WOULD
ADMINISTER VACCINATIONS
THEMSELVES.
I GOT THIS FEEDBACK FROM MY TEAM
AND IT HELPED ME RECALIBRATE TO
WHAT OUR MEDIUM TERM CHALLENGES
WOULD BE.
OF COURSE IN A FEW SHORT MONTHS
THE ISSUE WASN'T VACCINE SUPPLY
BUT AROUND DEMAND, AROUND
ADDRESSING VACCINE CONFIDENCE
AND GRAPPLING WITH THESE ISSUES
OF TRUST AMONG THE COMMUNITIES
THAT WE WERE SERVING.
WE DID A FEW THINGS TO TRY TO
RESPOND TO THOSE IDEAS AROUND
BUILDING VACCINE CONFIDENCE.
FIRST AND FOREMOST, I THINK OF
AS BAKING HUMILIATE INTO OUR
RESPONSE.
AND THAT MEANS THAT IT TOOK US
KNOWING THAT IN MANY CASES WE
WERE NOT THE MOST TRUSTED
MESSENGERS FOR THE COMMUNITIES
THAT WE WERE AIMING TO SERVE.
AND SO THAT MEANS PUBLIC HEALTH
OR GOVERNMENT WRIT LARGE HAS TO
HAVE THE HUMILITY TO TAKE A STEP
BACK AND INSTEAD EMPOWER OUR
PARTS, WHETHER THEY WERE FAITH
LEADERS OR HEADS OF COMMUNITY-
COMMUNITY-BASED ORGANIZATIONS OR
HEALTH WORKERS, WHICH I WOULD BE
HAPPY TO TALK ABOUT A LITTLE BIT
FURTHER, BUT FOR ALL OF THOSE
GROUPS TO BE THE UP WIONES WITH THE
FACES OF BUILDING VACCINE
CONFIDENCE AND BRINGING VACCINES
INTO THE NEIGHBORHOODS WE WERE
SERVING.
THIS IS BECAUSE TRUST IS NOT
GAINED OR LOST IN DAYS OR WEEKS
OR MONTHS.
IT IS A PROCESS THAT HAPPENS
OVER YEARS.
AND WE HAVE TO RECOGNIZE THAT
THERE ARE PEOPLE EVERY DAY WHO
HAVE BEEN WORKING IN THEIR
NEIGHBORHOODS, IN THEIR
COMMUNITIES, TO BUILD TRUST OVER
YEARS, IF NOT DECADES.
AND SO I THINK PART OF OUR
IMPULSE IN PUBLIC HEALTH IS TO
HAVE THE HUMILITY TO RECOGNIZE
THAT AND TO PARTNER IN ORDER TO
BECOME WORTHY OF THE TRUST OF
THE PEOPLE WE ARE SERVING.
>> ABSOLUTELY.
I'M WITH YOU 100%.
DR. MURTHY, WHAT ARE YOUR
PERSPECTIVES ON THIS TOPIC,
ESPECIALLY AT THE NATIONAL
LEVEL?
>> I THINK DAVE SAID IT WELL.
HIS LESSONS AND INSIGHTS APPLY
AT A NATIONAL LEVEL AS WELL,
NATIONAL LEADERS.
I HAVE TWO BRIEF THOUGHTS.
ONE IS THAT ULTIMATELY
MOBILIZING ENGAGED PARTNERS WHO
ARE TRUSTED MEANS WE HAVE TO
REACH PEOPLE WHO DON'T HAVE
HEALTH IN THEIR TITLE.
COMMUNITY ORGANIZATIONS, FAITH
ORGANIZATIONINGS AND OTHERS, BUT
REACHING THEM AND SUPPORTING
THEM MATERIALLY MEANS WE HAVE TO
THINK ABOUT HOW TO GET FUNDING
DIRECTLY TO THOSE ORGANIZATIONS.
WHAT I HAVE FOUND IS THAT
SOMETIMES WELL INTENTIONED
EFFORTS TO DISTRIBUTE FUNDING TO
COMMUNITIES GET TIED UP AT THE
STATE LEVEL OR IN COUNTY
GOVERNMENT.
I HEAR FROM COUNTLESS SMALL
ORGANIZATIONS ON THE GROUND THAT
ACTUALLY HAVE THE RELATIONSHIPS,
THE GROUPS THAT WHEN THEY SHOW
UP IN FRONT OF SOMEBODY'S DOOR,
THEY OPEN THE DOOR BECAUSE THEY
RECOGNIZE THEM AND KNOW THEM.
THEY ARE NOT SOPHISTICATED
FOUNDATIONS THAT HAVE BUILT A
HUGE GRANT WRITING OPERATION,
RIGHT?
THEY DON'T COME ACROSS TO
TRADITIONAL AGENCIES THAT ARE
AWARDING GRANTS AS SEASONED AND
SOPHISTICATED PROCESSER OF
FUNDS.
AND SO THEY GET OVERLOOKED,
RIGHT?
BUT THESE ARE THE GROUPS THAT
ACTUALLY HAVE THE TRUST.
MY WIFE ACTUALLY SPENT SOME TIME
WORKING FOR A NONPROFIT EARLY IN
THE PANDEMIC WHEN THE VACCINES
WERE FIRST BECOMING AVAILABLE
THAT WAS VERY WELL VERSED AT
GATHERING FUNDS.
THEY WERE SMART ENOUGH TO KNOW
WHAT THEY NEEDED TO DO WITH
THOSE FUNDS IS GET THEM TO THE
SMALL ORGANIZATIONS WHO WOULD
NEVER KNOW TO APPLY FOR THE
FUNDS, BUT HAVE THE
RELATIONSHIPS TO TALK TO PEOPLE
ABOUT COVID AND VACCINES.
THAT IS WHAT THEY DID AND THEY
WERE REMARKABLY EFFECTIVE IN
SUPPORTING GROUPS THAT COULD GET
ACCURATE INFORMATION TO
COMMUNITIES.
HOW WE DISBURSE FUNDING, IT IS
VITALLY IMPORTANT BECAUSE A LOT
OF THE FUNDING GETS NOT ONLY
LOCKED UP AT POINTS ALONG THE
WAY, BUT IT ENDS UP GOING TO
ORGANIZATIONS THAT ARE REALLY
GOOD AT APPLYING FOR FUNDS, BUT
MAY NOT HAVE THE FULL EXTENT OF
RELATIONSHIPS THAT SMALL GROUPS
ON THE GROUND HAVE.
