Welcome to the dough, where cash is queen and we hardly know her, but we're still here figuring her out together because, y'all. Season two is here, hosted every week by me. X Maya, remember me? I'm going to be talking to all types of people about their relationship to money. I'm talking to reality stars, entrepreneurs, financial experts, and even some of my own friends. Basically anyone who will get real with me about their dollars, how they make money, how they spend it, and how they save it, because I'm trying to retire early, people, season two of the dough is out. Now. Wherever you get your podcasts, join us on archetypes, a dynamic podcast hosted by Meghan, the Duchess of Sussex, as she digs into the labels that try to hold women back in each intimate and candid conversation. Meghan is joined by guests like Serena Williams, Mariah Carey, Paris Hilton, Issa Rae, and Trevor Noah as they delve into the roots of countless common descriptors of women like diva, crazy dumb blonde and the b word, and redefine and reclaim each identity along the way. The complete season of archetypes is out now, wherever you get your podcasts hi, last day listeners.

We at Lemonada are working on a show about caregiving for elder loved ones. If this is something you know about, we want to hear from you. Maybe you're part of the, quote, sandwich generation like me and have small kids who need everything from you all the time and are also caring for your parents. Maybe after decades of marriage, you are now a caregiver for your spouse and feeling lonely and burned out. Or maybe caring for your dad has left you without any savings. Whatever the situation, if you're caring for an older person in your life, we want to hear what caregiving looks like for you. All you have to do is record a voice memo and send it to uncared for@lemonade.com. That's uncared for. Uncaredfor one word@lemonadeia.com anything from just 30 seconds all the way up to five minutes works. Share the struggles of caregiving, the joys, and everything in between. We look forward to hearing from you. Just a heads up. This episode includes mention of suicide. Please listen with care.

For our staff to go home, see their family get sick, worry about getting their family sick, do this day after day after day after day for months, trying to keep myself safe every day, writing in my notebook like, what are the exposures that you had today? Did you have any breaches in your personal protective equipment? Do you feel know that one time when your mask was really wet. Something could have gone wrong. It was very clear that the psychological trauma of what we saw, what we did, and just being in that environment could have these profound physical manifestations. But everyone pushed through, and I did the same.

Dr. Craig Spencer is describing the harrowing experience of being in a hospital and staring down bed after bed of very sick patients fighting for their lives. Sometimes these patients make a recovery. They survive. But for the very young and the very old, all Craig can really do is hold their hands, share their space, and ease their pain. Now, this picture may sound and look and feel like the United States in the spring of 2020, when we saw the onset of COVID-19 but actually, it's 2014, and Craig is in guinea with Doctors without Borders, treating Ebola patients. At the time, he had no idea that only six years later, he'd be facing yet another terrifying infectious disease, this time right in his own backyard.

It was March 1 that we had the first confirmed case, I believe, in New York City. And it was like trickle, trickle, trickle, deluge. In the span of like a week, it went from trying to find that one person in the emergency room that might have COVID to trying to find one person who didn't.

This is last day, a show about the moments that change us. I'm your host, Stephanie Whittleswax. Today, we are telling the story of a virus, a virus that changed all of our lives overnight, told through the eyes of a doctor who had seen it happen before and tried to prepare us for when it would happen again on a scale we never could have imagined.

So my name is Craig Spencer. I am a few things. I am a parent to two young, wonderful people. I am an emergency medicine doctor, and I've been working in emergency medicine for gas, but. Sounds like forever. 15 years, and I'm now at the public health school at Brown University, where my focus is looking at basically how history informs the present of public health.

Craig has spent much of his career as a doctor, responding to crises both here and abroad. But before, he was trying to keep the world of public health from repeating its own mistakes, Craig was a kid in Michigan with a much simpler dream.

Initially, the goal was I was going to be a sharkologist, and I was also going to play part time, I guess, apparently for the Montreal Canadiens. As goalie, I don't know how I was going to balance those two things, but I was nine, and that made perfect sense.

Unfortunately, Craig later discovers that a sharkologist is not a real thing. Also, although he does play hockey, he's no goalie, and that doesn't bode well for his sports career. So at the ripe old age of eleven, Craig starts to reevaluate what he's going to do with his life.

And I was in a social studies class one day and we were looking at microfiche, and it said, a cardiothoracic surgeon can make like 120 or $130,000. And I was like, whoa, that is the most money of all of these things on this microfiche. Clearly, that's what I'm going to do. And so from that moment on, I committed myself to being a cardiothoracic surgeon.

Wow.

