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Paul Conti, M.D.: The psychological toll of a pandemic, and the societal problems it has highlighted
Paul Conti, M.D.: The psychological toll of a pandemic, and the societal problems it has highlighted

Paul Conti, M.D.: The psychological toll of a pandemic, and the societal problems it has highlighted

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Paul Conti, Peter Attia
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Apr 10, 2020
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Episode Transcript
0:11
Hey everyone, welcome to the drive podcast. I'm your host Peter Atia this podcast my website and My Weekly Newsletter all focus on the goal of translating the science of longevity into something accessible for everyone. Our goal is to provide the best content in health and wellness. And we've assembled a great team of analysts to make this happen if you enjoyed
0:30
This podcast we've created a membership program that brings you far more in-depth content. If you want to take your knowledge of the space to the next level at the end of this episode. I'll explain what those benefits are or if you want to learn more now head over to Peter Atia m.com forward slash subscribe. Now without further delay. Here's today's episode. Welcome back to another covid-19 episode of the drive podcast my guest this week is dr. Paul Conti. Some of you may recognize that name.
1:00
As Paul was a previous guest on a show about a year and a half ago when we spoke about mental health depression trauma a number of other things on this episode. We kind of pick up a little bit of that thread but obviously talk much more specifically through the lens of the anxiety trauma uncertainty that many people are experiencing in the midst of the pandemic the quarantine itself the isolation the uncertainty that comes from it both economically socially politically Etc.
1:29
Paul and I go off on a number of tangents here that I think you know on some level speak to societal problems on other levels speak to challenges that we all have at the individual level. So I hope you'll enjoy this as a bit of a deviation from the normal flow of information as it pertains to some of the more technical aspects of this which will obviously continue to return to but I found this to be a very helpful discussion and frankly the type of discussion that Paul and I will often find
2:00
Ourselves having in the midst of situations like this, but hopefully by being able to have this discussion and share it with you some of you may find Value in this. So without further delay, please enjoy my discussion today with dr. Powell County. Hey Paul. Thank you so much for taking time to talk this afternoon. I know you're even busier than you normally are, but I know you appreciate that some good can probably come of us setting some time aside to talk.
2:28
Thank you very much, and I so appreciate
2:29
She ate you having me back on it's such an important time and is so much to think about and talk about and thank you for taking the time to have me on
2:38
so Paul before we jump into some of the stuff. I really wanted to talk about it. It's probably worth you sharing with people your own experience with what has to be believed as a presumptive diagnosis of covid-19. You got sicker than hell about a month ago, as did one of your children and in as you've described those symptoms to me they are.
3:00
Very classic for the diagnosis here and you're no stranger to get in the flu and things like that, but tell folks a little bit about what you
3:07
experienced my wife and my two year old both just had malaise mild symptoms, but my six-year-old who is we're kind of like carbon copies of one another she had pretty significant symptoms by pediatric standards. So I kind of knew it was coming and I had to the malaise and just generally not feeling good and that was there for her.
3:29
A couple of days and then I very rapidly got very very sick in a way that felt different than flus or food poisonings or other illnesses felt extremely hot alternating with really terrible chills that kind of took over along with the can awful headache and this just deep nausea not like I've experienced before and interestingly. I wasn't congested was strange to start to have a feeling of shortness of breath.
4:00
Really having to catch my breath and start taking deep breaths and to be that sick but did not have any congestion. It was scary. I mean, I remember at one point I was in the shower and I had the water turned up high enough to scold me. Like it should have been really painful and Anton has to shivering and I had goosebumps and just things that haven't happened before and I could really see The lethality then someone who has some of the medical comorbidities. I'm fortunate not to have was
4:29
Is older and you know, it was scary. It was scary.
4:33
Well, I think it also kind of gives you an interesting perspective to be able to talk about the stuff. I want to talk about with you today. As you know, I've been spending the past month trying to figure out how to be useful and that required more starts and stops and fits and starts than normal because there is this feeling of helplessness you and I were talking about this earlier which is like the you have this desire to do something but at the same time you feel like you can't really do anything.
5:00
There are days when I just wake up and all I want to do is watch Netflix and play in my simulator and and literally have nothing to just forget that this is all happening. But then there's days when I wake up and I feel really motivated and I think how can I help and I haven't figure the answer to that I suspect doing these podcasts is helpful. The feedback has been great. And I also think that people are probably at least as interested. If not more interested in the kind of stuff. We're going to talk about today as they are on the nuances of this type of
5:29
Of RNA virus versus that type of virus versus this drug and that drug and while those things matter I get a very vague sense. There's a coming fatigue around the uncertainty of whether the case is going to Peak and what all these things and there's a little bit more of a sense of okay. Well, what does this mean for me as a person and how have you been sort of struggling with the role that you play as an individual to your family and then the role that you're trying to play with your patients and then maybe even thinking more broadly
5:59
as
5:59
I know that you know and you and I have talked about on your podcast. I see the world through the lens of trauma and I think part of what just frustrates me at times to just utter exasperation is I think the predictability of so much that has gone on around us and I think we've had an explosion of so much technology so much increase in capability and I think we've made errors
6:29
hours as a society in how we're utilizing that technology and we've really paved the way I think for deeply traumatizing ourselves as a society as a country and also used as species and and I think obviously I'm a psychiatrist and one of the principles that's that's a timed used in Psychotherapy is this idea that everything is as it should be which does not mean
7:00
Morally, right it means that the vast majority of things that a lusts mean some of them befall us. But so often there's a predictability that we've gone 19 steps down to 20 step path and then are surprised when we get to the 20th step and I think that we have been Paving the way for terrible trauma to happen both medically and also so
7:29
Socioeconomically and what's so disturbs me is that as the virus itself recedes in whatever way that ends up happening. We're going to have to make decisions and I think that those decisions have tremendous gravity to them. I mean I try not to be inclined to hyperbole but I think that they are as serious as you and I have discussed in other venues, I mean, is it America passing the torch as really no longer being the world leader that we
7:59
I've been since the second world war. Are we setting the planet on a reckless course that we can't recover from and and I think we have to learn from this and I think where I wring my hands and gnash my teeth is the idea that maybe we won't learn from this and I'm worried that we may then we could then sort of traumatize ourselves out of existence.
8:24
What do we know about how humans internalized this type of
8:29
stress versus other types of stress that are more potentially uniting so I know that this sort of there's a body of literature that would say look pandemics do different things to the human psyche than most other things like War terrorist attack even natural disaster because by their very nature they are isolating Sebastian Junger has written very eloquently in his book tribe about how post 9/11 suicide rates actually went down people.
8:59
United there was a common enemy and then there was something we could all do to stand together, but the literature on pandemics actually doesn't suggest that to be the case. What is your take on these sort of differences in the psychology and psyche of us when confronted with these different external stresses?
9:17
I think on the one hand it creates tremendous.
