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Art at the End of the World Class
The End of Sustainability with Stratis Giannakouros
THE WORLD IS ENDING! Again. Doomsdayers and apocalyptic prophets have warned of coming calamity for millennia. Still, humanity persists.
This podcast invites entrepreneurs, scholars, community leaders, artists, and many others to envision the end of the world according to their expertise.
Art at the End of the World is a hybrid class and public program series supported by the University of Iowa Stanley Museum of Art and the University of Iowa School of Art and Art History, and taught by Associate Curator of Special Projects, Vero Rose Smith.
Today’s guest is Stratis Giannakouros, Director of the Office of Sustainability and the Environment at the University of Iowa.
Music was written, performed, and produced by Gabi Vanek.
FULL TRANSCRIPT:
[Vero Rose Smith]: The world is ending. Again. Doomsayers and apocalyptic profits have warned of coming calamity for millennia. Still, humanity persists. This podcast invites entrepreneurs, scholars, community leaders, artists, and many others to envision the end of the world according to their expertise. I'm Vero Rose Smith your host, and this is Art at the End of the World. Today we welcome Stratis Giannakouros, the director of the Office of Sustainability and the Environment at the University of Iowa. Before coming to Iowa, Stratis served as a project manager and program director for the Julie Ann Brinkley Global Institute of Sustainability at Arizona State University. Before that he was assistant director at the center for sustainable communities seven for college and the sustainability outreach coordinator at Colorado State University. Stratis has a bachelor's degree in economics from Loras College and a master's degree in environmental politics and policy from Colorado State University. Our conversation was recorded on Wednesday, March 25, 2020.
[VRS]: So if you could just introduce yourself and tell us about your current role.
[Stratis Giannakouros]: So my name is Stratis Giannakouros and I direct the Office of Sustainability and the Environment at the University of Iowa. My role is essentially on the academic side so I'm part of the College of Liberal Arts and Sciences, and is supported by the College of Business and the College of Public Health, and our office is designed to promote the scholarship and research around sustainability and also to think of the campus as a living laboratory for sustainability. What that means is moving from thinking about problemitizing sustainability to thinking about what are the solutions our students, faculty, and staff can engage in across campus.
[VRS]: Thank you, great. And how did you get interested in this work?
[SG]: Well I started out as more of just an environmentalist back in the day and as I became more engaged in thinking about saving the environment, I realized that modern environmental thought is really - has an absence, or a missing a gap, and thinking about how societies are impacted, how individuals are impacted, and broadly thinking about the social pieces that go into why we have an environmental crisis on our hands. And so what sustainability does is it allows us to think more broadly about unequal exchange in trans-boundary impacts and how harms and benefits are unevenly distributed across the world and allow the solution to come up with the kids and allows a more human approach to thinking about why we conserve the environment what the best ways to do that so just a comprehensive view of what it means to save the environment and what it means to be part of the world in order to solve the biggest environmental crises we face.
[VRS]: That's a lot! So how did that become a professional trajectory for you? You started as an environmentalist with seems like a pretty personal orientation to this work, so describe that path for us.
[SG]: Well actually in college I was an econ major, because I thought at the time that was going to be the best way to get a job - yeah, is majoring in economics and it's like math other things - I actually didn't study [environmental issues] a lot. I didn't take a single environmental course I when I was in college, but I spent all my time outdoors in the woods on the Mississippi River doing things that I wanted to do outside of that, so my personal interests were diverging from my education because I felt that going to college at that time meant that you should do something that's gonna get you a job and what you're interested in what you're passionate about should be separate from that. I got out I worked for a year in finance and I realized that that was a non-starter for me and I was not going to be happy sitting in a cube and kind of thinking about these esoteric problems of finance and I really wanted to be engaged in the stuff that I loved to do and so I quit my job and I went and I found an organization in Greece called Medicet. What they were doing at the time was trying to preserve the Caretta caretta loggerhead turtle of the Eastern Mediterranean. A lot of nesting beaches - some of the most important nesting beaches in the world - are located in just a few spots in the Greek islands and they were being encroached upon by development and tourism and all these things are going on that were really going to severely the impact these turtles. And so I said "Hey, I'll volunteer for a year to come there." I saved some money to volunteer for free for a year to come down and help. They wanted me to do communications. I spoke good English and also spoke good Greek and so as communications officer, I hosted different groups that came in. The BBC even did a documentary with us. We talked to the European Commission. We talked to different groups around Greece and I worked there for about eight months and finally got burned out. I ran out of money and I was very frustrated with the pace of change in Greece at that time. The Greek government was not interested in designating a marine park or diverting funds that were earmark for good work in other things and I kind of saw first hand the complexity of of what environmentalism needs and by that I guess I mean that when I went down there I had a lot of Greeks who were in these areas we were trying to protect - they called me a traitor. They said you know you're a traitor, all I have is this field or this plot of land and why shouldn't I be allowed to develop it? My kids need to eat and get an education and I need to thrive and you know you are an American who is coming down here tell me what to do and we don't listen to you so we're gonna develope anyway and no one wants you around here. And I just I just look at the trade offs in the complexity of people trying to make a living respecting barman how this stuff works and what the drivers of these problems were and when I left I was burned out but I decided that I really had to go and study this more. So I came back and for a couple years anyway I worked with that new - we started our own NGO my brother and I started a non-profit called Green Dubuque. We were working directly on impacts of climate change and got involved in sustainability from that angle. I worked on some programs at Stanford and Berkeley and then at Babson in New York City at Pace University teaching cleantech entrepreneurship. Trying to take a more expansive view of business I did a lot of work in that field. And finally I went to grad school at Colorado State University and there I went to study non environmental policy and environmental politics. And when I was there I got really heavily involved in sustainability. I worked for the School of Global Environment and Sustainability and then that kind of set me on this on this career trajectory where I started working inside universities on sustainability select from there to Luther College after I graduated. I taught for two and a half years. I taught environmental studies and then worked as the director - assistant director of the Center for Sustainable Communities.
