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No Barriers Podcast Episode 85: Health and Humanity with Dr. Raul Perea-Henze

Wrapping up our Veteran series, Erik and Dave speak with Dr. Raul Perea-Henze, former Deputy Mayor for Health & Human Services for the City of New York. Dr. Perea-Henze has an extensive resume that includes service in the private and public sectors. Our podcast today discusses his work responding to the COVID-19 pandemic as well as his time spent serving the Veteran population. Please enjoy the conversation and share it with your community.

Dr. Perea-Henze is a global health physician, government official, and corporate executive who served most recently as Deputy Mayor for Health & Human Services for the City of New York since 2019. He was responsible for the citywide response for COVID19 from the start of the pandemic, preparedness for recurrences, and recovery efforts.

He was the Chair of the NYC Health and Social Services Sector Advisory Councils and Co-Chair of the Mayor’s Racial Inclusiveness and Equity Task Force. He also provided oversight for 14 agencies, including the departments of health & mental hygiene, social and homeless services, children, aging, the public hospital system, domestic violence, LGBTQ, data informatics, and food policy.

Nominated by President Obama and confirmed by the Senate, Raul served as the Assistant Secretary for Policy and Planning at the Department of Veterans Affairs from 2010-2013.

Currently, he serves as a member of the Advisory Board to the Comptroller General of The United States. His former affiliations include being a founding member of the Clinton Global Initiative, a board member for President George HW Bush Points of Light Foundation, and an advisor on global poverty and Veteran affairs for President Jimmy Carter Center and President George W. Bush Institute respectively. He’s been committed to philanthropic causes volunteering in over 30 non-profit boards in health, mental health, AIDS, and Latino affairs over the past three decades.

Dr. Perea-Henze graduated magna cum laude as a Medical Doctor in Mexico at age 21 and obtained a Master’s degree in Public Health, with a concentration in Health Policy and Management, from Yale University, School of Medicine. He has also completed Executive Leadership Programs at Harvard Business School and JFK School of Government and INSEAD, France. He has worked or traveled to 145 countries and is fluent in English, Spanish, French, and Italian.

“There’s a mission out there that is bigger than us. At some point, if you’re going to serve others in any way, you have to give up a little bit of who you are.”

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Raul : There's a mission out there that is bigger than us. At some point, if you're going to serve others in any way, you have to give up a little bit of who you are. It's not only about your self-definition and that being the end all. I think it's important but I don't think it's, at least in my case, what has driven me through my life.

Erik : It's easy to talk about the successes but what doesn't get talked about enough is the struggle. My name is Erik Weihenmayer. I've gotten the chance to ascend Mount Everest, to climb the tallest mountain on every continent, to kayak the Grand Canyon, and I happen to be blind.

Erik : It's been a struggle to live what I call a No Barriers Life, to define it, to push the parameters of what it means, and part of the equation is diving into the learning process and trying to illuminate the universal elements that exist along the way. That unexplored terrain between those dark places we find ourselves in in the summit exists a map, that map, that way forward is what we call No Barriers.

Raul : Today we have a fascinating conversation with Dr. Raul Perea Henze, who is a global health physician, government official, and corporate executive who served most recently as deputy mayor for Health and Human Services for the city of New York, where he was responsible for the city-wide response to the COVID-19 pandemic. Previously, he was confirmed by the Senate as the eighth assistant secretary for policy and planning at the US Department of Veteran Affairs from 2010 to 2013. He was the principal advisor to the secretary on veteran policy and strategy, transformation, and inter-agency collaborations with the Department of Defense, Health and Human Services, and the White House.

Raul : Raul has also been committed to supporting philanthropic causes, volunteering at over 30 nonprofits boards in health, mental health, AIDS, and Latino affairs over the past three decades. Currently, he serves as a member of the advisory board to the comptroller general of the United States. Enjoy the conversation.

Raul : Welcome, everybody to our podcast. Really excited and honored to have Raul with us today. Erik, happy week of Thanksgiving. Hope you're doing well, everybody. Today's conversation is going to meander through a bunch of really important territory as it pertains to everything from veterans to COVID to how we're surviving in this particular moment and how we can stay healthy and happy. I'm really excited.

