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Equity and Love with Dr Emily Smith

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Episode 120

Today we are joined by Dr Emily Smith to talk about epidemiology, the dangers of truth telling, and how the story of the Good Samaritan changed everything for her.

She is an assistant professor in the department of emergency medicine/surgery at Duke University and at the Duke Global Health Institute (DGHI). During the COVID-19 pandemic, she became known as the Friendly Neighbor Epidemiologist through her social media outlets which reached over 10 million people in 2020-2021. She continues posting on the social account and her Substack blog with a monthly reach of 2-4 million. Her work has been featured in TIME Magazine, NPR, the Washington Post, Christianity Today, and Baptist News Global.

Before joining the faculty at Duke University, she spent four years at Baylor University in the department of public health and was a research scholar at DGHI for two years. She received her Ph.D. in epidemiology from the Gillings School of Global Public Health at UNC Chapel Hill and a MSPH from the University of South Carolina.

She has been married to her pastor-husband for 20 years and they have two fantastic children, one spoiled golden retriever and a new very-friendly golden doodle puppy. Her debut book, The Science of the Good Samaritan: Thinking Bigger About Loving Our Neighbors, released on Oct. 24, 2023 from Zondervan. I’m very excited to welcome Dr. Emily Smith to the show today.

Support this podcast on Patreon at https://www.patreon.com/DowntheWormholepodcast

More information at https://www.downthewormhole.com/

produced by Zack Jackson
music by Zack Jackson and Barton Willis

AI Generated Transcript

Ian (00:04.911)
Okay. So our guest today is an assistant professor in the department of emergency medicines surgery at Duke university and at the Duke global health Institute. During the COVID-19 pandemic, she became known as the friendly neighbor epidemiologist through her social media outlets, which reached over 10 million people in 2020 and 2021. She continues posting on the social account and her sub stack blog with a monthly reach of two to 4 million people.

Her work has been featured in Time Magazine, NPR, The Washington Post, Christianity Today, and Baptist News Global. Before joining the faculty at Duke University, she spent four years at Baylor University in the Department of Public Health and was a research scholar at DGHI for two years. She received her PhD in epidemiology from the Gillings School of Global Public Health at UNC Chapel Hill and MSPH from the University of South Carolina. She's been married to her pastor husband for 20 years and they have two fantastic children.

one spoiled golden retriever and a newly and a new very friendly golden doodle puppy. Her debut book, the science of the good Samaritan thinking bigger, bigger about loving our neighbors released on October 24th, 2023. I'm very excited to welcome Dr. Emily Smith to the show today.

Emily Smith (01:15.144)
I'm very excited to welcome you all. Thank you for having me. It's a pleasure to be here for sure.

Ian (01:21.518)
Yeah. Um, as I was saying before we started recording, you know, I've found you because of your Facebook account and was just always amazed, obviously with your expertise in the science and, um, everything you were sharing, but also your lens as an evangelical Christian. Um, I thought that was really fascinating and trying to work with those two communities, right? Trying to kind of be a boundary, uh, spanning individual for that. But I think before we really get into that.

Emily Smith (01:43.734)
Yeah.

Ian (01:50.162)
I would love for you to just kind of talk to us a little bit about what drew you to epidemiology.

Emily Smith (01:56.476)
Yes, and prior to the pandemic, I don't think a lot of people knew what that word meant. By the way, it's seven syllables, and so throw that into a Thanksgiving meal or something if you need a big word to kind of wow family with. But, you know, people would get us confused with skin doctors, like epidermis instead of epidemics, or entomology, which I think is bugs, right? Yeah, it's just another really big E word. I don't know. So now...

Zack Jackson (02:00.95)
Ha ha ha.

Ian (02:19.548)
It is. Yes.

Zack Jackson (02:19.756)
Yeah.

Emily Smith (02:26.068)
People know kind of what we are and who we're about just because we've all come out of the pandemic. So if you need the nerdy, jeopardy definition of what that is, before I get into how I got into the field, is the distribution and determinants of disease. And so what makes a disease spread and who is at risk? I tend to say, you know, clinicians and nurses and dentists, they...

focus on one-on-one patients at a time, and we focus on one community or population level at a time, so the aggregate of a lot of individuals. I grew up in a tiny town in Eastern New Mexico, 10 miles from the Texas border, so it is West Texas culture, flat land, great sunsets and oil fields, and really good people. But it was a really small town and a lovely town.

And I just was always loved science. My eighth grade science teacher started talking about DNA and y'all would have thought he was talking about Beyonce or something. I was just like, what is this? And it's magic. And so he gave me a college textbook. This is as nerdy as it gets. Now it's kind of cool to be a nerd back then in the 90s. I guarantee it was not near as cool to wear glasses. Yeah.

Zack Jackson (03:44.687)
Ugh. Right?

Emily Smith (03:48.5)
So he, and I read it, I read it on a band trip, which is like double nerd points. But I just loved science and math. I don't know what it was, but he hooked me up with the first female scientist that I had ever met at Texas Tech University. And I started doing a science fair project with her in high school, because there really wasn't the capacity to do anything like that, you know, at my traditional high school, because it was too small.

Ian (03:48.514)
Mm-hmm.

Emily Smith (04:16.668)
And so I still thought I'm going to do something in science, but I had also grown up in the church and our family hosted a lot of missionaries that came into our church. And so I heard their stories. They were very gracious to listen to an eight-year-old, nine-year-old little questions about the world and their adventures. So early on, I knew I wanted to do, I thought I wanted to be a missionary and I still just love the science. And so I went to church.

The natural way to do that is go pre-med. I kind of thought the only way to do that is through medical school, so let's just do that. So I did, I chose medical school as a goal and took the MCAT, I got into med school, got married straight out of college to my pastor husband, and his first job in the church was all the way across the country in South Carolina. So I had a gap year.

Ian (04:50.218)
Mm.

Zack Jackson (04:50.222)
Mm-hmm.

Zack Jackson (05:13.506)
Hmm.

Emily Smith (05:15.872)
And I, I mean, I'm just a nerd, so I decided let's just get another degree because it's what we do when we have a gap year, right? Yeah, I mean, yeah, a lot of people might as well. Yeah. And it was in public health because I thought it'd look good for medical school. Day one of epidemiology, my professor, who was really just inspirational anyways, he did the jeopardy definition of epi. But then he said, this is a...

Ian (05:22.764)
Mm-hmm.

Zack Jackson (05:23.932)
Right.

Ian (05:25.748)
Not as well.

Emily Smith (05:44.192)
This is an equity science because most of the time we're gonna be working at people who are on the margins in these communities that are marginalized for health or poverty. And growing up in the church, it just clicked in my mind that that's the science of the Good Samaritan. It's quantifying the people who are most at need and then choosing not to walk by. So I didn't go to medical school, went to PhD in Epi instead and history from there. But I...

I also remember going to my first mission trip on the Mercy Ship to Honduras. And when the doctors were focusing one-on-one on these people who had traveled a very long way to get to care, I was naturally asking the bigger picture questions about poverty or why this community has such high rates of...

you know, diabetes or surgical needs when others didn't. And those are inherently epi questions. I just didn't know it at the time.

Ian (06:45.983)
That's interesting.

Zack Jackson (06:48.766)
Yeah. So you mentioned this is the science of the Good Samaritan, which is, uh, the title of your newly released book. Congratulations. Has that been a story that has that clicked with you then, or is this more of a recent connecting of the dots? Has this story been in, in your heart and mind this whole time?

Ian (06:48.776)
Yeah.

Emily Smith (06:52.662)
Yeah.

Emily Smith (06:58.037)
Thank you.

Emily Smith (07:10.172)
Oh, the whole time, for sure. I love that story of the Good Samaritan. And a lot of people are familiar with it, even if you're not of the Christian faith. You know, it's that story of where there's a man on the side of the road who is very sick. I mean, sick enough, hurt enough, where he can't help himself. And two people walk by. Jesus is telling this story, by the way. And those people are noted as religious leaders. And so they're kind of the people who...

Ian (07:11.913)
Okay.

Emily Smith (07:38.504)
represent power and privilege of the day, but there's one person who actually stopped who's the Samaritan. And in that time, that would have been not who you expected to be highlighted in a story. They typically do not have the places of power or privilege in the religious time of the day, but he stopped and he helped the man. And not only that, he helped him, he bandaged him up, he took him to a place to recover, and then he paid for all of it. And it's just a holistic

view of what helping, you know, true solidarity and helping means. So I think that story just growing up in the church has always very much resonated with me wanting to do missions. But then when I got into EPPE, it resonated on a scientific level.

Ian (08:26.198)
Interesting. I love how at the very beginning of the book, you know, you have all those little quotes before you get into the reading itself and, you know, talking, you know, from Mark, uh, thou shalt love thy neighbor as thyself. And then you kind of go into, you know, well, this is what health is the greatest of gifts from Buddhism, perform all work carefully guided by compassion from Hinduism. Then you go on with Islam, Judaism, and then you end, which I thought was really sweet with your kid.

Emily Smith (08:32.139)
Yeah.

Emily Smith (08:52.885)
Yeah.

Ian (08:54.418)
love your neighbor, that's just being a good human. That really resonated with me because I'm actually teaching a science and religion class at UNC Charlotte. And I wanted it to be not a science and Christianity class. I wanted it to focus on multiple religions. And so I'm doing it for the first time. And what, I mean, yes, this is coming more from a Christian lens, but what made you even include all of that in there? Because I thought that was really interesting.

Emily Smith (08:57.041)
Yeah.

Emily Smith (09:04.756)
Yeah.

Emily Smith (09:24.344)
Yes, one of my biggest fears about releasing this book is it being misconstrued as a Christian faith book and making that the center of all faiths. I work with all faiths. I work in predominantly Muslim countries. I've definitely worked with all faiths during the pandemic, but then that quote with my kid at the end.

You know, you don't have to be of any faith to just want to be a good human. He said that during the pandemic when he didn't understand why so many people were angry at me. Cause he lived through it. They heard and saw different things too. And so he just couldn't understand why being a good human wasn't just the top of the list for everybody. So I didn't want this book to come out even unconsciously.

Zack Jackson (10:06.053)
Ugh.

Emily Smith (10:22.472)
making people feel like you have to be of the Christian faith. That's the center of the world or the center of all faiths. Cause it's just not, there are gorgeous expressions of faith or non-faith or just being a good human around. And I wanted to be very careful in that. Also, when you read the book, you'll see that Christianity has been poorly centered for the sake of conquest or colonialism or

We see it even nowadays right here in America of we need to put the 10 commandments back in a courthouse or say a prayer before football games, but that's just a Christian prayer that's not inclusive of all. And I did not wanna be one of those people that even unconsciously said you have to be a Christian because I just, I don't think you do. You're beautiful people in the world. So thank you for talking about that. It was important to start the book for me with that.

Zack Jackson (10:54.766)
Hmm.

Ian (11:15.5)
Yeah.

Emily Smith (11:19.176)
kind of foundation.

Zack Jackson (11:21.474)
Hmm.

Ian (11:22.014)
Yeah, I thought that, like I said, it just really resonated with me and it probably because I'm coming from the lens of the class I'm teaching. Um, you know, I am a Christian Episcopalian, but I have always been very curious and fascinated by other religious traditions and I just love learning about them. Um, and so I love that you had that in there. And I just remember right away, just running to my wife, being like, Oh, look at this. And, um, so.

Emily Smith (11:28.681)
Yeah.

Emily Smith (11:39.232)
Yeah.

Emily Smith (11:45.628)
Yeah, well and I also didn't want to proselytize even some unconsciously. It's just I'm not a sneak attack Christian and I don't want to view people as projects. You know, I think the evangelical church has done a really bad job at that. And it's just not in my wheelhouse. I wanted to make that very clear.

Zack Jackson (11:52.523)
Mm.

Ian (12:02.825)
Mm-hmm.

Ian (12:08.787)
Yeah.

Zack Jackson (12:09.006)
Sneak attack Christians. That's such a good phrase. That...

Ian (12:11.955)
It is.

Emily Smith (12:13.508)
People are people, not projects.

Ian (12:15.56)
Yeah.

Zack Jackson (12:15.734)
Yeah. Oh man, I got to get that on cross stitch somewhere in my house.

Emily Smith (12:19.828)
There you go! I like that.

Ian (12:22.422)
So you in here, you know, not everyone who's listening has read the book yet, but what made you decide when the pandemic started? What made you decide to create your friendly neighbor epidemiologist?

Emily Smith (12:38.716)
Yeah, and you know, I was at two conferences right when Wuhan was starting to ramp up in March, 2020. And we, this is our training, this is our lane. You know, this is our day to really step in and go for it. So once we saw, and when I say we, I say public health and epidemiologists, we saw how this new virus was acting and what was happening. A lot of us paid attention pretty,

significantly to what was happening. Cause what was, it was different than Ebola. You know, Ebola is awful. And hopefully we'll talk about where I talk about that chapter in the book. But when someone is sick and contagious, you kind of know it. Cause it's really horrific in visual. With this, it looked like it was COVID or well, well we weren't even calling it COVID at the time. Whatever was happening.

maybe people were spreading it before they even knew they were infectious and contagious. And so it could catch a lot of people off guard. My day job here at Duke is also working with health equity communities around the world in very poor countries where they're affected daily by bad access to healthcare, poverty. And so if this really was going to be the pandemic that people have been predicting for years.

the margins were gonna be affected the most. So everything in me was just kind of like rising of uh-oh. So I get home and a lot of people were asking questions of what does flatten the curve mean? Do we need to buy a billion rolls of toilet paper? And the answer was always no. Oh, bye. I know, and don't hoard, that's just classic America, isn't it? But also there was a lot.

Ian (14:23.158)
People did it anyway though, yeah.

Ian (14:29.416)
Mm-hmm.

Zack Jackson (14:30.951)
Yeah.

Emily Smith (14:32.412)
And I, I re we all remember, I mean, this is a real fear. I do want to honor that of people who are high risk, the elderly, you know, do I need to be scared basically. And I wanted to calm fears, but not squash them because it was scary. So I decided why not, why don't I just start a Facebook page for the handful of real life neighbors that I had and like my family.