From there, I went to Arizona State University and I worked at a little start up that was a twenty six million dollar venture from the Walton Family Foundation that was earmarked for thinking about how universities could take the research they were doing and translate it into environmental or sustainability outcomes. The argument was that often good research is done in universities but there's not a really good mechanism for translating that research into solutions. So I worked as a project manager and program manager for for that outfit for three years. We worked in Albania and Lebanon and Jordan, we tried to spin up projects in Vietnam, and we did start here in the U. S.
I was always trying to find ways where we could take the research in university, take either a government or private partner, and figure out a way to get a project going that would make a difference for sustainability. When I was down there also started twenty different what I would call almost like like intervention programs where we would go with faculty and students to different countries around the world and try to do things like put solar panels or work on social policy. I ran them in Nepal, in Brazil, in Hong Kong, in Costa Rica, and Greece - all over the world. It was an opportunity for students to take what they learned in the classroom and translate it into these sort of real world environments. We work with cities to do this also. And then finally this opportunity at the University of Iowa opened up and I am from Iowa, I love the state of Iowa, and I'm an Iowan at heart and so I decided to come home to the university here to try to spin out some of the things that I learned in their office here where students could access internships and research. We can do interdisciplinary research with faculty, and we can have a bigger footprint in the state of Iowa around sustainability. That's kind of how I've gotten here that's that I guess maybe the short version.
[VRS]: Oh my goodness, that's an incredible story. So I'd like to know a little bit more about your one year in finance - was there a moment when you were just like "Okay, I'm done with this, I can't do this anymore"? Was it learning about the turtles or did the turtles come after? Describes the moment when you do make your life change.
[SG]: The turtles came after. I remember I was about six months in when I realized that this is not gonna drive me. It's interesting. People always say listen to yourself and follow your heart on these things. I think that when you're young - like twenty two years old - there's a lot of noise and a lot of anxiety, a lot of pressure. Student loan debt, all these things that come together and they make it really hard and it's easy to say, you know, follow your heart, be poor if that's what you think is gonna happen to you. You might say I'm not gonna take that risk. What I realized really quickly was I'm not going to be successful. I wasn't willing to invest the time and the energy to get really good at it. I had no pathway when I started job shadowing, a job above mine that I wanted to have and I thought I'm I'm gonna flounder here or I could try to invent myself along the lines that I want to. Part of my inspirations was friends taking a different course. One of my friends became a wildlife biologist working in Las Vegas. I guess he was studying burrowing owls and and desert tortoises and his job involved him, you know, running around the desert as project manager looking at NIPA contracts and you know all kinds of really cool stuff and I thought you know he's doing some really cool work and here I am doing something I don't want to do. I have to shift gears. I looked around for a job that would pay me but because I don't have that background - I hadn't studied it in college, which is what I should have done - eventually I just had to save my money and take an unpaid internship to kind of restart my career. That's how I ended up looking around and the reason I ended up being in Greece was because I talked to someone at Duke University about a project they were working on I was kind of interested in sea turtles. I'd seen them in Greece in the past and she said your Greek and I know a wonderful person who's working on this stuff in Greece and she would be able to take you on as an unpaid intern if you're willing. And that's how I ended up going to Greece to take this United Nations programme on sea turtles going on.
[VRS]: Amazing! Did you experience any push back from other friends or your family for taking this drastic shift in career?
[SG]: I think people looked at me like I didn't know what I wanted to do. No one really said, you know, why would you give up this great opportunity because it wasn't a job that that I clearly wanted to keep, you know? And so I would have had to to make some kind of a life change. I think they were probably thinking, you know, I'm having a hard time getting started and so here I am about to take six months and spend whatever little money I saved and restart my career. But honestly I didn't get anybody - I guess in my circle - that was upset about it, because in my circle, all of my friends were in environmental careers already. They had gone to college for environmental careers then came right out into them. So I think in some ways they weren't as worried as I was in college about going that route. They knew what they wanted to do and they were able to be more successful quicker. I think that I tell young people now don't be afraid to follow things that you know - if you're if you're spending all your time outside the classroom interested in something you should probably be figuring out ways to study that in the classroom also. It's gonna pay off.
