In the Bubble with Andy Slavitt: Our Shot

One on One with America’s Doctor (with Sanjay Gupta)

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Andy talks with Dr. Sanjay Gupta, CNN’s Chief Medical Correspondent, about his 20 years in cable news, what motivates people to peddle misinformation online, and how we can let go of some of the anger, resentment, and trauma from the past 18 months. Whether he’s talking to millions of people on TV or one AC repair person in his home, Sanjay rejects the approach of many of his TV counterparts and leads with honesty, empathy, and respect.

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

Follow Sanjay @drsanjaygupta on Twitter.

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Andy Slavitt, Dr. Sanjay Gupta

Andy Slavitt  00:20

Welcome to IN THE BUBBLE, I’m your host, Andy Slavitt. Sanjay Gupta is on the show today, Dr. Sanjay Gupta, who is, in my view, I think of him a bit as America’s doctor or an idealized form of that. And we’ll get into it a little bit with Sanjay and you’ll hear it in this conversation. And I really, strongly urge you to listen to this because it just feels different, to be communicated to by someone who clearly cares. Cares about getting it right. Cares about how you react to it. Cares about our country. Cares about us, as people. And in an age where people are out there distinguishing themselves by having the loudest voice, the most controversial statement, the edgiest tweet, he somehow manages to distinguish himself by being reasonable, and thoughtful, and cogent, and humble.

Andy Slavitt

You could tell I really liked the guy. And it’s part of the theme that I want to cover today, the sermon a little bit, which is just how we communicate as this pandemic drags on. There’s a lot of self-justification. There’s a lot of well-intentioned people that I think have some sort of misplaced form of self-righteousness or arrogance. I’ve caught myself doing that from time to time. And it’s really kind of embarrassing to feel like you thought you knew more than you did. You didn’t express yourself with as much humility. But it’s even worse, is not being able to admit that maybe you didn’t have it right. And so we’re gonna introduce a new feature on the show today, you can tell us how you like it. And it’s a new feature that we’re calling Come on people, can we just move on?

Andy Slavitt  02:29

And this is a feature intended to combat some of our own arrogance, at being unwilling to say the words that cause people to say, hey, somebody said something that was wrong. Now, we know differently. It’s also meant to acknowledge the amazing amount of energy we spend fighting Yesterday’s battles. And, you know, I think about someone who’s in a position of going into TV and having to say something. And it turns out over time, that what they thought about either how the vaccine worked, or the virus or various mutation was different than they thought. I can tell you as someone who’s going to be quite a bit, the first thing you think is well, I was justified in saying that, you know, I said what I thought was best at the time.

Andy Slavitt 

So come on folks, give me credit, for having good intentions, because and then often that comes across as the next time something changes, you say, Well, as I said, or as I said, all along. And you try to create this tie to some element of what you said that felt consistent or honest, but it really wasn’t what you emphasized. You know, the most significant example is this idea that we knew the vaccines are only going to be really good at preventing hospitalizations. And the truth is, there was a time when we didn’t think that and so we could say, Well, hey, you know what, they’re justified in thinking what we thought at the time. But isn’t it easier to just say, Hey, okay, I was wrong. We were wrong. And if it helps us just move the F on. Maybe we should do that. Now there’s reasons people don’t say the wrong and you ask them why they don’t say the wrong it’s because they get taken advantage of.

Andy Slavitt  04:22

Tucker Carlson will say ha, they were wrong, ah-ha they don’t know everything. Other reasons don’t people don’t say the wrong is because they think science allows them to change their opinions with new data, which it does. The problem is that not everybody gets that to people who are distrustful of science to begin with. That just sounds like plain old arrogance. It sounds like a plain old justification for when things change. And if people say I was never wrong, because the scientific process etc, then I think that leaves a whole bunch of people who are not believers in science sitting back and saying, these guys don’t know what they’re talking about. And when they get it wrong, they’re never willing to admit it. So the next time they come out with something, I’m just going to not believe them. Because they don’t get it right. It’s a hard thing. It’s a trap.

Andy Slavitt 

I know a little bit about it, because, I was, as you may know, listening to the show, I was in the White House, Biden ministration. And at the time, I was charged with one of the people charged with talking to the public directly about the pandemic, and I tried to use plain simple words, common words, the fewest number of words, to make a point to the question of do we have enough vaccines? Not an answer, which says, well, we’re going to have enough vaccines when blah, blah, blah, depending on your age, etc. But a shorter way of saying that, no, we don’t, we have a shortage. And you’ll hear me talking about these examples. I think this communication stuff’s important in our guests today. And our guests on Wednesday, are just some of the best communicators you’ll find.

Andy Slavitt  06:12

And this is where we go with Sanjay is a little bit of a health check on the public and a little bit of a check on how do we communicate? How does he communicate? How does Tucker Carlson communicate? And this is very, very important, because if we think science is just about having some amount of facts, we can persuade people of those facts. We can only persuade 75% of people to take the vaccine, then is that a failure of science? People would say no, I say yes. Because I say part of science is communicating. And that’s why I think the conversation with Sanjay is so great. And I just loved it. So we’re going to get into it. With Dr. Sanjay Gupta, here he is.

