19: Tim Cunningham - Part 1
WELCOME BACK to CIRCLE OF WILLIS, my podcast about science and the scientists who do it. In this episode, I introduce you to TIM CUNNINGHAM, VP for Practice & Innovation at Emory Healthcare, super nice guy, and badass who's given more of himself than you have to the cause of health, well being, and even literal survival.
Here in Part 1 of our interview, we talk about how caregivers and patients endure pandemics like the one we’re going through right now, from a guy who’s been through one before, as a pediatric nurse in Sierra Leone during the Ebola Crisis. Watch for Part 2, coming up in a couple of weeks, where Tim and I talk about the existential and life affirming practice of Clowning, and indeed about how Clowning dovetails with nursing and medicine, especially during times of crisis. Yes, I'm talking about being a literal professional clown. Tim is that, too.
Folks, the Music on Circle of Willis is written and performed by TOM STAUFFER and his band THE NEW DRAKES… For information about how to purchase their music, check the “Music of Circle of Willis” page.
Circle of Willis is Produced by SIVA VAIDHYANATHAN and brought to you by VQR and the Center for Media and Citizenship at the University of Virginia… And that Circle of Willis is a member of the VIRGINIA AUDIO COLLECTIVE! You can find out more about that at Virginia Audio Collective website. Special thanks Circle of Willis Associate Producer GRACE BOYLE, NATHAN MOORE, General Manager and swell guy at WTJU FM in Charlottesville, VA, and tough as nails editor-in-chief PAUL REYES at VQR—otherwise known as the Virginia Quarterly Review, winner of the National Magazine Award for General Excellence, in 2019, and finalist for the same award right here in 2020.
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Tim Cunningham
My title is Vice President of Practice and Innovation for Emory Healthcare, and within that title, I'm the head of nursing education for our 7000 nurses in our health system. Which means when we hire and onboard new nurses, I work with an extraordinary team of folks that provides, you know, up to date training, preparation, skills, trainings, etc. Programs for new graduate nurses, you know, annual programs to onboard them, and work them into our Emory fold. The innovation piece of my title is all related to resilience and resiliency. I was brought down here to look at ways to support, sustain, measure, and build resiliency programs for nurses, physicians, technicians, phlebotomist, anyone that walks into a patient's room, I consider a health care provider. And so a big part of my role is in building partnerships across the system, to support our caregivers so that they can provide compassionate care and the best care they know how.
Jim Coan
Well the international pandemic crisis was the perfect time to step into a role like that.
Tim Cunningham
Maybe so maybe so.
Jim Coan
Hey, guys, it's Jim Coan. Welcome, or perhaps welcome back to Circle of Willis. Some of you might remember that this is my podcast. About science and the scientists who do it brought to you by the generous folks there at VQR, at the Center for Media and Citizenship and WTJU Radio at the University of Virginia, here in fraught and little Charlottesville. Folks, I haven't released an episode of Circle of Willis in a long time and I'm not ashamed to say that the delay involved the recovery from my heart attack a couple of years ago. But it also included a new fellowship that I got that brought me a lot of joy through creative pedagogy, peda-go-gy, pedagogy? I... How do you even say that? I'm 51 I've been doing this for a long time. I don't know how to say that word. And, of course, the 'rona, right? The pandemic or is one of my freshman undergrads put it this fall in a paper, she wrote the goddamn pandemic. I hear you sister. It's been frustrating. That doesn't even factor in the civil unrest, the recent elections and all that Trump clowning we all had to go through. The forest fires in Australia and California, the hurricanes. I don't need to tell you that 2019 and 2020 have been grim. But here I am. I'm getting back on this old horse, because I love it. And I love it because I get to introduce you to people like Tim Cunningham, who's already introduced himself a little bit at the beginning of this podcast recording. So I won't belabor things, but I will say this. Tim is a super nice guy, yes, but also just an unbelievable badass. Very, very few of us have given of ourselves as much as he has in the name of health and well being, and even literal survival. Here in part one of our interview, we talked about how caregivers and patients endure pandemics like the one we're going through right now. And we're going to be learning about this from a guy who's actually been through one before, as a pediatric nurse in Sierra Leone, during the Ebola crisis. So listen up, folks. And while you're doing that, try to imagine me standing here in my little home studio facing you while holding a hand over my heart.
