0:00

Sometimes you can't trust your gut. Like when I

0:02

was getting coffee a few weeks ago and I

0:04

totally said that I didn't need, like my gut

0:06

told me you don't need a drink carrier, like

0:08

you're gonna be able to get out of the

0:11

heat or fine with a coffee cup. And then

0:13

I gave myself like incredibly horrific coffee burns on

0:15

my wrist when the lid inevitably popped right off

0:17

because I was holding donuts in the other hand

0:19

and then I burned my like arm really bad.

0:22

So while probiotics can't help you with most

0:25

of your gut decisions, if your gut needs

0:27

a little support, Ritual has your

0:29

back. They made a

0:31

three in one supplement with clinically

0:33

studied prebiotics, probiotics, and a postbiotic

0:36

to support a balanced gut microbiome.

0:38

I really like Ritual because they

0:40

prioritize sustainably sourced and traceable ingredients.

0:43

I like to take my symbiotic plus every morning

0:45

because I feel like it helps me start the

0:47

day off right and it helps my stomach just

0:49

feel settled throughout the day. The

0:51

daily three in one prebiotic, probiotic,

0:54

and postbiotic is getting all those

0:56

bases covered. It's made with

0:58

two of the world's most clinically studied probiotics

1:00

strains to support the relief of mild

1:03

and occasional bloating, gas, and diarrhea. Postbiotics

1:05

provide fuel to the cells that make

1:07

up the gut lining to support a

1:10

healthier gut barrier. The delayed

1:12

release capsule is designed to help survive the

1:14

harsh conditions of the upper GI tract. And

1:17

it's all in one minty capsule with

1:19

no refrigeration needed. There's no more shame

1:22

in your gut game. Symbiotic Plus and

1:24

Ritual are here to celebrate, not hide

1:26

your insides. Get 40% off

1:29

your first month for a limited

1:31

time at ritual.com/curious. This offer is

1:33

only available through January 31st, 2024.

1:37

Start Ritual or add Symbiotic Plus to

1:39

your subscription today. That's ritual.com/curious

1:42

for 40% off. That's

1:49

why this holiday season I am shopping

1:51

for my gifts on Quince. Quince

1:54

is my go-to place for luxury essentials

1:56

and affordable prices for everyone on my

1:58

list, including me. Quince offers

2:01

a range of high quality items with

2:03

prices within reach. All Quince

2:05

items are priced 50-80% less than similar brands. If

2:09

you follow my Instagram, you know I love

2:11

a bathrobe. So I got

2:13

myself this gorgeous bamboo jersey robe, which

2:15

is so comfortable, especially in the cold

2:17

weather, and I'm gifting some cashier sweaters

2:19

to my friends, my husband, because

2:22

they are budget friendly and they are so

2:24

buttery soft. I love. And

2:26

Quince only works with factories that

2:28

use safe, ethical, and responsible manufacturing

2:30

practices and a Perremium fabric than

2:32

finishes. I love that. Get

2:34

affordable luxury for everyone on your list

2:37

with Quince. Go to quince.com/curious

2:39

for free shipping on your order and

2:41

365 day returns. That's

2:45

quince.com/curious to get free

2:47

shipping and 365 day

2:49

returns. quince.com/curious.

3:00

Hey curious people, I'm Jonathan Van Ness

3:03

and welcome to Getting Curious. I

3:06

have been curious about our healthcare

3:08

system. You want to talk

3:10

about layers. There are endless

3:12

layers to the healthcare system, but

3:15

it got in a, it got in

3:17

a whole new frame for me late last

3:20

year. I think the experience of navigating the

3:22

healthcare system in December really brought up for

3:24

me the inequality in our healthcare system that

3:27

so often in the news we read about the inequity

3:30

that black people face, brown people

3:32

face, that women face, that marginalized

3:34

communities face, queer people's face. Why

3:37

is healthcare so unfair? How

3:39

did it get this way? How

3:42

do doctors experience the unfairness in

3:44

their system? I mean, they all

3:46

got experiences that they bring into

3:48

the healthcare system with them. So

3:50

what do they think about achieving

3:53

a more equitable healthcare system? It's

3:55

also Black History Month, so it seems like a good time for

3:58

us to talk about the Healthcare System. Then

4:00

the inequalities of the healthcare system,

4:02

the way that they show up.

4:04

I'm curious about all of the

4:06

myriad of ways in which this

4:08

happens and also the history of

4:10

why that happens. So to talk

4:12

about that, we are bringing in

4:15

Doctor Who Tape Blackstock. Doctor. Blackstock

4:17

as a physician and founder of

4:19

Advancing Health Equity. It's which partners

4:21

with healthcare organizations to dismantle racism

4:23

and close the gap and resell

4:25

health inequities. See the former Associate

4:27

Professor and the Department of Emergency

4:29

Medicine. At N Y U School

4:31

of Medicine Major, her writing hasn't

4:33

featured in Scientific American, The Washington

4:36

Post, The New York Magazine. Her

4:38

books legacy a Black physician reckons

4:40

with racism in Medicine just came

4:42

out in January Twenty twenty four

4:44

and is a New York Times

4:46

best. Seller. It's

4:48

healthcare faire. Let's. Find out now

4:50

and stick around to the end of episode

4:53

were will reflect on what we learned and

4:55

if we answered the question and how he

4:57

answered the question and when I'm sure he

4:59

thought now okay let's go once. Said

5:03

It's a welcome to getting curious. How

5:06

are you? What? I'm doing really

5:08

well. I'm very excited! To be here

5:10

as we get started. Can you tell

5:12

us about like what is you are

5:14

like because you are a position at

5:16

a hospital in Brooklyn when covered her

5:19

and twenty twenty which that's were almost

5:21

given you for your anniversary by the

5:23

can't believe that that's what. Like what

5:25

is a day to day. Life

5:27

look like for like an emergency room

5:30

physician or or for of is this

5:32

and like you know like prequels it

5:34

is Ers one. As the wildest

5:37

places. It's like it's but it's organized

5:39

chaos, right? You see everything from settling with

5:41

like a runny nose at a call to

5:43

someone coming in with a cardiac arrest like

5:46

a hard. Cc.

5:48

Away breath of pieces is always.

5:50

Super. Exciting! It's always very

5:52

busy. Ah, but cold.

5:54

It definitely. Is with.

5:57

The things up a huge not. To

5:59

the point where you do anything, see

6:02

if you do. Anything. Without.

6:05

Further the other sit for I would see

6:08

between like eighty and one hundred pieces. Are

6:10

assessed. Yes are I was

6:13

working a lot of hide. It is

6:15

urgent care of at the we would

6:17

have pieces walk in with oxygen levels

6:19

of like sixty percent. Ah but it.

6:22

Was the first time the others with you that

6:24

I was actually scared to go to work because.