Really, I mean, it was just very, very genetic, generic, not genetic. So I named it Friendly because I tend to be too friendly. Like if I sit by you on an airplane, I'm very sorry. Um, cause I, I'm, I really am anyways, it's just who I am. And I'm trying to accept that, but neighbor because of the good Samaritan story, I knew that COVID in particular was going to imply that we needed to neighbor one another well.

We were going to have to take care of the margins. There's going to be a lot of solidarity of staying home for those that couldn't. Get the vaccines for those where it would not work. There just was a lot of neighboring that was going to take place. So I named it because of that. I'm also a pastor's wife. So I thought this is going to be prime time for the church, the Big C Church to be the church.

And I say that, I know listeners can't hear it, but I say that with a smile, not as sarcasm, but I was so idealistic at, I really thought this was gonna be our time to shine and take care, you know, live, love thy neighbor really out in full blown faith. So I named it Friendly Neighbor Epidemiologist. And the only people that followed at the beginning were real life people that I knew. And then when the pandemic,

Ian (16:13.408)
Yeah.

Emily Smith (16:23.676)
started shifting. We all saw this when it became weirdly political. When national leaders started talking about it as the China virus or these othering type, I was going, what is happening? That is not the faith that I ascribe to. And then when it became, you know, faith that were fear, we started hearing that and people started saying that instead of wearing a mask. I was like, you have not read Galatians five in the Bible.

Ian (16:37.314)
Mm-hmm.

Zack Jackson (16:47.15)
Hmm.

Emily Smith (16:53.192)
You might say faith over fear, but that's not true faith. So I started posting about that too, from this perspective of pure science and then weaving in the faith part to try to help people anchor in a different way than perhaps they were able to anchor at their own churches. And that seemed to resonate with a lot of people for good and bad ways. So then it started going viral. George Floyd was murdered. And I talked...

Zack Jackson (17:18.55)
Hmm.

Emily Smith (17:22.724)
into that conversation at, especially in the white church, there's a difference between all lives matter and black lives matter and why that distinction is important. People couldn't understand. So it'd go viral for that. And I wasn't doing this to go viral. I don't actually think I was noticing what was happening because I was just busy writing and daily posting. And then the Capitol riot happened and I wrote about that one and that one really kind of exploded.

Zack Jackson (17:29.91)
Mm-hmm.

Zack Jackson (17:47.906)
Hmm.

Emily Smith (17:53.748)
So that's how I got into it. I'm sure we can talk about the nuances, but that's how it initially started.

Ian (17:59.362)
And you alluded to, you know, your children seeing the things being said about you and everything. What surprised you most as it started going viral with the reactions? Like, because you, you share some things in here and that were really challenging to read and you in there though, even said that, um, I will not share everything. And so I just, I can't imagine.

Emily Smith (18:13.341)
Yeah.

Emily Smith (18:19.457)
Really?

Ian (18:30.134)
the pain you went through and, but you, I love that you embraced your vulnerability with that because I also, I'll be honest. Yes, I, I am a Christian, but there are many times, especially over the last several years, and Zach knows this very well that I have a really hard time saying I'm a Christian because of the extreme baggage that comes with it. But I feel like if I say it, I have to qualify it really. And yeah, we had Brian McLaren on, um,

Emily Smith (18:47.032)
Oh, for sure. Yeah. Yes.

Zack Jackson (18:47.054)
Mm-hmm.

Emily Smith (18:53.98)
Oh, absolutely.

Ian (18:58.342)
last, what, May of 22. And we talked a lot about it then as well, because it just the extreme hate that I felt like we were seeing that, I guess, has always been there. But now is more acceptable to be said. And so I'm just curious, you are I've never been a member of an evangelical Christian community in that way. And so I'm just curious what surprised you the most or if you don't mind sharing some of that.

Emily Smith (19:00.52)
Nice.

Emily Smith (19:26.896)
Yeah, yes and that you know this portion of the book the book is separated into three different sections centering cost and courage um had to be three c's like a good Baptist I guess but that middle section is the thank you for that or evangelical I grew up charismatic and married a Baptist pastor and now we go to a liturgical church so I'm not sure what I am at this point. Did you?

Zack Jackson (19:39.138)
Yes.

Zack Jackson (19:46.531)
same.

Ian (19:51.925)
Yeah.

Zack Jackson (19:52.466)
I grew up charismatic and went to a Baptist seminary and married my wife there. And then now I'm a part of a mainline denomination. So look, I'm there with you.

Emily Smith (20:01.976)
Maybe that's just a natural. There's a lot of us out there. Maybe that's a progression. Yeah. Are you? Yeah, I have to figure out where to, like the call and response, do I say the bold or not? Because I would get it wrong or stand and sit. I just get it wrong a lot, but whatever. The church is fine about it. So the middle cost section is the shortest part of the book.

Zack Jackson (20:05.174)
Yeah. I'm seeing it more and more. Yeah.

Ian (20:06.559)
Yeah.

Emily Smith (20:27.492)
It was by far the hardest to write and the hardest to read on the audio. I read the audio book and when I was recording it, I realized the, these chapters still feel so messy. Um, and it's because I just couldn't do more. I couldn't get it. I couldn't package it in a way that some of the other chapters felt pretty and tidy and bowed up. And anyways, it feels like there's a lot of ums and ohs in that chapter because it is incredibly painful.

Zack Jackson (20:39.075)
Hmm.

Emily Smith (20:57.472)
We were in Texas at the time. We were in the belly of the beast, that kind of feels like, of Waco, Texas. Great, great people there. But also the buckle of the Bible belt, probably the latch of the buckle. So what surprised me is when I started talking more and more about faith over fear, we started getting little trickles. I say we.

I started getting little trickles of pushback from that online. And, you know, it's horrific stuff. It's not, I mean, you get called names and people, you know, you can put that aside. But when I started getting pictures of people sending pictures of guns and Holocaust imagery to me and saying awful things about my children, you know, threats against them, it became very real.

Zack Jackson (21:45.762)
Hmm.

Emily Smith (21:53.5)
And then one day in the middle of it, my husband came in and brought in a letter that was in our mailbox that was written in black and red marker. And it was an awful threat. And it was laced with, you know, you're part of the mark of the beast and a lot of these religious overtones, which I had heard and received for months at that point, but not in my mailbox. I mean, that is when it became too crazy.

Zack Jackson (22:11.894)
Oof.

Ian (22:17.771)
Mm-hmm.

Emily Smith (22:22.732)
close. You know, there's a cost that was to me, but then this was going to be a cost to the whole family and to the church, to our church. We ended up leaving the faith community. That not all faith, but that one. Some of the worst threats and harassment I got were people from within my own neighborhood or people that I worshiped with. Those are the ones that I won't share because I just can't talk about it yet.

Zack Jackson (22:45.451)
Mm.

Emily Smith (22:51.676)
The book is not a COVID book because I can't talk about it for 200 pages, nor do I think people want to read about it. The cost was awful because we couldn't let our kids go walk in around the neighborhood without one of us. They had safe homes that they could go in if they ever felt scared. They don't know why we were saying that. We just said, if there's a rainstorm, run to these five homes or

Ian (22:58.166)
Mm-hmm.

Zack Jackson (23:00.579)
Hmm.

Ian (23:11.19)
Hmm.

Ian (23:19.49)
Mm-hmm.

Emily Smith (23:20.488)
and they still don't know that. And that's very tender for me as a mom to have to hold. And two, at that time, it was also feeling like I was losing a foundation of faith because I grew up with Sandy Patty, Michael W. Smith, Bethel worship, I mean, come on now, really good, yeah. All of that evangelical stuff. And I remember watching the prayer rally that happened in November, 2020, and I'm sure,

Zack Jackson (23:39.222)
Yes.

Emily Smith (23:49.32)
you guys watched it as well, you know, on the Capitol steps, Michael W. Smith is there, Franklin Graham, I mean, these, it was a massive thousands of people rally. And this was also at the height of that first surge before vaccines. So my soul could not reconcile how that was standing on faith when I put the number in the book of how many died that day, but it was at the peak of the deaths in the US, like morgue trucks.

you know, scenarios. I couldn't, I just couldn't reconcile like, so I felt like we were losing our faith community, losing jobs, you know, or leaving jobs, losing real life friends. And then these foundations that I had just anchored in were, I was just losing that as well. So it's just difficult. I do wish

Ian (24:19.915)
Mm-hmm.

Emily Smith (24:45.556)
that I could have shielded my family from some of that and just taken more of the brunt of it. But it's just part of the, you know, it's part of the cost of us as a family. And I wanted to put some of that vulnerability in because I think a lot of people, especially from the faith communities, have lost a lot. Or Thanksgiving's and Christmases have been very hard and are still hard. I just get that.

Ian (24:55.126)
Mm-hmm.

Zack Jackson (24:55.138)
Hmm.

Zack Jackson (25:09.826)
Hmm.

Emily Smith (25:12.552)
At the same time, it's the tip of the iceberg of what I did put in there. So I wanted to be careful to not put too much just cause I couldn't talk about it.

Ian (25:20.235)
Yeah.

Zack Jackson (25:22.156)
Yeah.

Ian (25:22.61)
When I appreciate, like I said, I appreciate, I I'm someone who embraces vulnerability. Um, and you know, I really love Brene Brown's work around that too. But I very much appreciated you sharing that with all of us and the readers because I just, it was tough. It was tough to read and, um, but I admire that you continued to work a lot. You know, I really appreciate that too, because

Emily Smith (25:31.197)
Yeah, for sure.

Emily Smith (25:48.926)
Yeah.

Ian (25:52.438)
You are still continuing to do what you can to save lives.

Emily Smith (25:57.94)
Well, and that was a choice. I mean, there was a point in there where a couple of the threats, I mean, we were working with high up authorities at certain parts of it. And I just asked my husband, do we need to just stop? Do I need to, well, do I need to stop basically? Cause I would, I would have just pulled all of it. It was not worth having a child, having one of my kids hurt or worse.

And so we took a little bit of a break there in the middle of it to kind of discern and use wisdom and then I just decided to keep going with certain parameters in place of Some cameras and Authorities and some backup plans also Some boundaries around what I would or wouldn't stay who I would or wouldn't listen to I got asked to come on Far right like Breitbart type

podcast and just I automatically just saying no to that. I mean, that's just a boundary. So it was a it was a choice to keep going. But it was also at a cost. I mean, that was before I got sick in 2021. My body just said no more. And I just had a I don't know if it's a thunderclap or just a massive migraine never had it before. And it just put me in bed for 15 months. So it

Ian (27:23.838)
Yeah, that reading that was tough too. I, yeah. And I just, because it just, I felt like your pain that you were experiencing, at least some of it was coming across, which again, I, I appreciated that a lot. Um, and I have a very dear friend of mine that was in my PhD program with that deals with migraines. I don't think she deals with them as much anymore. This was, you know, back between 2004 to 2008, but I knew right before she started the PhD program,

Zack Jackson (27:24.148)
Ugh.

Emily Smith (27:26.952)
Was it? Yeah.

Emily Smith (27:38.125)
Yeah.

Ian (27:52.266)
she would have them where she would be bedridden for like a month or something like that. And just, I couldn't imagine what that was like, but even, you know, I know I asked you how things are going now with you and your family and you told us prior to recording that things are getting better. And, and, but again, you made the choice to continue trying to save lives. Like I think that's very admirable. And so I, that's one of the reasons why I was so excited to get you here.

Emily Smith (27:54.74)
Yeah. Oh, for sure.

Ian (28:20.934)
And to read your book because that truly is admirable because you know, I have faced hateful things just because of stuff I do with science and religion for a long time now, nothing compared to what you've done. But there have been plenty of times where I've thought, I can't, I'm not doing this anymore. Like, it's just not worth it. Um, and it was nowhere near to the scale of what you have experienced. And so I just, I think it gives a lot of people hope. And I just wanted to make sure you knew that.

Emily Smith (28:37.333)
Yeah.

Zack Jackson (28:37.559)
Yeah.

Emily Smith (28:45.052)
Yeah, well thank you. There was also a scrappy piece of me that did not want to let them win. And because there were there were months of being bedridden in an incredibly dark room, I mean laughing would send me to weeks of a migraine that no amount of medicine, including hospital type medicine, would touch.

Ian (28:55.039)
Mm-hmm.

Zack Jackson (28:55.313)
Hmm

Emily Smith (29:11.484)
And so I, there was a little bit of a fight in me too. I just, I was so terrified that was gonna be the rest of my life. And I was doing everything possible to get out of it. And so now that I've come out of it a little bit more, the tenacity, the scrappiness to keep going means not only did like the bad people, they did not win, but also living into probably who,

I am more of myself now than I have ever been because of it, because I'm a whole lot braver and courageous than I thought was actually in me. So thank you for saying that, because I think we hear stories of overcoming something and it looks like it was an overnight thing and you just believed your way out of it. And this is not the prosperity gospel. It is really difficult stuff.

Zack Jackson (29:43.149)
Mm.

Zack Jackson (30:00.311)
Hahaha!

Zack Jackson (30:04.023)
now.

Emily Smith (30:08.7)
you know, just day by day, I'm just doing, I'm just so grateful to be doing my job again.

Ian (30:14.475)
Yeah.

Ian (30:18.07)
Zach, did you have anything to add? Just, yeah. It's just, it's very inspirational, so thank you.

Emily Smith (30:23.693)
Thank you.

Zack Jackson (30:25.222)
Oh, you remind me of Julian of Norwich, my favorite dead Christian. Um, are you familiar with her story at all? Yeah. How she, uh, asked, asked Jesus for, uh, an encounter as close to death as possible so she could get to the heart of things and then to come back and be able to share that and the amount of revelation she encountered on those dark nights in that bed, um, changed her.

Emily Smith (30:28.618)
Yeah.

Emily Smith (30:32.574)
Yes.

Emily Smith (30:35.892)
Oh, for sure. Yes, I am.

Zack Jackson (30:54.31)
and really clarify the rest of her life. And I'm hearing that a lot from you as well. That's beautiful.

Emily Smith (31:03.592)
Yeah, she was probably a little bit more full of faith in the bed. I was just like, what is happening and I want out.

