Put Up Or Shutdown

And here in America, our government remains shut down. This is America Dissected. I'm your host, Dr. Abdul El-Sayed for the second to last time. And I'm your co-host, Dr. Caitlin Jettelina. I'm recording this on Wednesday, October 8th at 11 a.m. Eastern time. Caitlin, why are you right now? Hello from Berkeley, Northern California. How about you? You're somewhere. Yeah, I'm in Washington, D.C. occupied D.C. where the government is shut down. Everyone said. I'll be there next week. Caitlin, second to last time. The next time we do this, we are actually going to be live in D.C. And yeah, I'm looking forward to sharing some retrospectives of the show over the past five years together. So I really appreciate you making it what it's been over the last year or so. Yeah, what a wild ride for the past five years. I know. Yeah. Got to help us. All right. Let's kick off with things happening here where I am, this government shut down. We're on the eighth day. Democrats are holding the line demanding that Republicans extend subsidies to the Affordable Care Act. So for folks who don't understand what's at, at risk here. In the big ugly bill, there were a lot of slashes to pay for this gigantic tax cut that included subsidies for Affordable Care Act premiums. Now, that means that if this continuing budget was to pass, a lot of folks would watch their premiums more than double. And the hard part about this is that it doesn't actually have to happen. There's budgets an abomination for everyday folks, especially considering more and more people, particularly after COVID, 24 million people, to be exact, by the their insurance through the Affordable Care Act marketplace. And, you know, the big problem here is that if folks get priced out of health care, their only opportunity is in the emergency room, which means that that care gets redistributed across the rest of the system, which creates this vicious cycle. And it's really, really important to make sure that, A, folks can afford their health care, and B, that our health care doesn't unzip in this particular way. Kaelin, I know that you've been thinking a lot about what this means for the public health community. Yeah, so about... I don't know, 40 to 75% of the federal workforce is furloughed across health and human services, just depending on what arm they're in, right? A CDC, FDA, NIH. A lot of these federal employees are also embedded in state and local health departments. One state health department I was talking to has more than 100 federal employees that are now just stopped. And like that... obviously really impacts public health services and can definitely start impacting Americans on the ground. And so I've been really trying to think through like what is being felt now. And of course, the longer this goes out and it doesn't really look like there's much end in sight how much these gaps are become widened. Most immediately, data is impacted. A lot of federal dashboards are paused. Wastewater isn't being updated except for measles, for example. Telehealth for Medicare, this was huge. This was a pandemic era role that allowed Medicare patients to see doctors from home, and that expired.

This is going to remain unavailable unless Congress includes it in the next spending bill, really cutting off access for many homebound seniors, especially in rural areas. And delay right now, like immediate delays in health care help, right? Like if you're a Medicare or Medicaid and call and have a question about your coverage, you can just expect longer wait times and probably maybe delays in your care. Next immediate is WIC, which is women, infants, and children. This provides foods and formulas to. more than 7 million women and children across the United States. They have funding to operate for about two more weeks. So hopefully this doesn't go beyond two more weeks. And then what is also safe through October, but if this continues through November, SNAP benefits and payouts for SNAP as well as federally funded school lunches may be dramatically impacted because a lot of these programs just don't have the runway and the cash to just keep these afloat while the government is shut down. So I don't know, you know, I think bottom line, the longer this continues, the wider. the problems are going to get, you know, missed outbreaks, delayed guidance, et cetera. And I think it is in everyone's interest to really get this moving and get this government working again. Abdul, I know that state and local health departments are open, but you have run a county health department wondering how these funding streams. can change if the shutdown goes on for, say, another month or two. Yeah, to your point, Kailen, you think about one of the big programs that we operated in Wayne County as WIC. Right. And so you're already talking about operations that are potentially slowly trickling to a pause in local health departments. And then a lot of the other funding, you think about things like vaccines for children. You think about the Ryan White HIV program. These are federally funded programs. whose lines have the risk of running out over time. And so right now, a lot of health departments are likely scrambling to say, okay, how long can we potentially bridge via other sources of funding? What do we do if we need to pause? Is there a smaller version of a program that we could run that we could sustain and keep open? How do we reach out to local communities to let them know what the risks are and what the situation is? And the hard part, right, is that our federalized system of government relies on federal government, state government, and local governments all.