THE OTHER THING I WOULD JUST
SAY, ADD ON TO DAVE'S INSIGHTFUL
POINTS, HAS TO DO WITH HOW WE IN
PUBLIC HEALTH AND LEADERSHIP
POSITIONS ARE TRAINED IN PUBLIC
HEALTH COMMUNICATION.
THE TRUTH IS THERE ISN'T ENOUGH
TRAINING PROVIDED TO LEADERS ON
HOW TO COMMUNICATE WITH THE
PUBLIC.
OFTEN THAT COMMUNICATION CAN
COME OFF OVERLY SCIENTIFIC OR
JARGONY, OR NOT ENOUGH
ACTION-ORIENTED TAKEAWAYS.
IT MAKES IT VERY HARD FOR PEOPLE
TO KNOW WHAT TO DO AND TO SORT
OF TRUST IN INFORMATION.
IT IS HARD TO TRUST THINGS YOU
DON'T UNDERSTAND OR TO TRUST
MESSAGERS YOU CAN'T RELATE TO.
SO BEING ABLE TO NOT ONLY
COMMUNICATE INFORMATION
ACCURATELY, CONCISELY, AND
CLEARLY, BUT ALSO IN WAYS THAT
PEOPLE CAN RELATE TO IS REALLY
IMPORTANT.
THAT IS AS VITAL AS SKILL IN
PUBLIC HEALTH EDUCATION.
ANYTHING WE MAY LEARN IN
STATISTICS OR EPIDEMIOLOGY.
>> ALL GREAT POINTS.
WE KNOW TRUST IS A VERY
COMPLICATED TOPIC.
IT IS ONE, AS YOU BOTH POINT OUT
IN YOUR VARIOUS REMARKS, THIS IS
SOMETHING THAT REQUIRES
COMMUNITY COMPETENCE, CULTURAL
HUMILITY.
DR. CHOSKY DO YOU KNOW THE
ORGANIZATIONS THAT MIGHT BE THE
APPROPRIATE WAY TO DELIVER
MESSAGES, BEING CAUTIOUS THAT
HEALTH COMMUNICATION IS BEYOND
ACCURACY, THE RELATIONSHIP PART
IS IMPORTANT.
WHAT PEOPLE CAN CREATE TO
MAINTAIN TRUST IN SIGN AND
PUBLIC HEALTH POLICY,
PARTICULARLY THINKING ABOUT
DIFFERENT LEVELS OF GOVERNMENT
AND FOCUSING ON ASIAN AMERICAN,
NATIVE HAWAIIAN AND PACIFIC
ISLANDER COMMUNITIES.
>> YEAH.
THIS IS SOMETHING WE HAVE TO GO
A LITTLE DEEPER ON.
I APPRECIATE THAT.
I WANT TO ECHO SOMETHING THAT
VIVEK SAID ABOUT THE IMPORTANCE
OF COMMUNICATION IN PUBLIC
HEALTH.
FIRST VIVEK IS SUCH AND EXAMPLE
OF THIS WITH RESPECT TO THE
ABILITY TO FRAME IN A WAY THAT
RESONATES WITH PEOPLE, YOU KNOW,
THAT MOVES US, NOT JUST IN TERMS
OF THE DISPASSIONATE EVIDENCE,
WHICH, OF COURSE, HAS TO BE THE
ROOT OF ANYTHING THAT WE DO IN
PUBLIC HEALTH.
BUT TO THEN TRANSLATE THAT INTO
ACTION.
SO I THINK WE ALL CAN LEARN
SOMETHING FROM THE WAYS IN WHICH
VIVEK HAS ESPOUSED THAT IN HIS
ROLE AS SURGEON GENERAL.
I WILL ADD A COUPLE OF THOUGHTS
FROM MY EXPERIENCE IN NEW YORK
CITY.
THE FIRST IS TO JUST MAYBE STATE
THE OBVIOUS HERE, BUT TO STATE
THAT REPRESENTATION MATTERS.
YOU KNOW, I'M REALLY PROUD AS
WAS MENTIONED IN MY
INTRODUCTION, TO BE THE FIRST
NEW YORK CITY HEALTH
COMMISSIONER OF ASIAN DESCENT.
I KNEW THAT WAS MEANINGFUL TO
ME, INTRINSICALLY, BUT I CAME TO
REALIZE HOW MEANINGFUL IT WAS
FOR OTHERS AS WELL.
THE MEMORY THAT COMES TO MIND
WAS WHEN I WAS SERVING AS HEALTH
COMMISSIONER, I DID PSAs THAT
WERE RELATIVELY BROADLY VIEWED
ACROSS THE NEW YORK CITY AREA.
I WAS ACTUALLY WITH MY WIFE AND
YOUNG DAUGHTER AT A VOTING SITE.
WE WERE GOING TO CAST OUR BALLOT
AND WANTED TO BE DELIBERATE IN
BRINGING OUR DAUGHTER TO SHOW
HER WHAT DEMOCRACY LOOKS LIKE.
AFTER WE CAST OUR BALLOT, A
WOMAN CAME UP TO ME OUTSIDE OF
THE SCHOOL WHERE WE WERE, THIS
IS IN OUR NEIGHBORHOOD IN
JACKSON HEIGHTS QUEENS.
AND THE WOMAN STOPPED ME AND
WANTED TO INTRODUCE ME TO HER
DAUGHTER, A FEW YEARS OLDER THAN
MINE.
SHE TOLD ME THAT HER DAUGHTER
HAD WATCHED ME ON THE NEWS AND
HAD STARTED LEARNING ABOUT
PUBLIC HEALTH, YOU KNOW, SHE WAS
ABOUT 10 YEARS OLD, SHE WAS
LEARNING ABOUT WHAT PUBLIC
HEALTH WAS AFTER SEEING OUR
DEPARTMENT'S BRIEFINGS.
I THINK ABOUT HOW IMPORTANT
SOMETHING LIKE THAT IS TO SHAPE
THE FUTURE OF PUBLIC HEALTH BY
HELPING TO LAUNCH CAREERS IN
PUBLIC SERVICE BASED ON PEOPLE
WHO SEE OTHERS WHO LOOK LIKE
THEM AND SAY, HEY, MAYBE THAT IS
SOMETHING I CAN DO WHEN I GROW
UP OR AS PART OF MY CAREER AS
WELL.