Andy Slavitt 

You know, I’ve said I’m not the only one that said it. But I said, you know, I think if he was America’s doctor, and well, like, in an age when, when I think there’s a lot of people on TV, whose stock and trade is controversy, you have this ridiculous formula, where your stock and trade is being reasonable, being thoughtful, explaining things to people in a way that shows you care about them, which I think is that’s why I think of you as America’s doctor.

Dr. Sanjay Gupta 

But also, you know, like, I would think about the fact that things are nuanced. A patient comes to me and says, What do I got? And it’s like, well, here it is. And here are the various ways to approach this. Right? And it’s a conversation, there’s a nuance to it. And it’s not it’s hardly ever binary. And I think that sort of guidance, say, hey, talk, like you talk to a patient, and you’re not going to this, what you got to do, and in some situations, it’s very clear, but most situations, it’s nuanced. When you can reflect that I think, especially during this pandemic, I think it’s helpful for people they appreciate the real knowledge is in the nuance. They can get the headlines anywhere. But the knowledge is in the nuance.

Dr. Sanjay Gupta 

That means obviously, a lot and so much more coming from you, Andy, so I really do appreciate that, you know, it is interesting, because I remember when I started doing this business of television reporting, I had done writing before, just for magazines, and journal articles and things, but never television, and my wife again, I find it challenging. And I remember coming to her early on and saying it’s hard, you know, it’s not, it’s abnormal, you’re sitting in a studio, and you’re looking at a lens, and there’s no one around and the lens isn’t giving you anything back. They’re not nodding, there’s no feedback. And so, and she reminded me to talk to the lens, like I talked to patients, and there was a lot in that, right? I mean, I care about my patient, I want my patient to understand that’s gonna affect my word choice, it’s gonna affect my speed at which I’m speaking, it’s gonna affect whether I seem like I’m in a hurry or not, you know, speak a little bit more, you know, deliberately.

Andy Slavitt  09:16

I’d say but something that’s changing how you think about this, which is this notion of criticism. The question is like, how sensitive to feedback should you be? Because on the one hand, I think you strike me as very high emotional quotient person who is listening and taking feedback. On the other hand, there’s a lot of people who like maybe I’m starting to think, I don’t care if they like me, because you know what? They’re trying to do some of the wrong things. And if I end up pissing them off this kind of conversation with the White House about the president, which is, you know, if you’re so worried about not upsetting people who won’t take the vaccine, that people who felt like they did the right thing, who got vaccinated, feeled ignored that you’re not taking care of them, then you’re losing twice. And sometimes you kind of have to make a choice and say, you know what? There’s people in this country with less access. There’s people in this country with fewer choices who can’t get vaccinated or whatever. And I got to look out for them.

Dr. Sanjay Gupta  10:16

I totally agree with that part of things. You know, the challenge, I think right now, and I want to answer the question directly, but the challenge right now is I don’t know who the people are that are criticizing me. I don’t know the motivations. You know, I don’t even know if they’re real, to be honest. I mean, it’s a weird, I feel like I’m living in sort of Westworld sometimes, when it comes to, you know, if you’re starting to go through social media and look for stuff, I remember that study that came out when they got some discovery on Facebook a few years ago, and they said, what, there were some, there were more fake accounts on Facebook than the population of the United States. Now, that was the world but still, I mean, more than 350 million fake accounts.

Dr. Sanjay Gupta 

So I do, for me keeps in the back of the mind. It’s not like I dismiss everything and say, what’s just some troll or bot or whatever. But you know, I think that’s what has helped me. And it’s not something that came naturally. Because I think, especially starting off in television, you can you can be very thin skinned. I mean, it’s very vulnerable. I mean, everything people make fun of your clothes, they make fun of your hair, they make fun of your heritage, they do whatever, you know?

Andy Slavitt 

And you’re a dude, I mean, for women, I think it’s got to be like, merciless.

Dr. Sanjay Gupta

Worse. It’s merciless. And, so a lot of that stuff I’ve learned to ignore, which is fine, although what I will say about that sort of criticism and other criticism, is that what I think I’ve gotten better at is if there’s some truth to it, I listened to it, and I pay attention. And I think it does make us better. If it’s not truthful, and it’s just, you know, some nonsense, I just delete it and legitimately move on, legitimately not sort of yeah, moving on. No, I mean it, and I’m like, you asked me about it in a few minutes, 10 minutes, 15, whatever it may be.

Dr. Sanjay Gupta 

How have you learned to do that?

Dr. Sanjay Gupta  12:06

I think just I think it’s, that’s one of those practice makes perfect sort of things or practice makes better, at least sort of things. I mean, you know, I’ve been doing this for 20 years. And I didn’t think about sort of approaching things that way early on. There were a few periods of time when I felt like I was getting some criticism, and I needed to develop a motif or some sort of structure in my own head, at least of how to deal with that, I couldn’t, I couldn’t let it paralyze me, I realize that, but I also realized that maybe there’s some, if there’s some truth to it, then I change. And I’m okay to say that I’m wrong, which I’ve done on television before. I was wrong on that I was wrong. And that’s a hard thing to say. Because no matter what, 10 years later, people will be like, Well, that was the guy that was wrong. How can you trust that guy, right? Remember, he’s here played the clip over again, I was wrong. I was wrong. And so okay, I’m willing to take that hit