working together interrelatedly. And so when one shuts down, the impact is felt everywhere else. And, you know, the other hard part about this is there's a lot of guidance that you have to get, right, in terms of programs that, frankly, have been hurt since the doging of the federal government in the first place, guidance that doesn't get done. And you're still held accountable to your timelines, et cetera, even if you have nobody to talk to. So that's the other big risk that I'm sure health directors across the country are worried about right now. So. How long do we think this goes? I honestly have, I don't know. I feel like you would know better, Abdul. So the last time this happened, it was, what, more than a month? Has it been ever longer than that? Yes. And the worry I have is that nobody seems to have an incentive to end it. Like, they're talking about talking right now. And so there's not really the idea of a deal on the table and things are going to continue to get worse. And worse than that even is that Trump has empowered Russ Vought, who is his own B director, to in effect just make it worse, make it harder on federal employees. And so it may not just be that like you turn the government back on again and everything's back to what it was, but that in the silence of the shutdown, that things are even worse than they had been before. And that really is the big worry I have. coming out of this people are going to just start feeling it i mean i guess right i i think that's one of the only ways that we can get kick congress's butt to move forward and that's the sad reality i guess And that's the thing about it. It's like government does things for you. And when it shuts down, it's really bad. And at the same time, if the current budget is going to destroy health care access for 24 million people, we need movement on a budget that doesn't do that. And frankly, you would think it would be in the Trump administration's best interest not to let people's health care spike. But, you know, who am I to say? All right. So moving on, we got some vaccine news this week. The CDC formally approved last month's ASIP recommendations. We've talked a lot about this, but just to reiterate, they recommended the chickenpox vaccine be given separately from MMR, which is measles, mumps, and rebella. And there's no longer a blanket recommendation for all seniors for COVID-19 and said they want seniors to discuss it with their doctor. It took a minute for the CDC to quote sign off on these recommendations. Where do we go from here, Caitlin? Yeah, I mean, first of all, like finally, right? After this series of stalled dominoes of the vaccine, fall vaccine rollout, you're right, Monday marked really the last step that CDC's director signed off. And now RSV flu and COVID vaccines are going to be widely available. You know, I... I've been a little disappointed with the headlines that we've seen this week. Like, bottom line is that RSV flu and COVID-19 vaccines are available to a wide swath of people. The CDC recommendation is slightly different than last years. It includes this language called shared clinical decision-making.

And really, it's kind of already, it's not kind of. It's what doctors and pharmacists are already supposed to be doing, right? Empowering Americans to make the best evidence informed decisions. Historically shared clinical decision making has been used for vaccines that. aren't routinely used for everyone or recommended for everyone. So, for example, the HPV for adults vaccine comes to mind with shared clinical decision making. And so I think HHS added this statement for COVID-19 vaccines just to make it seem like they're giving choice back to individuals when they really had it all along. But in practice, This makes little to no difference to the average American. You're going to have a conversation with your doctor or your pharmacist. You may have to sign a document. You'll look at the risk-first benefits and that person gets to make the final decision on whether they want the vaccine or not. So it's like all of America's doctors and pharmacists were waiting for HHS to tell them that they should have clinical decisions or make clinical decisions with their patients. Like, oh, oh, thank you. Now I can actually advise my patients. Yeah, you know, yeah, totally. And that's just such a slight to physicians and pharmacists. I think it's also in the playbook, right, of anti-vaxxers. They've always kind of talked about this informed consent, perceived problem. I will say, though, that, you know, like a lot of people don't feel like they get the best. clinical advice or recommendations from their physicians. Physicians are so strapped for time. They are working in these systems that don't empower them to have really fruitful conversations with their patients. And so, you know, I think that this may bring up a broader conversation of like, how do we actually fix the systems to empower physicians to really meet the needs of patients that some feel like are failing? This is, I don't know, this was more of a slight to me than like actually trying to figure out of fixed systems. You might think that a HHS secretary who actually cared about fixing the system would be thinking about the pernicious ways that health insurers are putting the screws on clinicians reducing the amount of time they have with patients, hospital systems doing the same thing. You might think that that'd be a place to work. But who am I to say? As promised, we have a really great retrospective plan for you in the next segment. We're going to dip into the archives to play some of my favorite moments from the last six years. It's been six years, geez. So stick around through the break. I know. So stick around through the break. You won't want to miss it.