I'M SURE EVERYONE ON THE CALL
HAS A SIMILAR STORY.
BUT WE HAVE TO SHARE THEM.
WE HAVE TO REMIND EACH OTHER
THAT THERE IS THIS DEEP AND, YOU
KNOW, SORT OF RESONANT VALUE TO
IT THAT IS HARD FOR US TO
CALCULATE.
IT IS HARD FOR US TO MEASURE,
BUT IT IS SUPREMELY IMPORTANT IN
TERMS OF CHANGING WHAT OUR
LEADERSHIP LOOKS LIKE.
WHICH ULTIMATELY IS HOW WE
ACTUALLY HOLD OURSELVES
ACCOUNTABLE TO WHAT OUR
COMMUNITIES WANT FROM US.
JUST TWO OTHER THOUGHTS IN TERMS
OF WHAT PUBLIC HEALTH CAN DO
AROUND TRUST.
THE FIRST WAS I TRIED TO
EMPHASIZE WHEN I WAS LEADING THE
HEALTH DEPARTMENT THAT WE HAVE
TO ALSO THINK ABOUT ALL OF THE
SMALL OPPORTUNITIES WE HAVE TO
GAIN OR LOSE THE TRUST OF THE
PEOPLE WE ARE SERVING.
SO TO GIVE YOU ONE VERY CONCRETE
EXAMPLE, WE ARE CHARGED WITH
ADMINISTERING THE BIRTH AND
DEATH CERTIFICATES FOR NEW
YORKERS.
THAT IS ONE OF THE FUNCTIONS OF
THE NEW YORK CITY HEALTH
DEPARTMENT.
AND, YOU KNOW, THIS MAY SOUND
LIKE A VERY BUREAUCRATIC SORT OF
GOVERNMENT PROCESS, BUT TAKE A
STEP BACK AND THINK ABOUT IT.
IS THERE A MORE MEANINGFUL PART
OF LIFE THAN MARKING THE DEATH
OF YOUR LOVED ONE OR THE BIRTH
OF YOUR CHILD?
AND, YOU KNOW, SO I TRIED TO GET
US TO THINK ABOUT IT LESS AS A
PROCESS AND MORE AS AN
OPPORTUNITY TO GAIN OR LOSE THE
TRUST OF NEW YORKERS.
IN MANY CASES, IT WAS, YOU KNOW,
OUTSIDE OF A PANDEMIC AT LEAST,
THE ONLY TIME THAT PEOPLE EVER
INTERACT WITH THE HEALTH
DEPARTMENT AND IF THEY HAVE A
FRUSTRATING TIME WITH IT, IF
THEY ARE CAUGHT UP IN PAPERWORK
DELAYS OR IT IS A FRUSTRATING
PROCESS FOR OTHER REASONS, THAT
WILL HAVE BEEN A MISSED
OPPORTUNITY TO BUILD TRUST.
SO WE HAVE TO THINK ABOUT THOSE
MICRO MOMENTS THAT REALLY ADD UP
WITH RESPECT TO EARNING THE
TRUST OF PEOPLE THAT WE ARE
SERVING.
AND THEN THE LAST POINT IS LET'S
DO WHAT WE DO WELL IN PUBLIC
HEALTH AND BRING IT TO THESE
DEEP QUESTIONS.
THE WAY YOU FRAMED IT MONICA, I
THINK OF AS THE REASON THAT THE
PANDEMIC HAD SUCH A CATASTROPHIC
EFFECT IS BECAUSE IT WAS AN
EARTHQUAKE, BUT IT WAS AN
EARTHQUAKE THAT WAS BUILD ON
TECTONIC PLATES ON RACIAL EQUITY
AND ISSUES SANDRA SOCIAL
COHESION WHICH VIVEK HAS K
POINTED TO.
WE NEED TO BRING TO BEAR ON
THOSE TECTONIC PLATES.
LET'S MEASURE TRUST AS IT EXISTS
TODAY AND HOLD OURSELVES
ACCOUNTABLE AS PUBLIC HEALTH
PROFESSIONALS FOR WAYS IN WHICH
THAT TRUST CHANGES OVER TIME.
AGAIN, A CONCRETE EXAMPLE.
WE TRIED TO ADD JUST A HANDFUL
OF QUESTIONS ON THE ANNUAL
SURVEYS THAT WE DO OF NEW
YORKERS.
WHERE WE ASK ABOUT HEALTH
BEHAVIORS AND OTHER THINGS.
WE STARTED ASKING ABOUT MEASURES
OF TRUST AND SOCIAL COHESION SO
WE CAN AT LEAST START TO GET A
BEAT ON IT AND ULTIMATELY START
TO SHIFT THAT OVER TIME.
>> DID EVERYONE HEAR HE SAID, I
MAY NOT GET THIS EXACTLY RIGHT,
IT WAS REALLY PROFOUND.
AND EARTHQUAKE BUILT ON TECTONIC
PLATES OF INEQUITY.
I MEAN, THAT IS EXTREMELY DEEP.
IT IS ACTUALLY OVERWHELMING WHEN
YOU THINK ABOUT THAT WHAT THAT
MEANS.
I'M GOING TO FIND A WAY TO
INCORPORATE THAT INTO SOMETHING
I TALK ABOUT IN THE FUTURE
BECAUSE THAT WAS REALLY
INTERESTING.
I HAVE ANOTHER QUESTION, DR.
CHOKSHI, AS A PRIMARY CARE
PHYSICIAN IN YOUR EXPERIENCE OF
TAKING CARE OF UNDERSERVED
PATIENTS, WHAT ROLES DO YOU SEE
IN PRIMARY CARE TO ADDRESS
ISSUES OF TRUST IN BOTH MEDICINE
AND PUBLIC HEALTH POLICY?
>> I'M INTERESTED IN VIVEK'S
THOUGHTS ON THIS AS WELL.
AS HE MENTIONED, WE TRAINED
TOGETHER AND I HAVE LEARNED SO
MUCH ABOUT DOCTORING FROM HIS
EXAMPLE AS WELL.
I REALLY, YOU KNOW, I BROUGHT MY
CLINICAL IDENTITY TO BEAR IN
MAMY
PUBLIC HEALTH WORK BECAUSE IT IS
SO DEFINING OF WHO I AM.
