Shiny Epi People

Abdul El-Sayed, MD, DPhil on epidemiologists as advocates for public health

January 09, 2021 Lisa Bodnar Season 1 Episode 24
Shiny Epi People
Abdul El-Sayed, MD, DPhil on epidemiologists as advocates for public health
Show Notes Transcript

Dr. Abdul El-Sayed is an epidemiologist, physician, progressive activist, educator, author, speaker, and political contributor to CNN. Abdul holds a doctorate in public health from Oxford University, and in addition to his academic contributions, he served as Health Director in the City of Detroit. In 2018, he ran for Governor of Michigan and was endorsed by Senator Bernie Sanders, Congresswoman Alexandria Ocasio-Cortez, and others. And though he earned over 340,000 votes, he finished second of three in the Democratic Primary. Abdul tells me his views on the moral imperative that epidemiologists have in advocating for public health. He also shares what he worries about, how he maintains hope, how he handles imposter syndrome, and meeting Bernie, AOC, and Cher. This episode will inspire you!

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Lisa Bodnar:

Hi friends, welcome to Shiny Epi People. I'm Lisa Bodnar. As always, thanks for supporting the show by sharing it with your friends. If you can afford a couple of dollars a month and you would like to support us financially, I'm on Patreon at patreon.com/shinyepipeople that helps support this, me, myself, and I production. You can also follow us on social media on Instagram and Twitter at ShinyEpiPeople. I post other content there if you'd like to check it out. Today, you're in for a treat. My guest is Abdul El-Sayed. Abdul is a physician, progressive activist, educator, author, speaker, and epidemiologist. Abdul was active in the Society for Epidemiologic Research in the early stages of his career, which is when many of us epidemiologists met him and got to know him. Abdul holds a doctorate in public health from Oxford University, where he was a Rhodes Scholar, as well as a medical degree from Columbia University. Abdul joined the faculty at Columbia University's department of epidemiology, where he became an internationally recognized expert in health policy and health inequities.

Lisa Bodnar:

He was director of the Columbia University Systems Science Program and Global Research Analytics for Population Health. In 2015, Abdul was appointed health officer and executive director of the Detroit health department, which made him at only 30 years old, the youngest health officer in a major city at the time. In 2018 Abdul ran for governor of Michigan and was endorsed by Senator Bernie Sanders, Congresswoman Alexandria Ocasio-Cortez and others. Although he earned over 340,000 votes in Michigan, he finished second of three in the democratic primary, Abdul is currently a visiting professor at the university of Michigan and scholar in residence at Wayne state University and American University, where he teaches at the intersection between public health, public policy and politics. He has published over 100 papers and continues to be active in research. He also served as one of eight members of Vice President Biden's 2020 Unity Task Force for Healthcare.

Lisa Bodnar:

Abdul is only 36... Yeah, let that sink in. There are many places you can learn about Abdul's work and his platform. He's authored two books, Healing Politics: A Doctor's Journey Into the Heart of Our Political Epidemic. That book focuses on what Abdul calls our country's epidemic of insecurity and the empathy politics, we will need to treat it. The second book is coming out this year called Medicare for All: A Citizen's Guide, which he co-authored with Dr. Micah Johnson. You can hear Abdul on CNN where he is a regular contributor. Abdul also has a weekly podcast, America Dissected, where he dives into what really for our health. Today Abdul shares his views on the moral imperative that he feels epidemiologists have in advocating for public health. He discusses how epidemiologists can become advocates and how they can get involved in politics. I hope you enjoy this chat. Abdul inspired me and I think you'll feel the same.

Lisa Bodnar:

Hi there.

Abdul El-Sayed:

Hey, how are you?

Lisa Bodnar:

I'm great, how are you?

Abdul El-Sayed:

All things considered pestilence and injustice aside, I'm doing okay.

Lisa Bodnar:

I think that's the best answer I've ever heard to that question.

Abdul El-Sayed:

It's such a 2020 provisor right? Everything is odd with a huge caveat and if you're doing okay, you're doing great. Let's hope for a great 2021. Thank you for having me on, I really appreciate it, I'm excited about the podcast. I'm honored to be asked and excited to be on.