9:21
Feelings of loss of control and tremendous vulnerability and it also creates suspicion. We know that viruses are real but there's still that part of human beings that we can't see it. We can't just stop it. No matter what we're doing. It can be lurking around in visibly. And those are things really that terrify us the idea of an invisible enemy and we internalize this in a way that is more and more isolating and I think historically too
9:51
People very suspicious of one another. I don't know like the idea that hey if I meet you on the street, I don't know if we're going to accidentally kill me and I can't read I can't use what I would do to read safety to read control in order to keep myself safe. And I think in addition to that we have a very big added problem, which is that that feeling of vulnerability that feeling of loss of control is looking for an enemy. I mean after 9/11 whether we
10:21
ultimately were targeting the right enemy or not is there was there was an attack there was an enemy and here I am very very worried that the social structure we have allowed to arise is a social structure that searches for an enemy and I see the xenophobia the racism that then makes us feel that there's an enemy that actually isn't our enemy instead of seeing it.
10:51
Is a human element and people who are suffering are suffering in the same way. They mean as you and I know as Physicians when you see someone who's really suffering Nothing Else Matters and when I thinking about like, what's the color that person's skin and how much education or money do they have? Like, it makes us all the same but we lose that perception of people who are suffering in China suffering in Iran suffering in America suffering in Europe suffering in Africa and South America. We lose
11:21
That and we start to I fear further the processes that are separating us already to such a dangerous
11:32
degree Paul. If you could wind back the clock to January 12th, so the virus has been now identified the scientist and China have sequenced it if you could if you had mind control over world leaders at that moment in time and you could have programmed everyone in such a way.
11:51
That there would have been complete cooperation and borders would have effectively dissolved not from the standpoint of Interstate travel and things I've been in terms of nationalism. Everyone said hey, you know what? We're all in this together. This thing's going to be a potential disaster. Let's completely share every piece of information we have and we're all part of the same country. So whether you're our enemy and Iran from a political standpoint or not, no, no, we're all going to share resources of testing of data of
12:21
vacations etcetera. Is there any precedent for the world being cooperative and productive in a manner like that? Because I got to be honest with you. The only thing that comes to my mind is these goofy Sci-Fi movies where the aliens come to invade and all of a sudden the Russians and the Americans are friends because they have to sort of fight the alien like so outside of goofy sci-fi. Is there any reason to believe we even possess the ability for that degree of cooperation?
12:48
I don't think we do right now I
12:51
We can but I don't think we do and this is because it is much much easier to align around a common. Enemy. How long has the expression you might enemy's enemy is my friend. I mean that's probably been around since people develop language in some form or another. It's very easy to identify that as my enemy. So now you are my friend hence the Alien Invasion, even you look during the second world war Nations that had a lot of adversity there were examples of
13:21
Unification around fighting the common enemy. The problem is what is becomes much much much harder and requires different elements of the human beings ability to call upon the deeper parts of our brain the parts that don't just react with what I think of as traumatic aggression in order to align around something that really isn't an enemy. The virus isn't plotting against us. This isn't of intelligence. It's invisible.
13:51
People in order to unite we have to recognize our shared humanity and our ability to for people to cross borders our ability to destroy one. Another with weapons has so far exceeded our ability to do that. I mean, if you look at the reactions in various countries, it's been the same reaction. I mean, I think to me core principles here are the everything is as it should be if we make decisions 1 through 19, we're going to end up at decision.
14:21
Point 20 and the other point is how much the Middle School playground plays into all of this even if it was a three four weeks ago around maybe three weeks ago. My my father who's in his 80s his girlfriend who's in her 80s. We're going to go out to an event with a 500 people. My response is oh my God, stay home. And then he responds. Why would I stay home? There are no cases of the virus in New Jersey where my father lives right? Sure. If you don't test people then you don't
14:51
I know that there are cases and I think this is so part of the problem that we've reacted in this. Hey not I don't have the cooties. It's not mine. It's a middle school playground reaction. And when you combine that with how easy it is to just blame somebody it's someone else's fault and that we've I think socialized ourselves through how media in general let alone the subcomponent of media that social media has grown up around us.
15:21
Too self-indulgent to that appeal. It's not me. It's somebody else's fault. Somebody's my enemy can't land here. And then it's a combination of misguided aggression and sticking our heads in the sand and then look where this leads us. I mean this scenario that you cited shouldn't have to be science fiction. We should be able to collaborate in ways that recognize common threats to us, but we don't do that. We so quickly devolved.
15:51
Into the first part of what we were talking about, which is I feel insecure. I feel vulnerable. Are you my enemy and I certainly don't want you to think that there's something wrong with me. Maybe you'll think I'm your enemy and then we all put our heads in the sand and look what happens down the road. It's so clear how preventable this was. And also how inevitable it was given that we did not set the groundwork in place to
16:21
Prevent something like this.
16:23
So you've been very busy obviously in the last month you're as busy as I am. If not more busy generally, but my guess is that the people you help have found themselves relying on you perhaps even more than normal. Is that a fair assumption
16:40
in some ways. I mean, it's been interesting that has been the case for some people for other people. There is some sense of safety in sort of Hunker.
16:51
Down at home and that idea of circling the wagons. So it's interesting how much it has really dichotomized in that way. And also what I'm not seeing nearly as much of our the people who were so at-risk socioeconomically before this a lot of what I do bifurcates, you know, I'm the medical director at a place that a provides drug and alcohol treatment for most
17:21
Mostly ninja population that's part of the work. I do and other part tends to be with people with more resources. I'm not seeing is the gigantic and I mean gigantic swath of most of the country that were on a socio-economic precipice before this. So they're not only do they have the medical risk, the fears that I do think are pervasive and are perhaps temporarily soothe by holding up at home, but they're not soothed
17:51
By holding up at home. If you don't know what you're coming out to we've known for a long time that the specific numbers vary by study. But but the idea that like half the population in this country couldn't survive and move forward from $500 unexpected cost or 500 dollar shortfall. So on the one hand we've talked about look how great the economy is doing because employment rates are high, but so many people are living
18:21
Being either in desperation or one step away from desperation. And I think what we are doing is yes, a lot of people are traumatized absolutely but that gigantic swath of the population that is most of us are traumatized disproportionately because they don't know what they're emerging to because we've set up a system that is essentially made that inevitable mean. How long was it going to be if half or more of the population?
18:51
She can't survive through a $500 need or five hundred dollar shortfall. Something is going to trigger that and it's not a surprise that something triggers it on math. And I think that's where this is a gigantic medical problem. It is a social problem. It is an economic problem. When you add those things together those things synergize and it becomes a societally threatening medical socio-economic problem.
19:21
And we haven't had that
19:22
before.
19:24
So let's take both extremes of the types of patients that you're most working with most commonly working with in the first group. You said is the Indigent population who you're helping with substance abuse presumably many other medical and psychiatric problems that accompany those. How is that population doing in the presence of what's happened in the past four to six weeks
19:48
and it's a desperation on top of desperation.
19:52
Which is obviously not a good thing. It's a element of the population that I mean, I think in large part we've left behind because I see the world through the lens of trauma. I see part of my reason for existing and fighting the shame that's created by trauma, but there are ways in which shame is called for and I think as a society there are things that we really should feel ashamed of the ways. We don't give people chances to get back on their feet and then we have a
20:22
Populist that's the disease show much desperation in that part of the population that yes, this makes things worse, but it's not a change in how a lot of people in that situation or living day-to-day life. And I think that's lamentable
20:37
which is a sad statement.
20:38
Yeah. It's a terrible thing to say, but that's even in the 20 years or so that I've been doing this right which is it's not a gigantic amount of time. It's not a small amount of time but the change has been dramatic where
20:52
there is a part of the population that we just leave behind they need more resources than were willing to put towards them. So we check a few boxes and we say we're doing things that were not really doing as a society and we've written people off on mass now that is not true of everyone and there are people who of course work so hard and so selflessly to help other people but as a society we sort of decided that it's okay if you can't navigate complex.