Jim Coan
So, Tim.
Tim Cunningham
Yeah.
Jim Coan
Tell me, what are you up to right now, down there in Atlanta?
Tim Cunningham
So I started working here in Atlanta in August, and right when I thought I was figuring it out, COVID happened. So now it's a complete internal, external restructure of everything. And I'm also, you know, actively practicing everything that I preach, which I'm not always good at doing.
Jim Coan
Yeah, I'm actually I'm hoping to, I'm hoping to get some of your Tim Cunningham vibe into into my world a little bit with this call, because I think I think I could use it, like so many people.
Tim Cunningham
Yeah. Take it with a lot of grains of salt. And with some good espresso, if you like, that makes it work well.
Jim Coan
That's, that's a that's a foregone conclusion.
Tim Cunningham
Yes, so, it's been interesting. I just left a session where I was meeting with clinicians, nurses and patient care technicians, focus group asking them how things are going. I was asked to be a part of this session. And I said, "Well, we also have some psychiatrists available. If you want a psychiatrist to come in for more sort of, quote, unquote, professional support or Western support." And I was asked by a nurse manager, she was like, "Actually, no." She was like, "We want you because you're a nurse, for one. And so you get it at a different level. And two, there's so much stigma around sort of traditional therapy." She was like, "I know, my team needs it, but I'm going to lose more people to this if I bring in a quote unquote therapist," which I thought was really interesting.
Jim Coan
So let me get straight on this. There's stigma against traditional therapy among healthcare workers.
Tim Cunningham
Yeah. Which is ironic, isn't it?
Jim Coan
It is.
Tim Cunningham
And the stigma that I'm witnessing firsthand with the COVID response, and maybe we'll talk about Ebola a little bit too, because they were-
Jim Coan
Absolutely, yeah.
Tim Cunningham
-in that experience, as well. The stigma is more often nurses, technicians, sort of non physician professionals. But I also know a handful of physicians who though they have studied psychiatry, in their medical training, kind of push against it. I think one piece is one of vulnerability. And we as healthcare providers deal with vulnerability in a very different way. We, we need to be vulnerable. The best nurses are the ones that can sit and cry with their patients. And the strongest nurses are the ones who are able to do that, and then are able to walk out of the room and care for themselves enough so they can walk into the next room and laugh with that next patient, if that's what's needed in the space.
Jim Coan
Jeez, that's, that's sounds like a super heroic level of emotional awareness.
Tim Cunningham
Maybe, or maybe it's like, real human connection.
Jim Coan
Yeah.
Tim Cunningham
When I started offering support groups for COVID responders, nurses especially, I would end the conversations with "thank you for your heroic efforts." And I've been told by many nurses, they're like, "We appreciate it. But we're not heroes, we are doing our best at what we are trained to do. And we would rather you save the energy that you're using to call us heroes, and work your magic to get us the protective equipment we need so we can do our job the best." I even have a good nurse friend who just recovered from COVID. I was talking with her on the phone, she had a really scary go with it. She's thankfully doing better. And she was like, "I'm off social media now." She's like, "There's something about this hero narrative" that like it even irritates me now, because she said it made her feel like it distracts her from just being human. And like-
Jim Coan
Yeah.
Tim Cunningham
-that's what's great about nurses like...
Jim Coan
Well, there is- you know, so I used to do therapy with war veterans. And one thing that was, I heard a lot. I- first of all, I heard just basically a lot that people didn't, they found it distasteful to hear themselves being called a hero.
Tim Cunningham
Yeah.