And I didn't know exactly what it meant. I think it kind of, like, stumbled out of my mouth whenever I said it, but I became proficient enough in saying what I was going to do. I learned everything about the heart. I knew how it worked, the electricity, all these. I was like, this is what I'm going to do. So much so that I met a cardiothoracic surgeon once, and they were like, actually, you don't want to do this. This kind of sucks. I'm like, yeah, I do. I know more than you. I walked into med school convinced that I would be a cardiothoracic surgeon. I told everyone I was going to be a cardiothoracic surgeon. And that was the plan until sometime in the middle or towards the end of my first year in medical school, one of my friends was like, hey, what are you doing for the week off? We had like, a summer vacation. I said, I don't know, and said, well, I'm going down to the Dominican Republic with this World Health Student organization group and we're going to go help. I was like, okay, I don't know that I can help with anything, but okay, cool, I'll come.

I'd never really left the country all that much beforehand. And I went down to the Dominican Republic and the hospital that we were working in. As we walked in, the senior doctors were leaving because they hadn't been paid and the residents were kind of running the place. And I remember walking in to this hospital in Dominican Republic and just kind of like being blown away that this existed, that people were being treated or not treated in such tough conditions. And to see how much both the physicians did, the nurses did, but also like families did to help their families. And it left a massive impact on me. And I went back home and thought, all right, maybe I can be a cardiothoracic surgeon somewhere else in the world.

As it turns out, Craig still wasn't done questioning what he was going to do with his life. And at 27, he takes a year off medical school to study abroad in China, where he meets his future wife. After returning to the states, he does his residency in emergency medicine at a hospital in Queens. And it's while doing this work that Craig discovers his true passion, helping communities where the need is greatest, yet deeply underserved. This is what leads him to volunteer with Doctors without Borders in 2014. At the time, Ebola is ravaging West Africa, and the organization has set up a treatment center in guinea, where the deadly disease is spreading and conditions are getting worse.

Now, I've chosen to go to guinea because that nine year old self of me that wanted to be a goalie for the Montreal Canadiens and had started learning French, I continued that, and guinea was, you know, primarily french speaking, and so I was sent there to be part of the response with doctors sub borders, and I was with maybe a half a dozen other folks that were working with me on the same project, and we were among the only people on this massive Air France flight into Guinea. I have pictures of an empty first class, an empty business class. It seemed like hundreds of seats, like a sea of seats that were just kind of empty, with a half a dozen of us just kind of all huddled in the middle. And that's kind of when it really hit me that I was going into an area of incredible uncertainty, but also of really incredible need, and the fact that it was so critical to be able to get providers and supplies in as easily as possible. And so I was super grateful that I was able to get in, showed up in guinea, and kind of started amongst the five to six most distressing weeks of my life.

Up until that point, Craig has spent.

Most of his career going where his patients need him the most. But now he's dealing with a disease like Ebola, which is highly contagious, and that means there's something else he has to consider his own life.

There was this narrative at the time, in 2014, really in September of 2014, just as I was getting on that plane, there had never been, to that point, kind of an international staff working with our organization that had ever been infected with Ebola. That's despite responding to a bunch of Ebola outbreaks for almost 20 years. And so that in itself was encouraging. Like, yeah, it's tough and it's scary and it's crazy, but honestly, there's been so many people that have come before me. A lot of the people I'm working with that are training me. They're saying the protocols are rigorous and incredible, and it is going to be tough, but you're going to be okay. And it was really right before I left that there was the first of our international staff that had been infected. And it's kind of like tore down that wall of impenetrability. And there were people that I was training with at that time that decided to go home. And I said, I kind of committed this far. And if people like myself, quite frankly, that feel comfortable working in different places, have skills to work in those different places, are willing to work in those different places, are, like, not doing it, then who's going to do it?

I would go in, in the morning, at like seven in the morning, and we would walk down the hill. We would have. Because it was kind of like a frenzy. European mission, like, the neat breakfast. They had like a cup of black coffee and a little vash kiri, those little cubes of cheese. And I was like, this ain't a breakfast. Do you know what I'm about to go do for 12 hours? Come on, what's wrong with you people? And then I adapted, and it was okay because it got hot and it was kind of humid. And we'd go down, walk down to the Ebola treatment center, and we go in, we go through the whole process, take off our clothes, put on scrubs, walk through, get kind of decontaminated, make a plan for the day, and then within a half hour, would be in one of those yellow tivek suits in a hood and some goggles and would be going in to really take count of the horror that had really taken place overnight. Ebola was just like. It was just so mean. And you could see someone in the morning that looked fine in the afternoon, come back and be told that they died.

And that was really tough. But I think we all kind of put that to the side because there was just, like, more people that came in and there was not enough of us. And there was like three or four doctors for 60, 70, 80 patients. And every person that you wanted to do something, like put in an intravenous line so that you could put them on like a drip for some fluid that was like a ten to 15 minutes activity to do, to do correctly, because you can't do it incorrectly. Because the risk is if you get stuck with a needle that was in someone that had Ebola in their arm, and you stick yourself mistakenly, like, you'll die. It was just that. So, yeah, I was afraid. I was around folks that had been there for some time. The local staff were just absolutely amazing. All the guinea doctors and nurses that I worked with were just heroes beyond words and had showed up every single day and had gone home to family who had been sick and took care of them after they got home. I went home at the end of the day and the day sucked.