Zack Jackson (31:14.283)
Yes, but when she says, yeah, when she says all will be well and all will be well and all manner of things shall be well, she's saying it from that bed. And so it actually means something instead of the sort of, you know, pithy platitudes that you would see on a bumper sticker or a greeting card. And so when you talk about it and you talk about hope and change and good things, I feel, I believe it more.

Emily Smith (31:14.842)
This is not okay.

Emily Smith (31:33.113)
For sure.

Yeah.

Zack Jackson (31:42.262)
you know, because you've been through the flames. One of the things that I found

Emily Smith (31:42.724)
Yeah, that passage in particular that she said is, oh go ahead, there was a little, I was saying one of the things about that passage that you just quoted, that's what my husband would tell me just nearly daily during those really dark times, all shall be well and all, yeah all of that. So that's very special.

Zack Jackson (31:53.025)
Nope, go ahead.

Zack Jackson (32:09.542)
Yeah, that's my mantra. I repeat to myself almost a daily basis.

Emily Smith (32:14.963)
Yes.

Zack Jackson (32:17.75)
Yeah. One of the things that surprised me in reading some of your work, when I hear about epidemiology, I think of, well, that's spread of disease, clearly. But that's such a small part of your book and a small part of your writing. And I'm reading about gun violence and systemic racism and injustices and economics and...

all kinds of things that have nothing to do with disease? Am I reading epidemiology wrong as a study or is it that this is all just a part of how your heart works?

Emily Smith (33:03.692)
probably a both and of that. But epidemiology is not just the pandemic, epidemic, you know, disease detective type stuff that they make movies of. It's that, but it's also anything that affects a certain group of people differently than another group of people. And so that could be, you know, in my work, that's poverty and children's health. It could be who is affected the most by congenital

Zack Jackson (33:05.687)
Hmm

Emily Smith (33:33.356)
chronic type condition. So it's a really broad field than just disease detectives.

Zack Jackson (33:41.376)
Okay.

Ian (33:41.378)
All right. Well, so, and I remember your chapter, Trickle Up Economics. And so I'll be honest, Emily, there are so many, like I've now been putting like little markers in here, but I've folded down so many pages that I can't get, oh sorry, I can't get to everything I wanna say. So you made something and I can't find everything again because I just, I have comments on almost every single page.

Emily Smith (34:03.124)
Oh

Zack Jackson (34:09.218)
We'll leave a link in the description.

Emily Smith (34:09.484)
Oh yay! I'm gonna hang your reference business. Thank you.

Ian (34:10.414)
And your references in the end and stuff. And especially, so, you know, I'm also a fellow academic. And so I just was pulling your references. And I was like, oh my gosh, this is so amazing, honey. And just, and also too, I started down like the anti-racism journey. And I think 2016. And so some of the things I was aware of, but it was nice to also reread it and stuff, but that the chapter on trickle up economics, when you talk about, um, the question you ask us is, do you want to know the main factor per

Emily Smith (34:15.613)
Yes.

Emily Smith (34:26.858)
Oh yeah.

Ian (34:40.302)
Uh, predicted. Do you want to know what main factor predicted descending into poverty and not being able to climb back out, even when you account for everything else and it was having a child who needed surgery, which I was not at all surprised. Obviously it was health related, but that part and the part I'm trying to remember too, is that just for the communities in Somaliland or was that just also applicable worldwide?

Emily Smith (34:50.57)
Yeah.

Emily Smith (35:06.176)
it's applicable worldwide that look like, I mean the margins countries, you know, the poorest countries for sure. Yeah, yeah, and that, um, that was not something that we expected either. You know, in my day job, I work in communities like in Somaliland, which is the fourth poorest country of the world, on children who need surgical care. And so we know there's a group of kiddos who can get to, you know, a hospital when they need it.

Ian (35:08.17)
Okay.

Right, yeah.

Okay.

Emily Smith (35:34.752)
there's a whole slew of them that can't for reasons that are not their fault, nor their family's fault. That's the structure system, systemic racism, structural violence type stuff that happens. So we had been working with our community partners within the country for starting in 2016, trying to map out in the country, where are the kids who need the greatest care?

How far do they have to travel? I mean, it is hours and hours and hours on wheelbarrows and stuff that is just not equity. It's just not what we would want for our children by a landslide. And then we started teasing the data. This is part of epidemiology that I love is you start with the margins and then you go further in to get the truth of the story. Cause that's what laws and legislations are built on, policies. And we found that

There were a group of families in Somaliland that went into poverty because of something and never came out. There were some that were able to climb out of poverty. We see this in the US, right? Someone goes to the ER. If you have an insurance or a nest egg or family members that could chip in, it's going to be a huge expense. Some go into poverty and can come out and others can't.

So in Somaliland, that's what happened. And we started looking at those families at what was different about them than the rest of them. I thought it was gonna be the income level of the family or the number of kiddos that they had to feed, but it was having a kid with surgical care. And so we took that to the United Nations as a policy effort in 2019. There was a big summit there for universal health coverage.

And it's asking the question of what basically is going to be covered under a universal health coverage package. We know it's going to be vaccines and taking care of the sniffles, you know, primary care stuff. But what about surgery? Because that is what is impoverishing people. So we went to make that statement. And the chapter is about starting with the stories of the margin and then trickle your way back up.

Emily Smith (37:48.976)
instead of the whole trickle-down capitalism type where you put, you know, a hundred dollars in Jeff Bezos mailbox and you hope it reaches the poorest of the poor in inner Detroit. So it was a very, it was really interesting finding for me, but it also linked the story, their story, hopefully to policy change at the highest levels.

Zack Jackson (38:00.546)
Hmm.

Ian (38:10.634)
Yeah. Well, I've always said that I, I think it's, um, shameful that our country, which is the richest country, I believe in the history of the world, that anyone in this country could ever go into poverty because of healthcare or that people are in poverty, but still there's so many things there, right? But that healthcare can make people go bankrupt. I,

Emily Smith (38:29.96)
and we're the number one. Yeah.

Ian (38:39.958)
will never understand that with the amount of money and wealth in this one country that that's possible. It just is absolutely mind boggling to me. And then of course it elsewhere, right? I mean, you talk about in this chapter of like the wealth of like the 10 richest people or whatever the number was and what that could do for those countries in the margins, right? But even the margins in our own country. Um, and I just, I found that

Emily Smith (38:49.696)
Yeah.

Emily Smith (38:59.509)
Yeah.

Emily Smith (39:04.64)
Right.

Ian (39:08.35)
Uh, really interesting. I was really grateful that you went that route with that chapter because I thought it was just so important to see.

Emily Smith (39:14.696)
Right, and I think that that's where our centering is wrong because this story of medical impoverishment, healthcare impoverishment is in the Bible too. You know, the story of the bleeding woman who had spent her last resort was to go to find Jesus because she had spent all of her money for years trying to get care. And then she touches the hem of his garment to try to be incognito and he stops the crowd for her. Like his center.

His majority, his view was not the crowd. It was the medically impoverished woman. So there's a chapter about that too, about his majority, how we can make that, how we can visualize the world. I think perhaps like what he looks like. But I get all the time, we just need more resources or Emily, we just need more money type. And I think that's short-sighted. I don't think that's true. I think we have...

in the world enough resources and enough money that we need, we just don't have enough equity. And that's money, that's healthcare. We saw that in the pandemic with the lack of oxygen. There's a whole chapter in there on innovation. Yeah, and in India, yeah, when they were running out of oxygen, it's not because the world lacks oxygen. It's because the US and

Zack Jackson (40:18.158)
Hmm.

Ian (40:25.054)
Oh yeah, that was very heartbreaking. Oh yeah, that part, yeah, yeah.

Emily Smith (40:40.584)
stockpiles of it. And so the question innovation is making sure that oxygen is where it needs to be but also asking the harder systemic questions of why wasn't it there in the first place. That the other chapter in that section on courage is on valuing a life you know how do we value it which I think that one was the hardest one to write outside of the cost chapters. Do you remember those about Ebola?

Ian (41:09.574)
Yeah. Can we go into that a little bit? That, that was very challenging chapter to read too. You're right. Well, it just, and I'm in a butcher, their names, cause I'm getting to it, but I mean, do you mind telling us the story with that? The doctor who died, but then the other one who didn't. And yeah.

Emily Smith (41:10.34)
Yeah.

Emily Smith (41:15.56)
Yeah, go ahead.

Emily Smith (41:23.488)
Yeah.

Emily Smith (41:27.524)
Mm-hmm. Yes. So the it starts out introducing you to Dr. Khan. And for those of us in public health and global health, we know who Dr. Khan is. He is the Anthony Fauci of Africa. He had also been prior to the 2016 Ebola outbreak that hit his country and you know, West Africa. We all probably remember that epidemic.

He had been working with congressmen here in the US, people, legends like Dr. Paul Farmer, who the book is in part dedicated to, to advocate for pandemic or epidemic preparedness for his hospital or resources for something that, could really cripple their system with not a whole lot of fanfare, not much was done with that type of legislation. So I'm trying to set the stage that he is a,

very well known and respected doctor. When Ebola hit in his country, he was also frontline, because he's an MD. So he ended up getting Ebola. And this was in his health system that wasn't given the necessary resources to be ready for this epidemic, even though he was advocating for it. So with Ebola without the support of care, you deteriorate very quickly. Ebola is not highly

It's highly fatal without the support, but not here in the US, which is why a lot of people or the people that have gotten it and have received care here have not passed away. So he gets it, he gets very sick, he gets transferred to a MSF unit that was specifically made for Ebola, and he keeps deteriorating. So they were having to make a decision on, do we give him what's called ZMAP?

Zack Jackson (42:53.355)
Hmm.

Emily Smith (43:18.428)
And at that point, it was an experimental drug for Ebola. It was the only option available for treatment outside of supportive care like IVs and rehydration. I go into a little bit of detail in the book, but I would definitely encourage people to go read that full story by the New York Times article, and that's in the references. But they made a decision not to give him ZMAP. Now,

There were only a few vials of that in the world, one of which was actually at that MSF facility or very close by. He was also asked to be medevaced and that was given, a plane did come, but he was so sick, they refused to take him, cause it was not equipped like we see those, you know, the big ones here. So.

He ends up dying just a few days later. Without his family, they finally let a friend go in at the end to be with him. If you reverse time a couple of days, there were two other doctors in West Africa, well, one doctor then a nurse that got Ebola too. Same thing, got very sick, deteriorated, had to make a decision of what to do. They were also asked to be medevaced and there was a conversation about

ZMAP to be given to them. Both of them received ZMAP. And not only that, they were medevaced in the state of the art, you know, it looks like a sci-fi book airplane, just equipped with every legit thing possible to keep that contained and landed in here in the US. I remember that. I don't know if y'all remember that on the news where full hazmat suits.

Ian (45:01.95)
Mm-hmm.

Zack Jackson (45:03.778)
Yeah.

Emily Smith (45:06.844)
there's a team of 15, 20 doctors, and they walked out of that hospital a couple days later recovering. I was very intentional in that chapter who I named by name and who I didn't, because the point I was trying to make was if that was my family, I would move heaven and earth to get them medevaced. So I didn't want to dishonor that.

Ian (45:14.207)
Yeah.

Zack Jackson (45:14.608)
Hmm.

Emily Smith (45:34.46)
The question is more at a 30,000 foot level of who is worthy to get ZMAP? Who is worthy to get oxygen? Who is worthy to get medical resources or free healthcare or free education? How do we value a life and how are people's lives valued? Then when you take that to a country level, who gets what from a country? So as a person of faith,

I wanted to write a chapter that honored Dr. Khan, but then the bigger questions too of how should we value people if we are believers of, you know, of the Bible or of what Jesus says. So it was a hard chapter to write. I also wanted to, that mission organization of the two people that got medevacked out were part of Samaritan's Purse, and I had been a vocal.

I spoke against Franklin Graham's aspect, how he was treating the pandemic very vocally. So everybody knows what I think about that. I also have really good friends that work at Samaritan's Purse. So it's not about the missions agency. It's about some people having friends in very high places with a whole lot of money to help people in need while others don't and asking the question of why.

Ian (46:41.255)
Mm-hmm.

Ian (46:56.823)
Mm-hmm.

Zack Jackson (46:59.906)
Hmm.

Ian (47:00.07)
And I love how you bring it back to equity. Cause that, as you said, that's what this is all about. And which again is very tragic, right? But, um, I wanted to shift if I can, there was another thing I just wanted to, there was a quote that I loved is at the end of the chapter on, um, let's see, which one was this broadening our definition of health. When you're talking about the good Samaritan, I just wanted to read it out. Cause I, I just loved it. I read it to my wife.

Emily Smith (47:08.468)
Right.

Emily Smith (47:23.849)
Yeah.

Zack Jackson (47:24.184)
Hmm.

Ian (47:30.522)
And I just was really happy with this one. But you say blast paragraph, by the way, did the Samaritan tell the man the gospel or preach to him or hand out a tract? The parable doesn't tell us anything like that. I have a hunch Jesus would have mentioned it if it were important to the point he was making at the time, but he didn't. What he modeled for us with, with this story as being a neighbor and word indeed. And I actually was on a zoom meeting with, uh, my priest. It was last Wednesday. So, you know,

nine days ago and other lay leaders in our church. And I just was telling them that we were interviewing you and then read that to them because I really part of my struggle is when people the certainty aspect of things that they this is the way we're supposed to behave. Or, you know, it's my way or the highway when it comes to being a person of faith. And I just love that you pointed that out of just there. That's not in there. And you were right. Right. When I read it, I just was like, oh, my gosh, that's yeah.

Emily Smith (48:16.905)
Yeah.

Zack Jackson (48:22.902)
Hmm.

Ian (48:28.554)
Like that's a great lens to take to it. To show that was not the purpose. And I loved that. And I just, oh, absolutely. Yeah.

Emily Smith (48:28.821)
Yeah.

Emily Smith (48:34.272)
Right. Well, don't you think he would have put it in there? I mean, Jesus is super duper smart. Yeah, I mean, he's he was very sneaky and intentional with the parables and how he told the stories. So I think he would have let us know that we needed to put a track in there before we gave people health care. But gosh, I mean, unconditional love is not conditional on viewing people as projects or

Ian (48:47.68)
Yeah.