Lisa Bodnar:

I remember when I met you at SER, you were in red pants, a blazer and a pocket square. I have now learned that every time I've seen you, you were in a blazer and a pocket square. My first very hard hitting question for you Abdul, is do your pajamas even have a pocket?

Abdul El-Sayed:

How do I sleep if I don't have a pocket square in my pajamas? No actually, you know what it was, I went to grad school in England, when I was there, is just the different level of showing up in the UK. For my first year and a half, I would wear my traditional random t-shirt, jeans and a pair of flip flops. I remember one professor, we had a meeting and he's like, "Abdul, would you mind getting dressed?" I was like, "I am dressed." From that point, I was like, "You know what, maybe I will get dressed." Then I started really getting into it and I was like, "Oh, this is like fun, you can mix and match different colors and there's all kinds of things going on," and so it became a whole thing much to the chagrin of my pocket book. I can honestly say that I picked something up aside from an education in English, so I'm grateful for that.

Lisa Bodnar:

I don't know if you're still wearing the red pants, but those colorful pants were among my favorites.

Abdul El-Sayed:

I'll be honest, I've been wearing sweat pants for the past eight months, so there's that. Even when I'm on CNN it's sweat pants on the bottom, so it's the COVID-

Lisa Bodnar:

That's really good to know because on the top you're looking sharp.

Abdul El-Sayed:

If you only got to look sharp on the top, then you could pull off, especially since there's... I do a lot of morning, I got up about 20 minutes ago and part of me was just like pants at this hour is oppressive and wrong.

Lisa Bodnar:

Yeah.

Abdul El-Sayed:

I honestly like sweat pants are phenomenal, I'm really grateful for them. I honestly think that like the post COVID world will be a little bit harder because I don't know if it will be socially appropriate to go back out often with sweat pants. Part of me just says that like, there's a conversation we all need to have but I'll be like, "We all know for the past nine months, all we've worn sweat sweatpants, so why don't we just keep doing it because it's a lot more,"

Lisa Bodnar:

Totally, I'm not even in pants right now.

Abdul El-Sayed:

There you go.

Lisa Bodnar:

No, I'm in pants. Okay Abdul, so can you share some thoughts about the intersection between science and advocacy and whether or not you think that someone can be both an objective epidemiologist and also be an advocate?

Abdul El-Sayed:

I'll be honest, I don't think you can be an objective scientist without being an advocate because what you're doing when you're doing science is in effect advocating for the truth, even if it's hidden. Our jobs, should we believe in some objective truth, which is a fundamental premise of science is to find that truth and then once that truth comes out, then the question becomes, what do you do with it? If the truth is being hidden in the way that it's not manifesting in the world around us, then I actually think it's our responsibility to be advocating for that truth even beyond its discovery. Now, some folks would say, "Well, that makes you a subjective arbiter," my point is that in a world where resources are scarce politics is simply the way we as humans make decisions about what we do with scarce resources.

Abdul El-Sayed:

If we know that science is being under invested in that the findings of objective science are not being followed, the question I have is if you're an advocate for science, we should be demanding more funding for this thing and we should also be demanding that once we know a thing that that gets implemented into the public policies that we make. How many more papers do we need that show us that poverty and segregation and racism are bad for people's health? Yet, while we have the courage to be asking these questions, sometimes I worry that we lose the courage to advance a public policy that is true to what we know. Then the other side of that is also that, I think there is a way where if you are a scientifically driven and directed person, that you are comfortable adjusting your positions based on what you've learned, and so I don't believe in ideology per se, I'm not an idealogue, but I do believe in the process of science and in following that science toward a public policy that should guide us to listen to that science, and that to me means advocacy.

Abdul El-Sayed:

I actually think you cannot be an honest scientist and advocate for the truth and a discover of the truth without being willing to then promote that truth in the world in a way that makes that truth operational and foundational to how we make decisions in our lives.

Lisa Bodnar:

How do you think that epidemiologists can actually be those advocates?

Abdul El-Sayed:

Well, remember that our science was founded in the pursuit of truth to prevent disease in real time, right? Whether it was John Graunt in the Bills of Mortality, or it was John Snow, these were people who took what they found and then used it to advocate for a particular set of public policies. I think we need to bring that back because at some point we allowed our science, I think, to get relegated to a series of journals, to a set of institutions where we talk about it in ways as if the things that we learn aren't important to people's lives. I think we're not that science, right? If we wanted to be astrophysicists, there's not much we're going to do to interfere with the stars, nor should we. You can be confident and comfortable studying the stars and just knowing more about them, but our job is to do science, to move it out into the public.