Dave : Erik, you're about to head out climbing today but you weren't feeling well. Is that right?

Erik : Yeah. I'm glad we're talking to Dr. Raul Perea Henze today because I'm heading out climbing after the podcast and I woke up with the sniffles and it's like what to do? You know? Man, I would feel so guilty passing on COVID. I mean, I'm 99% sure it's just a head cold but it's like if I ever did pass COVID onto a good friend I'd feel terrible, unforgivable, you know? I just called and canceled Dave. It's not an excuse just to sit on the couch all day. I'll find something else to do.

Dave : Well, I love that you started there because, I mean, Raul is a doctor and has been focusing on COVID in New York City and, I mean, Raul, I love that we started in this very practical space for what a lot of us are dealing with on a day to day basis, these individual choices of, "Jeez, I have the sniffles and I don't want to put anyone at risk but I also want to be active and live a healthy life." Can you give us some guidance, let's start there, on how to navigate that terrain?

Erik : Yeah. You're right, Dave, that was painful canceling because you know how much I love being out in the sunshine climbing.

Dave : Yeah. We have these two beautiful days where it's going to be in the sixties and then it's going to start snowing on Friday.

Erik : Right. Great.

Raul : I don't even know where to begin. No. Truly, Erik, I was telling you before, it's so personal, number one, and, obviously, like you, most of us would not want to expose one of our loved ones, friends or family, inadvertently, right?

Raul : You know, let me back up a little bit. I spent the last year in New York as deputy mayor for Health and Human Services thinking that my biggest challenge was going to be homelessness, particularly, everything I learned when I worked at the VA on veteran homeless issues. Soon enough, COVID was in our hands in January when we began to hear things coming from China and I think the biggest issue, and it's interesting that you two are bringing it up, months later we still don't know enough. In January, we knew very little.

Raul : What we knew was more related to all viral infections. Basic precautions, still number one, wash your hands, wear your mask, try to be outdoors and, most importantly, keep as healthy as possible.

Erik : Yeah. I think it was partly, my decision was a bit of an emotional response because I have a friend who is an ER physician out in the eastern plain of Colorado and he got COVID. He was in his sixties and I think he was relatively fit and he was in critical care for nine days. Nine days. He kind of put the fear of God into me yesterday.

Raul : I think we're getting to the point, which every one of us in this country knows, sadly, someone who has tested positive and some of us have seen the horrors of seeing people die. In New York, I don't need to recount the experience but I was in charge of all the public hospitals. We saw people die in 24 hours. Again, when we looked at the associated factors, the comorbidities, the one that came out as the most dangerous one was obesity because obesity brings along heart disease and diabetes, bad habits, no exercise, and some of those people, sadly, just went very fast.

Raul : At the beginning, we also thought it was the elderly. Once we started working by March or April, we realized it wasn't the elderly only because they were older and immunocompromised but it was because they could have all of these other conditions, particularly heart disease and diabetes.

Erik : Right. Mayor DeBlasio brought you in to be the deputy mayor of Health and Human Services in New York City. Where do you start? I'm really fascinated. It's such an overwhelming problem. My brain would just ... I think about the COVID in the beginning and all of the things that you don't know and then I just think, "Wow. I would just be so incredibly overwhelmed" but that's partly because I'm not a doctor and I don't have a degree.

Raul : Well, I think that I suppose opposites attract, right? I'm fascinated by your ability to go climb mountains that I would never dream to do and your ability to zoom inside your energy and concentration in a way that imagine the same kind of skill but the other way around. I think my job is to extrapolate, "We have one case of this" and all of a sudden how do we discover early on if we're going to have other cases and how do we nip it in the bud?

Raul : As this evolved, like in all pandemics, usually, they start by being epidemics. The yearly flu we have is a very classical example. We just don't pay attention anymore. We know that it kills a lot of people but we just don't pay attention.

Raul : I think this one was spreading all over the world so fast with no knowledge that we didn't even have the ability to do what we did with H1N1 or Ebola, contain it, understand it quickly, put all our guns in one place and contain.