21:22
Systems or if a couple of bad things happen either things happen to you you make bad choices that as a society. I don't think it's subtle that we've written people off that way
21:34
and then what about the patient population you take care of for whom the economic stress of this is not nearly as it is for perhaps the majority of people but who still have their own demons their own neuroses their own stress is what are you seeing that is unique to this environment.
21:52
Isn't that is maybe either similar to or even distinct from other things that you have been in the capacity of being a therapist for example, during the economic catastrophe of 2008-2009 again post 9/11, you know any other sort of external stress or how does this Stack Up and what is it that you see that's maybe unique about
22:17
it.
22:19
I think I've never seen something that is supercharged has this idea that if I fear enough, then I'll be safe which I believe is an impact of the insecurity that many many people. If not most certainly most people I encounter I believe feel so feel about the world.
22:44
This idea that our biological drive to recognize threats so that we can stay alive and pass on our genes has in so many people mutated to where it were essentially living in a state of constant hyper-vigilant discomfort. There's always something else to do. It's never enough for us to be safe and secure and I think the societies always telling us that the news has mutated from providing news.
23:14
To grasping people's attention grabbing people's attention in a way that says look at that news again because you're going to see something else bad all the anecdotes of he got up at nine and felt healthy and by noon was in the Intensive Care Unit, right? It's like we know this we don't need to be assailed every moment by every threat to us and we have become prisoners of the insecurities that we have generated and I think
23:44
that comes through these biological drives that have led us to a place that is no longer keeping us safe. And and if you think of the biological drives and psychological drives to to increase our safety by participating in Social systems and economic systems, and a lot of that has mutated into strivings that make no individual sense within systems that make no group sense. So people that are working and working and putting money away for retirement.
24:14
Fireman, but the vehicles that they're in aren't safe Vehicles anymore. We've created so much insecurity that it affects people even who they have enough economic means but still have this pervasive feeling that there's always always always something to fear and then this idea that if I fear enough, I'll be safe then starts to spiral out of control and people get obsessive and people get ruminative the same the negative.
24:44
Thoughts go over and over and over what if something happened to my kids and and like, okay, what if we all get sick or well what if we don't get sick but there's a terrorist attack or what if what if what if what if and become so pervasive that what's fascinating to me is that I don't see peace in any demographic does it matter if people have tremendous amounts of money. We have no money. I just don't see peace anywhere and I think I am trying to scientifically ascertain for it, right?
25:14
I mean, I'm trying to listen to people talk to people learn what's going on inside of them and said what is uniting us is this pervasive in security and then these parts of our brain that want to keep us safe go into overdrive and inadvertently make us feel so much more vulnerable. What do
25:34
you think is actually happening from a neurobiology standpoint. I mean, we're now over a month into our quarantine here and spoken about this on the podcast before
25:44
For pretty fortunate there are people who are quarantining inside tiny apartments and they don't have the luxury of being able to go outside and their yard and things like that. So I want to be clear that I'm not for a second lamenting the quarantine I'm in because I feel really really lucky but I can't for the life of me understand the degree of irritability that I've experienced over the past month and I've done a little bit of a better job in the past few weeks at least not lashing out, but there's no denying internally a
26:14
Link that I have that is well frankly. I don't know how to explain it. I'll tell you because I mean it's so frequent. I can tell you how I felt this morning. So this morning I was I was exercising. So I'm lucky to have a gym at home so I can exercise so and again intellectually, it's not lost on me. What a privilege like, I think of all the people who can't go to the gym now and their best thing they can do is push ups and sit ups in their apartment. So intellectually I get that right.
26:42
But I'm sitting there thinking I don't really feel like doing this and frankly if this quarantine ended tomorrow, I don't feel like going anywhere. There's this weird feeling of I don't know what I want but I don't want this. I have a lack of interest in anything. But of course, I'm as busy as I've ever been. So there's this very difficult feeling of every minute. I'm moving. I'm hustling. I mean even my exercises scheduled and
27:12
In calls in this thing everything but if you told me hey, I could wave a magic wand and make the coronavirus go away tomorrow and everything will be back to normal. I didn't even have a sense of Joy over that I was just like, okay. Well, what would I do? I don't know how to describe this Paul. It's a I'm sure there's a word for this sort of overall just lack of interest in life. Maybe that's too broad a way to explain it. But it's this really weird oscillating feeling of sort of sadness and irritability and
27:42
almost wishing I could just Escape something but not sure what I want to escape does any of that make
27:46
sense. Absolutely and I am finding their more people who are escaping through say drugs and alcohol and other really unhealthy things through that sense of desperation. And I think what you are describing is demoralization and you tell me if this resonates with you and I haven't talked about this before so you tell me if this resonates that that I think somewhere in there is a
28:12
Sense of futility that says if you look on two different levels run on a personal level, you've worked very very hard to better yourself a better your situation in the world take care of your family and there's something that speaks to okay this roof over our heads and we're sheltered here, but have I succeeded in doing that? You're have those efforts been futile because I can't protect the people around me. I can't make things. Okay that my personal efforts to make life.
28:42
I'm okay. I've come to not let me know I've seen that saying these things are true. But this is what goes on inside of us because you feel that okay, you can shelter everybody for now. But what does it say about the world around us? And what does it say about the next threat that maybe you won't be able to shelter from that's one aspect of how we become demoralized the idea that hey no matter what you do and how hard you work. You can't make a difference you can be vulnerable anyway, and I think it brings that home to a lot of us because I think
29:12
I'm not saying that we should be demoralized but I'm saying I believe there's truth to that because I think the world around us the world around us leads to that the everything as it should be says the world is such that we're not safe on the other hand. There are things that you've done on a broader level that are about trying to contribute to the world in a bigger way around you. I
29:36
think what you said is incredibly spot-on and of course that's part of what makes you who you are is your
29:42
Ability to sort of see things I would never see. I've never thought of this as being demoralized but I think you're absolutely right. And I think you're right that I'm not alone. I suspect people in 2008-2009 were demoralized for a different reason which is if you're that person who did everything right and found themselves on the wrong side of a mortgage because the value of their home Came Crashing Down and they were not sophisticated enough to know that hey,
30:12
These types of loans have these hard nasty resets on interest rates, etc. Etc. You could very easily say hey I did everything right and look what happened, right? And now I think you're seeing that same thing all over again, but with far less economic stratification the economic stratification plays probably a broader role in your resilience to this, but it probably doesn't play.
30:42
As much of a role in what you just described which is whether you're the wealthiest person in the world or the least wealthy person in the world. There's still sort of a view that you should live in a world where you have some ability to control your health. If you do the right thing, if you take care of yourself, if you eat sleep correctly exercise correctly like you shouldn't be afraid for your life and I'm not saying that that fear is rational by the way because as
31:12
We've discussed the majority of healthy people who get this virus are going to be totally fine. But there is a degree of fear that says that that might not be true.
31:23
I think that's right. And that's where I'm sort of fond of saying it's the soup that we're all swimming in and I think that's the commonality wealth status social standing like those things don't matter when we're swimming around in the same soup, and neither you nor I we're not Political Animals and we don't have political discussions.
