Being An Ally, with Pete Buttigieg

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Andy and Pete Buttigieg talk about allyship, protest, and this week’s historic supreme court decision on LGBTQ rights. They also get into what it’s like to go straight from a presidential campaign into social isolation. (Spoiler: It’s weird!) Then, Andy calls Dr. Nzinga Harrison to chat about health equity, the relationship between racism and addiction, and how to do addiction treatment in America better. 

Show notes: 

Keep up with Andy on Twitter @ASlavitt and Instagram @andyslavitt

Find Pete on Twitter and Instagram @PeteButtigieg. 

Find Nzinga @naharrisonmd on Twitter. And learn about all things addiction on Nzinga’s new podcast In Recovery with Dr. Nzinga Harrison. Listen wherever you get your podcasts:

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Keep an eye out for the unedited version of today’s conversation with Nzinga’s coming to Patreon soon!

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[00:43] Andy Slavitt: Welcome to In the Bubble. This is Andy Slavitt. The Slavitt bubble shrank this last week as our oldest son Caleb moved to New York, and he is going to be starting a job and moving into his apartment. What I haven’t told the audience is that when Caleb came home in March, he had the Coronavirus and was isolated in the basement. Cal did not have symptoms, but nevertheless, people may wonder why he wasn’t on the show when he was here, even though I tried to entice him to come on a couple of times. And believe me, Coronavirus was the last thing he wanted to talk about. And he’s not alone. Coronavirus is something people are getting tired of.


[01:33] Andy Slavitt: People are bored with it. They want to go out and resume their lives. They want to move past this. You can see it everywhere. But as tired as we may be of Coronavirus, Coronavirus isn’t tired of us. This virus, the way it behaves, is it simply goes to where it hasn’t been before. That’s how it behaves biologically. And so when somebody asks me, as they do often when I’m on television, hey, Andy, whose fault is it that we’re seeing a lot of coronavirus cases? Is it the many barbecues? Is it the protesters? Is it the governors? Is it Trump? My answer is primarily the villain is the virus, because this is what the virus does. Now, I think we take our eye off the ball when we try to begin the dialog by pinning it on somebody else. Don’t get me wrong: we have a choice in how we react to the virus. And we should expect the president, governors and other political leaders to do what they can to keep us safe and keep the country moving. But we have simply just got to get past the fact that we can deny that the virus is here. Now, there’s things we can do to manage it, and we’ll talk about some of those things. And as you know, I believe we can live alongside this virus. It’s not something that needs by and large to paralyze us, but it is damaging, and it is going to take some of our beloved people, and people won’t make it through. And we just can’t forget that.


[03:06] Andy Slavitt: So I have put a piece out last week that was about what I described as the four different animals that represent our states. With the states that open up first, and really were reluctant to be closed down in the first place, the rabbit. States that opened up second, the cheetahs. The next states that opened next, the rhinos, which I think are a little bit slower but are still pretty fast creatures. And then the tortoises are the ones that have been reluctant to open and opened last. And shared some data that Nephron Research had put together, which showed that in the month of June, so far as you might expect, the rabbits have a much higher case growth, and the tortoises have much lower case growth. So this has everything to do with two things. One is how fast is the virus spreading? And second is what’s the response of our political leaders? So Zach, you didn’t get a fact out of you last week. Maybe we can get one of Zach’s Facts.


[04:04] Zach Slavitt: So my fact today, this is from Eric Feigl-Ding. 


[04:11] Andy Slavitt: He is an epidemiologist and health economist from Harvard. 


[04:16] Zach Slavitt: So he tweeted out some data from the CDC, from a study from the CDC, and they’ve examined clusters of Coronavirus and they found that the majority of cases were spreading from people between ages of 20 and 39. But also, interestingly, something that he didn’t really talk about as much, was that there was almost no spread coming from people under 19, which I guess shows that it’s not necessarily so black and white as just young people are spreading it. It’s actually just more of a specific group, I think.


[04:54] Andy Slavitt: This was a study in Japan of contact tracing where people had seen their cases come from, is that right? 


[05:01] Zach Slavitt: Yeah. And one thing I’m wondering is, well, obviously, this isn’t a definitive thing. It’s just kind of one study thing. But also with that 10 to 19 group, and I’m assuming the younger end of the 20 to 29 group not being serious spreaders, I wonder what this could say about school potentially opening. 


[05:20] Andy Slavitt: Something else happened this week on Monday. Do you want to talk about the action that the FDA took? 


[05:26] Zach Slavitt: Yeah, so the FDA removed hydroxychloroquine from emergency use authorization, which was obviously long overdue, I guess.


[05:36] Andy Slavitt: People may remember President Trump put a lot of stock and a lot of pressure on this as a potential therapy, and it caused heart conditions and had a number of other problems. One of the reasons this is important is because the use of emergency use authority is an important tool, but it should happen when it’s really necessary for the interests of the public. And there’s been rumors circulating that Trump is going to do the same thing come October, with a vaccine. That even without the data to show an effective therapy, or without much time in people’s bodies, that he will in October pressure the FDA to do an emergency use authorization to get a vaccine in the market before the election.


