Kimberlydawn Wisdom, MD, MS is the Senior Vice President of Community Health & Equity and Chief Wellness and Diversity Officer at Henry Ford Health System. She is a board-certified Emergency Medicine physician, the Chair of the Gail and Lois Warden Endowment on Multicultural Health, and Michigan’s and the nation’s First State-level Surgeon General. In 2012 she was appointed by President Obama to serve on the Advisory Group on Prevention, Health Promotion and Integrative and Public Health. Since 1987 she has been on the faculty of University of Michigan (UM) Medical School’s Department of Medical Education and adjunct professor in the UM School of Public Health. Dr. Wisdom focuses on health disparities/health care equity, infant mortality/maternal and child health, chronic disease, unintended pregnancy, physical inactivity, unhealthy eating habits, and tobacco use. She has worked collaboratively with school districts, faith-based organizations and the business community.

Dr. Wisdom provides strong leadership in community benefit/population health, and improving the health of those disproportionately affected by poor health outcomes. She founded the award-winning African American Initiative for Male Health Improvement (AIM –HI) and most recently, the Women Inspired Neighborhood (WIN) Network which aims to improve access to healthcare and reduce infant mortality in neighborhoods in Detroit. Since 2008, she has chaired the Detroit Infant Mortality Reduction Task Force. In 2007, she founded a youth leadership development effort – Generation With Promise (GWP) – designed to equip youth to drive policy, environmental and behavioral change in their school and community. GWP youth were featured on the cover of Modern Healthcare in June 2014. Dr. Wisdom is the recipient of numerous awards, has authored several peer-reviewed publications and book chapters and appeared on national television, including ABC’s Nightline, and has presented to audiences across the country and internationally.

 

Lauren Gunderson is a playwright, screenwriter and short story author from Atlanta, GA. She received her BA in English/Creative Writing at Emory University, and her  MFA in Dramatic Writing at NYU Tisch, where she was also a Reynolds Fellow in Social Entrepreneurship. She was named the most produced playwright in America by American Theatre Magazine in 2017 and 2019, was awarded the 2016 Lanford Wilson Award from the Dramatist Guild, the 2016 Otis Gurnsey Award for Emerging Writer, and was awarded the prestigious 2014 and 2018 Steinberg/ATCA New Play Award for her play, I and You (also a Susan Smith Blackburn Blackburn and John Gassner Award finalist) and The Book of Will. That play was an NNPN Rolling World Premiere that started at Marin Theatre Company and has seen over 40 productions nationwide. She is also a recipient of the Mellon Foundation’s 3-Year Residency with Marin Theatre Company.

Interview by Gary Gunderson

Gary Gunderson: This is a series that started when TC and I were with Gene Matthews and he quoted William Butler Yeats about the center does not hold, anarchy is loose on the land. He said, “You know, when I was …” I think it might have been in Legionnaires or this might have been anthrax or some horrible thing in the basement of the CDC and he said this was the 57th day of the emergency that we’ve been working and everyone was utterly, totally exhausted. And he quoted that poem to the CDC team in the incident room and said, “The center must hold and we’re the center.” The anarchy loose upon the land has more to fear from us because we have science and values and we will never quit.

Lauren, Kimberlydawn and I have been part of Gene Matthews’ road show. We meet with the public advocacy forum of the American Public Health Association Leadership Group and this is drama and theater in real time. When you’re with Gene his model of leadership is very much using all of the tools to communicate and evoke and lead and inspire and inform. It’s like a full performance art as a master of the craft of public health law.

Well, I’ve watched Kimberlydawn do the same thing. Probably quotes a little different verses and Gene Matthews can’t sing gospel. But Kimberlydawn, we were talking about let’s do a podcast series on the center holds. I dearly wanted… When I asked Gene, “Well, Gene, who else should we interview?” It took him about a quarter of a second to say Kimberlydawn has got to be in this series. He’s watched your leadership and said you’re really the master of this craft.

Kimberlydawn Wisdom: Wow.

Gary Gunderson: This is the greatest drama of our time but it’s not the only drama of our time. When I’m thinking of your career I sort of wanted .. COVID is in the background, but I really want you to speak about what you have learned about communicating in times of urgency and in other times when disparities, the lack of equity, the grossly unfair patterns of disease and suffering in our world and in your city is… That’s part of what we’ve got to communicate about and in ways to… I’m eager to have Lauren and you dialog about communicating, about messaging so that we can know what to do.