6:27

I didn't know what with cook but with coming

6:29

in we did really other said cove it yeah we

6:31

didn't have treatments for at I was scared that I

6:33

with that a brick at home to my. Kids

6:36

and my family are so that

6:38

was a really. A really tough

6:40

time. Do. All hospitals.

6:43

I'm Chris the kids so like

6:45

good. Away on my brain that

6:47

so many questions at once Because if you're a

6:50

doctor at the emergency room like what kind of

6:52

doctor is that is that? just like I have

6:54

a so. I forget what was

6:56

that. were actually is emergency medicine

6:58

specialty we are traded it emergency

7:00

medicine Opposites That is actually one

7:03

of the youngest specialties with his

7:05

Madison. ah. That our job is

7:07

to really like stabilize very critically

7:09

ill pieces like we put reading

7:11

cheese. doubt it will be though

7:13

her do Cpr we don't they

7:15

seek hear anything from like if

7:17

the colts you have up a

7:19

broken foot sue have some a

7:21

car accident trauma from at my

7:23

school and saw it exactly that

7:25

we don't see. Blaze all those

7:27

people We please make sure they're

7:29

good. As stable as that will. Request.

7:32

Like a consultation from like your the

7:34

trauma surgeon. Or the cardiologist, the heart

7:36

doctor. Or the kidney doctor. So we

7:38

really are. We call a. Sack.

7:41

Of all trades master of know that's what

7:43

people call emergency vet as into this is

7:45

so them like across the country does Like

7:47

every hospital or every state have like is

7:50

all the same rules for like how long

7:52

you're allowed to be like working or is

7:54

that like New York you can do eight

7:56

hours in the emergency room but like in

7:58

North Dakota you couldn't. you're like, work for the

8:00

rest of your life, no breaks, we don't care. Or is

8:03

it like standard or is it not standard? Yeah, no, it's

8:05

not really standard. The only place that standard is

8:07

among like residents when you're in your training.

8:09

Like you can't work more than

8:11

a certain number of hours consecutively

8:13

because you're still learning. You

8:15

don't have a license usually. You're being

8:17

supervised by someone else. But for other

8:19

doctors, I know a few doctors that

8:21

will work like seven days straight and

8:24

then get seven days off. Oh,

8:26

okay. Yeah. I've

8:29

been wanting to know this for a minute and

8:31

I'm just gonna confess. I do that thing where

8:33

I'm like, when people, like when old clients and

8:35

I would be like, oh, my kid's applying to

8:37

medical school and like they really wanna do their

8:40

residency and be like, I know what residency is.

8:42

I got two surgeon cousins. Like I'm very familiar

8:44

with residency. No,

8:47

I'm not. So what is that

8:49

again? So med school. Yeah, I know.

8:52

I think med school, I just explained to your

8:54

listeners. Yeah, so you do you four years of

8:56

medical school so at the end

8:58

of medical school, you decide like what specialty do

9:00

you wanna go into? Is it surgery?

9:03

Is it internal medicine,

9:05

geriatrics, pediatric emergency medicine?

9:08

And you apply to residency and it

9:10

could be anywhere from three years to

9:12

seven years. So that's where you are

9:15

really learning how to be a doctor. In

9:17

medical school, you really don't do that. In

9:19

medical school, you're kind of in class, the

9:22

session, but it's in residency that you actually

9:24

get to take care of patients on

9:26

your own with someone else kind of supervising you. And

9:29

then after you do that for three to seven

9:31

years, depending on what it is, because I bet

9:33

if it's like you're, if you're like a brain

9:35

surgeon, like I bet that's like seven years. Like

9:37

that one's like way long. Exactly. So

9:39

then you just, and then when you graduate, like your

9:41

little cohort of residents, like y'all are just like, oh

9:43

my God, we did like our whatever year, it's like

9:45

we're done. And then is there like a little like,

9:48

is there a little like graduation ceremony?

9:50

Yeah, there's a little graduation. And then again, it's

9:52

a little graduation. And then people actually go wherever

9:55

they're going across the country to find like

9:57

their first full-time job. So, you know.

10:00

Some people may stay where they did residency,

10:02

some people may actually travel to other places.

10:05

Prior to COVID, because you had said

10:07

at the beginning, like during

10:09

COVID, you were seeing how many to how many

10:11

patients a day, like on average? Like 80 to

10:13

100. And what was

10:15

average before COVID? Probably

10:17

a third of that. So like 20 in

10:20

a day or? Yeah. Okay. So

10:22

then, what? And

10:25

is it still that intense? Or? No,

10:28

no. I mean, so fortunately, it's not that

10:30

intense. But you know, I was working in

10:32

Central Brooklyn, and we were the epicenter. So

10:34

like, you know, we saw like by mid

10:37

March, we were getting hit really, really hard.

10:39

And so I actually I started

10:41

writing about what I was seeing. Because

10:44

I even though I'm doctor, I actually

10:46

I like to write. And

10:48

so I started writing about the observations that I

10:50

was making. And I

10:52

was working in a very racially, socioeconomically

10:55

diverse area. But I noticed like even

10:57

after a week that most of my

10:59

patients looked like me. So if you're

11:01

listening, don't know, I have brown skin.

11:04

I'm a black woman. And so I started

11:06

writing about like, you know,

11:08

I think this pandemic is going to

11:11

disproportionately impact black communities and

11:13

communities of color because of like the

11:15

problems we already have with the healthcare

11:17

system. 100% which

11:20

leads me to like, I think it was

11:23

it was during monkey pox, I got

11:25

to interview Dr. Steven Thrasher, who I'm obsessed

11:27

with. Oh, that's my friend. I

11:29

love him. And so in

11:31

his book, the viral underclass really blew

11:33

my fucking mind. And it's also giving

11:36

me a little bit like Celeste Watkins

11:38

Hayes vibes. Like I interviewed her about

11:41

like the HIV social safety net. And she compared

11:43

it to saying that, like, when people are like, Oh,

11:45

we're all on the same boat. She's like, Yeah, like

11:47

if you're in a fucking yacht, and I'm on like

11:50

the Rosen Jack fucking bed

11:52

frame trying to balance on a fuck, then

11:54

then it's the same boat, but very different

11:57

boats. Like there's a lot of equality there.

12:01

So, and I'm so glad that you brought that up.

