Marshall Ramsey, Mississippi Today’s Editor-at-Large, sits down to talk with Jennifer Bryan. Dr. Bryan was elected the first woman to chair the Mississippi State Medical Associations Board of Trustees. She educates legislators on global medicine issues and stresses the importance of patient communication. She is a family doctor in Flowood, Mississippi. Marshall and Bryan discuss how Mississippi will fare when the COVID vaccines become widely available in 2021. She also discusses how the medical community has remained resilient in the face of stressful and long hours. Find out more about coronavirus in Mississippi, as well as daily data and case updates. Click here to see more Marshall’s Mississippi Zoom Tour. Below is the full transcript of the interview with Marshall Ramsey. Marshall Ramsey: Hello, Marshall’s Mississippi Zoom Tour, I’m Marshall Ramsey. It’s a pleasure to have Marshall Ramsey, a person I have met through Facebook, as our guest today. You might be thinking, “Marshall? I don’t know. There are a lot of people I don’t want to meet on Facebook.” But Dr. Jennifer Bryan, a great communicator about all things COVID, and everything medical in Mississippi, is here. We’re going have her tell us about herself and then walk us through the next six month as the vaccine comes in. As you know, we are facing some of the same challenges as we have right now with COVID so I wanted her to be on the show. She is also the first woman to be elected chair of the Mississippi State Medical Association’s Board of Trustees, which has been in existence for over 150 years. It’s quite impressive. She is a force for medicine. I love that term. She educates legislators on global medicine issues and emphasizes the importance of patient communication. She is also a mother and a family doctor in Flowood. We might be able to get through this interview if I can actually say physician. Jennifer, thanks for taking the time to speak with us. I understand you are very busy. I don’t want your patients to be in the lobby, reading old magazines. I would find that unacceptable. Thank you for taking the time to visit today. Jennifer Bryan: I am so grateful for your time. As you, I enjoyed getting to know each other over the past year with our public personas. I met you once in, I believe it was a chamber-of-commerce thing in Rankin County. I was impressed. We had a great conversation with you while you were there, along with some of your media colleagues. I have really enjoyed our relationship and appreciated your leadership. Your ability to express emotions and current events through artwork has helped Mississippians stay connected and afloat. It’s also been a positive boost in times of need. Again, thank you. Ramsey: You’re very welcome. Ramsey: You’re welcome. This is what we need in 2020, not just on an individual but on a global level. We are fighting misinformation about the pandemic. I have gotten to know you through your Facebook page, but you are excellent. Justin Gentry, one of the doctors in Louisville, is a great example. His community has found him to be a great source of calm. But I wanted to just get you on the line today and tell you a bit about yourself, your career, and how you are coping with the pandemic. Then we’ll sort of walk through six months. We’re now looking forward to next summer, when everything can return to normal. There are many things that we have to do between now, and then. Let’s get started. Bryan: Sure, where would you like to begin? Ramsey: How did you get started in medicine? Bryan: My uncle, Dr. Tom Joiner (who practiced in Jackson many years ago), gave me a job at his office when I was young. I then joined him in the summers to work in a private clinic. It was a great experience. In that era, regulation was much less than it is today. It was a great job, and I loved being the town doctor. He was also involved in health policy, and was past president the state medical association. His best advice was to keep showing up and you will get what you want. So I did. To keep doing the right thing. My father is an attorney. He’s now retired, but he was the federal public defense for Mississippi for 17 years. They are both brothers so I had a solid foundation in understanding law and governance, as well as the compassion that comes with being a doctor. When I was five years old, I wanted to be a rockstar. I didn’t really have any other ideas than being a doctor. This was the course I chose early. I graduated from Brandon High School and went on to Mississippi State. There, I majored microbiology. While organizing some things, I came across some of the classes on an old transcript. It was fascinating. There were also some pathogenic microbiology, virology, and immunology. There was a lot I learned about the issues we face. I then returned to UMMC, did medical school there and fell in love again with family medicine. While I tried to be open-minded, I stayed true to what I knew from my childhood. I also developed a passion for health policy and did an elective during my