Recovery Diaries In Depth
Welcome to Recovery Diaries In Depth; a mental health podcast that creates a warm, empathic, and engaging space for discussions around mental health, empowerment, and change. Executive Director and podcast host Gabe Nathan brings a unique combination of lived experience with mental health challenges, years of independent mental health and suicide awareness advocacy, and an understanding of the inpatient psychiatric millieu as a former staff member at a psychiatric hospital. This extensive background helps him navigate complex and nuanced conversations with a diverse array of guests, all of whom are vulnerable and engaged; doing their utmost to eradicate mental health stigma through advocacy, storytelling, and open conversation.
Guests who have previously contributed a mental health personal essay read their essays aloud during the podcast and then chat with Gabe about what has changed in their lives since their essays were published on the site. By engaging in deep discussions with people living with mental health challenges like bipolar disorder, trauma histories, addiction issues, schizophrenia, anxiety, depression, obsessive compulsive or eating disorders, Recovery Diaries in Depth further carries out Recovery Diaries' mission to #buststigma by showing people that they are not alone, instead of just telling them. This mental health podcast features guests from all over the world and, while their own personal experiences are unique, the human experience is what unites, inspires, and connects. Subscribe, like, share, and enjoy!
Recovery Diaries In Depth is supported in full by the van Ameringen Foundation.
Recovery Diaries In Depth
Kindness is a Powerful Choice; with Dr. Erica Harris | RDID; Ep 113
Erica Harris is an emergency physician at Einstein Hospital, and she also serves on the Board of Directors of Recovery Diaries. Our "Recovery Diaries in Depth" interview with Dr. Harris is a wide-ranging, empathic conversation that you will be sure to want to hear.
Dr. Harris's experiences working in emergency medicine, surviving the trauma of COVID, are discussed in her interview and are also the subject of a beautiful documentary film we made several years ago, during the height of the pandemic where she thought about ideas of vulnerability and heroism, juxtaposing her career as a physician against that of her grandfather, a coal miner who fought for miner's rights and safety.
In today's profit-driven medical industry, many healthcare providers feel immense pressure to see as many patients in a shift as possible to maximize profits, but Dr. Harris emphatically believes that kindness and empathy don't cost anything and they don't make interactions take any longer. She is a true believer in vulnerable, intimate moments with her patients. She also is a strong advocate for de-stigmatizing and normalizing mental health, openly sharing that she is in therapy.
Dr. Harris knows for sure that helping others, whether during a pandemic or not, has its toll that it takes on the mental health of providers, but she is here to remind us that vulnerability is a strength and that we can get through anything.
Conversations like the ones on this podcast can sometimes be hard, but they're always necessary. If you or someone you know is struggling, please consider visiting www.wannatalkaboutit.com. If you or someone you know is considering suicide, please call, text, or chat 988.
Hello, this is Recovery Diaries In-Depth. I'm your host, Gabe Nathan. Thanks so much for joining us. We're very happy to have you here. We are so fortunate to have today as our guest Dr Erica Harris. She's an emergency room physician at Einstein Medical Center in Philadelphia. She's also a member of our Recovery Diaries Board of Directors. A few years ago, during the height of the COVID pandemic, we made a film about Dr Erica Harris and we were delighted to have her here as our guest.
Gabe Nathan:Each week we'll bring you a Recovery Diaries contributor folks who have shared their mental health journey with us through essay or video format. We want to see where they are in their mental health journey since initially being published on our website. Our goal is to continue supporting our diverse community by having conversations here on our podcast to follow up and see what has shifted, what has changed and what new things have emerged. We're so happy to have you along for this journey. We want to remind you to follow our show for new and back episodes at recoverydiariesorg. There, like the podcast, you'll find stories of mental health, empowerment and change. You can also sign up for our mailing list there so you never miss a new podcast episode, essay or film, and you can find this podcast pretty much anywhere you get your podcasts. We appreciate your comments and feedback about our show. It helps us improve, make changes and grow and, of course, make sure to like, share and subscribe. Erica Harris, welcome to Recovery Diaries In-Depth. Thank you so so much for being here with me today.
Erica Harris:Well, thank you for having me.
Gabe Nathan:It is an absolute pleasure. Just by way as a brief introduction, you are an emergency physician at Einstein Medical Center in Philadelphia. Can you talk a little bit about who else you are, aside from that title and that intro and all the gravitas that goes along with that?