Lauren, I’m not even sure how to fully introduce you to Kim. I don’t think in the back and forth we’ve had about you I mentioned that Lauren’s husband, Nathan Wolfe, is a virologist. You know, Lauren and Nathan have been doing cutout puppetry with corona and wearing little crowns and stuff. In real time, the family that Lauren is a part of understands virology and understands how to help inform us with no-kidding real science.

Many of the great characters that Lauren has brought to voice onstage are women of science. She generally gets the science right. This isn’t cartoon science. This is actually much like your life, the real drama that’s found. The closer you go to science and what it has to do with the human journey, the more dramatic the story gets. You don’t have to fake science. The better it is, the better the drama.

Lauren, does that sound like you?

Lauren Gunderson: Sure. I mean, the puppets are mainly for our kids, not each other, but, yes, that is correct.

Gary Gunderson: Good point. Thank you. Good point. Okay. I won’t go behind that. That’s great. Kimberlydawn, let’s start with a question. You’re in Detroit, which is now one of the most heartbreaking centers for this particular virus. You’re in this reality with a lifetime of experience about equity and disparities and the unequal way that every disease lays bare. Tell me a little bit about what it is to be in Detroit right now.

Kimberlydawn Wisdom: Well, Gary, for one, I’m really so honored that you all considered to invite me to be part of this podcast and to meet this exceptional playwright and Tom, so thank you for that.

It’s quite surreal in some respects but yet on the other hand very much a … We see it as a huge opportunity. It’s like I keep coaching my team and, for one, saying that never let a crisis go to waste. And not to seem insensitive but there are few occasions in our lives when we can really feel that we can make a difference. The window opens, the door opens and if we don’t truly take advantage of that opportunity the window will close and you’ll always look back and say, “I wish we had done more.”

While we’re in this very surreal time with a lot going on, there are also… I can’t say there are many surprises. From the standpoint of a pandemic, which we actually knew was coming. It wasn’t if we had a pandemic. It was when would we have a pandemic. Of course, didn’t expect it to outstrip resources and capacity in the way that it has but in many instances what we’re seeing in terms of the health disparities, it’s not surprising.

The health disparities have been profound, they’ve been persistent. Now there’s a bright light that shines on these disparities. If we truly don’t take advantage of this opportunity we will look back and I think be very, very regretful and… about it.

I say a lot of this to my team because in part it’s how I try to communicate to them, to lead them, but I’d say when we look back in five years, 10 years and we’ll be talking about the great pandemic of 2020 that we lived through in just the same way that when you hear about the Spanish Flu and people talk about that, my 93-year-old mother who turned 93 today actually, she talks about the polio epidemic and looking at children in glass caskets because they could not have the children exposed that were passing away from polio.

She lived through the tuberculosis epidemic. We have to ensure that as we look back … I think in part even though we’re moving forward it’s important for us to always look at what kind of narrative are we creating as we’re living today? One day we will look back and when we look back what are we going to be able to say about it?

Sure, there are things that we couldn’t control but there are a lot of things that we can control. Part of it is the narrative. Part of it is the way we communicate. Part of it is the way that we help people feel. Part of it is the way we help people navigate through these very challenging times. Part of it is how we unpack our own feelings and our own experiences.

I must underscore and, Gary, you touched on it a bit and I’m sure, Lauren, this is your field but I said to my team early on, “Communicate, communicate, communicate.” That is one of the biggest tools that we have. If we don’t communicate well then we’re going to be even further challenged.

When I had the privilege of serving as surgeon general for the state of Michigan, the first in the country, it was one of those situations where everybody is excited about it except you, the person who has to live it, because you have to build the plane as you fly it, which can be very unsettling. A lot of uncertainty.

I didn’t have a budget, I didn’t have money, I didn’t have… I had a fancy title and a lot of passion about what I cared about deeply. What I learned, especially in that experience, it was the value of communication, that if you can communicate well, you can make huge differences. You could see things change.