Emily Smith (49:01.196)
proselytizing. So I just wanted, especially in the evangelical church, to, you know, we do things with, or we should do things just out of a goodness of heart. Because we're, I mean, it says in the Bible too, when we do these, you do it unto me. When you take care of the poor and feed and clothe, then you take, you do it for him. And so I keep in, I think keeping that perspective, I think we should do more of it in the evangelical church for sure.

Zack Jackson (49:31.903)
You mentioned the evangelical church. You have a chapter in here called Topics Too Many Evangelicals Don't Want to Talk About. I would expand that to topics that Christians in general don't talk enough about. What sorts of things should we be talking about in our faith communities?

Emily Smith (49:38.932)
Sure.

Emily Smith (49:43.315)
Yes.

Emily Smith (49:50.2)
Yes, I wrote that because when I got back from that UN meeting that I was, I told you about earlier, you know, I'm a pastor's wife and so we get in there for Sunday school and somebody called me a socialist and I did not know, I didn't know how to respond because it caught me so much off guard that wait a minute, I just told you we were talking about like poverty, you know, we can all agree that that's a problem and let's help. So I, it

Ian (50:03.441)
Mm-hmm.

Zack Jackson (50:04.074)
Hahaha

Emily Smith (50:17.564)
it made me realize we need a conversation about what some of these topics are. It also came out of the pandemic, you know, when I would talk about structural violence or systemic racism or Black Lives Matter, climate change, there was such this hubbub of we don't want to talk about it or overtones of we just don't go there. But I think when we hold those to the sky, they reflect heaven

So I wanted to make, the whole first part of the book is on that, how to talk about that in non-threatening but challenging ways still. Then that last chapter on making the connections between climate change and poverty and the margins to try to at least let pastors know, talk about it from the pulpit. And here are some ways that you can talk about it where you don't have to scream.

You know, you don't have to come across as a crazy liberal if you're in a predominantly Republican Texas type church. But they are holy words because they are equity words. So that's what that chapter is about. Thank you for bringing that up. I chuckled at the title.

Ian (51:33.75)
Yeah.

Zack Jackson (51:34.598)
It made me chuckle too as an evangelical who's been, well, former evangelical who's been accused of all kinds of things that, you know, is Jesus taught me, you know. I have a shirt that says, um, cast down the mighty, lift up the oppressed, uh, feed the hungry, send the rich away empty handed. And I often get accused of like Marxism for that. And I say,

Emily Smith (51:44.86)
Yeah. Right.

Ian (51:45.438)
Yeah. So then how good.

Emily Smith (52:01.236)
Oh sure, yeah.

Zack Jackson (52:02.294)
That's the Magnificat. Mary says that. Hahaha.

Emily Smith (52:06.953)
Right. Or Jesus' first sermon, you know, when he rolls out the scroll from Isaiah, that is full of captives free and the oppressed and yeah. Yeah.

Zack Jackson (52:11.465)
Mmm.

Zack Jackson (52:16.35)
Yeah, good news to the poor. Yeah.

Ian (52:18.43)
Yeah. So kind of adding to that chapter in particular, you know, the pandemic, you know, there was already lots of divisions in our society, obviously pandemic, I believe made it much worse and more in our face. And so I'm curious, you know, especially as someone who does work with, uh, trying to figure out ways to combat misinformation, science misinformation in particular. Um,

Emily Smith (52:33.546)
Yeah.

Ian (52:46.878)
with either from my education lens or just research or work I do. You know, I started when you started seeing the, uh, the increased hesitancy around the vaccine, um, that really started raising a lot of flags for me of like, this is not ending that we're going to see this. This is going to, you know, spread to hesitancies and laws against other vaccines that have made it so that diseases that have been eradicated from our country.

solely because of those vaccines, those will come back. Um, and so I'm just curious, you know, the white evangelical community has a lot of power. And so how can one start to have conversations with those communities? You know, I've never been a member, so I know it'd be hard for me, but you were a member and you went through a lot because of what you were trying to do. How, how do we get back in to be able to figure out ways to work with those communities to build that trust again?

Emily Smith (53:45.577)
Yeah.

Ian (53:45.598)
Right. And to help them realize that the science is not there to get them. It's not evil. It's trying to save lives. I mean, that's the point. And so how would you recommend we do that?

Emily Smith (53:55.209)
Yeah.

Emily Smith (53:59.884)
I wonder if I would recommend something different if I answered this question in five years because I still feel like it's too close. But I think one of the biggest things is knowing who is actually going to have a conversation with you and who is not and having the wisdom to just leave the room or leave a church. Like it's okay. We don't leave a church because we don't like the color of the carpet. You know, I'm not that type of Christian. But

Zack Jackson (54:16.215)
Hmm.

Emily Smith (54:29.668)
If there are real equity things and faith issues, I think it is okay to leave a church. So if, I don't know, leave friends, lose friends. I know that's hard when there are kids and youth and some people have to stick with it. If you do stay and you're trying to have these conversations, I would be really careful to guard your heart on what you let in and...

what you hear because it can pummel you, which is why I wanted to write some of that cost section so vulnerably. I wish I would have known a little bit more, maybe it wouldn't have been so bad if I would have had some of the wisdom to not go to every fight that I was invited to. So, and there's a chapter on that, on the wisdom of Nehemiah having that type. Yeah, thank you. I would also...

Ian (55:18.172)
Mm-hmm.

Ian (55:21.566)
Yeah, I liked that chapter a lot. That's very good.

Emily Smith (55:27.56)
tell people to be very cognizant, to pay attention to people who are not learning or listening anymore. Because the evangelical church has an incredible amount of power, always have. You know, like faith and prayer at football games where I grew up was still going on in the 90s and 2000s. It's probably still going on.

Ten Commandments. And so we think that should be the norm or the centered of everything else when it actually shouldn't. And if somebody can understand why I just said that and why it matters, that's a person who listens. If others just dig in their heels more and we want the good old days, but don't realize those good old days were awful for a wide group of like Black Americans, any immigrants, then we've missed the point.

So I think I'm, I don't think I'm answering your question. I think I'm telling people to be careful. Yeah, and also just to, there's this whole notion in the evangelical space that we just need to come together and get along. And that phrase really bothers me because that inherently denotes that there are two sides that need to come together, that both are weighted equally. And in that case, sure, let's come together because that's the center, but.

Ian (56:23.878)
No, you are. Yeah.

Zack Jackson (56:26.402)
Yeah.

Emily Smith (56:48.84)
When you have two sides and one is their voices have had the microphone longer than another side, it's time to equal out that balance where both sides can be heard. And that is still just certainly not going on, especially with science.

Zack Jackson (57:00.034)
Yeah.

Zack Jackson (57:04.766)
Right. So it's less about finding the middle point between two things and more thinking about it like a binary star system where the one that is the center of gravity has to do with the relative mass of each one. And so a big star and a small star, the center of gravity is going to be closer to the big star because that's where the mass is. And when we're talking about

Emily Smith (57:27.37)
Yeah.

Zack Jackson (57:31.866)
On this side, we have a climatologist, and on this side, we have your uncle on Facebook. Then, the center of gravity is not going to be in the middle of those two things, right?

Emily Smith (57:38.636)
Sure.

Ian (57:41.931)
Right.

Emily Smith (57:42.948)
Yes, or even in, I'm working with some indigenous communities in Brazil and listening a lot longer as a researcher of what their health needs are, including how to overcome them. So talking with traditional healers and valuing and honoring where people's stories are and their needs more than maybe a preconceived idea of what I think it should be.

Zack Jackson (58:00.75)
Hmm.

Ian (58:13.098)
Well, we are. Yeah. Well, so I just had a couple of smaller questions if that's all right. Um, and I just appreciate your time really do. But, so I'm curious, especially for you with your expertise, you know, as we reflect back on COVID-19 and this pandemic, um, it's natural for us to think about what we could have done differently. And I'm curious what your thoughts on that, but also too, what can we learn from this to better prepare?

Zack Jackson (58:13.266)
We're nearing the end. So if you want to.

Emily Smith (58:19.584)
Good.

Ian (58:43.542)
for future outbreaks of infectious diseases. Cause I might say another pandemic's gonna happen right away, but there will be outbreaks of infectious diseases. We know that. And so I'm just curious, what are the things that we can learn from this to try to do more preventative measures in the future? Like what would you recommend?

Emily Smith (59:03.083)
Yeah.

recommend starting a conversation on trust in people's expertise instead of feeling like you're the expert on everything, which is a classic American thought. You know, we're very individualistic and so I think that could start, that's very 30,000 foot, but trust the experts. But then finding the community champions within the communities that are speaking

from a place of their own. You know, I think that's why part of why I went viral is because I was speaking into my own community. I knew the language. I loved the church. I understood what pastors and their families were going through. So if you can find those and that means, you know, if we have distrust in some sort of science or the vaccines, then find the communities where that distrust is and then find the people there that are the champions.

I just think it's a trust, it's a value issue. I know people don't like to hear about the political stuff, but who we vote for matters in very real ways on the ground, and we saw that. So I think having conversations about that too, you know, we are not voters of just one issue. If you are, that is going to trickle to a billion other types of issues.

Letting people, especially like my children, I've got a teenager telling her about the importance of who you vote for and why that matters.

Ian (01:00:43.958)
So is there anything that you want to share? Anything else we should have asked but didn't?

Emily Smith (01:00:51.684)
No, I mean, I hope if anything for the book, I hope that it makes people laugh. Because there's a lot of stories in there that hopefully are funny. There's really silly pictures from my science fair board. Please go look at that. It's fantastic and a little over the top. But I also hope it... Yes.

Zack Jackson (01:01:03.844)
I'm going to go.

Ian (01:01:06.464)
Yes.

Ian (01:01:12.402)
I think the picture, if I can say the picture that you're staring at, I forgot who you're staring at, but you talk about that you have it. Uh, oh yeah. That picture of the board is great, but then the picture of you staring at somebody and you put, you have that framed on your desk. I, who was that again? I, I couldn't find that again in the book right now.

Emily Smith (01:01:21.33)
Yes. It's.

Emily Smith (01:01:27.222)
It's, yes, it's Dr. Tedros. He's the WHO president and I ran into him at the UN and that is my picture of me, like total fan girl moment with him. Yeah.

Zack Jackson (01:01:38.382)
Hehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehe

Ian (01:01:39.851)
It was hilarious. And I just, I mean, I'm sure we've all done it. I do that with people all the time, but yours was captured on camera. And I love that you framed it and have put it on your own desk because I just find that hilarious. Like that's just such a wonderful story.

Emily Smith (01:01:51.228)
Yeah, I have-

Emily Smith (01:01:55.372)
Well, I have one that's a real one. I mean, they took one where we're both looking at the camera, legit, but I just keep it, because it was how I felt at the time. And... Oh, I'd like to show the card. Oh, thank you.

Ian (01:02:05.662)
When I love that you shared it with us, like I just, you know, I could totally envision it. And then all of a sudden I see the picture. I'm like, yeah, that's, that's what I was thinking. Like it just, that was really cool. Yeah.

Zack Jackson (01:02:07.53)
Yeah.

Emily Smith (01:02:13.549)
Yeah, this is a fangirl. Yeah. So.

Zack Jackson (01:02:15.55)
Yeah. And a completely honest review for those who are listeners and who hopefully trust the things that we say and do is that this book is really heartfelt. It is fact filled and it is driven by story and your own personal experience instead of just, you know, here's a list of objective facts. And for me, that not only conveys truth.

in a way that is easier to digest, but also shows how authentic you are and how important this book is, how much of your own soul is encapsulated in this and how much of your own experience and growth from a young and idealistic nerd who's going to save the world, who gets jaded and cynical, but then finds hope and emerges on the other side stronger and

I think all of our listeners should find a copy at your local bookstore or if you have to on Amazon. Or listen to the audiobook which is recorded by you and that must have been a fun experience.

Emily Smith (01:03:25.176)
Yes, it was fun. It's very hard to do too to just read it harder than expected, but it was fun to do.

Ian (01:03:29.703)
I'm back.

Well, and if I can just add to that, I think that's a great, um, thumbs up there, Zach and recommendation for this book. I can't recommend it enough for people. I think it's an outstanding book. Um, I agree with everything Zach said, but I loved, I just absolutely loved that you couched it in the good Samaritan story. And also in Jesus, the second commandment to us about love, I neighbor as yourself. Um, right. And I just,

Reading the whole book. It just the theme was so clear throughout and it was such so beautifully woven throughout the entire book About the importance of loving our neighbors, which is something that I really push for In my class. I have my motto is be curious not judgmental because I'm a huge Ted Lasso fan and really talk about that of how much more we can accomplish by just being curious and I'm

Emily Smith (01:04:06.668)
Good.

Zack Jackson (01:04:21.87)
the

Emily Smith (01:04:22.093)
Sure.

Ian (01:04:29.886)
Zach will tell you, I'm an insatiably curious person. I'm curious about everything. Um, but I just, I really loved how you really continue to provide more argument on the importance of love in our neighbors and what, and I think this could, this book can change things. I'm, and you can, and I'm really happy that you joined us today.

Emily Smith (01:04:42.804)
Thank you.

Emily Smith (01:04:50.272)
Thank you. What a pleasure. We've been circling each other for a while. Um, on trying to-

Ian (01:04:56.126)
Yeah, because you and I are only a couple of hours apart. I mean, you're in Durham, right? And I'm in Charlotte, so yeah.

Emily Smith (01:05:00.204)
I know, I know, just pop on down there to UNC is where I got my PhD so I can do both blues.

Ian (01:05:07.178)
Yeah, my wife went to Chapel Hill. So yeah, yeah. So anyway.

Emily Smith (01:05:09.116)
Okay, there you go. Lovely. Well, this has been a pleasure. Thank you for the honesty and it being just a kind of a safe space to talk about a book. My first book, yeah. Thank you.

Zack Jackson (01:05:22.967)
Hmm.

Ian (01:05:23.122)
Yeah. Yeah, it's really good. I've loved it.