Erica Harris:Yeah, so there's a lot. I don't know where to start. I am an emergency physician. I've trained, I feel like most of my life to do that and it's something that I actively work to do. But I think other important roles for me, you know, I've been the medical director of our violence intervention program at the hospital and in that role I try to help people with their physical and mental health recovery from injury. I am a mother to two young children, I am a friend and I'm a pet mom and I think these are all roles where I try to be a nurturer and that's sort of the thread between the things that I find most value in.
Gabe Nathan:You're also a coal miner's granddaughter.
Erica Harris:Correct, yes.
Gabe Nathan:We'll get to that a little later when we talk about the film that we made about you a few years ago. But I want to touch briefly on or I'd like you to touch on it this idea of nurturing. And you went through extensive training to become a medical professional and there is a lot that goes into that, that is didactic in nature, that you had to learn and process and apply, but nobody teaches you how to be a nurturer, no one teaches you what that means and how to do that for people. So can you talk a little bit about about nurturing and how you found your way into that aspect of your profession and your life?
Erica Harris:I think that for me, nurturing isn't necessarily something that comes naturally. I think for most of us, when we reflect on our life, we realize that we've been sort of nurtured into being ourselves, that we're here because we were nurtured, that that's a part of being part of the human community. Is that we require that? We require that to grow and develop, that we can't develop language if we're not nurtured appropriately. We can't develop our bodies if we're not nurtured if we're not cared for.
Erica Harris:That. That's a prerequisite for being alive. It's not just that's nice to have, it'd be nice if we could be. No, we actually have to. Our brains don't develop appropriately if we are not appropriately nourished and nurtured. So I think that, in reflecting on my life, that there were very key people in my life who nurtured me into being not just alive but alive and doing well, alive and able to function, alive and able to think, and these were, you know, various people throughout my life. These are, you know, obviously, you know my parents, the people closest to me, my, you know, my sister, my friends, but teachers. You know people who cared, people who came into my life and took an interest.
Erica Harris:Now going through that process of being ill, being very ill, having surgery, recovering and seeing, both within the healthcare system, what nurturing looks like and what it doesn't look like, what the opposite of that looks like. In obtaining healthcare and watching sort of the struggles of other people, created a model for me, a roadmap of what I wanted to be in a healing profession and sort of created in my mind what a best practice could be, what that nurturing could look like and believing in the potential for other people that I have a certain position of privilege as a physician, not just societal privilege as a title, but in my role as a physician, in what I'm able to do and provide people with, within the healthcare system, access to resources. And that became very important to me to really take that and turn it into something that could be useful for people, to turn that into something powerful within them, to show them within themselves what they're capable of and give that back. So it really for me is almost like a patchwork quilt of all the love that I've ever been given and shown in my life to give that back. To give that back to people when they're at their weakest and seeing that our healthcare system doesn't necessarily value that, that that's not something that we can monetize and sell and make money off of. And it's a very you know, we're a very monetarily driven healthcare system. We're and and it's a very you know, we were a very monetary, monetarily driven healthcare system. That we, we're a business. It's a business driven healthcare system. That's how things move through the healthcare system.
Erica Harris:But people are not the bottom line. People are what, the only thing that matters really when we're talking about, you know, healthcare to me, and that's a challenging something that I have to reconcile every day is like this is real. This is like we work in a business and we're working with people, and how do we, how do I reconcile that every day? And so that's a challenge. And that's a challenge, I think, in training and working with residents and medical students and trying to residents and medical students and trying to also share with them those values, sort of that ethos of caring for people, caring for their souls, not just for their bodies, but how do you do both?
Gabe Nathan:And you can do both and you must. It's a remarkable answer and my brain is making so many connections. As you're talking and I'm thinking about a long time ago, when I used to be an EMT for a private for-profit transport company that you know, we said that you know our ambulances are basically FedEx trucks with oxygen tanks and you know we're really just schlepping bodies and it could just be packages, it could be widgets, it could be anything. Because it was like how many transports can you do in an eight hour shift and a 12 hour shift? How much money can you make the company?
Gabe Nathan:But these were people on stretchers in the back of the truck and we were responsible for them and sometimes they were very, very sick, um, and I think about that, that role of humanity and how you can't. There's no ICD code for nurturing. You can't bill for that, um, but it is such an essential you can't bill for that, but it is such an essential human thing and it's people at their most vulnerable. They can't do for themselves, sometimes they can't feed themselves, they can't ask for what they need, and so how do you, on a day-to-day basis, kind of parse that out? That dichotomy of this is a business and money is involved and there is billing involved and all of that, and there's also pressure to, you know, see patients and make discharges and admit new patients, and it's all keeping that cycle going. How do you do that every day?
