Episode Transcript
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Gabe Nathan (00:01):
Hello, this is
Recovery Diaries In-Depth.
I'm your host, Gabe Nathan.
Thanks so much for joining us.
We're very happy to have youhere.
We are so fortunate to havetoday as our guest Dr Erica
Harris.
She's an emergency roomphysician at Einstein Medical
Center in Philadelphia.
She's also a member of ourRecovery Diaries Board of
(00:21):
Directors.
A few years ago, during theheight of the COVID pandemic, we
made a film about Dr EricaHarris and we were delighted to
have her here as our guest.
Each week we'll bring you aRecovery Diaries contributor
folks who have shared theirmental health journey with us
through essay or video format.
We want to see where they arein their mental health journey
(00:41):
since initially being publishedon our website.
Our goal is to continuesupporting our diverse community
by having conversations here onour podcast to follow up and
see what has shifted, what haschanged and what new things have
emerged.
We're so happy to have youalong for this journey.
We want to remind you to followour show for new and back
(01:02):
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(01:26):
make sure to like, share andsubscribe.
Erica Harris, welcome toRecovery Diaries In-Depth.
Thank you so so much for beinghere with me today.
Erica Harris (01:40):
Well, thank you
for having me.
Gabe Nathan (01:42):
It is an absolute
pleasure.
Just by way as a briefintroduction, you are an
emergency physician at EinsteinMedical Center in Philadelphia.
Can you talk a little bit aboutwho else you are, aside from
that title and that intro andall the gravitas that goes along
(02:05):
with that?
Erica Harris (02:07):
Yeah, so there's a
lot.
I don't know where to start.
I am an emergency physician.
I've trained, I feel like mostof my life to do that and it's
something that I actively workto do.
But I think other importantroles for me, you know, I've
(02:28):
been the medical director of ourviolence intervention program
at the hospital and in that roleI try to help people with their
physical and mental healthrecovery from injury.
I am a mother to two youngchildren, I am a friend and I'm
(02:51):
a pet mom and I think these areall roles where I try to be a
nurturer and that's sort of thethread between the things that I
find most value in.
Gabe Nathan (03:01):
You're also a coal
miner's granddaughter.
Erica Harris (03:04):
Correct, yes.
Gabe Nathan (03:06):
We'll get to that a
little later when we talk about
the film that we made about youa few years ago.
But I want to touch briefly onor I'd like you to touch on it
this idea of nurturing.
And you went through extensivetraining to become a medical
professional and there is a lotthat goes into that, that is
(03:32):
didactic in nature, that you hadto learn and process and apply,
but nobody teaches you how tobe a nurturer, no one teaches
you what that means and how todo that for people.
So can you talk a little bitabout about nurturing and how
you found your way into thataspect of your profession and
(03:56):
your life?
Erica Harris (03:58):
I think that for
me, nurturing isn't necessarily
something that comes naturally.
I think for most of us, when wereflect on our life, we realize
that we've been sort ofnurtured into being ourselves,
that we're here because we werenurtured, that that's a part of
being part of the humancommunity.
(04:19):
Is that we require that?
We require that to grow anddevelop, that we can't develop
language if we're not nurturedappropriately.
We can't develop our bodies ifwe're not nurtured if we're not
(04:41):
cared for.
That.
That's a prerequisite for beingalive.
It's not just that's nice tohave, it'd be nice if we could
be.
No, we actually have to.
Our brains don't developappropriately if we are not
appropriately nourished andnurtured.
So I think that, in reflectingon my life, that there were very
key people in my life whonurtured me into being not just
alive but alive and doing well,alive and able to function,
alive and able to think, andthese were, you know, various
people throughout my life.
These are, you know, obviously,you know my parents, the people
(05:02):
closest to me, my, you know, mysister, my friends, but
(05:25):
teachers.
You know people who cared,people who came into my life and
took an interest.
Now going through that processof being ill, being very ill,
having surgery, recovering andseeing, both within the
healthcare system, whatnurturing looks like and what it
doesn't look like, what theopposite of that looks like.
(05:46):
In obtaining healthcare andwatching sort of the struggles
of other people, created a modelfor me, a roadmap of what I
wanted to be in a healingprofession and sort of created
in my mind what a best practicecould be, what that nurturing
could look like and believing inthe potential for other people
(06:07):
that I have a certain positionof privilege as a physician, not
just societal privilege as atitle, but in my role as a
physician, in what I'm able todo and provide people with,
within the healthcare system,access to resources.
And that became very importantto me to really take that and
(06:28):
turn it into something thatcould be useful for people, to
turn that into somethingpowerful within them, to show
them within themselves whatthey're capable of and give that
back.
So it really for me is almostlike a patchwork quilt of all
the love that I've ever beengiven and shown in my life to
give that back.