Jim Coan
So I would say that most people that I talked to didn't have an excellent reason for why that was, they would just say they would just react negatively, and we could maybe post talk it in our therapy. But the most articulate among them would say that they held, they felt suddenly denied, just as you're saying, denied their basic humanity. And what that meant when I pressed further, was they wanted to be free to be a competent person, but also to be a little fucked up. And there was nothing to box them in about being regarded in this this heroic way.
Tim Cunningham
That makes so much sense. Because you really don't have the ability to, I mean, you kind of have to be perfect once people start calling you a hero. And then question what you're doing. Is this heroic now? Oh, I've been called a hero. Oh, is this heroic, what I'm doing is this... And yet I think there's a lot of beauty in the hero narrative right now, because I've never been married. I might get married one of these days if I'm lucky, I don't know. But there is a connection because we often talk about, you know, when people have a big wedding, sometimes you're asked the question, "Who are we doing this wedding for? Is this for the families? Is this for the parents to get together and celebrate? Or is it really for the two people uniting in love? And I think we've all been to weddings where it could be one way or the other, you know, and I think the heroism narrative, what I'm seeing now is similar where... Like, people need to do it because it feels good. It feels good to go out on your porch, and bang pots and pans and cheer for people. It feels good to see people coming together to support a united cause. So like to that end, it's, it's so profoundly beautiful. But at the other end, I'm not sure the intended effects are really reaching the folks that it's intended for.
Jim Coan
Yeah, yeah, no, it totally makes sense. And it's actually not the first time I've heard it even about health care workers. I mean, again, I don't want to like you, I think it's a beautiful thing, ultimately, and that it's something that is generally good for everyone. But it is important to be mindful that these heroes, so to speak, they need us.
Tim Cunningham
Yeah.
Jim Coan
They need support. And so we need to think carefully about what that support probably is. And it, it may include cheering and being regarded as heroic, but it certainly can't end there.
Tim Cunningham
Absolutely. And it's that support, what I'm I'm learning from the folks that I'm talking with, is also the knowledge that there are people willing to hold the space for them, whatever that space means or needs. I mean, this is a novel Coronavirus. And everything about it is novel, including the way we respond and react. And we just don't know. And I think in that not knowing some of the best ways that we can support each other is to admit, we don't know, but I will be present with you in this space. And I will do my best to be open to whatever outcomes arise and work with those. So if it's a parade, great, that's kind of more fun. If it's looking at each other for three minutes straight with my hand over my heart, and yours over your heart, which says I want to hug you or hold your hand, but I can't. But my hand over my heart says "I see you, and I'm with you, and I love you." That's something that I learned treating Ebola patients in Sierra Leone, who were on lockdown for two years. Two years in these countries in West Africa. And in Sierra Leone, people started putting their hands over their heart and that replace the handhold, the hug. That replaced the conversation at the mosque, at the church, at the market, in which you're right up in someone's face. You're smelling the like breakfast on their breath. But now we step back and put our hands over our hearts. So maybe that's a way, but like how do we how do we authentically hold space? And I think that's how we can best support.
Jim Coan
Can we pivot a bit and visit Sierra Leone with you? When did you first arrive there? And what are the circumstances when you first arrived there?
Tim Cunningham
So I was finishing my doctoral work in public health. I was working part to full time as an nurse, emergency nurse mostly nights in New York City while getting through school, Ebola hit. And I read a newspaper paper article interviewing a charge nurse, a nurse matron in one of the hospitals in Kenema district, in the New York Times. And basically she was asked what she needed after she talked about what it was like to come to work every day with fewer and fewer of her staff members there because they're all dying of Ebola. And she said "We need people that can hydrate patients. Period. We still don't have a cure for Ebola, we're finally getting closer." I mean, 1975 we first learned about this disease, but we're finally making some progress. And she said "We know that people can survive with nutrition and hydration." And when I read that I'm an emergency nurse. That's what I do all day, I hydrate people. I go to people and like give them fluids. I was like "I think I can do this." So I put pause on my my graduate work and flew to Sierra Leone with an organization called Partners in Health. And my first day, the very first person I met with Ebola was on Christmas Day 2014. And we had a few days of training prior to Christmas in Sierra Leone. We met some survivors. We did some like mock practices in the PPE. But my first day, the very first person I saw with Ebola was a five year old boy on Christmas Day. And the most fucked up thing- can I say fuck on this?