Having to rely on communication, which was something that was … Of course, I valued it but it was a bit foreign to me because that wasn’t in my…. I mean, I had pills and I had prescriptions and I had shots and I had all kinds of stuff in my toolkit but communication wasn’t … Having strong communication skills that was not part of something that I appreciated as much until I had those other things stripped from me. I didn’t have the ability to carry my black bag in and intubate a person or do a thoracotomy. I didn’t have those tools.

I relied on communication and, lo and behold, it became very clear that’s one of the most powerful tools that you have. When I’ve been coaching my team I say if we can communicate the result amongst each other, communicate messages really well to other people, we can play a significant role in this pandemic.

As we look back if we say that communication was one of the key things that we did or if our team members and others, our community members say, “Communicating to me was one of the most powerful things that happened” I would feel very proud of that. Communication is key.

Gary Gunderson: In your daily walk, when you go to some county where you’re not in charge and you’re observing great communication happening how can you tell it’s great? What’s great about it? When you look at it how do you say, “Wow. That is a tone perfect work of communication”? What are you looking at?

Kimberlydawn Wisdom: You’re talking about in general? Not necessarily about COVID, right?

Gary Gunderson: Yeah.

Kimberlydawn Wisdom: I would say one of the most powerful things is that when… I’ve always felt that communication that’s happened or has been impactful or effective when people begin to repeat the message. When they begin to embody and repeat your message and then become very engaged and motivated to act.

Mind you, I’ve made a lot of mistakes throughout my career and when I started with the surgeon general, I would use the bully pulpit as a way that I thought I was communicating well. I had all these statistics and all these sophisticated words and all of the jargon and the… But it fell flat for a good while there. It fell very, very flat and it wasn’t until I started simplifying my messages and saying things like, “I want Michigan to be the healthiest state in the nation” and, “This is what you can do.” When I spoke very directly, very succinctly, in very simplistic terms, not using all the sophisticated medical language, people would come up to me and they’d repeat what I said and said, “I’m going to go do this now.” That was like absolutely fantastic to me.

I felt like then it’s like, okay, I am beginning to understand the power of communication, the power of touching people with your words in a way that not only did they repeat your words, which means now they own those words, but then they’re motivated to act beyond that setting and do something about it.

Gary Gunderson: Lauren, I want to open up some space.

Lauren Gunderson: It’s amazing. It’s incredibly what you’re saying because it is similar in the theater. I’ve been thinking a lot about how science talks and how science speaks now, partly because of this urgency. We all get it quickly. We didn’t get it a couple of months ago and now we understand things like how to wash your hands, which you think that people would know and now we’ve been… All of the ways that we communicate and speak now are funneled towards this one message and this one moment.

It’s interesting because there is… In the theater, the simplicity, the thing that draws people, the repetition that you’re talking about is when it’s emotional, when it comes from a heart place. I do think that’s when we’re starting to see some of these messages, public health messages, ripple is because of the… It’s the human heart side of it. It’s people saying, “I’m worried about grandparents” and the heartbreak of seeing people separated and not being able to touch each other.

Everything is emotional now. I think you’re totally right that often times if you’re trying to change people’s behavior, it’s less about sharing statistics, although, a good statistic is great. You get like one, one bit of math before people get overwhelmed.

But if you tell that personal story of I don’t want you to be like the woman who lost her husband and thought just one more trip to the store without a mask was okay. Whatever version of it is and you don’t have to make it up, it’s there, the stories are there right now so trying to connect science with empathy, science with emotion, science with the human story makes the fuller picture.

I’m thinking about that so much about how we use this power of communication, and particularly my field of storytelling, which is all about the human experience. How do you make it human? How do you make it feel, one person to another, like, “Oh, that is something that I can understand” or, “I’ve been through it”, or, “I know someone like that”, whatever that is that we start sharing things in a different way when we feel that.

I’m so interested in how we can use that not just in this moment but in the moments subsequently. Because we’re going to need to come back to a place where we can talk about science as a trusted source and for half the country it seems like that’s not the case, where they look at science or doctors and think conspiracy and think that it’s partisan and you think it’s not partisan, this is science.

Of course, science has a long history and includes a lot of misogyny and racism and things that were the fault of the scientist, not the scientific method’s fault. How can we acknowledge those parts of science’s history while also saying but in general we need to be able to say, “Science has got your back. If you have its back, it has your back.” To try to blend these stories of what we can incorporate. Yeah.