To give that back to peoplewhen they're at their weakest
(06:52):
and seeing that our healthcaresystem doesn't necessarily value
that, that that's not somethingthat we can monetize and sell
and make money off of.
And it's a very you know, we'rea very monetarily driven
healthcare system.
We're and and it's a very youknow, we were a very monetary,
monetarily driven healthcaresystem.
That we, we're a business.
It's a business drivenhealthcare system.
That's how things move throughthe healthcare system.
(07:14):
But people are not the bottomline.
People are what, the only thingthat matters really when we're
talking about, you know,healthcare to me, and that's a
challenging something that Ihave to reconcile every day is
like this is real.
This is like we work in abusiness and we're working with
people, and how do we, how do Ireconcile that every day?
(07:35):
And so that's a challenge.
And that's a challenge, I think, in training and working with
residents and medical studentsand trying to residents and
medical students and trying toalso share with them those
values, sort of that ethos ofcaring for people, caring for
their souls, not just for theirbodies, but how do you do both?
Gabe Nathan (07:57):
And you can do both
and you must.
It's a remarkable answer and mybrain is making so many
connections.
As you're talking and I'mthinking about a long time ago,
when I used to be an EMT for aprivate for-profit transport
company that you know, we saidthat you know our ambulances are
(08:18):
basically FedEx trucks withoxygen tanks and you know we're
really just schlepping bodiesand it could just be packages,
it could be widgets, it could beanything.
Because it was like how manytransports can you do in an
eight hour shift and a 12 hourshift?
How much money can you make thecompany?
(08:39):
But these were people onstretchers in the back of the
truck and we were responsiblefor them and sometimes they were
very, very sick, um, and Ithink about that, that role of
humanity and how you can't.
There's no ICD code fornurturing.
(08:59):
You can't bill for that, um,but it is such an essential you
can't bill for that, but it issuch an essential human thing
and it's people at their mostvulnerable.
They can't do for themselves,sometimes they can't feed
themselves, they can't ask forwhat they need, and so how do
(09:28):
you, on a day-to-day basis, kindof parse that out?
That dichotomy of this is abusiness and money is involved
and there is billing involvedand all of that, and there's
also pressure to, you know, seepatients and make discharges and
admit new patients, and it'sall keeping that cycle going.
How do you do that every day?
Erica Harris (09:47):
I realize that
everything is business currently
Like.
We live in a capitalist society.
This is the framework thateverybody lives in, this is the
water that we swim in, and Ithink that that is not an excuse
to not be who you are, to notbe human to one another.
Kindness takes absolutely notime Connecting with a human
(10:10):
being.
I feel like it almost is aradical act anymore to really
truly connect, to step out ofyour own experience enough to
try to understand and feel whatsomebody else maybe has felt or
might be feeling.
That does not take a lot oftime.
That does not take time awayfrom moving people through a
(10:33):
busy emergency department.
In fact, I would argue it savesyou time.
It saves you time because thenyou're not asking 20 sort of
inane questions of them from achecklist right, you are
actually getting to the core ofwhy they're there and what you
can do for them and how you canbest serve them.
Right, you're actually gettingat the core of who they are.
(10:54):
They're having a betterexperience.
You, as a healthcare worker,are actually kind of
regenerating your batteries alittle bit as well, because
you've had something meaningfulto you.
Most people don't go intomedicine at any level.
You know, if you're going intonursing, if you're going in to
be a doctor, if you're going tobe a physician assistant, you're
(11:15):
not doing it really to make alot of money.
It's not like, it's not thepathway, and if it ever was, it
is most certainly not anymore.
To make a ton of money right,like go into finance, like go do
that, like this, is not whatpeople think of when they're
like you know ways to make quickmoney.
So you're doing it because youhave a desire to actually serve
people and to serve people whenthey are at their lowest, when
(11:36):
they need the most amount ofhelp, like you.
Actually, really, that was theoriginal reason, probably at
some level, that most people Iknow went into this profession.
And so when you're actuallyable to do that, that's, I think
, when people see, I see thislike light in their eyes and I
feel like the system can takethat out of you, because so
often you feel like you're justgoing through the motions and
(11:56):
you're just checking the boxesand you're just doing this.
But when you're able toactually, you know, make that
connection with a human beingand feel like you actually made
a difference for them, youactually serve them and you had
that moment.
I think that is fuel for us,and so it goes both ways.
You've served the patient, butyou've also served yourself, and
that matters.
(12:17):
I think that we can't excludeourselves from this equation,
that there's this idea of oh,the selfless, you know, provider
of services.
It's like we're not providers,we are humans in an interaction
that matters, and so, yeah, weget our paycheck, the patient
gets their medical services, butit's almost a holy interaction
(12:37):
and I think that we can't losesight of that, that it's up to
us to remember, that it's up tous to remember and we have
choices.