Jim Coan
Yep.
Tim Cunningham
Okay, shit, great. Fuck.
Jim Coan
Piss!
Tim Cunningham
The most fucked up thing about it that still keeps me up at night was he looked completely normal. Like he was a normal, playful five year old child. And everything I'd read, including the hot zone, which is a great work of fiction, but you should probably not read it before you're walking into a pandemic. Everything I had read was, you know, like blood and gore and bleeding and suffering. And so I was mentally ready for that. But when I saw this normal looking child, my heart broke. Because I was like, how, how can this kid be sick, right? Fortunately, he survived.
Jim Coan
Did he get sicker as things went along?
Tim Cunningham
No, he didn't. And that's what's weird about Ebola. Some people spiked a fever, their blood tested positive for Ebola. And then they had a hangout in our Ebola treatment unit surrounded by people dying every single day, and actually getting better and then going home. We saw this in the kids we treated, and adults we treated. It's also a confusing disease. So started late December 2014. I flew home right around Valentine's Day 2015. So spent nine weeks there. And when we arrived, we had about 97 patients in the unit where we were working. We did the calculation for all of our nurses and doctors we had working there. And we were working with folks from the US, from Cuba, from Sierra Leone. We had a patient to provider ratio that allowed us to provide about 20 minutes worth of one on one patient care in a 24 hour period. We had so few providers and so many patients. And if you think about that, like the folks that got sick with Ebola and were treated in the US, they had 30 plus doctors and nurses and specialists from around the world, tending to them one individual with all the equipment and gear 24 hours a day.
Jim Coan
Yeah.
Tim Cunningham
So it was stressful to say the least.
Jim Coan
And by this time, you're, you're actually you're not arriving there at the beginning of the pandemic.
Tim Cunningham
No, no.
Jim Coan
You're you're arriving there, as you said something like two years in, right?
Tim Cunningham
Yes, so about a year in officially in Sierra Leone. And I think our team arrived, right as we are kind of either just on the other side of the peak, or right around the peak in that specific region. Like COVID, we saw peaks and troughs throughout the three worst hit countries. So it was busy, it was not quite as busy as what it had been before. But we did have some really hot, heavy days. And then when our team arrived, more and more providers were getting access to be able to come. So even on the worst days, we had more doctors and nurses, so that kind of ease the workload a little bit.
Jim Coan
And so how are people coping?
Tim Cunningham
The biggest take homes that I learned from that, and I've written on it. And it's something that I'm really trying to impress upon people here with COVID. It seemed that a sense of camaraderie was one of the most influential factors when it came to coping skills and well being.
Jim Coan
And you're talking about among the caregivers.
Tim Cunningham
Yeah, I'm talking about among the caregivers. But I've actually recently learned as I've reached back out to friends in Sierra Leone, as COVID started to hit, that that concept of camaraderie was also shared amongst our national staff, health care workers, dietitians, folks that helped provide environmental services within the ETU Ebola treatment unit. And as well as community members, just because you can't go to the mosque on Fridays, you can still, I mean, this was the dark ages that we only had Skype, but people were still skype-ing, right?
Jim Coan
Yeah.
Tim Cunningham
People were still sitting out in nature, like what we see in some of the parks around the US with safe social distancing. And so it was that sense of people being together. Other things that we did, music, we sang together, we drank together, there was a bar up the road. That's where we would get all the latest CDC information that seemed like those researchers were frequently there as well. So we'd have a beer at the end of a long day. And that got sticky, as you can imagine.
Jim Coan
In what sense? Because you were in close proximity to each other? Or because you were consuming alcohol?
Tim Cunningham
I think it began with like, here's a great way to kind of blow off the end of the day, but I think some of us that maybe struggled a little bit with alcohol, it got the best of us at times as far as overconsumption.