[06:28] Zach Slavitt: Yeah, I think it’s important to note, though, that emergency use authorization isn’t necessarily always a bad thing. People just need to know what it means. For example, the drug remdesivir, which seems effective, was authorized and so far it’s still part of treatment in many countries. And so for people who are not doing well, this authorization is meant for them. And people need to realize that just because a vaccine or a drug is authorized for emergency use does not mean that any person should just go out and get it just to get it. 


[07:02] Andy Slavitt: So how does somebody know? I mean, if it was October and you were offered this vaccine and it was available under EUA, would you take it?


[07:10] Zach Slavitt: Well, ideally, the leadership would be providing proper messaging for what people should be using. But like you said, we don’t necessarily know about that. So I think people are just going to probably have to weigh their risk, whether or not they’re at high risk. Looking at what doctors are recommending, epidemiologists and just seeing if it’s worth it for them. 

[07:34] Andy Slavitt: You know, one of the challenges, even if it is a good idea, as you said, there are valid uses for EUA, people might look at it as political if it’s done in October. So it’s one of the things we’ll keep track of and we’ll have an expert on to talk about vaccines later.


[09:58] Man’s voice: I think it was better than anything we could have expected. It was unambiguous. It was clear. It was to the point. That LGBTQ Americans deserve to be treated in the workplace the same as everybody else. And judged on their talents and their merit and what they contributeA, and not on who they’re married to and not on their gender identity or or anything else like that. 


[10:23] Andy Slavitt: We have Pete Buttigieg on the show today, and that’s gonna be a great conversation. The clip you just heard was from an announcement on Monday that the Supreme Court made a decision by 6-3 to make it illegal for employers to discriminate against the LGBT community. Up until today, it was legal for employers to discriminate simply on the basis of someone’s sexual orientation. So that’s wonderful news. And we’ll talk to Pete about that in a minute. So now you’re updated on the news, both Zach’s facts and Andy’s opinions. And now you’re going to get a real treat and get to hear our conversation with Pete Buttigieg. I don’t think he needs much of an introduction, but mayor of South Bend, Indiana, and former presidential candidate, and someone who I think has really come to national attention by bringing a focus not just on the issues that I think many of us are focused on today, but how we unify as a country and get on the same page. So I hope you enjoy the conversation with Pete. 


[11:40] Andy Slavitt: Hey, Pete. Good to see you. And there’s so much we could talk about, but I think we absolutely have to start with the Supreme Court case today. 


[11:48] Pete Buttigieg: I think that’s right. It’s extraordinary. And especially to see a largely conservative court agree that the Civil Rights Act, just by plain logic, prevents discrimination in a way that maybe its authors didn’t fully grasp, but is no less valid for that reason. At the same time, just like the struggle for equality did not end with marriage equality, it doesn’t end here either. There are still a lot of ways beyond employment discrimination where LGBTQ Americans are vulnerable. And so it’s certainly good news. I think most Americans would consider it common sense. And as a matter of fact, a dangerously high number of Americans assumed that was already the case that you couldn’t get fired for being gay or trans. But I can tell you a lot of places, including Indiana, shortly after I became mayor, we passed a local ordinance. But most states don’t have these kinds of protections. And so it really was important that this get clarified at the federal level. I’m so glad that that happened. And at the same time, this does not take away from the need for a federal equality act so that across all of the different areas, including, of course, healthcare, where we just saw this terrible attack announced last week, basically denying that transgender people exist in the eyes of the administration. Obviously, there’s a long way to go and a lot of work to do. 


[13:05] Andy Slavitt: Yeah. Well, look, it reminds me of something that you said on the campaign trail when you were running for president, which is these are conservative values. I mean, these are not radical values. Protecting people’s rights, not discriminating, interpreting the Constitution. There’s no reason to think that those should be exclusively the domain of progressives. But I think you have taught us, coming from Indiana, that these are things that can be really rooted in people’s faith and people’s belief and they don’t have to be politicized. And so it was encouraging not just to see the court come out the way they did, but, as you said, to see Neil Gorsuch write the opinion. 


[13:43] Pete Buttigieg: That’s right. And again, in my view, when we talk about things like, for example, family values, that includes making sure that families like mine are protected. When we talk about rights and liberties, you shouldn’t have to be a progressive or a liberal to believe that all Americans deserve equal treatment. And that’s exactly what this is about. It’s not about special treatment. It’s about equal treatment. So I’ve always believed that conservatives should be able to support these rights. And I’m glad that at least a majority on the court agreed. 


[14:15] Andy Slavitt: Boy, it’s nice when we have good news. But as you said a few days earlier, late last week, the Trump administration using its own authority, not constitutional authority, made a decision that the protections that were in place for transgender Americans, they were going to unilaterally remove. Not only did they do that, they did it on the fourth anniversary of the Pulse shooting, which was a very painful day for all of us. And, of course, during pride month. So your point that we’re not done is something that we’re sadly reminded of.