final year of residency at UMMC. It was designed to allow me to spend some time in Washington, learning experience. Then I returned to Brandon, my hometown, and began practicing. I eventually drifted towards Flowood, where my children are now being raised. The love of medicine. I have always loved communicating and I enjoy people. It’s something about being able to explain serious conditions and help them through it in a speedy manner that I find very satisfying. From a population health standpoint, I believe that the pandemic was what attracted me to social media. It allowed me to try to explain what seemed so mysterious if that makes sense. Ramsey: Today I witnessed a wonderful exchange on my Facebook page. Someone called someone a sheep, and the person they were calling a shepherd about the virus is actually a researcher for the vaccine. The problem is that there are experts who understand the virus and can help us understand what we need. They are competing with the conspiracy of today. As a doctor, I can tell you that when you receive bad news, a lot of times you just sit there and listen to Charlie Brown’s parents. As it was in my case, you hear womp, womp, womp cancer. It can be hard to accept such hard news. We are in a situation where hospitals have record numbers of COVID patients. This means that we will soon be living in a time when everyone is indoors. The vaccine’s not yet available online, and won’t be for most people until spring. How do we communicate with the people and get them to see that this is a serious problem, and it could be very dangerous if they don’t act quickly? Bryan: There’s so much psychology that 2020 will require. The stages of grief could be discussed for hours. All of us have experienced grief at some point in our lives. There is a denial, “This isn’t happening.” We rage or cry about it, and eventually we accept it. We all know, however, that some of the narratives in this year’s election were hijacked by politics. It did. It was an election year, so conversations were heated and polarized. But, we are beginning to accept each other as individuals. As a physician, I felt the need to send a proactive message. It’s a prevention message. Exercise and healthy eating habits are key to avoiding these problems. Don’t be afraid to wear a mask and use handwashing and social distance. Live your life and let’s track, trace, track, isolate and help you get through it. As a society, we are less reactive than as a government. It is what it is, and I had to accept some aspects of it. It would be a grueling task to try and understand why people don’t do things I consider common sense or tried and true public health measures. You can meet people right where they are and people have already processed quite a bit. We are all going through a collective trauma. It’s awful. It is a crisis. It’s a full-blown crisis. But we will get through it. We are currently in the worst and it will only get worse. Unfortunately, we know this because deaths increase as the cases get more severe. While some of this has been mitigated by the fact science has improved, we have some tools, we are better at managing people, keeping them out the hospital, and so forth, it will only get worse. Because of the sheer number of people affected and how many have been personally affected, I think that people are starting to realize how serious this is. What are our options? We’ve already got the vaccine in place. We have healthcare workers now who can… get the vaccine in just a few weeks. Bryan: That timeline is a great way to break it down. I appreciate it. We don’t have enough, but we can get enough to send 187,000 doses to Mississippi in December. This is what I have heard. We can stop significant transmission by simply vaccinating healthcare workers if we do that. It would be a good idea to vaccinate all the matches that had the virus in them. We know that this will reduce some. It’s possible that we will see some deaths starting to level off around January 1, according to models. It’s going be a painful slow process. We will continue to watch, we’ll bring more vaccine online in the first quarter next year. I’ve seen that the majority of the population can be vaccinated well into the spring or early summer. They’re still working out the details of who gets the vaccine and when. However, right now I am adamant that the world is on fire. Now is the time for you to put your feet down. These next few weeks will be crucial. Ramsey: It’s difficult because Christmas is coming up, and everyone wants to be inside singing carols, drinking eggnog. We will also pay for the Thanksgiving events that occurred in the next few weeks. My concern is that you are very well-informed about what’s happening in Mississippi’s medical community. It’s wonderful to have a ventilator, but if there isn’t anyone who can run it then it becomes a problem. I have spoken to a number of nurses and doctors who are extremely burned out. They are frustrated when they see people on TV, on Facebook and see people saying “Aw, it’s just flu” or something similar. It’s unbelievable that they still say this. Everyone I notice sees it through their own lens. It doesn’t touch their family, or they haven’t had it yet. They don’t know how serious it could be. What are we going to do? I understand that medical staff will receive the vaccine first and long-term care residents second. It should be that way. What can we do to mentally support our medical staff for the next six months? It’s almost as if they’ve been fighting since March. Bryan: It’s awful. By the end of all this, we’ll have a workforce afflicted with PTSD. We are already seeing professional health programs used at levels that they have never been before. What can the public do to help? Pay attention to the doctor that you have listened to all your life about your cancer diagnosis. They won’t lead you astray. We are generally on the same page. There will be someone who hollers about masks and hollers over the latest treatment. But doctors communicate in real-time all day. There isn’t much controversy because we talk all the time in our groups. We have a lot more doctors at home than we need, so there’s lots of frustration. We got a lot clapping in the beginning, to show that people can support these men. It was a great experience to have a lot of health care heroes working here. We also have many burnt out doctors. There are many doctors in my home. Another doctor informed me this morning that her baby and her daughter have been placed in quarantine due to COVID they contracted at work. Because if a doctor is ill, there aren’t any other doctors who can help. These guys were operating with minimal PPE. They are still in crisis-level PPE, but I would say modified crisis. You used to walk into a room carrying an N95 and one patient. Once you were done, you tossed it away. You would put on another one if you saw them again at three in the afternoon. Some of this was probably excess, and we are learning more about it. But in the meantime, we know that these resources are finite. Every day, people reuse things that weren’t originally intended (for reuse). It’s something they know, and it’s something that keeps them busy. They are there for the dying and try to pass this on to their loved ones. So I believe I saw it today, someone called (out) Dr. LouAnn Woodward on Twitter, “panic??” Kinda teasing her about the situation. I have been laughed at, ridiculed, and called out. While you receive a lot of appreciation, you also get negative comments. The more people can listen, accept what is unfortunately the reality, and make small changes, the better. This week, we talked about Christmas. We don’t need to give up Christmas. However, we must figure out how to solve problems through it. We must also figure out how to adapt. The importance of adaptability in our lives cannot be overemphasized. It’s important to figure out how you will get through it without going crazy. The public must figure out how to prevent Christmas’s spike from happening again. How can we reduce the Christmas effect? We can’t make Thanksgiving a second time. There will be a bump. We all know it will. Because it’s impossible to get everyone on the same page. It’s unlikely that it will happen. Do you have a firepit, or a favorite firepit outside? How can you use zoom? Is it possible to postpone February, as we did with our family out of state? How do you plan to be normal during abnormal times? Ramsey: I have been trying to be normal for 50+ years. I don’t know if I can do it anymore. Listening to Dr. Thomas Dobbs’ powerful interview was very inspiring.
Talking about hospitalizations, they are at an all-time high. After the mask mandate was lifted, everything fell and the governor took it down, we’ve been back up. Okay, he did that. Now we’re back up. But what happens? We’re full and 12 hospitals have full ICU beds. Where do we go from there? Even though Thanksgiving has not yet arrived, Christmas will soon be here. Are we talking about putting facilities in the garage? What are our plans for the next two to three months in order to survive this next surge? Bryan: This is a great question. Unfortunately, there’s no easy answer. What are our options? There are many options. You can add more hospitals. The most valuable resource, however, is the human resource. We have a finite amount of nurses, doctors, and respiratory therapists. I don’t want anyone to be left behind, and I am grateful for all our amazing healthcare professionals. They are a finite resource. You can look at what has worked and you will see that it does not take long to free up beds. In anticipation of Dr. Dobbs’ and Dr. Paul (Paul) Byers asking physicians six weeks ago, they asked them to ramp up their performance in these types of procedures to prepare for a request to begin self-moderating. They did. They have tried to make sure that the doctors are aware of this fact and not do as many elective procedures in order to preserve bed space. Up to this point, the hospitals have done an excellent job with auto