Erica Harris:I realize that everything is business currently Like. We live in a capitalist society. This is the framework that everybody lives in, this is the water that we swim in, and I think that that is not an excuse to not be who you are, to not be human to one another. Kindness takes absolutely no time Connecting with a human being. I feel like it almost is a radical act anymore to really truly connect, to step out of your own experience enough to try to understand and feel what somebody else maybe has felt or might be feeling. That does not take a lot of time. That does not take time away from moving people through a busy emergency department. In fact, I would argue it saves you time. It saves you time because then you're not asking 20 sort of inane questions of them from a checklist right, you are actually getting to the core of why they're there and what you can do for them and how you can best serve them. Right, you're actually getting at the core of who they are. They're having a better experience. You, as a healthcare worker, are actually kind of regenerating your batteries a little bit as well, because you've had something meaningful to you.
Erica Harris:Most people don't go into medicine at any level. You know, if you're going into nursing, if you're going in to be a doctor, if you're going to be a physician assistant, you're not doing it really to make a lot of money. It's not like, it's not the pathway, and if it ever was, it is most certainly not anymore. To make a ton of money right, like go into finance, like go do that, like this, is not what people think of when they're like you know ways to make quick money. So you're doing it because you have a desire to actually serve people and to serve people when they are at their lowest, when they need the most amount of help, like you. Actually, really, that was the original reason, probably at some level, that most people I know went into this profession. And so when you're actually able to do that, that's, I think, when people see, I see this like light in their eyes and I feel like the system can take that out of you, because so often you feel like you're just going through the motions and you're just checking the boxes and you're just doing this. But when you're able to actually, you know, make that connection with a human being and feel like you actually made a difference for them, you actually serve them and you had that moment. I think that is fuel for us, and so it goes both ways. You've served the patient, but you've also served yourself, and that matters.
Erica Harris:I think that we can't exclude ourselves from this equation, that there's this idea of oh, the selfless, you know, provider of services. It's like we're not providers, we are humans in an interaction that matters, and so, yeah, we get our paycheck, the patient gets their medical services, but it's almost a holy interaction and I think that we can't lose sight of that, that it's up to us to remember, that it's up to us to remember and we have choices. So, yeah, we may be operating in a system that tells us you have to see this many patients an hour. This has been a very busy respiratory season. There are 60 plus people in our waiting rooms, and this is true across the country. It's not just at Jefferson Einstein Hospital, this is everywhere, across the city, across the country, nationally. People are backed up. We want to serve people better, we want to get them out of the waiting rooms, we want to see all those patients.
Erica Harris:It's frustrating for everybody, it's frustrating for the patients, it's frustrating for us, but even within that, that we can find joy in the people that we are able to serve and we are able to take care of, and everything that we do as a choice, everything that we are able to have control over.
Erica Harris:We get to make those choices, like I'm going to choose that day to go in and have good interactions with the patients that I am able to serve that day, and it is, I'm going to say, I'm just going to say it's becoming more and more every day of a radical choice to be decent to one another, to actually intend to set out on that day and really maybe find out one interesting thing about that patient that day, like one thing that maybe doesn't have to do with the complaint of knee pain, but you found out kind of something that they did when they were, you know, younger.
Erica Harris:They tell you an interesting story and you're like, wow, that's, that's an interesting fact that I learned just from you know, sitting and making space for that person and really kind of reserving judgment and're just walking down the street kind of ignoring people with your head down on your phone, that we get all these opportunities to talk to so many people in a day and they're naturally going to be more vulnerable with you because they're in a vulnerable place and they have to tell you their story, they have to tell you what's going on with themselves, and so we have all these opportunities in any given day to open up and allow that, and so that's really what I try to get across. I have my days. Most certainly I'm not a walking model of you know. I'm getting joy, squeezing joy like orange juice, out of every moment of every day. There's tougher days than others, but on the whole, I think that's something that we can strive for and it's worth striving for.
Gabe Nathan:I think people are so hungry for it. I think they're so wanting to share of themselves with somebody who actually genuinely cares, somebody who is going to make eye contact with them, somebody who is going to express an interest. You used the phrase a holy interaction and I was thinking about. My GP passed away at 92 on a Friday and he had a full docket of patients to see on Monday and the receptionist had to go through calling everyone. Dr Landers passed away and he used to make house calls to my great grandmother and so you know, we, just everybody just kept seeing Dr Lander Right and, um, I remember one day I was in his waiting room and there was this old guy. It was just the two of us in the waiting room and the guy looked at me and he said, are you here to see him? And he pointed at the ceiling like God you know.
