tv Emma Goldberg Life on the Line CSPAN August 16, 2021 10:40pm-11:39pm EDT
>> good evening everybody. here at the strand before we launch into discussion i would like to share some history. found in 1927 grow gradually grew into 48 bookstores after 93 years therv strand is the sole survivor after third-generation owner. thank you for your support. without you supporting our authors we would not be here today. now we have the young on —- the latest book life on the line. writing for her health and science national gender and culture featuring backlash and
low income medical students. and the best new journalist award and for the masters from cambridge university on conversation tonight joining "the new york times" editorial board 2018 where she covers politics also msnbc political analysts to discuss national politics covering mayor de blasio first at the daily news than the wall street journal. serving as the national teachers reporter in her first job staff editor from washington dc and began her career with the michigan daily
at the university of michigan at ann arbor. and from new york city in the great outdoors without further a do what's will come and then goldberg to the stage. >> hello everybody. i am like enough to be a colleague of emma goldberg and also a dear friend. i'm so proud she is here the hometown bookstore able to talk about her book with you and i just want to dive right in because she is a star is my first time moderating anything so congratulations i'm so excited for you. can you just start by telling
us about the subject matter yours is among the first to be published anywhere about new york's first wave that was brutal some people may have a hard time reading about the pandemic so as he marched toward reopening why is it important to keep writing and talking about front-line communities and providers. >> first of all i'm so grateful to be here in conversation. your first book covering the new york city primaries. so that we could steal her away for a night also with coverage over the pandemic. because i have heard from some
people isn't it too soon with those stories that of come out over the last year? and i'm hoping the book is just a snapshot of one moment in time that is ongoing around the world. and around the us for those communities that cannot access and this is just a time capsule of the time here in new york city. and to me it was powerful to zoom in on that particular moment in time and an airy time in a frightening time. first of all the streets were
empty and the hospitals were packed. and they were normally operating like we were. and that is something can incredibly constructive and valuable.t i was grateful to be connecting with the young doctors. what about what it was like to be a reporter in the early days of the pandemic but what kind of work?
>> and i start to do some reporting and how they replied to the crisis. and what reporters were experiencing was from medical students because march and early april they were stuck at home and how they could put their skills to use. many were sent home from the hospital and then to a large extent not able to be in the hospital. that they were sure they would have that opportunity to do so.
and then a story for the times about the medical students who had the option to graduate early and dive into medical care so they just went right to the frontlines and someone around the same age as them that they were just diving right in. >> that's a great jumping off point if you have not had a chance to read the book it will not take you long. this is embarrassing for this audience but sometimes it's hard for me to get through books these days but i got through yours in no time. it was a weekend it follows a small group of medical students that the stories are extremely compelling and what is striking is these are
really young people. so it is difficult and historic. so where do you think that comes from with the junk graduates? >> one of the greatest gifts is seeing their definition. so now i will let the siren pass. conjuring the spirit. [laughter] but to see the definition and understandingee of courage was changing in real-time as they did the work they were trained to do i anticipated the greatest fear word come from what we were experiencing with
the fear of the unknown and terrifying virus. and that all of them delved into the work without fear of falling victim. and that they cannot do the life-saving work they wanted to do. i remember iris admitted the patient and this is one of her first patients and introduced herself told him she would be his doctor which was a shock to the system because it was the first time saying she was a doctor and then he passed away and she has this moment of feeling maybe she should not have volunteered to work in the covid board because that maybe she didn't have the right to feel the grief
because she voluntarily showed up to do the work when others had spent years or decades in the medical field. so she felt a sense of guilt feelings sad and that she cannot save her patient's life which is why she got into the medical field inot the first place. so for me that was fascinating when she told me she was experiencing those layers of guilt and grief w because the courage was not necessarily in doing the work she knew she had to put her own body on the line but then to grapple with the layers in the lives that she could not save even while doing the a life-saving work so
it's a shift to understand what courage really means for those were always trying to do. host: i went to go back to the beginning as i listen to you talk and reread the book, was thinking how difficult it is to report out and write and share the stories at a time when so many americans especially are looking forward that the pandemic is over so can you give readers are folks here why you felt mission bound to tell the stories that so many people have a hard time looking at? >> that's an important
question. i was reading recently why there are not that many monuments or memorials to the 1918 pandemic so first of all there is the rush to forget the national trauma and develop a narrative with us some foreign agent the disease came from abroad in the us had battled it back and was in the roaring twenties and and then to conquer something unknown into the next decade so that was a natural response to crisis to put blame with that zeno fullback narrative and then rushing back to normalcy without remembering how many
people are not flourishing under those normal times anyway this really has a lot of critical lessons about health disparities and inequities so there is so much to learn and there is a real risk falling into the ez narrative rushing back into normal times and there is some pushback against that to process and remember who is vulnerable before or even more vulnerable during the pandemic during the last year. >> because several of the doctors that you followed are from underrepresentedd minority groups was that a conscious decision on your part?