regulation. If the damn breaks, which I believe is what we are seeing, then there’s a problem. We are seeing health workers at home, full hospitals, and we have the option to transfer out of state in certain situations. That’s why we have a state officer for state health. Public health laws are necessary for this reason. This problem will only get worse if we all sit down and wait for everyone to figure it out. In the weeks ahead, I see the governor and state health officer working closely together to make some unique management decisions. It will have to happen. This will require leadership from our leaders, and I ask that the public embrace some of those. These are difficult decisions. Many physician practices almost went out of business during the shutdown, just like small businesses. Our doctors are still under pressure. Hospitals and so forth. These decisions are difficult but I expect there to be additional recommendations. Some will benefit from holiday breaks. Because the virus doesn’t care about you, a crowd is just a crowd. It will spread. It’s going to spread if we do it in small groups. It works. We know that masks work. I believe you will see more encouragement from elected officials. The health department will be more encouraging you to do the things that we know work. They ask you questions, then ask you to do the work. This is what I have seen. Ramsey: You’ve worked with them for many years on various public health issues, so you understand what you’re talking on. I understand you have a busy schedule. I don’t want you to be too slow. Although they have not been peer reviewed, the press releases regarding the information about the vaccines, and I assume the one from England, have been encouraging. They have been amazing. What is your opinion on vaccines? Is that going to make a huge difference? Bryan: Absolutely. Despite the ongoing peer review process, we are all connected in these scientific circles. Our colleagues nationwide that are on ASIPP and AMA (American Society of Interventional Pain Physicians), and all the physicians we’re speaking to have all looked at the science and found it sound. We’re only getting wonderful, promising reports from independent reviewers. When Dr. Dobbs speaks about the vaccine, he is extremely confident. So am I. I cannot wait to get mine. To be completely honest, when the politicking began, I didn’t realize that I would feel so confident at this stage in the game. Even if I didn’t feel confident, I wouldn’t claim that I was. I could sit there and tell you that I have a problem. But I don’t. I have spoken to enough people to know that science is available. We’re still not there yet, but we expect great news and the ability to deliver this vaccine to healthcare workers in the next month. I am confident in this process. We have some difficult days ahead of us, but I believe we have good days ahead. Now is the time to take care of your family. It shouldn’t be your livelihood. Stay home if you can. Please don’t leave if you are not required to. Please treat this virus with seriousness and let’s get to the other side as well as possible. Ramsey: It was the best and worst times. That’s probably the best way to summarize it. When you think of that vaccine, you can see a scientific achievement comparable to the moon landing. It takes about four years to create a vaccine, but we did it in one year. I’m glad that a lot this research was based on the original SARS virus, which hit in the early 2000s. To be able get this out there… I agree that I would not want to have a chance if the government built it on a low bid. Bryan: Right, absolutely. Ramsey: I don’t want a tail, or anything like that to happen. Bryan: This is an amazing achievement. Ramsey: We’ll now have to coordinate the logistics of getting it there. I know that you’ll be wrapping up in that and having your freezers ready for when you give shots. Bryan: Doctors have already met with the health department to discuss it. We’re thrilled to share this information with them as they’ve been great sources of information. Let me end by pledging our psychological health. These are difficult times. I already mentioned adaptability, and I’ll repeat it. Find the joy in this moment. It is not the reality we wish was true, but the reality as it is. Over the next few weeks, sticking to normal, usual, normal and normal will only lead to disappointment. Innovation is how we find ways to do things differently and make it through. Smaller is okay right now. Invest in your family. Invest in your family. It’s going back to your psychologically to help get through a crisis. We have new traditions, such as trying to make Christmas ornaments from old family recipes. Those things will carry you through. Ramsey: This is a great way to say thank you. I wish you a happy holiday season and thank you for taking the time to speak with me today. Bryan, thank you so much for having me. Thank you again for all you do for Mississippi. Ramsey: Many thanks. Thank you, Dr. Jennifer Bryan. Bryan: Take care.