[VRS]:Thank you. that's a really wonderful message. I'm wondering if we could switch a little bit to talking specifically about sustainability now. So you describe how complex of a concept this is and how your skills linguistically, your skills both in your background as a person in finance and as a person who didn't formally study environmental sciences until a little bit later after you got going in the field, all came together to help you now in your work as an advocate for sustainability. But what is sustainability in the simplest definition?
[SG]: In the simplest definition this definition I go back to is the Brundtland definition of the Commission that was put together that first discussed in 1986 what sustainability was. It was a United Nations commission. In the preamble to what they wrote, which is called "Our Common Future" - it's a great document to look up, it's bigger than just the definition - they said that sustainability is the ability of current generations to meet our needs without impinging upon or inhibiting the ability of future generations also to meet their needs. Sustainability is an intra-generational and intergenerational concept that says live well today without you living well, you know, causing your daughter, or grandchild, or great grand child to have a worse life. It's understanding that these are generational issues and you can't do things that take away from future generations' ability to live as well as you do.
[VRS]: So that's a really hopeful, beautiful definition and now I'm going to ask you to destroy it.
[SG & VRS]: *laughter*
[VRS]: What is the end of sustainability? What's the absolute worst case scenario for your field?
[SG]: So for my field, you know, this is a question of climate change, in some ways has become the elephant in the room, or the eight hundred pound gorilla, if you will...
[VRS]: Mhmm
[SG]:...because you can't have any discussion anymore. It used to be that, I mean, when I was younger I was talking about the need to protect the rainforests and biodiversity and clean water and all the things we think about as just pure environmentalism, right? Like, let's protect the national endowments that we have. Now with climate change, we understand the threat of climate change more clearly. It's obvious that yes, you can go into the cloud forest in Costa Rica and try to save the frogs that are there from clear cutting forests. But if climate change, you know, keep apace, the cloud forest as we know it in Costa Rica will vanish. The entire cloud forest will vanish over the next fifty years. Right, and so you have to address climate change to address anything and make anything sustainable. So the end of sustainability in that respect looks like a scenario of runaway climate change, where the worst catastrophic effects of climate change kick in. We know that that's largely gonna start beyond one and a half degrees Celsius and so we're approaching that number, and that's, you know, a scary thought. There does come a point where if we put enough carbon in the atmosphere, the radial forcing that goes along with it and the additional heat that comes in and everything, and all the feedback loops that are going to kick in are gonna mean that humans are gonna be taken out of the equation.
So an example of that is looking at the the frozen tundra, or the methane frozen methane in Siberia, for instance. There comes a point where we will get warm enough that the frozen areas of Siberia will start to thaw. When they do, they're gonna release a lot of methane. Methane is a gas - CH4 - right, it's carbon and hydrogen. Four carbons and a hydrogen - oh, sorry, a carbon and four hydrogens - so that that gas in the atmosphere as nearly twenty nine to thirty times the global warming potential of carbon dioxide and once the methane starts thawing and that CH4 starts getting released, it will cause a dramatic amount of warming in atmosphere the we can't stop that will cause more warming it will cause more melting glaciers, will cause other feedback loops to kick in and once this process starts we can't do anything about it. And that will cause - really, climate change will cause ecological collapse across the planet. So sustainability really has become about stopping climate change but then within that you have these issues of of the immediate impacts of climate change and unsustainable living are not evenly distributed, right? So you have people in the very wealthy areas of the United States at least - we'll feel the effects of climate change in a different way than people in the developing world who don't have this financial or technological buffer. So sustainability says, yes, climate change is a problem it's probably the biggest problem we face but the impacts of how climate change affects all of us is going to be uneven and we really need to worry about how all will suffer. Some of us will suffer earlier and more than others, and that matters also.
[VRS]: How does sustainability intersect with our current situation of a pandemic?
[SG]: Really tough question. I guess my first thought on the pandemic is what that it is a really terrible time for all of us
[VRS]: Yeah.
[SG]: Especially of us that are more vulnerable and it's honestly hard to know who is more vulnerable, right? Just because you're twenty years old or thirty years old doesn't necessarily mean you are out of the woods. I think we're seeing something like forty four percent of patients in New York City right now are between the ages of twenty and forty five - those are the people in the hospital, not people who have contracted it. So I think that what it means is - and that's where I want to start with - is that it means it's a social problem. It's something we're all connected to and it can affect us in profound ways.
