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Dr. Jennifer Ashton: ...the roadmap to resilience in the pandemic era

Laura: Welcome to Nobody Told Me! I'm Laura Owens.

Jan: And I'm Jan Black.

Laura: As we all know, our world has been permanently impacted by the pandemic. Our guest on this episode has been a knowledgeable and calming voice helping millions of Americans understand what the crisis has meant to virtually every aspect of our lives.

Jan: Our guest is ABC News Chief Medical Correspondent, Dr. Jennifer Ashton, who's appeared on the ABC Network, at times, up to 14 hours a day, from Good Morning America to World News Tonight, and all things in between. She's been helping us understand this crisis that has upended our lives for more than a year now. Dr. Ashton's the author of a new book entitled, The New Normal: A Roadmap to Resilience in the Pandemic Era. Doctor, thank you so much for joining us.

Jennifer: It's great to be with you guys, thanks for having me.

Jan: You say we will never be the same again, and that our old normal is never coming back. Why?

Jennifer: First of all, when I titled my latest book, The New Normal, it was for a couple of reasons. One is, I wrote the book in August and September of 2020. During that time, people were starting to throw around that term, 'the new normal'. I always cringed when I heard it because the reality is, what we're going through now is neither new nor normal. We've been going through it for over a year, and it's definitely not normal. I think there's some irony there in that terminology. But also, I think it's important to realize that trying to go back in time is something that we do all the time with a number of different things. We wish we were 10 years younger, or whatever. That's very common, it's a common kind of emotional and psychological place to be.

I think now, in the setting of this pandemic, what it reflects is the really strong, compelling need that a lot of us, if not all of us, are feeling in one degree or another, to go back to what we had before we lost so much. I think that there's some kind of tongue-in-cheek about it, but there's also some reality in that term.

Laura: You talk about, too, how a lot of us have gained a lot during the pandemic. We've gained new skills, we've become self-starters, we've been successful in business, gotten new routines, all these things that we maybe shouldn't want to give up and go back to our old selves.

Jennifer: I think that the human spirit is very resilient. I know that from being a doctor in private practice for 16 years. But I also know it for being in national network news for 14 years, covering stories that have to do with great human tragedy but that reveal kind of the resilience of the human spirit. I do think that we've learned new things, and there are silver linings in this pandemic. But it's also been a time of real uncertainty and we've also been upended in totally unfamiliar territory, unchartered waters, and it's not over yet. We're still going through it.

Jan: The subtitle of your book is, A Roadmap to Resilience in the Pandemic Era. When I think of resilience, I think of something that you're sort of forced into, I don't think of it as being something that you can kind of plan to be resilient. But you say we really need to adapt that kind of thinking; we need to become resilient, and work at it.

Jennifer: I do think that. First of all, my medical specialty is OB/GYN, it's women's health and surgery. As I've said, and as you guys know, I still have real patients. I'm not #notjustadoctoronTV. But my role as Chief Medical Correspondent at the largest, and number one network in the country, has given me a ringside seat for this pandemic.

Covering this story, this global and historic health emergency, for a year and three months now, on a regular basis, I'm speaking to the world experts in all things COVID. Just this morning, I spoke to the US Surgeon General. I text with Dr. Anthony Fauci on a regular basis. I've spoken to the CDC Director, I've been down to the NIH vaccine development lab. I'm literally getting the latest information directly from the horse's mouth, so to speak, and then helping the American public distill that down so that they can use the information and not get that medical headline whiplash that is so easy to get.

I think that one thing that's come across to me in taking a 360-degree view of this pandemic, is that we are more resilient than we think. Sometimes, yes, you can learn the tools to become resilient, and sometimes you might have had them all along and just not realized it. So, everything in between.

Laura: You've had to be resilient to make everybody else resilient since you've been on the air so much and been such a comforting and reassuring voice to us from the start of COVID. But you say that you hit a wall when it was announced that President Trump had gotten it. Why was that moment the time when you decided that was it?

Jennifer: That really was it for me. First of all, as I relate in the book, and as people may remember, that story broke at one o'clock in the morning, on a Friday morning. Because news networks are prepared for breaking news 24/7, we get these text alerts on our cell phone that sound like an amber alert or a hurricane warning kind of thing. I happened to have gotten up to use the bathroom, which is very rare for me, and I was in the bathroom when I heard that alarm-like sound coming out of my phone. No sooner did I get back to my phone, then ABC called and said, "Dr. Ashton, hold on, we're putting you on the air." I called in with, what we call, a phoner and then, an hour later, because I had a home studio for all of the pandemic, I was actually on television in the middle of the night talking about it.