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All right, we're back. So since this is the penultimate episode, we did want to take some time to look back at the last six years of the pod. And look, this has been an absolute privilege to bring to you all. And I'm just so grateful, as I said, to have had Caitlin along for the ride in this last bit here. Caitlin, I know that you've prepared some questions for me. So let's dive right in. I do. All right. Are you ready? Let's go. Start at the beginning. Summer of 2019. That sounds like a lifetime ago. I know. We had no idea a pandemic was coming. Well, I think as epidemiologists always thought a pandemic was coming eventually. But you developed a podcast, Abdul, about public health before a pandemic even arrived. What interesting timing you have. How did that come about? So I had been a guest on Podsafe when I was running for office the first time in 2018 and got to know the guys really appreciated the approach that they were taking and building their company. And I was like, you know, we don't have a podcast about public health. What if we did like a 10 episode limited run series about the key questions at the intersection between science and society? And so reached out to them and they said, all right, pitch us. So I flew out to L.A., pitch them on this idea. You know, the first 10 episodes were these sort of like documentary style podcasts about a critical set of questions, right? The opioid epidemic, the Flint Water Crisis, infant mortality. And I'll share one, you know, just from that first episode about infant mortality, that's really quite personal for me. Just one century ago, 32%, nearly one in three children, died before the age of five. By 1950, thanks to public health improvements, things had gotten slightly better globally, 20%, or 1 in 5. Statistics tell one story, but the lived experience is something completely different. If you've been through it, you know. And if you haven't, I want to take you back in time, just one generation in my own family. My mom made a lot of favorite food, actually. She was amazing cook. Her rice was just amazing, perfect. It felt like eating a cloud. Oh, yeah, it was just like, that one thing I never really mastered as she did. In case you couldn't already tell, that's my father, Dr. Muhammad I Sayyid, Baba Timi. He grew up in a very different time, in a very different place, in 1950s Egypt. At the time, nearly one in four babies died in Egypt before the age of one. My father's family, with its eight children, lived that statistic. Bedria was the first girl mom had, and she was very, very excited. She had her daughter that she always wanted. And when Bedriya was less than a year, I think I got a hoop and cough. And then Badrilla picked it off from me. But she was a baby. My father, three years old at the time, had inadvertently given his baby sister Wuppinkoff. Also called pertussis, whooping cough is a highly contagious bacterial infection of the throat. It suffocates kids. I know she was not doing very well. So my mom...