Andy Slavitt 

it does it take some of the sting away? When you say, guess what I was wrong? Like, what else can you say? You know? And, look, the moments we regret the most are the moments where we forget the humility, I have these moments, where most of the time I’m pretty good at saying, well, this is what I hear. This is what people tell me, or it but occasionally I’ll have said, well, this is what is, right? And with more confidence than I deserve to. And I always regret that. I mean, well, I don’t always regret it when I’m right. I’m like patting myself on the back and running in circles, just playing Rocky. But, you know, there are occasions that this audience doesn’t really begin to believe this, but I have occasionally been wrong before too. Remember that happy days when […] said he

Dr. Sanjay Gupta  14:03

You know, you come from a place though where I think you know people know you and they know your humility. And I have to say, I want to point out one thing that you did the other day, which I thought was a really instructive for me. And I think that the question that you got asked was something about the appropriateness of rationing health care, and based on vaccination status, and because there’d been a bunch of late-night comics who had talked about it the night before. And you paused and you basically said, no, that’s, I believe healthcare is a right. And that means something. I remember thinking to myself, God, that’s so it’s so good. It’s so good, because it is what you stand for, people that know you and a lot of people and they know that. And then in the moment, I don’t know, if you maybe prep that?

Andy Slavitt 

I didn’t. I didn’t expect the question.

Dr. Sanjay Gupta 

In the moment, it was just the perfect answer, Andy.  And I think that there’s times when, you know, we can do all sorts of prep. But I think the reflection of who the person really is comes out in moments like that. And it was perfect. And  I made a note to myself that that is that is, that’s him. And that’s right.

Andy Slavitt 

Interesting. You know, when I get interviewed by really good interviewers, I realize that they’re just probably basically the canvas stuff comes off as canned. And so figure out what you believe. And then let the words come to you real time. And I remember doing one of my first north lawn interviews from the White House with Fox. And it’s funny, it’s true story that I get on I put on the headphones, do you know how like there’s a top track where the where the announcers are talking to each other. And this is a morning because Fox and friends and they were talking to one another. And he says to her, what do you think of these questions that were written up for this guy? And she’s, I think, the kind of weak, he goes, they’re very weak. She goes, I’m gonna nail this guy. Watch. And they didn’t really yeah, they didn’t realize I could hear them. And I was just like, super calm. I mean, because I like I knew my job was I could care less about the anchors. My job was to talk to conservatives about the vaccine. So the way he chose to nail me was he said, you know, President Biden hasn’t given any credit to Donald Trump for operation warp speed. And I’m gonna ask you right here right now on the spot. Do you think that you should tip your hat to Donald Trump?

Andy Slavitt  17:18

And it’s funny, I had just gotten out of a West Wing meeting where people were complaining about Trump taking credit for things that Biden had done. And I just said, I said, of course, I said, look, we should never be stingy with credit. When things work. Everybody who had any part in it should have a share in this and the mRNA platform has been at work for two decades, through the Bush administration, to the Obama administration, through the Trump administration through the Biden administration, private sector, public sector, everybody should feel good. So yes. So he was stunned. He was stunned. And he kind of tripped on his words, because he expected me to say no, anyway, here’s the funny after effect is I’m leaving the north lawn walking back into the West Wing. And my phone buzzes it is political headline, Slavitt tips hat to Trump.

Dr. Sanjay Gupta  18:08

Oh my gosh, it’s all a farce. It’s the tail that wags the dog. Yes, I but again, the right answer. I mean, you know, you have to expect the headline, I guess, but that’s the right answer. And if you did at the time too, if I remember, you know, tip the hat or give credit where credit was due?

Andy Slavitt 

I mean, look, I could recount and I have in massive detail, how he lied to the country and all these other things. But they did place a bet on 10 vaccines, and they proved to place the bet on some of the right ones. Good for them and good for us that they made those bets. Let’s go back to the health of the country doctor, because if your role is American doctor, like stepping now up to 100,000 feet, and you could take this question anywhere you want to take it because it’s both related to the pandemic, but it’s also related to the mental health impacts. It’s related to what’s happened with kids in schools really do a lot of things, like diagnose how we’re doing as a country, like how is our health? Are you concerned about this patient of the American populace?

Dr. Sanjay Gupta 

Yeah, I’m concerned right now the patient is, is still in the intensive care unit. It’s the country where a patient and there have been some, you know, positive indicators, intermittently unstable, but I’m optimistically guardedly optimistic that the patient’s going to continue to improve. There have been some signs recently. The conversations We’ve been having with this patient’s family have been challenging because inadvertently, some version of this didn’t need to happen to this patient always comes up. It’s awkward, it’s uncomfortable and makes people feel guilty. But it’s true. And you have the conversation, because maybe it’ll leave a message with the rest of the family to prevent this sort of thing from happening to them. But yeah, I think that it’s been a really rocky road for the patient for some time, in the summer of this year, I thought the patient was not out of the hospital, but on the general care floor, maybe even going ahead to physical therapy and start getting rehab, things like that. But then the patient ended up back in the intensive care unit. So there’s also, it’s multifactorial, as they say, in medicine in terms of why this is. But I think that’s sort of the status of things now. And I see I look at other patients, like my patient around the world. And I see that some of those patients are starting to improve in a way that I anticipate my patient may improve, but by no means out of the woods.