And it was twelve to 14 to 16 hours, and we went in a bunch of times and it was sweaty and tiring and all you had was some vashkiri and some kind of crappy coffee to make it through the day sometimes. And that sucked. I can only imagine what it was like because I got to go home and have a beer and sit and relax, and for our staff to go home, see their family get sick, worry about getting their family sick, do this day after day after day after day for months. To me, it's absolutely unimaginable. And they didn't get enough credit for everything that they did. It was tough because at that time, there weren't vaccines really. There weren't good treatments for Ebola. It was kind of just a cross your fingers and hope for the best. And if you're younger than five and older than like, 60, the likelihood that you're going to make it is really dismal. If you're in the middle of that range and you're well nourished and don't have a bunch of health problems, the likelihood that you'll make it is a lot better. But a lot of it was just kind of out of our hands.

And so we did everything we could. Putting in IVs, giving medications, treating symptoms, giving dignity, holding someone's hand, things like that. When people are in these kind of, these tents and seeing so much kind of death and destruction around them again, despite how horrible it must seem for me, and gobsmacking, it may sound like I got off easy.

After six overwhelming weeks at the Ebola treatment center, Craig flies back to New York. It's October, and he returns home to peace and comfort. And that is when everything he'd seen hits him hard.

Having gone from a month and a half of seeing what I just described to you every day, seeing maybe half the beds in any space with someone dead or empty, waiting for another patient because someone died overnight, I got good at putting that off and not dealing with it then, but ended up dealing with it when I was back in New York City. And so being at home, feeling really kind of profoundly depressed, asking questions of like, could I have done more? What could we have done more? What about people that are left behind? Things like that. And I wasn't working clinically. I wasn't allowed to go back to work. And so it's kind of just like sitting around, which, for an emergency doctor, is probably the worst possible form of punishment. I tried to find ways to cope and adapt and would try to go for a run or try to do these other things, but there was one day when a good friend of mine was like, man, you're a hot mess. We need to get you out the house. And I was like, I don't want to leave the house. I'm fine here.

I want to leave, but I don't want to leave. And so he was like, no, we're going to take the train. Come down here. We're going to, I don't know, go bowling, do something. It'll be fun. I was like, I don't want to go. I ended up going and ended up the next morning waking up and feeling like something was a little bit off.

And how long did it take from feeling like something was a little bit off to figuring out that something was incredibly off?

Unofficially or officially? Well, unofficially, I knew. Yeah, it took about three minutes when I took my temperature, and I was like, oh, it's 100.3. That is officially a fever. That was the unofficial. Like, you took all your malaria meds, and everything else is okay. So, okay. Process of exclusion, not looking great. And then I think it was later that evening, maybe 12 hours later, that I'd gotten a test back. After I'd gone into the hospital. The pre authorized version of the Ebola test that was done across the street at the New York City lab was positive for Ebola.

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Visit betterhelp.com lastday today to get 10% off your first month. That's betterhelp. He lp.com lastday. We're back. After six days of being home in New York City, Craig tests positive for Ebola. The illness that wrought so much horror in guinea has followed him back home. What on earth goes through a person's mind when you have seen the horrors that you have seen and then you find out this test result?

I don't know that I thought so much of my own mortality. Like, okay, I know I am at this point 33 years old and I'm healthy, and the likelihood that I'm going to die is probably somewhere between 40% to 50%. I don't think I did those numbers. I was like, wow, that really sucks. Now what do I do? Knowing, of course, there was nothing really to do but thinking one about, did this impact my family? What about my fiance at that time? Was she exposed? And, oh my gosh, that would be the worst thing in the world if that were the case. My own mortality seemed more manageable than the idea of infecting the person that I love the most.

Suddenly, though, this diagnosis is much larger than even that. Craig reports his symptoms to the health authorities in New York, and he's rushed to the hospital in an ambulance. And before his Ebola diagnosis is even officially confirmed, he is headline news, because Craig is literally the first Ebola case in New York City.

Breaking headline right here in New York City. A young american doctor back from Africa raced to a New York hospital, and tonight, it is confirmed, a new case of Ebola. Frankly, people in the neighborhood are scared, and some of them are panicked. In fact, I had one gentleman who wouldn't even shake my hand because he was scared.

Spencer sparked Ebola fears in New York City after health officials revealed he rode the subway, ate at a restaurant, and went bowling with friends. The day before he showed symptoms, the.

Venerable New York Times asked, can you get Ebola from a bowling ball?

Experts say the simple answer is no. With no Wi Fi or TV in his room, Craig has no idea how big his story has gotten. Instead, all he's thinking about is how the hospital he's in and the care he's getting is so vastly different compared to what he'd just seen in Guinea.