The reason it represented hitting a wall for me is really kind of a multitude of reasons. One is that it set off about four days where, once again, it was 14 hours a day, talking about President Trump and his COVID. So, it was kind of around the clock. It was the biggest story in the world, clearly, at the time. But it also reflected a challenge for me to have to talk about an individual, a public figure, who, at that time, was a patient and maintain the sacred, I'll call it sacred, bond that doctors and patients have, even though obviously, I was not the President's physician.

My responsibility, first and foremost, when talking about any public figure, is to that person as a real patient. I was balancing that with the fact that, I think it's really no secret, but that in many ways from the start of this pandemic, President Trump had kind of sent out mixed messages in terms of the medicine and science. It was very difficult to tread that fine line for that story.

I remember after that, I did my weekly phone session with my therapist, and the first 10 or 15 minutes was spent talking about the President's COVID. I thought, "Now, I have hit rock bottom. I am wasting time that I'm paying for. I should be working on myself, and instead I'm talking about the President and his COVID." So for me, that was definitely the breaking point.

Jan: Yeah.

I'm wondering if you were surprised, as I was, that the wearing of masks became a political issue?

Jennifer: Yeah, I was surprised by it. In medicine, we don't ask how a person voted before we start taking care of them. Medicine and science should be non-partisan. There were times in this pandemic that I was critical to what may have been considered a conservative viewpoint. And there were times that I may have been considered critical to what would have been considered a liberal viewpoint. I stay in my lane, which is that of medicine and science. Unfortunately, a lot of people did not stay in their lane, and I think that complicated this considerably.

Laura: What do you think about the political situation we're having regarding vaccines right now?

Jennifer: In terms of vaccines, I think there's this term that's being used now everywhere, vaccine hesitancy. It's clearly being used as a negative, right? I don't really see it as a negative, I see it as, "This is normal." It's appropriate for people to have questions, have concerns, even have some skepticism about, not just these vaccines, but anything. Anyone who is a practicing health care professional deals with this every single day. I don't call it patient hesitancy when I have to counsel patients about something, I call it my job to do that, provide that information, and help the patient make the best decision for herself or himself. And by the way, I respect what that decision is.

I think that's what's missing from this dialogue is that, there's a lack of respect, there's a lack of understanding, and there's a judgment that is being thrown around, implicitly or explicitly. I just think that is wrong in medicine. What I do think is that if provided with the right factual information, and if explained the way to think about risk, that almost everyone will make the right decision for himself or herself. But unfortunately, that hasn't happened as much as it should.

Jan: What do you see, as far as the future is concerned, in terms of us needing vaccine booster shots?

Jennifer: It's not just what I see. We've heard the CEO of Pfizer, we've heard Dr. Anthony Fauci, just the natural history of Coronaviruses, in general. Remember this family of viruses are the family that causes the common cold. We've all had more than one cold in our lifetime. It's kind of assumed that at some point we will need a booster shot. Whether that's in 6 months, or 12 months, or whether that's in 3 years, we don't know. But people should not be surprised when they hear that headline. That's why they're continuing to follow the people in the clinical trials really closely.

Laura: When do you think is the right time to go back to social gatherings?

Jennifer: I think that the answer, that depends, right? It's not one size fits all. It depends if people have been vaccinated. It depends whether the setting is indoors or outdoors. It depends what's going on in that community. It depends what the baseline medical risk factors are of the people who are gathering. If you're talking about a bunch of 80-year-olds gathering indoors, that's a very different situation than a bunch of 40-year-olds gathering outdoors, if all have been vaccinated. We're going to have to navigate that, do it safely, and not just act like children and say, “Well, this is what we want to do, so let's just do it.” That's just not smart now.

Jan: You talk about how we can pandemic-proof our bodies. I found this really, really fascinating, in that losing weight is one of the things that we can do. Tell us more about that, and some easy ways to go about it.

Jennifer: Remember that two-thirds of the country is either overweight or obese. Those are considered chronic medical conditions. We know that COVID, like many upper respiratory viral infections, really like people who are overweight or obese. People who are obese are at very high risk for severe complications of COVID-19. The best thing to do, if there were ever a time for a wakeup call, boy, this is it. Remember that it's not just the number on the scale that matters, it's the inflammation, it's all the things that go along with being overweight or obese. At a time when everyone feels so helpless, like there's nothing we can do to deal with this pandemic, taking steps to get your body weight into a healthy range, is difficult for sure, but it is under our control. I think that's one of the silver linings of this pandemic, is seizing the opportunity to do that.