Andy Slavitt

So I’m going to beat this analogy to death here for a second, when like, if you’re trying to get a patient to recover, you got a couple of modes, right? One mode is, hey, look, here’s the good news. We have some science, that if you take it, if you take this medication, you abide by some of these ways of taking care of yourself, you’ll get better. And that’s the great news. And we couldn’t say that in 2020. In 2021, we could say we have an arsenal, it’s a growing Arsenal, we’ll add to it with hopefully, with antivirals, so forth, but we have the side. But here’s what you can’t control as a doctor, and I think in our society, or either you mess up, I think we are more dangerous than the virus. I mean, the virus by itself, if it didn’t have people willing to spread it, we didn’t have willing people who say, I don’t want to make even a small inconvenience to my life. Whether it’s getting a rapid test before I get in an airplane, whether it’s not going to a wedding, unless I’ve been vaccinated, whether it’s putting on a mask before I go to school, if I’m not willing to make a small sacrifice, or the equivalent of a lifestyle choice, you might give a patient if they’re leaving, your neurologist, neurosurgeon so that you know there’s an equivalent of three, you have to ask the patient to do it. And by the way, all the medicine in the world isn’t going to help you. If you’re not willing to go through these rehab steps, and they’re tough. It’s been called breaking routine, where I get pessimistic is all of the good science in the world isn’t going to make us better if we’re not willing to help ourselves.

Dr. Sanjay Gupta  22:33

Yeah, I agree. I but I think, Andy, if the ultimate question you’re asking is, should you still do it, I think you still do it, you still sit there with a patient and really convince them of these things. You don’t know if it’ll leave a mark, or if it’ll leave a mark now, maybe it is a piece of evidence that that patient collects along with other evidence that ultimately is a preponderance of evidence that makes the patient start doing these right things. So yeah, I think that I would never give up in terms of like, continuing to give that message. In fact, even more so probably, you know, like the people who are already hearing me, that’s great. And I’m glad they’ve heard me in some ways, the obligation now is to up my game, and try and get the message to people who aren’t hearing me or haven’t heard me or you know, I think can be convinced. I do. I will say one thing and this is just from a practical sense, I think there’s probably like, if you’re talking about the vaccine, specifically, let’s say I think there’s a certain percentage that will not be convinced.

Dr. Sanjay Gupta 

And I think you have to accept that because I think you can bang your head against the wall over and over again, trying to convince that small you know, that remaining percentage, whatever it is 20%-15% you know, depending on which poll you look at, say No way No How are they ever going to do this and not let that suck up so much of your energy and resources where you have, you know, whatever, percent that’s more movable on this issue. So, you know, we did this documentary before the pandemic on vaccine resistance as related to the measles outbreak. And I interviewed all these people and went all around the country. And in Brooklyn, you remember it was in the Orthodox Jewish community. It was in Minnesota, where you formerly were among the Somali community. so fascinating to talk about why people wouldn’t take the vaccine. But it was really instructive. You know, for me to have those conversations I would never give up in terms of trying to get my patient to rehab making sure they do everything they can to stay out of the hospital.

Andy Slavitt  24:34

Yeah, so a couple of really amazing points you make here, which I agree with one of them is you’re never gonna get everybody. And guess what, the math isn’t gonna give it to people, shaming people isn’t gonna convince people. And so to a certain extent, you got to try other things and by the way, have other tools in the arsenal. That besides the vaccine and but you know, the sad reality is that means COVID is here longer COVID has more chances to create variants. Those are just simple facts that we’re going to have to figure out how to wrestle with. But the thing you also said that, I wonder how you process this is just our ability to have a dialogue in a peaceful way, even to disagree in a way that’s respectful where you could say, you know what I really wish you’d reconsider whether you’re talking to your patient, or you’re talking to the audience.

Andy Slavitt 

And they say, you know, what, I have my reasons or not, and you don’t think they’re a dummy, because they’re not doing it. And they don’t think you’re out to coerce them and, you know, be a totalitarian state for that reason. But that dialogue, you know, and this speaks to directly kind of what you do every day. And CNN is, you know, you had a bunch of people who for a long time said, what you do is fake news. Because you’re in CNN, you got people who only watch Fox News, people who only watch CNN, and it’s sort of demonization. And how do we cross that? Or is too much made of that? Is it really not that big of a threat?

Dr. Sanjay Gupta 

I don’t know that we’re making too much of it. It’s been surprising how interlaced I think politics in the science have been, I don’t think you can disentangle just about any part of this pandemic story, even the very scientific parts from politics. So I think it’s real. And I do think it’s concerning. I mean, you know, I live in Georgia, it’s a red state, and I, you know, live, I have people that I know, really well who have not been vaccinated, you know, people who are smart, don’t talk to me about it. Like if I run into them somewhere, they’re not, you know, hey, by the way, I didn’t get vaccinated. They don’t want to pick that discussion. Let me say with me, but I know that they’re not. And I and I will tell you, Andy, I don’t think I’ve even relatives of mine, you know, on my wife’s side of the family, so it’s really, it’s interesting to me how pervasive it is. I don’t think we’re making more of it. I think it’s real.

Dr. Sanjay Gupta  26:58

But I had the story the other day, I our air conditioning broke in our house, and it’s really hot, and we needed a guy to come fix it in this guy shows up. It’s in his mid-70s. Seems like and nice guy, really nice guys wearing a mask and everything. He goes and is working on the air conditioning. And then at the end, I’m walking them out. And I didn’t know if he knew who I was, or cared or anything. But it seems that he did because he said, hey, do you mind if I ask you a question? I said, sure. He goes, should I get vaccinated? And I said, yeah, you really should. I mean, there’s really no reason not to, you know, there was some concern about allergies early on, I sort of talked him through it. And he said, well, the reason I asked because I have a stent in my leg. And they, you know, I heard there was some concern about blood clots, blood clots forming from the vaccine, you know, he probably heard about the J&J, you know, sort of trial maybe a few months earlier.