>> i really wanted a group of doctors to represent a new generation of american medicine and the desires and identities in the medical field. and for that reason i wanted to seek out doctors whose identities are essential to the medical care they offered whether the parents had a certain degree of skepticism or gabriella who is hispanic and was told she should not pursue medicine and look toward an easier career and she knew there wasn't that much representation of her community in the medical field that threatened her and we doubled her commitment so i want to look at all the different faces where the
other providers and supervisors don't look like them are the communities that they come from. >> before we move on, i want to pause there because i hope people watching i think it's important with that push back the new generation of doctors bring to american medicine and it's interesting but you write so movingly and with such empathy and power i won't read anything long but i do want to share this one sentence that i think sums up where you were coming from which is for some doctors truly hearing a patient's voice is a skill
that can prove more difficult to master than dressing a wound or reading and x-ray. that's really powerful. if you sign anything different the doctors were bringing to this profession because of their life experiences? and what did you bring to the reporting from your own life experience? >> i love that question. i really do think the extent to which they put an emphasis to build relationships with their patients that's incredible to hear and to see because to a certain extent with those idea that a patient-doctor relationship and patient centered care but for so long that was not the
norm and that's coming from the new generation of doctors and what makes that all the more impressive that in medicine there is a rigid hierarchy and the degree to whichyo younger doctors don't feeler empowered with a more senior position with the new ideas so i thought that was bold and now we hear that from the new generation of doctors that want to put that at the center of their care. it's interesting to see this new generation of doctors because theyy have access to a whole new field of research about what it does to help outcomes in patients and doctors have a relationship. and patient seeth themselves represented in the medical care. there is a study i talk about in the book done in oakland a
couple years ago that black men had better health outcome when seen by black doctors rather than nonblack doctors. also cholesterol test in diabetes screenings as preventative test there is life or death consequences when patient see themselves represented in the medical field it isn't just the nice to have thing that actually impacts people's health and that's all the more urgent and it's a sharper message in a pandemic you saw in the early weeks of the pandemic in new york that new yorkers were dying at two times the rate those are not just statistics
in communities of color and that are in poverty, so specifically for black americans to become doctors in their own communities even duringev segregation, so that is really the foundation for the doctors that we have or at least one of the foundations, doctors that were african-american. i wonder if you could tell us a little bits. more about the connection between the disparities and outcomes that we saw in this pandemic over the last year and the basis for modern american medicine. >> that was a piece i was fascinated on in doing research for the book. the homogeneity under the directors and the directors that were black. around 7% of medical students
now are black and i had this kind of based on -- 7%, far under the share of the general population and i had these kind of statistics that i didn't necessarily know how deeply rooted in the history of the u.s. medical education system these were, so i was fascinated to learn actually there were a lot more medical schools that were educating black physicians and rural and low income physicians in the 1800s. there was this whole wave of openings across the u.s. and the sense that it was a lot more inegalitarian than the system in europe, which was very restricted by these kind of elite medical societies. then at the turn-of-the-century in the u.s. there was a concerted effortto to shut downa lot of medical schools and a lot ofan that stemmed from the repot that was commissioned by the
american medical association. and this was by an educator named abraham who essentially decided there were too many american medical schools and low quality ones or ones that were not rigorous enough in their training, so he had a real effort to shut down a lot of medical schools. so on a surprisingly [inaudible] the rural medical schools that t were training the lower income people to care for their communities. and so, you had all of these, over a dozen black medical schools at the usturn-of-the-century just two f them remained after this big push, so there was a real kind of effort of leaders in the field to make a lot more restrictive and then as a result of that at all the more homogenous and i think that is an important history to understand that we are looking at the representation in the field today because the representation has shifted very little in recent decades. it's been only a tiny inching