Raul : Without this being a political statement, I think that there was a lot of confusion from lack of guidance from the WHO, from CDC, from the federal government and, in many cases, the state governments. I think all localities ended up making their own rules as they went. We ended up learning from each other. Sadly, we lost a lot of people that we should not have had, if we would have had a more organized and concentrated response. I think that that's something that should be very clear in our heads.

Erik : Because you were in New York City and you were in the midst of the crisis, you were one of the leaders probably because, as you said, you weren't getting a lot of support and information from the federal government. You probably were right in the middle of trying to create all the policies and make the hard decisions for yourself, for the city.

Raul : We saw, first, let's put it that way, the west coast and New York saw first the number of cases just exploded in our hands. We very quickly followed normal public health principles, which is at the beginning you try to identify every case and then track their contacts. You get to a certain tipping point in which you cannot do that anymore and you just protect all your healthcare infrastructure, your healthcare workers, your hospitals, all elective surgery in 40 hospitals in New York City stopped and we prepared all the hospitals to just take COVID patients almost 100%. All the other emergencies happened but it was a citywide effort.

Raul : Yes, sadly, we did it in the absence of the science being there and the leadership at different levels telling us, "Okay, we are with you. Eventually, we're going to send the military." Critical. If we did not get the chairman of the joint chiefs and the secretary of defense sending us the comfort and a lot of troops to take care of all the temporary hospitals and morgues, the city would have gone under. I think that's what you don't want.

Raul : Imagine, Erik, when you're climbing and you have this ability to perceive and know by instinct where you shouldn't put your foot. A public health professional, that's the same feeling through experience is like if I have 10 more cases in this particular location, it's going to get out of hand.

Raul : To raise your flags to the leaders of the city, the mayor, the governor, the president, saying, "This is what science is showing us." In a very interesting way, we ended up working with hedge fund managers who reached out to us saying, "We do modeling. We do projections. We can show you exhaust data where the activity of the people is and that way we can track where the epidemic is expanding or contracting." It was a very interesting team effort.

Dave : Yeah. Raul, I'm curious, from on a personal standpoint, that seems at some points it must be completely overwhelming. You've worked on these big national and, in this case, global issues, veteran PTSD, veteran suicides, and the mental health issues that are facing veterans and then you've got this major thing that you went in thinking that your job was going to be one thing and now you're dealing with a mass pandemic that nobody knows what to do. How do you manage the ... There must be really tough moments there where you're seeing thousands of people dying and you're not sure what the solution is and yet you have to feel confident that you can lead us forward in a pathway that is positive. How do you do that as a leader?

Raul : I think two major factors. One is you have to have good people. I was absolutely blessed to have people reporting to me, the CEO of the public hospital system, the health commissioner, the commissioner for social services, we distributed about 100 million meals to seniors and children. I could not have done that if I did not have the right senior leaders who managed their agencies to cover the entire almost nine million New Yorkers, right?

Raul : I think that, again, in the absence of leadership coming from up top, you kind of, number one, rely on your people and, number two, you learn how to pace yourself and your people. I remember the time in which I was at VA and twice a year we will have continuity operations exercises. You know? These are the exercises that are very codified. The federal government has for what is called the presidential succession in case of a catastrophe.

Raul : When we say the federal government didn't know what to do, that's not necessarily true. There are protocols in place in case of something like this happening. They just did not activate them. Right?

Raul : I think that whether it's a national security risk and this comes from my veteran days or whether it's a pandemic, what we saw in New York, what we're seeing right now, from my perspective is the closest that I will ever be in a conflict situation. Much like Iraq. Right? I think what is more distressing for me was in New York and continues to be here in Washington is to see the city boarded up and people afraid for their safety and the economy in shambles and in New York we had almost two million unemployed in three months. It was just a tsunami.

Raul : I think that we really need to come together as a country. Again, no political statement, it's just fact. I'm speaking as a public health physician. We need everyone to do their part to make sure that we'll come through out of this.

Erik : As a public health expert, was that a surprise? I mean, I have to say, I feel like I'm a pretty smart person and somebody was like, "I think we're going to go into quarantine" and I'm like, "No way. I don't think it's going to happen." Maybe I was in denial. Was it a surprise to you, as an expert, or were you thinking, "This is something that could happen in America"? Was it an easy decision to make some of those hard decisions? Because you're like, "Hey, the science backs up what we need to do." Was it a torturous decision?