I was in a hospital room with one physician that could spend an hour with me. There was like 30 something people on call, a pulmonologist and a nephrologist. If I needed dialysis and this and that and a cardiologist. There were like 30 people on call for me. And just a few days beforehand, I had been taking care of 30 patients by myself. And so I knew that I was going to get way better care, even if it seemed like just a few weeks ago, like no better care existed, right? This is all we could do. We don't have a treatment. We don't have a cure. This is all we can do. And you come face to face with the fact personally that there is something better that can be done, and that I was going to receive that, and I was grateful for that, but at the same time, just really disturbed by that idea that, damn it, this is what everyone should get. What would have been like if just a few weeks ago, I could do the same thing for every person to get a test result back in less than half a day, as opposed to three or four days sometimes, where people just kind of sat in limbo without knowing?

And then we go back to them and say, hey, you don't got Ebola. You just have malaria. You can go home now after you've been in a place with other people that may have had Ebola, and maybe you're exposed. And what does that mean for your community and for your kids? These were things we thought about every day. And I didn't have to think about that. I didn't have to think about the hospital where I was at, or the people that were taking care of me, running out of their own supplies or equipment or. I didn't have to think about that. It was reassuring and also disconcerting at the same time to know that I was in a place where I was going to get the best, but I'd come from a place where I had seen the worst.

As Craig's care team swirled around him, debating how best to treat him, his mind flashed to another doctor who had been infected with Ebola, Dr. Sheik Umar Khan. Dr. Khan was at the forefront of fighting Ebola in Sierra Leone. But he wasn't offered an experimental drug that would treat his illness. The World Health Organization and Doctors without Borders debated whether it would be ethical to give Dr. Khan the one drug available in the area. He died in July, just a few months before Craig was hospitalized. But in the US, Craig's cup was overflowing with treatment options.

We were on the phone with the FDA. By we, I mean my wonderful physician Laura, on the phone with the FDA, trying to get approval to get one of these medications that was just like another medication that was being used at that time to come in the country or to get access to it, to get it flown up to New York. And then when she was trying to do this, they were like, well, actually, we can get you the real thing. It'll just come down from Canada. And so someone was willing to send down, ship down, drive down a medicine from Canada to give to me at a point in my illness where it was clear that I was likely going to survive. And at the same know, one of the best physicians in this area who put his life on the line wasn't able to access the same thing. And people talked about it and debated it for such a long period of time. And for me, it was like, well, here we got this thing and this thing and this thing and this thing and this thing and this other thing, and there's this other thing.

I don't know that any of them made a difference, but just having them there, the inequities were obvious. It was just huge.

After 19 days of being confined in his little box of a hospital room, Craig is cleared to go home. And he attributes his full recovery to his amazing care team, who not only looked after his physical health, but showered him with love.

The nurses that took care of me every day were just so great. When I got to the point where I was like, yeah, I'm ready to eat again. There was one of the haitian nurses that was like, great. I'm going to make you the best black rice you've ever had. And I was like, well, I've never had black rice, so it's a low bar, but bring it. And it was so good. And there was this nurse who had grown up in Korea who was like, I'm going to bring you the most amazing bee, bibim Bob. And sure mean, it was just so know to be sheltered from the outside and just have kind of like an internal bubble of love from those folks was great. And so it wasn't until I left the hospital that I interact with the media. I got to read a statement that I think was short and sweet and basically express a lot of things I've already shared with you. I was like, I'm just one dude. There are thousands of people right now in West Africa that are infected, about to be infected, dying. While my case has garnered international attention, it is important to remember that my infection represents but a fraction of the more than 13,000 reported cases to date in West Africa, the center of the outbreak, where families are being torn apart and communities are destroyed.

Put your focus where it belongs. And I wrapped that up, got in my car and said, I'm never talking to the media ever again. I'm done.

Yeah, that's what we call dramatic irony.

Yeah, that's what we call being dumb and being like, I'm done with this. There's no value in this. Like, what am I going to do? Whose mind am I going to change? Who would want to hear from me in the future?

For now, though, Craig is eager to return to his regular life. Over the next five years, Craig is all across the world staying very busy. He flies back to West Africa to track Ebola, followed by stents in Chad and Burundi. Then he's on a ship caring for migrants crossing by sea and later doing research in the deserts of Niger. Like I said, he is a busy, busy guy. As for his family, he and his wife welcome their daughter into the world. And in early 2019, the family moves to Paris for Craig's teaching job. When he returns to work in New York, he's flying high. And pretty soon, it's January 2020. Those friends Craig and his wife made while he was studying abroad in China suddenly start hitting him up. They're on lockdown due to this new virus that's circulating. They don't know what the hell is going on, but they do know who to ask.

I'm the doctor, so everyone is like, hey, Craig. Yeah, I haven't spoken to you six months. I'm just going to cut through the shit. What is going on? What's the deal? Like, hey, I'm in Beijing and I'm not allowed to leave my house. What do you know about this? And I'm like, oh, what about what it was at that point that I kind of jumped in and was concerned. Concerned enough to the point that within a couple of weeks, my wife was the one at Trader Joe's with, like, two carts full of groceries. And she's like, y'all are laughing at me now, but you won't be soon, assholes. She was that kind of person. And in retrospect, I love her. No one's laughing at her. I was like, we had toilet paper for days, weeks.