[14:51] Pete Buttigieg: Yeah, I mean, you know, whether it was that announcement on the anniversary of the Pulse shooting, or the proposed scheduling of a Juneteenth rally in Tulsa, where one of the worst instances of racial violence, a massacre of black Americans in our history took place. This administration has an impeccable sense of hurtful and destructive timing. And, of course, it’s not just about the timing, it’s about the substance of what they’re doing. And all the more reason why we have to remember what’s at stake in elections. Now, I think in the progressive movement, and certainly from voices leading the way in the movement for racial justice, we’re hearing a lot of people rightly point out that this is bigger than an election. You can’t just say, well, because of this, therefore, vote for my candidate that I’ve been pushing all along. It’s, of course, about more than that. But at the end of the day, if we want institutional practices to change, if we want policy to change, if we want laws to change, then we’ve got to make sure the leaders change. And that’s what elections are all about.


[15:51] Andy Slavitt: I want to come back and ask you about being an ally in a second. But first of all, maybe we should go back a little bit. You’re an immensely popular figure, probably only less popular than one person I could think of, which is your husband, Chasten. Who somehow ended up, I think, really nicely, gratefully capturing a connection to the public. And so maybe just start a little bit more personally, take us a little bit of what you’re pandemic routine — now, your lives are affected deeply by the fact we’ve had an election coming and you’re working very hard for one of the candidates. But I think a lot of people listening to the podcast have seen their lives uprooted by the pandemic and certainly by latter events that have happened. Take us through a little bit of a day in the life of your routine. 

[16:44] Pete Buttigieg: Yeah. So, first of all, thanks for acknowledging Chasten. So our wedding anniversary is coming up and it’s been an amazing journey with him. This will be the second. So obviously the first year and a half of our marriage went through quite an experience. You get married and almost right away start running for president, puts a lot of pressure on a marriage. And, you know, in many ways, while the pandemic is a terrible reason for it to come about, we’ve also been able to be at home and be around each other in a way that presidential politics did not allow. And so I’m trying to be mindful of counting our blessings in that regard. Like a lot of people, we’re learning new things about our marriage and about ourselves and about each other in this context. One of the things I’m finding is that we’re very different and that’s OK. But we’ve had to kind of negotiate that. So for me, salvation comes through routine. I need to establish a kind of rhythm or else nothing gets done. And so I work very hard to keep weekdays from being different from weekends. 


[17:54] Andy Slavitt: I’m sensing he’s Oscar and you’re Felix. 


[17:58] Pete Buttigieg: Yeah. For him, it’s the reverse. I think, you know, he works very hard. He’s just now in the process of completing his book, which is going to come out in September. I’m really proud of the work he’s put into telling a story that I think a lot of Americans are going to connect to. But for him, he may have a day where nothing is structured and then just enter into a work trance and just be at his computer pushing for 12 hours. For me, as much as possible, I try to have a rhythm, some reading and writing in the morning. I’m doing Zoom conversations like so many of us are in the afternoon. And then campaigning as much as I can, especially the evenings for candidates I believe in, from Vice President Biden to the 22 candidates that my political action committee, Win the Era, has endorsed. And part of what we’re trying to do there is to kind of make good on what I think so many of us have come to realize, which is that the presidency is not the only office that matters. It’s hugely consequential. I think the world would be a very different place right now, of course, if we had a different president. But we’re seeing county and state and local elected officials on the front lines dealing with public health. And so it’s an important time to be present in supporting those candidates. 


[19:10] Pete Buttigieg: And I think in a different way, we’re being reminded of that in the crisis over racial justice that we’re experiencing, too. You know, offices that were not usually on the radar of progressive activists as recently as a decade ago, at least in terms of running our own candidates, like district attorney offices, attorney generals, prosecutors, where it is clearly every bit as important that a prosecutor have a heart for racial justice as a public defender. Anyway, to get to your question, you know, I’m trying to be present in those campaigns, and those debates and those conversations, and at the same time, you know, it’s a strange thing to come off the presidential campaign. And so part of what I’m trying to do is just be a person again, in a way that isn’t really fully possible when you’re in that unbelievable grind of running for president.


[19:58] Andy Slavitt: It seems like it would be with all the momentum and energy and constant focus you need to run for president, it would seem like it would be, I don’t know if let down is the right word, but just some challenges to the adjustment. 