First and foremost, we need to figure out how to stop this and how to think about an anti viral or palliative regime or a vaccine or something that's gonna stop it. In the meantime social distancing is a big part of this. All of these sort of concept I think we can think about for the lens of sustainability. It's a helpful tool in my work to think about this pandemic through that lens. What that means is as we scale across all society you see an impact,right. This pandemic is gonna have an impact on a certain percentage of people. People might perish in this. Our economies are disrupted. There are a lot of issues that we can name that are that are going along with this. But those impacts are unevenly distributed, right. Again, think about this as if I'm twenty perhaps as a twenty year old age category my risk is less. But your responsibility to others, right, to the older generation is really important. And this is a similar thing with sustainability - you may not suffer the effects of climate change war or water quality or poor air quality directly you don't want to say well that's not my problem because you're thinking about someone else downstream of you or someone else in a different part of the world who doesn't have the same you know I guess offer from this so the pandemic is the number to think about regardless of age, regardless of how you're gonna come out on this, you have to be concerned. You know, we think about economy on this also. Economically, some of us are going to be impacted harder than others. You work as a bartender - and I did when I was in college so I know kind of what that would feel like for someone to say "Hey, the restaurant's closing, you got to go home," right? I didn't have health insurance. I didn't have a a paycheck. I couldn't work from home. So I would've been more severely impacted as a bartender than I would now in my current role.
I think that we have to be really careful to think about how in this time of need do we think about society as a whole and think about the fact that resources and effort has to be put on to help the people who work in the most impacted. Now, that said you have groups at Stanford and others were talking about the rise of pandemics. So, you know, they call it zoonotic pandemics which come from our interaction with other species like bats, or pangolins, or whatever. You have these different viruses are are probably the product of us pushing further and further into biological spaces we haven't been in the past. And this is a longer conversation, I really want to parcel the two or separate the two. I don't want to point a finger and say humans are encroaching environment that's causing this pandemic because that's insensitive to the fact that we have to deal with this right now. But I think long term, the balance of how we live, our footprint on the planet, it is gonna be really important. Every time we kind of move into spaces where we haven't been and we disrupt natural balances that existed we expose ourselves to these kind of risks and we are going to have to think really seriously about how we, you know, predict these things coming, how we live in a more balanced way with these wild areas and wild species that we're encroaching upon. And how if we don't, these effects will continue to be felt. And that's kind of how I think sustainability comes into this.
[VRS]: What gives you hope right now?
[SG]: For what?
[VRS]: *Laughs* For human life, for the future of our planet and our species!
[SG]: I think we really have to get serious about thinking about, you know, I said that that climate change, in terms of sustainability, right? Sustainability is balancing our social endeavors and social well-being with our economic vibrancy, so the economy, and then with the environment. So it's this balancing act and we're not doing a great job of that right now and the answers are really complex in that the trade offs are really complex, right? You can't tell people to stop their livelihoods and we want to make sure that we protect the environment. We want to make sure that we are not disproportionately impacting the most powerless, weakest, most economically insecure parts of society and so I think that my hope for sustainability is that we really get serious in thinking about what that balance is.
[VRS] Hmm.
[SG] If we don't we're gonna find out that there are limits to what we can do as a society right there are capacity limits, maybe not at the local level. I think about this all the time. You know,Las Vegas doesn't have any water but there are millions of people living in the desert. So carrying capacity in a biological sense, right, means nothing for human beings.
[VRS] Mhmm.
[SG]: We can do whatever we want to, we can move resources around at the local scale. But when we scale up to put a two spaceship earth, it's a lot harder to think about it about overshooting our limits. If we overshare limits as a planet, there are consequences. If we figure out what those limits are in what we want to do with them, my hope for sustainability is that we will figure out a way to stop climate change but in the process also thinking about it's not just climate change right it's it's about our biodiversity loss, a whole bunch of different things that are underneath climate change. Right now,we have to think about, you know, we have other issues and pressures. Like by the year - I think it's by the year twenty fifty - we have to have fifty percent more food on this planet to feed the growing population. That means putting an area the size of the Amazon basin or the Congo rainforest into food production. If we're talking about biodiversity and producing more food we have to have a technological change in how we deliver food from an agricultural perspective. We're talking about, you know, fifty percent of people being water insecure by the year twenty fifty, also. How we deliver water, how we use water has to change. So in a very real way my hope is that we'll get serious about thinking about how do we live well. We don't turn the lights out and go back into caves - people often say sustainability is about taking things away. That's not true. What it does mean is we have to be smarter and more efficient in how we deal with resources and think about what our priorities are socially and then let our actions follow from that.
[VRS]: Do you think this pandemic is helping us re prioritize our social needs?
[SG]: I think it's really too early to tell in the middle of a crisis. A lot of what we are doing is reacting to, responding to, what we think are the immediate needs. I think our number one goal is to keep people alive, you know. And that's people who are five years old and people who are eighty five years old. I think our resources should be put towards making sure that we minimize the number of deaths associated with this. I think for me that - that's as an American - at least that's what my number one priority is. To say how do we get out of this in a way that we preserve human life and then we can take time to reflect. You know, I think that what this crisis has done is it showed us really clearly how globalized our world is. We always talk about globalization, talk about supply chains from China or Indonesia or Brazil being intertwined. I think this is shown us, it has laid bare the insecurities of all supply chains and the problems of being a globalized interconnected community. And the lessons we can take from that are either to become less connected or to think about being more connected and sharing information better and working together. And my hope is that the latter would be the result and it wouldn't be just kind of a protectionism that emerges from so often have a crisis. You have a sort of objective reality but the subjective interpretation is unpredictable, right? It doesn't mean that just because we had a crisis we're gonna work better together. It can cause us to actually retrench more and go back into a protective stance, which would be bad for everybody, I think.