Dr. Sanjay Gupta 

And I said, yep, that’s true. But it was really rare, is primarily in postmenopausal women. And when you look at it, the risk of a clot is far greater from getting COVID than from the vaccine. So and then he says to me, and he says, you know, my daughter died last week of COVID. And before she went on the ventilator, she begged me to get vaccinated. And I really want to get vaccinated. But I didn’t know about this clot issue, and I’ve been calling my doctor, I haven’t heard back from my doctor’s office, and you’re the first person I saw since my daughter died. So I’m asking you. And it was like, man, that was powerful emotion to kind of move his chest, you know, really, really powerful. And, but it also reminded me like you were saying, at the beginning of this conversation, like I do imagine that guy listening, when I’m talking about it, and if I say, hey, these guys are just all terrible, they’re just reluctant. They’re just hurting America and all that. Some have just totally politicized it, but not everyone. And I think, you know, those are the reachable folks that guy will probably be vaccinated. You know, I’m sure he’s may be vaccinated by now, which is great.

Andy Slavitt 

Right. Well, this is a powerful story. And it reminds us that most people have questions that they believe are legitimate. Now, people who are maybe more informed might say, That’s not a legitimate question. Of course, that’s not the case. But the fact that you drew him out, and he talked about what he heard. And then, you know, the next question I asked people is, where can I get information from someone you trust? Who do you trust? Now, the fact that he asked you and that you’re a physician, and you’re well known was great, because he had finally had someone to ask the question to who he trusted. But you know, the guy doesn’t want to die. Nobody wants to die. He saw his daughter die. He had to know that this was serious. And he obviously wasn’t doing it for what he thought was her legitimate concern.

Dr. Sanjay Gupta 

I always wonder at any given night, how many people are watching the news in America, you got what 350 million people. I don’t even know what the numbers are ratings, but I would guess it’s far less than 10%.I mean, all the news broadcast cable everything.

Andy Slavitt 

You got kind of Tucker Carlson.

Dr. Sanjay Gupta  30:10

Yes. But you know, many are getting their stuff from social media, they’re getting it from whatever their newspapers smaller and smaller point is like I was thinking about that guy a lot like where he hadn’t heard anything he’s never really watching he’s working all day, he goes home, he’s probably tired, he’s not watching the stuff, he’s probably not reading about it because you know what? It’s depressing to read about so it’s not like he’s gonna go out there and search for COVID stories. So how does a guy like that get educated? there’s a there’s a larger issue here, I think you know, just in terms of the overall knowledge flow in general, even outside of a pandemic, for people.

Andy Slavitt 

Here’s the problem. And I know this, because of my battles with Facebook from the White House, is this is where algorithms are poisonous and insidious. So if he went into Facebook and said, concern about blood clot from vaccine, the algorithm will give him exactly what the people who have been out there trying to plant doubt. So want that person to get. So let’s say you’re 90% sure, Sanjay, that you want to get a vaccine. But you’re kind of needle phobic. If you went to Facebook, you would see the picture of the giant needle close up super thick, probably not even the needle use for everybody vaccine and for the 1940s. If I went there, and I wasn’t needle phobic, I never see that. So part of the problem is this algorithm is designed to get people the wrong information at exactly the right time. And it is perpetuated by a relatively small number of people who really know how these engines work and knows how this game works. So if they could get someone with a little bit of doubt, to see that that doubt has merit, they’ve done their jobs.

Dr. Sanjay Gupta 

Why do they do it? I mean, and I don’t mean to sound naive, but like, it’s all product, and like, I’m gonna show you a Ford ad every time you like Google car, right? Like I get, like I’m being really block headed, but I’m just saying they’re not selling anything except fear, right? And doubt. How is that a strategy? What are they selling really?

Andy Slavitt  32:19

So now you’re getting into the patient, like what’s going on in the patient with this patient, this theoretical American patient we’re talking about in a really interesting way. Because, you know, there are a set of people, a large set of people call it Qanon. But I don’t know, I don’t try to typecast it even to say, well, maybe I’ll type pass it a little bit, that sowing chaos against the establishment is an end and of itself. And that was a is a larger block of people than I think we ever knew. And look, by the way, the way they got they weren’t born cynical, right? So you’d have to go back and say, well, what happened over this patient’s lifespan? What was it the financial crisis and then lost her house? Was it, you know, being lied to about the Iraq and Afghanistan was, you know, what are all the cumulation of events that led us down this path? Was it the closing of, you know, was it trade that closed a lot of things in rural communities? Was it immigration, you know, that they caused them to see immigrants is the other that so I don’t think there’s any financial aim. But I think that there doesn’t have to be that many of them. Social media is a playground for trouble for those folks.

Dr. Sanjay Gupta 

I mean, if chaos is the goal, that obviously really like widens the umbrella of all the nefarious things, you know, that come under, you know, that will lead to that. But I mean, like, so if you take this, if you continue this metaphor, and you think, okay, the vaccine, and you got to ask that question about tipping the hat on operation warp speed. But let’s say, you know, President Trump had taken a lot of credit and, you know, gotten the vaccine on television or, you know, made it very publicly known and advocated for it. Would chaos still be the goal? I mean, that I guess, like I’m saying, chaos, to what end? Was it to support a particular political party?

