Los Angeles Times (Sunday)

State’s first surgeon general has navigated the pandemic

For Dr. Nadine Burke Harris, one of the most influentia­l U.S. health figures, it’s ‘heartbreak on top of heartbreak.’

- By Marissa Evans

When Dr. Nadine Burke Harris received her COVID-19 vaccine in Oakland last month, she internally rejoiced.

As California’s surgeon general, the state’s top physician, she was glad to get the Johnson & Johnson vaccine to show others it was safe. But one of the most critical parts of the pandemic’s vaccine rollout — reassuring Black and brown communitie­s that the vaccines available are safe — is an ongoing task.

“I think that I myself probably didn’t realize how ... just that level of tension that I was holding, you know, around it,” Burke Harris said in a recent interview. “The fear of exposure, the fear of getting sick, it wasn’t even conscious for me. It was that awareness, that idea of being protected . ... I would, of course, want everyone to feel that feeling.”

Burke Harris, 45, a Jamaican American pediatrici­an born in Canada and now based in San Francisco, has so far spent half of her tenure as one of the nation’s most inf luential public health figures guiding California’s efforts during the pandemic.

Her sweeping charge by Gov. Gavin New

som to create a government­al office tackling the state’s health problems, including adverse childhood experience­s, toxic stress and healthcare inequities, has amplified the need for solutions amid the pandemic.

She is the first person to be California surgeon general, and is building on her legacy as the first Black person and first woman to have the role. It’s rare to see a Black woman lead in an even rarer position — only three other states have a surgeon general.

“One of the things that I find most infuriatin­g about health inequities is that they are so endemic that people believe they are insolvable, and that makes me ill,” Burke Harris said. “That’s intolerabl­e to me.

“Part of being in the role of state surgeon general is having the opportunit­y to say, ‘No, this is not something that’s going to happen.’ We’re going to put our back into it and use our full force and weight to push against these inequities.”

But Burke Harris is still learning how to sit in the discomfort­s of her work amid the “heartbreak on top of heartbreak” in the last year.

It hurts to know that 60,000 California residents so far have died during the pandemic. It hurts to see people of color dying at disproport­ionate rates from COVID-19. And it hurts to know there is community healing to be done.

Still, Burke Harris’ voice is calm, assuring and, one would dare say, even hopeful. Her days are a flurry of Zoom calls, reading reports and studying new data. But she sticks with a strict morning routine that includes decaffeina­ted coffee, 20 minutes of meditation and a walk in the Presidio in San Francisco with her husband before getting her four sons ready for school.

“The hardest part of the job is sitting in proximity to so much harm and suffering, and sitting there long enough to be a difference,” Burke Harris said.

Growing up in Palo Alto, with her mother working as a nurse and her father as a biochemist, Burke Harris knew she wanted to be a doctor at 4 years old. She would sometimes make patient house calls with her mom after school. Burke Harris would read mail to elderly patients.

A proud “super hardcore science nerd,” she would help in her father’s lab and in the greenhouse. Her dad would join Burke Harris and her brothers on science experiment­s around the house, such as adding vinegar to different foods and calculatin­g air resistance when making paper airplanes.

She completed her undergradu­ate studies at UC Berkeley, medical school at UC Davis and received her master’s of public health at Harvard. She did her medical residency at Stanford. In 2007, she became the first medical director for the California Pacific Medical Center Bayview Child Health Center in San Francisco and in 2012 founded the Center for Youth Wellness, a clinic focused on identifyin­g and treating toxic stress in children.

“That combinatio­n between caregiving and science, for me, I was probably born for it,” Burke Harris said.

But there’s been heartache over the years. In August 1993, one of her brothers, who has a mental health disorder, went missing and hasn’t been heard from since.

While her family has not lost anyone to COVID-19, Burke Harris’ mom was in the intensive care unit twice last year for non-COVID issues. She said having her own stress management plan and leaning on her support system got her through.

“I was working really hard, working on the pandemic, working with my team, and then in the middle of meetings and Zooms and calls, I was on the phone with my mom’s doctors every day,” she said.

Newsom appointed her to the role in 2019. He had previously appointed Burke Harris to the San Francisco Citizens’ Committee for Community Developmen­t while he was mayor.

The governor wrote in the surgeon general’s report that adverse childhood experience­s and toxic stress could cost California over a trillion dollars in the next decade from “years of life lost from poor health, disability or early death.”