Gabe Nathan:But obviously I was there to see Dr Lander, as he was too, and it was so heartwarming to me to be like, oh, this guy loves Dr Lander the same way I do. And why? Sure, because this man was interconnected in so many people's lives through so, so, so many years of service, but also because he was warm and kind and thoughtful and asked about you and asked about the family and knew all the stories and wanted to learn more. And I mean, of course, there wasn't a computer in sight in his anywhere, not even at reception. It was a typewriter.
Gabe Nathan:But when I had to find a new GP, I remember going to a guy who had his laptop on his lap and he did not look at me once, just stared at the screen until it was time for the H&P, just went through questions, did not look at me and I was like God. There could not be a bigger difference here and, like you said before, eye contact doesn't take any extra time and these things make for such a more human interaction and just such a lovely, a lovelier experience and I think we need need that so, so desperately, um, and it's, it's a wonderful thing that you're able to provide that for people. But I'm curious about the cost um to you as far as being a healthcare provider you know you were, obviously you were a healthcare provider through COVID and that ain't over yet and just the impact of the profession and the expectations and the pressures on your mental health and wellbeing. How has it affected you through the years and how do you help yourself?
Erica Harris:I think COVID was it was sort of the way I've best heard it described was a slowly unfolding mass casualty event and it wasn't just sort of something that happened out there. Because when we think of mass casualty events, you think of mass shootings or like a building collapse or an earthquake. You think of something that happens outside the hospital walls, right, and then we become sort of the second victims of that as healthcare workers that we receive the victims and we manage the trauma and things like that. But it happened to us too. We were there witnessing it, but we were also of it. We were people that we were sort of victimized by it, in a sense that we were primary targets that we were receiving patients and getting sick from them also, and we knew that that we were vulnerable to the effects of the diseases that we saw. We were the first people to see it. We were the ones that were we talk about. We talk about the victims from the past, the original COVID, like the way that it was, in the very beginning. We talk about it like remember those days where the patients would come and their eyes would be bugging out and their oxygen saturations would be low. We talk about it like the way people talk about war stories, like if they talk about them at all.
Erica Harris:We often don't talk about it. It's rare. I find these rare moments where I'll be talking with somebody and it comes up sort of in passing. It'll be like we're walking down the hallway to the cafeteria and we sort of allow ourselves this moment of reflection and it's a dark one. It's not like oh yeah, you know, that was sad, that was rough, that was hard. I'm glad it's over. It's very much what I would consider a vulnerable moment and it's among very trusted friends and colleagues. It's not something that we ever talk about. I've never seen it happen casually. It's never happened for me casually with people I've just met where we're talking about sort of our feelings around it. We'll talk about the numbers, we'll talk about sort of the way that you can deconstruct it and make it very generic, very bland, very removed from our own experience with it, very removed from our own experience with it. But to actually talk about how it felt the fear, the panic, the feelings of being out of control, the worry for our own health. And even I was thinking about in preparation for coming here to discuss on the podcast with you watching the video, watching my video, it's hard. For me it's actually hard. It's like a time capsule, because it was made very close to that first wave of COVID. It was sort of like things that calmed down a little bit, and I just remember, though the feelings it brings up are very strong and very powerful.
Erica Harris:It really did cause an exodus of people from nursing at least I know there's physicians who have left the field because of it, and it's complicated. It's not just about oh, we saw a lot of victims of disease. I think there were a lot of social and cultural factors that played into that, but there was a lot of things. I think, and I think, as per a lot of other similar mass casualty events, the ways people don't talk about it, the ways that we're encouraged to be strong and keep going and that's the culture of medicine in general is to be strong and not talk about it. You don't want to admit to other people, to the person next to you, that you were scared, that you were worried I know in training. You don't want to admit that you had a case that frightened you or that you were afraid that you were going to mess up, and I think we were collectively afraid of messing everything up because nobody knew what they were doing. So there were like layered fears layered fears of not being enough professionally, layered fears of getting sick and taking it to your family, fears of your own death, fears of just watching just this massive suffering and what it meant for all of humanity that we felt in charge of. And so there was really no also collective debriefing. There was no way for us to like what do we do with this now? It's like okay, everything's fine, everything's great. To like what do we do with this now? It's like okay, everything's fine, everything's great. And sort of.