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Equity and Love with Dr Emily Smith

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Episode 120

Today we are joined by Dr Emily Smith to talk about epidemiology, the dangers of truth telling, and how the story of the Good Samaritan changed everything for her.

She is an assistant professor in the department of emergency medicine/surgery at Duke University and at the Duke Global Health Institute (DGHI). During the COVID-19 pandemic, she became known as the Friendly Neighbor Epidemiologist through her social media outlets which reached over 10 million people in 2020-2021. She continues posting on the social account and her Substack blog with a monthly reach of 2-4 million. Her work has been featured in TIME Magazine, NPR, the Washington Post, Christianity Today, and Baptist News Global.

Before joining the faculty at Duke University, she spent four years at Baylor University in the department of public health and was a research scholar at DGHI for two years. She received her Ph.D. in epidemiology from the Gillings School of Global Public Health at UNC Chapel Hill and a MSPH from the University of South Carolina.

She has been married to her pastor-husband for 20 years and they have two fantastic children, one spoiled golden retriever and a new very-friendly golden doodle puppy. Her debut book, The Science of the Good Samaritan: Thinking Bigger About Loving Our Neighbors, released on Oct. 24, 2023 from Zondervan. I’m very excited to welcome Dr. Emily Smith to the show today.

Support this podcast on Patreon at https://www.patreon.com/DowntheWormholepodcast

More information at https://www.downthewormhole.com/

produced by Zack Jackson
music by Zack Jackson and Barton Willis

AI Generated Transcript

Ian (00:04.911)
Okay. So our guest today is an assistant professor in the department of emergency medicines surgery at Duke university and at the Duke global health Institute. During the COVID-19 pandemic, she became known as the friendly neighbor epidemiologist through her social media outlets, which reached over 10 million people in 2020 and 2021. She continues posting on the social account and her sub stack blog with a monthly reach of two to 4 million people.

Her work has been featured in Time Magazine, NPR, The Washington Post, Christianity Today, and Baptist News Global. Before joining the faculty at Duke University, she spent four years at Baylor University in the Department of Public Health and was a research scholar at DGHI for two years. She received her PhD in epidemiology from the Gillings School of Global Public Health at UNC Chapel Hill and MSPH from the University of South Carolina. She's been married to her pastor husband for 20 years and they have two fantastic children.

one spoiled golden retriever and a newly and a new very friendly golden doodle puppy. Her debut book, the science of the good Samaritan thinking bigger, bigger about loving our neighbors released on October 24th, 2023. I'm very excited to welcome Dr. Emily Smith to the show today.

Emily Smith (01:15.144)
I'm very excited to welcome you all. Thank you for having me. It's a pleasure to be here for sure.

Ian (01:21.518)
Yeah. Um, as I was saying before we started recording, you know, I've found you because of your Facebook account and was just always amazed, obviously with your expertise in the science and, um, everything you were sharing, but also your lens as an evangelical Christian. Um, I thought that was really fascinating and trying to work with those two communities, right? Trying to kind of be a boundary, uh, spanning individual for that. But I think before we really get into that.

Emily Smith (01:43.734)
Yeah.

Ian (01:50.162)
I would love for you to just kind of talk to us a little bit about what drew you to epidemiology.

Emily Smith (01:56.476)
Yes, and prior to the pandemic, I don't think a lot of people knew what that word meant. By the way, it's seven syllables, and so throw that into a Thanksgiving meal or something if you need a big word to kind of wow family with. But, you know, people would get us confused with skin doctors, like epidermis instead of epidemics, or entomology, which I think is bugs, right? Yeah, it's just another really big E word. I don't know. So now...

Zack Jackson (02:00.95)
Ha ha ha.

Ian (02:19.548)
It is. Yes.

Zack Jackson (02:19.756)
Yeah.

Emily Smith (02:26.068)
People know kind of what we are and who we're about just because we've all come out of the pandemic. So if you need the nerdy, jeopardy definition of what that is, before I get into how I got into the field, is the distribution and determinants of disease. And so what makes a disease spread and who is at risk? I tend to say, you know, clinicians and nurses and dentists, they...

focus on one-on-one patients at a time, and we focus on one community or population level at a time, so the aggregate of a lot of individuals. I grew up in a tiny town in Eastern New Mexico, 10 miles from the Texas border, so it is West Texas culture, flat land, great sunsets and oil fields, and really good people. But it was a really small town and a lovely town.

And I just was always loved science. My eighth grade science teacher started talking about DNA and y'all would have thought he was talking about Beyonce or something. I was just like, what is this? And it's magic. And so he gave me a college textbook. This is as nerdy as it gets. Now it's kind of cool to be a nerd back then in the 90s. I guarantee it was not near as cool to wear glasses. Yeah.

Zack Jackson (03:44.687)
Ugh. Right?

Emily Smith (03:48.5)
So he, and I read it, I read it on a band trip, which is like double nerd points. But I just loved science and math. I don't know what it was, but he hooked me up with the first female scientist that I had ever met at Texas Tech University. And I started doing a science fair project with her in high school, because there really wasn't the capacity to do anything like that, you know, at my traditional high school, because it was too small.

Ian (03:48.514)
Mm-hmm.

Emily Smith (04:16.668)
And so I still thought I'm going to do something in science, but I had also grown up in the church and our family hosted a lot of missionaries that came into our church. And so I heard their stories. They were very gracious to listen to an eight-year-old, nine-year-old little questions about the world and their adventures. So early on, I knew I wanted to do, I thought I wanted to be a missionary and I still just love the science. And so I went to church.

The natural way to do that is go pre-med. I kind of thought the only way to do that is through medical school, so let's just do that. So I did, I chose medical school as a goal and took the MCAT, I got into med school, got married straight out of college to my pastor husband, and his first job in the church was all the way across the country in South Carolina. So I had a gap year.

Ian (04:50.218)
Mm.

Zack Jackson (04:50.222)
Mm-hmm.

Zack Jackson (05:13.506)
Hmm.

Emily Smith (05:15.872)
And I, I mean, I'm just a nerd, so I decided let's just get another degree because it's what we do when we have a gap year, right? Yeah, I mean, yeah, a lot of people might as well. Yeah. And it was in public health because I thought it'd look good for medical school. Day one of epidemiology, my professor, who was really just inspirational anyways, he did the jeopardy definition of epi. But then he said, this is a...

Ian (05:22.764)
Mm-hmm.

Zack Jackson (05:23.932)
Right.

Ian (05:25.748)
Not as well.

Emily Smith (05:44.192)
This is an equity science because most of the time we're gonna be working at people who are on the margins in these communities that are marginalized for health or poverty. And growing up in the church, it just clicked in my mind that that's the science of the Good Samaritan. It's quantifying the people who are most at need and then choosing not to walk by. So I didn't go to medical school, went to PhD in Epi instead and history from there. But I...

I also remember going to my first mission trip on the Mercy Ship to Honduras. And when the doctors were focusing one-on-one on these people who had traveled a very long way to get to care, I was naturally asking the bigger picture questions about poverty or why this community has such high rates of...

you know, diabetes or surgical needs when others didn't. And those are inherently epi questions. I just didn't know it at the time.

Ian (06:45.983)
That's interesting.

Zack Jackson (06:48.766)
Yeah. So you mentioned this is the science of the Good Samaritan, which is, uh, the title of your newly released book. Congratulations. Has that been a story that has that clicked with you then, or is this more of a recent connecting of the dots? Has this story been in, in your heart and mind this whole time?

Ian (06:48.776)
Yeah.

Emily Smith (06:52.662)
Yeah.

Emily Smith (06:58.037)
Thank you.

Emily Smith (07:10.172)
Oh, the whole time, for sure. I love that story of the Good Samaritan. And a lot of people are familiar with it, even if you're not of the Christian faith. You know, it's that story of where there's a man on the side of the road who is very sick. I mean, sick enough, hurt enough, where he can't help himself. And two people walk by. Jesus is telling this story, by the way. And those people are noted as religious leaders. And so they're kind of the people who...

Ian (07:11.913)
Okay.

Emily Smith (07:38.504)
represent power and privilege of the day, but there's one person who actually stopped who's the Samaritan. And in that time, that would have been not who you expected to be highlighted in a story. They typically do not have the places of power or privilege in the religious time of the day, but he stopped and he helped the man. And not only that, he helped him, he bandaged him up, he took him to a place to recover, and then he paid for all of it. And it's just a holistic

view of what helping, you know, true solidarity and helping means. So I think that story just growing up in the church has always very much resonated with me wanting to do missions. But then when I got into EPPE, it resonated on a scientific level.

Ian (08:26.198)
Interesting. I love how at the very beginning of the book, you know, you have all those little quotes before you get into the reading itself and, you know, talking, you know, from Mark, uh, thou shalt love thy neighbor as thyself. And then you kind of go into, you know, well, this is what health is the greatest of gifts from Buddhism, perform all work carefully guided by compassion from Hinduism. Then you go on with Islam, Judaism, and then you end, which I thought was really sweet with your kid.

Emily Smith (08:32.139)
Yeah.

Emily Smith (08:52.885)
Yeah.

Ian (08:54.418)
love your neighbor, that's just being a good human. That really resonated with me because I'm actually teaching a science and religion class at UNC Charlotte. And I wanted it to be not a science and Christianity class. I wanted it to focus on multiple religions. And so I'm doing it for the first time. And what, I mean, yes, this is coming more from a Christian lens, but what made you even include all of that in there? Because I thought that was really interesting.

Emily Smith (08:57.041)
Yeah.

Emily Smith (09:04.756)
Yeah.

Emily Smith (09:24.344)
Yes, one of my biggest fears about releasing this book is it being misconstrued as a Christian faith book and making that the center of all faiths. I work with all faiths. I work in predominantly Muslim countries. I've definitely worked with all faiths during the pandemic, but then that quote with my kid at the end.

You know, you don't have to be of any faith to just want to be a good human. He said that during the pandemic when he didn't understand why so many people were angry at me. Cause he lived through it. They heard and saw different things too. And so he just couldn't understand why being a good human wasn't just the top of the list for everybody. So I didn't want this book to come out even unconsciously.

Zack Jackson (10:06.053)
Ugh.

Emily Smith (10:22.472)
making people feel like you have to be of the Christian faith. That's the center of the world or the center of all faiths. Cause it's just not, there are gorgeous expressions of faith or non-faith or just being a good human around. And I wanted to be very careful in that. Also, when you read the book, you'll see that Christianity has been poorly centered for the sake of conquest or colonialism or

We see it even nowadays right here in America of we need to put the 10 commandments back in a courthouse or say a prayer before football games, but that's just a Christian prayer that's not inclusive of all. And I did not wanna be one of those people that even unconsciously said you have to be a Christian because I just, I don't think you do. You're beautiful people in the world. So thank you for talking about that. It was important to start the book for me with that.

Zack Jackson (10:54.766)
Hmm.

Ian (11:15.5)
Yeah.

Emily Smith (11:19.176)
kind of foundation.

Zack Jackson (11:21.474)
Hmm.

Ian (11:22.014)
Yeah, I thought that, like I said, it just really resonated with me and it probably because I'm coming from the lens of the class I'm teaching. Um, you know, I am a Christian Episcopalian, but I have always been very curious and fascinated by other religious traditions and I just love learning about them. Um, and so I love that you had that in there. And I just remember right away, just running to my wife, being like, Oh, look at this. And, um, so.

Emily Smith (11:28.681)
Yeah.

Emily Smith (11:39.232)
Yeah.

Emily Smith (11:45.628)
Yeah, well and I also didn't want to proselytize even some unconsciously. It's just I'm not a sneak attack Christian and I don't want to view people as projects. You know, I think the evangelical church has done a really bad job at that. And it's just not in my wheelhouse. I wanted to make that very clear.

Zack Jackson (11:52.523)
Mm.

Ian (12:02.825)
Mm-hmm.

Ian (12:08.787)
Yeah.

Zack Jackson (12:09.006)
Sneak attack Christians. That's such a good phrase. That...

Ian (12:11.955)
It is.

Emily Smith (12:13.508)
People are people, not projects.

Ian (12:15.56)
Yeah.

Zack Jackson (12:15.734)
Yeah. Oh man, I got to get that on cross stitch somewhere in my house.

Emily Smith (12:19.828)
There you go! I like that.

Ian (12:22.422)
So you in here, you know, not everyone who's listening has read the book yet, but what made you decide when the pandemic started? What made you decide to create your friendly neighbor epidemiologist?

Emily Smith (12:38.716)
Yeah, and you know, I was at two conferences right when Wuhan was starting to ramp up in March, 2020. And we, this is our training, this is our lane. You know, this is our day to really step in and go for it. So once we saw, and when I say we, I say public health and epidemiologists, we saw how this new virus was acting and what was happening. A lot of us paid attention pretty,

significantly to what was happening. Cause what was, it was different than Ebola. You know, Ebola is awful. And hopefully we'll talk about where I talk about that chapter in the book. But when someone is sick and contagious, you kind of know it. Cause it's really horrific in visual. With this, it looked like it was COVID or well, well we weren't even calling it COVID at the time. Whatever was happening.

maybe people were spreading it before they even knew they were infectious and contagious. And so it could catch a lot of people off guard. My day job here at Duke is also working with health equity communities around the world in very poor countries where they're affected daily by bad access to healthcare, poverty. And so if this really was going to be the pandemic that people have been predicting for years.

the margins were gonna be affected the most. So everything in me was just kind of like rising of uh-oh. So I get home and a lot of people were asking questions of what does flatten the curve mean? Do we need to buy a billion rolls of toilet paper? And the answer was always no. Oh, bye. I know, and don't hoard, that's just classic America, isn't it? But also there was a lot.

Ian (14:23.158)
People did it anyway though, yeah.

Ian (14:29.416)
Mm-hmm.

Zack Jackson (14:30.951)
Yeah.

Emily Smith (14:32.412)
And I, I re we all remember, I mean, this is a real fear. I do want to honor that of people who are high risk, the elderly, you know, do I need to be scared basically. And I wanted to calm fears, but not squash them because it was scary. So I decided why not, why don't I just start a Facebook page for the handful of real life neighbors that I had and like my family.