Raul : That's a very astute question, Erik. In my career, I have often found that you always want to have as much information as you can in order to make decisions. Never have I had all the information I needed or I thought I needed to make decisions and so at some point, you just have to pull the trigger and be able to understand the risks and how to handle risks if they appear. That's one side.

Raul : Decisions are not easy, never easy, and in this case were even more difficult but at some point you have to make a decision. I think the one thing that was so different for me this time around was that we were literally going 24/7 with the mayor and the senior team and I learned what it was like to shutdown the entire economy of the largest city in the country industry by industry. You know?

Raul : First, it was non-essential and then it was the restaurants and then, at the very end with a lot of pain, were the schools. We knew that, at least for New York City, schools are the nerve center of all activity, not because of only the kids but the parents. There is 1.1 million kids in the public school system in New York City. More than 150,000 live in shelters and go from shelters to school and the only meals they get are those meals they get at school. We needed to create a whole system of come and pick up your meal because, otherwise, those kids would be completely starving.

Raul : The second part to your question, Erik, is it's humbling to understand in your gut that your decisions can leave someone with no job or stranded with no help and, at the same time, you're forced to do that and to do that in the absence of complete science that tells you exactly that you're right is also unethical. It brings up your ethical frames and that's when you realize I think what people are made of when you try to say, "Hey, is it only me or is it everyone around me?"

Raul : Sorry for the long answer but the last thing, Erik, is I was born and raised in Mexico and I think when you have an experience of what could happen in developing countries, you know that things can happen. I think we, in our country, don't believe it can happen to us. You alluded to that. You were not the only one who was in denial. I was in denial.

Erik : Right.

Raul : We were all thinking all these other countries are a mess but we're not ever going to get there. You have to, at some point, believe that it could happen here and without being alarmist, right? The conditions that are created by this or any pandemic, shattering the economy, creating much bigger differences between the privileged and the people who are completely at the other end, in other countries, can create and have created revolutions, right? Unrest, minimum. That's what's happening now.

Raul : If we could have had this interview in April or May I was already looking ahead at what is the consequence when we're coming out and people are beginning to look at the rest of life and, all of a sudden, exactly what happened. You know? Riots, the differences of our country. Instead of getting those together to say, "Boy, we just had an earthquake, how do we help each other?" No, everybody kind of went to their corner and I think that that is what is most dangerous for our country right now.

Erik : Yeah. When you're backed up against the wall and you're stressed out, that's when crazy things happen. You and I have a connection with Nepal from all the mountains that I've climbed in the Himalaya. When they put Katmandu into lockdown, it's different ... It's more dramatic I think than America because there's so many people who are just on the edge of hunger and you lock people down and you put them in their houses, well, some of them don't have houses but some of them if you put them in their house, they have no way to make an income and they're starving to death in their house.

Erik : Every action has a reaction. When New York went into quarantine, you must have really had to go to work now like thinking, "Okay, how do we solve all the reactions that are going to take place as a result of this decision?" Like with the vets who are already feeling isolated and, as you said, kids who are food deprived and so forth.

Raul : We also got a reminder of how connected we are to each other.

Erik : Right.

Raul : Particularly, New York. There is nothing you can do. You can live on Park Avenue or you can live in the Bronx. You are connected. You had a choice. You either come in and try to help one another or you just say, "This is not my problem" and you go to a corner. The interesting thing is that even if you try to go to a corner, you're still not going to be an island all to yourself.

Raul : I have vivid memories of all my work with veterans and how, particularly, the work that you do, David, helps because others rally to help one person that is going through a new adaptation for a disability or for a challenge. Right?

Raul : I thought you build resilience and I, sadly, saw that the majority of Americans may not necessarily know or practice resilience and I think for the foreseeable future part of the remedy that I see is resilience type of programs, like the ones that barriers has, will be very beneficial. As you and I corresponded, David, it's worked for veterans but it doesn't mean that it could not work for other groups. I would not offer it to a city. I would offer it to specific groups. Right? To children, to people in different industries, and more importantly, it's really how do you help others by also building your internal strength on how to overcome adversity? Erik, you are a great example of that.