Abdul El-Sayed:

Number one, I honestly think that all of us have a responsibility to share what we learn and to be public about it. I honestly think that the institutions in which we work ought to reward the work of publicizing and translating our science. I think number two, there is a responsibility to serve when you're called upon to serve. I think that willingness to step up and step out and when you're asked by bodies of government or folks making big decisions about resources to serve that we have that responsible. Then the last thing I'll say is that we have possibility to be arbiters of science itself, right? When science is under threat or the process of doing science is being interfered upon, we have a responsibility I think, to step up and be guardians of it.

Abdul El-Sayed:

Now some of us choose to take it a step further, I'm not advocating that everybody do that, but I am saying that all of us have to be equipped with the ability, not just to do a science but to explain the science and advanced science itself.

Lisa Bodnar:

When you say take a step further, what do you mean?

Abdul El-Sayed:

I'm still involved in through a number of different projects that I was able to be a part of when I was in the academy, and I'm really proud of continuing to do that work and it keeps me grounded to the process of science and to epidemiology, which as a craft, I think is beautiful and enjoyable. I don't spend most of my time doing research, I spend most of my time in the public debate or the public conversation in some particular way.

Abdul El-Sayed:

I think for me, the choice to become an epidemiologist was an instrument to me, between a recognition that there were profound inequities in people's access to a long, healthy life. From there, there is a moral aspect of that, which I think comes with the knowledge that actually the causes of poor health are themselves transmutable and if that's true, then there's a responsibility to address them. I spent a lot of my time focused on the backend of that, asking if we know that poverty and segregation and racism and climate change are antecedents to poor health, among large populations who fall on the wrong side of systemic oppression. Then I think the responsibility I'm tasked with, with my science is not simply to understand that that problem as if these were inanimate objects and I was dispassionate about the outcomes, but to take that science and to leverage it into the world and to try and do something about it.

Lisa Bodnar:

We're not trained in how to do that, how do you make that leap?

Abdul El-Sayed:

Ah, we ought to be trained in how to do that, I think if you're getting an MPH or PhD in epidemiology, you ought to be taught the basics of public communication and the basics of organizing, those ought to be just part of your curriculum, because I think they are fundamental to what you do. Then the second is learning by doing, if you spend some time outside of the data collection, right? You put yourself in the places where people are living their lives, it changes the way that you understand them, right? Because one of the problems with data collection is that it tends to give us an abstract understanding of what these different data points are rather than a contextualized understanding of how these things interact with each other in a broader system. I think spending some time asking who are these folks and what is the system bearing down on their lives? What value is my research in helping to advocate for them in the spaces in which they are? I think that's a great place to get started.

Lisa Bodnar:

How can an epidemiologist get involved in politics? Either at the local state levels maybe to start out with.

Abdul El-Sayed:

Well, I'll tell you right now, there are a lot of folks who have a lot of questions for epidemiologists, so there's that. Honestly, just reaching out, but then the second is just getting involved in the process. Whether it's like something simple as deciding to volunteer with a campaign or to engage with a candidate or somebody in elected office about their public policy on an issue that you care about, that kind of advocacy I think is really powerful, and so doing the work of saying, "look, we wrote this paper, let me translate it into a memo. Let me find out who is interested in this area, let me reach out to them, share my research and suggest to them paths forward," I think it's a great place to start. The other places, honestly, if you can ever spend some time knocking doors as an epidemiologist, it's really quite fascinating.

Abdul El-Sayed:

I ran for office at the statewide level and it was as if... I had done a lot of research that actually included data about all of Michigan and to meet these folks in their living rooms and their VFW halls and shake their hands and listen to what they had to say in their own words, fundamentally reshaped the way that I understood what we do, right? Because there is a real data collection that comes with just soaking yourself in somebody else's life. Just getting involved in knocking on doors, or in the socially distance world, sending texts or making phone calls, that's a great place to start too.

Lisa Bodnar:

Abdul, what do you worry about?