Erica Harris:It felt like also a slap in the face when you know people, the whole debate about masking or unmasking, or vaccines or no vaccines, it felt very personal for a lot of people. I think when people are like my body, my rights, it's like okay, like there's room for conversation here, there's room for, I think, healthy discussions around vaccine hesitancy and around, you know, personal autonomy. But I think that for a lot of us in healthcare it's sort of like but we almost died, like we watched people die. It is so hard. And then everything. Just one day it's like okay, everything's normal now. It's like but it's not for us, it's not we, just we carry it with us and there was, there wasn't a lot to make that transition from catastrophe to everyday, normal life. Now it's like get back to work, get back to the next thing that's going to happen, everything's great.
Erica Harris:A lot of these situations for people that you know that the rain comes and then the rain stops and then the sun comes out and then everything normal, the world goes on for people and it doesn't feel that way to them, and so that's what I think that we're reckoning with now is a lot of just stored, dormant energy from that. It's there, it's in the dirt, it's just sitting there, it's stagnant, and I hope for people that they are processing that, that they are working with that, at least on their own. But I don't think, if there were a way to collectively debrief, to collectively mourn and to collectively move forward from that, I think that would be very healthy. If there were a way to do that, that would be the way forward for us to recognize that this is something that requires a great amount of healing.
Gabe Nathan:I'm listening to you talk and I'm thinking about law enforcement and about how similar so many of the things that you're saying about the medical profession are applicable to first responders, particularly law enforcement, and we did the series of films quite a while ago called Beneath the Vest stories of first responder mental health. Many of the participants were police officers who I mean. The similarities between the medical culture and law enforcement are so much. This idea of this happened to you. Now get over it and move on to the next thing. You have to be strong. You have to have all the answers. You cannot admit that you were afraid or scared about something, and it's so unhealthy and it's so unhealthy and it's so anathema to what people need, because I'm thinking about you and your colleagues and what people needed the most was probably sitting next to someone who went through something that they did and hearing. I was so scared and they could be able to say God, me too.
Erica Harris:Yeah.
Gabe Nathan:I didn't feel like I could say it until I heard you say it. Yeah, but everyone is. So you're taught to not say it, and so nobody is going to be the first one to say it, but everybody needs to hear it. Do you know what?
Gabe Nathan:I'm saying Right and I used to work in a psychiatric hospital and I was thinking about traumatic things that we saw and went through and and violent assaults, and it was the only time there was a debriefing was when something went really wrong and everybody was forced upstairs to the boardroom to watch, to be re-traumatized, to watch videos of a really fucked up incident and watch them over. And I remember when I was assaulted I was called upstairs and you watch it over and over and over again. So you get to be re-traumatized and shamed.
Gabe Nathan:Well, you know you really could have done this here and this here. And let's pause it and watch it again. Let's watch it in slow motion now. And it's the way in which trauma is handled in these professions and these institutions. It's so shocking to me every time I hear it or every time I think about it, when what is needed is just like nakedness and vulnerability and tears, and people holding each other, literally or figuratively, and saying me too, and I can't believe we got through that and I have no idea how and I didn't know what I was doing. But there is that expectation of you that you have to have all the answers and I don't know. Or I was scared or it's not acceptable, but it has to be.
Gabe Nathan:And I don't know how we change that. I don't know where that process of change begins. I mean, I know, in law enforcement, one of the hopeful things that's happening is these old commanding officers who have these dumb, stupid, macho views. They're dying or they're retiring and they're being replaced by people who are maybe better educated, who have a better understanding of mental health, who understand hey, we want guys on the force who are in therapy. We want people to say I'm having issues with alcohol or I'm having issues with depression and speaking about it. I don't know if there's a similar culture change happening in the medical profession.
