205: Why Listening is Important in Public Health

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Thursday, June 23rd, 2022. I'm Robert Johnson.

Now, a special edition of the newscast from the Association of State and Territorial Health Officials.

A few weeks ago, ASTHO hosted a summit bringing together federal, state, and territorial health officials to discuss the next phase of the COVID-19 response. During that meeting, we had the opportunity to catch up with Dr. Randall Williams, the former state health official from Missouri. On this occasion, we connected on a topic other than the pandemic. Dr. Williams has written a book, due out in October. We talked about it in today's morning conversation.

You've been out of the public health arena for about a year, maybe a little longer. What have you been doing during that time?

RANDALL WILLIAMS:

Well, Robert, thanks for asking. Sadly, my mother developed cancer at age 92 and she was in hospice for four months. And I was an obstetrician gynecologist for 30 years, so I helped take care of my mom and she passed away in September.

And also, when I was in North Carolina and Missouri, where I served for three governors as state health director for about six and a half years, I would keep notes. So, I've written a book—it'll be published in October—about my experience working in public health at the state level with three governors in both North Carolina and Missouri.

JOHNSON:

We don't hear of too many state health officials who leave office and write books. Pretty common in other job descriptions and titles—you know, people leave and then they write.

What's your book about?

WILLIAMS:

It really has three themes.

One is I wanted to memorialize a lot of the wisdom I got from so many people—the three governors I worked for, the colleagues I worked with, certainly ASTHO, Mike Frasier, and others I learned so much from—and I wanted to pass that along. So, the book has lots of quotations and things I learned.

The second one is obviously these jobs now are very much in the public eye, often contentious in this day and age. And Winston Churchill famously said in 1942 in the House of Commons, when asked how history would judge him, he said, "Well, it will judge me very well because I'm going to write it." So, this is my version of the events we lived through during those years, very much in the public eye.

And the third thing, Robert, is that I believe that life is hard. Even though in public health and as a practicing physician for 30 years we practice prevention, it's just my sense—especially taking care of patients in the last couple of years—that no matter how careful you are, often things happen. And so, the book is things people have passed on to me—and I've certainly learned from my colleagues in North Carolina and Missouri—on how to develop kind of that resilience so that when the storms come, you not only prevail, but you can help others.

JOHNSON:

This book obviously was in the works during the pandemic. It includes more than that.

WILLIAMS:

Absolutely. It includes my time in North Carolina, my time in Missouri, but also things I learned practicing medicine. I've also worked overseas in Iraq and Afghanistan and Libya, and includes my experiences there as a physician taking care of patients in those countries.

JOHNSON:

Does it include a story you can share?

WILLIAMS:

Oh, it includes lots and lots of stories. The book is, if nothing else, many, many stories, one that I'm particularly fond of is that Winston Churchill—most people aren't aware of this, but the Churchill museum in the United States is in Fulton, Missouri, where he gave his great speech as a guest of Harry Truman about the Iron Curtain. And Winston Churchill said that when he looked at the arc of his life, a lot of good things had happened and a lot of bad things had happened, but he was fully convinced that all of them had been for a reason when he became prime minister and led England out of World War II. And I saw so much of that in my time in Missouri during COVID.

I asked each of my colleagues, "What gets you up every day to work 12, 14 hours and do that all the time?" And you know, to a man and woman, they would talk about being part of a team. They would talk about that they had been trained to help people. And this was a chance, kind of like a lifeguard, to go out there and swim through tough waters and help them. They talked about not wanting to let people down. Many of them mentioned their faith, that they felt like they had been put in that position at this time to do the work they were doing.

And so, I found it incredibly gratifying to work with people who were so other-centered that they were able to kind of do superhuman things in very tough times.

JOHNSON:

Do you expect this to become a best-selling book among public health professionals, especially?

WILLIAMS:

You know, I don't. Again, what I really do hope is that it will help people. I often say in the book that being a practicing physician for 30 years, I think that people are either getting ready to go through tough times, they're going through tough times, or they're getting over going through tough times. And so, I hope the books' accumulated wisdom—not wisdom from me, but wisdom I've learned from so many people.

Another story, I got a chance to meet Senator Kit Bond one time—four-time United States senator, two-time governor from Missouri, pretty successful guy. And I said, you know, "Senator Bond, I just have to ask you, how do you do that?" And he said, "Randall, you can put in your book, two words—I listened." And he said, "That's really what it came down to. I just listened."

So in Missouri, I went to every county, and in North Carolina, I went to every county, and I just listened. And it was one of the most wonderful experiences in my life because, especially during COVID, it gave me a real sense of how everybody in Missouri kind of looked at events. Not just one particular area of the state, but people in Worth county, a little county up in Northwest Missouri, and St. Louis and Kansas City, which are obviously very big cities. I found that invaluable.

JOHNSON:

Is listening the takeaway that you think public health people might draw from reading your book?

WILLIAMS:

You know, I said during my Senate confirmation hearings that you need three things to do this job really well.

One is to get up everyday knowing what a privilege it is to serve. Governor Parson said it's a very noble thing to serve other people, and I believe that fervently.

I think the other thing is you have to be humble. You don't have all the answers. You have to be able to turn to other people.

And the third thing is courage. I think that these jobs require a great deal of courage because you're trying to help other people and a famous historian said your courage is directly related to your knowledge of your profession and training. So I think in ASTHO, we've been so fortunate to have people who are so well-trained and knowledgeable, I think it has given them the courage to sustain them and others during what we've gone through for the last two years.

JOHNSON:

I've asked you a lot about how you think the public health profession will react to the book, but that's not really who you wrote it for.

WILLIAMS:

I didn't. You know, John Steinbeck famously said that every author writes a book with one person in mind, whether it's a novel or a memoir. And I've really written this for my grandson, Carter. He's less than a year old, but I hope someday he'll be able to read it and understand why we did what we did during some very tough times. But most of all, the courage that the people I was fortunate enough to work with in Missouri and North Carolina exhibited to help other people.

JOHNSON:

Maybe he'll get to do a book report about it.

You can't tell us the title?

WILLIAMS:

The subtitle again is "A State Health Director Reports From the Front Lines." But I can't—it's from a poem by Tennyson, my favorite poem. So, I'll give you a little bit of a hint. Ulysses is the name of the poem and the title comes from that poem.

JOHNSON:

And it's out in October?

WILLIAMS:

Out in October.

JOHNSON:

That'll do it for today's newscast. We're back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.