towards the positions of color and that kind of is baked into the dna of the u.s. medical education system. >> you know, as i was listening to you, i was thinking about the health outcomes in new york over the past year which in general i think are horrific for all new yorkers and were especially catastrophic for black and hispanic new yorkers. why is that? can you pull back and take us a little bit not just through your your reporting in the book but also as a reporter here in new york and for "the new york times," how would you assess new york's public healthcare response to this pandemic? you may have i believe some of the most of close knowledge of any reporter in the country on thisor right now. i think you're going to be a
pretty popular person as we start these investigations into where things went wrong. >> i remember when the city put out a report and we talked about this last spring looking at the disproportionate hospitalization, case rates and death rates among the communities of color in new york and one of the points that the city report made is that people in communities of color were so much more likely to be workingin frontline jobs and jobs where they couldn't socially isolate whether they were working in emts on the front lines. there were so many people who were not able to shut themselves in at home and isolate and on top of that i was talking with a
doctor who was a historian also in the book talking about how he saw all these headlines in the early weeks of the pandemic. a lot of the patients were not even really able to focus on protecting themselves because they were focusing on trying to find shelter and where to sleep when the subways were not running 24 hours and so they
were livingng with all of these daily struggles. >> i hope again i hope if i am repeating something that everybody here already knows one of the most compelling characters in the book i believe his name was manny is the young son and the young disabled son actually ofge someone who, a new who died of ko covid and
the doctors kind of looked after him but were not sure where to take him so they were very well-being andis his long-term safety and security and happiness. and i think, you know, it was really hard for me to read about that because in some ways i don't know if this was intentional or maybe i'm reading too much into this but for some ways to me, he works as a kind of stand-in for the forgotten new yorkers. this is a city where they call it a tale of two cities, but i've been saying that it's kind of like jerry mcguire like you know, first classre you see a better meal and now it's a better life. of thet funny because pandemic the disparities that new york already had were not about whether or not you live in a luxurious building. it's whether you go to sick or your housing or
your job. and he just seemed to be this almost every man stand in for the new yorkers who are nameless and faceless and really vulnerable as anybody in the developing world in many cases. how did you deal with this emotionally. i know you quite well and if you are wonderfully empathetic and a kindhearted person so how did you deal with this emotional burden in your reporting while trying to live your life in the middle of a pandemic and working full time in "the new york times" as needed? >> i was so touched by the story and it was such a gift to get to talk with not only j, the mainai doctor who was carrying with him but others on his team. because his care was all hands on deck and there were doctors who were spending, they were working 12 hour shifts and
staying after that to make sure he got the food he liked andnd clothes and toys and other things that would keep him occupied. you touched on this in what you were just saying, which was so beautiful, but this was a young man, it's true, who had every vulnerability possible really during the pandemic. he wasas living in the city with his dad who was his only immediate family member and then when his dad passed of covid, he had no one to take care of him and the hospital took him in and agreed to let him live there for a couple of weeks, which is a very unusual situation. he ended up being in the hospital for over 100 days which is pretty crazy when you know how it is to be in these covid busy hospitals. and i think one thing that i felt wasas fascinating talking with the doctors who are caring for him is kind of how are they
dealing with the emotional weight of it and i think that his case had so many logistical layers and kind of day today snafus that were coming up, and i felt in a similar way that it was hard because at the time every story had new layers of logistical development whether it was the doctor's finding new medical records that indicated he was partly death or taking him to interview at a group home. that realized his emotional needs were too great for them to handle. or they had a doctoro that was sent to his old apartment to try to find some medications and other things for him and they found out that his dad was a hoarder and it was a hard to get around the apartment to find anything because it was filled with things. so every day there were all of these kind of new logistical developments, so it was hard to feel this emotional -- until he was released from the hospital
and taken in at a group home and then it was possible i think for me and the doctors to do that and look at what this young man had just experienced which was kind of persevering against the impossible odds and then getting to see the videos and photos of him. he was a joyful young man and he brought out a lot of joy in the hospital. he would be walking around playing songs on someone's iphone or getting the doctors to come over and bring guitars and play with him. so in spite of everything, the amazing thing about his story is that had these amazing moments of life for he and the doctors going above and beyond to care for him. >> i think that is very well said, because along with the fact that people -- there are so many vulnerable people, millions here in new york and around the world, you do such a great job in your reporting of making sure