Jim Coan
Yep. Get that.
Tim Cunningham
And that was self care, right? You know?
Jim Coan
Yeah. So, you were mentioning earlier, that people that you were involved in treating, or family members or people that you were involved with treating, had been in isolation from others for long periods of time while they were sick, while they were not sick? How did that go? And how did it, how did that look in comparison to what's going on in, you know, our communities here in the US today?
Tim Cunningham
So in Sierra Leone, the government laid out a rule that they called ABC, which stood for avoid body contact. You'd see it spray painted all over the city, posters, ABC, ABC, which means no hand holding, no hugging, no close communication. Now, folks, like we're seeing in the US, if you live in a family unit, of course, you're in close communication with that family unit. And so people were encouraged to stay separate, but you can't stay so separate from your family. As people would get sick, there was extraordinary contact tracing going on. And we're finally way behind the curve in this country rolling that out more robustly. I know, Partners in Health is doing some extraordinary work in the state of Massachusetts right now.
Jim Coan
Yeah.
Tim Cunningham
The contract tracing that was going on in the Western African countries was inspiring. So someone would get sick, show symptoms, come to an Ebola treatment unit. There would be social workers there at the treatment unit who would ask the person who their contacts were, then that person would reach out to family members, asked the family from that home to quarantine, sometimes it had to be military enforced, which meant food had to be delivered other community members would bring food to families and support families that way. So you'd have sort of locked ins in quarantine. Quarantine for Ebola is 21 days based on the transmission of the disease. And so people would be monitored for 21 days, if someone else got sick, then those contacts would be traced and spread out throughout. So there were no police saying "you're too close to each other, you have to stay apart." But it became a part of the culture where we just got used to staying apart from each other. And something that I keep reflecting on, right? We've only been in this for a month or two.
Jim Coan
Yeah.
Tim Cunningham
And these community members where this ABC was enforced were told to be done for a two year period.
Jim Coan
And there's every possibility that we're in for the same kind of thing.
Tim Cunningham
And I think we should.
Jim Coan
Yeah.
Tim Cunningham
I mean, look how bad Ebola was in the West African countries that were worst hit. Look at the DRC Congo. And we know Ebola is way less contagious, although it's more deadly. But look at the contagion of COVID. I think we really, we have to stay separated at least until we get a vaccine. And even after that, we got to make sure it works.
Jim Coan
How did the folks in Sierra Leone cope with that separation other than I mean, what you know, you mentioned earlier, sort of practice of visually, placing a hand on a heart and expressing things as best one can without actually touching or holding hands or anything like that.
Tim Cunningham
So that the hand of the heart was a really meaningful, beautiful gesture that we saw. And when we landed as expats, we are all encouraged by our Sierra Leone, Sierra Leonean colleagues, to start doing that. I remember a gentleman that we would walk to and from our treatment unit. So that was another form of self care, we, we were stationed about two kilometers away from the treatment unit, we had a driver who would take us but we had an option to walk. And so we would walk. And this gentleman had survived Ebola in our treatment center, he was super sick, and he was discharged before my team had arrived. But you know, we learned stories of past patients. This guy had one arm, because he survived the Civil War. And during the Sierra Leone Civil War, one of the tools of torture was called sleeving, right? where people would have their, their wrist cut off, or their, or their arm cut off at the elbow. They would literally be rounded up, and they would be given an option, a long sleeve or short sleeve. And so he was missing one arm and with his good arm every single day, when we walked by, he came out to his front yard, and he put his hand over his heart. And I think about the, sorry.
Jim Coan
It's alright.
Tim Cunningham
-about the firefighters, I think about, I think about the folks coming out in their their balconies and cheering for care providers. Like this guy was that in 2015.
Jim Coan
Yeah.
Tim Cunningham
An army of one, but representing what the world is doing now. And he would encourage his kids to come out and his kids are kids kids were playing, you would see parents constantly trying to keep kids separate, but like he can only do so much with kids.