She took her and went to the hospital and didn't come back without her. And that was the most shocking thing in my life at this point. Before we had a vaccination for it, Whooping Steve Witkoff killed millions of kids, like my aunt, Bedrilla. Upper respiratory infections used to be one of the most common causes of death among children. The other common causes were gastrointestinal infections, things like typhoid fever and cholera. which also came to visit my father's family. Jabber. Yeah, his name was Jabber. And I remember that he could not keep anything inside him. And I remember him actually vomiting on the carpet that we had. And it looked kind of darkish, yellow and gray. And I was a little bit disgusted because I was a little bit older. How old was he? He was also this and a year old. I loved him a lot. He was so handsome boy. And then when he was not doing well, my mom took him to the hospital and my heart started beating. And again, she came back without him. Where he vomited and I was disgusted. I wanted to treasure that and I didn't want anybody to clean it because that's the last thing I had from my brother. You see your mom's suffering and it really affects you tremendously. And it leaves a stamp on your own life. My dad never told me these stories. It's something he doesn't talk about much. And I get it. Even though these stories are devastating, hearing them gives me an appreciation for how far we've come. Today, globally, deaths to babies under the age of one is down to 29 deaths per 1,000 births. That's 2.9%. Down from 10 times as many a century ago. That's pretty remarkable. How did it happen? Public health. And in that clip, right, you're hearing my dad talk about his experience of losing his two siblings before he turned five. I think one of the challenges with... The present moment is we don't necessarily know the stakes of what happens when public health fails because it's been so effective. And, you know, my dad lost two siblings to vaccine preventable diseases before he turned five. His mom lost two babies before, you know, she had her next six or five. And, you know, that's real life. And it doesn't take that long. You know, it's not that long ago in a place that's not really that far away. So I really didn't want to share that with folks. So how did the show change once the pandemic hit? Yeah. Honestly, we had been done with our 10 episode series that ran through, get this November of 2019. And then COVID starts to become a thing. And they call me up and like, hey, can you come on the show and talk a little bit about this? So I remember going on Pod Save the World and being like, oh, the CDC's going to handle this. We should be okay. I was clearly wrong. How did that go? I was just, I mean, like I had expected that, you know, we were going to have this locked down. I didn't really see that this was going to be the big one. I saw, you know, clearly before a lot of folks came to that realization. But, you know, I remember, you know, just December of 2019 having this conversation, being like, look, our public health apparatus handles things like this all the time without us even knowing it. And so they reached out, you know, in February and said, hey, like this one looks like you, you know, are you willing to do?

show about this. So we did a second season that was more in the format that we do right now where, you know, two times a week we checked in on the state of the pandemic and then brought different perspectives on the pandemic, whether it was on mental health or the interaction with the pharmaceutical industry. or the impact on homeless and incarcerated people, you know, solutions in terms of, you know, government investment in basic lives. And got to talk to some folks who were really at the edge of this, including a guy whose voice you probably are all going to recognize. We'll play it here. What keeps you motivated on these long days? You know, I can't imagine you've been doing this almost for six months now. How do you keep your motivation? Well, you know, it really is. You have to be up to the task of the seriousness of the problem. It's so clear that we are in a very difficult situation globally and in the United States. I mean, we're having a massive outbreak. Currently, literally, in the last couple of weeks, we've seen the flare-ups. in the south and southeastern part of the country, you know, four states, California, Arizona, Texas, and Florida are accounting for 52% of all the new cases. So it's really concentrated in an area that we've got to put that fire out. You know, it's unfortunate everybody wants to and needs to understandably try to reopen because we can't stay locked down forever. But as we've seen in the attempts... to reopen, at least in the states that are involved, it hasn't turned out well. We've had surging of cases. Now we have increase in hospitalizations, and then soon we'll be seeing some increases in deaths. Those are the things. We've just got to turn around that trend if we're ever going to successfully open in a way that could get us back to some form of normality. So we're in a very critical period right now. You know, I just, you can't slack off because this is... You know, this is really, it's crunch time now. It's life or death. You know, one of the things as someone who spends a lot of my time thinking about how to communicate complex topics in science and public health is that, you know, we've had this really complex moment where the science is unfolding in real time. We're dealing with a virus that we've never as a species dealt with before. And... The recommendations that we make to people have changed over time. You are a remarkably gifted communicator honed over a long time really thinking about how to communicate these complexities to people. And I want to ask you, you know, what is your process as you think about relaying complex, quickly changing messages to a public that is both scared and frustrated and, you know, in their mind sick of this already? Well. I think the first thing, there are a couple of guidelines that I have used now for decades. And one of the things is that you've got to speak in a way that people can understand what you're talking about. Often, scientists, physicians, you know, health authorities speak in such an archaic way that they confuse the public. You've got to be really very consistent and very, very clear in what your message is.