“We must listen and be advised by the evidence that clearly tells us that cumulative adversity, particular­ly when experience­d early in life, is a root cause of some of the most detrimenta­l, longest lasting and costly health challenges facing our state and nation,” Newsom wrote.

Burke Harris has made adverse childhood experience­s and the health effects of stress some of her main focuses. Research has found that varying forms of abuse, neglect and a child’s household experience can lead to long-term health problems such as heart disease, stroke and cancer.

In 2014, she gave a 16-minute speech with TEDMED on the importance of finding ways to identify and treat people who have experience­d childhood trauma. The speech has more than 8.5 million views.

The lowest point of the pandemic for Burke Harris was last spring, when she and her colleagues in the state operations center watched then-President Trump talk on television about how beautiful it would be to have packed churches and an open economy by Easter.

She and other public health officials were working on contact tracing, COVID-19 tests, getting supplies, and various data projection­s. Reopening by Easter was impossible.

“I went into the bathroom, and I sobbed,” Burke Harris said. “I felt like we were all working so incredibly hard, and then there was this other narrative out there that just didn’t have any foundation in reality or science or data, and it only was making our job harder. That was a moment that I broke down, I would say.”

Burke Harris’ role amid the pandemic has included overseeing the state’s Community Vaccine Advisory Committee and planning how the vaccine will be equitably distribute­d to vulnerable population­s. It also includes helping community leaders talk to people unsure about the vaccine and combating misinforma­tion.

Her office released a playbook on stress relief, urging people to make a stress management plan that includes exercising, sleeping and maintainin­g nutrition.

California officials have faced criticism during the pandemic, particular­ly when vaccine access codes meant for Black and Latino communitie­s were being misused by people who were not yet eligible. Burke Harris said building trust is an ongoing process.

“I think maybe one of my favorite parts of working in government, especially in this pandemic, is to witness the way that my colleagues in government continue to show up and recommit and try to fix our mistakes and try to solve some big problems,” she said.

Burke Harris has touted the state’s success with its ACEs Aware initiative, in partnershi­p with the Department of Health Care Services, which has trained 17,115 health providers to screen for adverse childhood experience­s, recognize toxic stress and respond with trauma-informed care.

Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network, recalled Burke Harris saying in their first meeting that she was “deadly serious about addressing health disparitie­s.”

She has witnessed Burke Harris leading discussion­s on how the COVID-19 vaccines would be distribute­d statewide with the Community Vaccine Advisory Committee. Savage-Sangwan said these are tough conversati­ons, as multiple groups vied to have the communitie­s they serve prioritize­d.

Burke Harris is charged with “marshaling the resources of state government to address these real longstandi­ng problems and even addressing equity ... it’s not something government has always been good at or engaged in,” Savage-Sangwan said. “Being in the position to move the giant bureaucrac­y of the state of California to address health equity is a huge challenge.”

Burke Harris is looking ahead to how the state will help people heal.

She wants to “cut ACEs and toxic stress in half in one generation” and work across education, law enforcemen­t and the workforce to heal and recover from the pandemic, according to her surgeon general report.

Earlier in April, Dr. Rochelle Walensky, director of the federal Centers for Disease Control and Prevention, declared racism a serious public health threat. Burke Harris said the decision on whether California will make the declaratio­n is ultimately up to the governor.

“I think without a doubt it’s clear that racism harms the health and well-being of California­ns,” Burke Harris said, “and whether that is a declaratio­n and what the specifics [are] of how we address that, I think that’s what we are all still figuring out.”

 ?? Paul Kuroda For The Times ?? DR. NADINE BURKE HARRIS, 45, California’s surgeon general, meditates in the backyard of her home in San Francisco.
Paul Kuroda For The Times DR. NADINE BURKE HARRIS, 45, California’s surgeon general, meditates in the backyard of her home in San Francisco.
 ?? Paul Kuroda For The Times ?? DR. NADINE BURKE HARRIS’ days are full of Zoom calls, reading and studying. “Part of being in the role of state surgeon general is having the opportunit­y to say, ‘No, this is not something that’s going to happen.’ ”
Paul Kuroda For The Times DR. NADINE BURKE HARRIS’ days are full of Zoom calls, reading and studying. “Part of being in the role of state surgeon general is having the opportunit­y to say, ‘No, this is not something that’s going to happen.’ ”

Newspapers in English

Newspapers from United States