As a non medical person. I remember I was washing the dishes. It was January. I was listening to that daily episode about Wuhan. I remember distinctly being like, fuck, it's no good. Like, yeah, I mean, really? It's like, how many daily episodes have I listened to? And I can remember it's, like, place in, like, where things started to feel like they shifted. Take us to that moment in your life, your career. And then at what point, based on all of your expertise, did you realize that this was going to hit home and it was going to be not just bad, but really, really fucking bad?

Yeah. This had been something that I'd seen. I know what happens with these infectious disease. I know what they look like. I know that I got to keep myself safe and my family safe. And so I started wearing a mask in January because I knew that these things were already moving. And if history has taught us anything, especially with respect to infectious diseases, by the time you pick it up, it has already been on the move. It's already moved around. Travel bans are probably not going to help. All these other things that we do don't necessarily make much of a difference. I was like, all right, well, if we can do anything, we can kind of get ourselves ready, our family ready, kind of work with my colleagues and be like, hey, this is what's coming down the pipeline. You should be prepared for this. We all should be prepared for this and how we're going to think about it, things that we're going to do. If we get sick, our family gets sick. And so that was kind of like, in January and in February. And, I mean, obviously, what we saw in Italy and in Iran was really just kind of like soul breaking and concerning.

And I remember late February just kind of waiting, like, where in the hell is this thing? Like, in New York City? Why have I not seen these? I don't understand what is going on. I know it's definitely here. And then it was March 1 that we had the first confirmed case, I believe, in New York City. And it was like Trickle, trickle, trickle, deluge in the span of like a week, from middle to late March. It went from trying to find that one person in the emergency room that might have COVID to trying to find one person who didn't.

All of a sudden, Craig and his colleagues find themselves on the front line trying to fight a deadly virus that is spreading so fast. The rest of us, regular degular folks, looked on from our television sets at home or sat on a fire escape every night and clapped our hands or banged pots and pans together to support the first responders. Remember all that? But the reality is our best, our heroes were sent off to battle unarmed.

In the emergency departments. Before 2020, you got to put on an n 95 mask once a year, and that's when you went and did your fit testing as part of your hospital compliance. People didn't really know how to use them, didn't really have to put them on. Maybe if you saw patients that had concern for TB, maybe you'd put it on tuberculosis, but you just weren't wearing it. And so there were few, few people like myself that had gone to places like West Africa that had learned how to use personal protective equipment as if your life depended on it, because it did. We had way too few of those folks here in the US because it was way too difficult for people to leave their jobs in 2014, 2015 to go to West Africa. Too many places made it difficult or impossible, including some of our best medical centers in this country, made it impossible to send staff to West Africa at that time. And the result was that we had so few people that had any damn idea about how to work in a place like that with an infectious disease. Things that are second nature, after doing this for just a few weeks during Ebola, for example, were things that we learned the really hard way in March and in April of 2020.

Are you seeing as things ramp up in March and change so rapidly, are you having flashbacks to 2014? Are you feeling like this energy that you've never seen at home? What are the sort of differences and similarities that you're sensing both kind of internally and as you're actually visualizing.

Yeah. What was weird for me was that I had done this in a bunch of other places. I'd gone to hepatitis outbreaks and I'd seen Ebola outbreaks and gone to respond to other diseases in other places. But I never expected it at home in one of the finest medical centers in the country or in the wealthiest city in the world, that we were going to be not fully up to the challenge. That was something that I was used to in other places, but not here. Like, home is where I came to for refuge from all of those things, not as a place to kind of experience that all over again. So it was definitely traumatic, and it was tough initially to try to reconcile those weird realities with some things that even I just knew as very basic things that we could be know. One example is a personal protective equipment buddy. We call it a PPE buddy. And in West Africa during Ebola, you didn't check your own PPE. Someone else was responsible for it, because you can't see. Someone else can get underneath and take a look at all the nooks and crannies and see and make sure your mask is covering your eyes, et cetera.

I was like, oh, wow, why didn't we do that initially? And that's something that we ended up talking about and implementing and thinking more through. But there were missteps for everybody, myself included, and we could have and should have done a much better job. I think the trauma of those first few weeks was because we were flat footed and short sighted and not prepared. And all of those things kind of collided, especially in New York at the end of March 2020, where on many days, I saw more people die in that emergency department than I did most days while working in West Africa during Ebola.

Working in the ER is grueling, which is familiar to Craig in some ways and worse in others. And as he's treating patients and layering his PPE and coming home and cleaning off and going back and doing it all over again in the morning, he pauses and reflects on just how severe things had gotten and how quickly Craig takes these thoughts, and he writes them out in a series of tweets. He doesn't have many followers at the time, maybe 500, but this report from inside the walls of a hospital, it strikes a nerve.