[VRS]: Yeah
[SG]: What we do know it is a crisis and we do know that it has exposed the frailties in our economy and how an interconnected globalized society works. And we have to figure out how do we move forward in a way that we don't lose prosperity. And that we continue to enhance the resiliency of the system we live in. I think a big piece of that is the environmental, right? It's how do we continue to have, you know, an environment that is livable.
[VRS]: Absolutely. Anything else I should have asked you?
[SG]: No, don't mean to ramble, that's all.
[VRS]: You've been great. Thank you so much for sharing your time and your expertise with us!
[VRS]: This has been Art at the End of the World with Vero Rose Smith. Tune in next week to learn about another way in the world may end. The music for this podcast was written, performed, and produced by Gabi Vanek. You can hear more of her work at her Soundcloud which is linked in the show notes. Thanks, Gabi! And thanks for listening.
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In addition to her advocacy work and non-profit leadership role with the Iowa Harm Reducation Coalition, Sarah is currently pursuing a medical degree at the University of Iowa. Music was written, performed, and produced by Gabi Vanek.Transcript produced and edited by Molly Bagnall, University of Iowa Class of '20.--BEGIN FULL TRANSCRIPT--VRS: The world is ending again. Doomsayers and apocalyptic prophets have warned of coming calamity for millennia. Still, humanity persists. This podcast invites entrepreneurs, scholars, community leaders, artists, and many others to envision the end of the world according to their expertise. I’m Vero Rose Smith, your host, and this is Art at the End of the World. Today we welcome Sarah Ziegenhorn, founder and executive director of Iowa Harm Reduction Coalition. Sarah holds an undergraduate degree in geography and biology from Macalester College and has many years of experience in public policy and community organizing. In addition to her advocacy work and nonprofit leadership, Sarah is currently pursuing a medical degree at the University of Iowa. Our conversation was recorded on Wednesday, April 8th 2020. VRS: So thank you so much for taking time to do this interview and could you introduce yourself and a little bit about your current role?SZ: Sure, so my name is Sarah Ziegenhorn, I’m the founding executive director of the Iowa Harm Reduction Coalition. Um, for short we go by IHRC commonly and we’re a statewide nonprofit that does advocacy, technical assistance, training, education, and direct services for people who use drugs. So all of our work is really focused on protecting and promoting the health, rights, and dignity of people who use drugs in the state of Iowa. VRS: Amazing, and how did you get interested in this work? SZ: Sure, so I uh- about ten years ago I was living in South Africa and um- I had a home stay family that I lived with for about a year during my study abroad as an undergraduate and um- in in the neighborhood where my homestay family lived was fairly low income and there were a number of women who worked in the neighborhood as, um, as street based sex workers and so I got really interested as I developed friendships with people in the neighborhood and with the folks that were engaged in this kind of survival economy. I got interested in sex worker health and rights and so when I came back from my study abroad experience, I did a research project on um- on urban transportation project in the Twin Cities, at time they were starting to build a light rail and in this area that had been notorious for people doing outdoor and street based sex work for many many decades and so I was really curious how the street project which many people saw as gentrification is going to impact the health and well being of people who were working outside on the street where this light rail was meant to be built. And so kind of from there everything else sort of flowed and developed really easily. I moved to Washington D. C. after I finished my undergraduate degree and because I had had these these research experiences and done this work in South Africa and in the Twin Cities, on the first day that I started a new job at a DC think tank during health policy work, I had a friend or colleague come up to me and say what are you doing tonight can you commit to do a forty hour training to be a volunteer at the needle exchange program here in DC? and I just having the CDC was like sure why not? I don't have anything going on and the rest is sort of history from there. So I started working with the needle exchange program in DC, providing overnight outreach on a weekly basis, so driving around the city of DC between 10PM and 7AM providing syringe exchange services to folks who inject drugs and then working with the people who do street-based sex work in the city of DC.VRS: That's an incredible story and such amazing inspiring work. Can you tell us a little bit more about how your training influenced where you are today? So you mention your first experiences in this world of advocating for people who use drugs and people who engage in sex work as part of your undergraduate studies, could you tell us a little bit more about your course of study and then your professional training before you founded this organization? SZ: Sure! I completed my undergraduate degree at a private liberal arts college in St Paul Minnesota called Macalester and Macalester is a small school with a number of unique opportunities for individualized study and so I majored in geography which is a really good grounding in social science research methods, especially research methods used in geography and taking a place based approach to thinking about social problems in the world and because people in public health recognized how important place is to shaping people's health and wellbeing, there's sort of a nice synergy with community health and global health work and so I had an interdisciplinary concentration in community and global health that I completed as well as a second major in Biology. So I got sort of a well rounded training in hard sciences and social sciences and then went to work in DC at a think tank applying some of the conceptual and more theoretical training that I’d received. And I’d worked and done a lot of, a lot of social science research in geography as an undergrad and so moving to DC, the think tank that I was working at was a research one it's called the the Institute of Medicine, and now known as the National Academy, or the National Academy of Medicine and so in that role the work that we did was really focused on synthesizing research so that it could be presented to policymakers and then delivering evidence based strategies for public policy change to folks working on the Hill in DC, so people shaping federal policy. So that has been really really helpful training for the work that they do now with IHRC because it gave me a very practical lens on how to communicate about science and how to engage policy makers and build