[20:11] Pete Buttigieg: Yeah, it’s an abrupt deceleration, right? You and hundreds of people on staff and tens of thousands of volunteers are all trying to drive toward this one goal, this one thing that’s going to happen or not happen. And then suddenly you’re not. And so what I’m getting used to, even after the better part of the decade as mayor, where it’s a very complex job with a lot of different sides to it, but it’s one job that dominates your life. Now, it’s about finding a lot of different areas where I can make myself useful, a lot of different ways where I can make a difference with a very small but mighty team and a different kind of structure. So it’s a good moment to take stock of where we are. And if it were a quieter time, it might be a good moment to just take a long vacation. But, you know, I would not have believed you if you had told me that the stakes were going to go up even higher than what they were like when I was running for president. And yet here we are again and again, the outpouring of anguish over systemic racism in this country and police violence. This world historical emergency in terms of the pandemic. And it does have me thinking about the fact that this probably is not the last time that the year 2020 will serve up an event of massive historic proportions. You know, we started this year with the impeachment of a U.S. president. It’s a distant memory now, an asterisk. And so I do worry about what more might be thrown at us, whether it’s a national security event. Or extreme weather events, which are more frequent each passing year as climate change comes upon us. And we will continue to be tested I think as a country. 


[21:45] Andy Slavitt: Yeah, I did a tweet yesterday that was something to the effect of I don’t invoke God very often, but if 2020 isn’t God trying to send us a message we need to change our country, I don’t know what it is. And I didn’t just mean change the presidency, but I meant really examine the things that we have long not thought enough about in our country. I will say, just to go back to something you said,I was in Iowa for the steak fry, which for those of you who’ve never been there, all of the presidential candidates get to flip a steak and give a speech in Iowa. We’re here in Minnesota, so it was a short drive. It was a lot of fun. And I think your supporters, I mean, and what it must be like, we talked to a number of people wearing Pete jerseys and they were some of the most emotional supporters. And a lot of them had stories about how you connected to them and won them over. And it was really powerful. You weren’t really great at cooking a steak, but you didn’t have the Biden like, you know, glasses and the steak flip. 


[22:52] Pete Buttigieg: Practice makes perfect on that stuff. I was mostly just trying to negotiate the heat blast of the grill. No, that was a very special day. I remember it very well. And it was one of the moments we really knew our campaign was getting somewhere because it was a test of organizational strength. And to see 1,000 people out there at a steak fry, you know, rallying for you showed us that we’d really reached a lot of people. And it was, I think, a very deep sense of connection that people felt attracted to the values about how our campaign wanted to go about campaigning, not just, you know, the policy ideas, which at the end of the day, even the candidates furthest from each other were in the same general part of the ballpark when it came to where we needed to go as a country. But it was also a chance to talk about what a campaign could look like, how we could show versus tell the kind of belonging, the sense of belonging we wanted to create just in the campaign itself that could respond to this crisis that our country, I believed, was experiencing that I think we’re only seeing become more and more acute among all the other dimensions of the emergency we’re facing. And I think you’re right. It certainly feels like a reckoning. We’ve known that there were problems in our healthcare system. We’ve known that there are unsustainable proportions to the racial and economic inequality in this country. And so the real question is now that we’re brought face to face with it in a new way, people who have always believed that this wasn’t sustainable but never really made it a top priority to do something about it, how do we change? 


[24:17] Andy Slavitt: I think one of the interesting things to talk about is what are the lessons that we should be taking out of 2020 and all these experiences. I mean, to talk about two of them, they’re deeply connected, which is allyship, learning to be a good ally for people who are on the wrong end of things in this country too often. And whether that is police violence, whether that is lack of access to medical care, whether it’s lack of access education or nutritious food, for many of us, it connects to the second topic, which is privilege. And it’s one of those things that increasingly, I think we are being called upon to address in this country, which is how did some of us get where we got pretty easily and why is it made so much harder structurally for other people? You have dealt with all sides of this issue as a mayor. You’ve had police violence in your own community. What can you teach us? What have you learned about how to be a good ally in a country that needs it badly? 


[25:26] Pete Buttigieg: Yeah, there’s so much to unpack there. First of all, I think that Pride is a good season to think about allyship. And I say that as somebody who knows that I’ve benefited from the involvement, the activism of people like me, and people not at all like me. From the black trans women who helped lead the way at the very beginning of Pride as we know it, to mostly or perhaps all straight judges and justices who delivered decisions like marriage equality, and this most recent decision about the Civil Rights Act. 


[26:00] Pete Buttigieg: And so there are so many people who have to be pushing in the same direction, usually led by those with the most at stake, but with so many people pulling together. And so I think you can’t truly compare one pattern of exclusion or experience of privilege or discrimination to another. But we can certainly learn lessons from how allyship has made a huge difference to the LGBTQ community, continues to. I think where we are when it comes to racial justice is a reckoning among well-intentioned white people, including white progressives, because, as Robin DiAngelo very convincingly describes in her book about white fragility, there is a discourse about racism that makes it sound like only a top-to-bottom evil person could be capable of doing or perpetuating something racist. When actually all of us are kind of socialized into racist patterns and practices and structures and vocabularies. And breaking out of that means coming to terms with the fact that there’s two sides to that coin. That actually advantages that each of us who are white have had are directly connected to disadvantages that people who are black have had. It’s very hard to admit that you would want to think that because you intellectually detest racism, you’re not implicated in it. But it doesn’t work that way. And so I think now’s the moment — and there will be, I think, missteps and clumsiness in the allyship that takes shape. And that’s gonna have to be OK in order for us to get anywhere. I know a lot of black leaders and friends that I speak to are expressing on one hand, appreciation for a lot of their white friends reaching out. And on the other hand, I think a kind of bewilderment and impatience of being sort of assigned to the work of now educating them. So we’ve got to do a lot of the work. Those who are only benefiting side at any number of privileges need to do a lot of the work to get to the other side here. Even while acknowledging and amplifying and seeing leadership from those who are on the excluded side of those same privileges.