Really, I mean, it was just very, very genetic, generic, not genetic. So I named it Friendly because I tend to be too friendly. Like if I sit by you on an airplane, I'm very sorry. Um, cause I, I'm, I really am anyways, it's just who I am. And I'm trying to accept that, but neighbor because of the good Samaritan story, I knew that COVID in particular was going to imply that we needed to neighbor one another well.

We were going to have to take care of the margins. There's going to be a lot of solidarity of staying home for those that couldn't. Get the vaccines for those where it would not work. There just was a lot of neighboring that was going to take place. So I named it because of that. I'm also a pastor's wife. So I thought this is going to be prime time for the church, the Big C Church to be the church.

And I say that, I know listeners can't hear it, but I say that with a smile, not as sarcasm, but I was so idealistic at, I really thought this was gonna be our time to shine and take care, you know, live, love thy neighbor really out in full blown faith. So I named it Friendly Neighbor Epidemiologist. And the only people that followed at the beginning were real life people that I knew. And then when the pandemic,

Ian (16:13.408)
Yeah.

Emily Smith (16:23.676)
started shifting. We all saw this when it became weirdly political. When national leaders started talking about it as the China virus or these othering type, I was going, what is happening? That is not the faith that I ascribe to. And then when it became, you know, faith that were fear, we started hearing that and people started saying that instead of wearing a mask. I was like, you have not read Galatians five in the Bible.

Ian (16:37.314)
Mm-hmm.

Zack Jackson (16:47.15)
Hmm.

Emily Smith (16:53.192)
You might say faith over fear, but that's not true faith. So I started posting about that too, from this perspective of pure science and then weaving in the faith part to try to help people anchor in a different way than perhaps they were able to anchor at their own churches. And that seemed to resonate with a lot of people for good and bad ways. So then it started going viral. George Floyd was murdered. And I talked...

Zack Jackson (17:18.55)
Hmm.

Emily Smith (17:22.724)
into that conversation at, especially in the white church, there's a difference between all lives matter and black lives matter and why that distinction is important. People couldn't understand. So it'd go viral for that. And I wasn't doing this to go viral. I don't actually think I was noticing what was happening because I was just busy writing and daily posting. And then the Capitol riot happened and I wrote about that one and that one really kind of exploded.

Zack Jackson (17:29.91)
Mm-hmm.

Zack Jackson (17:47.906)
Hmm.

Emily Smith (17:53.748)
So that's how I got into it. I'm sure we can talk about the nuances, but that's how it initially started.

Ian (17:59.362)
And you alluded to, you know, your children seeing the things being said about you and everything. What surprised you most as it started going viral with the reactions? Like, because you, you share some things in here and that were really challenging to read and you in there though, even said that, um, I will not share everything. And so I just, I can't imagine.

Emily Smith (18:13.341)
Yeah.

Emily Smith (18:19.457)
Really?

Ian (18:30.134)
the pain you went through and, but you, I love that you embraced your vulnerability with that because I also, I'll be honest. Yes, I, I am a Christian, but there are many times, especially over the last several years, and Zach knows this very well that I have a really hard time saying I'm a Christian because of the extreme baggage that comes with it. But I feel like if I say it, I have to qualify it really. And yeah, we had Brian McLaren on, um,

Emily Smith (18:47.032)
Oh, for sure. Yeah. Yes.

Zack Jackson (18:47.054)
Mm-hmm.

Emily Smith (18:53.98)
Oh, absolutely.

Ian (18:58.342)
last, what, May of 22. And we talked a lot about it then as well, because it just the extreme hate that I felt like we were seeing that, I guess, has always been there. But now is more acceptable to be said. And so I'm just curious, you are I've never been a member of an evangelical Christian community in that way. And so I'm just curious what surprised you the most or if you don't mind sharing some of that.

Emily Smith (19:00.52)
Nice.

Emily Smith (19:26.896)
Yeah, yes and that you know this portion of the book the book is separated into three different sections centering cost and courage um had to be three c's like a good Baptist I guess but that middle section is the thank you for that or evangelical I grew up charismatic and married a Baptist pastor and now we go to a liturgical church so I'm not sure what I am at this point. Did you?

Zack Jackson (19:39.138)
Yes.

Zack Jackson (19:46.531)
same.

Ian (19:51.925)
Yeah.

Zack Jackson (19:52.466)
I grew up charismatic and went to a Baptist seminary and married my wife there. And then now I'm a part of a mainline denomination. So look, I'm there with you.

Emily Smith (20:01.976)
Maybe that's just a natural. There's a lot of us out there. Maybe that's a progression. Yeah. Are you? Yeah, I have to figure out where to, like the call and response, do I say the bold or not? Because I would get it wrong or stand and sit. I just get it wrong a lot, but whatever. The church is fine about it. So the middle cost section is the shortest part of the book.

Zack Jackson (20:05.174)
Yeah. I'm seeing it more and more. Yeah.

Ian (20:06.559)
Yeah.

Emily Smith (20:27.492)
It was by far the hardest to write and the hardest to read on the audio. I read the audio book and when I was recording it, I realized the, these chapters still feel so messy. Um, and it's because I just couldn't do more. I couldn't get it. I couldn't package it in a way that some of the other chapters felt pretty and tidy and bowed up. And anyways, it feels like there's a lot of ums and ohs in that chapter because it is incredibly painful.

Zack Jackson (20:39.075)
Hmm.

Emily Smith (20:57.472)
We were in Texas at the time. We were in the belly of the beast, that kind of feels like, of Waco, Texas. Great, great people there. But also the buckle of the Bible belt, probably the latch of the buckle. So what surprised me is when I started talking more and more about faith over fear, we started getting little trickles. I say we.

I started getting little trickles of pushback from that online. And, you know, it's horrific stuff. It's not, I mean, you get called names and people, you know, you can put that aside. But when I started getting pictures of people sending pictures of guns and Holocaust imagery to me and saying awful things about my children, you know, threats against them, it became very real.

Zack Jackson (21:45.762)
Hmm.

Emily Smith (21:53.5)
And then one day in the middle of it, my husband came in and brought in a letter that was in our mailbox that was written in black and red marker. And it was an awful threat. And it was laced with, you know, you're part of the mark of the beast and a lot of these religious overtones, which I had heard and received for months at that point, but not in my mailbox. I mean, that is when it became too crazy.

Zack Jackson (22:11.894)
Oof.

Ian (22:17.771)
Mm-hmm.

Emily Smith (22:22.732)
close. You know, there's a cost that was to me, but then this was going to be a cost to the whole family and to the church, to our church. We ended up leaving the faith community. That not all faith, but that one. Some of the worst threats and harassment I got were people from within my own neighborhood or people that I worshiped with. Those are the ones that I won't share because I just can't talk about it yet.

Zack Jackson (22:45.451)
Mm.

Emily Smith (22:51.676)
The book is not a COVID book because I can't talk about it for 200 pages, nor do I think people want to read about it. The cost was awful because we couldn't let our kids go walk in around the neighborhood without one of us. They had safe homes that they could go in if they ever felt scared. They don't know why we were saying that. We just said, if there's a rainstorm, run to these five homes or

Ian (22:58.166)
Mm-hmm.

Zack Jackson (23:00.579)
Hmm.

Ian (23:11.19)
Hmm.

Ian (23:19.49)
Mm-hmm.

Emily Smith (23:20.488)
and they still don't know that. And that's very tender for me as a mom to have to hold. And two, at that time, it was also feeling like I was losing a foundation of faith because I grew up with Sandy Patty, Michael W. Smith, Bethel worship, I mean, come on now, really good, yeah. All of that evangelical stuff. And I remember watching the prayer rally that happened in November, 2020, and I'm sure,

Zack Jackson (23:39.222)
Yes.

Emily Smith (23:49.32)
you guys watched it as well, you know, on the Capitol steps, Michael W. Smith is there, Franklin Graham, I mean, these, it was a massive thousands of people rally. And this was also at the height of that first surge before vaccines. So my soul could not reconcile how that was standing on faith when I put the number in the book of how many died that day, but it was at the peak of the deaths in the US, like morgue trucks.

you know, scenarios. I couldn't, I just couldn't reconcile like, so I felt like we were losing our faith community, losing jobs, you know, or leaving jobs, losing real life friends. And then these foundations that I had just anchored in were, I was just losing that as well. So it's just difficult. I do wish

Ian (24:19.915)
Mm-hmm.

Emily Smith (24:45.556)
that I could have shielded my family from some of that and just taken more of the brunt of it. But it's just part of the, you know, it's part of the cost of us as a family. And I wanted to put some of that vulnerability in because I think a lot of people, especially from the faith communities, have lost a lot. Or Thanksgiving's and Christmases have been very hard and are still hard. I just get that.

Ian (24:55.126)
Mm-hmm.

Zack Jackson (24:55.138)
Hmm.

Zack Jackson (25:09.826)
Hmm.

Emily Smith (25:12.552)
At the same time, it's the tip of the iceberg of what I did put in there. So I wanted to be careful to not put too much just cause I couldn't talk about it.

Ian (25:20.235)
Yeah.

Zack Jackson (25:22.156)
Yeah.

Ian (25:22.61)
When I appreciate, like I said, I appreciate, I I'm someone who embraces vulnerability. Um, and you know, I really love Brene Brown's work around that too. But I very much appreciated you sharing that with all of us and the readers because I just, it was tough. It was tough to read and, um, but I admire that you continued to work a lot. You know, I really appreciate that too, because

Emily Smith (25:31.197)
Yeah, for sure.

Emily Smith (25:48.926)
Yeah.

Ian (25:52.438)
You are still continuing to do what you can to save lives.

Emily Smith (25:57.94)
Well, and that was a choice. I mean, there was a point in there where a couple of the threats, I mean, we were working with high up authorities at certain parts of it. And I just asked my husband, do we need to just stop? Do I need to, well, do I need to stop basically? Cause I would, I would have just pulled all of it. It was not worth having a child, having one of my kids hurt or worse.

And so we took a little bit of a break there in the middle of it to kind of discern and use wisdom and then I just decided to keep going with certain parameters in place of Some cameras and Authorities and some backup plans also Some boundaries around what I would or wouldn't stay who I would or wouldn't listen to I got asked to come on Far right like Breitbart type

podcast and just I automatically just saying no to that. I mean, that's just a boundary. So it was a it was a choice to keep going. But it was also at a cost. I mean, that was before I got sick in 2021. My body just said no more. And I just had a I don't know if it's a thunderclap or just a massive migraine never had it before. And it just put me in bed for 15 months. So it

Ian (27:23.838)
Yeah, that reading that was tough too. I, yeah. And I just, because it just, I felt like your pain that you were experiencing, at least some of it was coming across, which again, I, I appreciated that a lot. Um, and I have a very dear friend of mine that was in my PhD program with that deals with migraines. I don't think she deals with them as much anymore. This was, you know, back between 2004 to 2008, but I knew right before she started the PhD program,

Zack Jackson (27:24.148)
Ugh.

Emily Smith (27:26.952)
Was it? Yeah.

Emily Smith (27:38.125)
Yeah.

Ian (27:52.266)
she would have them where she would be bedridden for like a month or something like that. And just, I couldn't imagine what that was like, but even, you know, I know I asked you how things are going now with you and your family and you told us prior to recording that things are getting better. And, and, but again, you made the choice to continue trying to save lives. Like I think that's very admirable. And so I, that's one of the reasons why I was so excited to get you here.

Emily Smith (27:54.74)
Yeah. Oh, for sure.

Ian (28:20.934)
And to read your book because that truly is admirable because you know, I have faced hateful things just because of stuff I do with science and religion for a long time now, nothing compared to what you've done. But there have been plenty of times where I've thought, I can't, I'm not doing this anymore. Like, it's just not worth it. Um, and it was nowhere near to the scale of what you have experienced. And so I just, I think it gives a lot of people hope. And I just wanted to make sure you knew that.

Emily Smith (28:37.333)
Yeah.

Zack Jackson (28:37.559)
Yeah.

Emily Smith (28:45.052)
Yeah, well thank you. There was also a scrappy piece of me that did not want to let them win. And because there were there were months of being bedridden in an incredibly dark room, I mean laughing would send me to weeks of a migraine that no amount of medicine, including hospital type medicine, would touch.

Ian (28:55.039)
Mm-hmm.

Zack Jackson (28:55.313)
Hmm

Emily Smith (29:11.484)
And so I, there was a little bit of a fight in me too. I just, I was so terrified that was gonna be the rest of my life. And I was doing everything possible to get out of it. And so now that I've come out of it a little bit more, the tenacity, the scrappiness to keep going means not only did like the bad people, they did not win, but also living into probably who,

I am more of myself now than I have ever been because of it, because I'm a whole lot braver and courageous than I thought was actually in me. So thank you for saying that, because I think we hear stories of overcoming something and it looks like it was an overnight thing and you just believed your way out of it. And this is not the prosperity gospel. It is really difficult stuff.

Zack Jackson (29:43.149)
Mm.

Zack Jackson (30:00.311)
Hahaha!

Zack Jackson (30:04.023)
now.

Emily Smith (30:08.7)
you know, just day by day, I'm just doing, I'm just so grateful to be doing my job again.

Ian (30:14.475)
Yeah.

Ian (30:18.07)
Zach, did you have anything to add? Just, yeah. It's just, it's very inspirational, so thank you.

Emily Smith (30:23.693)
Thank you.

Zack Jackson (30:25.222)
Oh, you remind me of Julian of Norwich, my favorite dead Christian. Um, are you familiar with her story at all? Yeah. How she, uh, asked, asked Jesus for, uh, an encounter as close to death as possible so she could get to the heart of things and then to come back and be able to share that and the amount of revelation she encountered on those dark nights in that bed, um, changed her.

Emily Smith (30:28.618)
Yeah.

Emily Smith (30:32.574)
Yes.

Emily Smith (30:35.892)
Oh, for sure. Yes, I am.

Zack Jackson (30:54.31)
and really clarify the rest of her life. And I'm hearing that a lot from you as well. That's beautiful.

Emily Smith (31:03.592)
Yeah, she was probably a little bit more full of faith in the bed. I was just like, what is happening and I want out.