So, yeah, we may be operatingin a system that tells us you
have to see this many patientsan hour.
This has been a very busyrespiratory season.
There are 60 plus people in ourwaiting rooms, and this is true
(12:57):
across the country.
It's not just at JeffersonEinstein Hospital, this is
everywhere, across the city,across the country, nationally.
People are backed up.
We want to serve people better,we want to get them out of the
waiting rooms, we want to seeall those patients.
It's frustrating for everybody,it's frustrating for the
patients, it's frustrating forus, but even within that, that
we can find joy in the peoplethat we are able to serve and we
(13:20):
are able to take care of, andeverything that we do as a
choice, everything that we areable to have control over.
We get to make those choices,like I'm going to choose that
day to go in and have goodinteractions with the patients
that I am able to serve that day, and it is, I'm going to say,
I'm just going to say it'sbecoming more and more every day
(13:42):
of a radical choice to bedecent to one another, to
actually intend to set out onthat day and really maybe find
out one interesting thing aboutthat patient that day, like one
thing that maybe doesn't have todo with the complaint of knee
pain, but you found out kind ofsomething that they did when
they were, you know, younger.
They tell you an interestingstory and you're like, wow,
that's, that's an interestingfact that I learned just from
(14:03):
you know, sitting and makingspace for that person and really
kind of reserving judgmentand're just walking down the
street kind of ignoring peoplewith your head down on your
phone, that we get all theseopportunities to talk to so many
(14:30):
people in a day and they'renaturally going to be more
vulnerable with you becausethey're in a vulnerable place
and they have to tell you theirstory, they have to tell you
what's going on with themselves,and so we have all these
opportunities in any given dayto open up and allow that, and
so that's really what I try toget across.
I have my days.
(14:51):
Most certainly I'm not awalking model of you know.
I'm getting joy, squeezing joylike orange juice, out of every
moment of every day.
There's tougher days thanothers, but on the whole, I
think that's something that wecan strive for and it's worth
striving for.
Gabe Nathan (15:07):
I think people are
so hungry for it.
I think they're so wanting toshare of themselves with
somebody who actually genuinelycares, somebody who is going to
make eye contact with them,somebody who is going to express
an interest.
You used the phrase a holyinteraction and I was thinking
(15:30):
about.
My GP passed away at 92 on aFriday and he had a full docket
of patients to see on Monday andthe receptionist had to go
through calling everyone.
Dr Landers passed away and heused to make house calls to my
(15:52):
great grandmother and so youknow, we, just everybody just
kept seeing Dr Lander Right and,um, I remember one day I was in
his waiting room and there wasthis old guy.
It was just the two of us inthe waiting room and the guy
looked at me and he said, areyou here to see him?
And he pointed at the ceilinglike God you know.
(16:13):
But obviously I was there to seeDr Lander, as he was too, and
it was so heartwarming to me tobe like, oh, this guy loves Dr
Lander the same way I do.
And why?
Sure, because this man wasinterconnected in so many
(16:35):
people's lives through so, so,so many years of service, but
also because he was warm andkind and thoughtful and asked
about you and asked about thefamily and knew all the stories
and wanted to learn more.
And I mean, of course, therewasn't a computer in sight in
his anywhere, not even atreception.
(16:57):
It was a typewriter.
But when I had to find a new GP,I remember going to a guy who
had his laptop on his lap and hedid not look at me once, just
stared at the screen until itwas time for the H&P, just went
through questions, did not lookat me and I was like God.
(17:21):
There could not be a biggerdifference here and, like you
said before, eye contact doesn'ttake any extra time and these
things make for such a morehuman interaction and just such
a lovely, a lovelier experienceand I think we need need that so
(17:46):
, so desperately, um, and it's,it's a wonderful thing that
you're able to provide that forpeople.
But I'm curious about the costum to you as far as being a
healthcare provider you know youwere, obviously you were a
(18:07):
healthcare provider throughCOVID and that ain't over yet
and just the impact of theprofession and the expectations
and the pressures on your mentalhealth and wellbeing.
How has it affected you throughthe years and how do you help
yourself?
Erica Harris (18:29):
I think COVID was
it was sort of the way I've best
heard it described was a slowlyunfolding mass casualty event
and it wasn't just sort ofsomething that happened out
there.
Because when we think of masscasualty events, you think of
mass shootings or like abuilding collapse or an
(18:51):
earthquake.
You think of something thathappens outside the hospital
walls, right, and then we becomesort of the second victims of
that as healthcare workers thatwe receive the victims and we
manage the trauma and thingslike that.
But it happened to us too.
We were there witnessing it,but we were also of it.
(19:11):
We were people that we weresort of victimized by it, in a
sense that we were primarytargets that we were receiving
patients and getting sick fromthem also, and we knew that that
we were vulnerable to theeffects of the diseases that we
saw.