relationships with individuals who shape policy at many many levels and the work that I had done in in my undergrad and also in the five years that I spent at the think tank and made it very clear to me that a lot of times when we think about advocacy work we focus so intensely on the individual people who are making policies through a legislative decision making process but um- in public health and in federal policy work we we understand and we recognize that everybody has a role to play in making communities healthy places to live and so that has been really foundational for me and thinking about how do we achieve better health for people who use drugs in Iowa, a lot of that is done not just by focusing on advocating to politicians or policymakers but connecting with and building relationships with broad stakeholder groups community.VRS: And what brought you back to Iowa specifically? And was there more of a need here than other places? SZ: That's a great question and so I came back to Iowa in 2015 to pursue a medical degree at the University of Iowa and so I have diverged a lot from that path and I plan to finish my medical degree within the next couple of years. But then, I've spent a lot of time working for I. H. R. C. as something I didn't foresee I would do, sort of taking a break in medical school to work it's not very common but when I came- Iowa is my home state where I grew up, I was raised in Iowa city and on farm outside of Muscatine and so when I came back to Iowa I had been living outside of the state for almost a decade but I was really alarmed after about a year of being back, in recognizing what happened during the time that I’d lived elsewhere and so sort of as a teenager I grew up in a part of history in Iowa was rate very common for people especially at youth and adolescents to be using prescription opioids and using pills as something that they did recreationally or at a party with their friends. But by the time in had come back a lot of the people that I knew who had been casually using pills, many of them were dead, many had passed away of overdoses and then many had been incarcerated or many were actively using heroin and so on when I thought about everything I had learned in DC, both working in the needle exchange there and in the federal health policy role that I’d worked in and I knew there was so much great work going on to build community support for people that use drugs and I saw none of it happening in Iowa and so I was alarmed at how far, and I hate to use that this idea that Iowa is behind because it creates an idea that we're all heading in the same direction and that communities don't have their own unique destiny that the EArth is a sort of homogenous place and some places are better in a hierarchy than others but um, when it comes to public health solutions for overdose prevention, infectious disease prevention, substance use treatment, Iowa really was behind and they really are a number of a sort of gold standard approaches to these problems that can be implemented to stop them and that other communities had been engaged in for many many years previously. VRS: Thank you so much for that explanation. Does the ruralism or the geography of the state of Iowa affect availability of the types of resources that I H. R. C. now provides? SZ: Definitely. We- we're the only organization in the state that provides the types of services that we do and we are very very very poorly funded, while we are well resourced in terms of the number of individuals and volunteers that we have collaborating with the work that we do. Iowa has not made it a priority to use any of the federal funds that they've received to address the opioid crisis to fund the types of initiatives that our organization works on and so because public health is funded primarily with public dollars be they state local or federal dollars, we're really at a disadvantage as being the only service provider of our kind in the state without very much support from traditional streams of public health funding. But we see all the time that we receive receive requests for support, request for services every day from people living all over the state so folks as far away as Fort Dodge and Sioux City and Mason city too and some of the closer rural counties in our state. We have an office in Cedar Rapids and we know that um- many individuals will drive over an hour to get to our office, and it's not just the services that we provide that people travel long distances to, but its treatment as well so when we meet with individuals who are interested in changing their drug use patterns and are looking for a treatment, people are typically needing to travel up to two hours one way just to get to a doctor's appointment because the number of individual doctors or advanced practitioners, PA's and MPs, who are providing substance use treatment services in the state are so low and the regulations, up until actually it's interesting, up until a couple weeks ago due to the coronavirus pandemic, there were a number of restrictions on treatments, especially for people of opiate use disorder, that required that you must visit a clinic every single day to receive dosing for medication and so for many people they’re driving an hour and a half in their car every day to a clinic just to get treatment for opiate use disorder and that’s, that's unusual and because Iowa’s population is spread out fairly sparsely and in not a lot of dense clusters in many parts of the state, it's just not feasible that we're ever going to have lots and lots of new addiction treatment centers pop up in small towns or in in places that are closer to where people live, so then it means we need to think of new ways to get services to meet people where they're at rather than requiring people to kind of come everyday for dosing for medication. VRS: That is a dire picture in many ways, it's so resource intensive to do that kind of daily commuting. Can you tell us a little bit about some of these new ways I H. R. C. is exploring to bring services and treatments to folks at a distance? SZ: Sure, so for our services, we use a very very old fashioned method called the US postal Service and we do a lot of service provision via the mail, and we use, as much as possible, we’ll provide training and services to people over the phone, via text message, or Facetime, or a basic phone call and then mail people what they need. Through some of the changes that have just taken place at the federal level that regulate access to treatment, while we're not a treatment provider ourselves, we operate a patient navigation program that helps connect people directly into treatment. And so with our patient navigation program, what we've seen happen in the last couple weeks is rules that have been in place since the 1970s have suddenly shifted at the federal level, making it so that people who are looking for treatment for substance use disorders, whereas once there is a ban on providing telehealth services for people who are seeking treatment especially for opiate use