that -- this book is not a tragedy to her. it isn'ter a poverty tour. this is about human dignity and the fight for that, you know, in the face of really one of the toughest moments i think in new york t history. it is just a really powerful testament. a testament to that. again, i can't urge you all enough to read that. i don't want to get emotional, so w i will stop there. before we take questions, i did want to ask emma, is there anythingep about your reporting- that could be something in the book or not in the book that you think is really important for new yorkers and others who may be or not as hard-hit by the pandemic as those in your book to understand what should peopll
who were not in new york or left new york or just who were not that impacted -- what should they know or take away from your reporting and what you've learned here? >> yeah, i think one of the things that really stands out to me is the degree to which it felt both for the doctors and patients it was like a war zone, like a battlefield. for some of the doctors, there is kind of a frightening aspect to all of this because the hospitals were referring to them as the coalition forces or the covid army. you had and why students that graduated and in early graduation on webex and they agreed as those coming into battle and i think those that had been expecting to spend a couple of months to prepare which was intense kind of taking in the lessons of medical school
and doing celebration with family and suddenly for what all intents and purposes felt like a war. and i remember this. i think both of us felt as reporters there were headlines in "the new york times" saying that quote on quote for doctors it feels like a war zone and they didn't have enough and it felt like they were left behind, the city government, it felt like they didn't necessarilyke have all of the support they needed while they were going to confront. and i think that there's going to be a real kind of mental health epidemic the hospitals will have to deal with and doctors have to deal with and ordinary people leaned new yorkers are going to have to deal with and it is kind of as we are celebrating we had a big day of reopening yesterday. people are eager to get out and
start celebrating and that is an understandable impulse and i think also that we probably are not fully processing the degree to which we are going to have this crisis that is h particulay sharp in the city and for frontline providers in the years to come, because what they saw was just incredibly challenging and they didn't feel like they had the support they needed from the higher ups. >> we have some good questions here. one is a good segue actually from jasmine who says historically becoming a doctor had been seen as a career path where is becoming a nurse had been viewed the most part as a working class career. so during the height of the pandemic she says we saw separation of all workers. how do you think that we will say all essential workers post
pandemic and i think it is a great question of beyond doctors i believe. >> i think that that is such a key question. and i have gotten to this question a lot of times like why is this about doctors and it's true that it should be written about all the people that were on the frontlines of the pandemic and in so many different ways. every doctor that i interviewed said they were going above and beyond not just to do the kind of day today stuff but provide emotional support for patients. in a lot of ways they couldn't have family members with them and so they were standing in with their loved ones sometimes holding up an iphone so that the patient could see their family members. so the nurses were going above and beyond. there should be and have been untoldha stories as well, and i
think that there are so many other kind of frontline people who experience this pandemic in the most challenging ways and it continues to be told whether it is through clerks and operators and so many people here. there was a beautiful piece about some of the emts and others on the front line that have been instrumental in recovery. i think all of those stories we need to continue telling. and there was, for some of the doctors, a sort of strangeness to the fact that we were all out at 7 p.m. every evening [inaudible] and it sort of fizzled out a certain point and now we are seeing again a rush to word of reopening and i think we need to kind of continue to think about how to kind of memorialize those mthat are lost but also how to celebrate those in different ways. new york had as a beautiful memorial that you've spoken about and have written about to
those lost to covid but i think we need to continue to think about the fact that we are memorializing and celebrating those that rushed to theng front lines and put their own bodies on the line. >> i totally agree. we have those fireworks from governor cuomo yesterday. i love a party as much as the next to a girl but i thought it was strange, considering the fact that we are still in a pandemic, people are still dying every day and we haven't really gotten off to memorialize those that we have lost through a lacs of closure, but that is a different conversation. just to ask a good question here michael says i can't even imagine the level of stress the doctors had being thrown onto the front line. the did any of them express anxiety or stress about the experience or student loans or anything of that sort?