We were the first people to seeit.
We were the ones that were wetalk about.
We talk about the victims fromthe past, the original COVID,
(19:36):
like the way that it was, in thevery beginning.
We talk about it like rememberthose days where the patients
would come and their eyes wouldbe bugging out and their oxygen
saturations would be low.
We talk about it like the waypeople talk about war stories,
like if they talk about them atall.
We often don't talk about it.
It's rare.
I find these rare moments whereI'll be talking with somebody
(19:57):
and it comes up sort of inpassing.
It'll be like we're walkingdown the hallway to the
cafeteria and we sort of allowourselves this moment of
reflection and it's a dark one.
It's not like oh yeah, you know, that was sad, that was rough,
that was hard.
I'm glad it's over.
It's very much what I wouldconsider a vulnerable moment and
(20:17):
it's among very trusted friendsand colleagues.
It's not something that we evertalk about.
I've never seen it happencasually.
It's never happened for mecasually with people I've just
met where we're talking aboutsort of our feelings around it.
We'll talk about the numbers,we'll talk about sort of the way
that you can deconstruct it andmake it very generic, very
(20:39):
bland, very removed from our ownexperience with it, very
removed from our own experiencewith it.
But to actually talk about howit felt the fear, the panic, the
feelings of being out ofcontrol, the worry for our own
health.
And even I was thinking aboutin preparation for coming here
to discuss on the podcast withyou watching the video, watching
(21:08):
my video, it's hard.
For me it's actually hard.
It's like a time capsule,because it was made very close
to that first wave of COVID.
It was sort of like things thatcalmed down a little bit, and I
just remember, though thefeelings it brings up are very
strong and very powerful.
It really did cause an exodus ofpeople from nursing at least I
(21:30):
know there's physicians who haveleft the field because of it,
and it's complicated.
It's not just about oh, we sawa lot of victims of disease.
I think there were a lot ofsocial and cultural factors that
played into that, but there wasa lot of things.
I think, and I think, as per alot of other similar mass
(21:50):
casualty events, the ways peopledon't talk about it, the ways
that we're encouraged to bestrong and keep going and that's
the culture of medicine ingeneral is to be strong and not
talk about it.
You don't want to admit toother people, to the person next
to you, that you were scared,that you were worried I know in
training.
You don't want to admit thatyou had a case that frightened
you or that you were afraid thatyou were going to mess up, and
(22:11):
I think we were collectivelyafraid of messing everything up
because nobody knew what theywere doing.
So there were like layeredfears layered fears of not being
enough professionally, layeredfears of getting sick and taking
it to your family, fears ofyour own death, fears of just
watching just this massivesuffering and what it meant for
(22:31):
all of humanity that we felt incharge of.
And so there was really no alsocollective debriefing.
There was no way for us to likewhat do we do with this now?
It's like okay, everything'sfine, everything's great.
To like what do we do with thisnow?
It's like okay, everything'sfine, everything's great.
And sort of.
It felt like also a slap in theface when you know people, the
(22:52):
whole debate about masking orunmasking, or vaccines or no
vaccines, it felt very personalfor a lot of people.
I think when people are like mybody, my rights, it's like okay
, like there's room forconversation here, there's room
for, I think, healthydiscussions around vaccine
hesitancy and around, you know,personal autonomy.
But I think that for a lot ofus in healthcare it's sort of
like but we almost died, like wewatched people die.
(23:16):
It is so hard.
And then everything.
Just one day it's like okay,everything's normal now.
It's like but it's not for us,it's not we, just we carry it
with us and there was, therewasn't a lot to make that
transition from catastrophe toeveryday, normal life.
Now it's like get back to work,get back to the next thing
(23:37):
that's going to happen,everything's great.
A lot of these situations forpeople that you know that the
rain comes and then the rainstops and then the sun comes out
and then everything normal, theworld goes on for people and it
doesn't feel that way to them,and so that's what I think that
we're reckoning with now is alot of just stored, dormant
(24:01):
energy from that.
It's there, it's in the dirt,it's just sitting there, it's
stagnant, and I hope for peoplethat they are processing that,
that they are working with that,at least on their own.
But I don't think, if therewere a way to collectively
debrief, to collectively mournand to collectively move forward
from that, I think that wouldbe very healthy.
(24:21):
If there were a way to do that,that would be the way forward
for us to recognize that this issomething that requires a great
amount of healing.
Gabe Nathan (24:31):
I'm listening to
you talk and I'm thinking about
law enforcement and about howsimilar so many of the things
that you're saying about themedical profession are
applicable to first responders,particularly law enforcement,
and we did the series of filmsquite a while ago called Beneath
(24:53):
the Vest stories of firstresponder mental health.