Jim Coan
Yeah, that's right. And kids are really taken a lot of the brunt of these kinds of things.
Tim Cunningham
So much, yeah. And knowing that they need that level of contact. So you would often hear the voices of loving parents, scolding their kids to kind of separate a little bit, you know, kind of a lost cause. Hands over hearts. And you would... you would hear people yelling at each other across the street from house to house. Which was kind of a beautiful sound, because it was kind of acknowledging we can't get any closer. But we still want to know what's going on with our neighbors.
Jim Coan
Yes, yes.
Tim Cunningham
So like, amplification of sound is like song almost.
Jim Coan
Indeed. And I've been doing it myself. I put a, I put a little table- we, my wife Kat and I made a little victory garden. And we transformed our front lawn into a garden. I should say she did, while I scandalously am watching but, but I did put out a little table and chairs out there. And I like to sit out there in the mornings and in the evenings, in the mornings with a cup of coffee in the evenings with a glass of wine. And I troll for social contact. Like I'm a living "Will you be my friend sign?" And people are happy to oblige.
Tim Cunningham
Yeah. Something that I think came up in Sierra Leone, and I think is coming up here too, is the recognition of the intense need for connection that I think we've muted with social media. Like we, like I feel connected because I got 20 likes on my last post.
Jim Coan
Right.
Tim Cunningham
You know?
Jim Coan
Yes, we think of it in my lab as as the equivalent of having eaten 20 Doritos. Now I feel sated.
Tim Cunningham
Yeah, right?
Jim Coan
When you are in Sierra Leone, and we'll get back to the US again pretty soon, and you were exhausted, you would go grab a drink with colleagues and that got a little dicey at times. But what that really reflects is your need as a human being for relief.
Tim Cunningham
Yeah.
Jim Coan
And what I wonder is, what did you... what were some of the options for that? And given how shy ironically, caregivers can be about seeking out therapy? What do people, what do people do for each other? And how did people seek help?
Tim Cunningham
A couple of things. One thing that I found incredibly helpful, and this was taught to me by a father of a kid, two of his children were in our unit. So in our unit, we had a suspect ward, and a confirmed ward. And within each of those two areas were multiple wards inside so we could you know, that hundreds of people. But if you had symptoms of Ebola, you would go to our suspect ward, your blood would be drawn, then it would take two to four days to get the blood results back to say whether you had Ebola or not. So in that sort of interim period, you had to stay within the treatment unit, but away from all the people that we knew who had Ebola, so you didn't possibly get infected.
Jim Coan
Right.
Tim Cunningham
Then when your blood results came back, if you were positive, you'd go to our confirmed ward, where if you were negative, you'd go back home. We had a bench outside of our suspect ward, underneath this beautiful old mango tree, there was a little shelter over the bench. And there were two fences, each three meters apart, but they were see through, they were like chain link or plastic sort of that plastic link fence you see and all the MSF, Doctors Without Borders, images. And one day I was walking home from work and I saw a guy sitting there at the bench. And I don't even know why I went over there because I was exhausted. I was, I was done. I was beat. But I don't know, so I went over and I asked if I could sit next to him. And he said, Yeah, we sat from a distance. And I looked and he was facing off with his two kids who are on the other side of the fence, holding hands, waiting for their blood results. And the guy told me, he said, "I'm a local teacher here, you know, the school shutdown really early in this pandemic. So I don't, I don't have have work. And both my kids spiked a fever yesterday. So I brought them here because I know that's the right thing to do." And as we were talking he told me about from sunup to sundown, he sat on that bench, telling his kids to drink water, to eat food, to listen to the nurses and the doctors, take whatever medicine they give them and stay next to each other. And he literally created this mantra, over and over, and the kids were nodding, you could see they were scared. And he shared that with me. And then we talked about something and then all of us laughed about something I can't remember what and then I left. And he took care of me in this way that I don't even have words for. But I think part of it as caregivers was communicating with people who were not lying on the stretcher or dying of this horrible disease. Knowing that it's still okay to communicate with other people, outside of our colleagues and outside of our patients. So the ability to hear his story, I think that brought a big sense of of healing to me. And also connection among providers. When I came home I had to go to court, I was living in New York City at the time, was in a 750 square foot apartment in Midtown, New York. And the rules at the time were you go in you go into quarantine. And you don't leave for 21 days. No matter what, even my plumbing broke. At one point my shower didn't work. And my landlord wouldn't come fix it because he was afraid that I was going to make him sick because there's so much fear. So the state of New York, I called them and I was like, I don't have a shower that works. The state of New York delivered me a bucket. They brought it to my door. So I could take bucket showers.