The other thing is you've got to maintain credibility. So you've really got to tell things as they really are. You never want to frighten or overly and inappropriately alarm the public, but you should not. keep from the public information that they really need to know. Because if you do either of those, sugar-coded or over-exaggerated, sooner or later people are not going to listen to what you're saying. And you also got to be consistent and then also don't be afraid. If you do not know the answer to something, to say, I don't know the answer. One of the worst things that you can do when you communicate is to guess. There's no room for guessing. You either you know or you don't. And if you don't, you say that you don't know. That was in Anthony Fauci's, you know, talk to everyone all the time era. And, you know, I think when all is said and done in this Robert F. Kennedy Jr.., maha era of public health has been proven a lie. I think we're going to look back at that moment and really appreciate the public service that had been rendered. And, you know, I know what it takes to try and educate the public in a really challenging situation. And look, we didn't get it all right. But folks tried really hard to use the best we understood to help folks protect themselves. And my hope is that, you know, in the next one, we are better prepared. And I worry that we may not be at this point. So as the pandemic wore on, the show continued, how did you pivot to all the other issues in public health? Well, as you well know, Caitlin, you were writing YLE. Public health doesn't stop because a pandemic stops being a pandemic. It keeps going. And I really wanted folks to understand. what had driven so much of this experience, right? The circumstances at the edge of science and society that really were the motivating feature of the beginning of the podcast, you know, whether it was the impact of the Dobbs decision or the M-Pox outbreak or, you know, the legalization of cannabis, like all of these things had really important implications and impact on our lives. And, you know, we wanted to use the same sort of process that we had developed during COVID to start exploring some of these issues. And one conversation I was particularly proud of was an episode we did with Dr. David Jernigan, who writes on the cannabis industry, right? And I'm always been pro-legalization, but he talks about the impact of the circumstances under which legalization has happened and the age-old question of how you regulate. corporations whose products may have harm. And I'll give you a clip from that here.

I feel like the conversation tends to be legalize or don't legalize. But there's not much nuance about how to legalize and legalize safely and to do so in a way that predicts what the cannabis industry is going to try and do post-legalization. What do you wish policymakers understood better? Yeah, it's a great question. I think what I most wish they understood better is the lessons that we already have in hand from alcohol and tobacco. We created big tobacco. Then we had to dramatically rain in big tobacco. We have big alcohol. We have, oh, roughly, well, we have. Two beer companies that sell 80% of the beer in the U.S., five spirits companies that sell about half the spirits. These are very large, politically powerful companies. I know this because I've spent my career going up against them in every form you can imagine because their push is to make the product as cheap as possible, as attractive as possible, and as available as possible. And public health protection suggests that we push. in the opposite direction. So I wish our policymakers would learn more of the lessons from the past than just the war on drugs was a terrible mistake. There are other lessons there. And then if I were to really sum it up, my message would be in two words, go slow. States are rushing into this in the hopes of, you know, the pot of gold at the end of the rainbow. You get more revenues and you do good things for social justice. And it's just not playing out that way. And we know that it's much harder to go backwards. in a more conservative direction from a very liberal regulatory regime than to take a more conservative approach at the outset and then loosen things up as you learn how things are going. That's not what we've been doing. And the thing I love about that clip is because he captures the fact that it's the incentives underneath the development industry that allow it to consolidate both vertically and horizontally to take power to resist the kind of regulation that can protect folks from the downside of the situation. And I think it's that kind of perspective that we need to be thinking about more as we evolve and we move as a society.