[28:00] Andy Slavitt: That’s right. Yeah, it’s amazing how all of us can confess to being not racist, and yet we live in a racist country. So something is going on. 


[28:08] Pete Buttigieg: Yeah, someone described it as racism without racists. And, you know, that’s what we’ve really got to come to terms with. In addition to the people who are knowingly and proudly waving a racist flag, for every one of them, there’s an awful lot more who are mixed up in racism without wanting to admit it.


[28:23] Andy Slavitt: Well, I learned a lesson in that I asked some of my friends how I could do a better job articulating the issues that were getting underrepresented in healthcare in the black community. And the answer I got was, no, no, no, you don’t need to articulate it. You need to listen. And what I ended up doing was giving my Twitter platform over to black healthcare professionals and allow them to speak using my platform to the extent that in healthcare it reaches more people. And to be honest, my first instinct wasn’t the right instinct. I want to ask you a question that sort of along a similar vein, but it’s a question my son Zach has.


[29:14] Zach Slavitt: I was just wondering, what have you learned from working across the political aisle with people of all different backgrounds within Indiana that you think current leadership should be invoking more effectively to spread Covid messaging to Republicans and younger people who aren’t necessarily wearing masks and distancing?


[29:35] Pete Buttigieg: Yeah, it’s a great question and, it hits home for me as somebody who is a Democrat in a very conservative state where, you know, when we were trying to get work done, especially during my time as mayor, you know, anything that had a strong partisan profile to it might be dead on arrival if I was trying to get anything done with the state or get anything done across the aisle. And so things like public health protection, especially protections to prevent people from getting infected with a deadly disease, should have nothing to do with partisan politics. There should be nothing partisan about whether you wear a mask. There should be nothing political about whether you comply with a stay-at-home order or recommendation. This should simply be about keeping one another safe. And I think the most important thing that we can do is remember that we’re talking about complicated human nature that’s capable of doing good and bad things every day. We’re capable of being proactive or being lazy. We’re capable of being selfless or selfish. Every one of us is capable of all those things. And there is a tendency in our political language now to divide the world up into good and bad people. And so, you know, I would invite everyone to think about what the people who disagree with most politically, and then think about one of the most decent things you’ve ever seen them do or one of their best qualities. And that’s a good way to just reboot. Doesn’t mean we give up an inch on our values. I’m a committed Democrat. I believe passionately in the progressive philosophies and policies that I believe in. But part of what I found on the campaign trail, campaigning in, for example, parts of Iowa that had voted for Barack Obama but then voted for Donald Trump and then voted for me. Is that not everybody views the world through this prism.


[31:12] Pete Buttigieg: And while, unfortunately, we have a president who I think is really carving up the world into sort of his base versus everybody else. And the Republican Party, certainly in the Senate, that I believe has become an organization that really is much more about that tribal and partisan identities and problem-solving. That doesn’t speak for people of either party that you meet everyday. Republicans, Democrats and independents. And so what I’ve found both as a mayor and as a candidate is that without watering down your values or pretending to be something you’re not, you can see others as human beings and try to connect on that level toward a common purpose and a common goal by pointing to results. Nobody wants their loved ones to suffer. So that’s a pretty good starting point for something like this. And then we can work our way through the things that have more of a partisan profile to them. This, of all issues, should be so far removed from partisan politics and political culture wars. And I think all of us need to continue finding ways to do that. And I know that Andy has done a great job of this. It is to try to make it as factual and as forward thinking as possible.


[32:22] Andy Slavitt: Thank you for that. I think one of the things that both you and Vice President Biden stood out for during the campaign, even when it was not the easy thing to do given the nature of a primary, to say we’re going to have to unify as a country. To say we’re not going to get where we’re going to need to get, we’re not going to be able to realize the potential of our role in the world, of our role for the people in this country, unless we can talk to each other, as you just described. That’s a long journey to unify this country and one election won’t do it. And putting aside who wins or loses in this or any other election, is there a path back to a place where we all feel like we’re on the same team again, because you can’t do it during a virus, it’s hard. 