Jim Coan
So many layers of symbolism there.
Tim Cunningham
Yeah, right. And they're like, "we're so proud of you, hero. Thanks for all you've done. Here's a bucket."
Jim Coan
Here's a bucket.
Tim Cunningham
And one thing that I had asked for, as a pediatric nurse, our survival rate for children was 20%.
Jim Coan
God.
Tim Cunningham
There was so much-
Jim Coan
God. Are you...
Tim Cunningham
Yeah.
Jim Coan
I can't even fathom that.
Tim Cunningham
It was really bad. It was really bad. So I told the state of New York who was putting me in quarantine, I said, I'm a runner. And I know that for me moving my body helps me heal. And so one of the reasons I walked with the teams back and forth, like we were able to do that every now and then some of my colleagues and I would have energy and we go for a run safely distancing through the community where we were staying. So I told the state I was like, I'm a runner, I live near Central Park. Can you give me a waiver to let me break quarantine from, I don't care 2am to 4am every day, I'll go run alone in Central Park. No one's gonna be out there. And that way I can take care of myself and be safe and the state was like "nope, you're you're a threat to the health of the public. Not going to happen" and then they're like, "but we will give you a therapist for free and they will Skype in, you know, as much as you need."
Jim Coan
And therapist will run for you.
Tim Cunningham
Exactly, right? They will brag about how good their running is, because they're, they're talking with all these people who are in quarantine.
Jim Coan
It's just this amazing spring day out here.
Tim Cunningham
Yeah, totally Oh, if you could only smell the air.
Jim Coan
Yeah.
Tim Cunningham
And so I graciously are not so graciously turned that down. But then my colleagues that I worked with, we set up this sort of Skype communication where, if any of my colleagues called at any time, and my phone was on 24/7, I would drop everything and pick up to have a conversation with them. And the same they would do for me, and there's still some folks that I have that connection with. I've never done well, with Western therapy, I've fired a lot of therapists or they fired me. But so that-
Jim Coan
Same.
Tim Cunningham
That's, that's why we get along Jim. The connection with my colleagues, that way, has been the most meaningful and has prevented me from making choices in my life that I would have regretted severely.
Jim Coan
You're a special person, though, Tim, you're a special person. And I want to, I want to suggest to you that one of the ways in which you are special is that you are uniquely capable of being vulnerable. And I really do think that, think of that as an ability, like a capability. That some people can yield their own efforts in response to someone else's offer of help. And that's, that's a unique place to be for a lot of us, especially a lot of Americans, where we are supposed to be so individually capable. But you know, you're really quite capable of doing that. And I'm not sure that being vulnerable is the same thing as accepting help, but I think it invites the possibility because it invites bonding, and at the very least bonding, and open communication and authentic connection is salubrious. I'll use the GRE word. It's helped people, right? It's nice.
Tim Cunningham
Yeah.
Jim Coan
And so, you know, one of the things that I've been telling people, to the extent that I can give any kind of advice in this situation is to embrace vulnerability whenever they can. Because that will, that's just sort of sets the stage for an authentic personal contact with somebody.
Tim Cunningham
Yeah, I think you're absolutely right with that, Jim. And I would almost suggest adding to that, or at least in my opinion, micro dosing vulnerability.