BUT THERE ARE SO MANY LESSONS
WITH RESPECT TO HOW WE MIGHT DO
THINGS DIFFERENTLY WITH RESPECT
TO PUBLIC HEALTH.
AND THE FIRST ONE IS TO CONNECT
TRUST TO SOMETHING VERY SIMPLE,
WHICH IS LISTENING.
YOU KNOW, WHEN IT COMES TO
SOMETHING LIKE VACCINE
CONFIDENCE, I STARTED BY
THINKING ABOUT WHAT HAPPENS IN
MY OWN EXAM ROOM.
AND I KNOW THAT I HAVE A ZERO
PERCENT CHANCE OF CHANGING THE
MIND OF MY PATIENT IF I START
WITH A LECTURE, WITH A DIATRIBE,
WITH A YOU MUST DO THIS AND YOU
OUGHT TO LISTEN TO ME BECAUSE
I'M THE AUTHORITY.
THAT JUST DOESN'T WORK AS ANY
CLINICIAN KNOWS.
IT HAS TO START WITH LISTENING
AND IT HAS TO START WITH SOMEONE
ACTUALLY BELIEVING THAT YOU CARE
ABOUT THEM AND I CAN TELL YOU
FROM EXPERIENCE THE BEST WAY TO
DO THAT IS TO ACTUALLY CARE
ABOUT THEM.
SO THAT'S THE PIECE THAT WE HAVE
TO START WITH IS LISTENING AND
EMPATHY.
MY CLINICAL PRACTICE NOW YOU
MENTIONED I'M AT BELLEVUE
HOSPITAL.
I'M SPECIFICALLY IN A CLINIC FOR
PEOPLE EXPERIENCING
HOMELESSNESS.
IT IS INTERESTING TO ME.
I HAVE BEEN PRACTICING PRIMARY
CARE ALMOST A DEK DECADE, BUT I
HAVE BEEN IN THIS CLINIC A FEW
YEARS.
MY OWN CLINICAL PRACTICE HAS
CHANGED WITH THIS SHIFT.
IN SOME WAYS IT IS SIMPLIFIED
WHAT MY TASK IS AT THE INITIAL
VISIT WITH ANY PATIENT.
AND THAT IS BASICALLY DEVELOPING
ENOUGH OF A RAPPORT, YOU KNOW,
HAVING THEM TRUST ME ENOUGH TO
COME BACK FOR THIS SECOND VISIT.
THAT IS REALLY WHAT IT BOILS
DOWN TO.
SURE I HAVE A LIST OF 15 THINGS
ON MY CHECKLIST.
IF I FORGET MY EHR ALERTS I WILL
MAKE SURE I REMEMBER.
I DO NEED TO GET ARE THROUGH
THEM TO MAKE SURE I TAKE CARE OF
PREVENTIVE SCREENINGS, BLOOD
PRESSURE AND DIABETES
SCREENINGS.
PEOPLE WHO EXPERIENCE
HOMELESSNESS LIKE SO MANY PEOPLE
LIVING ON THE MARGINS HAVE
COMPETING DEMANDS ON THEIR TIME
AND ATTENTION.
THE ONLY WAY WE WILL MAKE
PROGRESS ON THOSE OTHER THINGS
IS IF WE INCULCATE THAT SENSE OF
TRUST THROUGH LISTENING AND
EMPATHY IN THE FIRST PLACE.
I GUESS THE LAST THING I WILL
SAY IS ONE OF THE OTHER THINGS
MY CLINICAL PRACTICE HAS REALLY
BROUGHT TO THE FORE FOR ME IS
THE WAYS IN WHICH WE SHOULD BE
TALKING A LOT MORE ABOUT VICIOUS
AND VIRTUOUS CYCLES IN HEALTH.
VICIOUS CYCLES, AGAIN, ANY
CLINICIAN WILL BE FAMILIAR WITH
THEM.
A PATIENT WITH DIABETES GAINING
WEIGHT WHICH MAKES IT HARDER FOR
THEM TO EXERCISE WHICH WORSENS
THEIR DIABETES.
VIRTUOUS CYCLES ARE WAYS IN
WHICH WE CAN INTERRUPT THAT
DOWNWARD SPIRAL AND ULTIMATELY
TRY TO CREATE AN UPWARD SPIRAL
FOR PEOPLE.
SO WE GET THAT IN THE CLINICAL
CONTEXT, BUT I THINK WE HAVE TO
BRING IT INTO THE PUBLIC HEALTH
OR THE BROADER PUBLIC CONTEXT AS
WELL.
AND THINK ABOUT THE
INTERVENTIONS WE SHOULD DEVELOP
SPECIFICALLY WITH AN EYE TOWARD
INTERRUPTING VICIOUS CYCLES,
WHETHER IT IS DUE TO
HOMELESSNESS OR ECONOMIC
CIRCUMSTANCES OR SOCIAL
ISOLATION.
AND SEEDING VIRTUOUS CYCLES TO
LIFT PEOPLE UP PARTICULARLY IN
SOME OF THE LOWEST MOMENTS OF
THEIR LIVES.
>> THAT'S FANTASTIC.
SEEDING VIRTUOUS CYCLES.
THAT IS DEFINITELY A VERY
ASPIRATIONAL GOAL WE SHOULD ALL
BE STRIVING FOR IN TAKING CARE
OF PEOPLE.
I WOULD LIKE TO MOVE ON TO
ANOTHER TOPIC OF HIGH IMPORTANCE
THAT IS RELATED TO MENTAL HEALTH
AND WELLNESS.
SO DR. MURTHY, WE ARE EXCITED
ABOUT THE RECENT, WAS IT LAST
WEEK RELEASE OF A NEW SURGEON
GENERAL'S ADVISORY, THE TITLE IS
OUR EPIDEMIC OF LONELINESS AND
ISOLATION, THE SURGEON GENERAL'S
ADVISORY ON THE HEALING EFFECTS
OF SOCIAL CONNECTION AND
COMMUNITY.
AND THE ADVISORY CONTAINS REALLY
IMPORTANT AND ACTIONABLE
INFORMATION ON THE IMPORTANCE OF
SOCIAL CONNECTION FOR INDIVIDUAL
HEALTH AS WELL AS ON
COMMUNITYWIDE METRICS OF HEALTH
AND WELL BEING AND DESCRIBES THE
CONSEQUENCES WHEN SOCIAL
CONNECTIONS IS LACKING.
