On the Frontlines

Today we are joined by Dr. Italo Brown, an Emergency Medicine Physician on the frontlines. We have a candid conversation about COVID-19 but also mental health, wellness, health disparities and social emergency medicine. 

Transcript

Copy Transcript Copied

spk_0:   0:04
stay in a welcome to the millennial health podcast. I'm Dr J. Cherie Alan, a board certified family position who's passionate about the health of my fellow millennials. I know we're booked and busy, but your first wealth is your health. So I'm taking some of my most important health messages and bringing them here to you on this podcast. My goal is to share some valuable information and draw awareness to some important health issues. But I encourage you to please consult your physician for personalized medical advice. Today we're joined by my dear friend and medical school classmate Doctor. It's hollow Brown, who's an emergency medicine trained physician on the West Coast but recently completed his training in New York City. He is one of our health care workers on the front lines, who has been very vocal in the midst of this crisis and hosting multiple sessions online. Dr. Brown, it's a pleasure to have you here with us today. Welcome to the millennial help podcast.

spk_1:   1:18
It was going on now.

spk_0:   1:20
Thank you so much for joining me. Honestly, I really wanted to talk to you today and I mentioned this just before me. That started because I think you are one of the people doing a really good job balancing kind of that narrative out there. You know, you're putting now as much information about code 19 as you possibly can accurate up to date information. But also, you do so much more work outside of this pandemic that I think you know shouldn't be forgotten in these times because, as I mentioned earlier, you know, people still have the issues they had in health care prior to this pandemic. And I want us to remain as well as possible throughout all this. You know that. So could you please tell us a little about your background in emergency medicine, but particularly social emergency medicine? It's really interesting,

spk_1:   2:13
you know? No problem. So I've always been a big fan of being able to give care to people regardless of their ability to pay and no matter where they are on the whole spectrum of wellness. So when I was ah, in school with you, kind of like what I knew I wanted to do something that was oriented around primary care, but really could ah remove those boundaries. Ah, and still be able to do some invasive things. So I started looking into emergency medicine and I had a buddy that I went to college with. I went to Morehouse College and, ah, he was an E R physician. And one day I went up, Just hang with him at Cook County, and during that shift, I kind of made a decision that emergency was gonna be my thing. Now, the cool part about emergency medicine is there are so many different subspecialties in it that are almost cutting edge in an in an extent on one of those whose social emergency medicine. So when I tell people about social emergency medicine out basically encouraged them to, like blend which you know of public health and social determinants of health and put it in the context of an e. R. There's several reasons why people come to the hospital. What are some of the social factors that draw them into the hospital, where some of the barriers that they face toe have to deal with, you know, unconventional modalities such as, like, race, health, ethnicity, um, more, particularly gender. Are there issues with how they're being given pain medication? Do certain E. M s vehicles take people from certain neighborhoods to poor hospitals or county hospitals, as they're described versus like academic or rich hospitals as they're described. We look at all of these factors and trying to understand what we can do from a program stance to to improve situations and make him or equitable.

spk_0:   4:13
Oh, that's that's incredible. So piggybacking on that I know you just did this survey actually on health and wellness on behalf of the fancy Social Emergency Medicine program. Tell us a little about that because I was really fascinated by that.

spk_1:   4:32
Yeah, So I mean, I came out here to Stanford to pursue this Social Emergency Medicine Fellowship after completing my work up in the Bronx. And, you know, I loved every step of my journey. I've been in an underserved community. I just I seek it out. You know, I never expected to work in any type of other environment, and I've always liked made it up point to try to improve those vulnerable populations. So when I came to Stanford, I'd already been working with a group called Trap Medicine of a buddy named Jamil Lacey, who I also went to college with. Who started this? This movement essentially around Using barbershops as a, uh, you know is like cultural collateral, you know, like trying to find safe spaces in black community And for us, you know, barber shops have historically been that. So what we try tried to do a trap medicine or we do actively in trap medicine is lower those barriers to care and discussion around health and wellness. So once I got on, uh, on with Stanford, I really believe that there was a piece I could bring that was extremely valuable in health equity dialogue, health equity programming and the essentially the pilot of all of this was going to be using trap medicines, model of ah, care delivery and opening discussion and increasing health literacy. And seeing how Stanford's of resource is could help brought in that scope. So the survey itself essentially was built to, uh, prove something. You know, the medical community and large does not believe that African American men go to barber shops and have discussion outside of just getting their ears lowered. Um, I think that, you know, straight up people don't believe, like you could go to a barber shop and they will talk about who's the best basketball player and then two seconds. I mean, two minutes later, they're talking about someone's girlfriend. Then a few minutes later, after that, to talk about the best movie that's out. And then next thing you know they're talking about when they went to the doctor and got a colonoscopy. So we just leverage that coat that cultural capital in that space. And this survey was like designed to prove to the medical and more specifically, the research community that black men can respond to in large numbers and do have a vested interest in their own health. And we can do it by using a safe space as the medium.