Erica Harris:I think that there is, I think, one thing that we're trying to work on actively. I know that within my department, I think more broadly nationally, that we're trying to work on is doing debriefings, doing standard debriefings after difficult events, and this is not the punitive debriefing where you're watching the video and it's a clinical focus on wow, you should have given more medications at different times. It's focused on how did you feel? And training people on how's everybody feeling, like a kind of a pulse check, just making space for people to feel what they need to feel. And I think an important part of that is also offering, I think, layers of support along the way that there's like you need to be doing the baseline work right, the maintenance work on yourself to make sure that your substrate's okay, that you're coming into work as healthy as you possibly can be, because life happens around before, during and after your shifts before, during and after all the work that you have to do, you're bringing yourself in, you're bringing the preexisting trauma in and the healthier that you are coming in to work to these traumatic events. If you're in law enforcement, if you're any kind of first responder, if you're in healthcare, you need to be as healthy as you possibly can. If you're bringing a traumatized self and an acutely traumatized self, you're just adding layers upon layers to what's already there and that's challenging. So that work kind of exists for you. But if organizations can provide that kind of support to people before they even get to work, they can make it easier for people to obtain mental health resources. And, for example, a lot of physicians I know this probably is true in other industries they're worried about seeking mental health care because of the implications for licensing. You have to report it. You have to report. If you have been on antidepressants, anti-anxiety medications, do you have to report that to the state medical board when you are going for your medical licensing. That is a huge deterrent for physicians seeking care. I know that for a fact that they will tell you that, that they think twice before obtaining psychiatric counseling because they're worried about having to report it, to disclose it for their state licensing, for hospital licensing, because they're worried about it.
Erica Harris:It's not just the stigma in general. I will stand on top of the mountains, I tell everybody who will listen I'm in therapy, because I will be the girl with the toilet paper on my shoe and I will say look, here it is. Everybody gets toilet paper on their shoe. It's fine. Come join me, it's great. I love therapy. I have therapy today. Do you have therapy? Do you want a therapist number? I have it. Here it is. I want people to know it's okay and it's more than okay. It's actually should be standard, should be in the water. So I'm fine with that. But I do understand the legitimate concern that people have about it affecting their livelihood. It's beyond just what will people think of me? It's like will I be able to, you know, get a job and feed my family? It's very practical concerns.
Gabe Nathan:It's not just what people laugh at me in the break room. Do the thing that I spent hundreds of thousands of dollars and years and years and years of my life, that I've now pigeonholed myself into this career, that if it gets taken away from me, what the fuck do I do?
Erica Harris:Correct and I want to be able to practice and I don't think that it makes me an inadequate doctor to say I'm on anxiety medications or I'm on antidepressants. I think it makes me a great doctor because it means I'm taking care of myself.
Erica Harris:If I have a bad heart rhythm, which I do, and I take antiarrhythmic drugs, which I do. I think that makes me a better doctor, because I'm handling myself so that when I go to work I'm not going to have a medical emergency, I'm not going to have a psychiatric emergency. My body and my mind are in great shape to provide care to you. You want the doctor taking care of you to have their medical and mental and physical and spiritual self together. You don't want somebody walking in the room who's falling apart to take care of you, and so all of that, I think, needs to be revisited. I think that we need to fundamentally revisit how we both encourage and discourage health care workers and frontline workers and all workers, either implicitly or explicitly, from seeking care. I think that that's fundamental because we can't say like take care of yourself and then also have no time provided for it, Make it physically impossible.
Erica Harris:Right. I mean there's a lot of people who I know will go seek mental health counseling and they'll do it kind of like off the books. They're not going through their insurance, which, first of all, is challenging enough. If you can even find somebody who takes insurance which I understand is for the mental health providers out there is not a fun task to have to do. But if you can find somebody, they're worried about being linked to their employment-based insurance and having it be on their employment records.
Erica Harris:There's just a lot of barriers and so stigma goes in a lot of different directions and sometimes it's a very practical thing. It's not just about sort of how you feel on the inside. It's about actual concerns about the impacts that it could have on your career and your ability to be licensed, and that's that's, I think, very unfortunate. And then people get to the point where you know their their mental health has to degrade to the point of an emergency for them to even be able to consider seeking care, because they realize it's like, well, I can't work anymore anyway because you know I'm not functioning anymore, and then they're able to go get the care that they need. And it should never get to that point for any human being, least of all somebody who's actively taking care of other human beings.
Gabe Nathan:And we saw that in another film that we made about another physician, dr Michael Weinstein, who was absolutely falling apart, suicidal, hospitalized, and what could have happened if he had taken care of himself earlier, if he felt safe and at ease enough and not stigmatized and not fearful. But, like you said, things have to get to the breaking point, to the point where, well, I can't practice anyway, so I might as well. Just, it's absolutely deplorable and sometimes I hear, oh, stigma, stigma, stigma, and it's a huge buzzword in mental health, of course, health, of course. And it sometimes seems overblown or overplayed or just a very nebulous concept and I can feel like, well, yeah, stigma exists, and yet so many more people are talking about mental health now, so many more people are being open and vulnerable about going to therapy and taking medication, all of that stuff. So is stigma really as big as, and vulnerable about, going to therapy and taking medication, all of that stuff? So is stigma really as big as people make it out to be? But then, of course, we hear about it from your perspective and about the very, very real, tangible costs of stigma in the medical profession, in the military, in aviation, in the medical profession, in the military, in aviation in first response, all of these things where you are. Basically you're putting your job and your livelihood on the line simply for needing help.