Andy Slavitt  34:07

I’ve come to believe, you know, I mean, I think of politics is a reflection of culture, as opposed to the other way around. And I’ve come to believe that as a populist, Trump has very few of his own original ideas. I think he has a couple. Like I think he’s a protectionist. I think he’s anti-immigrant. I think he comes by those things more honestly. But I think other than that, he’s putting his finger in the wind. And he’s sensing these cultural shifts that exist. And he’s riding those waves. I don’t think he much cares. Do I think he respects people in West Virginia that vote for him by 70 points. I don’t see them invited to his, you know, his golf course in New Jersey. I think he is a populist in the kind of classic sense of someone who knows how to play to the crowd. When you see him, you know, back when he had a Twitter account, he was constantly testing, what could create responses because of the roar of the crowd. So I don’t think Trump had the power to go against the grain. I think that grain that 20% of people that you talked about, was pre-resistant, and he can’t afford to isolate him and leave him alone. Which is why even when he says get vaccinated, he has to keep one foot in the cabin, but freedom gotta keep going. Because those are the people that are buttered his bread. He can’t leave them anywhere. He can’t leave them to a better place, because that’s not him. He’s there leading him.

Dr. Sanjay Gupta

Right, right. And then if you get back to what you’re saying about the chaos sort of instigators, that’s leading as well, it’s not that they’re acting with some purpose other than to create chaos, but then somebody may start to follow them. Because it’s generating a lot of energy or a lot of movement or momentum, whatever. And it’s dead wrong, like showing the big needle to a guy who’s thinking about getting the vaccine. Like, it’s nothing but harmful at that point. That’s the part that I find just so if I’m pessimistic about anything, it’s that, because I feel like otherwise we would sort of, you know, it would be very logical, just as a species to want to take care of each other find order, realize that, you know, survival of the fittest was never actually a thing. That, you know, reciprocal altruism was really the only way we are going to survive and thrive as a species, that just natural, everything else that’s happening is unnatural.

Andy Slavitt  37:03

[…] Tucker Carlson briefly and kind of tongue in cheek. But how do you explain like, that guy? Like, first of all, Fox News has a vaccine requirement and a daily testing requirement. And, like, I understand Robert F. Kennedy, Jr. Like there are people who are like, this is what they believe I’m not gonna diagnose it, whatever. But Tucker Carlson. And I had this conversation with people at Facebook, because they promote him endlessly. Is like, I feel like he’s doing the opposite of what you’re doing. He’s planting mistrust. He’s planting doubts. He’s giving people reasons to suspect. And he’s a very popular figure.

Dr. Sanjay Gupta 

Yeah, I mean, it well, you know, just in the context of things as well, which is always worth reminding people, it’s still maybe 2% of the country a night that are watching him, it’s, you know, I think we talked and I get that it’s shared in different ways, and all that, and obviously, a lot of people know who he is, but it’s not, you know, I think sometimes we look at things as being totally representative of the country or a society and they’re not, they just get a lot of attention. You know, Andy, I think television news is, it’s a tough business. And I think, you know, he clearly it’s one of these things where I think he knows who his audience is and saying the things that his audience wants to hear, it’s a little bit of the tail that wags the dog again, you know, is it leading? Or is it basically enabling?

Dr. Sanjay Gupta  38:35

And I think that that’s, I think, what some, some of these folks, they really do feel strongly about what they’re saying. But I don’t think there’s that many of them actually. They are saying they feel strongly only because they know it’ll rally a certain segment of the population. And it’s easy. It’s a little bit, you know, it’s not that hard to do. You can say these types of things and know that I think we have a, you know, I think there’s a there should be a larger obligation. When you’re saying things to a lot of people at once on television. I really feel like you know, the fact checking and the vetting and the thinking and all that giving numbers being accurate. I think it matters, you know, and, you know, and to find, you know, yet 100 studies, you find one study that says something different and you say we’re leading with that tonight, you know, that type of thing kind of makes me a little crazy, right? Well, hang on. There’s not, that’s not how science works. But it can be how television sometimes works.

Andy Slavitt 

He must think it’s just like an hour performance. And his job is to succeed in that hour. And look, I mean, I know I could tweet something they could get 200,000 likes by just putting something really edgy out there. You know that there’s times where you could get a viral clip by you know, calling someone out just being a tiny bit edgy. The problem is that’s addicting. Is it when people to someone some people like him taste that, that becomes the end and of itself. And that just negates people that are out there to do really responsible thing. Thank God that people watch your network and watch you for other reasons. So I want to add a new feature to our podcast and I’m gonna do it starting at this episode, okay? And it’s called, let’s move on people, okay, let’s move on people. And here’s how it works. We all learn something at one point during the pandemic, and it was like, okay, it turned out we should be taking the vaccine two weeks apart. Okay, now we know that we should take the vaccine longer periods apart, it helps more. Okay, so that was wrong then we now have new facts. Okay? Is it healthy for us to spend our energy Sanjay dwelling on the fact that we thought it was two weeks, but it turns out, it should be longer? Or should we just move on and adjust to the new information?

