Transcripts For CSPAN2 Dr. Kelli Harding The Rabbit Effect 2

It is a part of the new yorks famous book proved that ran around Fourth Avenue from astor place to union square and there were 48 used bookstores that competed with one another. All of them have shuttered except for this tren for the sts allies want to thank all of you voracious readers because we are Still Family Owned and still thriving. In fact, we are doing 400 events and discussions and even tonight we have for events and its fun. [applause] and thank you to cspan for filming this. Happiness is the best medicine, yet americans will spend 3. 1 billion on medicine and healthcare this year. A sum that i sound that is largo send every family of four check for 40,000 for their care. And we all know that happiness is not a big ticket item. Our guests tonight, doctor Kelly Harding will discuss this. Shes an assistant professor of psychiatry at Columbia University Medical Center and a diplomat to the american board of psychiatry and neurology. Doctor hardings work in the emergency room is as at Presbyterian Hospital and is the daughter of a 91yearold, ive spent a lot of time there so i had a lot of admiration. She has appeared on today, good morning america, npr, New York Times and the u. S. News world report. Doctor harding is here as the author of the rapid effect. [applause] starting with the story of a nurturing treatment of rabbits with doctor harding spoke discusses the groundbreaking new research that shows how love, friendship, community and environment and lifes purpose can have a greater impact on our health than anything that happens in a Doctors Office. Joining in the conversation is being had jumped professor at the Columbia School of Public Health and was for 12 years the chief medical officer for the new York State Office of Mental Health. The nations Largest Mental Health agency where he was a psychiatric advisor. Hes written many books including ones we have here tonight. Addiction, solution, trading our dependency on opiates and other drugs. He is also written a family guide to Mental Health care and improving Mental Health, for secrets in plain sight. Please doctor harding to the strand for this important discussion. [applause] first of all, nancy, thank you for having us and that beautiful introduction. It is an honor to be at this famed bookstore. I mean, really i didnt grow up in new york and the strand has this mystique to it to be sitting here and sitting among these books is just one of the highlights of my life so thank you so much. And to be surrounded by so many people that i absolutely love, this is just an incredible treat. So, i just cant i am seeing so many faces so thank you, thank you so much. Because this is a book about kindness, we also just want to take one second and if you could say hello to your neighbor and introduce yourself if you dont know them. [laughter] [inaudible conversations] good evening. We wanted to get to know you as our guests a little bit more, so how many of you are scientists ask how many of you are from the Mental Health field . Good representation. How many of you over writers, journalists x. Its a special form of writers. Let me ask this. How many of you over here tonight because you are a relative of doctor harding . [laughter] how many of you are here tonight because you are her neighbor and rely on her medical advice . [laughter] and is anybody here because they think that this is a book about vampires . [laughter] because it is not. It must be in one of the other rooms. [laughter] and i guess some of you are also probably wondering what is the deal with the rabbits. So, we will talk about that. Lets learn a little bit more about you. He heard that you have a pretty busy life as an emergency room dr. You have three children. How in the world did you gather the time and energy to write this book . I have to say that its an incredibly Important Message and i know many of you in the room knows this. It became something that felt urgent. I know this is something that you also share a passion about the conference publichealth. Theres been an important story that we are not talking about and it affects every Single Person sitting in this room. So, tell us about the rabbits. [laughter] before i get to the rabbits, i want to say something. Restore hand if youre a clinician again. We had a lot of clinicians in the room. So, as clinician, theres a lot of mystery when it comes to the mismatch between what we expect when we know about a diseas thee and what transpires in life and in the hospital. Patients that have a serious diagnosis that on paper they found were not doing well but then you meet them and in fact they are functioning and living their lives fully. Its also the flipside of that. Patients who may be when you look at all of their labs and imaging and Everything Else they look okay but they are not functioning in life if so, this mystery propelled me through many years of education starting in internal medicine psychiatry had something to do with my body connection and then i ended up in a Research Fellowship looking at medically unexplained symptoms of columbia and i still didnt really feel like i have an answer until i heard about the rabbits. So in effect this book is part of your discovery of what you have been searching for. Exactly. So, one of my mentors told me when they i think you might want to hear about this and he said i heard something about them and how of a social world impacts social health but he didnt know the details, so i searched and searched and found peace studies that were done in the late 1970s, early 80s had here but it its cool as the studies were were actually done with the intention of looking at part health and rabbits. At the time it wasnt known a high fat diet made a difference, so these genetically identical rabbits were fed a highfat diet and then they looked at the results into something was wrong. One of the groups have for Better Health Outcomes Using different markers than