spk_0:   7:10
How's it going so far? How are your results looking, or is it even still open at this whole?

spk_1:   7:16
I still keep it open on a running basis just because I think you can capture data a little bit better passively, particularly during this time, where people are just like at the house and, you know, have very, uh, limited spectrum of activities that could do. I'm like, yeah, you know, it takes three minutes to do this Survey s o. Tell your uncles. Tell your you know your dad, your boyfriend, your partner or whatever to do this survey. But, um, yeah, I initially launched with a goal of trying to get 5000 responses. At times I tried over shows like Let's do 10,000. I ended up landing around 2600 respondents, which is the largest number of blackmail. Responded for any survey study in the scope of work. So, yeah, I'm satisfied with the fact that we got that, but I know that there's more to go, so I left it open. The hope is to Taylor that into a second phase where we were supposed to be hosting activations in four U. S. Cities to do like on site qualitative data collection.

spk_0:   8:20
Oh, could you tell our viewers where they could find the survey if they're interested in taking that now?

spk_1:   8:26
Yeah, sure. I mean, eso on my instagram. I have a link tree. It'll be right there. It's a Google form. My instagram is at gr the number eight vision. So at great you vision just hit me up on Instagram and I would absolutely make sure you get a copy. That link

spk_0:   8:43
Hey, All support and Dr Brown and the survey soul. I want to jump ship a little bit because you are one of our doctors on the front lines into these, uh, a national Doctor's day, By the way. So happy national doctors, Happy national doctor. But as one of the docks on the front line, you know, there was so much information, I think at the beginning of this pandemic, you know, geared towards elderly adults. And I think the narrative is shifting now with us, you know, being a little more mindful of how millennials play a role not only in the spread as asymptomatic carriers, but also but coming like acutely ill, you know, and representing a significant portion of hospitalized patients. Now, this recent Jim article that just came out, you know, what would you like to share with Millennials as one of the docks on the front lines of this?

spk_1:   9:45
Well, I would say, like one of the things that stands out the most to me about this about covert 19 as a pandemic is it just does not discriminate like we knew from earlier studies that it would almost select older individuals and people who had co morbidity ese and what we ended up finding out in the US is that our population is completely different from some of these other populations that were reporting their findings early on, like is just a basic understanding of population health and a basic understanding of public health is like, you can't make generalizations just because you can see the same effect modification. Right. So the thing that I I was worried about from the beginning is like, what of this study city is made up of in these places where we're getting data from and what the average U. S. Cities look like fried? Yeah, that's right. And I started seeing a train early, like living in the Bay Area. We were one of the first places that started seeing Kobe 19 and I mean, I work at Stanford, so obviously we were, uh we have a research community that is international. So we were getting a lot of this information front, like, firsthand and trying to come up with a response for it. Then the numbers just started climbing, and we started seeing something that was different than what was anticipated, which is like, you're getting more reports of younger individuals who don't have, like a ton of coal. More biddies, like some of them may have had some smoking history or vaping, but nothing like you were seeing in China or in Italy s O. That kind of creates a ah nineties for concern. When you start Oh, understand. Like, you know, this is taking people who were calling the walking well and they'll get tested positive and then four days later, that come in and they're short of breath and like on the verge of being intubated. So you know that that is scary in itself. Because you know, the General American public, especially when you try to give a longstanding ah, very broad public health message, it takes a long time for them to adopt it, right? Like take us forever to get people to wear seat belts. It took us forever to get people to reduce their smoking and stop secondhand smoke. It takes forever to get people to wear condoms. These people for ever wanted, you know, use vaccines like every public health measure. We're still fighting some of those struggles today, and this was like an immediate we need you to do this now and some of the hard, most hard hit people in the world are folks in our age group, you know, like Millennials is because we're intelligent and we we know that there's multiple ways to go about doing something and and you have to find a way to break through that barrier, particularly t to get them to understand how real this isn't how none discriminatory this virus is. So that was like my main takeaway from it