Raul : In fact, probably most people don't even think of you as having any limitations. I think that those kinds of examples are missing right now. We're getting lost in, sadly, the political moment, very important, historic, but I think we're forgetting the humanity in all of this.

Dave : Raul, you mentioned, the veteran work that we do and that you've done. We've been very concerned about the veterans that we serve, because we know that they are prone to isolation and suicidal tendencies and already have a lot of mental health issues and so we've been very concerned about how in these times we can support them and support their ability to build community and to build a resilience in their mental health. Can you talk to us about what you know from your work as it relates to the veteran community and how we might be able to support them in this particular time?

Raul : Looking at the silver linings, and we always should look for what is the positive side of any catastrophe. All of this has actually brought us together in a virtual way, in which now people can visit and be with one another that way. Is that perfect? No. Does that substitute the human touch? Never, from my perspective, as a doctor. Can we adjust in the coming months and years to be connected through apps or this type of media with people who are at risk, particularly, veterans, who in isolation tend to go the wrong way? Right?

Raul : I'm still very connected with a program that helps veterans with substance use disorder and that model has a meditation component, the medication, and the trick of that is that it's a one-stop shop. You bring all the services to the veteran. I think that what I know about what you do with Barriers USA is that kind of a model. You bring a veteran into a new family, if you will, and I think that's what people need right now. People need to feel that they're part of a community, even virtual, that they're part of a family. It may not be their own ...

Raul : By the way, that's the last thing I will say on this, another silver lining, I saw so many families forced to spend time together. Now telling me so many times how happy they are because they were all able to bunker down and they brought their kids from college and everybody was just at home and they felt safe and helpful to each other. Beautiful stories.

Raul : At the same time, there were the other families who probably already had issues to deal with that either were able to resolve them by being forced to be together or they just realized that there's something there they just couldn't resolve.

Raul : I think that we've never been forced in America to actually quarantine this way since 1918. You know? The Spanish Flu. This whole new ... In my mind, our life will never be the same. We are into the history will be written with the pre-COVID way of doing things in America and the way things are going to be after this. I do hope that hugs come back. I do hope that gatherings with family and friends come back. I hope that bigger gatherings come back but I think that they should happen at the right time. Vaccine, all of that.

Raul : I hope that we keep this considerations for our fellow Americans and wear the mask even longer than needed and be more considerate in washing our hands and cleaning surfaces when we use. Right now it's just about adapting and I think if nothing else, I am fully confident of if not the resilience, the persistence, the stubbornness, and the adaptability of our country. Truly.

Erik : Yeah.

Raul : We'll be okay.

Erik : I agree. Yeah.

Dave : I'd love to get your advice for ... I think, in your case, the story you told about what you went through in New York City and the 24/7 work to just try to solve constantly every problem that was coming your way, I think on a smaller scale, many of our listeners have dealt with that, whether they've lost their job or they've had to cut positions at their businesses, I think a lot of us have gone through these ebbs and flows of 24/7 trying to figure things out in our own lives and manage the ever-changing landscape. How do you recommend people take care of themselves, their own personal health, in the midst of all this kind of really intense things that are happening to us?

Raul : David, I guess that's probably the biggest challenge we'll have as individuals and members of families, right? First of all, I think for those who have lost jobs or loved ones, I think, number one, my heart goes to them because it is not of their own doing. At the end of the day, I'm speaking as a physician.

Raul : I think this may be a reminder that we all have to take care of ourselves, trying to, again, eat well, have good hygiene and try to actually protect our physical presence as much as our mental resilience. I think meditation, even in the form of prayer, in some cases, for people who believe in a certain belief, really need to internalize that resilience.

Raul : You know, there are three areas in mental health that we often refer to as the three pillars of someone's wellbeing, one is family, the other one is career, and the other one is self. I think that we all have to figure out how to have one of those three stable at any point in time so we use it as the linchpin, the rock, for when the other two are very fluid.

Raul : Which one can you rely the most on? I will say self but I think, in some cases, when any of us as human beings get a weak moment, your family or your career, internalizing the form of passion, your passion to serve, your passion to have consequences on something meaningful, will sustain you.