Dr. Sanjay Gupta  41:00

I think we should move on. And here’s why. I think there was actually, as I’ve learned since then, from because I dug into this, you know, I don’t know that I would have even called it wrong. That the interval I, you know, I guess Pfizer, three weeks in Medina, four weeks, whatever it is, what I understood after sitting down and really talking to people, including going back to […], but also people like Barney Graham at the NIH, I really wanted to understand this. Because I looked at vaccine schedules, and I may be giving you an answer that’s longer than you want to know. But when I look at vaccine schedules for other vaccines, you know, it is true that many of them do have multiple shots and separated by, you know, some quite some duration. But what I thought was interesting is that, you know, if you talk to someone like Peter Hotez, he will say, they were always going to need to boost at, you know, 6, 7, 8 months, whatever, like, much longer period away, that was always going to be part of the plan, and say, well, why did they do it at three weeks then? Right? He said, well, because they gave a shot. And then they saw they were getting 64%-65% efficacy, which was really good. But realize that even though it was a really short interval, if they gave another shot, within three or four weeks, they really were raising those neutralizing antibodies, and even closer to 90 plus percent protection against severe illness. So he’s like that it was like we’re in the middle of a disaster. So we wouldn’t normally get..

Andy Slavitt  42:27

4000 people were dying every day.

Dr. Sanjay Gupta 

Yeah, so we will go ahead and just fortify the gates as much as we can right away.

Andy Slavitt 

Guess how long it would have taken to study a vaccine interval that was six months apart, right? Six more months. Exactly. This is where I can get we’re like so obsessed with this like and caught up in this battle over the past that I’m okay, pretend the pandemic started today. Okay? The pandemic started today, and we had all the knowledge we have today. We know a lot more about vaccines, we know a lot more about masks. We know a lot more about a lot of things. Let’s just act accordingly. So I want to give people the permission to cleanse themselves of all those bad feelings feeling misled, feeling misinterpreted, and just say, hey, folks, say with it me, Sanjay, let’s move on people.

Dr. Sanjay Gupta 

Let’s move on people. I love it. I love this feature. And you’re in a perfect position to sort of champion this feature. It is a really interesting way to think about just sort of Tabula Rasa let’s just start right now and we have a lot of knowledge let’s not dwell on there because it’s not it’s not accomplishing anything either to dwell on.

Andy Slavitt 

Just save the next person, let’s save the next person’s life let’s prevent the next death that we have the power to do. We can’t do it as well if we’re if we’re caught up in I get this was an exhausting 18 months, and it’s been an exhausting and trying and scary period. And we’ve got anger, we have unresolved issues. And this is maybe where we should begin to wrap up if the conversation is they need a place to go like those emotions need a place to go like we have, whether we call it PTSD, formerly or whether we would just call it anger issues. Each one of us feels like there’s a point in time when we were right. And the country did something wrong and weird and weird now, see, I knew we shouldn’t close the schools. I knew that nursing homes, I knew this I knew. And so like we’ve got all this like energy that people are going to have to expand, to move on in a healthy way. So maybe as we kind of close it kind of goes back to where we started about the patient. How do we help the patient psychologically, from a wellness standpoint, from a caring standpoint, let some of these things go.

Dr. Sanjay Gupta  44:43

Well, you know, I’d say a couple things. One is that I do think that to this point you’re raising about I was right on this, I got it you know you guys, you know you didn’t you didn’t get it. I think that people do want to be recognized. They want credit. You know, I think it’s a very human sort of instinct and if they feel like they’ve been diminished, or they’ve been ignored, that just fuels that sentiment, I think even more. So instead of arguing, I think, you know, giving credit where credit’s due, I guess, look kinda like you, you know, you were telling your story. I think it does sort of level the field a little bit. You know, I think sometimes there was this poll that came out Andy, that Dr. Fauci actually shared with me about attitudes towards scientists. And one of the headlines for him was that they have been increasingly seen as arrogant scientists increasingly seen as arrogant. And I thought, that’s a good note for me to remember.

Dr. Sanjay Gupta

Because, you know, if you just give some credit, yeah, you were right on that, you know, so we were learning back then, I think the other thing is that we are going to get through this. And I think that, you know, if it feels so gloom and doom all the time when people watch or reading the stories, then I think, even if they’re very interested, eventually they start to just tune it out. It doesn’t leave as much of an impression. So I think that for the patient, I would be constantly reminding them of that as well. I mean, maybe there were moments during this pandemic, where I thought, legitimately, things are really heading south, you know, in terms of the patient care, but I’m optimistic and I think I need to reflect that and share that with my patient to make sure they know that and give credit where credit is due. I mean, there’s been a lot of people who’ve been involved with this pandemic, that have, you know, you get, you’re, you’re on the task force, you’re doing these things, people see you. But there’s a lot of people out there who’ve been part of this that have tried to contribute as well. Maybe not always in meaningful ways, but in ways that I think sometimes deserve credit. And we try and do that. I know you do.

Andy Slavitt

I did it all myself, right. I’m the only one that can fix this, isn’t that the saying?

Dr. Sanjay Gupta 

I don’t totally disagree with that. But I think like I just want to say that when you I think I texted you, but when you left? I don’t want it I’ll just leave it when you left things changed a little bit, I think in terms of the cohesiveness of the task force.

Andy Slavitt  47:03

That’s nice.