Abdul El-Sayed:

For our country I worry, so much of our politics has been sieved down into us versus them, and it doesn't matter which us you're talking about and it's not just Democrats or Republicans, right? It's constantly these extreme battles of us versus them that you hear played out or see played out in social media that we will forget that the purpose of government is to deliver a basic set of resources, which a lot of folks don't have the access that they've needed for a long time. That pain tends to contribute to this... I hate to say it, this feed forward cycle of retrenchment and tribalism. Personally, I have a three-year-old I think a lot about the world that she's going to grow up in and the responsibilities that all of us have to our kids. I worry a lot about balancing between the personal responsibility to be a great dad and the public responsibility to build a world into which my daughter, as ethnically half Egyptian, ethnically half Indian Muslim 100% American little girl is growing up. I worry that I'm not going to be able to fulfill either of those responsible well.

Lisa Bodnar:

How do you maintain hope when things look bleak?

Abdul El-Sayed:

I think really great public leadership, if that's what I'm aspiring to do is like being a laser, you don't generate the light you just take a whole bunch of light and try and point it in one place. I get to spend a lot of time with young people in my work who are so much more clairvoyant about where we are and where we need to go about who we are and who we want to be and that's where I get my hope. I also think we have a responsibility in a moment like this to be optimistic, to believe that better is possible less we become a part of communicating pessimism into the world and driving a spiral. I just think that you always got to look at the positive and reflect on the positive.

Abdul El-Sayed:

The last thing is this, there is so much beauty in the world, I think sometimes we get caught up in what's ugly because we live in a time that is unique in terms of the nature of human interaction and communication. In no other time in the world, except for, since the last 60, 70, 80 years, could you get all the bad news in the world at the same time doom scrolling your phone, right? I have a phone in my hands that has more computing power than the entire rocket module that sent people to the moon for the first time but then gives me a constant feed of bad news all the time because the corporations that have monetized it and make a lot of money, keeping my eyes on it and they know my fear is a much more powerful driver than my hope, so they feed me fear and I keep strolling so that they can sell me something.

Abdul El-Sayed:

I just think that there is a responsibility we have sometimes to pull our eyes away and look at the things that are beautiful, whether it's watching my little girl smile at a book she's read 15 times, right? The basic joys that we sometimes forget about, those things give me hope.

Lisa Bodnar:

How did you grow personally, as a result of your gubernatorial campaign?

Abdul El-Sayed:

I have to tell you it was one of the hardest and most profound experiences I've ever had. First, there's something about people sharing their hardest moments with you in the hope that you can fix it, but when you're running you see them live and living color in their own space and that's really humbling, right? Because it reminds you however big your challenges are and however much worry you have, people have existential challenges all the time. The second is that I didn't win my race, as someone who's gotten some things done in my life, I am known best by most people for the thing I failed at, and everybody was like, "Oh, you didn't fail, you ran a great race," et cetera, but I lost I didn't win my race, and that's an important thing.

Abdul El-Sayed:

I think it's important to be humbled that way and it's important to have understood what it's like to try something big and to not succeed. At the same time, there was a recognition that 340,000 people gave me their stake in democracy. Just somebody who was at that point 33 years old, I've never run for office before, has a very long foreign name and someone who for all intents and purposes not supposed to succeed. Then the last thing is, as a Muslim American growing up there weren't very many people I could look up to and say, "That person shares any experience with me." I hope that being proudly Egyptian and Muslim American gives other folks who feel like they don't belong some license to feel like they do and that they can and I think that to me was one of the most important experiences of having run of at least trying to go out there and be a Muslim guy who's known for something other than being Muslim.

Lisa Bodnar:

Despite having so much success, Abdul, do you have moments of feeling insecure or feeling some imposter syndrome?

Abdul El-Sayed:

All the time. It comes with the territory of trying to constantly be better and constantly looking out and realizing that we're comparing ourselves to the highlight reel and everybody else's life, that's the other secondary downside of social media or one of many. Is that you're constantly looking at the highlights of people's lives and you're constantly saying, well, I don't measure up, I haven't done this, I haven't done that. I'm failing at this, this thing is not going quite right. I also think that there is a challenge with knowing that there are always going to be the same old barriers to being in doing in the world, when you have a name like mine and you pray like I do. Those things are a challenge.