the other groups and being a tragic scientist he figured there was something wrong of the protocols he looked at it again and then everything checked out so they looked back at who was caring for the rabbits and they noticed one was a very caring woman who was actually picking up the rabbits, not just giving them pebbles with putting them, loving them, talking to them and they realized that it be the social environment is actually changing their physiology. So, to their credit is at the time it was a radical idea, they went ahead and replicated the study of this time with really tightly controlled conditions and they got the same results and published in the prestigious journal of science. I just want to take a step back because a lot of the studies are somewhat serendipitous and i think that this was an example of that because this is a groundbreaking study showing the social world is having an impact, but the thing is it was just the beginning of a much bigger story. Then this is the nature of really good science when something doesnt make sense, you dont dismiss it, and you pursue it. So, this was a protective effect in a way that it protected them from disease. Help us understand that sort of phenomenon interesting to discover. First, it seemed somehow our social world is changing our physiology and that defies our understanding of how the body works right there, but then sort of trying to think about the mechanism and what is amazing is we now have you know, for decades of science since then the show and this is all through the field of Public Health is really shows how our social world is impacting all of our livelives on every salesperson n this room, everything the person listening on cspan, their lives are impacted by the kindness that they are giving to others and the kindness that they are receiving. It comes back to so many different factors relating to Mental Health advocates that is where we entered the discussion. You described these as hidden factors. Somebody hides them or are they there yet to be discovered . I described them as hidden factors and it thats what is called the social determinants of health or social dimension of health which is a bit of a mouthful and i think the thing to keep in mind is these hidden things in our daily relationships talking about whats happening in our homes and our workplaces, whats happening in our schools, in our communities come in the neighborhoods, what is happening in our broad social environment. Its really coming down to help me take care of one another and actually it raises the plaintiff you dont mind im going to stop for one second. I want to take a second to think about kindness in your life for a second and then i life, lets just take a second and think about somebody that has shown you kindness recently just for a couple of seconds. For me this exercise is very easy because i am looking out at a sea of people that have done that and sitting next to me so thank you. I think that you know, it is those things that it makes us feel good but theres actually all of this amazing science, like really cool stuff about how the body works and how our social world is actually changing who we are. And you are saying that these moments of kindness actually are protective, they are going to make a difference in how we lead our lives and how we feel. It seems like such a ready resource that you are saying that its one that is hardly used. I think actually im curious oabout your thoughts on it. Why do you think it is so under used . I wont let you get away with not answering your own question. [laughter] i have to say after i wrote my book, doctor lloyd wrote as it covers a lot of things. Theres all these secrets are hidden in plain sight physically but you know, it is hard sometimes to take science and actually implement it into your daytoday when you have a certain mindset, so the goal of this book i realized when i crossed the street from the radicals and then started, i realized this is information that needs to be in everybodys hands because they need to recognize that their actions do matter. It turns out that a bigger predictor of your health by far is your workplace. We think about it usually like diet, sleep, exercise, and occasional trip to the doctor, but not thinking about the workplace as having such an important impact on our health and wif they are not necessarily thinking about the neighborhoods where we live, access to the food that we have, for better or worse how our stress levels are impactinhaveimpacting our healty basis and it is a conversation we need to be talking about because the other thing that is the big pieca big piece of thiss mentalhealth and we know in this country until health is not something that has been committed resume of a stigma for sure. You have seen it firsthand in your career. How is yet another Public Health problem widely talked about now related, namely loneliness. How do you connect loneliness to these problems with our health and with our reaching one another in kindness . It comes down to taking care of one another. When we think about it as a society, we are not doing a great job of this. Loneliness is a big piece of this. So, you know, theres opus dei do not actually loneliness as this detrimental to your health as very well established fixed factors like smoking 15 cigarettes a day or heavy alcohol use them even high blood pressure. You know, the question is how many times does your doctor ask you do you smoke and drink but are they asking you you know, when is the last time you called a good friend or something you really cared about or if things got rough with you have somebody to reach out to end it turns out that is really critical. So, it is time we started talking about it. Do you get a hard time from your colleagues were saying that we are missing the boat when we ask about smoking or drinking or asking about, that we are missing this whole aspect of the relationships with our allies when was the last time a doctor asked