Many of the participants werepolice officers who I mean.
The similarities between themedical culture and law
enforcement are so much.
This idea of this happened toyou.
Now get over it and move on tothe next thing.
You have to be strong.
(25:14):
You have to have all theanswers.
You cannot admit that you wereafraid or scared about something
, and it's so unhealthy and it'sso unhealthy and it's so
anathema to what people need,because I'm thinking about you
and your colleagues and whatpeople needed the most was
(25:38):
probably sitting next to someonewho went through something that
they did and hearing.
I was so scared and they couldbe able to say God, me too.
Erica Harris (25:50):
Yeah.
Gabe Nathan (25:51):
I didn't feel like
I could say it until I heard you
say it.
Yeah, but everyone is.
So you're taught to not say it,and so nobody is going to be
the first one to say it, buteverybody needs to hear it.
Do you know what?
I'm saying Right and I used towork in a psychiatric hospital
and I was thinking abouttraumatic things that we saw and
(26:11):
went through and and violentassaults, and it was the only
time there was a debriefing waswhen something went really wrong
and everybody was forcedupstairs to the boardroom to
watch, to be re-traumatized, towatch videos of a really fucked
up incident and watch them over.
And I remember when I wasassaulted I was called upstairs
(26:35):
and you watch it over and overand over again.
So you get to be re-traumatizedand shamed.
Well, you know you really couldhave done this here and this
here.
And let's pause it and watch itagain.
Let's watch it in slow motionnow.
And it's the way in whichtrauma is handled in these
(26:55):
professions and theseinstitutions.
It's so shocking to me everytime I hear it or every time I
think about it, when what isneeded is just like nakedness
and vulnerability and tears, andpeople holding each other,
literally or figuratively, andsaying me too, and I can't
(27:20):
believe we got through that andI have no idea how and I didn't
know what I was doing.
But there is that expectationof you that you have to have all
the answers and I don't know.
Or I was scared or it's notacceptable, but it has to be.
(27:41):
And I don't know how we changethat.
I don't know where that processof change begins.
I mean, I know, in lawenforcement, one of the hopeful
things that's happening is theseold commanding officers who
have these dumb, stupid, machoviews.
They're dying or they'reretiring and they're being
(28:04):
replaced by people who are maybebetter educated, who have a
better understanding of mentalhealth, who understand hey, we
want guys on the force who arein therapy.
We want people to say I'mhaving issues with alcohol or
I'm having issues withdepression and speaking about it
(28:24):
.
I don't know if there's asimilar culture change happening
in the medical profession.
Erica Harris (28:33):
I think that there
is, I think, one thing that
we're trying to work on actively.
I know that within mydepartment, I think more broadly
nationally, that we're tryingto work on is doing debriefings,
doing standard debriefingsafter difficult events, and this
is not the punitive debriefingwhere you're watching the video
and it's a clinical focus on wow, you should have given more
(28:54):
medications at different times.
It's focused on how did youfeel?
And training people on how'severybody feeling, like a kind
of a pulse check, just makingspace for people to feel what
they need to feel.
And I think an important partof that is also offering, I
think, layers of support alongthe way that there's like you
need to be doing the baselinework right, the maintenance work
(29:17):
on yourself to make sure thatyour substrate's okay, that
you're coming into work ashealthy as you possibly can be,
because life happens aroundbefore, during and after your
shifts before, during and afterall the work that you have to do
, you're bringing yourself in,you're bringing the preexisting
trauma in and the healthier thatyou are coming in to work to
these traumatic events.
(29:37):
If you're in law enforcement,if you're any kind of first
responder, if you're inhealthcare, you need to be as
healthy as you possibly can.
If you're bringing atraumatized self and an acutely
traumatized self, you're justadding layers upon layers to
what's already there and that'schallenging.
So that work kind of exists foryou.
But if organizations canprovide that kind of support to
(29:58):
people before they even get towork, they can make it easier
for people to obtain mentalhealth resources.
And, for example, a lot ofphysicians I know this probably
is true in other industriesthey're worried about seeking
mental health care because ofthe implications for licensing.
You have to report it.
You have to report.
If you have been onantidepressants, anti-anxiety
(30:20):
medications, do you have toreport that to the state medical
board when you are going foryour medical licensing.
That is a huge deterrent forphysicians seeking care.
I know that for a fact thatthey will tell you that, that
they think twice beforeobtaining psychiatric counseling
because they're worried abouthaving to report it, to disclose
it for their state licensing,for hospital licensing, because
(30:41):
they're worried about it.
It's not just the stigma ingeneral.
I will stand on top of themountains, I tell everybody who
will listen I'm in therapy,because I will be the girl with
the toilet paper on my shoe andI will say look, here it is.
Everybody gets toilet paper ontheir shoe.
It's fine.
Come join me, it's great.