Kimberlydawn Wisdom: To me, as you’re talking it’s about the head and the heart. The more that we can help people connect the data because I’m a scientist, I’m not poo pooing the data. I’m just saying when you talk to an audience they don’t want to hear number after number, statistic after statistic. They really want you to touch their heart. Sometimes you have to use some data to touch their heart.

I remember about 20 years ago, a colleague of mine and I did a series on… It was called Into The Heart of Darkness and it was about basically he was a Caucasian guy in the ivory tower at the University of Michigan, of course, I’m an African-American woman, and so he wrote this editorial. Well, we had a little bit of tension… We had a lot of tension between the two of us and because he was bright, very ivory tower-like, and in a setting where he wasn’t really doing research on the African-American community but wanted to keep a distance.

It was very apparent and so we had a fair amount of conversation about it. Ultimately, this is … Actually, the video is available and the editorial. He wrote an editorial and asked me to review it, which was very insightful, very thoughtful and it was about racism from his perspective. Basically, what he said was he denounced the notion that he was racist in any way but once he realized that there are racist structures that he has to live within and he realized that maybe he’s been influenced by those.

He gave me this editorial to read and I read it. Actually on the plane flying back from Boston. This is like 1997, ’98. Lo and behold, by the time I cried over it and wrote notes in the margin it was very clear to me that he had… That I had written another piece.

I went to my office that morning, wrote this other piece, drafted this other piece very quickly and tweaked it a bit and then gave it to Bob, Bob Anderson. And I said, “Bob, you’re a prolific writer, you’re well funded, you’re a full professor here at the University of Michigan. I would like you to read my piece and I would like when you submit this piece for publication, because I know yours will get accepted, that you submit it with mine.”

That was kind of a healing experience. He read it and he was pleased with what he read so they were submitted together. They were published. Then we were asked to speak at a conference in Minnesota shortly thereafter to 3000 people. I’d say probably 98 – 99 percent Caucasians were in the audience.

All of our data … In terms of communicating, all of our data was in the form of pictures. We had no numbers on the slides. All photographs, all telling our stories. Then we asked people in between about every 15 minutes to pause and reflect amongst each other. We were pretty nervous about it. We usually had slides. You would have all the numbers and very convincing. This was edgy. We had decided if we had to run offstage, let’s both run to the right so we don’t run into each other because we were both on different podiums at the same time.

At the very end—mind you, we couldn’t see any of the audience. It was total blackness. Big auditorium. They had our images projected on screens so that people way in the back could see.

At the end, I gave this quote at the very end: if you are here to help me, you’re wasting your time. If you are here because your liberation is bound in mine then let us begin. Said that at the very end while we stood in the middle of the stage together. They turned up the light. We could finally see everybody because it’s strange talking to an audience where you can’t see one face.

At the end, we had a standing ovation. People were touched by the pictures, by the words. It was the first time not using the numbers and the statistics and all the data. It demonstrated the ability to communicate in a way to touch hearts.

We were whisked off quickly and the American Association of Diabetes Educators, that’s who we were presenting to, they said, “We want to make a video of this. We’ve got to capture this.” Lo and behold, that happened. It was pretty amazing. For the next couple of days we were at the conference, you would think I was … Bob and I were both treated like royalty. I mean, people were giving us their pins, giving us things like, “We just have to give you something.” People were saying, “I want to go back and apologize to people that I’ve done things to or with unknowingly over the last 20 years. I want to go back and apologize.”

Now that was not the impact that we thought we would have. We were just telling our story but realizing the power of that was just transformational for both of us. Storytelling is powerful. Actually, my 93 year old mother who turned 93 today and she’s a black storyteller, National Association of Black Storytellers. When she was 91 won a national award for storytelling. I have great … At the age of 67, she received her associates degree in communication. She went back to school at 64, finished her communications degree at 67, and then began storytelling.

Lauren Gunderson: Oh, wow.

Kimberlydawn Wisdom: Occasionally, after I give a talk people will come up to me and say, “You were doing storytelling.” I’m like, “That is the best thing you could have said to me.” That is the best thing. Not, “Great data” but that I was able to convey it in a storytelling form.

Gary Gunderson: Kimberlydawn, I could not be less surprised that your mother was a great storyteller. Of course. I was thinking, “I know you didn’t learn this in med school. You learned this by your mother.” That confirms a hunch.