Laura: A lot of us have gotten out of shape and out of our exercise routines, and it seems almost impossible to get them back after all this time, at least for me. I was kind of happy to hear that you found the same thing, that you got a little off of your routine. Now that gyms are reopening and people are getting vaccinated, I'm finding that it's harder to find a reason not to go to the gym. How can we get back into that health mindset, that workout mindset, after all of this time and our new routines having taken place of our old ones?

Jennifer: I think, first of all, it's, again, not about going back. It's about finding something new, maybe. A lot of people haven't gotten to the place where their gyms are reopened or they feel comfortable, I know I definitely don't. I was one of the many people who was on a long waiting list for dumbbells.

Laura: Totally, I was too. I was on that list.

Jennifer: Signed up for the Peloton app so I could do 10-minute core exercises off my phone. I think it's just about doing the best we can, and a lot of people are doing that. Luckily, the weather's getting nicer, so for a lot of people, they can be outside. But it's really about finding a new way to get those things done and not just sitting and waiting for, miraculously, the old way to come back.

Jan: I was actually somewhat comforted by the fact that you say we all have a touch of PTSD as a result of this, so it's not just me. It just seems like the rug has been pulled out from under us. Tell us more about how you're seeing that PTSD reflected in people.

Jennifer: First of all, I see it in my patients literally every day. I think that everyone's anxiety, stress, and sadness for the things that we've lost is right there just below the surface, it's not buried that deep. I think that it's normal to feel a lot of those feelings. With a loss, or a trauma, which arguably you could say this pandemic has been, people can get PTSD. Obviously, if they suffered from any kind of mental illness before, they're at higher risk. So anyone with anxiety or depression before 2020 is at higher risk for these things. I think it's really just about the awareness that it's common, you're not alone, everyone's been through a sort of trauma in various ways. And then it's about supporting each other and supporting ourselves so we can get through it.

Laura: I feel guilty if I say that it's been a tough year, or that I feel some sort of PTSD from it, because I've been lucky enough not to have a loss. But I know you say that we really do need to address those feelings. What benefits are there to opening up and saying we've had a tough time when we know other people have had it tougher?

Jennifer: It's almost like you were on the phone with me and my therapist at one point because I said those exact words to her. I said, "Listen, I'm lucky. I still have a job, I still have a roof over my head, I still can get food. No one in my immediate family has died due to COVID." She said, "Hold on, I'm going to stop you right there. That is a concept called multiple truths in psychology. Yes, those things are all true and you can also feel a degree of anxiety, sadness, loss, grief, and PTSD. They're not mutually exclusive, one doesn't negate the other. And it's not a contest or competition as to who has lost more."

I think having perspective is important in medicine. Yes, obviously, it is important to say, "Okay, you still do have your health, or you still do have your job, or your home." Those things absolutely can help, but that does not mean that you're not entitled to feel a degree of the impact that this pandemic has had. I learned that from my therapist, and I thought it was really, really important information.

Jan: What kind of a long-term impact do you think the pandemic is going to have on the mental health of this country? We weren't in a great spot going into this.

Jennifer: That's definitely true. I think, in speaking to mental health professionals, they are concerned about that. But no one has the answer to that question because we're living through this big human experiment in real time. Anyone who says that they think they know where it's all going to, unfold, and play out, really doesn't. I think that all we can do is hope for the best and understand, acknowledge, and recognize what people have gone through. That's it. At the end of the day, that's all we can do right now.

Laura: Worrying has caused so much anxiety for everyone. I think we all want to think that nothing like this is ever going to happen again, but are we just fooling ourselves to think that? What kind of a realistic mindset do we need to have?

Jennifer: If you ask and speak to emerging infectious disease specialists, like I do oftentimes in my role at ABC, they will say, "Yes, we are just fooling ourselves. It's only a matter of time until this happens again, so we might as well learn from our mistakes and prepare for it.” That doesn't mean that it's going to happen again in three years, but it does mean that we can't live in denial. That's kind of an example of how to think like a doctor, you hope for the best, but you still prepare for the worst.

Another way, or astronism, that I like to say that is, it's great to be idealistic in medicine, but it's really important to be realistic, too. Idealistic would be, "Nope, this is never going to happen again." Realistic is going to be, "You know what? It is going to happen again, it's just a matter of when. We're not going to live being paralyzed with that fear, but we are going to take steps to prepare for it."