Gabe Nathan:And you know I touched on Michael Weinstein's film and I do want to talk about yours. You know your film came out of an essay that you wrote. Is that right? Can you talk a little bit about the essay and then segue into the film?
Erica Harris:Sure. So the essay was called Dressing Up. It was published in JAMA in 2020, so around the time of the beginning of the COVID pandemic. It was based very much on sort of my feelings around PPE and that sort of as a reflection not just of putting on PPE and the difficulties of doing that not just physically putting on PPE but sort of as a reflection of what it meant to assume this role of being this physician in the emergency department during the pandemic and what that meant. That I became sort of this other person and I looked different. I felt different. I was being expected to do things that I didn't think I could do and it felt very much like dressing up, like dressing up for a role that was somebody else. I looked like somebody else and I was feeling like kind of I would see these glimpses of my grandfather, who was a miner in northern Idaho, and he was somebody I never actually met, but I heard a lot of stories of his kind of bravery in, I think, just period working in the mines.
Erica Harris:Working being a miner is very difficult work, but also he did a lot of work working to secure protections for miners, including just basic protective wear, and that's what we were seeing, also in the COVID pandemic in the very beginning, was difficulty obtaining basic protection, basic masking, recycling gowns, just because of shortages that we had. It wasn't so much that people were trying to deny us these things, just that they didn't exist and it was really a very hard job for people to try to find these things, and a lot of fear around shortages, lot of fear around shortages and so this idea of scarcity further adding to the fears that existed about the disease in the first place. But really, seeing as I would see reflections of myself going into these rooms with really sick patients, feeling like I looked like a minor, feeling like I looked like my grandfather, and actually finding strength in that, finding strength and being like kind of a reminder like this is who you are, this is who you come from, you will be okay, and finding that, you know, finding a very important historical reminder for where I came from. And I think that that was important for me to reflect on that part of my past, that part of my ancestry, that I can do hard things, that my family has done hard things, I can do hard things and that, even if I'm fearful, even if I don't feel lovely, every moment of every day, that feeling of fear, that feeling of disgust with the way that things are. That's not the point.
Erica Harris:The point is what I'm actually able to do anyway, that, despite those things, I'm able to do this, that I thought being called a hero just didn't feel how I was actually feeling, and that there was a lot of discomfort with that, that people were saying oh, you're a hero, you're a healthcare hero, and I was like I don't feel like it, I don't feel heroic at all. I feel very much the opposite and I don't like being called a hero. It's very uncomfortable for me to be called a hero and I think that the way that I reconciled being called a hero with how I actually felt was just saying I'm doing this anyway. It doesn't matter how I feel on the inside, it matters what I'm actually able to do, which, at the end of the day, was, at a minimum provide comfort to people, even when we didn't know the best practices for treating the disease. The day was, at a minimum provide comfort to people, even when we didn't know the best practices for treating the disease. We didn't have a lot of treatments. We didn't have, certainly didn't have vaccines at that point, didn't have medications. We were just doing kind of old medicine for a new disease that I could still be, like we talked about at the beginning a human. I could still be there, I could still be a source of comfort. I found a way to do that.
Erica Harris:Despite these layers, I looked like an insect. I had a patient once look frightened of me. She's like you, look like a bug. I'm like I actually really do, and we laughed because I agreed I'm like I look. I actually look like a praying mantis. I look kind of weird. I'm sorry we laughed about it, but being able to what it was and just accept it and still come in and do my best Despite those fears, I realized it's like okay, you can keep going. People keep going no matter the difficult circumstances, and there's people who have faced even more difficult circumstances and continued to do things that they never thought that they could do and continue fighting, and so I think that people can find inspiration in a lot of different sources to keep propelling them forward.
Gabe Nathan:When I was watching your film in preparation for the podcast interview, a moment that really struck me was these beautiful shots of you just layering and layering and layering and the cap and the respirator and the mask and the shield and it's like my God, how many more things can she possibly put on? And the last thing that you do is you're clipping this photo of yourself, just as you as human, Erica, as this way to comfort patients and this way to say okay, I look like this, I look like the praying mantis, but this is who I actually am, and I thought that was such a wonderful way to be human and to connect. And again at the, at the beginning of the interview, we talked about how important that is and how that doesn't cost anything and that doesn't take away any time. Um, but it's just such a thoughtful, meaningful thing to do. Even the stickers, uh, on the top of your uh, your shield, the headpiece these are little parts of my identity and I loved that.