31:42
In that way and this isn't about politics. I mean, I'm a believer that many things in the world are driven by strong individual people good bad or otherwise, but I do believe that that's not always the case. There are cases when social forces evolve and then they produce something that's going to be a certain way regardless of the specifics about so this isn't republican-democrat like it's so far from that but the idea
32:12
At the importance of expertise actually has become less and less and less and less important because everybody can have an opinion and can just yell that opinion louder and then what we get is it Roshan of expertise? We're just in so much matter any what does somebody know or not know because Well, everybody's got an opinion and I think we've seen that evolved and my thesis is that the inevitable outcome where the basics that we think of about this.
32:42
State around us the government right keeping us safe. That just isn't true. And we do expect that. We live in this Society we participate in we vote we pay taxes like I expected if I'm driving down the highway there's not going to be like 20 foot long hole that's 20-foot deep that my car Falls in and I expect that's not going to happen. But that's not the only expectations. We have we expect that. There's something going on that's providing us with some
33:12
Sense of protection that there's some Force to the world around us that everything isn't just based upon opinions and opinions have been justify whatever the person expressing them wants to justify and I think what we're seeing here is a truly that the emperor has no clothes and again, I'm not speaking. This is not me trying to be political about the president. I mean like the emperor of the society we live in it's not adorned with the
33:42
That we think will protect us. There's a truth here that there can be hurricanes that devastate individual places and people don't come to help. I mean some people go to help but not in a way that says look let's make sure that this doesn't evolve into complete lawlessness like we've been able to pull that off in focal settings. How are we going to pull that off on a national setting where there has to be a cumin and resolved to decide what tests should we deploy to?
34:12
Have the willpower to deploy. I mean, it's not that long ago where people were still saying. Oh some person somewhere in this place had the coronavirus. Oh my gosh. Oh my gosh, when we look at that person had it. We now know this pay half a million people who have it. There's a seduction of like, let's look at that person and look at that bad thing and then we can posit that were other than that and to say that that never made any sense that never made any sense that example you gave where everybody's cooperating.
34:42
Would identify who's been exposed know who those people are test? Those people protect their contacts? We could have done so much better containment but instead the really hasn't been that much going on to protect us and I think this lays that bear in the way that the hurricane showed us in a focal way, but it's not just about health. I think it's about socio-economic
35:06
risk Paul or shift gears for a minute and talk a little bit about health care workers. I don't know how much
35:12
Time you've spent thinking about that in this setting but do you have any thoughts about sort of a lingering effects of this on that population which has a couple of things working against it one there on the front line. So well people like you and I have the luxury of working remotely with people we care about during a time like this. They don't the doctors and nurses that take care of these patients don't get
35:42
Do so remotely so now they're at this increase physical risk, and there's still some evidence to suggest that the risk that they face is even greater just based on potentially the viral loads, they're encountering and things like that. So this is real risk. Secondly, you have the sort've the morale insult that comes with seeing their own colleagues also become patients, so when they start to have to care for each other
36:12
Do you have any thoughts about sort of the PTSD that comes to this population in the months that follow this or potentially even longer?
36:21
I think it's going to be so pervasive. I think the trauma is going to be pervasive and even generational. I think that family members children of people in that situation will be affected by it and potentially deeply affected by it going forward. I think we are.
36:42
A scene V. What I think of as the appalling consequences of compounded ignorance mean look at what we have done in our health system like you and I have both been in it in a whole bunch of different ways. And I think people in it can see how little it makes sense that we're trying to run our healthcare system in a way that is to pushing people to the limits and extracting profit and reducing
37:12
us wherever possible and then ultimately everything is running in a way that stretches people to the Limit stretches people to the Limit and how much have we seen of that in any one doctors nurses social workers the respiratory therapist. I mean everybody is pushed to the limit in systems that have innocence abdicated their intelligence their not being run with intelligence to being
37:42
By rules that no one is looking at whether they make sense or whether they keep people safe or whether they make the people who are doing the work in that system feels so disempowered and so devalued how many times have we heard? I mean, you must be getting here. This is the way I do have health care workers. Just talk about the feeling of their own expendability the working in a system that doesn't know them care about them value them and again, I'm not trying to criticize
38:12
Were people there so many people trying to do their best, but we've allowed the systems evolved into this compounded ignorance where we can't take care of the people who are supposed to take care of us and they know that and they've known that for a long time and they're seeing it come to the Forefront.
38:33
So what's a path forward either in the scenario where this just lingers on longer than any of us would like to imagine
38:42
Or where it becomes sort of a vacillating ebbing and flowing pandemic or even under the scenario where look six months from now, everything is back to normal. This virus is squarely in the rearview mirror. We have effective treatments and Healthcare System is back on its feet in either situation. How would you think about managing the long-term toxicity of this?
39:12
This because especially if it's sort of smoldering but not resolved. I mean that from a psychological trauma
39:18
perspective. I think the first thing we have to do which is by no means a given is acknowledge the trauma when a person has been through trauma, there is a strong and reflexive impulse to keep that inside. We don't understand it. We feel ashamed of it. It's so threatening and we push it down and we need it to be valid.
39:42
I think we need to validate as a society that we set ourselves up for this that we set the Healthcare Systems up to be overwhelmed to not have the protection mechanisms in the testing that they needed and now we need to essentially acknowledge and a tone and I don't mean in some way that's atonement in some abstract way, but we actually need to make things different. I mean I think
40:12
Would agree and again you're the master of what data tells us. Right? I think we can look at data and see how we can and should be doing things better. There's not a tremendous mystery to that. I mean there are places that are doing it better. There are paradigms that we could utilize more that don't reduce people to cogs in a system and I think we need to number one acknowledge that to the people who have felt like just
40:42
He's in the system and you can throw away a mask. Just like the four way down just like you can throw away a person we have to get out of the interchangeability of employment in the modern world in healthcare as well. And we have to look at what are we doing with our resources and we have to make it different. So people feel like you understand me and what has happened to me and you are trying to make it better the you being all of us as a society. If we don't do that just like with any other trauma if
41:12
no one acknowledges it and there's nothing being done to try and make it better. Then it will stay with that person in fester and will lead to all sorts of bad outcomes that will see years down the road. We'll look in retrospect and we'll see rises in rates of alcoholism will see rises in rates of domestic violence will see rises in rates of suicide will see rises in rates of people just giving up and walking away from important things to them like will see all of this. We will see all of this because if we demoralize the
41:42
Action and we don't Rectify that it's not going to be okay. And if somehow it seems to be in six months that will be a deceit that it will be tempting to just believe that and go on but we have to have with the courage of our convictions to know that like, that's not okay. Let's look at is it true that everything is as it should be meaning we let ourselves here. If it's not let's argue about that and prove that it's not if it is, let's look at it and change it and I think it involves people standing up and saying
42:12
Saying look this needs to change their needs to be not. How do we make the system's better? How do we fine-tune this or that or give this to this population that really suffered no know is how do we acknowledge the need for Change? And that's the hardest thing to do is not that we're going to make systems better. We're going to look at systems and we're going to bring change to
42:31
them. What does that look like? I mean, I understand what you're saying in the abstract. I don't think I understand what it means. I don't think I know what that
42:42
It's like five years from now when this is long forgotten. How does this Society from a mental health perspective. Look if they are going to be resilient to the next pandemic. So if there's a SARS Covey 3 that's coming in 2030. What does a national psyche what this the mental health of a population need to look like the year before that hits to do a better job than we might be doing today and to do maybe the best job that can be done given the
43:12
um stances what has to be true of that population.