Zack Jackson (31:14.283)
Yes, but when she says, yeah, when she says all will be well and all will be well and all manner of things shall be well, she's saying it from that bed. And so it actually means something instead of the sort of, you know, pithy platitudes that you would see on a bumper sticker or a greeting card. And so when you talk about it and you talk about hope and change and good things, I feel, I believe it more.

Emily Smith (31:14.842)
This is not okay.

Emily Smith (31:33.113)
For sure.

Yeah.

Zack Jackson (31:42.262)
you know, because you've been through the flames. One of the things that I found

Emily Smith (31:42.724)
Yeah, that passage in particular that she said is, oh go ahead, there was a little, I was saying one of the things about that passage that you just quoted, that's what my husband would tell me just nearly daily during those really dark times, all shall be well and all, yeah all of that. So that's very special.

Zack Jackson (31:53.025)
Nope, go ahead.

Zack Jackson (32:09.542)
Yeah, that's my mantra. I repeat to myself almost a daily basis.

Emily Smith (32:14.963)
Yes.

Zack Jackson (32:17.75)
Yeah. One of the things that surprised me in reading some of your work, when I hear about epidemiology, I think of, well, that's spread of disease, clearly. But that's such a small part of your book and a small part of your writing. And I'm reading about gun violence and systemic racism and injustices and economics and...

all kinds of things that have nothing to do with disease? Am I reading epidemiology wrong as a study or is it that this is all just a part of how your heart works?

Emily Smith (33:03.692)
probably a both and of that. But epidemiology is not just the pandemic, epidemic, you know, disease detective type stuff that they make movies of. It's that, but it's also anything that affects a certain group of people differently than another group of people. And so that could be, you know, in my work, that's poverty and children's health. It could be who is affected the most by congenital

Zack Jackson (33:05.687)
Hmm

Emily Smith (33:33.356)
chronic type condition. So it's a really broad field than just disease detectives.

Zack Jackson (33:41.376)
Okay.

Ian (33:41.378)
All right. Well, so, and I remember your chapter, Trickle Up Economics. And so I'll be honest, Emily, there are so many, like I've now been putting like little markers in here, but I've folded down so many pages that I can't get, oh sorry, I can't get to everything I wanna say. So you made something and I can't find everything again because I just, I have comments on almost every single page.

Emily Smith (34:03.124)
Oh

Zack Jackson (34:09.218)
We'll leave a link in the description.

Emily Smith (34:09.484)
Oh yay! I'm gonna hang your reference business. Thank you.

Ian (34:10.414)
And your references in the end and stuff. And especially, so, you know, I'm also a fellow academic. And so I just was pulling your references. And I was like, oh my gosh, this is so amazing, honey. And just, and also too, I started down like the anti-racism journey. And I think 2016. And so some of the things I was aware of, but it was nice to also reread it and stuff, but that the chapter on trickle up economics, when you talk about, um, the question you ask us is, do you want to know the main factor per

Emily Smith (34:15.613)
Yes.

Emily Smith (34:26.858)
Oh yeah.

Ian (34:40.302)
Uh, predicted. Do you want to know what main factor predicted descending into poverty and not being able to climb back out, even when you account for everything else and it was having a child who needed surgery, which I was not at all surprised. Obviously it was health related, but that part and the part I'm trying to remember too, is that just for the communities in Somaliland or was that just also applicable worldwide?

Emily Smith (34:50.57)
Yeah.

Emily Smith (35:06.176)
it's applicable worldwide that look like, I mean the margins countries, you know, the poorest countries for sure. Yeah, yeah, and that, um, that was not something that we expected either. You know, in my day job, I work in communities like in Somaliland, which is the fourth poorest country of the world, on children who need surgical care. And so we know there's a group of kiddos who can get to, you know, a hospital when they need it.

Ian (35:08.17)
Okay.

Right, yeah.

Okay.

Emily Smith (35:34.752)
there's a whole slew of them that can't for reasons that are not their fault, nor their family's fault. That's the structure system, systemic racism, structural violence type stuff that happens. So we had been working with our community partners within the country for starting in 2016, trying to map out in the country, where are the kids who need the greatest care?

How far do they have to travel? I mean, it is hours and hours and hours on wheelbarrows and stuff that is just not equity. It's just not what we would want for our children by a landslide. And then we started teasing the data. This is part of epidemiology that I love is you start with the margins and then you go further in to get the truth of the story. Cause that's what laws and legislations are built on, policies. And we found that

There were a group of families in Somaliland that went into poverty because of something and never came out. There were some that were able to climb out of poverty. We see this in the US, right? Someone goes to the ER. If you have an insurance or a nest egg or family members that could chip in, it's going to be a huge expense. Some go into poverty and can come out and others can't.

So in Somaliland, that's what happened. And we started looking at those families at what was different about them than the rest of them. I thought it was gonna be the income level of the family or the number of kiddos that they had to feed, but it was having a kid with surgical care. And so we took that to the United Nations as a policy effort in 2019. There was a big summit there for universal health coverage.

And it's asking the question of what basically is going to be covered under a universal health coverage package. We know it's going to be vaccines and taking care of the sniffles, you know, primary care stuff. But what about surgery? Because that is what is impoverishing people. So we went to make that statement. And the chapter is about starting with the stories of the margin and then trickle your way back up.

Emily Smith (37:48.976)
instead of the whole trickle-down capitalism type where you put, you know, a hundred dollars in Jeff Bezos mailbox and you hope it reaches the poorest of the poor in inner Detroit. So it was a very, it was really interesting finding for me, but it also linked the story, their story, hopefully to policy change at the highest levels.

Zack Jackson (38:00.546)
Hmm.

Ian (38:10.634)
Yeah. Well, I've always said that I, I think it's, um, shameful that our country, which is the richest country, I believe in the history of the world, that anyone in this country could ever go into poverty because of healthcare or that people are in poverty, but still there's so many things there, right? But that healthcare can make people go bankrupt. I,

Emily Smith (38:29.96)
and we're the number one. Yeah.

Ian (38:39.958)
will never understand that with the amount of money and wealth in this one country that that's possible. It just is absolutely mind boggling to me. And then of course it elsewhere, right? I mean, you talk about in this chapter of like the wealth of like the 10 richest people or whatever the number was and what that could do for those countries in the margins, right? But even the margins in our own country. Um, and I just, I found that

Emily Smith (38:49.696)
Yeah.

Emily Smith (38:59.509)
Yeah.

Emily Smith (39:04.64)
Right.

Ian (39:08.35)
Uh, really interesting. I was really grateful that you went that route with that chapter because I thought it was just so important to see.

Emily Smith (39:14.696)
Right, and I think that that's where our centering is wrong because this story of medical impoverishment, healthcare impoverishment is in the Bible too. You know, the story of the bleeding woman who had spent her last resort was to go to find Jesus because she had spent all of her money for years trying to get care. And then she touches the hem of his garment to try to be incognito and he stops the crowd for her. Like his center.

His majority, his view was not the crowd. It was the medically impoverished woman. So there's a chapter about that too, about his majority, how we can make that, how we can visualize the world. I think perhaps like what he looks like. But I get all the time, we just need more resources or Emily, we just need more money type. And I think that's short-sighted. I don't think that's true. I think we have...

in the world enough resources and enough money that we need, we just don't have enough equity. And that's money, that's healthcare. We saw that in the pandemic with the lack of oxygen. There's a whole chapter in there on innovation. Yeah, and in India, yeah, when they were running out of oxygen, it's not because the world lacks oxygen. It's because the US and

Zack Jackson (40:18.158)
Hmm.

Ian (40:25.054)
Oh yeah, that was very heartbreaking. Oh yeah, that part, yeah, yeah.

Emily Smith (40:40.584)
stockpiles of it. And so the question innovation is making sure that oxygen is where it needs to be but also asking the harder systemic questions of why wasn't it there in the first place. That the other chapter in that section on courage is on valuing a life you know how do we value it which I think that one was the hardest one to write outside of the cost chapters. Do you remember those about Ebola?

Ian (41:09.574)
Yeah. Can we go into that a little bit? That, that was very challenging chapter to read too. You're right. Well, it just, and I'm in a butcher, their names, cause I'm getting to it, but I mean, do you mind telling us the story with that? The doctor who died, but then the other one who didn't. And yeah.

Emily Smith (41:10.34)
Yeah.

Emily Smith (41:15.56)
Yeah, go ahead.

Emily Smith (41:23.488)
Yeah.

Emily Smith (41:27.524)
Mm-hmm. Yes. So the it starts out introducing you to Dr. Khan. And for those of us in public health and global health, we know who Dr. Khan is. He is the Anthony Fauci of Africa. He had also been prior to the 2016 Ebola outbreak that hit his country and you know, West Africa. We all probably remember that epidemic.

He had been working with congressmen here in the US, people, legends like Dr. Paul Farmer, who the book is in part dedicated to, to advocate for pandemic or epidemic preparedness for his hospital or resources for something that, could really cripple their system with not a whole lot of fanfare, not much was done with that type of legislation. So I'm trying to set the stage that he is a,

very well known and respected doctor. When Ebola hit in his country, he was also frontline, because he's an MD. So he ended up getting Ebola. And this was in his health system that wasn't given the necessary resources to be ready for this epidemic, even though he was advocating for it. So with Ebola without the support of care, you deteriorate very quickly. Ebola is not highly

It's highly fatal without the support, but not here in the US, which is why a lot of people or the people that have gotten it and have received care here have not passed away. So he gets it, he gets very sick, he gets transferred to a MSF unit that was specifically made for Ebola, and he keeps deteriorating. So they were having to make a decision on, do we give him what's called ZMAP?

Zack Jackson (42:53.355)
Hmm.

Emily Smith (43:18.428)
And at that point, it was an experimental drug for Ebola. It was the only option available for treatment outside of supportive care like IVs and rehydration. I go into a little bit of detail in the book, but I would definitely encourage people to go read that full story by the New York Times article, and that's in the references. But they made a decision not to give him ZMAP. Now,

There were only a few vials of that in the world, one of which was actually at that MSF facility or very close by. He was also asked to be medevaced and that was given, a plane did come, but he was so sick, they refused to take him, cause it was not equipped like we see those, you know, the big ones here. So.

He ends up dying just a few days later. Without his family, they finally let a friend go in at the end to be with him. If you reverse time a couple of days, there were two other doctors in West Africa, well, one doctor then a nurse that got Ebola too. Same thing, got very sick, deteriorated, had to make a decision of what to do. They were also asked to be medevaced and there was a conversation about

ZMAP to be given to them. Both of them received ZMAP. And not only that, they were medevaced in the state of the art, you know, it looks like a sci-fi book airplane, just equipped with every legit thing possible to keep that contained and landed in here in the US. I remember that. I don't know if y'all remember that on the news where full hazmat suits.

Ian (45:01.95)
Mm-hmm.

Zack Jackson (45:03.778)
Yeah.

Emily Smith (45:06.844)
there's a team of 15, 20 doctors, and they walked out of that hospital a couple days later recovering. I was very intentional in that chapter who I named by name and who I didn't, because the point I was trying to make was if that was my family, I would move heaven and earth to get them medevaced. So I didn't want to dishonor that.

Ian (45:14.207)
Yeah.

Zack Jackson (45:14.608)
Hmm.

Emily Smith (45:34.46)
The question is more at a 30,000 foot level of who is worthy to get ZMAP? Who is worthy to get oxygen? Who is worthy to get medical resources or free healthcare or free education? How do we value a life and how are people's lives valued? Then when you take that to a country level, who gets what from a country? So as a person of faith,

I wanted to write a chapter that honored Dr. Khan, but then the bigger questions too of how should we value people if we are believers of, you know, of the Bible or of what Jesus says. So it was a hard chapter to write. I also wanted to, that mission organization of the two people that got medevacked out were part of Samaritan's Purse, and I had been a vocal.

I spoke against Franklin Graham's aspect, how he was treating the pandemic very vocally. So everybody knows what I think about that. I also have really good friends that work at Samaritan's Purse. So it's not about the missions agency. It's about some people having friends in very high places with a whole lot of money to help people in need while others don't and asking the question of why.

Ian (46:41.255)
Mm-hmm.

Ian (46:56.823)
Mm-hmm.

Zack Jackson (46:59.906)
Hmm.

Ian (47:00.07)
And I love how you bring it back to equity. Cause that, as you said, that's what this is all about. And which again is very tragic, right? But, um, I wanted to shift if I can, there was another thing I just wanted to, there was a quote that I loved is at the end of the chapter on, um, let's see, which one was this broadening our definition of health. When you're talking about the good Samaritan, I just wanted to read it out. Cause I, I just loved it. I read it to my wife.

Emily Smith (47:08.468)
Right.

Emily Smith (47:23.849)
Yeah.

Zack Jackson (47:24.184)
Hmm.

Ian (47:30.522)
And I just was really happy with this one. But you say blast paragraph, by the way, did the Samaritan tell the man the gospel or preach to him or hand out a tract? The parable doesn't tell us anything like that. I have a hunch Jesus would have mentioned it if it were important to the point he was making at the time, but he didn't. What he modeled for us with, with this story as being a neighbor and word indeed. And I actually was on a zoom meeting with, uh, my priest. It was last Wednesday. So, you know,

nine days ago and other lay leaders in our church. And I just was telling them that we were interviewing you and then read that to them because I really part of my struggle is when people the certainty aspect of things that they this is the way we're supposed to behave. Or, you know, it's my way or the highway when it comes to being a person of faith. And I just love that you pointed that out of just there. That's not in there. And you were right. Right. When I read it, I just was like, oh, my gosh, that's yeah.

Emily Smith (48:16.905)
Yeah.

Zack Jackson (48:22.902)
Hmm.

Ian (48:28.554)
Like that's a great lens to take to it. To show that was not the purpose. And I loved that. And I just, oh, absolutely. Yeah.

Emily Smith (48:28.821)
Yeah.

Emily Smith (48:34.272)
Right. Well, don't you think he would have put it in there? I mean, Jesus is super duper smart. Yeah, I mean, he's he was very sneaky and intentional with the parables and how he told the stories. So I think he would have let us know that we needed to put a track in there before we gave people health care. But gosh, I mean, unconditional love is not conditional on viewing people as projects or

Ian (48:47.68)
Yeah.