[33:12] Pete Buttigieg: Well, I think the biggest thing we need to do is develop a shared experience and a shared reality. Look, there’s always going to be political division and people working from the same set of facts will reach different conclusions. People coming off the same scripture have gotten to very different places. People watching the same broadcast news back when you only had three news programs to choose from reach very different conclusions about what the right thing to do was. But at least they were working from a common starting point. We don’t even have that now. That’s what it means to live in an era of alternative facts and social media bubbles, coupled with something that I think is very frightening in terms of a general suspicion of what experts have to say. And part of that suspicion is maybe because experts have blown it from time to time. But part of it’s also being stoked for very dishonest reasons in the political sphere. And so I’m on the lookout not just for leaders like Joe Biden, but ways for us to have more shared experiences like, for example, service. One of the reasons I’m a big believer in dramatically expanding opportunities for voluntary civilian national service is because more people from different backgrounds will have shared experiences. And certainly, I think back to my time in uniform when I was in the military serving its people dramatically different for me, who I came to trust, not because I got to know them inside-out and then decided I could trust them with my life, but rather because I was put in a situation where we had to trust each other with our lives. And then got to know each other better through that. And I think that, you know, the military is not for everybody. But that experience of working hard on something important for something bigger than yourself can be created in a number of ways. 


[34:59] Pete Buttigieg: I think excellent public schools create a shared experience. And if we have more economically and racially integrated schools, there is another example of where more people with different backstories or home lives come to be part of the same reality, and therefore have an easier time and part of the same country for the purposes of our political and social decision-making. So I think you’re right. We need leaders who have an instinct to unify. But it’s not the work of one election. It’s really the work of a generation to try to emerge with a more shared sense of reality. And unfortunately, coming back to that idea of, you know, God sending a message, if all else fails, we will be served up the hard way. Right. Whether we’re talking about a pandemic or whether we’re talking about climate change, a very direct shock to the system that will show that we do, in fact, live in the same reality, whether we have the same level of admitting it or not.


[35:56] Andy Slavitt: These reminders that we share the same planet, creating a common vision for our country, focusing on values of empathy, finding the places that we share common experience. But, look, I just got off the phone with someone you know well Governor Jared Polis in Colorado. And he said, you know, they’ve got AmeriCorps out there now doing volunteer work and contact tracing and so forth. And the more people feel part of the solution, the less they feel like victims, the better they can just make it through an experience like this. And it does take people to call us out and call us to do that at a national level. It’s one of the reasons why the first time I talked to somebody who had met you, they said, you’ve got to meet Pete. He is an extraordinary person. And we’re lucky to have him in the political arena, which if you think about it, it’s much more flattering than saying you’re that you’re a great politician. And so if you can be that person, then you help us shape this country, it gives me hope for years to come that we can do it and do it together. So thank you. And thank you for being on today. 


[37:07] Pete Buttigieg: Well, thanks for that. And I think we can all be that person in any number of ways, reaching out, finding and fashioning that common purpose and a common vocabulary to find our way through. And look, this is a terrible and challenging time in the life of the country and the life of the world. But, you know, major needed often positive changes tend to come out of moments of upheaval like this. And for better, for worse, we get to be those generations that are alive and in charge of things right now, get to be a very consequential set of generations of Americans. Because I think on our watch, it will be decided whether or not the 2020s is a massively positive turning point for the American project or it’s when things fully spiral out of control. And we are confronted with those choices, these choices that we make, how we’re going to get out of this situation. It’s nothing less than the choices over what our political, social and economic life is going to look like for the future. Let’s get it right. 

[38:04] Andy Slavitt: That’s right. It’s up to us. Together, we will all both mourn what we lost. bear witness to what we’ve seen this year. And it’s not Pollyanna-ish to say that out of those experiences work together for a better country. And appreciate you doing that. And I appreciate you coming on and talking to Zach and I today and our listeners. 


[38:27] Pete Buttigieg: Thanks, Zach and Andy. Great to be with both of you. And thanks for all the work that you’re doing to shed light at such a difficult time.


[41:34] Andy Slavitt: Thanks to Pete for coming on and that conversation about so many important topics. In our third segment, I wanted to introduce you to somebody who is doing incredible work that is so relevant at this time. Her name’s Nzinga Harrison, and she is a psychiatrist and the co-founder of Eleanor Health, which provides treatment in a really completely different way to people suffering from addiction. She has a completely different way of thinking about addiction. She’s launched her own podcast called In Recovery. And it is spectacular. I have known her and worked with her and really admire her. And I think you’re going to find this conversation very relevant to a lot of the topics that are swirling around the country right now. And the best way to treat people when they need help. Let’s give her a call.


[42:40] Andy Slavitt: Hey! I was actually pitching your Eleanor services to people in Baton Rouge, Louisiana. I mean, there are people at places all around the country calling and they’re like, we’ve got to get serious about health equity. What do we do? I’m like, well, if you want to walk your talk, I’m going to tell you. But it’s not going to be comfortable. Are you prepared to disproportionally put the resources where they’re needed? Are you prepared to disproportionately understand people’s lives? And are you prepared to hire people culturally competent that can connect and do that? Because if you’re not, if you’re not willing to get uncomfortable and prioritize those things, then it’s not for real. We’ve talked to people in Baltimore, conversation with Baton Rouge, conversation with communities in Kentucky, and all of them or them contacting us. 