Jim Coan
Micro dosing vulnerability, fascinating. What do you what do you mean?
Tim Cunningham
So Ebola, my experience working with people who are affected by Ebola, radically changed my vulnerability. Before I was a nurse, I was a professional actor. And in my acting training, vulnerability is key because you're never going to connect with an audience if you're not vulnerable. So I had some like, non real life theater training, and was able to kind of tap into that when I was feeling it come up treating Ebola patients. Prior to Ebola, I was not as vulnerable as I am now. And I think as we look at casting a supportive net, for all of us, because we're all affected by COVID. If we can help folks recognize when they're having a micro vulnerable experience, that's that micro dose, if we can support that not be like, "hey, yeah, high five, you're vulnerable now good for you. Let's blast this on social media," because that's going to shut them down even more. But if we can help people recognize that, I'm afraid that when we say the "V" word, many people think if I need to be vulnerable, that means I need to sob for days.
Jim Coan
Yeah, right, right, right.
Tim Cunningham
And everything fall apart. Like that's not- I mean, that's a form.
Jim Coan
Yes.
Tim Cunningham
But what are those little elements of it? And can we sort of when we see them, and others support them and say, "yeah, that's, that's okay. That's great. I still love you," you know? And let vulnerability be nurtured maybe.
Jim Coan
Yes, I love this idea, the microdosing vulnerability because one of the reasons that people avoid vulnerability, of course, is that there's this perception, there's this fear that if they open the door, a crack, it'll open up all the way and then they're just going to be non functional for a month, because they, you know, fall on the ground and sob and-
Tim Cunningham
Yeah.
Jim Coan
-they're, you know, it can feel that way. I have felt that way, in the last few weeks. A couple times.
Tim Cunningham
Yeah.
Jim Coan
And I'm not going through, you know, anything near what people like you and people that are, you know, actually in the hospitals working with patients right now are going through. And so that those-those micro doses that they're like, it's It reminds me a little bit of the vulnerability analogue of small talk. Small talk, people small talk gets a bad rap. But smack talk is not a bad thing. It's actually, one of my students described it as a kind of a net that catches you when you're walking through, you know, making your way through the social world, not knowing what to do. And it just provides this this supportive fabric. And I also think of humor. And I want to talk about the fact that you're a clown.
Jim Coan
Okay, that's it. Thanks to Tim Cunningham for an unusually candid and sensitive conversation, given how public he knew it would be. And thanks, also to you, the listener for forgiving our audio quality, as we adjust to the realities of podcasting in the age of social distancing. Also, watch for part two coming up in a couple of weeks, maybe. Maybe sooner. Where Tim and I talk about the existential and life affirming practice of clowning, and indeed about how clowning dovetails with nursing and medicine, especially during times of crisis. Yes, yes, folks you heard that right. I am talking about clowning. I'm using the word clown. To c l o w n. What is this all about? Well, you'll have to wait to part two to find out.
Unknown Speaker
Folks, the music on Circle of Willis was written and performed by Tom Stauffer and his band the New Drake's. For information on how to purchase his music, check the about page at circleofwillis podcast.com. That circleofwillis podcast.com. Circle of Willis is also produced by Siva Vaidhyanathan and brought to you by VQR and the Center for Media and Citizenship at the University of Virginia. And Circle of Willis is a member of the Virginia audio collective. You can find out more about that at virginia audio dot O R G. That's virginiaaudio.org. Special thanks to Nathan Moore, General Manager and swell guy at WTJU FM in Charlottesville, Virginia. Tough as nails editor in chief Paul Reyes at VQR, and Lulu Miller, plucky genius, co founder of the podcast invisibilia, co host of radio lab and author of "Why Fish Don't Exist." Story of loss, love, and the hidden order of life, which you can find wherever you go to get your books. If you like this podcast, how about giving us a little review at iTunes and letting us know how we're doing? It's super easy and we like it. Or send us an email by going to circleofwillis podcast.com and clicking on the Contact tab. Alright? Until next time, bye bye