12:03

And I think, you know, Steven said, it's like back

12:06

with, or with COVID, it was like, if you're

12:08

someone who's living like a multifamily home, like

12:10

multi-generational home, like if you don't have the

12:12

access to the resources of like, grandma and

12:14

grandpa have their own house and the kids,

12:16

like, then you're going to be running into

12:18

especially with like a respiratory illness, you're

12:20

going to be more vulnerable

12:23

to this. Yeah, absolutely. And so that's

12:25

what I saw in terms of my

12:28

patients. I saw mostly essential workers and

12:30

service workers. So people who had

12:32

jobs where they had to interface

12:34

and interact with the public where they

12:37

had no choice. And

12:39

for a lot of the service workers, we know like

12:41

they're more low income workers. So they're less likely to

12:43

have paid sick leave. They're

12:45

less likely to have employer sponsored health

12:47

insurance. And so, you know, I saw

12:49

a lot of like delivery, you know,

12:51

delivery people, you know,

12:53

come in with symptoms because

12:56

they were not able to work home remotely.

12:58

So those are like the issues that like

13:00

Steven talks about, like this, you know, group

13:02

of people that are just more

13:05

likely because of their social circumstances

13:07

to be exposed to the virus.

13:10

What was the risk to densely populated

13:12

urban places in 2020? Like,

13:15

can you set the stage for like, how

13:17

fucking serious that was? And like, if you

13:19

saw like, I mean, yeah, there were like

13:21

young doctors that were dying. There was like,

13:23

it was, and it was, it

13:26

was scary. And it was surreal. I

13:28

mean, I know that even

13:30

before I went to work, I literally would hear

13:33

ambulance sirens multiple

13:35

times an hour, multiple

13:38

times an hour. And

13:40

when I would get to work, there would be a

13:42

line of patients waiting to be seen. And

13:46

I spent a lot of time in urgent care,

13:48

which is where less seriously ill people

13:50

come. But because the ERs were so

13:53

overcrowded, we got a lot of sick people coming

13:55

to us. And I remember, I write

13:57

about this in my book, I write about

13:59

how I had several patients

14:02

including an older black man who came

14:04

to the ER short of breath

14:07

Fever and I said you

14:09

need to go to the ER Like I'm calling

14:11

an ambulance for you to take you from

14:13

here to the ER and he was like,

14:15

I don't want to go they're

14:17

not going to treat me well, but the ERs are packed

14:19

and they were packed because We

14:22

you know, they were packed door to door

14:24

like it was just something

14:26

we had never seen before like how so can you

14:28

tell us like how There

14:31

was and is a lot of

14:33

mistrust around kovat and just like

14:35

mistrust and misinformation for the black

14:37

community How has that? Yeah happened?

14:39

Yeah, and it's interesting It's like one of

14:41

the reasons why I actually like started using my

14:43

platform more during the pandemic to make sure I

14:45

was sharing accurate

14:47

and responsible health information because

14:50

What happens when there's already like

14:52

this broken bond of trust between certain

14:54

groups in the healthcare institution? People

14:56

are not going to seek care when they need it

14:58

and they're gonna go to other sources of care So

15:01

or not even of care other sources

15:03

of information so we know definitely social

15:05

media people will actually read things on

15:07

social media Think

15:10

it's true and You

15:12

know follow that information or follow that

15:14

guidance. I Had

15:17

a number of patients who would tell me

15:19

but my barber or my hairstylist told me

15:21

x y if I drink this tea

15:24

You know, I won't get coded So

15:26

I'm like, oh, wow. We're actually listening to non

15:30

healthcare professionals about this

15:32

new virus that I know that we're Getting

15:35

more and more information. I know we don't

15:37

know everything about it, but at

15:39

least Maybe you want

15:41

to listen to people who actually have a background

15:44

in that area Well, I don't know if

15:46

you know this but I just saw in

15:48

tick tock that In

15:51

King Louie's day the barbers were

15:53

also surgeons. They call

15:55

them barber surgeons But

15:57

y'all I feel like in this century

16:00

you got to ask the

16:02

doctors. Don't ask your hairdresser about

16:04

your COVID or your butthole or, I

16:06

mean, I guess sexually yes, but

16:08

not health wise. Right,

16:11

I know. And so, but we

16:13

just saw how social media like

16:15

played such a big, big role

16:18

in spreading misinformation. And there were

16:20

always like a few accounts that

16:22

did it that really had pretty large

16:25

platform that were able to disseminate this

16:27

information. And it's really unfortunate because

16:29

people, if they

16:31

follow that guidance, are not able to

16:34

protect themselves as much. But again, that's

16:36

based on this legacy or

16:38

history of distrust, right? So

16:40

the problem is, it's like when something happens,

16:42

like the pandemic all of a sudden, how

16:44

can you tell people, oh, no, no, no, trust me,

16:46

trust me. I'm going to, you know, I'm going, I'm

16:49

telling you the correct information. So we have to

16:51

think about these things before a pandemic happens.

16:53

We have to think about engendering

16:56

trust with all these different communities before,

16:59

you know, before something devastating happens,

17:02

not during. Your

17:09

girl Kiki Palmer is out here doing all

17:11

the things, winning and ending, acting, singing, looking

17:14

fabulous. And my favorite role yet, podcast. In

17:16

my podcast, Baby Business Kiki Palmer, I'm talking

17:18

to so many cool people. Some of my

17:20

favorite conversations have been about growing up as

17:22

a child start with Ellen A.J. Queer

17:25

rights and trans issues with J.D.N. abusive

17:28

relationships with Dr. Drew, still present with the

17:30

V.V. and the music

17:32

that shapes us with Mean Girls Renee

17:34

Rap. So many issues. And

17:36

in this new season, just wait for

17:38

all these opportunities. This dog

17:41

sitting around, the weedy, the name of

17:43

you, follow Baby Business Kiki

17:45

Palmer on the Wondery app or wherever you

17:47

get your podcasts. Watch full episodes on YouTube

17:49

and you can listen to Baby Business

17:51

Kiki Palmer early and add food right

17:54

now by joining Wondery Plus. And

17:58

you can trust your bet. Like when

18:00

I was getting coffee a few weeks ago and

18:02

I totally said that I didn't need, like my

18:04

gut told me you don't need a drink carrier,

18:06

like you're gonna be able to get out of

18:08

the here fine with a coffee cup. And then

18:10

I gave myself like incredibly horrific coffee burns on

18:13

my wrist when the lid inevitably popped right off

18:15

because I was holding donuts in the other hand

18:17

and then I burned my like arm really bad.

18:20

So while probiotics can't help you with

18:22

most of your gut decisions, if your

18:24

gut needs a little support, ritual has

18:26

your back. They made a three

18:28

in one supplement with clinically studied prebiotics,

18:30

probiotics, and a postbiotic to

18:33

support a balanced gut microbiome.

18:35

I really like ritual because

18:37

they prioritize sustainably sourced and

18:39

traceable ingredients. I like to

18:41

take my symbiotic plus every morning because I feel

18:43

like it helps me start the day off right

18:45

and it helps my stomach just feel settled throughout

18:47

the day. The daily three

18:50

in one prebiotic, probiotic, and postbiotic

18:52

is getting all those bases covered.