disorder, that ban has now been lifted and so now rather than play a game where we, in the past, have tried to fill in, sort of fill in the gaps and figure out how we can piece together a solution to get somebody to a treatment provider who lives two hours away by stringing together a series of cabs or ubers and meeting someone at a hospital to advocate for them, now it's suddenly very different. We're able to allow people access to meet with providers via telehealth for their first time to receive their treatment for addiction and that's a huge deal, it has made compliance with appointments, are people are following through on coming to their appointments, the rates have increased really dramatically but it’s also made it a lot easier for people to find providers that they will work well with. For example, many providers in the state of Iowa use a treatment model that's been pioneered by the Betty Ford Hazelden foundation in Minnesota which uses an abstinence based model of treating substance use disorders, but in Iowa there only a few providers who are willing to take a harm reduction philosophy and approach to treatment and working with people where they are and meet people with flexibility when it comes to thinking about what a person or a patient’s goals are and allowing that to dictate the course of treatment rather than requiring that the provider’s goals or a certain philosophical approach to treatment’s goals dictate how that person's process should go in treatment. So that has been really powerful in that it- these new telehealth regulations changes allow for people to start accessing treatment through a provider of their choosing not just the only provider please just with an eight two hour radius. It gives people a lot more flexibility and freedom in finding a provider that really is able to work with them on their individually unique goals.VRS: That's incredible and really hopeful. Could you tell us a little bit more about, in your opinion, what the most vital service or treatment I H. R. C. offers is and you've already spoken to these changes in telehealth, but are there any other changes that have really shaped how IHRC functions recently? SZ: Sure. So one of our most important services that we provide is overdose prevention, and in our program we’ll at least apply people with this medication called naloxone also known as the brand name Narcan and the medication is one that reverses an opioid overdose so for people who are using drugs like heroin or prescription opioids, overdose can be something that happens fairly commonly and this medication works essentially to bring people back from the dead almost, it’s sort of a miracle drug in that it has no adverse side effects. It's not dangerous to administer someone who is not overdosing and in fact it's really not dangerous at all and there's no there's no upper limit of dosing so it's a really really safe medication. Many physicians will tell you that it's safer, many many times safer, than a number of the medications that are for sale in the aisles of the HyVee pharmacy like Tylenol or ibuprofen. So this medication is one that we distribute to people all over the state. We’ve distributed nearly forty thousand doses in the last two and half years and we've had a lot of success with distributing the medication because many people that we distributed it to come back to us looking for more medication and they tell us that they've used it so we know that at this point we’ve had around 2,600 individuals whose lives have been saved from the medication and having had an overdose reverse. There's really really good data about this medication that exists at the government level, I’m sorry at the national level, and so the federal government has put out a lot of guidelines on how to best uh, best target the distribution of this medication in the community and so there are many messages from people like the Surgeon General who say everybody should carry naloxone with them, everybody should obtain this medication carried it on them in case they observe an overdose. But really what we know is that people who are most likely to reverse an overdose and administer this medication are people who are actively using substances and then the close close family and friends of people who use drugs, so if you don't know someone in your life that you see on a regular basis in a place like Iowa where we don't have an intense activity of people living and working and being out on the street, there's not a lot of a lot of life that happens necessarily outside in Iowa other than people like going for a walk or a run it's certainly not like Philadelphia or New York you're not likely to witness an overdose in a public setting. But for people who have a sister or a boyfriend or someone really close to them that does use heroin or other opiates then carrying naloxone is often something that they're more likely to have a need for than somebody in the general public but even more so than law enforcement and other first responders, so people who use drugs reverse about eighty five percent of all overdoses that are reversed with naloxone whereas law enforcement and emergency medical responders reverse about five percent each respectively. So within the last few weeks one thing that we have all thought may happen but it had a hard time tracking is that there may be an increase in overdoses due to social distancing that leads to social isolation. So when people are isolated, that can be a time when their drug use increases because a lot of times opiate use in particular is a response to a painful stimulus or something that's uncomfortable and being alone is something that often times can be uncomfortable and leave people feeling vulnerable to pain of some kind and so many people around the country are anticipating that there will be a spike in overdose,s especially in fatal overdoses because when people are by themselves, especially people using drugs by themselves, there isn't, that means there's not somebody else there to administer this medication, Narcan, in the event of an overdose. So when people are overdosing, they’re unconscious, they’re not breathing, they can't administer it to themselves and there's not really, there's no predicting when somebody's going to overdose so you really need to have people watching out for each other, spending time around one another, physically checking up on one another in order to be able to make overdose prevention work and when we have uh, people are so isolated and distant from one another then it becomes trickier to make sure that people can do that, that act of looking out for and protecting one another. So while we don't know yet what the impacts will be or what the what the effect will be, many people do anticipate that the pandemic second area of effect will be to drive an increase in overdose deaths.VRS: That is hard to hear and terrifying, I'm sure you and everyone that you work with and loved ones and people that you know that are vulnerable right now. So how are you responding at IHRC to the pandemic