I love therapy.
I have therapy today.
Do you have therapy?
Do you want a therapist number?
I have it.
Here it is.
I want people to know it's okayand it's more than okay.
(31:04):
It's actually should bestandard, should be in the water
.
So I'm fine with that.
But I do understand thelegitimate concern that people
have about it affecting theirlivelihood.
It's beyond just what willpeople think of me?
It's like will I be able to,you know, get a job and feed my
family?
It's very practical concerns.
Gabe Nathan (31:22):
It's not just what
people laugh at me in the break
room.
Do the thing that I spenthundreds of thousands of dollars
and years and years and yearsof my life, that I've now
pigeonholed myself into thiscareer, that if it gets taken
away from me, what the fuck do Ido?
Erica Harris (31:36):
Correct and I want
to be able to practice and I
don't think that it makes me aninadequate doctor to say I'm on
anxiety medications or I'm onantidepressants.
I think it makes me a greatdoctor because it means I'm
taking care of myself.
If I have a bad heart rhythm,which I do, and I take
antiarrhythmic drugs, which I do.
I think that makes me a betterdoctor, because I'm handling
myself so that when I go to workI'm not going to have a medical
(31:58):
emergency, I'm not going tohave a psychiatric emergency.
My body and my mind are ingreat shape to provide care to
you.
You want the doctor taking careof you to have their medical
and mental and physical andspiritual self together.
You don't want somebody walkingin the room who's falling apart
to take care of you, and so allof that, I think, needs to be
(32:20):
revisited.
I think that we need tofundamentally revisit how we
both encourage and discouragehealth care workers and
frontline workers and allworkers, either implicitly or
explicitly, from seeking care.
I think that that's fundamentalbecause we can't say like take
care of yourself and then alsohave no time provided for it,
(32:41):
Make it physically impossible.
Right.
I mean there's a lot of peoplewho I know will go seek mental
health counseling and they'll doit kind of like off the books.
They're not going through theirinsurance, which, first of all,
is challenging enough.
If you can even find somebodywho takes insurance which I
understand is for the mentalhealth providers out there is
not a fun task to have to do.
But if you can find somebody,they're worried about being
(33:03):
linked to their employment-basedinsurance and having it be on
their employment records.
There's just a lot of barriersand so stigma goes in a lot of
different directions andsometimes it's a very practical
thing.
It's not just about sort of howyou feel on the inside.
It's about actual concernsabout the impacts that it could
(33:23):
have on your career and yourability to be licensed, and
that's that's, I think, veryunfortunate.
And then people get to thepoint where you know their their
mental health has to degrade tothe point of an emergency for
them to even be able to considerseeking care, because they
realize it's like, well, I can'twork anymore anyway because you
know I'm not functioninganymore, and then they're able
(33:46):
to go get the care that theyneed.
And it should never get to thatpoint for any human being,
least of all somebody who'sactively taking care of other
human beings.
Gabe Nathan (33:54):
And we saw that in
another film that we made about
another physician, dr MichaelWeinstein, who was absolutely
falling apart, suicidal,hospitalized, and what could
have happened if he had takencare of himself earlier, if he
felt safe and at ease enough andnot stigmatized and not fearful
(34:18):
.
But, like you said, things haveto get to the breaking point,
to the point where, well, Ican't practice anyway, so I
might as well.
Just, it's absolutelydeplorable and sometimes I hear,
oh, stigma, stigma, stigma, andit's a huge buzzword in mental
(34:40):
health, of course, health, ofcourse.
And it sometimes seemsoverblown or overplayed or just
a very nebulous concept and Ican feel like, well, yeah,
stigma exists, and yet so manymore people are talking about
mental health now, so many morepeople are being open and
(35:01):
vulnerable about going totherapy and taking medication,
all of that stuff.
So is stigma really as big as,and vulnerable about, going to
therapy and taking medication,all of that stuff?
So is stigma really as big aspeople make it out to be?
But then, of course, we hearabout it from your perspective
and about the very, very real,tangible costs of stigma in the
(35:22):
medical profession, in themilitary, in aviation, in the
medical profession, in themilitary, in aviation in first
response, all of these thingswhere you are.
Basically you're putting yourjob and your livelihood on the
line simply for needing help.
(35:42):
And you know I touched onMichael Weinstein's film and I
do want to talk about yours.
You know your film came out ofan essay that you wrote.
Is that right?
Can you talk a little bit aboutthe essay and then segue into
the film?
Erica Harris (35:56):
Sure.
So the essay was calledDressing Up.
It was published in JAMA in2020, so around the time of the
beginning of the COVID pandemic.
It was based very much on sortof my feelings around PPE and
that sort of as a reflection notjust of putting on PPE and the
(36:20):
difficulties of doing that notjust physically putting on PPE
but sort of as a reflection ofwhat it meant to assume this
role of being this physician inthe emergency department during
the pandemic and what that meant.