18:55

It's made with two of the world's

18:57

most clinically studied probiotics strains to support

18:59

the relief of mild and occasional

19:01

bloating, gas, and diarrhea. Postbiotics provides fuel

19:03

to the cells that make up the

19:05

gut lining to support a healthier gut

19:08

barrier. The delayed release capsule

19:10

is designed to help survive the harsh conditions

19:12

of the upper GI tract. And

19:14

it's all in one minty capsule

19:16

with no refrigeration needed. There's no more

19:19

shame in your gut game. Symbiotic

19:21

Plus and Ritual are here to celebrate,

19:23

not hide your insides. Get 40%

19:26

off your first month for a

19:28

limited time at ritual.com/curious. This offer

19:30

is only available through January 31st,

19:32

2024. Start

19:35

ritual or add symbiotic plus to your

19:37

subscription today. That's ritual.com/curious

19:39

for 40% off. ["I'm

19:45

a Fuckin' Doctor"] Can

19:49

you give us other examples of like ways that you've

19:51

seen not to like, but just you're like, I'm

19:53

a fuckin' doctor. These are the myriad of ways

19:55

that I see health inequalities show up on a

19:57

day-to-day basis. You know, we're the only high income.

20:00

country that doesn't have

20:02

universal health care. But

20:04

we have like the very worst health outcomes.

20:06

And it's not just among black people and

20:09

people of color, it's among everybody.

20:11

Like we are not doing

20:13

well as a country health wise.

20:16

And you know, people, we

20:19

need to just look at that disparity,

20:21

like we're spending billions, but then people

20:23

are still dying. So for example, like

20:25

life expectancy, when COVID

20:27

hit life expectancy in all high

20:30

income countries dropped. But

20:32

since then, life expectancy actually

20:34

has picked back up in all of

20:36

those countries, except guess where here, it

20:39

actually continues to go down for

20:41

all racial demographic groups, much

20:44

worse for people of color.

20:46

And that's because like, you know, I

20:48

don't know, I don't think universal health care

20:50

is going to be the one solution. But

20:53

I think it's going to be part of the solution.

20:55

We have 30 million uninsured people.

20:57

And then people who are insured,

20:59

many of them are under insured,

21:01

meaning they can't pay their premium,

21:04

you know, they can't, we know what

21:06

we know so many people actually who

21:08

are diabetic, they have to ration their

21:11

insulin, you know, so they

21:13

make decisions about, you know, should

21:15

I buy this medication? Or should

21:17

I buy my groceries? Like, and

21:19

those are people who are insured. So

21:21

that should never be the case. But then when

21:24

we look specifically at black

21:26

people, like the the sad I always use

21:29

is that even myself with, you know, I

21:31

went to Harvard for undergrad and medical school,

21:33

even with those degrees, I still as

21:35

a black woman, and five

21:38

times more likely to die of

21:40

pregnancy related complications than my

21:42

white peers who are college educated.

21:45

And the people will say, well,

21:47

what's that about? Because you have, you have

21:49

good insurance, You live a pretty

21:51

good life, right? But What that's about is a

21:53

few things. One, A lot of times we're not

21:55

listened to, and that doesn't matter about your socioeconomic

21:58

status. We saw what happened to Serena. Why

22:00

Am? And she had. Her. Blood

22:02

clot us He previously told her

22:04

medical teams with having solicitors. Don't

22:06

listen to her. The blood clot travel to

22:08

her lungs your site. So. That happens

22:10

to subpoena Williams. Second, Happened to it

22:12

and he average. Black Woman. But

22:15

the other the that we don't

22:17

have enough about is actually how.

22:20

Races. Are. Causes. A

22:22

we're in here are black body is

22:24

in the Me: Mom when a company

22:27

called Weathering the at the Public Health

22:29

researcher. Or early to rise of

22:31

as he termed sad expression. Weathering

22:33

so anything, living in any

22:36

chronically. Stressed addition: Whether it's looking at

22:38

the poverty weather's living with racism causes this,

22:40

we're It's here on the body that prematurely

22:42

age. Is it. That makes it

22:45

susceptible to developing chronic diseases or

22:47

delivering a baby orally. You're having

22:50

complications when you deliberate a baby.

22:52

Re. It's so there's that's more

22:54

invisible. If we don't see that, it's

22:56

more. Covert. And

22:58

so I think people, because it's more cobra,

23:01

people pilate. Now I don't believe that,

23:03

but there's a lot of really great

23:05

data out there that shows this, whether

23:07

it process, You. Know short in. The

23:09

live the life that everyone deserves. The

23:11

lead. Full. Beautiful by. But.

23:14

It's sort of the lives of of black people

23:16

in this country would visit. Think about like that's

23:18

big that thing on like the football field worth

23:21

like explaining privilege and then it's like to go

23:23

to the tenure at like so it's like yeah

23:25

I'm a white queer percent but then when you

23:27

put like a of black her purse and latino

23:30

queer personally at like or if they're trans and

23:32

queer as like it's just more things that like

23:34

yeah layered on it that makes it harder for

23:36

someone to not judge you, listen to what you're

23:39

saying and then like get the care that you

23:41

need it right Which is why I really thought

23:43

about like with the responsibility. Of like medical

23:45

schools and health profession schools like really

23:48

to make sure they're educating. Our.

23:50

future positions and health professionals sooth

23:52

here for as a bird Pc

23:55

Populi said like diverse recently like

23:57

said the authorities it like. We

24:00

need to have, like any patient needs to walk in with us

24:02

and feel seen, heard, and appreciated.

24:04

Like it's, you know, it's

24:06

so important, but you know, medicine is

24:08

one of the most traditional and

24:10

very conservative disciplines.

24:13

It takes a lot to create change

24:16

and we see that it's needed now

24:18

more than ever. So what have you noticed about

24:21

equity in our healthcare system since the beginning

24:23

of COVID? Like it's, cause you said earlier,

24:25

like other countries are getting better, we're getting

24:27

worse. I know. Is

24:29

there a lineings? Is there, or is it just really bad? Well, I

24:32

mean, there were some really wonderful things

24:34

that happened during the pandemic, like

24:36

the CARES Act, where basically people

24:39

could get tested for COVID and not

24:41

have to pay. People could get

24:43

COVID treatments and not have to pay. You

24:46

know, the funding for that ran out and Congress

24:48

never renewed it. Right? You

24:50

know, there, there were, so those

24:52

kinds of things, like that's like a

24:55

piece of universal care, right? Universal healthcare.

24:58

And we saw that in states that had

25:00

Medicaid expansions, people actually did

25:02

better when it came to COVID because they

25:04

had, they had health insurance. They

25:06

could go to the hospital. Crazy how

25:09

that works. Yes, exactly. So there, there

25:11

are all these things that we know,

25:13

these policies that we know, I always call

25:15

them health and all policies. Like we know that

25:18

having paid family and sick leave, make people healthier

25:20

because then they don't come to work sick one.