43:15
I think what we need is what I would call an alliance of common sense and I was talking about this earlier this morning with our friend and colleague Jim coach Alka about the ideas of how would one how would we work towards an alliance of Common Sense where people would say I can't pretend that something is okay just because it suits my
43:42
Interests, even if I know it is false. I have to first prioritize looking at truth. And can we the people who would do this which ideally could be a growing movement led by people with influence and with the ability to say we have to put aside whatever our wishes might be whatever our animosities might be that we actually do have to treat this like post 9/11 or like the second world war and say what we need to look at.
44:12
Now is truth. What are the failings in our public health system as a planet and also as a nation they stretch people to the Limit. They stretch resources to the limit. When do we pretend that lies or truth? And how can we say that? That's okay Republican Democrat or other who cares and again this gets contentious because as soon as you get political and you can't talk about change
44:42
Without treading into the political then there's such bitter and brutal animosity that it tells all of us being part of me. I want to have this conversation because I care about the world even if I didn't have children I would care about the world. I hope but the fact that I have children as I want to have this conversation, but there's a part of me that says hey put your head down and go back home because ultimately whatever you say is going to make some people really really angry and
45:12
People get angry and bitter and vindictive. What we need is something that fights against that that says we are going to alai around truth in our medical system in our social systems in our economic systems. We have to look at this and if people start a lying in that way, then we have all the expertise that we need medically social systems public health economically whether its economic on a
45:42
Galore on an international Commerce system. We absolutely have every single bit of expertise. We need what we do not have is an alliance of common sense of people who say I will stand by that come hell or high water. I will not give him 2 lies. I will stand by that then we can start making the world better if half the population can't survive a 500 dollar shortfall. I am not going to pretend that the economy is, okay.
46:12
Or that our social systems are okay, or if they Health Care choices that people are facing or too complicated for them to understand and then people ultimately don't get the care that they need they show up in emergency rooms for their Primary Care demoralizing the emergency room staff that wants to take care of people who have emergencies like there's so many thousands and thousands of examples and we just need people to say it's
46:32
enough. Do you think that this event is potentially a catalyst for changing the way people think about
46:42
Science and truth and again, I use those two in the same sentence because when you take a step back and think about what the truth means I think we have to differentiate between personal truths and absolute truths. I think it's true that formula one is amazing. But I also recognize that that's a personal truth. It's shared by you but it's not necessarily shared by everybody else and that's
47:07
okay you and I believe it that doesn't make it true.
47:12
I believe Ayrton Senna is the greatest Formula One driver of all time again, I think that verges on being an absolute truth, but leave it in the category of a personal truth. Yes, but when you start to get into things that are absolute truths, that's really where science comes in science is a tool kit that allows us to test hypotheses. It's a methodology that allows us to examine absolute truths. And do you think there's a chance?
47:42
That what we're seeing here could ever be a catalyst for allowing that distinction to be made in broader Society because I it's not clear to me that it does. I think that for for the majority of society there's a blurred line between absolute truth and personal truth or relative truth
48:02
Peter. I think you're striking to the heart of the matter because absolute truth operates through logic systems in our brain.
48:12
Rain, and we ultimately this does relate to brain biology.
48:17
Absolute truth resonates with logical systems in our brain relative truth personal truth resonates with emotional. It was got effectively limbic systems in our brain when we engage effectively in the world around us. And again, I've a thesis that says we as a society are not engaging effectively because we have lost the distinction between those two that lets us.
48:46
Make the personal Truth secondary to the absolute truth. So the idea is there's a strong resonance if I feel something to be true. I mean there are social issues. I feel very strongly about that resonates with me emotionally. Why because I'm a human being and says because I believe that that makes it true. That's my belief. So it's how I want it to be so that's true. But then there are the other systems in my brain say there are absolutes that I want.
49:16
Hold up and against that and I want to have those absolutes govern my own personal feelings. So I may feel just as rabidly that for me. The one is the greatest sport ever. I want everybody to believe that and if I let my emotion run away with me, where do I end up I end up thinking everybody who doesn't believe that is an idiot as opposed to saying look, I feel that way. But hey, look at all these other sports and they're people who really love those other sports and they see the excitement.
49:46
And the personal strivings that I see in Formula 1. So the reflex in US is to elevate the personal truth the emotional to Supremacy and we need to overcome that so that logic wins the day because logic is not charged the way that emotion is and I think media social media. I mean, this is the heart of the matter. I have made it very easy to elevate personal truths you believe a I believe be instead of having a conversation about it, isn't it? Just easier and
50:16
In some ways doesn't it feel better for a nice to say the other ones an idiot? And that's that were indulging that in a way that then starts making logic subservient that makes the absolute truth subservient to the emotion. So the personal truths and if you look at how change happens the concept of a dialectic where you have something and you have something different from it, right? You have two different things and they become something that's different from both of them. I think is where we're at. This is
50:46
NG to be a catalyst to something and the something on the other side of it I strongly believe is going to look differently than what it looks like now if it's not after this and things seem to be back to normal this will just be one of steps that lead us to things being different and one way things could be different is that absolute truths really do go out the window we very much come back to superstitions and we're really kind of not that far away from it now and we could
51:16
Very very easily get there or this will be a catalyst for us writing ourselves and saying look we must prioritize logic whether I like what it says or not and there I think how do we make the Catalyst the resolution of that dialectical one way and not the other is we need people to make this I'm just calling is no magic to the words. But an alliance of common sense that says hey,
51:46
Hey, if you think a or you feel a and I feel be that's a weird of you feel a and I feel be that instead of immediately being at each other's throats. Let's stop and look at the facts. Let's stop and look at logic. Otherwise, I mean how far I get I'm not trying to be overly dramatic. But look when the Khmer Rouge took control in Cambodia, right? One thing they did away with was doctors, right? It is very easy to boil. You put one person's blood into another we can teach people to do that. Okay.
52:16
What about blood types? You have any doctors or science or hospitals? And then they just started randomly transfusing people and either making hemorrhages or putting one type of blood into another. I mean that was an utter human catastrophe there, but their widths of that going on now who cares what the science says about hydroxychloroquine try it. I mean, this is emblematic of us leading ourselves away from logic. I don't see how we're not heading towards destruction. Like they everything is as it should.
52:46
Should be tells me that we can't let that happen because that ends of Destruction there's nowhere else it ends. So we need this Alliance of common sense of people who will stand up and say if I disagree with you because I feel differently. I'm going to look at the logic and for logic tells me that what you're saying is right what I'm saying is wrong then damn it. I'm gonna I'm gonna go forward with your way of seeing get no matter how I feel we need more of that.
53:10
I mean, do you worry Paul that we have spent such a
53:14
Scant period of our evolutionary history with any formal language around logic and science. I mean for all intents and purposes. It's about one-tenth of 1% of our evolutionary history has operated with even the nomenclature of science the skill set in the tools for logical thought the reason that I think religions exist in the reason that mythology exists and superstitions exist is they became ways.