[43:41] Dr. Nzinga Harrison: Yeah, well, you know, I am you’re a man corner on holding people’s feet to the fire to actually walk the talk. And you’re exactly right. Like, if you’re not intentionally putting your eye on, like you said, disproportionate lead directing resources to the marginalized and underserved. Because there’s a hole there. So you can’t think you can give the same amount of resources to a segment of the community that’s in a hole. You have to bolster that hole before you can get to equitable funding.


[44:10] Andy Slavitt: I used to say to people like, do you have a strategy on social determinants of health? And they’re like, oh, yeah, absolutely. And I’m like, OK, so do you have a strategy on ingrained poverty, multigenerational, structural racism? And they’re like what? I’m like, how do you focus on social determinants of health and not focus on multigenerational, structural racism? And they’ll go I meant we have a transportation program. And we’re bringing healthy food in the community. I’m like, OK, so you’re focusing on food and you’re focusing on transportation. And that’s good. But do you think this is gonna solve these problems? Right. And I’m like you, I’m not going to say I’m optimistic, but I’m going to say people are paying attention. 


[45:01] Dr. Nzinga Harrison: Yeah, you can say optimistic, Andy, because people are paying attention in a way that is most certainly new. Like when you see NASCAR ban the Confederate flag, you’re like, oh, OK. So something about this is different. Seriously, when you were talking about the difference between, yes, we have a social determinants of health plan, and no, we haven’t talked about generational stress and structural racism, like one of the ways I really drive that home for people is part of the mistake we’ve also made in this country is conflating poverty and black race and health outcomes. So, yes, poverty has a negative effect on health outcomes. Black race actually independently is associated with negative outcomes, even when you control for socio-economic demographic. And so people like really get shocked when you say, for example, structural racism literally almost killed Serena Williams during her childbirth story. And by the way, when we take out socio-economics, the risk that a black mother dies in childbirth is still magnitudes higher than that of any other race. It’s like, yes, black doctors, black physicians are dying in childbirth at higher rates than impoverished white mothers because of systemic racism. 


[46:28] Andy Slavitt: Well, this is where data is really, really, really, really important. And, you know, so, like, I’ve just started taking this as an invitation to ask people, do you and will you consider publishing data on your hospital, your system, by race? Don’t tell me what the average person — and by income and by zip code. And then, you know, what’s really interesting is, you know, because you’re on a large call with 3,000 people like I did this week when I was doing it, everyone’s like, yes, careful not to say no. And then, of course I waited and one person says, sure, if it’s adjusted for socio-economic blah blah blah risk factors. I said, I’ll tell you the truth, what you basically said, and you didn’t intend it, and I’m not, you know, trying to embarrass you. You basically said, you want two standards. You want a standard for white people, and you want a lower standard, you want an excuse. And I don’t think that’s the right thinking. 


[47:30] Dr. Nzinga Harrison: You know, Andy, you are down for the people. You are holding feet to the fire. That is exactly right. It’s not what that person meant, but that’s like literally how ingrained it is in the way we’re thinking. And so as much as the reflex is unintentionally, because I believe in most people’s good intentions. So as much as the unintentional implicit bias drives the creation of those two systems, we have to be as intentionally creating the two systems that right the problem. 


[48:05] Andy Slavitt: Right. I have to go back and say what we’re doing here. I don’t officially start these conversations, we just have them. But at some point, if I don’t tell people who you are, what you’re doing, how I know you, then people are going to be like, who is this amazing woman you’re talking to? And so, first of all, I should probably tell people that you have an unbelievable new podcast that you’re kind enough to share with the public. And I want you to explain what this is, but I think it fills a gap in our country that hits every community and most every family in talking about various kinds of addictions. I listen religiously because it is one of those podcasts, it’s for everybody and everybody needs to know about. 


[48:57] Dr. Nzinga Harrison: Well, thank you. Yeah. So the podcast is In recovery and our tagline is like it’s about all things addiction. And so usually when we think about addiction, we think about substance use disorders. And most recently, we really think about opioid addiction because of the really tragic kind of epidemic that we’re in the middle of with opioids. And so what I wanted to do with this show is really break down the stigma, like, the idea that there are those people who have addiction and then there are the rest of us. Because that really helps us not do the right things in taking care of people that have addiction. And so this is not just about opioid addiction. It’s about alcohol. It’s about cigarettes, but it’s also about non-substance addictions. So it’s about gambling. It’s about sex. It’s about those things that we all do that kind of we can do them to our own detriment, but they are accepted in society. So like work. It’s about food. It’s about exercise. So basically, the thesis that we use for addiction is any behavior that we continue to engage in despite negative consequences. And so to that point, our most recent episode is actually on racism. And we conceptualize racism as America’s addiction using that definition. We continue to engage in the same behaviors in this country despite extremely negative consequences, one of which we’re all experiencing right now, which is George Floyd’s death. But also all of the other consequences that come from institutional racism in this country. So it’s been fun, the podcast has been a ride, and I hope people are listening. We’re really trying to capture the minds in a health-equity and stigma reduction in a way. So I should say it’s a question and answer show. So if these folks don’t ask questions, there will be no show. We basically comb our social media and our voicemails for what people are talking about, what people are asking questions about. And that’s what we talk about on this show. 