25:22

And then two, they see home with their, whoever

25:24

a family member is sick to help them get

25:26

better. Like these are things that just

25:28

like are really beautiful, thoughtful

25:31

policies to have. But in our

25:33

country, in the US, there

25:36

is so much political will against having it. It's

25:38

almost like, you know, people

25:40

think about these entitlement programs.

25:42

They think people are not going to work,

25:45

want to work as hard, you know,

25:47

or people are getting free, free days.

25:50

And it's like, no, no, no, you want to

25:53

help. We want healthy, healthy, healthy

25:55

people. But even that

25:57

free thing, it reminds me of like. me

26:00

if this is true or not. But it's like

26:02

I remember in like, some speeding class

26:04

that I had to take because I got a speeding

26:06

ticket and like Phoenix and like the early odds and I'd

26:08

like go take this like seeing class. And that they

26:10

were saying like, Oh, if you think that

26:13

you're like, well, I want to drive myself to the bar because

26:15

I don't want to pay for a cab. So you're saving the

26:17

$20. But then if you get a DUI, you're paying 10,000. So

26:20

you actually really just spent way more money

26:22

trying to save it. So when I think

26:24

about with our health insurance and just our

26:26

health care, if someone is under insured or

26:28

not insured, they cannot pay. So

26:30

let's say someone got into a car accident,

26:33

they go to the hospital, they get like

26:35

a leg surgery, they get like stabilized in

26:37

their insides, like it's like some open stomach

26:39

thing, like a really intense surgery, I've seen

26:41

surgery bills for like family members of mine

26:44

that have had surgery or cancer treatment, it's

26:46

like a million dollars $600,000 these insane prices.

26:48

So when someone gets that amount of surgery

26:50

and they can't pay because they don't have

26:52

insurance doesn't what happens

26:55

with that? Isn't that like why everyone's

26:57

insurance is so fucking high because like

26:59

that increases premiums? Yeah, so it's just

27:01

like, it leads to everything being more

27:04

expensive. But also the other thing is

27:06

if we had universal health care, part

27:09

of that is having an

27:11

emphasis on disease prevention. So

27:15

you know, we end up in

27:17

this country seeing people with like full

27:19

on diabetes, full on high blood

27:22

pressure heart disease, we don't

27:24

want people to get to that point. Like

27:26

we need to invest more in public

27:29

health prevention, so that

27:31

people just are healthier so

27:33

they don't develop these diseases would actually

27:36

end up yet end up getting

27:38

more money treating them. Hey,

27:46

do you ever look at a closet full

27:48

of clothes that still feel like you

27:50

have nothing to wear? Honey, I know

27:53

the feeling, but then I decided to

27:55

use quince to upgrade my wardrobe to

27:57

high quality essentials that never go out

27:59

of style. And the best part

28:01

is that I stayed on budget. Quince

28:04

has all the luxury essentials I need, like 100%

28:07

Mongolian cashmere sweaters for $50. Organic

28:10

cotton sweaters, which are so nice

28:12

on the skin. Washable silk tops

28:14

and timeless 14 karat gold jewelry.

28:17

The jewels, honey! All Quince

28:20

items are priced 50 to 80% less

28:22

than similar brands. Quince is also where I

28:24

go for my self care essentials. I got

28:26

a bamboo jersey robe and 100% washable silk

28:28

scrunchies from Co-Wins. I use them both to

28:30

unwind after a long day when I want

28:32

to feel my late Mariah and I just

28:34

want to like drape my naked body and

28:37

above my ass. Indulge and

28:39

affordable luxury. Go to quince.com/curious for

28:41

free shipping on your order and

28:43

365 day returns. That's

28:48

q-u-i-n-c-e.com/curious to

28:50

get free shipping and

28:52

365 day returns. quince.com/curious.

28:58

Honey, if you follow my fashion,

29:01

you may have seen me in

29:03

these gorgeous, luxurious body hugging spaghetti

29:05

strap. Gorgeous, just

29:07

skin hugging. Some of them are more kind

29:09

of short and some a little bit longer,

29:12

but these, but they're scams, honey. They're scams

29:14

dresses. I love their dresses so much the

29:16

way they feel on my, feels good

29:18

on my body. Anyway, it's the Fitz Everyone

29:20

Collection and I feel like it's their best

29:22

kept secret. The fabric is like nothing I've

29:25

ever worn before. It's so stretchy and soft.

29:27

It just kind of like melts on your

29:29

body. I have liked skims for

29:31

a long time, but I only recently just tried

29:33

the Fitz Everybody Collection and it's truly life-changing. That

29:36

T-shirt bodysuit, so good

29:38

I could eat it. The regular T-shirt

29:40

and long sleeve T-shirt, get in my

29:42

fucking belly. They're super easy to

29:45

pair with a cute skirt or a nice pair

29:47

of pants. And it just elevates the outfit because

29:49

they are simple, cute and so soft and comfortable.

29:51

You can dress them up, dress them down, which

29:54

I love. They're giving versatile and

29:56

comfortable. What could go wrong? Believe

29:58

the hype. Skims has over

30:01

100,000 5-star reviews for a reason. The

30:03

Fitts Everybody Collection and more perfect

30:06

fit essentials are available now at

30:08

skims.com. Plus, get free shipping on orders

30:10

over $75. After

30:12

you place your order, be sure to let them know

30:14

that we sent you. Select podcast in the survey and

30:16

be sure to select our show in the drop-down menu

30:18

that follows. Please! What's

30:27

at the scene? In America today, infant

30:29

mortality rates and maternal mortality rates are

30:31

highest among Black women, and Black men

30:33

have the shortest life expectancy of any

30:35

demographic group. The Hippocratic Oath,

30:37

which all doctors take before they begin practicing,

30:40

is all about doing no harm. So,

30:43

how did we get here? I

30:45

know. How did we get here in 2024, where

30:47

despite advances in research, innovation, technology

30:52

over the last 20-30 years, especially,

30:54

we actually are seeing even worse

30:56

numbers. I

30:59

think that speaks to how deeply

31:01

embedded systemic racism is in

31:03

our healthcare system and in

31:06

our other social institutions in

31:08

this country. I think people

31:10

like to say, oh, people want to say,

31:12

oh, socioeconomic status. No, because you know socioeconomic

31:15

status is not protected. I already say that

31:17

I'm still more likely than my white peers,

31:19

right? To die

31:24

of pregnancy-related complications. We need

31:26

to think about what

31:28

happens when Black patients,

31:31

again, are interfaced with the healthcare

31:33

system. Are they being listened to?