Emily Smith (49:01.196)
proselytizing. So I just wanted, especially in the evangelical church, to, you know, we do things with, or we should do things just out of a goodness of heart. Because we're, I mean, it says in the Bible too, when we do these, you do it unto me. When you take care of the poor and feed and clothe, then you take, you do it for him. And so I keep in, I think keeping that perspective, I think we should do more of it in the evangelical church for sure.

Zack Jackson (49:31.903)
You mentioned the evangelical church. You have a chapter in here called Topics Too Many Evangelicals Don't Want to Talk About. I would expand that to topics that Christians in general don't talk enough about. What sorts of things should we be talking about in our faith communities?

Emily Smith (49:38.932)
Sure.

Emily Smith (49:43.315)
Yes.

Emily Smith (49:50.2)
Yes, I wrote that because when I got back from that UN meeting that I was, I told you about earlier, you know, I'm a pastor's wife and so we get in there for Sunday school and somebody called me a socialist and I did not know, I didn't know how to respond because it caught me so much off guard that wait a minute, I just told you we were talking about like poverty, you know, we can all agree that that's a problem and let's help. So I, it

Ian (50:03.441)
Mm-hmm.

Zack Jackson (50:04.074)
Hahaha

Emily Smith (50:17.564)
it made me realize we need a conversation about what some of these topics are. It also came out of the pandemic, you know, when I would talk about structural violence or systemic racism or Black Lives Matter, climate change, there was such this hubbub of we don't want to talk about it or overtones of we just don't go there. But I think when we hold those to the sky, they reflect heaven

So I wanted to make, the whole first part of the book is on that, how to talk about that in non-threatening but challenging ways still. Then that last chapter on making the connections between climate change and poverty and the margins to try to at least let pastors know, talk about it from the pulpit. And here are some ways that you can talk about it where you don't have to scream.

You know, you don't have to come across as a crazy liberal if you're in a predominantly Republican Texas type church. But they are holy words because they are equity words. So that's what that chapter is about. Thank you for bringing that up. I chuckled at the title.

Ian (51:33.75)
Yeah.

Zack Jackson (51:34.598)
It made me chuckle too as an evangelical who's been, well, former evangelical who's been accused of all kinds of things that, you know, is Jesus taught me, you know. I have a shirt that says, um, cast down the mighty, lift up the oppressed, uh, feed the hungry, send the rich away empty handed. And I often get accused of like Marxism for that. And I say,

Emily Smith (51:44.86)
Yeah. Right.

Ian (51:45.438)
Yeah. So then how good.

Emily Smith (52:01.236)
Oh sure, yeah.

Zack Jackson (52:02.294)
That's the Magnificat. Mary says that. Hahaha.

Emily Smith (52:06.953)
Right. Or Jesus' first sermon, you know, when he rolls out the scroll from Isaiah, that is full of captives free and the oppressed and yeah. Yeah.

Zack Jackson (52:11.465)
Mmm.

Zack Jackson (52:16.35)
Yeah, good news to the poor. Yeah.

Ian (52:18.43)
Yeah. So kind of adding to that chapter in particular, you know, the pandemic, you know, there was already lots of divisions in our society, obviously pandemic, I believe made it much worse and more in our face. And so I'm curious, you know, especially as someone who does work with, uh, trying to figure out ways to combat misinformation, science misinformation in particular. Um,

Emily Smith (52:33.546)
Yeah.

Ian (52:46.878)
with either from my education lens or just research or work I do. You know, I started when you started seeing the, uh, the increased hesitancy around the vaccine, um, that really started raising a lot of flags for me of like, this is not ending that we're going to see this. This is going to, you know, spread to hesitancies and laws against other vaccines that have made it so that diseases that have been eradicated from our country.

solely because of those vaccines, those will come back. Um, and so I'm just curious, you know, the white evangelical community has a lot of power. And so how can one start to have conversations with those communities? You know, I've never been a member, so I know it'd be hard for me, but you were a member and you went through a lot because of what you were trying to do. How, how do we get back in to be able to figure out ways to work with those communities to build that trust again?

Emily Smith (53:45.577)
Yeah.

Ian (53:45.598)
Right. And to help them realize that the science is not there to get them. It's not evil. It's trying to save lives. I mean, that's the point. And so how would you recommend we do that?

Emily Smith (53:55.209)
Yeah.

Emily Smith (53:59.884)
I wonder if I would recommend something different if I answered this question in five years because I still feel like it's too close. But I think one of the biggest things is knowing who is actually going to have a conversation with you and who is not and having the wisdom to just leave the room or leave a church. Like it's okay. We don't leave a church because we don't like the color of the carpet. You know, I'm not that type of Christian. But

Zack Jackson (54:16.215)
Hmm.

Emily Smith (54:29.668)
If there are real equity things and faith issues, I think it is okay to leave a church. So if, I don't know, leave friends, lose friends. I know that's hard when there are kids and youth and some people have to stick with it. If you do stay and you're trying to have these conversations, I would be really careful to guard your heart on what you let in and...

what you hear because it can pummel you, which is why I wanted to write some of that cost section so vulnerably. I wish I would have known a little bit more, maybe it wouldn't have been so bad if I would have had some of the wisdom to not go to every fight that I was invited to. So, and there's a chapter on that, on the wisdom of Nehemiah having that type. Yeah, thank you. I would also...

Ian (55:18.172)
Mm-hmm.

Ian (55:21.566)
Yeah, I liked that chapter a lot. That's very good.

Emily Smith (55:27.56)
tell people to be very cognizant, to pay attention to people who are not learning or listening anymore. Because the evangelical church has an incredible amount of power, always have. You know, like faith and prayer at football games where I grew up was still going on in the 90s and 2000s. It's probably still going on.

Ten Commandments. And so we think that should be the norm or the centered of everything else when it actually shouldn't. And if somebody can understand why I just said that and why it matters, that's a person who listens. If others just dig in their heels more and we want the good old days, but don't realize those good old days were awful for a wide group of like Black Americans, any immigrants, then we've missed the point.

So I think I'm, I don't think I'm answering your question. I think I'm telling people to be careful. Yeah, and also just to, there's this whole notion in the evangelical space that we just need to come together and get along. And that phrase really bothers me because that inherently denotes that there are two sides that need to come together, that both are weighted equally. And in that case, sure, let's come together because that's the center, but.

Ian (56:23.878)
No, you are. Yeah.

Zack Jackson (56:26.402)
Yeah.

Emily Smith (56:48.84)
When you have two sides and one is their voices have had the microphone longer than another side, it's time to equal out that balance where both sides can be heard. And that is still just certainly not going on, especially with science.

Zack Jackson (57:00.034)
Yeah.

Zack Jackson (57:04.766)
Right. So it's less about finding the middle point between two things and more thinking about it like a binary star system where the one that is the center of gravity has to do with the relative mass of each one. And so a big star and a small star, the center of gravity is going to be closer to the big star because that's where the mass is. And when we're talking about

Emily Smith (57:27.37)
Yeah.

Zack Jackson (57:31.866)
On this side, we have a climatologist, and on this side, we have your uncle on Facebook. Then, the center of gravity is not going to be in the middle of those two things, right?

Emily Smith (57:38.636)
Sure.

Ian (57:41.931)
Right.

Emily Smith (57:42.948)
Yes, or even in, I'm working with some indigenous communities in Brazil and listening a lot longer as a researcher of what their health needs are, including how to overcome them. So talking with traditional healers and valuing and honoring where people's stories are and their needs more than maybe a preconceived idea of what I think it should be.

Zack Jackson (58:00.75)
Hmm.

Ian (58:13.098)
Well, we are. Yeah. Well, so I just had a couple of smaller questions if that's all right. Um, and I just appreciate your time really do. But, so I'm curious, especially for you with your expertise, you know, as we reflect back on COVID-19 and this pandemic, um, it's natural for us to think about what we could have done differently. And I'm curious what your thoughts on that, but also too, what can we learn from this to better prepare?

Zack Jackson (58:13.266)
We're nearing the end. So if you want to.

Emily Smith (58:19.584)
Good.

Ian (58:43.542)
for future outbreaks of infectious diseases. Cause I might say another pandemic's gonna happen right away, but there will be outbreaks of infectious diseases. We know that. And so I'm just curious, what are the things that we can learn from this to try to do more preventative measures in the future? Like what would you recommend?

Emily Smith (59:03.083)
Yeah.

recommend starting a conversation on trust in people's expertise instead of feeling like you're the expert on everything, which is a classic American thought. You know, we're very individualistic and so I think that could start, that's very 30,000 foot, but trust the experts. But then finding the community champions within the communities that are speaking

from a place of their own. You know, I think that's why part of why I went viral is because I was speaking into my own community. I knew the language. I loved the church. I understood what pastors and their families were going through. So if you can find those and that means, you know, if we have distrust in some sort of science or the vaccines, then find the communities where that distrust is and then find the people there that are the champions.

I just think it's a trust, it's a value issue. I know people don't like to hear about the political stuff, but who we vote for matters in very real ways on the ground, and we saw that. So I think having conversations about that too, you know, we are not voters of just one issue. If you are, that is going to trickle to a billion other types of issues.

Letting people, especially like my children, I've got a teenager telling her about the importance of who you vote for and why that matters.

Ian (01:00:43.958)
So is there anything that you want to share? Anything else we should have asked but didn't?

Emily Smith (01:00:51.684)
No, I mean, I hope if anything for the book, I hope that it makes people laugh. Because there's a lot of stories in there that hopefully are funny. There's really silly pictures from my science fair board. Please go look at that. It's fantastic and a little over the top. But I also hope it... Yes.

Zack Jackson (01:01:03.844)
I'm going to go.

Ian (01:01:06.464)
Yes.

Ian (01:01:12.402)
I think the picture, if I can say the picture that you're staring at, I forgot who you're staring at, but you talk about that you have it. Uh, oh yeah. That picture of the board is great, but then the picture of you staring at somebody and you put, you have that framed on your desk. I, who was that again? I, I couldn't find that again in the book right now.

Emily Smith (01:01:21.33)
Yes. It's.

Emily Smith (01:01:27.222)
It's, yes, it's Dr. Tedros. He's the WHO president and I ran into him at the UN and that is my picture of me, like total fan girl moment with him. Yeah.

Zack Jackson (01:01:38.382)
Hehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehehe

Ian (01:01:39.851)
It was hilarious. And I just, I mean, I'm sure we've all done it. I do that with people all the time, but yours was captured on camera. And I love that you framed it and have put it on your own desk because I just find that hilarious. Like that's just such a wonderful story.

Emily Smith (01:01:51.228)
Yeah, I have-

Emily Smith (01:01:55.372)
Well, I have one that's a real one. I mean, they took one where we're both looking at the camera, legit, but I just keep it, because it was how I felt at the time. And... Oh, I'd like to show the card. Oh, thank you.

Ian (01:02:05.662)
When I love that you shared it with us, like I just, you know, I could totally envision it. And then all of a sudden I see the picture. I'm like, yeah, that's, that's what I was thinking. Like it just, that was really cool. Yeah.

Zack Jackson (01:02:07.53)
Yeah.

Emily Smith (01:02:13.549)
Yeah, this is a fangirl. Yeah. So.

Zack Jackson (01:02:15.55)
Yeah. And a completely honest review for those who are listeners and who hopefully trust the things that we say and do is that this book is really heartfelt. It is fact filled and it is driven by story and your own personal experience instead of just, you know, here's a list of objective facts. And for me, that not only conveys truth.

in a way that is easier to digest, but also shows how authentic you are and how important this book is, how much of your own soul is encapsulated in this and how much of your own experience and growth from a young and idealistic nerd who's going to save the world, who gets jaded and cynical, but then finds hope and emerges on the other side stronger and

I think all of our listeners should find a copy at your local bookstore or if you have to on Amazon. Or listen to the audiobook which is recorded by you and that must have been a fun experience.

Emily Smith (01:03:25.176)
Yes, it was fun. It's very hard to do too to just read it harder than expected, but it was fun to do.

Ian (01:03:29.703)
I'm back.

Well, and if I can just add to that, I think that's a great, um, thumbs up there, Zach and recommendation for this book. I can't recommend it enough for people. I think it's an outstanding book. Um, I agree with everything Zach said, but I loved, I just absolutely loved that you couched it in the good Samaritan story. And also in Jesus, the second commandment to us about love, I neighbor as yourself. Um, right. And I just,

Reading the whole book. It just the theme was so clear throughout and it was such so beautifully woven throughout the entire book About the importance of loving our neighbors, which is something that I really push for In my class. I have my motto is be curious not judgmental because I'm a huge Ted Lasso fan and really talk about that of how much more we can accomplish by just being curious and I'm

Emily Smith (01:04:06.668)
Good.

Zack Jackson (01:04:21.87)
the

Emily Smith (01:04:22.093)
Sure.

Ian (01:04:29.886)
Zach will tell you, I'm an insatiably curious person. I'm curious about everything. Um, but I just, I really loved how you really continue to provide more argument on the importance of love in our neighbors and what, and I think this could, this book can change things. I'm, and you can, and I'm really happy that you joined us today.

Emily Smith (01:04:42.804)
Thank you.

Emily Smith (01:04:50.272)
Thank you. What a pleasure. We've been circling each other for a while. Um, on trying to-

Ian (01:04:56.126)
Yeah, because you and I are only a couple of hours apart. I mean, you're in Durham, right? And I'm in Charlotte, so yeah.

Emily Smith (01:05:00.204)
I know, I know, just pop on down there to UNC is where I got my PhD so I can do both blues.

Ian (01:05:07.178)
Yeah, my wife went to Chapel Hill. So yeah, yeah. So anyway.

Emily Smith (01:05:09.116)
Okay, there you go. Lovely. Well, this has been a pleasure. Thank you for the honesty and it being just a kind of a safe space to talk about a book. My first book, yeah. Thank you.

Zack Jackson (01:05:22.967)
Hmm.

Ian (01:05:23.122)
Yeah. Yeah, it's really good. I've loved it.

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