Raul : A long way of answering your question, David, I do believe that paying attention to that mix can help all of us kind of get through one of the toughest moments in probably some of our lives.

Erik : Raul, what about medical professionals? You know, I know that there's incredible training that goes on with being a doctor or a nurse or a first responder but we're all only human. Do you worry about doctors and nurses and first responders?

Raul : I do. I worry about them daily. We are seeing that a lot of them are reaching a burnout point. We thought that we would have the ability to give them a break before a resurgence and you all have seen that just when they can actually take a little break then, all of a sudden, we're all the way up again. There's no question, Erik. I think we're going to see PTSD out of this, the same way we're seeing for veterans coming out of multiple deployments. I think it's just a hammering of the same intense feeling.

Raul : I can also tell you, in 30 years of my career, I can go back to AIDS and what it was like and what it is now. Even for me, I cannot really watch a movie that relates to AIDS. It's just too much of a reminder and I want to believe that we conquered that and then we are addressing mental health issues. I think 20 years ago, they were so stigmatized that we wouldn't even be able to talk about them.

Raul : I have great hopes that, indeed, this generation is going to be skittish and harmed by the memory of COVID but we're going to put it in the past like we have conquered other challenges and I'm fully confident of that.

Erik : Because you brought up AIDS, now you were instrumental in creating the policies around AIDS and attacking that challenge in New York. Were there a lot of differences or similarities between the AIDS crisis and the COVID crisis? Was there any overlap?

Raul : I found it fascinating and sad that as we were navigating through the lack of knowledge, some of the stigma, very much like AIDS, started popping up. "Oh, well, if Blacks and Latinos seem to have more predisposition I don't want them in my store" or, "I don't want them in my Uber" and then I started seeing signs of discrimination.

Raul : I started seeing that division that I experienced during the AIDS crisis of if you get it, that means that you are tainted and bad and you are not doing the right thing or you must deserve it, like it was in some point at the beginning of the AIDS epidemic, right?

Raul : Obviously, yes, as a public health professional, that worries me because it's there. It's latent in our human behavior and I think what I want is to promote more the other side of it doesn't matter how you got it, I'm here to help, and we're going to figure this out together as a community, as a country.

Erik : Raul, do you mind if I ask a more personal question? I've learned that our work and our lives are so intricately connected. A lot of us, there's no way to separate our life and our work, the two impact each other. I understand that you are gay and you are also an immigrant. Does that affect your approach to life, your approach to people, to empathy, to the work that you got into, to the map that you use to navigate your life and the world?

Raul : I suppose it does. I've never thought about it that way. I think that it makes me maybe a little bit more tolerant of differences, not only being gay but an immigrant. Also, because I spent 10 years of my life working for Pfizer and Merck and I went to 145 countries doing a lot of work on more research for how doctors can work with patients better. It was not so much about product. It was more about the patient/physician relationship.

Raul : Honestly, I think sometimes I wish Americans of all kinds were more exposed to one another. What unites us is probably bigger than our differences, right? Yes, it is important who you are, Erik, it is important who you are. The fact that you are blind defines you in many ways but at the end of the day, I think that depending on what we're doing, there's a mission out there that is bigger than us.

Raul : I often tell people who are immigrants, Latinos, other gay men who come and ask for mentorship, at some point, if you're going to serve others in any way, you have to give up a little bit of who you are. It's not only about your self-definition and that being the end all. The whole point is if you're going to help others, try to understand them and try to learn from them.

Raul : It may sound too Pollyanna-ish but I sometimes think that the diversity we should be looking for is in thinking, in approaches, in ... For some reason, we don't have a label for that yet. When I came into the VA, it was like for me to walk into another country, a different language, different codes, different way of succeeding or what success was defined, how success was defined.

Raul : Think about what you do, Erik. I wouldn't even know how to understand the beauty of your world if I don't put myself in your hands when I walk in there and say, "Erik, show me why you're so passionate about what you do." Right? It shouldn't be because of you're only thinking about yourself. I've read your book. I follow what you've done for so long with admiration. Same as David and what he has created and continues with Barriers USA. I still kick myself for not going to Antarctica with you and Prince Harry.

Dave : That's right.