WHAT WOULD YOU SHARE WITH US IN
TERMS OF THE MAJOR TAKEAWAYS
FROM THE ADVISORY?
>> SO THANKS FOR MENTIONING IT,
MONICA.
THIS IS AN ISSUE THAT REALLY
CONNECTS DEEPLY TO WHAT DAVE WAS
TALKING ABOUT WHEN IT COMES TO
STRENGTHENING PRIMARY CARE.
ONE OF THE THINGS THAT DAVE IS
MODELING IN HIS CLINIC, WHICH
MOST PEOPLE HAVE HAD THE CHANCE
TO CARE FOR PATIENTS RECOGNIZE
VERY QUICKLY IS THAT IT IS YOUR
RELATIONSHIPS WITH YOUR PATIENTS
THAT ARE AN INCREDIBLY IMPORTANT
PART OF THE HEALING PROCESS.
BUT IT TURNS OUT THAT KIND OF
HEALING DOESN'T COME FROM JUST
THE RELATIONSHIPS BETWEEN A DR.
AND A PATIENT, BUT ALL OF OUR
RELATIONSHIPS, WHICH HAVE THE
POWER TO HELP US HEAL.
THE SCIENCE INTERESTINGLY BEARS
THIS OUT.
ONE OF THE SORT OF FACTS THAT WE
ILLUSTRATED IN THE ADVISORY WAS
THAT WHEN PEOPLE EXPERIENCE
SOCIAL DISCONNECTION, A FEELING
OF LONELINESS OR PHYSICAL
ISOLATION FROM OTHERS, THAT
ACTUALLY HAS REAL EFFECTS ON
THEIR MENTAL HEALTH, IT
INCREASES RISK OF DEPRESSION'
AND SUICIDE.
IT HAS EFFECTS ON PHYSICAL
HEALTH, CARDIOVASCULAR HEALTH.
AND DEMENTIA.
THE INCREASE OF RISK OF DEMENTIA
AMONG OLDER PEOPLE RELATED TO
SOCIAL DISCONNECTION IS AROUND
50%.
WE SEE THE INCREASED RISK OF
PREMATURE DEATH ASSOCIATED WITH
SOCIAL DISCONNECTION IS ON PAR
WITH SMOKING DAILY.
IT IS GREATER THAN THE RISK WE
SEE ASSOCIATED WITH OBESITY.
THINK ABOUT THAT FOR A MOMENT.
SMOKING, OBESITY, UNQUESTIONABLY
PUBLIC HEALTH CONCERNS.
IT TURNS OUT IN THAT SAME BUCKET
SHOULD BE THE ISSUE OF SOCIAL
DISCONNECTION.
THESE ARE SOME OF THE FACTS E ES
-- FACTS WE LAID OUT TO MAKE
THE CASE REBUILDING CONNECTION
IN H OUR LIVES HAS TO BE A
NATIONAL PRIORITY.
IT IS EVEN BIGGER THAN HEALTH.
WE KNOW WHEN PEOPLE ARE
DISCONNECTED FROM ONE ANOTHER,
IT AFFECTS HOW KIDS PERFORM IN
SCHOOL, HOW PEOPLE PERFORM IN
THE WORK PLACE, IMPACTS
PRODUCTIVITY AND CREATIVITY.
AND CIVIL ENGAGEMENT AND TO HAVE
HEALTHY DISCOURSE.
WHEN WE LOOK AT COMMUNITIES THAT
ARE MORE CONNECTED TO ONE
ANOTHER WE ALSO FIND THEIR RATES
OF VIOLENCE ARE LOWER, THAT
THEIR RATES OF ECONOMIC
PROSPERITY ARE HIGHER, AND THEIR
RESILIENCE IS ALSO GREATER IN
THE FACE OF NATURAL DISASTERS
LIKES HURRICANES AND TORNADOES.
ALL OF THIS IS THE CASE BECAUSE
SOCIAL CONNECTION IS SOMETHING
THAT IS VITAL FOR OUR OVERALL
HEALTH AND WELL BEING.
IT IS LIKE FOOD AND WATER.
SOMETHING WE NEED FOR OUR
SURVIVAL.
WHEN WE DON'T HAVE IT, THAT
COMES IN AND THE FEELING OF
LONELINESS, WHICH IS SIMILAR TO
HUNGER OR THIRST.
WE LAID OUT IN THE ADVISORY A
SERIES OF STEPS WE CAN TAKE AS A
KOUN
COUNTRY, STEPS WE CAN TAKE AS
INDIVIDUALS TO ADDRESS
LONELINESS.
FROM BROADER POLICY ORIENTED
STEPS, LIKE INVESTING IN SOCIAL
INFRASTRUCTURE, POLICIES AND
PROGRAMS THAT BRING US TOGETHER
IN OUR COMMUNITIES AND CREATE
SPACES FOR PEOPLE TO ENCOUNTER
ONE ANOTHER.
INVESTMENTS IN RESEARCH AND
BROADEN OUR UNDERSTANDING OF
WORK.
IT HAS STEPS THE HEALTH CARE
SYSTEM CAN TAKE TO SCREEN PEOPLE
FOR LONELINESS AND TO REFER
THOSE INDIVIDUALS TO PROGRAMS IN
THE COMMUNITY THAT CAN HELP THEM
BUILD STRONGER SOCIAL CONNECTION
AND SO WHILE THERE IS A LOT IN
THE ADVISORY, I WILL LASTLY
POINT OUT THE STEPS WE LAY OUT
FOR INDIVIDUALS.
IT TURNS OUT ONE OF THE MOST
PAINFUL THINGS ABOUT LONELINESS
CAN BE STRUGGLING WITH THE
DEEPENING SENSE OF, I THINK, OF
DISEMPOWERMENT AND LACK OF
AGENCY WHEN COMES WHEN YOU
STRUGGLE WITH LONELINESS.
OVER TIME YOU THINK YOU ARE
LONELY BECAUSE YOU ARE NOT
LIKABLE, ITS IS YOUR FAULT, IT
IS TOO HARD TO BUILD CONNECTIONS
WITH OTHER PEOPLE.
LONELINESS IS A DOWNWARD SPIRAL.
ONE OF THE THINGS WE ALL CAN
ACTUALLY REACH FOR TO HELP BREAK
THAT SPIRAL IS SERVICE.