Let me ask a question about in Detroit today there are 2000 to 3000 healers, healthcare providers who are testing positive and yet the hospitals are still showing up for the community. You’ve worked in public health very frequently meeting teams of public health scientists to walk knowingly into harm’s way and certainly into civic anger trying to save the lives of communities that really didn’t want to hear it.

Tell me what you’ve learned about helping the healers expose themselves to the public challenges of a community that probably doesn’t really want to hear what they have to say. Lauren, be thinking about some of the drama that has done the same thing, about the difficulty of communicating to people who really don’t want to hear what you have to say.

Kimberlydawn Wisdom: I’m not on the frontline, frontline right now. I practiced emergency medicine for 20 years so I’m not in the emergency department, I’m not but I have a department of about 45 people that I’m guiding them. Actually, I talked to my leadership team, we have a huddle every single morning at eight o’clock and today was day 31. We’ve met every business day since this happened.

Then the 45 of us met on March the 13th before we knew how serious this was, we were social distancing as much as we could but we had no idea the toll that this would take on our community, our staff, our system, emotionally, economically. We didn’t understand the whole depth and breadth of the experience.

But I would say that, for one, I have to applaud… the healers out there on the front frontlines, people that are exposing themselves to the virus, worry about exposing their families to the virus, out there each and every day, putting people on vents, pronouncing people dead.

I mean, I’m talking to my team members, not that report to me but my colleagues, all the time because in one form or fashion I’m always working with a family who has somebody in house. They’re asking me, “Can you transfer me to another place or to another unit? Can this happen? Can that happen?” Whether it’s my health system or another health system, I’m constantly interacting with people and talking with physicians and talking with nurses and talking with team members about this. So I’m feeling the frontline but I’m not being in the frontline directly.

What I would say in terms of the people that communicating messages to them that may not want to listen, I think it’s important sometimes to have not only a sound message but the messenger is key. It’s not just words that you’re communicating but it’s who is communicating? The trust and the faith and the confidence that you have in that person.

That’s why diversity is so important, that people can hear messages from a diverse group of people. Racial and ethnic, of course, but age because each person will touch somebody in a different way. I think in many ways people do want to hear messages and they do want to try to respond. You’re always going to get some people that are going to be outliers and not respond at all but I’ve been doing a lot of talking to the faith community, especially the Baptists or the Christian community, to their councils on the radio, that sort of thing.

Early on, like five weeks ago, asking them, “Please don’t congregate. You are a trusted voice. What you say, what you do, is what people are going to respond to.” Physicians with all our credentials and background and experience, they can say, “Don’t congregate.” But if your pastor says, “Don’t worry, congregate and we’ll pray about it”, that’s going to be what’s going to ultimately occur. It’s critical that their voice… They understand the absolute power that they have and that often times it is a voice that has much more impact and is much more effective than any political person or a scientist.

I find people want to hear but they want to hear from people they can trust. And they want to hear from their pastors, they want to hear from other entities. Hearing from politicians, hearing from scientists, it works for some. You know, I want to hear from a scientist because I’m science and data oriented and data-driven but other people want to hear from people that they feel trust in. Mind you, especially people, communities of color, scientists are not a trusted source.

There’s even been some pushback around the hydroxychloroquine trial here in Detroit because people go, “Oh, great. Trial in Detroit.” There’s an element of appreciating when we can do things in our community but there’s also pushback too because it’s science and it’s experimentation.

In my view, when you’re involved in a trial it’s an altruistic act. You’re not expected to benefit from it. It’s truly an altruistic endeavor. People that are involved in trials… a clinical trial isn’t there to benefit you, it’s to benefit the future you. Because you may not do well in a clinical trial. You’re part of the scientific process. It isn’t, “Sign me up for a clinical trial …” It hasn’t been proven. That’s why it’s a trial.

We also on the scientific side we understand in order to generalize results, from a generalizability standpoint, you have to have a diverse group of people in the trial otherwise you can’t generalize it to every population. If you only have white men in the trial then you can’t generalize it to Latino women.

It’s that delicate balance between helping people understand it’s important to participate in the science but helping them understand there are IRBs, institutional review boards, and the Nuremburg trials ensure that we would not repeat some of the atrocities that have occurred through scientific experimentation so balancing the protections with the benefits, and that’s sometimes not so easy to do.