That I became sort of thisother person and I looked
(36:41):
different.
I felt different.
I was being expected to dothings that I didn't think I
could do and it felt very muchlike dressing up, like dressing
up for a role that was somebodyelse.
I looked like somebody else andI was feeling like kind of I
would see these glimpses of mygrandfather, who was a miner in
northern Idaho, and he wassomebody I never actually met,
(37:04):
but I heard a lot of stories ofhis kind of bravery in, I think,
just period working in themines.
Working being a miner is verydifficult work, but also he did
a lot of work working to secureprotections for miners,
including just basic protectivewear, and that's what we were
seeing, also in the COVIDpandemic in the very beginning,
was difficulty obtaining basicprotection, basic masking,
(37:29):
recycling gowns, just because ofshortages that we had.
It wasn't so much that peoplewere trying to deny us these
things, just that they didn'texist and it was really a very
hard job for people to try tofind these things, and a lot of
fear around shortages, lot offear around shortages and so
(37:50):
this idea of scarcity furtheradding to the fears that existed
about the disease in the firstplace.
But really, seeing as I wouldsee reflections of myself going
into these rooms with reallysick patients, feeling like I
looked like a minor, feelinglike I looked like my
grandfather, and actuallyfinding strength in that,
finding strength and being likekind of a reminder like this is
who you are, this is who youcome from, you will be okay, and
finding that, you know, findinga very important historical
(38:16):
reminder for where I came from.
And I think that that wasimportant for me to reflect on
that part of my past, that partof my ancestry, that I can do
hard things, that my family hasdone hard things, I can do hard
things and that, even if I'mfearful, even if I don't feel
(38:39):
lovely, every moment of everyday, that feeling of fear, that
feeling of disgust with the waythat things are.
That's not the point.
The point is what I'm actuallyable to do anyway, that, despite
those things, I'm able to dothis, that I thought being
called a hero just didn't feelhow I was actually feeling, and
(39:02):
that there was a lot ofdiscomfort with that, that
people were saying oh, you're ahero, you're a healthcare hero,
and I was like I don't feel likeit, I don't feel heroic at all.
I feel very much the oppositeand I don't like being called a
hero.
It's very uncomfortable for meto be called a hero and I think
that the way that I reconciledbeing called a hero with how I
(39:27):
actually felt was just sayingI'm doing this anyway.
It doesn't matter how I feel onthe inside, it matters what I'm
actually able to do, which, atthe end of the day, was, at a
minimum provide comfort topeople, even when we didn't know
the best practices for treatingthe disease.
The day was, at a minimumprovide comfort to people, even
when we didn't know the bestpractices for treating the
disease.
We didn't have a lot oftreatments.
We didn't have, certainlydidn't have vaccines at that
point, didn't have medications.
We were just doing kind of oldmedicine for a new disease that
(39:50):
I could still be, like we talkedabout at the beginning a human.
I could still be there, I couldstill be a source of comfort.
I found a way to do that.
Despite these layers, I lookedlike an insect.
I had a patient once lookfrightened of me.
She's like you, look like a bug.
I'm like I actually really do,and we laughed because I agreed
I'm like I look.
I actually look like a prayingmantis.
I look kind of weird.
I'm sorry we laughed about it,but being able to what it was
(40:13):
and just accept it and stillcome in and do my best Despite
those fears, I realized it'slike okay, you can keep going.
People keep going no matter thedifficult circumstances, and
there's people who have facedeven more difficult
circumstances and continued todo things that they never
thought that they could do andcontinue fighting, and so I
(40:38):
think that people can findinspiration in a lot of
different sources to keeppropelling them forward.
Gabe Nathan (40:44):
When I was watching
your film in preparation for
the podcast interview, a momentthat really struck me was these
beautiful shots of you justlayering and layering and
layering and the cap and therespirator and the mask and the
shield and it's like my God, howmany more things can she
(41:08):
possibly put on?
And the last thing that you dois you're clipping this photo of
yourself, just as you as human,Erica, as this way to comfort
patients and this way to sayokay, I look like this, I look
like the praying mantis, butthis is who I actually am, and I
(41:30):
thought that was such awonderful way to be human and to
connect.
And again at the, at thebeginning of the interview, we
talked about how important thatis and how that doesn't cost
anything and that doesn't takeaway any time.
Um, but it's just such athoughtful, meaningful thing to
(41:51):
do.
Even the stickers, uh, on thetop of your uh, your shield, the
headpiece these are littleparts of my identity and I loved
that.
And I was thinking, too, aboutyour grandfather and about the
(42:11):
way that he fought for hiscolleagues and pushed for change
and for safety enhancements,even something as simple as
gloves.