53:44
To explain things prior to a nomenclature that could describe things the sun went up on this side and the sun went down on that side. And before you understand that the Earth is spinning around the Sun you have to concoct another explanation. And so we're not hardwired to think critically our limbic system has literally billions of years of repetition and maybe not our limbic system exclusively, but
54:14
Say from amygdala up, right in other words the most primitive part of our brains have billions of reps in them. And as you point out the brain stem the amygdala the limbic system are generally driving us. Now when in reality this would be the time to have higher cortical functioning take over but that is such a recent recent development. Not just evolutionarily where maybe for the past fifty thousand years. We've had those structures of our brain and I could be off by some magnitude there.
54:44
Directionally but really only about 500 years in terms of formal structure of scientific methodology. Is this just not even a fair fight. I mean we're sitting here having this philosophical discussion about logic, but I mean in times like this when we recede to our lowest common denominator how in the world can we expect those systems of logic and science to Prevail?
55:08
So on the one hand you speaking to a very powerful truth, which is we are
55:14
Driven to be driven by the limbic system by emotion. It is always held the upper hand so it's not a fair fight, but it's a fight we can win. You know what I mean? The odds may be stacked against us, but we can win that fight as evidenced by the fact that we have evolved in a way that the scientific method was became understood and then we learned. Oh, wait a second the Earth does revolve around the sun we can fight that just because the odds are against us because we're swimming against a strong current does it mean that we can't
55:44
right preparation and cooperation successfully swim against that current what has happened and I think my amateur read of the sociological data is that what has happened is our ability to unleash emotion has way outpaced our ability to sort of for our logical processes to keep up with that the explosion of social media of people being able to communicate with one another
56:14
Other so rapidly about what they feel are control mechanisms haven't kept up with that. I mean the fact that the lead physician in charge of fighting this virus has to have bodyguards, correct, right? I mean it whether he does or weather's been talked about I get I don't know it's part of this anger that that person said something I don't like so Stone him right? I mean these emotional responses are in us and what we need to do is like be adults.
56:44
Not be children. We're being children and we need to be adults and we need to say look, we need to hone our control mechanisms. But what we're not doing is saying we can't have systems around us that propagate just how someone feels about something and then Stokes the emotion of everyone else who feels the same way. I don't like this that person is bad. I like this political opinion. I don't like whatever it is. I don't like that spreads like wildfire I think in a way, I don't know if it's happened.
57:14
Dance or not, but I think the wildfires that are plaguing Us in California and Australia, right? It's these are far-flung events that I think mirror the wildfires of emotion that go on and it doesn't matter. What's true people's emotion runs wild and what we need to do is to step up to the plate and develop greater control mechanisms and look at how do we stop misinformation? Well, how do we establish sources that are Arbiters of Truth outside of politics that are arms what's actually true
57:44
And we don't have that we need more of the things that aren't sexy and aren't glamorous. Otherwise this emotion you're talking about is running wildly ahead of us and it's going to metaphorically make wild fire that consumes us and I don't think that's catastrophizing
58:02
do you think part of it is we're also not very well equipped genetically to understand uncertainty. So in what we're talking about of sort of absolute truth.
58:14
With versus personal truth, there's another layer of complexity. So if the personal truth is that formula one is the most exciting thing on the face of the earth. I think most people if they're being intellectually honest can come to an understanding that that's a personal truth no matter how strongly one feels about it. But let's use the example. You've brought up the example of hydroxychloroquine as a potential treatment for this to say that hydroxychloroquine is in a
58:44
Active treatment for covid-19 doesn't really fit in either of those categories. It depends on how its expressed. It could be expressed as hey. It's my opinion that looking at the scant data to date the risk of this is lower than a certain threshold which deems it an effective treatment in someone whose risk is high enough that level of nuance to
59:14
something kind of straddles both personal and absolute truth. Another example is climate change part of this struggle with climate changes. Nobody can really talk about it in terms of probabilities in with error bars. And so you basically get polarized arguments that both sort of have their own flaws. So on the one hand you have people that just completely deny it or if they don't deny climate change. They're sort of adamant that man can play no role in
59:45
And on the other end of the spectrum you have these extreme hyperbolic estimates that might represent a scenario but not necessarily the most likely scenario or not necessarily a complete picture of the plausible scenarios. In other words. Again, it comes down to uncertainty and probabilities and I think that something like this this experience that we're dealing with makes it very complicated.
1:00:14
For our little plebeian brains our little reptile brains to deal with and I'm struggling with it and I'm someone who understands probability and I understand logic and I understand science, but I have to be honest with you. I am tired of saying I don't know and yet it is the only answer. I have to give a hundred times a day. I get asked a question and it can be my daughter saying Dad. When do we get to go out and have dinner and it can be one of my patients and
1:00:44
He was asking me let me ask you your opinion Peter. What do you think is going to be happening in six months. And again, all I can say is I don't know. I can give you five different scenarios of maybe this may be this may be this may be this but there is no absolute truth that I can offer that person so I could give a personal truth, which is this is my opinion but science rarely proves anything. It's not like mathematics right in mathematics.
1:01:14
We have
1:01:14
proofs
1:01:16
but in science, we just have high degrees of certainty. And again, I just I worry that this introduces a new layer of complexity to a discussion that already makes it impossible to sort of cope with a lot of signal of a reasonable amount of signal an extraordinary amount of noise and then a supercharged emotional swamp that dilutes an amplifier.
1:01:44
Wrong things if that makes sense. I'm rambling a little bit. I think my point is I'm generally pessimistic Paul I guess is my
1:01:50
point. Yes, Peter, of course. I don't know for sure, but I see it.
1:01:57
Maybe in a more simplistic way. I don't think there's another level on top of it because I think that I don't know is actually a beautiful answer. If you don't know what do we really know I said we know so little that admitting that we don't know in genders humility. It engenders the humility that makes us careful. I don't know if a pandemic is coming. Let's look look.
1:02:27
I have some preparedness to it. I don't know if this is helpful or not. Let's learn more about there's a caution that then leads to Alliance. I mean we started early on talking about how can people countries Nations to a lie. It's through a sense of humility that you know what I don't know and I'm not ashamed of not knowing I mean think about in medical school, I think part of the myths of medical education right is that you never say you don't know. I think it's the worst thing ever.
1:02:57
/ I think why would you ever say, you know when you don't know and we're talking about somebody's Health. There's a humility in I don't know that leads to collaboration that pushes against aggression. It pushes against that Middle School playground of all, I don't know and now I'm ashamed and it leads towards progress. The other side of that coin is what I see is the hubris that leads people to just declare that they know.