Gary Gunderson: Thank you. Lauren, sometimes great drama is almost overheard where there’s like a drama going on the stage and it’s almost like the actors look and realize, “Oh, there’s an audience watching us.” Tell me a little bit about how you’re hearing … Public health people do not think of themselves as playing and they don’t think of themselves as performing. In what sense is this theater at all?

Lauren Gunderson: What I keep thinking over and over again is authenticity. You can tell when somebody is telling you something because they believe it and when they’re telling you something because they’re being forced to or because… Anyway, all the other reasons that we talk.

I’m thinking about the sincerity and the honesty and of vulnerability that often happens. Certainly, great drama has those things and those are the things that make it so powerful. Because part of what you can say that actually exposes the greatest strength as a communicator is when you say, “I don’t know.” I mean, that’s an honest thing.

I feel like if we had more scientists say, “I don’t actually know,” versions of that, “We’re working on it”, all of those things. But that can actually be comforting because then you can get a sense as an audience that there’s process going on and that if you’re strong enough to say, “I don’t know”, I will trust you when you say you do know.

Kimberlydawn Wisdom: Exactly. Exactly.

Lauren Gunderson: It brings people into what the actual musings and the work and the struggle, the intellectual struggle, and all of those things about science.

I also will say that it’s about what you do, not what you say. I think that’s what we’re seeing now is we can see what actually happens. You can say everything you want, and there’s a lot of leaders out there saying all kinds of things but the truth always will out. The truth will out because it’s what’s happening. People are making bad decisions based on bad advice. People are going out when they shouldn’t go out because somebody said, “Well, it’s optional for you to wear a mask or for you to go out,” you know, all of these things. Georgia, of course, being where I’m from and they’re reopening and I just think in a couple of weeks we’re going to see what that did.

It goes back to the very core principle of dramatic storytelling, which is it’s what people do, not what people say that defines who they are.

And that is the same thing when we see the people at Whole Foods or Walmart or … Those folks are doing. They are doers. What heroism and bravery to be doing that when there’s a lot of people saying how brave and heroic they’re being and they are not necessarily but that’s not true with their actions.

I’m trying to match these realities. I think it’s also a very hard time to talk about this moment as a play because we’re in the middle of it. We are in the thick of this play and nobody in the middle of a play, no character knows what the heck is going on in the middle of the play. They know what they want, they know what the goal is. Do they know how vulnerable they are? Do they know what they’re willing to sacrifice to get that goal? Probably not yet. We learn that, dramatically speaking, in the second act. That’s when that comes out.

Yeah. I’m finding myself going… The whole society is being tested right now. Also, exposed. It is being exposed. To your point, there are fundamental issues that are coming up because you can’t avoid them now, because access to health, who gets the health, what communities are prioritized over others, who has access to healthcare, I mean, all of the things.

A lot of it comes down, as everything does in America, to race, to location, to where you live or allowed to live, to jobs you have or allowed to have, how you support your family, over and over, it all goes back to the same kind of thing.

That exposure is … I mean, this is going to sound like an odd comparison but in the middle of the play King Lear, Lear thinks that the field and a storm is brewing and he’s trying to get into his daughter’s castle and she refuses him. She says, “No. You can’t come in” and her action exposes the rottenness at the core of his entire family system, that he has lived with, a rottenness at the core of his kingdom, of himself because it is his action who gave birth to her action. So it’s that kind of exposure where you really see, “Oh, that’s who you are? That’s what you believe in? That’s what you’re willing to do to someone else?”

We’re able to see it very clearly now. There will be all sorts of denial, “Oh, that’s not what you’re saying it is. That’s because of something else.” But, again, the truth will out. I’m most impressed by seeing that so plainly and I really hope, much like you’re saying, that we take this chance to not just fix the current moment but to fix and talk about the longstanding issues at the heart of this.

Kimberlydawn Wisdom: Exactly. I think I really resonate with some of the elements that you mentioned related to the exposure. For one, we know that public health when it functions, typically, it’s quite invisible. I had a chance to do a CNN interview and one of the quotes they took was, “COVID-19 is public health front and center” because it’s exposed the… typically it’s  very invisible in terms of people don’t realize the safety around food and air and water and vaccination. All of that is public health. People think public health is insurance for the poor. Probably why the budget is often times not close to what it should be in terms of prevention, disease prevention, and health promotion.