>> that is a great question. and aa challenging way to start. i think particularly in the context of the fact medicine is always going to be challenging to start because you always have the layer of accountability and supervision and then suddenly you are carrying your own patient and have people looking to you to sign off on prescriptions and all sorts of fthings and that can be a terrifying moment. in the uk they call july killing season because it's when the new interns start and they say that there is a higher rate of accidents or other kinds of injuries for patients which hasn't always been borne out by the research, but it is a terror of starting your medical career in all the more so to this degree when you're starting in the midstou of a crisis. and what i was kind of amazed by his health frankly the doctors that i am speaking with just
kind of started to assimilate into their work. and even to a certain extent to feel confident in the new role and the work that they were doingg and i think part of what helps is that treating covid was novel in the medical field no matter how much experience you had. in some cases within a few weeks of work, somebody starting out as the recent medical graduate turned dr. could have the same level of knowledgeam of care is the most experienced doctors that offered a certain kind of confidence and similarly there was a real collaborative and cooperative experience and the hospitals that ask for volunteers and one of the first people that sign up is the dean of the medical school. so there was a collaborative experience as the hierarchy
thworking together and recognizg one another's contribution. i think that fostered a hopeful experience and of the doctors. >> so, timothy asks the question about whether there are any lessons that india, which is being ravaged by covid unfortunately right now, that india and others that are right now going through that can learn from what your subject's learned in the early days of the pandemic. you can take that to mean that from a medical point of view, in terms of patient care, health systems. i don't think we have gotten much into the assessment of how the public healthcare system here in new york city. but if you want you can sort of answer any part of that that you aret up for.
>> that is a great question and i think that again it speaks to why i want this to be a time capsule of one moment in one city because it's pretty much been ongoing in so many parts of the world right now. it's hard to say right now what lessons the u.s. has to offer because there were a lot of stumbling blocks in the u.s. in the path through the pandemic. if it reopened far too soon, there were people that rejected some of the science and levels of authority. so i think it is hard to say what lessons there are necessarily to be learned from the u.s. response. i will say i think something hopeful as we saw how much the protective equipment works looking at it because i was fascinated to see of all of the doctors that none of them felt
sick in the hospitals and those that didn't feel sick were outside of the confines of the hospital so the protective equipment was extremely effective and when it was available it was fairly useful. and in the early weeks there wouldn't be enough protective equipment but fortunately all of the hospitals were ableth to get together and protect their own staff. so that it jumped out as one of the key lessons and another one i think is just providing mental health support. i heard that from so many frontline survivors over the last years though there is so much trauma that they are experiencing particularly in those that had to pass away without family members present. that is a kind of trauma that has been seen with so many doctors. i think for the u.s. and other countries just kind of continuing to think about how to provide adequate mental medical
support is such a critical issue. >> yes. your point about the success of the ppe, personal protective equipment, is so important because as we are thinking about what went wrong in the united states, it's one of those things, and you touched on this a little while ago, part of the reason that of the vulnerable communities got hit so hard is because essential workers in those communities, sanitation workers, subway workers, bus drivers were not protected in the same way that doctors that work in a far better resource hospitals were and so that is one of the tragedies that we saw play out firsthand. so, rosa asks how -- what was your writing process like? were there any stories that you heard that were compelling that didn't make it into the book?