WHEN WE SERVE OTHER PEOPLE,
VOLUNTEERING IN A SOUP KITCHEN
OR IN AN ORGANIZATION IN OUR
COMMUNITY OR HELPING SOMEBODY IN
OUR LIFE WHO HAS A NEED, A
CO-WORKER IN THE OFFICE OR
SOMEBODY IN OUR NEIGHBORHOOD,
THOSE MOMENTS ARE POWERFUL.
THEY CONNECT US AUTOMATICALLY TO
SOMEBODY ELSE IN A WAY THAT
FEELS MEANINGFUL.
IT REMINDS US WE HAVE VALUE TO
BRING TO THE WORLD WHICH IS
SOMETHING WE OFTEN FORGET WHEN
WE ARE STRUGGLING WITH
LONELINESS.
IN THIS MOMENT WHEN WE ARE
SEEING WHERE ONE IN TWO ADULTS
ARE RECOGNIZING MEASURABLE
LOINLINESS AND THE YOUNG PEOPLE
ARE THE GROUP EXPERIENCING THE
HIGHEST LEVELS OF LONELINESS, WE
HAVE TO THINK ABOUT HOW TO
REINVEST IN EACH OTHER, HOW TO
REIMAGINE AND REIDENTIFY
OURSELVES AS PEOPLE WHO ARE
THERE FOR ONE ANOTHER.
IF WE DON'T RECOMMIT TO EACH
OTHER IN THIS MOMENT MY WORRY IS
WE WILL BECOME LONELIER AND
LONELIER AND HARDER TO TAKE ON
ADVERSITY WHEN IT COMES OUR WAY.
A FUTURE PANDEMIC, CLIMATE
CHANGE OR ONGOING CHALLENGE WITH
RACISM.
IT IS THE SMALL STEPS THAT MAKE
THE DIFFERENCE HERE.
I WILL TELL YOU IF YOU ARE
LISTENING TO THIS CALL AND
STRUGGLING WITH A SENSE OF
LONELINESS YOURSELF AS I HAVE AT
MANY POINTS IN MY OWN LIFE
INCLUDING ADULTHOOD AS WELL AS
CHILDHOOD.
JUST SPENDING 15 MINUTES A DAY
REACHING OUT TO PEOPLE YOU CARE
ABOUT CAN MAKE A BIG DIFFERENCE
IN YOU HOW FEEL.
MAKE SURE WHEN YOU TALK TO
SOMEONE, A FAMILY MEMBER OR
FRIEND, GIVE THEM YOUR FULL
ATTENTION, PUT YOUR TWICE AWAY.
THAT CAN DEEPEN THE CONNECTION
AND STRENGTHEN THE BOND.
OF COURSE FINDING WAYS TO SERVE
AND HELPING ONE ANOTHER IS ONE
OF THE MOST POWERFUL ANTIDOTES.
WE HAVE A LOT OF WORK TO DO.
FOR ME, IT IS AN URGENT PUBLIC
HEALTH ISSUE, WITH PROFOUND
IMPLICATIONS WITH PHYSICAL
HEALTH AND MENTAL HEALTH AND
HEALTH OF SOCIETY.
>> THAT IS REALLY IMPORTANT AND
I APPRECIATE HOW YOU
INCORPORATED MORE OF WHAT PEOPLE
CAN DO.
ON THAT NOTE, WE HAVE A COUPLE
OF QUESTIONS THAT HAVE COME IN
RELATED TO WHAT YOU ARE
DISCUSSING.
I WOULD LIKE TO BRING THOSE IN
AND HAVE YOUR THOUGHTS ON THEM.
ONE IS QUESTIONS FROM THE
AUDIENCE ASKING ABOUT HOW
THOUGHT LEADERS AND ADVOCATES
CAN GET INVOLVED WITH YOUR WORK
ON SOCIAL ISOLATION.
AND THEN ALSO WHAT WOULD YOU
THINK ABOUT THE INTEGRATION OF
SPIRITUALITY IN HEALTH
APPROACHES TO ADDRESS THIS AS AN
OPPORTUNITY?
>> I WOULD SAY THOSE INTERESTED
IN HELPING BUILD GREATER
CONNECTION, THIS STARTS WITH US
AND OUR OWN LIVES.
TAKING STEPS TO STRENGTHEN
CONNECTION IN YOUR OWN LIVES.
THE NEXT STEP IS TO LOOK AT
ENVIRONMENTS YOU ARE OPERATING,
YOUR WORK PLACE, NEIGHBORHOOD,
IF YOU ARE IN SCHOOL AS WELL, IT
COULD BE THE CLASSROOM OR
COMMUNITY OF CLASSMATES.
THESE ARE ALL SPACES WHERE SMALL
STEPS FROM YOU CAN CAT LIZ
GREATER COMMUNITIES.
THINK ABOUT IN YOUR NEIGHBORHOOD
DOING WHAT MY WIFE DOES SO WELL
AND I'M TRYING TO LEARN FROM
HER.
SHE PERIODICALLY SENDS AN E-MAIL
TO OUR NEIGHBORS AND SAY, WHY
DON'T WE GET TOGETHER.
PEOPLE HAVEN'T SEEN EACH OTHER
IN A LONG TIME AND IT OPENS UP
OUR DOORS.
I'LL TELL YOU, PEOPLE ARE SO
EXCITED TO COME TO THOSE GET
TOGETHERS.
THEY USE INTERESTING WORDS.
THANK YOU FOR YOUR COURAGE TO
BRING US TOGETHER.
THE FIRST TIME I HEARD THAT I
REALIZED PEOPLE FEEL SCARED TO
GET TOGETHER AND THEY THINK OF
FOLKS WHO ORGANIZE GET TOGETHERS
AS COURAGEOUS.
I THINK THAT IS THE FACT THAT IN
SOME WAYS WE HAVE COME TO ADOPT
A LIFE WE JUST ASSUME WE ARE ON
OUR OWN AND IT FEELS INTRUSIVE
TO BE A PART OF SOMEONE ELSE'S
LIFE OR GO TO THEIR HOUSE OR
HAVE THEM OVER.
THAT IS THE NORM.
HOW WE HAVE EXISTED FOR HUNDREDS
IF NOT HOWS OF YEARS, BEING A
PART OF EACH OTHER'S LIVES,
LIVING TOGETHER, EATING
TOGETHER, CELEBRATING TOGETHER,
MOURNING TOGETHER.