spk_0:   12:44
from this and no, definitely also, you know, last week we spoke thio at Dr Jasmine Marcel, and she's an I d specialist in the breast them and we had a conversation about this and, you know, one of the things she said that really struck me, uh, was that you know, even if right, you want to take your chances right, you're young, you're healthy. You think you'll recover, you'll be just fine. You know, you have to consider the other people in your life, right? You have to consider the other people around you, your parents and your grand parents. You know, what are their odds of coming out of this? You know, unscathed, and you don't want to do that to them, you know, So even if not taking precautions for yourself, do it for the ones you love,

spk_1:   13:30
you know, And one of the things that I think it's underestimated is how interconnected millennials are. We are a group, people who we live together. We like to live in our own will cohorts, and it's kind of like a perfect situation for any respiratory, a droplet born illness or spread illness. Thio continue to affect people that have a faster or ah, greater attack rate because, you know, we are so interconnected and and all those things have to be taken into consideration. And I think that what's happening now it's like people finally are starting to realize that this is the biggest public health crisis of our generation and we actually have a choice like we can choose to be the downfall of our society by ignoring what's happening. Or we could actually be agents of change there in

spk_0:   14:24
Oh my gosh, I love I love that you just sent that, But let's let's jump ship for a second. There's another topic. I really want us to get to you. We share similar passionate views on mental health you know, especially with there being our communities. You know, I think about what we're going through in this pandemic, and some of the mental health ramifications are some of the emotional ramifications that we're facing. You know, I think of, like, grieving there, people who really have lost love ones. I'm their people who have lost jobs in this time. They're people who have lost dreams, you know, to put it quite frankly, in this time. And really, that's taking a tall Tollan. People you think of, you know, people being home for the majority of the day what their relationships were like in their home, if they weren't at their healthiest, you know, are their relationships with themselves that with all this extra time now you're forced to confront and, you know, like that really is laying. I'm really thinking about that. And how will come out of that? So, what are some, like, strategies or whatever your even your thoughts in general on, like the state of our mental health as millennials, you know, kind of the stigma surrounding it and how this pandemic is gonna affect that.

spk_1:   15:49
Well, you know, I was I was encouraged at the start of 2020. And I know that this is gonna be a weird way to say that because 2020 basically has been like this huge practical joke way got. Please give me a refund on all of 2020. You look like no. Everyone came in with their vision boards. Aspirations of making this decade, like the most popping decade effort and 2020 years like hold my beer, just come with something completely like left field. But, you know, like I was encouraged because, you know, even in the midst of like, what I would consider one of the most significant tragedies that I've seen, which with with Kobe Bryant and G. Gene, you know, this is something that, like rock everybody universally and I felt like out of that, you know, watching someone like you know what, my man Shaq, Shaq Diesel was on national television on TNT, crying and saying, like openly expressing his feelings and emoting for the masses to see. And I was like, This is such a major pivotal moment for mental health like this is what we've been asking for in terms of trying to normalize mental health. And there's several celebrities who, like showed like they're out crying there, there, poor of emotions, going to social media or taking ah, time to spend time with others. And giving that I was like This is huge, you know, particularly for our generation, who I have learned to compartmentalize things so well. Uh, so I was encouraged. But, I mean, I know that this time is a little bit different, you know, with with Kobe 19 there's so many things that people are having to deal with at one time, other than just the physical health element of, you know, like there's, um imagine, for example, like being a child right now who you depend on school for three square meals and now you can't get a meal right? So there's that right? And then there's Imagine being a person who is in a relationship that has an element of domestic abuse or some type of power differential, and now you can't escape that person. Um, And then there's your own things, like isolation, feeling of isolation, social social distancing as a means to kind of help yourself but harming yourself because you're not getting the interaction in the feedback that you might need or even the fear of someone who has chronic illnesses and feeling like they can't even go see a provider because of fear of walking outside and getting in Kobe 19. So I definitely feel like there is a There's gonna be a post traumatic stress associated with this time period, and we've got to do what we can as far as clinicians go to continue to treat this as assess serious as any other type of illness and find out ways that we can mitigate this in the midst of this crisis. One of the things that I've really enjoyed and I think that is helping is this is forcing people to be creative as hell. You know, like No, I'm just saying like,

spk_0:   19:04
this is what

spk_1:   19:05
I'm talking about. Like I've never seen Exume like People are having zoom happy hours 50 60 people who lie, Yo, we're figuring it out.