It's kind of the day that, I think pulls it all home for me in terms of what it was actually like working in the emergency department at that time, what the new normal had become and how normalized it had become for us, what it felt walking into this kind of UV wonderland was just like, there's this lights kind of everywhere, bouncing off of people's goggles. And what the kind of, I think I called it a cacophony of coughing. Sounded like you just walked through these just like, corridors of people coughing everywhere and hoping you don't get sick. And what are you going to do when you leave? And how do you stay safe? And what happens when you go home? And then I think overnight, my phone just was on a continuous seizure, and it was like a bajillion likes and retweets. And I was like, what happens? And I woke up in the morning and I was like, I don't know how to engage with this. I got to go to work. People have no idea what the hell is happening inside an emergency department, which is why I want to come home. And over the span of like 1520 minutes, just truly write what I do at work.

I was like, this is what I did at work today. Just like anyone normally would be talking about what they're doing at work today. And it just hits end. I had no clue that was resonating so much with people because people had no damn idea what was happening. I had no clue. Like, I knew that people wanted to know, but I don't know. I just assumed people knew that things sucked inside and it was bad and people were dying. That was all I was thinking about. How could that not be all everyone else was thinking about and knew about?

Hi there. It's Julia Louis Dreyfus.

You may know me from my podcast called Wiser than me, where I talk to older women and get their wisdom from the front lines of life. After season one aired, I was amazed by how many people told me our show made them look forward to getting older, which is why I'm here to.

Talk about season two of the show.

Sally Field, Billy Jean Kane, Beverly Johnson, Ina Garten, Bonie Ray, just to name a few. And of course, my 90 year old mom, Judy. All hail old women wiser than me. Season two is out March 27 from Lemonada Media can't get enough of your favorite Lemonada Media podcasts? By subscribing to Lemonada Premium today, you'll gain access to fun and inspiring bonus content from all of our podcasts across the Lemonada Media network. As a subscriber, you can listen to never before heard interview excerpts, behind the scenes segments, and continue to uncover new ways to make life suck less through all of our exclusive subscriber audio. Check out a free trial of Lemonada Premium today in the Apple Podcast app by clicking on our podcast logo and then the subscribe button.

We're back. So Craig tweets about his experience as an ER doctor in New York City. And for many, reading an account from the inside is a harrowing wake up call, a shock to the system, and a reason to be even more scared to create even more distance from other people. But Craig and every other frontline worker has to keep going back day in and day out. Was there a moment where you felt yourself starting to get fatigued, overwhelmed? Like, when the fuck is this going to be over? How are we going to get through this? Did you hit a wall at any point? What was that experience like? Or maybe not. You're a superhero and you don't hit walls, but let me know.

No, I mean, I certainly did. I had all those walls from West Africa that I think that those tools had kind of better prepared me for COVID, such that I'd go to work. I know it was going to be tough. We'd see people die. I would kind of put that aside. And people also, I guess people don't understand that I work in an emergency room. It's still pretty rare for me to see people die. People just don't die. People are like, oh, you just go into work every day and people are dying left and right. No, I mean, I can go for weeks working without seeing someone die. My colleagues weren't used to going into a room and seeing someone they just talked to 20 minutes before seeing that person dead. That's just not something that we're used to. And having that experience in myself didn't make it easier for me. It just made it easier for me to be able to cope and think about how I'm going to manage this later, as opposed to in that moment, break down, stop functioning. But for a lot of people that just haven't done this, to see that day after day after day was a lot.

I remember one day working in one of the smaller kind of satellite hospitals that we had in northern Manhattan, and the concerns that we had, because all of the bed spaces that were next to the wall where the oxygen was at were all taken by people on ventilators. And we had a space inside, closer to where kind of the doctors and everyone else sat that we wanted to put patients, but we didn't have a way to get oxygen over there. We couldn't string it across the ground. So what we ended up doing is connecting the tubing to the wall and then stringing it all the way up along the wall, up through the ceiling, and then down in the middle of the emergency department so that these nasal cannulas, these little oxygen things, would be able to go into people's noses so they didn't have to rely on a tank underneath them, which often ran out. And there just wasn't enough people to know when the oxygen tank had run out and when people were suffocating. And so we put this in place. And I remember working with a friend and colleague, Dr. Lorna Breen, that day on that, and just thinking about how horrible that was and kind of the length through which we were going to try to keep people alive in the emergency department.

I remember her asking me, how much longer do we have of this? And I think I remember saying something like, I think we have at least a couple more weeks to get through the worst. And I think it was just a couple of weeks later that Lorna died by suicide. And it was just really, it's impossible to describe just how tough it was for everyone that came to work as much as they could. Many people couldn't anymore because they got sick. We lost especially a lot of our nurses very early on because they were at the bedside the most. We lost one of our nurses who got sick with COVID after coming out of retirement and came back to the front line to try to help and got sick himself and died a few weeks later. That seeing your friends get sick, seeing your friends die, the people that you worked with, it was all really, really tough and really hard, but that was by far the hardest part of it and still hurts.