1:03:27
His recklessness to that right? I mean, I think we're a society of angry frustrated people and we're getting angrier unique. We're not going to come out of this with more of that. I mean people are ready. We feeling insecure traumatized by the systems that we live in the insecure about where my health care is coming from or people's fear of that five hundred dollars. It's going to sink them. We're not going to come out of this angrier and the anger is what fuels the emotion and then it's the
1:03:57
emotion that then falls into the political Spectrum. So if that's the case then whether you agree with something or not. It becomes a mechanism of Your Allegiance. We start to look more like systems that say doesn't matter. What's right or wrong you agree with me because if not, you're bad and we're doing that all the time. Why is the efficacy of hydroxychloroquine a politically charged question? That's insurmountable that we need to make it not a
1:04:27
Typically charge question. There are political issues taxation rates social equality value systems were deploying there are lots and lots of political questions. But because we are so angry and I think so traumatized in Desperate is a population. We make everything a political question and then that adds to that emotion side of things. I think it is just the real truth versus personal truth logic versus emotion it is that but it's become so convoluted because the
1:04:57
Ocean is so high and it gets attached to things as vehicles for that emotion. And that's what we have to work against that's where the have Alliance of Common Sense would say that we have to not be children. We have to be adults and we have to look at what is it that I don't know and if they're 20 questions and I don't know the answer to any of them. Well at a minimum, I hope that that engenders humility in me and ability to work together with other people and listen to their opinions. Even if I
1:05:27
A say if I have a strong personal opinion about 15 of those questions, but actually there's no logic to know any of the twenty of them. Can I find it in myself to have the humility to admit that and to say that and to say that to you and know that you're okay with that you're not going to humiliate me for it then embarrass me for it, right? That's what people are afraid of. Did you have to know because you have to fight with what you're going to say, you know, we need to stop that and we don't have to be Outlook. I'm pessimistic to but that doesn't mean that I feel hope.
1:05:57
Because I am pessimistic but not nihilistic because I think the wake-up call what this can catalyze is people who are trying to do good things but may be hesitant to step into what seems like a political Arena. I don't mean run for office right? I'm just saying that truth personal Truth Versus real truth just has to stand aside from politics and our economic system our social system. These are systems tied in politics and we have to look at the truth of those systems.
1:06:27
They are not serving us. Well, we have to separate ourselves our trauma in our anger and our shame and our frustration from what is logical truth or not. And I think again, I think you and I between us is what I was talking to Jim about this morning. There are enough people who could step up to this plate, but boy, it's a thing people are least inclined to do because it's a thing that draws the most flak and the most personal animosity.
1:06:55
I want to shift back from the macro to the micro.
1:06:57
Micro now you and I have spent a lot of time over the years talking about something that I think you're better at than I am but I think we both struggle with what has been your recipe in the past month for self-care. I don't know how you do what you do. I mean I think and I don't just mean you. I mean people like you right people whose job it is to take on sort of the burden of other people's pain and suffering and then to be able to do it in a manner. That's
1:07:27
Detached but rather to be fully involved and invested in whatever crisis whatever struggle whatever turmoil that person exists and how you then manage to buffer yourself from that without being detached take care of yourself so that you can continue to take care of people take care of your family again you and I have had endless discussions on the types of things that one can do here. I just wonder if there's something that you can teach listeners about how you've done that and what can
1:07:57
can somebody take away from this when they're feeling going back to where we were while I go back to that feeling of sort of low and morale just I forget how you describe it if the way you do you very aptly describe how I was sort of feeling demoralized, right? Yeah demoralizing thing is the word use. Yeah. So let's assume that this quarantine is going to continue in the weeks and even months that follow and people are going to be in their routines that are full of
1:08:27
Stresses and stress or is that they might normally be able to escape from and they don't have the luxury of picking up the phone and speaking with you or Jim or some of the other amazing people out there who are really just sort of a godsend to folks who have access to you. Is there something that they can do to ease the suffering and I mean the suffering in their mind which is of course the worst kind I
1:08:55
think.
1:08:57
I think the answer to that is finding ones way to the lowest common denominator of what matters and I think if people are experiencing a truth now that they're say with their family the realization that that is what matters the most now and it's also what's going to matter the most tomorrow and I'd rather be with my family in a lean-to out in middle of
1:09:26
Nowhere, then any luxurious living situation alone and part of that realization that I think I can sustain that if everything else went away. I could probably I don't know put some sticks together. Give us some shelter right? Like it gives me a feeling that what matters is Karen concern.
1:09:47
Between people being with the people we care about and look I'm hearing that from people to I'm hearing a lot about the silver lining of this which is more time with family. I talk to now almost nobody who say purchased anything in the last month other than Necessities. I don't care so much that I think matter matters doesn't matter and look I'm not advocating. Like I'm not a Luddite to raising. Let's go back to just living like we did a thousand years ago.
1:10:17
A hundred years ago or whatever but it is Meaningful to realize that the things I care about most are actually more immediately accessible to me in the moment. And I think that's still going to be the case tomorrow. Hopefully everyone staying safe and we're trying to ensure that that's what most matters and it's a good place to start from I think it engenders practicality. It engenders humility. It engenders a sense that everything is okay. I've sat at home with my family.
1:10:47
For a period of time I wouldn't have before and I have a very strong sense that everything is okay sit around with my families of a six-year-old in a two-year-old and we blew up six balloons and we're just throwing these balloons between the two of us. I mean and we're happy right and I think we need more of that because it works against the trauma. There's a realness and the connectedness to that that works against the trauma. Now look I think we need to change the social systems where we are not going to change the trauma and things are not going.
1:11:17
Okay, if I might answer your question not saying how do we fix this on an individual level of people in their homes? I think the answer is we don't but how do we feel better? How do we let ourselves find some peace? I think that is the answer. My daughter is turning six this coming weekend said to me she said Daddy with you at home more. It's like spring has come but inside of me and my thought was oh I'm not sure what else really matters and that doesn't mean I don't want to go to work and do my
1:11:47
My job, but when I'm talking with people on the phone, I'm looking more through that lens of what else really matters to that person that I'm talking to then the people that they love and I think we need more of that. We need to fix our social systems, but we need more of that and that's something that each of us can do at home. Right because it's really our interpretation of things are things not okay, because I don't know what's going to be like when it boots back up. That's true too. I don't have to live in that every moment and I can live in more time with my kids. That's real and that's
1:12:17
Tangible and that's going to mean something to me this evening and tomorrow and that can be real for everybody and people who don't get to be with people that they love and that love them. So thinking how do we make more of that in our life the idea that we all need love and we need things that are generative that make where there wasn't before does not just have to apply to Human Relationships. It can apply to nurturing a path or nurturing a garden to making a poem where there wasn't before like like it's kind of strange but our needs are not that complicated, but I'll
1:12:47
A damned if they aren't hard to meet in the system that we've set up around us. We need to change it. We need to change the systems but part of how we change his systems is to change how we're looking at them as individual people. What am I valuing?
1:13:01
So if I'm hearing what you're saying, it sounds like you think that this sort of attachment to others or connection to others is sort of an antidote to this
1:13:11
trauma put more broadly. I think the attachment to things that are meaningful.
1:13:16
Yeah. Yeah. Sorry not to
1:13:17
Yeah, that meaning to other people in relationships that matter to our kids to our friends to our
1:13:23
spouses.
1:13:25
Right, right, right because City but not for all the money success Prestige World Mastery. I mean if you could have all of it, I mean you wouldn't sacrifice the ability to be with one of your children like that stuff matters the most to us and it's also where we generate our own meaning. That's where I don't feel demoralized. That's where I don't feel demoralized because I know that I'm have meaning to people and people have meaning to me and then I can
1:13:54
Within Myself the strength to put one foot in front of the other keep doing what needs to be done even though I sure do feel demoralized often. We mean the reason why I think I can project and guess how you were feeling is because I want you and I know each other very very well and I'm feeling the same way that you are as whatever I contributed to the world made a difference or whatever I've done for myself and my family made a difference. I mean the answers to those questions are yes, but we feel that they're know when we're confronted with.