31:35

One example is

31:38

pain. There's this issue of pain and equity.

31:41

We actually saw it with the beginning of

31:43

the opioid epidemic when Black

31:45

patients were less likely to be given

31:47

prescriptions for pain medications, but white patients

31:50

were more likely, and then

31:52

they actually unfortunately developed addiction

31:54

to it. People

31:56

say, oh, that was protected for Black people. No,

31:58

it wasn't because when your pain is not

32:00

treated, when your pain is not

32:02

treated, that impairs your quality of life. When

32:04

your pain is not treated, you're missing an

32:06

underlying reason for that pain so the doctor

32:08

is not doing, you know, a deeper dive

32:10

into why you're having that pain. It

32:13

actually impacts your emotional well-being. You

32:15

become depressed and anxious. So, you

32:18

know, but we see that repetitively even

32:21

in pediatric patients that, you know,

32:24

black and Hispanic pediatric patients with

32:26

appendicitis are given less pain medication than

32:28

white kids. It's like, how

32:31

can that be? Do we see other ways

32:33

that the Hippocratic Oath promise is not being

32:36

kept for the black community specifically? You know,

32:39

that's such a great question. Yeah,

32:41

I think most of it is

32:43

in how people are not listened

32:46

to when they seek care. I

32:48

talked about the wear and the

32:50

tear, but I also think that

32:53

doctors need to understand, this is for any

32:55

patient, like when you're talking to a patient

32:57

and they're in your exam room,

32:59

like it's not just you and

33:01

them. It's your patient's family, it's

33:03

their employer, it's where they live.

33:06

If you're not thinking about like all

33:08

the other factors that make people healthy,

33:11

then it's not like you have to have

33:13

a solution to all of that, but if you don't

33:16

know that your patient is housing insecure, if you don't

33:18

know that your patient is

33:21

not having access to healthy foods

33:23

in their neighborhood because there's no

33:25

supermarket because it's a food desert,

33:28

right? If

33:30

you are not like thinking about all

33:32

those other factors, what we call the

33:34

social determinants of health and only thinking

33:36

about prescribing a medication or telling

33:38

someone you should eat better, that's

33:41

not holistic

33:43

care that we should be providing

33:45

people. Like we need to make sure we understand

33:47

everything that's going on with our patients because that's

33:49

really how we can be the best position

33:52

to them and I think also when it

33:54

comes to black patients, we really don't

33:56

understand the history as much. So for example, like you know I

33:58

talked in the book about red-black Redlining,

34:01

you know, was a policy in the 1930s

34:03

that graded neighborhoods just solely based on who

34:05

lived in those neighborhoods. If racial and ethnic

34:07

minorities lived in the neighborhood, it's a D.

34:10

If it was mostly white and affluent, it

34:12

was an A. And what those

34:14

grades reflected was your ability to

34:16

get a federally backed mortgage or

34:18

mortgage insurance. Well, fast

34:20

forward from the 1930s

34:23

to 2024, when you look at formerly redlined neighborhoods, those

34:25

are neighborhoods that have the very worst

34:27

health outcomes. You can have differences in

34:29

life acceptancies of like 30 years between two

34:31

neighborhoods that are next to each other.

34:34

One was redlined and one wasn't. And

34:36

that's because when you deprive communities

34:39

of resources or opportunities

34:41

for generational wealth,

34:43

supermarkets, you know, we know

34:45

that schools are funded through tax bases from

34:47

property taxes. All of

34:49

that impacts health. So

34:52

we need physicians, health professionals

34:54

to think more holistically about

34:56

what makes their patients healthy.

34:59

And I also think it's an obligation for

35:01

us to be advocates for our patients. Like

35:04

we can't just think about what's happening in

35:06

the exam room. If there are policies that

35:08

are going to improve the lives of our

35:10

patients, we need to be out there whether

35:13

it's protesting, speaking in front of Congress, sharing

35:15

our knowledge to improve their quality of life.

35:18

So can you talk a little bit more about

35:20

the history of why

35:22

black Americans might distrust the medical system? Yeah,

35:24

I mean, it's a series of things. I

35:26

know most people have heard. So

35:28

I typically don't like to call it the SISG

35:30

experiment. I like to use like the formal name

35:32

is the US Public Health Service Study of

35:35

Syphilis in the Untreated Black Male because it

35:38

was the US Public Health Service, which is

35:40

now known as the CDC. They're

35:43

the ones who orchestrated it. I

35:45

know. And basically, in

35:48

the study on these, you know,

35:50

men in rural Alabama, these black

35:52

men, low wage workers who

35:55

were told that they had bad blood.

35:57

So they were diagnosed with syphilis just told they

35:59

weren't. told they had syphilis, they were told they

36:01

had bad blood. And they were part of this

36:04

study to see what happens to people when you

36:06

don't treat them. Oh my God.

36:08

They didn't treat their syphilis. So the syphilis

36:10

was allowed to advance. Neurosyphilis. Heart,

36:13

affects the heart too. Yeah, and

36:15

they- Gave it to their partners. Gave

36:18

it to their partners. And their babies were

36:20

born with congenital syphilis. And

36:22

so even in 1947, it started in 1932 to study. And even in 1947,

36:25

I believe, when penicillin the

36:30

treatment was discovered, they were not

36:33

given the treatment. And the

36:35

study went on until 1972 actually

36:37

when a black epidemiologist at the

36:39

CDC found out about it and

36:41

was like, I need to tell

36:43

the AP associated trust about this.

36:45

AP broke the story and they

36:48

stopped the study right away. In

36:50

1972. Yeah, 40

36:52

years. So

36:54

we were purposely not

36:57

treating black men in Alabama

37:01

with their fucking syphilis that

37:03

caused like, infinitesis permanent disfiguration,

37:07

like to their community. Okay, so what

37:09

was really screening for me, as you

37:11

said, that is because I've

37:13

done a lot of HIV advocacy work a lot of

37:15

times, I feel like I have people who will say

37:18

like, oh, but you know, like, you

37:20

know, it's like, but the black men and the

37:23

Hispanic men, like we really, you know, they're just

37:25

not listening. And so that's really, and it's like,

37:27

that just makes a lot more sense. Why? Yeah,

37:29

why you wouldn't trust like, and then also you

37:31

wouldn't trust like, the medicine that you're getting, is

37:33

this a medicine that's going to work? Or is

37:35

it not going to work? You

37:38

know, and the government's never apologized for that or

37:40

like really made a- They

37:42

did. Clinton issued an

37:45

apology to some of the

37:47

living participants of the study. Like, I

37:49

think maybe the 1990s, maybe? Yeah. After

37:53

World War Two, President Truman was serious about creating

37:55

a national health insurance program

37:58

system. What was the historical connection? between

38:00

the civil rights movement and legislation for healthcare

38:02

for all. Did racism get involved in dissolving

38:04

support for that legislation? Like what

38:07

was that about? Yeah, so part of it

38:09

was so Truman actually, yeah,

38:11

he did propose universal healthcare,

38:14

but it was the American Medical Association,

38:16

which is the oldest and largest organization

38:18

of physicians. And actually, can I tell

38:20

you, they have their own history with bias

38:22

and racism. They didn't allow black doctors in

38:24

for a very, very long

38:26

time, like not until like the 1900.