[51:03] Andy Slavitt: And the people who ask questions are asking the questions that are on everybody’s mind. And I think the distinction you made between things that are destructive and you know are destructive and we all do them. I mean if you didn’t do some of these things, what kind of human being would you be? That perfection would probably be your addiction. 


[51:23] Dr. Nzinga Harrison: Yep, that’s exactly right. And that’s one of the things we talk about on the show, is that I say humans don’t continue to do behaviors that have no benefits. And so when we’re talking about — even when we, you know, cross the line, if you’ll let me use that phrase into this concept of addiction, like I’m continuing to do whatever this behavior is to the detriment of my own health, with health defined very broadly. There are benefits to whatever that behavior is. And so we talk about the neurobiology that drives behavior. We talk about the physiology that underlies the medical condition of substance addiction. And what is driving kind of behaviors for other things we do that could fall in the addiction bucket. 


[52:10] Dr. Nzinga Harrison: And it’s really all with just this concept of all of us being able to see ourselves in people who are struggling with the most severe addictions. We’re all on a spectrum. But this is, I think, the same thing, to bring it back to George Floyd. Part of what I think is happening right now is that it is just neurobiologically, it’s the way the brain works and we don’t have to judge ourselves for it, it is easier to see yourself in somebody who looks like you or who otherwise shares a part of the identity that is important to you. And George Floyd being killed the way he was, I think people are able to see themselves in George Floyd that they haven’t been able to see themselves in black people being killed by the police before. And that’s why we’re seeing this response. And so on the podcast, I’m just really trying to help all of us see ourselves in an addiction framework so that we can have more empathy and, quite frankly, more motivation to call people to the curb and put feet to the fire to demand that addiction treatment in this country get better. 


[53:13] Andy Slavitt: That’s great. Well, you have a podcast co-host. I, too, have a podcast co-host. My co-host is our 18 year old son, Zach. And I just want you guys to say hi to each other. He is very familiar with Eleanor Health because I talk about it quite a bit here. 


[53:46] Zach Slavitt: Nice to meet you.


[53:48] Dr. Nzinga Harrison: Hey, Zach, nice to meet you, too. 


[53:50] Zach Slavitt: Yeah, I’m a big fan of your work on your podcast and with Eleanor Health.


[53:55] Dr. Nzinga Harrison: Well, thank you. I’m actually a big fan of your work on your podcast because I am all about data. And so I love that you’re the voice of data at the top of this show to pin the conversations that you have. I have a 14 year old and a 13 year old, and I’ve had them listen to you to say this is how we’re gonna use data in our lives, guys. So I’m a fan of your work. 


[54:16] Andy Slavitt: Wow, that’s great. Thank you so much. I would wish you the best of luck, but we’re going to talk frequently and maybe have you come back. You’re just a great help to so many people. And I would say in all sincerity to you, and I know you’ve heard me say this before. But more importantly, the people listening, you are one of my sources in life when I’m stuck and want to understand the issues here. You are one of the people that I call and listen to and ask questions of and make me feel like, wow, there’s people that know these things. I’m so relieved because we all go through these things. And you’re right, to feel like a pack animal versus a lone wolf, it’s a better feeling. 


[55:01] Dr. Nzinga Harrison: It is better. So thank you, Andy. I really appreciate you, I mean, having me on the podcast is the smallest of what I appreciate about you and the work that you’re doing in the world. So I hope to roll on your coattails a bit more as we go forward. 


[55:17] Dr. Nzinga Harrison: Let’s do this together. 


[55:23] Andy Slavitt: Wow. Thanks for sticking with this entire episode. I hope you listen to it on normal speed because I watched Lana listen to it on fast speed and it’s crazy. Just crazy, I talk fast enough as it is. But I really appreciate Pete Buttigieg coming on the show. I love the conversation with Dr. Harrison. And we look forward to catching you up next week. We’ve got two great episodes which we’ll be publicizing shortly. Monday and Wednesday, like we always do. Have a great rest of the week.


[55:59] Andy Slavitt: In the Bubble is a production of Lemonada Media. Niccole Galteland is our producer and Ivan Kuraev is our editor. Music is by Dan Molad and Oliver Hill. Zach Slavitt is our co-producer and my co-host. You can find out more about our show on social media @LemonadaMedia. And you can find me on social media at @ASlavitt on Twitter, @AndySlavitt on Instagram. If you liked what you heard today, tell your family and friends, but tell them at a distance. For now, stay safe. Share some joy. We’ll get through this together. And #StayHome.


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