So sorry.

Thanks.

So here we are. We're in 2024. It's four years after the pandemic first struck. And, you know, my little person who was toddling is now a full blown kindergartner with opinions and thoughts and feelings of his own. Time has passed, and I think for a lot of us who may not be immunocompromised or have other preexisting conditions, it feels like things have returned to quote unquote normal, or in a lot of ways, the new normal, where a stuffy nose means swabbing and testing, right? My nine year old's like, get the COVID test. I have a pickle, which is just wild. And so I guess my question is, you're an expert. How would you describe the stage that we find ourselves in today? Like, is it actually normal? Is it not normal? What's the actual reality?

Confused. So as of just a few months ago, you had 1000 people dying per week of COVID so you're talking 50,000 people per year, which still puts it, like, in the top in terms of killers in this country. Do we think about it like that in the same way as we did a year ago, two years ago, three years ago? No. Do we take the same precautions, the majority of us, including myself, as we did a couple of years before? No. Even when I see patients in the hospital, I'm not wearing a mask for every patient. If I think it's someone that is sick or is immunocompromised, I do. But if it's something that someone that maybe broke their ankle, maybe I'm not. And so even for us providers that were so diligent a few years before, things have changed. So it's a confused time because, yeah, lots of people are still dying of COVID Are they dying of the same COVID of March 2020, when I saw people coming in, struggling to breathe with their lungs whited out on a chest x ray? No, almost never. I never see that anymore. Are they dying because COVID does things to your body, like makes you more dehydrated or makes it more likely for older people to fall and hit their head and bleed?

Yeah, absolutely. So COVID is continuing to have an impact. It's still taking the lives of many people and still remains, again, for what will be the fourth year in a row as one of the top killers of Americans, which is, again, incredible, given the fact that it's been nearly 100 years since an infectious disease was amongst the top three killers in this country. And so is it normal? No, that's not normal. No one should make an argument that's normal. If they do, they're absolutely silly. But have we reached a place in which most people have gone back to some sense of normal, where we're sending our kids back to school and knowing that if they're sick, it's probably something other than COVID and. Right. Most of the time, yeah. Are we better prepared than we were four years ago, three years ago, two years ago? Sure. We have vaccines and we have therapeutics. We're in a much better place. That doesn't mean that we're in a perfect place. So I know it's really, really tricky for a lot of folks to think about what this moment means for them, because four years ago, what it meant for everybody was the same thing.

It was scary. It could potentially impact you, your family, your loved ones. We've had over a million people die in this country. So many people have lost a family member in the past four years. And continue losing family members. It's really hard to reconcile those kind of Dr. Jekyll and Hyde sides of this virus, where people are just like, we're ready to move on. And for the majority of people, I'm like, that's okay. We've done this. We've been vaccinated. Nearly everyone has been infected. Yeah, it feels safe to move on, but at the same time, we can't overlook the fact that it's not normal. There are so many things that we can take from this moment to think about how we prevent a similar moment in the future. We saw, I remember in April of 2020, looking at the maps of who was being infected with COVID in New York City and who was dying. And I feel convinced that I could show this to a teenager and say, look at these maps and show me where the wealthy people live and where the people that are less well off live and have that correlate to infection rates and death rates.

The inequities that we saw had been built in. And we have so many of the same problems. We still have a bunch of states that have not expanded Medicaid. We still have millions and millions of uninsured people in this country. We still have a healthcare system that spends trillions of dollars a year. And where you are lucky, if you're lucky enough to get the best health care in the world, you can, but you still have neonatal and maternal mortality, especially in communities of color higher than developing countries around the world. We have so many other massive health threats that might make COVID, at this moment, look less dramatic and horrible than it is. But that's only because those are really bad, not because COVID necessarily isn't.

I mean, when you put it in those terms, it seems like it's so demoralizing, because what that suggests is that when we look into the future, we are still in great danger. I mean, it's. Until we fix those systemic inequities and so many other things that are broken. Like, if it's not COVID, it has to be something else. I don't know. How do you get out of bed every day?

Well, because I'm encouraged. I'm encouraged by the fact that we have those maps from April 2020 to say, look at the experience of hispanic and black New Yorkers and what happened. We have people who are committed to making sure that this is highlighted at each and every stage that make sure that data reflects the realities, not just for wealthy white Americans, but for everyone in this country. We have people in communities and centers and schools and universities and labs focused on highlighting these inequities. Has there been change? Undoubtedly. I'm optimistic about the recognition of the things that are wrong. The people who are committing their whole life and all of their energies to reversing and addressing those, the changes that have been made and the challenges ahead. Like, yes, there'll be another COVID or there'll be another something else that's going to take disproportionately the lives of people who are poorer or communities who are more vulnerable or marginalized. But there will now always be a light on those communities. There will be people focused on fixing those inequities. And I am confident that there will be change, that we will continue to make progress in addressing these issues and other issues that have plagued medicine and public health and really our society in general.