about the . Do you get a hard time from some of your colleagues . I would love to hear from colleagues in the room about this. There are records i was just talking about this with the medical students actually, the numbers have burned out among the physicians and people who work in medical care, and i think a big piece of that is because the Current System is just simply not acknowledging the major determinant. This actually brings me to the statistics. Medical care probably only accounts for about ten to 20 of our overall health. Tso think about that for a second, ten to 20 . Yet when it comes to how we spend on health care in this country, we are spending 95 of our dollars on medical care. And administrative costs. That being said, its important, access to medical care is absolutely critical that at the same time, we have to start looking at the Bigger Picture that tells, and that includes what is happening in the communities in thinking about the School System into thinking about all these other things typically we have minimized in the glare of medicine which i love it, i am a total science nerd. I would say this has been my experience in as many of you have seen, kindness is a practice its something you have to do every day and because we are human beings we fail at it every time into this exciting is recognizing gives you coffee and looks even the ey you in the eys good morning. Were talking about basic things and how we are treating other people and the promise of our society is kindness different from niceness . Thats a good question. I dont know. What do you think . We can probably put it together. Im using it somewhat loosely because i think that when we think in the Public Health world or in the medical world its happening more in the Public Health world i would say when we talk about all these social factors, when it boils down to it, for me it was one of the great pleasures of writing this book was actually hearing my wonderful editor debate and it came down to kindness and its true because that is the golden thread that runs through all of this and its got an amazing ripple effect. You just feel good when somebody smiles at you and do something nice fodoes somethingnice for yn your shoulder when you are having a rough time with somebody that you know has your back. We know those things make us feel better but now its cool because we are getting the science to show it so weve got to do more of it and this room is filled with people that i know have had my back and i am so grateful to you. Gratitude is also good. I was going to ask because that has been another important idea that you have advanced as a practice which is gratitude. Tell us about the practice of gratitude. What is so cool about kindness and what is needed is this dovetails with a love o thf a variety of different religious backgrounds. Its not just words results which is important also kindness towards others but another way is to start with gratitude. Its like when we are talking about the person that is kind to us we are using all these studies that show gratitude, mindfulness, these are all good for our party and it comes down to stress. Stress is a thing that weve known about for a while and its an inevitable part of life. Love how you talk about stress and your work and its one of those things we have to think about buffers because we know stuff comes up and it is a big part of the book is trying to build up our reserve of resilience and also reserve as stress buffers but it doesnt knock us on the floor. Of the inflammatory process is say phenomenon that you have emphasized. It is essential to the development of the disease and disability. How is kindness and antidote to the response, what is happening here help us understand. It is the immune system basically. Like not understanding how those working in this sort of explains what i was seeing during my Research Fellowship of the patients that are not feeling well but we cant quite find something wrong on our traditional test and that is because they are not measuring some of the right things necessarily. But i think what is also really could do without it is in this country we tend to separate the mind and bod the body and we dot in a very difficult way when it comes to Mental Health, we have separate Mental Health places of care. We dont think of people, you know, there is a doctor for every bit of your body and weve gotten so super specialized. On the onehanded is hopeful that on the other hand we need to be stepping back and looking at these Bigger Pictures and conversations that are going to be happening in the bookstores and communities around the country. Are you asked by your readers and friends to coach them about how to talk to their doctors about the islam of three response about kindness, about the social factors, and also helhowdo people go about bringis up with their doctors . Spinnaker would be curious to hear your experiences. People are telling me i have this one doctor that is phenomenal, and they are asking these kind of questions. Part of it is the system, the way that currently people in healthcare are paid its not really to ask somebody about their social life in a ten minute little focused visit command ten minute suspended if youre lucky it feels like opening up the lid of pandoras box. So, one of the ways ive been talking about come i to come int this in the book, raise your hand if you are familiar with asis. I am so impressed. Theyve been taking the lessons to heart. One of the things is actually thinking about experiences that happen, something present in our environment over time kind of like smoking used to be back in the 1940s. People didnt think smoking caused lung cancer. It took many years before they figured it out, this is actually causing all kinds of diseases across the board. So it turns out its one of those things into something we are not really talking about and many doctors dont know about it there is an easy test you can even take online. Its called aces t