spk_0:   19:16
D J d name,

spk_1:   19:17
right dog d j d. Nice. I mean, Timberline battle, Swiss beats, you know, they're having producer battles, songwriter battles, dance parties, deejay sessions like you're getting world class talent coming to you through phones and trying to use that that vehicle to decompress, and I think that that is going to, like show it is a new avenue that we haven't tapped into yet. So I'm excited to see where that goes. Shoot Netflix parties like they were told to watch a video with somebody like remotely like all of this kind of telecom telehealth stuff that's emerging, I think is going to give us a substrate to try. Thio, address this like feelings of loneliness, anxiety, social distancing and depression in a new way. So I'm encouraged, and I think that half of the battle is going to be like just normalizing the behavior and getting people to just open up and say, like, you know, this is a really tough time. This is difficult and we're in this together. And if you are a person who is struggling in the silence, you don't have to because we're all right here with you.

spk_0:   20:32
I love across love, love, love that. You just said that, honestly, my episode next week I actually speak to a psychiatrist, and she mentioned exactly what you just said that you know, one of the things that we need to just start kind of singing that. Hey, this is a tough time just being honest about what this is because you doing that also gives other people permission. Do that same thing. You know,

spk_1:   21:01
it's super powerful when you can, uh, you don't make it relative. You can lower that threshold to care onto, essentially, like, express openly that something is difficult. And I really feel like that's what you're starting to see in a broader sense, like we try to bury our emotions and means we bury our emotions in, like, you know, instagram culture and social media culture. But now you have, you see it being used in another capacity, and I think that that is the key for our for like for millennials and generals like we communicate in a different way were interconnected. So if we can figure out how to, uh, lower this threshold to share our emotions and then fortify that with, like, actual strategies and skill sets to overcome some of these things that we're dealing with, I think you'll see like a more holistic approach to wellness, and people will start to, like, literally implement these things in their day to day interactions, even as we come out of this like crazy ass tells

spk_0:   22:14
you actually brought me right into my next question. You know, therapy is a big one, you know, and whether it's just pursuing these dreams that you've put on hold for some time, right in that book, starting that podcast, like, you know, using this time productively. What are some other strategies that you'd suggest him some of our fellow millennials to kind of cope with? You gave some really good ones, but anything else kind of burning back there? You? No. Good.

spk_1:   22:46
I think right now is a critical time to do some micro journaling. Like I think that you're gonna So the last time we had a recession, some of the greatest ideas came out. Ah, and I'm talking about, like, life changing ideas came out. I want to say, out of the 2008 recession you got born, uh, I wanna say instagram came out of that look, he But that was the real emergence of crypto currency. Like, there's so many different things that come out of these periods of struggle. Uh, that end of being beautiful and world altering that I almost literally encourage every single person to write their ideas out now. But you have the time start riding out. The idea started brainstorming. Things don't come from the angle of like, all right, so now that I've done this has gotta magically occur in the next three weeks. That's not gonna happen. But the fact that you can lay groundwork for things and kind of play with ideas in a vacuum is helpful. So I would say, like micro journal, right out ideas explore things that you didn't explore before, like reading things, watching a documentary Because all of these elements are going to trigger parts of your mind that you probably have neglected for sometime. Given that, you know, life continues to move rapidly on, and now we're being forced to stop and actually see what's in front of us. Another technique that I think people should do. And this is something that you know, if you ask me, you know, six months ago, if I was going to sit down and meditate or listen to somebody else talk to me talking about breathing in three seconds, breathe out three e like, man, I got time for that. But what I found especially as I continue to goto work and I'm enduring like the's. Very, uh, I would say heavy shifts like the shifts are heavy, you know, because you're seeing, you know, 2030 sometimes 60 people in a day in testing them for this thing that they're all afraid off. So no dealing with that you have to come in with a game plan and a strategy. And I found that meditating in doing that 20 minute exercise of breathing puts me in a place where I'm a lot more centered and I have clarity s. So I think that that can be applied broadly, you know? And I mean, if you're any facet of are already field getting centered and being able to have clarity is going to make you better.