So that's how I get out of bed. I work with awesome students that are so fixated on this. I work with people at local levels or at the federal level, in government, in nonprofits that are like this cannot stand and work their ass off every single day to make that change a reality. And we are far, way away from being able to scoff the next time a new respiratory virus comes to our shores and say, you won't kill any of us. We're going to make mistakes and we're going to see other threats, whether chronic diseases or infectious diseases. We should be humble enough to admit that we're not perfect. But damn it, we need to work all of our asses off to addressing those inequities and to fixing those issues that have plagued health, public health, for quite some time and do our part to reverse those trends.

Craig and all of us really exist now in this strange space where we are holding two mind bending ideas at the same time. One, that we have experienced incredible loss and crisis over the past few years, and two, that we have come out the other side, which means we can hope and we can plan for a better, more equitable future. Now, if you've been listening to this show for a while, you know that we call a space like this the happy sad. And after everything Craig has witnessed and experienced, I wanted to hear about his.

My sad is pretty clear in that spending 19 days in a tiny little box on the 8th floor of a hospital in New York City where it wasn't clear that I was gonna make it out to the other side, was definitely a low point, definitely a sad. I'm glad that I did. I'm super glad that I had access to unbelievable care in great people in great food from the nurses. All that stuff was so great. But it was still really sad. It was sad to think about the care that I received and how it was so different from the care that I was able to give. That's what hurts me, I think, the most to this day. So you may be like, well, how in the hell do you turn that around, Craig, and make that into something? Know, that experience showed me a lot. It showed me that one I could use a platform. Like when I got out of the hospital and was able to say, hey, I'm ready for my book deal. Instead, say something like, hey, stop focusing on me. I'm not important. What's important is the people that are continuing to die today that represent an ongoing loss of life to something that should not happen and that should get access to the exact same care as myself.

And so I think that instilled in me this sense of purpose, the ability to kind of share other people's stories and plight that the podcast mic, or the camera, or the radio was not necessarily focused on. So that was one thing. And the other thing is that in the ensuing time, I have recognized that, oh, my gosh, there are so many unbelievable people, just like those doctors I worked with in guinea that worked their ass off every single day, not knowing if they were going to get paid, not knowing if they were going to get sick or what was going to happen to them if they got sick, or if one of their family members got sick. Like, showed up every day, taught me everything that I ever knew about Ebola, or did it the next time that I went and worked in some other place where they were there and their family was there, or did it here. Over the past few years, when I saw so many people sacrifice so much to put themselves on the line, to fight for better things, to raise their voice for better things. And my sad moment was sad.

The happy moment of seeing how many freaking incredible people are out there committed to doing the right thing, despite the risks of themselves, despite the risks of their reputation or their politics or their followers on social media. Like, damn if that is not so cool. And something that I'm just like, elated to be part of, to talk with students that can hear my story, that can be like, that's not okay. And to say, yeah, you're right, it's not okay. And then have them get fired up to go do something about it, and to be committed to a career in public health where they focus on these things, I don't know that I would have had a similar platform had in 2014. I not been infected. That sad moment sucked. But like so many of the people that I've worked with that have found a way of translating their sad into something impactful. I hope that's what the last, I guess decade has been for me. And that makes me happy.

There's even more last day with Apple Premium subscribers get exclusive access to bonus content, including the juicy parts of my conversations with guests that didn't make it into the final episodes. Subscribe now. In Apple Podcasts, last Day is a production of Lemonade Media. The show is produced by Keegan Zemma, Aria Bracci and Tiffany Bowie. Our engineer is Brian Castillo. Music is by Hannah Brown. Steve Nelson is our vice president of weekly content and production. Executive producers are Jessica Cordova, Kramer and me, Stephanie Whittleswax. If you like what you heard today, we have three other seasons that you can check out. Have a story you'd like to share, head to bit ly slash last days stories, or click the link in the show notes to fill out our confidential Google form. This series is presented by the Marguerite Casey foundation. Follow and subscribe wherever you get your podcasts or listen ad free on Amazon Music with your prime membership. You can find us online at Lemonade Media and you can find me at Whittlestephany. Thanks for listening. We'll see you next time.

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Fatigue about what to make for dinner, we get it. I'm Jane Black. And I'm Liz Dunn. We're veteran food journalists, and as parents ourselves, we know how hard it can be to feed your family. That's why we created Pressure Cooker, a podcast that offers practical strategies for navigating the marketing madness and cultural expectations around meal time. Each week, we'll check in with the experts from social media diet trends to baby led weaning and AI meal planning, we have all your food related questions covered. Listen to pressure cooker wherever you get your podcasts.