America Dissected is brought to you by the American Public Health Association. APHA is excited to welcome you to the 2025 annual meeting and expo, taking place November 2nd through 5th in Washington, D.C. APHA's annual meeting attracts thousands of public health professionals and partners from around the world and across a variety of disciplines each year. This year's theme is making the public's health and national priority. With countless sessions, networking opportunities, and unique experiences lined up, you'll leave with new tools, insights, and connections to advance your work. Don't miss the live taping of America Dissected while you're on site. Don't miss the chance to be part of the world's largest gathering of public health professionals. Secure your spot at APHA.org slash annual meeting. Listeners of the podcast get 10% off using discount code, Dissected 25. So what are some of your other favorite episodes and guests? I mean, Abdul, you had some pretty crazy cool people on this podcast. What were your favorites? I mean, it was fun to interview, you know, sort of my favorite uncle Bernie Sanders and really enjoyed the conversation with him about the future of health care in America. My good friend, the late, great Adi Barkin, came on the show to talk about his fight for Medicare for All. Leslie Welch, who was my deputy director in Detroit, who's now leading an incredible organization called Birth Detroit, building standalone birth centers in the city to talk about. about how we empower folks to have equitable access to birthing opportunities. And then we had some, like, really interesting topics, right? Like, do we shower too much? Should we be worried about gas stoves? I mean, if you talk to James Hamblin, maybe, like, right? I think that it was like kind of one of those like all or nothing situations. You know, like why everyone's wearing hoka sneakers? And like why noses get stuffed up? Like these were fun episodes that were really fun to produce and then also to just think through. I learned so much interviewing folks. And that was like one of the best parts about hosting a podcast is like you're constantly being educated by people who know something more about a situation than you. And like I just find that to be the best part of this work. And then, of course, we got to have Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, Bill, and I'll leave you with a clip there. The other part of this is that there has been a distinct effort on the part of the president and his acolytes to politicize science itself. He's an attack on the... The guy said the other day, the other day, well, science, science doesn't know what's going on. What did you say? What was this? Yeah, I think he was talking about the wildfires in California. It's a smirky, smirkivity. No, sorry, Mr. President, you're wrong. So, you know, sorry. But what a... What a legacy for people younger than I am. We've messed up climate change. We've done nothing the last 20 years at least. We enabled this system, the electoral college, to elect presidents that don't get the popular vote. We've enabled these. states with a very small population to have control of the U.S. Senate and just turn everything against what the majority of people want. So this is, we've really, my people my age have really blown it. What do you say to folks? I mean, imagine you're having a conversation with someone at a bar and they're just parroting the presidents.

Talking points. So you're asking a question that I'm asked a lot, and I don't know the answer, man. This is a situation where you present people with provable facts, and they don't accept them. And so what has happened is people on the other side have been seduced by what I like to call the liar's dividend, which is a phrase I heard recently. This thing is great. And so. Whoever gets the information out first, the lie, is at a huge advantage because then the other side has to whack them all their way through all these lies. And so the lie continues to pay dividends after it's been presented. So the earth's not flat. It's not going to be flat. I'm sorry. Vaccines work. They will work. Vaccines will not be ready before the election. These are facts to get over it. And the liar's dividend that the president plays on all the time has really damaged us. So it was just really cool to have Bill Nye, somebody whose whole job it has been to like educate the public about science and how science works to talk about the attack against science. And I really appreciated his participation in the show and, you know, learned a lot from like a consummate science communicator. The OG. Definitely. Trump's re-election. Big turning point for the show. Dr. Caitlin Jettelita got to come on. I'm just kidding. But walk us through. Man, walk us through the past year. That was our Caitlin era. Look, I mean, we kind of all saw it evolving. We saw Robert F. Kennedy Jr.. on the march. We saw the sort of crystallization of Maha. And, you know, it just became too much, frankly, to cover alone. And so I'm really grateful that you joined us. We also went to video. Our incredible producers, Andy and NAR, I've just been amazing setting us up and putting us out on YouTube. And then we wanted to have conversations with folks who remind us what we're fighting for. And I particularly like this interview that we had with Dr. Carmen Rojas, who is the president and CEO of the Marguerite Casey Foundation. My folks immigrated from Egypt. I spent a lot of my childhood summers there. There was never democracy in Egypt. And I think we had it for one election. But for most of anyone's experience in that place, there has been no democracy. And I remember talking to my father about this moment and him saying, you know, for 46 years since I immigrated here, I've taken for granted that I can say whatever I want, about whoever I want, wherever I want, and nobody can tell me anything because I'm protected by the Constitution. And he said for the first time in my life here, it feels more like Egypt than it does like America. You know, I know from my experience, I spent a lot of time with my cousins in Egypt who don't live the same lives that I live. Very, very different lives, not as a function of hard work or talent, but as a function of opportunity. And, you know. in the moments where I've made risky decisions, both as an institutional leader and then also as an individual, folks sometimes looking at and say, well, that's a lot of risk. And I'm like, you don't understand. Like, I'm an accident of history. Like, the life that I got to live should not have actually been. So I know what I got. Like, and at the end of the day, you know, that ability to sort of then walk in and say, I know also what I'm protecting. Oh, I like, I love, I love this description.