1:14:24
The state of the world around us and again, it just brings me back to that. Something more is called from us. I mean, there's a little bit of a get I'm not trying to be political but when John F Kennedy said look ask not what your country can do for you, but what you can do for your country and yes, he was speaking about difficult things. He wasn't just a do more of what you're good at doing or what's easier for you to do or even think they're hard for you to do, but you may need to do some things that are very very difficult to you. See
1:14:52
people having a difficulty.
1:14:54
Back into the world when the quarantines lift. Do you see lingering fears? I mean fears literally of infection recurrence of pandemic other forms of phobias that might not even seem logical or rational. I mean do we have any insight into what people do after quarantines and what their psyches are left with
1:15:18
this idea that if I am more afraid I will be safer is going to
1:15:24
Precedence we're going to see more anxiety more obsessiveness more Panic more agoraphobia right fear of being outside of the home. We're going to see more and more of that and we're going to see more of the unhealthy coping mechanisms to that more drugs and alcohol. We're going to see more of the unintended result of that like depression and accidents. We're going to see more of all of those things because there's nothing to prove to you that you're not safe like a period of
1:15:54
Time in which you were very clearly not safe and I think if we reintegrate into the previous lies then underneath that is the knowledge that this is not okay. It wasn't okay before so if we're now back to it, it's not okay now either which is why we need to make change that ultimately yes. This is about trauma and how this pandemic is traumatizing Us and how we paved the way for the trauma of it to be so bad.
1:16:24
And we need to change that just like we need to change what traumatizes people individually if someone has been traumatized individually. Someone has been attacked in hurt and that person knows that there are people around them that care about that the care about them the care about what happened to them and that are working for change in the systems that allowed the trauma to happen in the first place. Then we help move that person towards healing.
1:16:54
Like and yes, we need to do that for individual people in their trauma treatment and we need to do that as a society. Otherwise, we will be no more successful as a society. Then we'll be the individual sufferer from trauma who is trying to deal with that trauma by pretending everything is okay, which is a natural response because we're afraid of it and were ashamed of it and we don't know how to deal with it and there aren't the systems around us to say you can come and talk about that. Then you don't have to be ashamed of it and you know what I have that too.
1:17:24
Maybe I have a different flavor from you. But I have what you have and like you and I know this I mean part of the reasons, I think we've survived our own traumas is because we have not gone through them alone. And we've had them validated and we ourselves have been validated and then we look to ways to make the world better and that's part of our demoralization that like it kind of hasn't had as much of an effect as we might have wanted to let's start doing something new about it because it does not have to be this way say rape culture.
1:17:54
Yours on college campuses, you know what doesn't have to be that way and we start making changes might Goods not that we've made the changes we need to but we start looking at that looking at what it really is and looking at the lies that said. Oh, it's all okay and people are consenting and everybody who's drinking. Is he facto giving consent? We look at those lies and we start making change and we start making less trauma and we start better being able to help the people who have suffered trauma. That is a very
1:18:24
Very real and tangible example that we are going to need to do on an individual basis, whether it's healthcare workers who are afraid to go back in the hospital or its people who are afraid to try and go find the next job or it's our society as a whole. We have to change those things. There's nothing else that makes it better
1:18:44
I think is worth pointing out for listeners you and I have known each other for 25 years were pretty much Inseparable. In fact, this is probably the longest we haven't seen each other in person because the last time we were together in person was January,
1:18:54
It's for us. That's an eternity. I think it's worth the listener knowing you and I have never once talked about politics except in the context of history. In other words you and I together we are not the type of people that sit here and wax on about current political Affairs week over a meal will sit here and discuss the Cuban Missile Crisis Ad nauseam and talk about Nixon and all these things. We love to talk about the history of politics. We're not political people and I think it's important that people who are listening to this. Don't take this, too.
1:19:24
Be a political rant everything we've talked about today seems to come down to a common theme, which is those of us who sit here in the peanut gallery who are not in a position of leadership are going to have to sort of become the movement of change. In other words. It's not enough to just sit around and pontificate about this stuff. We are going to add some point have to do something about it. We're going to have to take some sort of action. It's not going to be enough to just think about this lament this
1:19:54
Talk about this with our friends. That won't change this system everything you've talked about from this most recent example, which I think is a great one of sort of Date Rape culture on college campuses to social support network. I mean all of these things in the end come down to not just being open about what we think is right and not right but it's also taking some sort of action. It is going to come down to that and I don't know. I don't know it's funny. I didn't come into this discussion with any sense of what we
1:20:24
We were really going to talk about I just knew it was going to be something sort of interesting and not sort of the how does this drug work forces that drug work, but I don't know that I really thought about it as broadly as you've been thinking about it. It sounds to me like this experience. You've made good use of your time. You're forced Exile from The Busy travel schedule and you thought even more broadly about and deeply about some of these problems that we've thought about and talked about in the past together, but but I don't think I think you've coalesced abroad.
1:20:54
Our mission urgency around
1:20:56
this I think so Peter because I've just felt it. These are not foreign Concepts to me and these are things I have been afraid of but really seeing it play out it becomes so compelling and you talk at we're all going to have to do things for those of us in the peanut gallery. We're going to have to do things and it's not just that is we're going to have to do things that are unpalatable and that's what I've really come to realize. It's like a couple weeks ago.
1:21:24
Garbage disposal when it gets kind of clogged and and like there's a whole bunch of strategies. I have to try and fix that. I mean I put a bunch of water down and I've got a butter knife and I'm trying to do things with it. Right and like I'm doing things but ultimately what I had to do to make it better was the thing that was on palliative at the stick my hand down there and do a bunch of gross stuff and unclog something and now everything is okay. Like I have a willingness to do things and you do too and lots and lots of people do right, but we shy away from is doing the
1:21:54
It's unpalatable. And the way Society has developed. I don't think we can get around the political flavor of this right because if you want to set up like if I had my way they would be Committees of people with expertise, but would look into these different areas. But what they have to do is really unpalatable things stand against the status quo enter into areas Arenas that are politically charged enter into Minefield knowing this something unpleasant is going to happen right? I'm good.
1:22:24
I not to get myself killed doing it, but something unpleasant is going to come of it. And I think those are the things we shy away from and I have the privilege of knowing and interacting with lots and lots of people who are helping and God bless that people are helping but there's a difficult message for all of us here that says yes helping the ways that you're built to help and comfortable helping but you got to help in I'm sticking my hand in the garbage disposal way too which is why when child calls and talks about this and he starts talking about
1:22:54
Leadership in ways that come through humility that come through marshaling people to do unpleasant or unpalatable things to really look at this. It resonates with me in part because like you and I mean he and I have an ongoing dialogue about life, but because I just I can't not believe that's what's necessary. I try and do thought experiments where I come at a position. That's diametrically opposed to mine. It's different from mine. I feel differently have a different personal truth and
1:23:24
II can't but come to this conclusion which obviously does it mean that it's right, but I'm using all the due diligence I can inside of myself and I can't but come to any other
1:23:37
conclusion. Well Paul on that note. I want to thank you for this discussion today. I look forward to continuing our discussions over the coming weeks.
1:23:48
I rely on them heavily. Thank you so much as always Peter. I appreciate your trust in me and my
1:23:54
Opinions to have me on and as always I deeply appreciate your friendship. Thank you Peter.
1:24:01
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