I think another key part that we can never … Once you come to a realization, you can never go back. You can’t unlearn it or un-understand it. In terms of health disparities, it’s very clear now these disparities exist, they’re profound, they’re persistent. There are very few people in this country that are watching any type of TV or looking at a paper who can say, “I didn’t know health disparities existed.” I mean, now it’s exposed. Everyone knows.

What’s also I think interesting in that is there’s still a lot of victim-blaming, that people who are … Where these health disparities exist it’s because of their behaviors, eating and alcohol and substance abuse and lack of physical activity and that sort of thing. I keep urging that we have to go back and we have to look at the historical underpinning of what we’re seeing and that people make a lot of choices based on the choices that they had available.

We have to understand the historical context if we’re truly going to address inequity and just as many inequities… and it’s not about a shame/blame game but it’s about the realities about systems that are in place that were perpetuated so that we see and if we’re going to, just as some of these systems were planned, they need to be unplanned, if we’re truly going to see change and truly see health disparities eliminated.

I think there are a lot of people … It’s all about calling people in, not calling people out. There are many people who are very interested in helping close these gaps, that are not people of color. I’ve experienced a lot of them… Even my former CEO of Henry Ford Health Systems did all kinds of things to help us address health disparities by setting up a center, funding a center for us. When I left as Surgeon General he said, “I want you to come back” and he was no longer CEO but he said, “I’ve raised an endowed chair to address what you care about.” He raised $1.5 million to setup an endowment, the endowed chair that I hold.

I’m all about calling people in, not calling people out but we do have to recognize the historical element and the historical elements behind lack of trust. Why is there lack of trust in government? Why is there lack of trust in science? Why? If you understand those then you’re much more equipped to make substantive improvements because you understand how those inequities were generated and how they were perpetuated and then you can go about, once you’ve recognized those, making a change.

Gary Gunderson: Kimberlydawn, there are young women who look at you and they’re finishing medical school and they’re thinking about going into emergency practice and then they look at what you’ve done with your life in public health and influencing large scale systems and being a truth teller with your whole life, not just your voice. What would you say to those young women?

Kimberlydawn Wisdom: Well, what I often times say to them is… Because I do meet with a fair amount of them and I do mentor quite a few young women, actually Nadine Burke Harris, the recently appointed surgeon general of California, I’m mentoring her. What I often times say to them is … They’ll come to me and they’re like, “Wow. I want to do what you’ve done” and, “Tell me how you did it.” And I say, for one, your trajectories are greater than mine will ever be. You have far greater things that you will achieve in your lifetime because you have so much more to work with, and you have so much more support than I had.

Mind you, most of my life people have told me, “No, you can’t. No I won’t let you.” You know? From guidance counselors, from my sixth grade teacher in elementary school that said, “No, they’re not going to let you take French.” Why? “Because you’re a Negro girl. You’ll never go to France so why should we waste a slot on you?” I mean, that’s just one.

Fortunately, I had great parents. They promptly took me out of that public school in Connecticut and put me in a private school, the Williams Institute, and I not only had French, I had Spanish and I had Latin. Of course, Latin was awesome for medical school. I mean, of course, you don’t speak Latin but if you could understand Latin and then medical terminology. Like are you kidding me? I could figure out all that stuff because you had Latin.

My guidance counselor in high school saying, “There’s no such thing as a woman physician.” Certainly no such thing as an African-American woman physician. By that time, I had evolved from Negro and colored to African-American. She said, “No.”

I had the honor society tassels, I was 20th in my class of about 600 and something. I have data for all of this … Actually when I went to my interview for Penn undergrad I took five scrapbooks. That’s where I went for my interview and my family laughed. They said, “That’s ridiculous.” I said, “Well, it’s data. Five scrapbooks of data.”

I could say things and I could say here it is: Here’s my graduating class, here’s where I ranked, here’s this, here’s that. None of it was made up because I had the data.

I come from a place where most people would say no, no, no. I tell these young women that, yeah, people that are part of my generation that can say, “Yes, yes, yes. You can do it. Why not? I’ll make a way for you. I’ll help you get on the committee. I’ll write the letter.” I didn’t have any of that.