Gabe Nathan:And I was thinking, too, about your grandfather and about the way that he fought for his colleagues and pushed for change and for safety enhancements, even something as simple as gloves. And I wondered about you talked about the word hero and your discomfort with that, but I was thinking about your grandfather and the word that came up for me was advocate someone who advocates for others, and I wonder how you feel about that. Do you see yourself as an advocate?
Erica Harris:I think that that is when I'm at my best. Yes, is what I'll say, that when I realize, I think, the full, the full strength of the privileges that I have, when I'm fully optimized, I think that that is the best role that I can have. I think that is sort of like my highest calling on the best day. That is what I am able to successfully do. I think that is what I aspire to be and to do and that is, I think, what anybody with any amount of privilege, even a little bit, I think, is called to do, and that is, I think, what anybody with any amount of privilege, even a little bit, I think, is called to do for their fellow man, for their fellow creatures. I think that that's what we are supposed to be doing to advocate for one another and for things that really.
Erica Harris:I don't like to use the word voiceless, because every human has a voice. I think that sometimes it's being drowned out, so like, maybe making room for their voice is a better way than saying voiceless. But even sometimes it's just a matter of handing the mic back to the person who was speaking. You know if you're able to do that, but absolutely I think that that's the key. I think that also a reminder that the little things that you were talking about like that's a reminder that we always have choices, even when things seem hopeless, when you have what seems like nothing. Even within that and I know a lot of people feel that way now. They feel that way about the world right now, in this exact moment, that people feel like there's nothing I can do, it's just everything's horrible. It's like. That may be true, maybe it's not true, maybe it is true.
Erica Harris:Regardless, you can make even the smallest choice, for yourself or for somebody else. It does not have to be the thing that, like turns the axis of the earth and changes the shift of the moon's pull on the ocean. It can be a thing that you do, it's a choice and it matters. Every little choice we make matters and it could matter to you, it could matter to somebody else. It can be something that you reached out and you said something positive to somebody else, or it can be you just said it to yourself, you just chose to be kind to yourself that day. But we always have a choice in what we do and how we do a thing, and that's power. I mean that's power. It's the little things, it's the little people. It is working together. It does not have to be huge, it does not have to be a huge thing. It starts with those little things and just focusing on like the one little thing that we can do is so critically important. I think, now more than ever.
Gabe Nathan:People who listen regularly to this podcast would be sick of this quote.
Gabe Nathan:Well, I think it's only the second time that I'm using it, but it's a Mark Twain quote that I love very much and I'm paraphrasing it.
Gabe Nathan:But he says real change doesn't occur at the center, it occurs at the edges, in the everyday lives of everyday folk, and I'm hearing that over and over in my mind as I'm listening to you. Those little choices that we make looking up at someone in the hallway instead of looking down at your clipboard and saying good morning, making yourself a cup of tea, because it's going to put you in a better mood or frame of mind to have an interaction that's coming up in half an hour All of those things do matter in half an hour. All of those things do matter. And if we think that the only things that matter are decisions made by CEOs or presidents or whatever, it's not true, absolutely not, and it's a really empowering, beautiful note that I think that's what I want to leave our listeners with that you are more powerful than you know and those little choices that you make have a really big impact, and thank you so, so much for reminding us of that.
Erica Harris:Absolutely, absolutely.
Gabe Nathan:I'm so grateful to you for the work that you do for the human being that you are, for being on our board of directors at Recovery Diaries, for just being a real badass human being.
Erica Harris:Thank you.
Gabe Nathan:Thank you for being here and spending some time with us.
Erica Harris:Thank you for having me.
Gabe Nathan:It's my pleasure. Thank you again for joining us in conversation today. It's beautiful to see the progression of our contributors. Thank you so much to Dr Erica Harris, physician at Einstein Medical Center in Philadelphia and Recovery Diaries board member, for that wonderful interview reminding us of the little things that we can do to help our mental health and the mental health of others. Before we leave you, we want to remind you to check out our website, recoverydiariesorg. There, like this podcast, you'll find additional stories, videos and content about mental health, empowerment and change. We look forward to continuing to grow our community. Thank you so much for being a part of it. We wouldn't be here without you. Be sure to join our mailing list so you never miss a podcast episode, essay or film. I'm Gabe Nathan. Until next time, take good care.