Abdul El-Sayed:

I'll tell you how I try and get through them, I try and focus a lot more on process than I do on product. I think there's a really deep joy in mastering a craft and all of the things we do, right? These are Crafts and we're so privileged to be able to do work that is intellectually stimulating and challenging, and that we get recognition for, right? Sometimes I think about... A friend of mine, really a mentor actually, he was an immigrant and he was a surgeon couldn't retrain when he got here, he came as a refugee and ended up cleaning bathrooms. When he was over the bathroom it was spotless. One time I asked him, as we guys got to talking to each other, I asked him, I was like, "You used to be a surgeon, and I'm just so amazed by the attention to detail you bring to your work, I want to know what drives you to do that," he said, "At the end of the day, the work that I get to do is out of my control, but how I do my work is in my control and even if I'm not operating on people and saving their lives every day, I'm cleaning their bathroom and that's important service. I really pay attention to the details because that's how I was taught to work."

Abdul El-Sayed:

I so admired that, right? You could imagine somebody in his circumstance being like, "What the hell, I used to save lives, I used to be a surgeon," then in there I hold myself to that standard that no matter what work I'm doing, I want to bring all of my focus and all of my effort to mastering my craft, even if I were to be humbled in my life and in a circumstance, be in a situation where nobody who knew who I was, and I was the janitor in the bathroom on floor four. For those of us whose lot in life is not to do that work, first our job is to serve people who do that work and second, our job is to do the best by the work that we can. If you focus on the process and you focus on the joy of the work rather than the output of the work, or the scoreboard that tends to exist out there, it's centering and it reminds you what a joy and what a privilege it is to be able to do work like the work that we do.

Lisa Bodnar:

Did becoming a father change how you approached politics or science?

Abdul El-Sayed:

No doubt. For me the experience of having a kid was the moment when my life stopped being about me and started being about her and not to say like about me in a selfish way, but about the things that I could do in the world, rather than the things that we could do in the world. I was a bit ambivalent honestly, about having kids, I love kids but I also, I didn't know if it was something that I really wanted to do and Sarah really wanted to have kids so we inevitably going to have kids. The minute she was born there was a... It's like a fifth ventricle in my heart I didn't know existed that just opened up and it is such a unique set of feelings that you have for this young person in the way that they can fundamentally change your day for better or worse and that you constantly sieve every question around, not just what's right for you and your responsibilities in the world, but what's right for that person.

Abdul El-Sayed:

Then it's just a lot more joy, right? I never thought that after the age of like three or four, I could get joy reading the same book 15 times, but it's not my joy it's her joy which makes me even more happy, right? Even on the worst days, there's an opportunity to just step aside and step out and be like, "Let me just let me just engage with this human being for a while because I know no matter what that that is productive, important, and meaningful and joyful for me." It really has fundamentally changed things.

Abdul El-Sayed:

Then the last point is that so much of public policy, I think, and politics are about who we are and who we want to be and there is no manifestation of than our children. You can understand the theory that people love their kids and will do anything for their kid, but until you have your own, the level of commitment and the visceral nature of that commitment, you just can't know. When that opened up for me, it just fundamentally changed the way that I heard and understood people talking about their fears and their hopes and what they want in the world around them and I think it just made me that much more empathic.

Lisa Bodnar:

Can you tell me about meeting someone famous?

Abdul El-Sayed:

Yeah, I'll tell you about the first time I met Bernie Sanders, he is exactly who you think he would be, except for he smiles a lot more than they make him out to smile.

Lisa Bodnar:

Oh nice.

Abdul El-Sayed:

He's also super tall.

Lisa Bodnar:

He is?

Abdul El-Sayed:

Yeah. That's the thing, you don't think he's going to be super tall, right? I'm not a very tall guy... on the campaign trail, I remember one time a blind woman had come up to me and when I stood up, I shook her hand and got to talking she said, "Oh, you're shorter than I thought you would be." I was like, "I'm sorry," she was like, "I can hear from where your voice is coming, I would've thought it was going to be coming from up here, but really it's like coming from down here," I was like, "Yep, that's true."

Lisa Bodnar:

Oh, I love that.

Abdul El-Sayed:

But Bernie is like six one, and they always portray him-

Lisa Bodnar:

Really?

Abdul El-Sayed:

Yeah, he's a tall man. I remember the first time, I met him and he just had this big broad toothy smile. Imagine like the super tall, big smiling Bernie Sanders, that's not how you think about Bernie Sanders, right?