THESE ARE SMALL THINGS YOU CAN
DO IN YOUR NEIGHBORHOOD AND IN
YOUR WORK PLACE.
CREATING SPACES FOR PEOPLE TO
GATHER.
NOT ONLY FOR WORK, BUT TO GET TO
KNOW ONE ANOTHER.
WE DO A HUMANS OF OSG, OSG
STANDS FOR THE OFFICE OF THE
SURGEON GENERAL.
IT IS A 10-MINUTE EXERCISE WHERE
ONE OFFICE MEMBER INTERVIEWS
ANOTHER ABOUT THEIR LIFE.
MAYBE THEIR CHILDHOOD, HOBBIES,
DREAMS AND WHAT THEY WANTED TO
DO GROWING UP, THE
DISAPPOINTMENT OF THAT AND
PEOPLE WHO MEANT THE MOST TO
THEM OVER THE COURSE OF THEIR
LIFE.
THESE ARE THE STORIES THAT HELP
US KNOW PEOPLE.
EVEN FIVE OR 10 MINUTES OF
CONVERSATION LIKE THAT MAKES SO
MANY OF US IN OUR OFFICE FEEL
CLOSER AND MORE CONNECTED TO THE
PEOPLE, THE PERSON WHO IS
INTERVIEWED.
SO THESE ARE SMALL STEPS, BUT,
AGAIN, WHEN IT COMES TO THE WORK
OF HUMAN CONNECTION IT IS THOSE
SMALL STEPS THAT MAKE A BIG
DIFFERENCE IN HOW CONNECTED WE
FEEL.
>> THANK YOU VERY MUCH.
>> ONE LAST THING, MONICA, IN 30
SECONDS.
SPIRITUALITY.
SINCE I WAS BROAD UP, 100% I
BELIEVE THERE IS A PLACE FOR
SPIRITUALLY AND FAITH-BASED
COMMUNITIES.
WE HAVE SEEN A DECLINE IN FAITH
COMMUNITIES.
THAT HAS LIKELY HAD AN IMPACT ON
HOW CONNECTED WITH ARE.
IT IS NOT THE ONLY REASON WE ARE
FEELING LONELY, BUT A BIG ONE.
SPIRITUAL AND FAITH COMMUNITIES
ARE VITAL WHEN IT COMES TO
REBUILDING CONNECTION IN OUR
COUNTRY.
>> THANK YOU FOR ADDING THAT,
THE SPIRITUALITY QUESTION FROM
THE AUDIENCE.
I DO WANT TO ASK ANOTHER
QUESTION ABOUT THIS AND I
REALIZE WE HAVE FOUR MINUTES
LEFT, SO I'M GOING TO ASK ONE
MORE QUESTION, TRY TO
INCORPORATE ANOTHER QUESTION
THAT CAME IN FROM THE AUDIENCE
WITH THIS QUESTION.
THIS POTENTIALLY LAST QUESTION
IS DIRECTED AT DR. CHOKSHI.
YOU HAVE ALSO WORKED TO IMPROVE
MENTAL HEALTH AGAINST RACIAL AND
ETHNIC MINORITY COMMUNITY
MEMBERS.
WE KNOW THERE ARE SIGNIFICANT
STIGMAS THAT EXIST TO NORMALIZE
MENTAL HEALTH, EVEN ACKNOWLEDGE
FEELINGS OF SOCIAL ISOLATION,
LACK OF CONNECTEDNESS.
CAN YOU TALK ABOUT THIS TOPIC,
IN ADDITION TO HOW PUBLIC HEALTH
PROFESSIONALS AND HEALTH CARE
PROVIDERS CAN WORK TO GAIN TRUST
AROUND WHEN ONE SHOULD SEEK
ASSISTANCE FOR MENTAL HEALTH,
HOW TO ADDRESS THE INFORMATION
IN THE MEDIA THAT MAY NOT BE
HELPFUL TO OUR PUBLIC HEALTH AND
WE KNOW THAT THE STIGMA EXISTS
FOR MENTAL HEALTH CARE ALSO IN
ASIAN AMERICAN, NATIVE HAWAIIAN
AND PACIFIC ISLANDER COMMUNITIES
ACROSS THE LIFE SPAN.
ANY THOUGHTS HOW WE CAN PROVIDE
SUPPORT, ADDRESS THE TRUST AND
NORMALIZE THESE IMPORTANT
ISSUES.
>> THANK YOU, MONICA.
THESE ARE EXTREMELY IMPORTANT.
THESE ARE LIFE-OR-DEATH
QUESTIONS THAT WE ARE ALL
GRAPPLING WITH.
MY STARTING POINT AS VIVEK
ALLUDED TO IS SO MUCH OF OUR
MENTAL HEALTH IS ROOTED IN
TRAUMA.
IT'S TRUE AT THE INDIVIDUAL
LEVEL, WHICH IS WHY WE NEED
TRAUMA-INFORMED APPROACHES IN
HEALTH CARE SETTINGS, BUT ACROSS
A BROAD ARRAY OF SETTINGS.
I THINK THE LEAP WE HAVE TO MAKE
IS TO ALSO RECOGNIZE THAT THAT
LINKAGE TO TRAUMA IS TRUE AT THE
POPULATION LEVEL AS WELL.
AND THIS IS WHY WE NEED TO
RECKON WITH HISTORICAL TRAUMA,
WHICH CONNECTS THESE IMPORTANT
CONVERSATIONS AROUND THE HISTORY
OF RACISM AND XENOPHOBIA, TO
WHAT PEOPLE ARE EXPERIENCING AND
SUFFERING FROM TODAY.
WE TALKED ABOUT HOW COVID-19,
AMONG OTHER THINGS HAS LAID BEAR
THE CATASTROPHIC COMBUSTIBILITY
OF ILLNESS INTERSECTING WITH
HISTORICAL PATTERNS OF
INJUSTICE.
WE HAVE TO SAY FOR THE ASIAN AND
PACIFIC ISLANDER COMMUNITIER,
THIS IS NOT JUST WITH OUR LOVED
ONES GETTING SICK, NOT JUST
HUNGER AND HOUSING INSTABILITY
AS WE SAW DURING THE PANDEMIC,
BUT ALSO INCREASED STIGMA AND
HATE.