You know, one of the things that has never lost on me is that my mom at 18 left her 16 siblings. She's second eldest of 17 kids in this small town where she could have had a good life, you know, like a really good life. Like if she did not. want for more outside of this small town. But you want it for more. And she wanted, yeah, she wanted for a different life. If she wouldn't, she did not come to San Francisco, not speaking one word of English, working, sewing clothes in factories throughout San Francisco. If she had not done that, You know, my parents didn't graduate from middle school. And I think that we have like a story about how horrible your life is if you don't do those things. Again, like, I think she could have had a decent life. And. Ah, she blew open the entire universe. It's like looking at stars as like stickers on the ceiling of a room, you know, the globe of dark stars. And then looking at stars in the night sky. My parents... had a kid, me, who ends up getting a doctorate from one of the best public universities in the world, getting to live everywhere, getting to have this job. And so I am clear that everybody deserves to see the night sky. Everybody deserves to see the night sky. And I want to make sure that I do everything that I can in this job and in whatever job I have, you know, to be able to make that available and not create restrictions on only people with green and blue eyes can see the night sky. Only people without student debt can see the night sky. Only people who can afford the rent that's too damn high can see the night sky. I want it for everybody because my parents wanted it for me. My people wanted it for me.

I appreciated that because she set the stakes for what this fight is about and what we're all trying to do here. And that doesn't end. Obviously, I'm really sad to say goodbye. I really love the show and love the audience and really enjoyed the opportunity to get to break down the most important issues at the edge of the most important question of our lives, which is how do we keep ourselves and our loved ones healthy? But the work continues in some respects. For me, it like... it continues in a different way which meant that i had to set this one aside um and so i really appreciate you walking me down memory lane uh i really enjoyed the this this opportunity to sort of reminisce And we've got one more episode that's going to drop on November 6th. It's a special episode recording at the American Public Health Association annual meeting. We'll be interviewing Dr. Peter Marks in a live audience. He was, of course, one of the first FDA employees to resign during Robert F. Kennedy Jr.'s tenure. So we'll see you back for one more in November. And I just want to say thank you all for your time, for giving me your ear, allowing me to share my perspective with you. Hopefully this is not go by forever. And the work continues. And Caitlin, I know that you're going to be doing this work on YLE. I do hope that folks who have not yet subscribed do. You're going to get really incredible up-to-the-minute insights from a voice you can trust. And I appreciate you doing that public service, Caitlin, and appreciate you joining us here for this last bit of the show. Godspeed, Abdul. I'm excited about your future. We'll be cheering you on and see everyone in November. See you guys. That's it for today. You can find more content on our website, incisionmedia.com. Check out our shop at store.com for our new America Dissected merch, including our logo shirts, hoodies, and mugs. And don't miss out on our vaccine's work, science matters, t-shirts. You can follow or subscribe to American Dissected on your favorite podcast platform and on YouTube at America Dissecting. And you can follow me on Instagram, TikTok, and X. At Abdul El-Sayed, no dash. And make sure to subscribe to Caitlin's incredible newsletter, your local epidemiologist, which breaks down the latest scientific evidence for over 300,000 followers. You can search for your local epidemiologist on site. upstack. Links to all our sponsors are available right here in the show notes. I really do hope you'll check them out and show them some love. They make the show possible every single week. Finally, on your way out, don't forget to leave us a five-star review. And if you're watching on YouTube, drop us a like or a comment. Word of mouth still goes a long way, too. So if you know someone who might like to keep up with everything that's happening in the world of health, please do let him know. America Dissected is a product of incision media. Our co-host is Dr. Caitlin Jenelina. Our producer is Andy Gardner Bernstein. Video and audio editing by Maddie Naalconia. Our theme song is Guantauceau and Alex Uguera. Sales and Marketing by Joel Fowler and McFreeman at Big Little Media. Our executive producers are Tara Knight and me, Dr. Abdul El-Sayed it, your host. Thanks for listening. This shows for general information and entertainment purposes only. It's not intended to provide specific health care medical advice and should not be construed as providing health care or medical advice. Please consult your own physician with any questions related to your own health.