I’m doing small things compared to what you had the ability to do. It’s a different day, it’s a different age. People aren’t telling you no. You’ve got people like, “Yeah. Go for it. How can I help?” I… mother. They weren’t women in these kind of roles. They weren’t black men in these kind of roles. My mentors were white men who said, “You can do this” but that was after I had gone quite far in my career . I say sometimes… but I grabbed it and flew with it.

Women today, the world is their oyster. I mean, of course, you can do these things, far more. The surgeon general, Nadine, I let her know I didn’t have Twitter and all the social media. And she’s tweeting out all the time. I said, “You’ve got so many technological advancements to your advantage.” I said, “Are you kidding me? You’ll do far more.” I know that.

Lauren Gunderson: How amazing? I mean, I do think that’s the exact kind of personal connection that made all the difference to me and I’m sure is making the world of difference to these women you’re talking about is to have somebody who says, “Yes”, without hesitation, “Of course you can. Of course you can.” That’s just magical. It’s amazing and important.

Gary Gunderson: Lauren, as a master of the arts and crafts of voice, what would be your counsel to public health people about trusting their capacity by voice and by action and all the arts of drama as arts of persuasion, leadership. What would you say to them as a theater person right now?

Lauren Gunderson: What would I say? I would be amazed if somebody would say that they’re scared. To say, “I understand why you’re feeling the way you are.” That’s the empathetic response. “I am scared too.” I am not scared out of a fear that we can’t manage this. I’m not scared that this would be endless but, of course, I’m a human being. I worry about my family. I’m worried about my colleagues. I’m worried about how this disrupts already fragile human ecosystems. I am scared. I’m afraid.

Using that as a place to meet people where they are and then say, “But here’s what we can all do right now.” All of that messaging I think is coming across about social distancing, about masks, all of that is I think in most regions, I’m in California, Bay Area so we were the first to shelter-in-place so we’ve been getting that message for quite a while but …

Kimberlydawn Wisdom: That’s right. You were.

Lauren Gunderson: We’re on … I don’t even know what week we’re on. I’ve given up counting. I do think there is something incredibly and simply powerful about saying, “I’m a human being first. And then I am a practitioner, a scientist, a professional whose job is to say, ‘We’ve got a plan. Stick to the plan. Here’s the plan.”

I don’t know if I’ve heard anyone say that really. I mean, I’ve heard some people but to have a very powerful voice in public health say that. I don’t think it will cause panic, I think it will feel real. It’ll feel like, “Oh, they’re a real person. This is coming from a place of humanity plus competence.” That’s what science should be. It should be both.

Kimberlydawn Wisdom: Yes. Well, I love hearing that because actually one of my major efforts is to introduce the idea of every state having a state level surgeon general and, in part, for that very reason. That issue brief out on it, working with the National Academy for State Health Policy… I talked to CNN about it. I’ve talked to others about it. I’m in the midst of talking to a few other people, the American Public Health Association meetings, whether it’s virtual or not, there’s going to be a session on that. I’m hoping it will get some traction even during this time because having a trusted voice that can communicate messages to the general population and in a coordinated way across perhaps many states and working with the US surgeon general as that trusted voice, I think could really play a significant role during these kind of challenging times, whether it’s a pandemic or some other health emergency.

And address the sort of diversity, equity, and inclusion element of state government, which I don’t think consistently occurs. It’s not all just racial and ethnic, of course, that’s the big news of the day right now. But it’s also for LGBTQ community, our veterans, those affected by disabilities, women. There are many other constituents where we would see disparities. Of course, there’s intersectionality when people are represented in several groups.

This structure… Because one way to address biases and some of these structural issues are to have structures in place that can ensure that vulnerable communities have the ability to not just survive but thrive, especially during challenging times.

I often times even say when places like Detroit … When the general population catches a cold, places like Detroit or communities of color catch pneumonia. It’s because everything is exaggerated in those communities. If you have the structures in place to ensure that those exaggerations and impacts are mitigated as much as possible I think we’re better off as communities and as an overall society.

Gary Gunderson: Thank you very much. For both of you, I know your schedules are just ridiculous and you’ve spoken out of your heart and out of your spirit and your mind and all three of those are great. Thank you. Thank you for this.

Kimberlydawn Wisdom: I agree.

Stakeholder Health Podcast