AND THERE WERE A NUMBER OF
EXTRAORDINARILY PAINFUL, VIOLENT
INCIDENTS IN NEW YORK CITY AND
ACROSS THE COUNTRY BECAUSE OF
THAT STIGMA AND HATE.
SO I DO THINK THAT A BIG PART OF
EQUATION HERE WITH RESPECT TO
WHAT WE NEED TO DO IS TO FOCUS
ON YOUTH MENTAL HEALTH AS VIVEK
AND HIS OFFICE HAVE ALSO CALLED
ATTENTION TO, BOTH IN TERMS OF
THE RECENT ADVISORY ON SOCIAL
CONNECTION, BUT A DEDICATED
ADVISORY LAST YEAR ON YOUTH
MENTAL HEALTH.
I WILL SHARE FROM A PERSONAL
PERSPECTIVE, MY WIFE IS AN
EDUCATOR.
SHE WORKS AT A PUBLIC MIDDLE
SCHOOL HERE IN QUEENS.
AND I'LL JUST QUOTE HER FOR A
SECOND.
SHE SAYS THE KIDS AREN'T THE
PROBLEM.
IT'S ALWAYS THE ADULTS.
AND SO IT IS ON US.
IT IS ON US TO CULTIVATE
BELONGING, NOT JUST AS AN
ANTIDOTE TO LONELINESS AS VIVEK
HAS SAID, BUT BELONGING AS AN
ANTIDOTE TO XENOPHOBIA AS WELL.
THAT MATTERS FOR ASIAN, NATIVE
HAWAIIAN AND PACIFIC ISLANDER
COMMUNITIES.
THE LAST NOTE I WILL END ON IS
THESE ARE URGENT PROBLEMS WE ARE
CALLING ATTENTION TO.
BUT WE CAN JUST AS WE LOOK BACK
TO HISTORY TO UNDERSTAND THE
ROOTS OF THOSE PROBLEMS, WE CAN
ALSO DERIVE INSPIRATION FROM
HISTORY.
I THINK ABOUT THE FACT THAT A
CENTURY AGO THE SUPREME COURT
RULED IN THE U.S. VS. SINGH CASE
THAT INDIANS WERE INELIGIBLE FOR
NATURALIZED CITIZENSHIP BECAUSE
THEY ARE NOT CONSIDERED WHITE.
HALF A CENTURY LATER MY FATHER
IMMIGRATED TO THIS COUNTRY AND
BECAME A NATURALIZED CITIZEN AND
HALF A CENTURY AFTER THAT, HIS
SON BECAME THE FIRST NEW YORK
CITY HEALTH COMMISSIONER OF
ASIAN DESCENT AND HAD THE CHANCE
TO WORK WITH THE FIRST INDIAN
SURGEON GENERAL IN A PANDEMIC.
IT IS NOT ABOUT VIVEK AND ME,
BUT THE FACT THAT PROGRESS IS
POSSIBLE, BUT IT REQUIRES
CONTENDING WITH THESE
DEEP-ROOTED ISSUE, UNEARTHING
THEM, NAMING THE TRAUMA THAT
UNDERLIES THEM AND TAKING THE
SMALL STEPS WE HAVE TALKED ABOUT
TODAY.
>> WOW.
I'M SORRY.
WE ARE AT TIME.
YOU ARE BOTH SUCH INSPIRING
PEOPLE AND WE COULD HAVE
CONTINUED TO TALK.
I WILL JUST TURN IT OVER TO DR.
MURTHY IF YOU WANT TO WRAP THIS
UP FOR US AND THEN WE CAN CLOSE.
>> SURE.
WELL, LISTEN, THANK YOU EVERYONE
FOR JOINING US TODAY.
MONICA, THANK YOU SO MUCH FOR
MODERATING THIS CONVERSATION.
TO EVERYONE WHO HELPED PUT IT
TOGETHER.
AND I WANT TO ESPECIALLY THANK
DAVE FOR BEING OUR DISTINGUISHED
GUEST TODAY.
IT IS HARD TO PUT INTO A FEW
WORDS JUST HOW MUCH DAVE HAS
MEANT TO ME AS A FRIEND, BUT
ALSO TO PUT INTO WORDS WHAT HIS
CONTRIBUTION HAS BEEN TO
SOCIETY.
A CONTRIBUTION THAT FAR PRECEDED
HIS STUDY OF MEDICINE THAT
REALLY BEGAN FROM THE EARLIEST
OF AGES: I THINK IN HIS STORY
AND HOPEFULLY WHAT YOU HAVE
HEARD TODAY YOU SEE THE KERNELS
OF WHAT WE NEED TO DO AS A
SOCIETY, CREATE A SENSE OF
BELONGING, RECONNECT PEOPLE WITH
ONE ANOTHER, APPROACH OUR WORK
AS LEADERS WITH INTEGRITY,
ASKING OURSELVES HOW WE CAN
MERIT AND DESERVE THE TRUST THAT
WE NEED TO INSTILL IN SOCIETIES.
AND ALSO ASKING THE QUESTION OF
HOW WE CAN BE BETTER PREPARED
FOR WHAT IS TO COME.
WE ARE CONSTANTLY EVOLVING.
THERE WILL BE ANOTHER PANDEMIC,
ANOTHER PUBLIC HEALTH CHALLENGE.
WE HAVE TO THINK AHEAD OF WHAT
IS TO COME AND PREPARE FOR THAT.
THAT IS THE IMPORTANT WORK OF
LEADERSHIP.
I'M GRATEFUL FOR EVERYTHING YOU
DO, DAVE, FOR INSPIRING ME AND I
KNOW SO MANY OTHERS.
PLEASE THANK MAYLA FOR THAT
ADVICE, DAVE'S WIFE.
IT IS NEVER THE KIDS, IT IS
USUALLY THE ADULTS.
ESPECIALLY IN THE MIDST OF A
YOUTH MENTAL HEALTH CRISIS IT IS
A CALL TO AX FOR ALL ADULTS TO
DO MORE AND ULTIMATELY DO RIGHT
BY OUR CHILDREN.
THANK YOU, DAVE, FOR BEING WITH
US TODAY
>> SUCH AN HONOR.
>> IT IS ON US.
THANKS TO EVERYONE WATCHING.
APPRECIATE YOU JOINING TODAY AND
WE WISH YOU ALL THE BEST.