38:29

But anyway, they lobbied against it

38:31

because they were concerned that black

38:34

people, even black people would get healthcare because

38:36

up until that point, healthcare was only employer

38:39

sponsored and only certain people had

38:41

the type of jobs where they would provide

38:43

health insurance. So the

38:45

American Medical Association, which is a, you know,

38:48

physician organization, but they were also worried about

38:50

losing profit as well. So

38:52

there's that financial piece as well. So they

38:54

just, they lobbied, they spent, and they still

38:56

send millions of dollars

38:59

lobbying against universal healthcare. So that's

39:01

what they did. But also of note

39:03

in 1964, we know the Civil Rights

39:05

Act was passed the year after

39:08

that Medicare went into effect in

39:11

order for hospitals to get Medicare funding.

39:13

So that's funding basically for the elderly,

39:15

elderly can get care without having to

39:17

pay. In

39:19

order to get federal funding, hospitals had

39:22

to desegregate. So

39:25

that Medicare, the Civil Rights

39:27

Act, 1964, the Medicare legislation,

39:30

essentially forced hospitals

39:33

to desegregate and to provide care for

39:35

all patients. There were still a lot

39:37

of hospitals that tried to get around

39:39

that. But if you wanted to get

39:41

federal funding for your Medicare patient, you

39:44

had to desegregate it. So that's like the impact of

39:46

the Civil Rights Act. So that's good. Or that was

39:49

good. Yeah, it was good. But like,

39:51

why did you have to, and

39:54

1965 though, like that, that wasn't

39:56

like, I think it's another thing that people, if

39:58

there's still like, I

40:01

guess because I was

40:03

raised I reckon with this a lot in

40:05

my second book love that story like really

40:07

realizing like how I was raised who raised

40:09

me like my maternal grandmother like was from

40:11

Raleigh, North Carolina like there was a lot

40:13

of like in like racism that was just

40:15

like past that I didn't even understand or

40:17

like name it as such. But

40:20

that is one thing

40:23

that I just you know when I would try

40:25

to explain to her or like my father or anyone

40:27

who I you know have these conversations with it's like

40:29

it really blows my mind like the thing that really

40:31

like made me go like like

40:33

how can you even argue with this black women didn't gain the

40:36

right to vote in the United States until 1965 which is

40:39

literally their families their

40:42

family interests like what they thought should

40:44

happen that's like 200 years

40:46

of not getting to like vote

40:48

your fucking interests like reparations

40:51

now I'm flipping this fucking table over

40:53

like these guys. Well

40:55

let's flip it together. Let's do

40:57

it. Um so okay so you so in the

40:59

book in your book did you go more into

41:01

like that whole like civil rights movement and like

41:03

that legislation like you talked about that history in

41:06

there? Yeah I talked about it a little bit

41:08

more in the book. You guys get the fucking

41:10

book. Oh yes by the way

41:12

I didn't mention it's a New York Times

41:14

best seller it's been on the New York

41:16

Times list the last two weeks. That

41:19

is cute. I know. And

41:21

did you do the audiobook too? I

41:23

did I narrated it myself it was so

41:25

much fun I loved it I fell in love with my

41:27

book all over again. Her new book is

41:29

available now it's legacy a black physician reckons

41:32

with racism and medicine it just came out

41:34

in January rapid buyer last segment how

41:36

how long did it take you to write the book? It

41:39

took me a year and a half. Oh a

41:41

year and a half um and you and everything that you've

41:43

shared with us like you break this that was just like

41:45

a little tiddly teaser how do you that's like a little

41:47

just a little teaser yeah but but I

41:49

wanted to say people like the book is about

41:52

my like my own personal story as a

41:54

second generation black woman physician my mother my

41:56

twin sister and I are the first black

41:58

mother daughter legacy from Harvard. medical school.

42:01

And so I use our experiences to talk

42:03

about these larger, larger systemic issues. But also

42:05

I end the book with a call to

42:07

action, what people can do to make a

42:10

difference. Which do we need

42:12

to read that for that? Or is there anyone

42:14

who you're like, you should just do this and

42:16

read the book? Yeah, okay. So I would just

42:18

tell people to, you know, the most important

42:20

is to look at what's happening in

42:22

your communities or other, other communities around

42:25

you, black communities, there are a lot

42:27

of community-led efforts, birthing centers,

42:31

groups dealing with climate crisis between those

42:33

related to systemic racism. So I want

42:35

people to look at hyper locally, locally,

42:37

so they don't get overwhelmed. They

42:39

need the black-led organizations, volunteer

42:41

with black-led organizations, all those

42:44

organizations at a neighborhood level

42:46

impact health. So you can make a

42:48

difference by knowing what's happening in your area or

42:50

other areas close by. If you're a

42:52

young med student or you have a young med student

42:54

in your life, what is something you

42:56

recommend that they do? Rapid fire. Oh

42:59

my goodness. I would recommend that they get

43:01

together and question everything that's in their curriculum.

43:03

Let's do their curriculum. Say if it's dealing

43:05

with the history of medical racism, if it's

43:07

not, you demand that your administration puts that

43:09

in the curriculum. Okay. And also you guys,

43:11

it's rapid fire because Uche has a flight

43:13

to catch, not because I could like keep

43:16

her for 17 more hours that she's like,

43:18

got fucking shit to save in the goddamn

43:20

world. What even is single payer

43:22

universal health care? And what could that look

43:24

like in America if you can do that

43:26

in like three sentences? Yes. A single payer

43:28

universal health care is when one public entity

43:31

or agency manages

43:33

all of the funding and

43:35

payments for health care. And

43:38

so it doesn't have to necessarily be a public

43:40

one. It can be public, but also I want

43:42

people to understand single payer use can still have

43:44

a choice about what doctors you see, what

43:48

specialists you see doesn't mean that someone's going

43:50

to determine all of that for you. But we

43:52

know that it could potentially save a lot

43:54

of money and a lot of lives. And

43:56

if someone has just like fallen head over heels,

43:59

butt crazy and with you and your work

44:01

as I have over the last hour. Where are you

44:03

the most active on social? Where can we follow you

44:05

if we want to just like see your work? Or

44:07

did I give you a lecture about being on TikTok

44:09

and making lots of videos? No, so I do

44:12

a TikTok account but I'm mostly on

44:14

Instagram, Uche BlackstockMD and I'm on ex-formally

44:17

known as Twitter, Uche underscore Blackstock. Okay, well I'm really

44:19

on Instagram a lot so if you could please just

44:21

like show your face, tell us about things, tell us

44:23

about your work. Like we would just love to see

44:25

it. So Uche, thank you so much for coming on

44:27

Getting Curious. I love you so much. I

44:30

feel like I got such about ADHD in the middle of that.