Raul : I think that we have forgotten on how to define ourselves through others and our actions on behalf of others. I think we are promoting more and more self-definition as the end all. I think it's important but I don't think it's, at least in my case, what has driven me through my life.

Erik : Well, thank you. That's a great answer. Excellent. Very wise I think.

Raul : It's the gray hair.

Dave : We really appreciate, Raul, your time today and your wisdom that you've shared with us and our listeners and your lifetime of service. Thank you so much for being a part of our community.

Raul : Thank you. Thank you, both. Erik, good luck.

Erik : Thank you.

Raul : Keep hiking. I think it's the best medicine for COVID. Honestly, your state of mind is the most important healing mechanism against disease all around. All around. There is a lot of research on how your mental state, particularly, stress, can trigger conditions like cancer or autoimmune diseases.

Erik : Right.

Raul : Again, I think before you reach for the pills, I think you should reach for the hills.

Erik : Wow. Did you just make that up?

Raul : I think I just did.

Erik : That's amazing.

Raul : Honestly, that is much better medicine.

Erik : I'm going to have to steal that, Raul.

Raul : All right. All yours.

Erik : All right. Yeah. Next thing you see on social media will be a quote from Erik Weihenmayer, don't reach for the pills, reach for the hills.

Dave : Get it all over the website. Yeah.

Raul : Exactly. Well, thank you, both.

Dave : [crosstalk 00:42:00]. Thanks, Erik. It's been a great conversation. We really appreciate it.

Dave : Erik, that was an amazing journey we just went on together.

Erik : He's a beautiful man. I have to say. That's good that there's people like that putting heart and soul into this kind of work, right?

Dave : Oh my goodness.

Erik : I mean, so much of what he said is so powerful but when I asked him whether being gay or being an immigrant, whether that affects his approach to life, I thought his answer was brilliant. I thought that was brilliant. I was really contemplating that as he was talking because, okay, yeah, we all think that our background impacts our work and our approach and how we deal with other people and interact with other people but I really like what he said about in a way, at some point, you have to give up a little bit of who you are to be able to really understand others because it can't be all about you and your traumas or your abilities or your background or your struggles.

Erik : It has to become about them. You have to be able to step into their world and into their shoes. I've never heard somebody express it like that, you have to give up a bit of yourself to really become a fully evolved human being. That was powerful to me.

Dave : Yeah. I really liked what he had to say about how in the midst of great chaos and strife, you try to have some mental sanity and that idea that he expressed of you look to family, career, or self and hope that maybe one of those can be your anchor if the other ones are a mess in the midst of all this going on and how do you create those anchor parts of your life, even though, other parts are in chaos, was a pretty powerful idea.

Erik : For sure. Yeah.

Dave : And, of course, head for the hills instead of the pills. That will come up several times now in the next few weeks.

Erik : That's going to be our new No Barriers [crosstalk 00:44:08].

Dave : Yeah. Yeah.

Erik : All right. Well, Dave, thank you so much. [crosstalk 00:44:14].

Dave : I know it was tough to book that. There was a lot of back and forth so thanks for doing that. I thought he'd be a great guest and he really was.

Pauline : Yeah. He was amazing.

Erik : Pauline, if we're recording, keep your voice in here. Everyone needs to hear the real person behind the scenes.

Dave : Totally. The person who makes this all happen and brings the story [crosstalk 00:44:35].

Erik : Keep Pauline in the recording here.

Pauline : Thanks. Great job, guys.

Erik : Let's hear you say our new slogan, Pauline, to close us out.

Pauline : Reach for the hills before you reach for the pills.

Erik : Okay. Good. Yeah. You're getting there.

Dave : All right, guys. Thank you so much.

Erik : Thanks. Bye bye.

Pauline : Thanks.

Raul : The production team behind this podcast includes senior producer Pauline Shaffer, sound design, editing and mixing by Tyler Cottman,. Special thanks to the Dan Ryan Band for our intro song Guidance. And thanks to all of you for listening. We know that you've got a lot of choices about how you can spend your time and we appreciate you spending it with us. If you enjoy this podcast, we encourage you to subscribe to it, share it, and give us a review. Show notes can be found at No Barriers Podcast dot com.

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