>> the writing process was challenging in that it was hard to know the moment that the transition for the reporting to start to write particularly with a short timeline for putting together the book and it involved a lot of reporting certainly back to the doctors and asking them a million questions and details of what i have seen. but it was also a really exciting writing process because i had been used to just doing so many quick turnaround articles and short pieces where you are on a deadline. so being able to retreat from that news cycle and just sort of spend every morning when i woke up doing writing that i wouldn't have been doing and that would be going up online within a couple of days, just writing in a little bubble land that was such a treat for me because it is something that we do not
always get to do in the media and the newspaper, just writing without a deadline and immediate editorial feedback. and it was very enabled by the kick up in all of our lives it was a little bit away from the normal routines of the pandemic that allowed for a lot more writing time. a story that didn't make it in the book, and there are so many of them, but there was a wonderful woman that i didn't get to include inud the book but she was working as a graduate and one of i the things i loved, she graduated to go work in the war i and ended up working on a team with her brother and her best friend who were all just wfriends and they were all in e
covid work together. as she fell sick not long after starting. one of the amazing things was getting to hear about the support she had from her brother and best friend while she was dealing with her own case and those of herer patients. when you are in the thick of things and in the trenches, to understand what you are going through in a way no one else can it's such an important thing. she was one of the people who spoke to the families and communities that worked in the hospital after the pandemic. >> i hope thatt you will forgive me. i'm going to play editor for a moment. for those of you thatt are not journalists. one of the annoying but
important questions that you get from your bosses after you deliver a really successful case of journalism is where does the story go from here. and so, you are now on another and i'm asking you, and the, not just for you but about new york and a time of the pandemic, where does the story go from here? >> looking at the culture over the coming years can be critical. a lot of testified to the fact that during the pandemic so many norms and routines got completely upended. learning what it meant, seeing some of the hierarchies and so many norms of care, the fact
they couldn't see people's facial expressions with ppe, so i think that during the pandemic there were things that changed were the good and the things that changedal for the bad in te hospitals. one that is going to be continually important is how you seekta the good that changed whe shifting back to normal and for someme of the norms that were changed. some of the hospitals are beginning to let back visitors, which is critical because the hospitals were understandably cautious and as you know they are starting to figure out communication.f there was a shift to telehealth and i think one of the questions is going to be how do we keep some of the collaborative modes
that emerged in the pandemic while shifting back to normal in other respects particularly in termss of allowing visitors. and i think the most critical question is going to be how do we allow for the recovery that is equitable and leave behind the subcommunities that were devastated to begin with. the economic crisis that devastated the city is its touched a lot of people's lives and people have lost jobs, small businesses have shut down and there is a danger that we kind of rush into the recovery that doesn'tre lift up everyone particularly the communities that m were left behind during e pandemic. and you know, we have a primary that is going on right now touching on that question in a key way. and i think some of the doctors can speak to what an equitable recovery looks like in a critical way. so continuing to try to bring many voices into theti
conversation and what the recovery looks like will be such an important question. for me i felt like it was a treat getting to know the doctors in the book and getting to share their stories. i wanted to continue to ensure young people in the medical field heard that their voices are heard and their stories are being heard and that they have a microphone to share their voices because all too often you hear from the most senior people in the field. first of all just figuring out what it looks like from a here on out and what the equitable recovery looks like and continuing to hold a microphone to those that saw the inequities and the challenge of the pandemic.
these are all things that i would like to continue to follow. >> journalists don't like to talk about ourselves. we are pretty uncomfortable but i hope that you all get the sense for why it is that journalists are considered to be essential workers under state law because they are. we are and i am just wondering, emma, what do you do to stay sane. not only doctors that have been kind of on the front line as reporters, like you, but how are you doing and recovering and what are you doing to make sure that you are feeling healthy and whole during this dark period
finally walking towards the finishal line? >> celebrating this moment i remember last year talking about the realistic timeline that we could expect everyone to be vaccinated and the fact that 70% have been able to get vaccinated is a miracle and the fact we can start to reopen businesses because that is important for the business owners, tomac and i think that celebrating the moment is critical. we process and memorialize and remember, i think we have to figure out how to do all of that at the same time. i think we have to do those things because it is a hard one
victory and we can do that at the same time as processing. and with the joy it is important. >> okay. i am going to push you on this. what are you doing for your own emotionalwn health reading, running, swimming? >> may be forcing you to hang out with me. [laughter] one of the greatest things about being done with the book is getting to dive into a stack of books i've been wanting to read. there've been to so many books coming out and i am so excited to read more fiction.
though i don't knoww if i am ready for any pandemic related fiction but there are no more that i want to dive into right now and i think because last summer was such a [inaudible] and i think this is something i really want to do. >> again, thank you so much to everyone for coming out and to emma for this extraordinary debut. i really appreciate your work so much andat congratulations. >> thank you so much for the wonderful conversation. it was so fun to see people's questions in the chat and really grateful to you all for making time for it.
>> my name is michael cannon. i'm the director of the cato institute. today we will be talking about the latest book the policy institute, titled malpractice litigation how it works, why tort reform hasn't helped, doctors make mistakes it can be devastating for patients and for doctors. we have a medical malpractice system m that exists to compense