44:32

I want to have you back. I just did

44:34

we do good. I just love talking to you and I want

44:36

to have you back. You're just incredible. I feel like we just

44:38

like tap, we just like scratch the surface. Like

44:40

I want to go so much deeper. Uche, thank you so much for

44:43

coming. I'm getting curious. Catch your flight. I love you so much. Thank

44:45

you for coming. Okay, thank you so much for coming. And I want

44:47

to say thank you so much. Thank you so much for having me.

44:49

This is a lot of fun. How

44:51

obsessed are we with Dr.

44:53

Uche Blackstock? In fact, when

44:56

a healthcare system is fully

44:59

and absolutely and totally based on

45:01

capitalism, it is going to leave

45:03

your public,

45:06

your people, the health of

45:08

your people open to so much,

45:11

gonna make you very susceptible. And,

45:14

you know, it's like that short red haired

45:16

lady said in the weakest link,

45:19

you are the weakest link.

45:22

I feel like our healthcare is that it is

45:24

one of our weakest links, the way that our

45:26

healthcare shows up for our people, the way that

45:28

we take care of people really

45:31

is one of our biggest,

45:33

weakest American links. And

45:35

it's gonna make the universe

45:37

say goodbye to us because

45:40

we are not doing great. I think

45:44

the other really important thing that we learned here

45:46

is that when people don't trust their sources, they

45:48

look for information elsewhere, you

45:51

know, from their friends, their hairdressers,

45:53

you know, and that part hit

45:55

home close. They

45:57

look for really important information elsewhere where maybe

45:59

those people don't

46:01

have the fullness of the information

46:04

that they need. So the link

46:06

between mistrust and then accessing and

46:08

gaining misinformation is very

46:10

real. So

46:12

the other thing there is that it's really

46:15

when Dr. Blackstock said to us, we

46:17

need to work on engendering trust. Wow,

46:21

I mean, we really have engendering

46:23

gender down pat in this society,

46:25

but we do not have engendering

46:28

trust down very, very well.

46:30

So that's, and we have

46:33

to do that between pandemics, not only

46:35

when it's an emergency. So

46:37

that was a really

46:40

interesting, important part to nail

46:43

there. I think, you

46:46

know, as so many episodes that we've learned on Getting

46:48

Curious and not to be like, you know, we've learned

46:50

this so much, but it's, it just is so true.

46:52

I mean, racism leeches

46:55

itself into every facet of our

46:57

society. Our healthcare system is no

46:59

different. There's several ways that Dr.

47:01

Blackstock shared that with us. And

47:04

I'm I know in their in

47:06

her book, she goes so

47:08

much more into so many of them. But the

47:11

US Public Health Service that

47:13

created the Siplas experiment,

47:15

also known as the Tuskegee

47:17

experiment, that didn't end until the 1970s. And

47:21

it was started in the 1930s. And

47:23

that just, you know, if you are

47:25

a white person who has ever

47:31

thought, or if you're

47:33

anybody who's ever thought, especially

47:36

white person, you know, why don't they just take

47:38

the vaccine? Or, you know, why don't they just

47:40

take PrEP, whatever it is, there is real generational

47:44

trauma there. And I don't think there

47:46

are, you know, we weren't

47:48

going to compare that to Twitter, for instance, I remember

47:50

someone told me once you have to tweet about something

47:52

like four times before anyone really knows

47:54

how important it is. It's like, you

47:57

know, one apology by one president

48:00

Bill Clinton in the 90s isn't

48:02

enough to fix all that. And

48:05

really, it's like every administration needs to say

48:07

that so many times to

48:10

start to earn that trust back.

48:13

And even through COVID,

48:15

we had so many Republicans

48:17

who were undermining, we

48:19

just had so many politicians who were undermining

48:21

that trust and continue to undermine that trust

48:23

at every turn, which I

48:25

think really points to the crisis of

48:27

information that we are in. When we

48:30

have a whole party who is married

48:33

to sowing chaos

48:35

and division in terms of like

48:37

making its constituents not

48:40

believe in what scientists

48:43

say, we're really in

48:45

a world of hurt. And I think

48:48

part of why a lot

48:51

of those politicians are

48:53

so able to continue

48:55

to sow that distrust and

48:59

cherry pick that information to create misinformation

49:01

in terms of like, why

49:03

people shouldn't trust the government. It's because

49:05

the government hasn't done a really great

49:07

job at rectifying

49:09

its mistakes and correcting its mistakes. Here's

49:11

some other the most interesting things we

49:14

took away from this conversation. We're

49:16

the only high income country without

49:18

universal health care. We are the

49:20

only one. And our

49:23

health outcomes are bad for everyone.

49:25

It's bad for everyone. Also, why

49:29

is health care so expensive? And what

49:31

happens when someone can't pay their bills

49:33

when someone is uninsured or underinsured and

49:35

ultimately is not able to pay

49:37

their bills? What happens to that? And

49:41

is that part of why health care is

49:43

so unaffordable in the United States? Like, why

49:45

is the economy of our health care so

49:48

fucked up? And is it possible to

49:50

fix it? That's what I want

49:52

to know. So

49:55

wow, getting curious. Y'all,

49:59

I love you. Thanks for listening! You've

50:02

been listening to Getting Curious with me,

50:04

Jonathan Dannes. You can learn

50:06

more about this week's guest and their area of

50:08

expertise in the episode description of whatever you're listening

50:10

to the show on. And honey,

50:13

there's more where that came from. You can follow

50:15

us on Instagram, at curiouswithjvn. We are doing the

50:17

most over there and it is so much fun.

50:20

You can catch us here every Wednesday

50:22

and also make sure to tune in

50:24

every Monday for Pretty Curious. Still

50:26

can't get enough? Subscribe to

50:28

Extra Curious on Apple Podcast

50:31

for commercial-free listening and

50:33

our subscription-only show Ask JBN

50:35

where we're talking sex, relationships,

50:38

and so much more. Our theme

50:40

music is Freak by Quinn. Thank you so much to

50:42

her for letting us use it. Our

50:45

engineer is Nathaniel McClure. Getting

50:47

Curious is produced by me, Chris

50:49

McClure, Julia Melfi, and Alison Weiss

50:51

with production support from Julie Carrillo

50:54

and Curry in Chad Hall. Thank

50:58

you.