And I wondered about you talkedabout the word hero and your
discomfort with that, but I wasthinking about your grandfather
(42:33):
and the word that came up for mewas advocate someone who
advocates for others, and Iwonder how you feel about that.
Do you see yourself as anadvocate?
Erica Harris (42:43):
I think that that
is when I'm at my best.
Yes, is what I'll say, thatwhen I realize, I think, the
full, the full strength of theprivileges that I have, when I'm
fully optimized, I think thatthat is the best role that I can
(43:04):
have.
I think that is sort of like myhighest calling on the best day
.
That is what I am able tosuccessfully do.
I think that is what I aspireto be and to do and that is, I
think, what anybody with anyamount of privilege, even a
little bit, I think, is calledto do, and that is, I think,
what anybody with any amount ofprivilege, even a little bit, I
think, is called to do for theirfellow man, for their fellow
(43:26):
creatures.
I think that that's what we aresupposed to be doing to
advocate for one another and forthings that really.
I don't like to use the wordvoiceless, because every human
has a voice.
I think that sometimes it'sbeing drowned out, so like,
maybe making room for theirvoice is a better way than
(43:47):
saying voiceless.
But even sometimes it's just amatter of handing the mic back
to the person who was speaking.
You know if you're able to dothat, but absolutely I think
that that's the key.
I think that also a reminderthat the little things that you
(44:07):
were talking about like that's areminder that we always have
choices, even when things seemhopeless, when you have what
seems like nothing.
Even within that and I know alot of people feel that way now.
They feel that way about theworld right now, in this exact
moment, that people feel likethere's nothing I can do, it's
just everything's horrible.
It's like.
(44:28):
That may be true, maybe it'snot true, maybe it is true.
Regardless, you can make eventhe smallest choice, for
yourself or for somebody else.
It does not have to be thething that, like turns the axis
of the earth and changes theshift of the moon's pull on the
ocean.
It can be a thing that you do,it's a choice and it matters.
(44:51):
Every little choice we makematters and it could matter to
you, it could matter to somebodyelse.
It can be something that youreached out and you said
something positive to somebodyelse, or it can be you just said
it to yourself, you just choseto be kind to yourself that day.
But we always have a choice inwhat we do and how we do a thing
(45:13):
, and that's power.
I mean that's power.
It's the little things, it'sthe little people.
It is working together.
It does not have to be huge, itdoes not have to be a huge
thing.
It starts with those littlethings and just focusing on like
the one little thing that wecan do is so critically
important.
I think, now more than ever.
Gabe Nathan (45:33):
People who listen
regularly to this podcast would
be sick of this quote.
Well, I think it's only thesecond time that I'm using it,
but it's a Mark Twain quote thatI love very much and I'm
paraphrasing it.
But he says real change doesn'toccur at the center, it occurs
at the edges, in the everydaylives of everyday folk, and I'm
(45:54):
hearing that over and over in mymind as I'm listening to you.
Those little choices that wemake looking up at someone in
the hallway instead of lookingdown at your clipboard and
saying good morning, makingyourself a cup of tea, because
it's going to put you in abetter mood or frame of mind to
have an interaction that'scoming up in half an hour All of
(46:16):
those things do matter in halfan hour.
All of those things do matter.
And if we think that the onlythings that matter are decisions
made by CEOs or presidents orwhatever, it's not true,
absolutely not, and it's areally empowering, beautiful
(46:36):
note that I think that's what Iwant to leave our listeners with
that you are more powerful thanyou know and those little
choices that you make have areally big impact, and thank you
so, so much for reminding us ofthat.
Erica Harris (46:53):
Absolutely,
absolutely.
Gabe Nathan (46:55):
I'm so grateful to
you for the work that you do for
the human being that you are,for being on our board of
directors at Recovery Diaries,for just being a real badass
human being.
Erica Harris (47:08):
Thank you.
Gabe Nathan (47:09):
Thank you for being
here and spending some time
with us.
Erica Harris (47:13):
Thank you for
having me.
Gabe Nathan (47:14):
It's my pleasure.
Thank you again for joining usin conversation today.
It's beautiful to see theprogression of our contributors.
Thank you so much to Dr EricaHarris, physician at Einstein
Medical Center in Philadelphiaand Recovery Diaries board
member, for that wonderfulinterview reminding us of the
(47:35):
little things that we can do tohelp our mental health and the
mental health of others.
Before we leave you, we want toremind you to check out our
website, recoverydiariesorg.
There, like this podcast,you'll find additional stories,
videos and content about mentalhealth, empowerment and change.
(47:56):
We look forward to continuingto grow our community.
Thank you so much for being apart of it.
We wouldn't be here without you.
Be sure to join our mailinglist so you never miss a podcast
episode, essay or film.
I'm Gabe Nathan.
Until next time, take good care.