Dr. Sanjay Gupta 

I shouldn’t say anymore.

Andy Slavitt 

I think they were very, very tough. These are very tough things, very tough job to do. And this, this idea that you have of working our way through it, all of us, and finding a way to heal. As we do try to put this past this or accept the reality that think life’s gonna be tiny bit different, or conveniences. to mourn people we lost to listen to the doctors and nurses on the front line who didn’t get listened to and have real perspective to not sweep this under the rug when it’s gone. Or when it’s calmed down. But I feel like, whatever, like my advice to people listening to this show is the same advice I’d give to myself or my kids. There are things that heal us all. And they’re different for each one of us. And, you know, they’re kind of things you talk about, and I’ve talked about historically, that perhaps people haven’t paid as much attention to in terms of their own wellness and self-care. And sometimes we think, well, who’s got time for that? But maybe, you know, we ought to be rethinking that take care of ourselves and take care of each other better.

Dr. Sanjay Gupta  48:16

Well, you know, I do think that it’s very important, impossible to have the conversation about why the United States, for example, had such an unhealthy sort of population to begin with, that put us in a much worse position in terms of handling this pandemic. I think, like everything else it gets, it gets wrapped up into issues that don’t shaming and blaming and things like that. Yeah, obesity was a big risk factor for outcomes with regard to this disease. Sure. And you know, it hasn’t gotten enough attention. And it’s, it’s multifactorial, again, there’s people who simply do not have, you know, healthy food very available to them living in these food deserts and things like that we spent $4 trillion on health care 70% of diseases preventable, we spent 1% of that budget on making sure people had healthy food, it would go a long way towards that. But we don’t do those things either in this country, you know, it’s reflective of a larger problem. But are we allowed to have a conversation saying yes, the people who are most vulnerable to this disease or people who are more likely to have been sick from other, you know, comorbidities in the first place, and we can actually do something about a lot of that, I think, I think it is reasonable to have that conversation.

Dr. Sanjay Gupta 

And to be really, really empowering about it. What is it about your microbiome, that actually is generating your immunity or helping your immunity? How does your breakfast today help the likelihood that you’d have a better outcome if you got COVID tonight, you know, things like that. I’m exaggerating a bit, but there’s real connections there. Sure. And I think we did ignore, not ignore. I mean, in some ways, it’s like the patients in the ICU for heart attack prize, not the time to start telling the guy to stop eating cheeseburgers. I’ll get to that, you know, but now’s the time I think to get to that with the country as a whole, it has to be part of this conversation going forward. Wealth does not buy health. I think we realize that I’ve been reminded of that, at least during this pandemic, diseases of affluence, like we see in you know, in the Western world we’re really significant risk factors for this disease and that’s a lesson, you know, we’ve learned it before but we’ve been really reminded of it here and I think hopefully as part of all the public health you know, spending that has now been approved that’s going to be part of it. You know, making sure that the basics in terms of allowing people to show up at a pandemic fight well suited some of those things are addressed.

Andy Slavitt  50:40

Yeah, well look I don’t say this lightly but I would be more than comforted to know that whatever we face as a country you’re going to be there to help lead us through it both personally and as a society I keep thinking very few people who are better trusted with good reason. Well, maybe you’ll come back some time on the show talk somewhere, this was really fun. I love where this conversation went.

Dr. Sanjay Gupta 

I have a lot of respect for you, Andy, I really do you have you how you lived your life. The things you’ve chosen to contribute to I mean, we need we need people like you and also just the way that you teach because like I said, I watch you and I feel like I can see how your mind works sometimes. And it’s really instructive and helpful to me.

Andy Slavitt 

Thank you. I really appreciate you saying that. It’s quite mutual. And I look forward to spending more time working on all these important things together.

Dr. Sanjay Gupta

You got it. I’m here for you anytime. Thanks for having me.

Andy Slavitt 

That was really nice conversation with Sanjay. Not everything has to be like a huge heated argument. I eat David Agus, big arguer. Several people out there. Some tough issues. Yes, people are dying and people are getting sick. And politics is a little bit nuts sometimes. But there are civil people that you can have conversations with. So I’m applauding Sanjay. No, I’m not just I’m tipping my hat to Sanjay, that’s an inside joke. Okay, who do we have coming up on the show? Three people coming up on the show. If you don’t know them, you will know them soon. You’ll love them. Katherine Wu, from the Atlantic. A phenomenal journalist communicator and she’s writing about what we can expect in winter. That’s what we’re going to talk with her. Celine Gounder, she is a physician in New York. She has a great podcast. She was part of the transition team. And then Ashish Jha, we’re gonna have fun with Ashish Jha. Oh, we’re gonna have some fun with Ashish Jha. Okay. Thanks All. Talk Wednesday.


Thanks for listening to IN THE BUBBLE. Hope you rate us highly. We’re a production of Lemonada Media. Kryssy Pease and Alex McOwen produced the show. Our mix is by Ivan Kuraev. Jessica Cordova Kramer and Stephanie Wittels Wachs still rule our lives and executive produced the show. And our theme was composed by Dan Molad and Oliver Hill, and additional music by Ivan Kuraev. You can find out more about our show on social media at @LemonadaMedia. And you can find me at @ASlavitt on Twitter or at @AndySlavitt on Instagram. If you like what you heard today, most importantly, please tell your friends to come listen and please stay safe, share some joy and we will get through this together.

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