Jan: How important is sleep in helping us cope with this pandemic right now, and being ready to cope with whatever might come our way in the future?

Jennifer: Listen, if you guys watch me on Good Morning America, you'll know, you've heard me say this before, that sleep has a massive PR problem in this country because people think of sleep like it's a luxury. The reality is it's a medical necessity. If you look at this like we're in battle, which I kind of feel like we are.

Jan & Laura: Yeah, yeah.

Jennifer: We need to be well-rested to do that. If we were elite athletes, we wouldn't be going into the Olympics on no sleep, right? I think that we really do need to reframe how we think of sleep. I tell people, if I could write a prescription for 'Commit to good sleep', I would. Unfortunately, people accept prescriptions for sleeping pills much more readily and willingly than they do for someone saying, "Listen, you have to make this a priority in your life." What does that mean? It means that you make it a priority, that you say, "I'm getting 7-9 hours of sleep every single night, no matter what." I've done that and I'll tell you that I wouldn't have gotten through this past year without it.

Laura: How do you make a COVID emergency plan?

Jennifer: I think that's something that people should have at all times anyway, right? This doesn't necessarily mean it's a pandemic plan. But what I mean by that is, first of all, if you take prescription medications, or even if you don't, you should have some basic medications in your home at all times. A lot of those can be gotten in a regular drugstore. But the concept is, you don't want to have to be running out in the middle of the night when you're sick, or when you're on quarantine to get something. By the way, I was guilty of not being ready for this myself. When everyone went on stay-at-home, lockdown, whatever people want to call them, all of a sudden, if people got sick, they were like, "Uh-oh, I don't even have Tylenol at home," or something.

Jan: Yeah.

Jennifer: Part of it involves having some supplies. Part of it involves knowing who you would call. Do you have a health care provider? If you don't, I always recommend to people, meet one or find one when you're healthy. It's never ideal to find one or meet one when you're sick. And look into, "This would be the hospital I would want to go to. This is the nearest hospital. If I'm traveling, this is where I would go, this is what I would do." Go through those plans. You'll never be sorry. Hopefully you'll never need them, but if you do, you'll be glad you did.

Jan: You also point out that laughter and love are things that haven't changed during the pandemic and that they can really help us be resilient.

Jennifer: One thing that we've all seen in this pandemic is incredible stories of just that, laughter and love. That's part of the human spirit that is not going to be affected by the pandemic. Laughter is said to be good medicine, and I do believe that. I think that love can get us through a lot as well. But I think at times when we're stressed, it definitely can be easy to forget those things. And they can be really powerful.

Laura: Dr. Ashton, at the end of each show, we ask our guests, “What is your nobody told me lesson?” What is it that nobody told you about resilience, mental strength, or getting through a pandemic that you wish that they had at the beginning?

Jennifer: That's a great question. Nobody told me that 15 months of watching the country, and the world, suffer would feel like it does now; both in terms of the pain that I feel that it's still going on, but also in terms of the strength and resilience that I feel on behalf of other people and myself. I think just the range of that emotional roller coaster, if you will, is something that nobody told me. But that's also because nobody has been through this before. To me, that's kind of what's standing out to me the most at this point.

Jan: Doctor, how can people connect with you on social media and the internet, and find out more about what you're up to?

Jennifer: Instagram is really the only platform I use, it's @drjashton. I try to respond to as many questions or comments as I can, as long as they're nice. If they're not nice, they will be ignored.

Jan: Sounds good.

Jennifer: And people can see me every day on ABC, on GMA3: What You Need to Know, along with my co-hosts, Amy Robach and T.J. Holmes. We're on at 1pm Eastern, 12pm Central and Pacific. We cover a bunch of issues and stories, both inspiring and educational, about the pandemic, not about the pandemic, you name it. That's probably where I live the most these days.

Jan: Thank you so much, we really appreciate your time. We know you have a very busy schedule, so we'll let you go. But we really want to give you our deepest thanks for joining us.

Jennifer: Thank you, guys. You guys were great. It was great to be with you. Stay well and have a great weekend.

Jan: Same to you. Our thanks to Dr. Jennifer Ashton, whose new book is called, The New Normal: A Roadmap to Resilience in the Pandemic Era. And her website is jenniferashtonmd.com.

I'm Jan Black.

Laura: And I'm Laura Owens.

Jan: You're listening to Nobody Told Me! Thank you so much for joining us.

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