Lisa Bodnar:

No.

Abdul El-Sayed:

He's usually telling you about Medicare for all. The funny thing about it was like, at this point I was 33 and he was 76 and he was like, "Abdul, you got to stick with the young people," and I was like, "With all due respect sir, I am the young people." He was such a breath of fresh air, love him or disagree with him. He has been talking about the same issues, the same way for decades, and it was a real privilege to see that up close and in person. He's also just a lot warmer than you think he's going to be, and it shows you exactly how the power of a media portrayal of something gives you an image of what that thing is. The other famous person I met, was Cher on the campaign trail and there's a video of her somewhere-

Lisa Bodnar:

Really?

Abdul El-Sayed:

Yeah. I introduced myself, I said, "Is really a privilege meet you and I'm running for governor of Michigan," and she puts her hand on my face and she's like, "But you're too small to be running," and I was like "What is it with people telling me I'm small?" I was like, "Do you mean young?"

Lisa Bodnar:

Yeah. She meant young, Abdul she meant young.

Abdul El-Sayed:

I was waiting for her to be like, "But your voice is coming from here and not up here."

Lisa Bodnar:

Totally. When you met Alexandria Ocasio-Cortez, was she dressed better than you?

Abdul El-Sayed:

Oh definitely.

Lisa Bodnar:

When are you going to get on Among Us and play live? Because she really set the bar pretty darn high.

Abdul El-Sayed:

She did. Look, AOC is one of the most incredible people you'll ever meet, I'll be honest with you, there are people that you meet in politics, you're like, "Oh there is the brand you, and then there's the you, you." AOC is her, that's just who she is. I remember we did a three stop tour in one day and every time we'd go, right? We'd be looking for where AOC was and she would be like in the corner, hanging out with some kid. She’s just like a good, good person who cares about the folks who nobody else pays attention to. I guess who she is. She's definitely better dressed than I am definitely better at, Among us. At some point, maybe I'll get into video game. Funny thing is my little brother who eight years younger than I am is a big gamer. When I was a kid, I wasn't really into video games, I was definitely the kid was outside playing sports and my brother was like, "Who would have thought that you should have been a gamer the whole time?" I was like, "Yeah, you're right I guess I should have, I guess I missed out,"

Lisa Bodnar:

Totally, you could have won that race Abdul.

Abdul El-Sayed:

I know, or at least won Among Us, right?

Lisa Bodnar:

But getting their endorsement, must've just been a thrill.

Abdul El-Sayed:

Yeah, it was cool. I was really grateful for their support and really grateful that they'd come in and support the campaign and both of them have been just incredible supporters since, and now I've done my best to support them as well. The thing about politics, whether it's a big P politics or little P politics, is that sometimes we forget that relationships really matter. Reflecting back on my time in the academy, we have this sense that it's all about productivity and it's all about just putting out more work, but I've often found that getting to know folks and building strong relationships can really be helpful, not because it's like short-circuiting the work, but because it makes your work better, right? And I think that if we brought more of that into a lot of these other kinds of institutions would be valuable.

Lisa Bodnar:

When you watch the presidential debates, what vegetable did you throw at your screen?

Abdul El-Sayed:

It would have been cabbage because... I hate to say, honestly, I don't know why we started eating cabbage, it's like a vegetable that smells like the fart.

Lisa Bodnar:

It causes a lot of farts.

Abdul El-Sayed:

Yes, the whole thing is just very gaseous, the whole experience.

Lisa Bodnar:

Thank you for taking time to do this, I know you're so busy. This was such a privilege to chat with you-

Abdul El-Sayed:

Well, Lisa I really appreciate it and thank you for what you're doing. Thank you for hosting this pod and thanks for having me on it. It's nice to like be considered an epi person again.

Lisa Bodnar:

Hell yeah.

Abdul El-Sayed:

I'll always, at my core I will be an epi person.

Lisa Bodnar:

You're one of us man you can't lose us now.

Abdul El-Sayed:

Never.

Lisa Bodnar:

Thank you Abdul.

Abdul El-Sayed:

Stay safe and stay warm and hopefully we'll get to see each other in person once this is all over.

Lisa Bodnar:

That sounds good.