spk_0:   25:15
I subscribe to that. So much so there's a really cool app called head space That's really good. And they are actually offering a free subscription right now to health professionals to help them through this time. So any doctors, nurses or, you know, anyone working on the front lines listening to this, definitely check that out. But they also have free ones, and I actually do that with my hospital staff. So when I'm the hospitalised, I stopped and we do five minute meditation. And I told you know, we're here working 12 hour shifts. If you can't take five minutes out of these 12 hours, we have a problem. There's like room we need to stop. So, yeah, I grew up with my hospital staff when I So

spk_1:   25:59
I think I'm gonna take a page out of your book and start trying to do that with the folks on my team. Uh, hopefully I can make it work in emergency department, but I was going to say the other thing is, you know, I I've been having guys meet on Zoom. My having a session with a is called a spoken, spoken Yogi. He's the guy who basically like Lee's yoga classes. But because now you can't physically jump in a yoga class, he's taking a lot of it to, ah, the Web. And so I connected with him through my brother's your meal into trap medicine, and we just hold a zoom session for about an hour where we start off with a breathing exercise for 15 minutes and then we talk about, you know, like what everyone is experiencing right now. And so I think, like those types of group therapy are therapeutic sessions are going to become more popular, and I've found valuing it

spk_0:   26:55
so well. I definitely encourage our listeners. Maybe reach alto couple friends in Consider doing something like that, you know, And one other thing. I'll add two strategies that we can use to cope in this time to pick up the phone and call some people you haven't spoken to in a while. Honestly, we're all feeling this. We're all hurting. Even those of us who still have to go to work every day, you know, essential personnel. But we're all feeling this. I've had three phone conversation yesterday, three conversations with, like, you know, friends who I just haven't had the time to talk to. You want You know, Amanda, I was on the phone with Amanda Saturday from medical school for like, an hour yesterday. I can't tell you. The last time I spoke to Amanda, you know, soul, it's important. Just pick up the phone and catch up with some friends. We're all in the same boat. You don't need to explain why you're calling e.

spk_1:   27:57
I mean, I had a call the other day, right? I had a really rough shift and then came back and I was on social media, like saying I mean, you know, people need to understand that your physician's daughter and then like the very next day, I get a call from my brother Rob Gore. Rob Robert Gore is like he's one of the I would say trail blazers and pioneers in terms of like social medicine and violence prevention. And he works as an E R physician has been doing it for like, 20 years on. He called me and I was like, This is crazy, man He just called me, was I am. And I just wanted to check on you. And he's in Brooklyn right now, dealing with the thick of the mess and took a second to give me a call out in the Bay Area where you know, the population density is nothing like New York. And just to see how I was doing. And I realized in the middle of the conversation met this was actually a twofold discussion, like he needed it to. That's how cool this is. You know, we are. We're breaking new ground in terms of how we are sharing things with people. And it's not wrong to pick up the phone and call somebody who you haven't talked to in the year to two years or more. It's just matter that they you care about him and they want O you want to hear from

spk_0:   29:18
Oh, and God, that's thank you so much. It's all And I'm happy we were able to connect on through this medium, you know, like please stay strong, be safe out there. You know?

spk_1:   29:33
No, I'll do the same. And I know that you got ah, your plate full. And I just wish you wellness as well as, uh, a continued persistence in this struggle right now and just leave from the front. And don't be afraid to jump in the middle and push a couple people from behind.

spk_0:   29:49
And amen to that, Theo. So, everyone, thank you so much for joining us here today. I'm the millennial health podcast. Though my goal is to share valuable information and draw awareness to some important health issues. I encourage you to please consult your physician for personalized medical advice. I do hope this information was beneficial to you. And if so, please subscribe to the millennial help podcast and share with your friends. If you've got questions or comments, feel free to reach out to me on instagram At your favor, Doctor friend. Thank you. Goodbye. You you.