specifically? SZ: So we've kept our services open and we're continuing to function as sort of as usual but we're encouraging our clients and our participants to receive deliveries from us rather than coming into our office and into our drop-in center. We’re really promoting and encouraging that people stay home and let us come to them and deliver supplies. We’re taking many many precautions when we interact with people so making sure that we keep a distance between ourselves and others, playing appropriate personal protective equipment, and making sure to practice good hygiene practices, and making sure that we reduce the amount of contact between ourselves and our clients as much as possible. But one of the most important things that we've been doing is just working to educate the people that we serve about this pandemic because many don’t have very strong sources of information where they receive news about public health, this is something that's been very confusing and especially because many of the people that we serve are relatively low income and have a history of arrests and incarceration there's a general sense of mistrust of government. So people have not necessarily been heeding the warnings of government officials and not necessarily listening to the instructions and orders to practice social distancing but have had sort of a big gap in understanding about what is real and what is not real when it comes to the pandemic and its signs and symptoms and opportunities for prevention. So that's the most important role that we play at this time is getting out accurate information to a community that has been deemed by traditional public health services as too hard to reach or impossible to access.VRS: That's incredible, important work. In non pandemic times, how does I H. R. C. advise folks who want to speak to the issues that you deal with every day about the language that should be used to address the stigma of addiction? What kind of language is best and how can we shift community thinking about these topics? SZ: Sure, so we often talk about using person centred in language and and so you'll notice that while we've been talking I haven't referred to anyone that we work with as an addict or as a more inflammatory term that people sometimes used to describe the community of people that experience uh- experience substance use disorders or just use drugs recreationally. Many people used drugs and do not have a substance use disorder, so we try to use language that is broad and encompasses many different types of behaviors and life experiences and that means leading with uh- leading with language where the word person or people comes first so then ensuring that people are not identified by their behaviors, but the people identified first as people and then as an action second. So people use drugs, rather than a drug user or a drug addict, and then removing some of those identified- those terms that reduce people to their behaviors like an addict from our lexicon. There are people who choose to self describe themselves in those ways and then that is never something that needs to be stopped or ashamed, you know we don't want people going around and saying oh you just get referred to yourself as an addict, don't you know that that’s stigmatizing. No, for many people, referring to themselves as as somebody who is an addict can be something that is seen as empowering and claiming a certain narrative or story or identity. But, for people in the broader community who want to dissolve stigma, adjusting our language can be a first step that people take. Probably the biggest and most important way to address stigma though in the community is a really dramatic step and it's a big one but it gets at the heart of the issue and that is that substance use is stigmatized because it's something that we believe to be criminal, and while many people know and will say things like ‘we really can't arrest ourselves our way out of the drug problem’, ‘arrest and incarceration is not the solution to a medical or public health problem’, until we can move past just giving lip service to those ideas and actively change the laws around sections used in order to make sure that people that use drugs are actively not criminalized then we don't have much hope for changing the way in which substance use and the people that use drugs are stigmatized. Decriminalizing substances, but most importantly decriminalizing the people who use them is the most important step to be taken in order to reduce stigma, because without having that criminal association it's hard to continue to stigmatize people.VRS: Thank you, so we’ve talked a lot about the client facing services that IHRC offers but you bring up a lot of important intersections with policy at both the state and federal level, so how does IHRC affect policy or try to affect policy? SZ: So our policy program program works to address a number of legislative priorities and so we primarily work at the state level to change and shift policy, working on policies that affect infectious disease and overdose rates for people who use drugs. So as an organization we develop public policy working with our partners at the national level to develop policies that take into account the lessons learned from other states and best practices from other policy environments, and then bring those pieces of legislation to elected officials in our state house in Iowa and work with them to see those, those bills introduced and then moved through the state house. At the federal level we don't do nearly as much and so our focus is really at the state level but we work with our national partners to support campaigns that they lead at the federal level in order to make sure that our federal lawmakers know that their constituents in their districts are paying attention and do care about the issues that federal advocates are asking them to pay attention to.VRS: Great. So you've talked about some good scenarios like decriminalizing drug use as an optimal outcome for the work that you do, could you describe for us the end of public health? What is the absolute worst case scenario in your opinion?SZ: I think that the worst case scenario for the community of people that we work with in many ways we have been- we have been living in the worst case scenario for quite some time and living in a world in which things are actively getting worse for people who use drugs. I think if, if you could design a system in which you wanted people to continue to get sick and you wanted people to die from accidental poisoning, you would design a system that we live in now. Because over the last 150 years we've created a world in which people believe that people who are experiencing pain and who take very rational, very reasonable steps to minimize the discomfort or the pain they feel on a daily basis, be it physical pain, or psychological pain, or emotional or spiritual pain, when people work to address that pain, they’re viewed as deviant and criminal and so what we have essentially done is decided that other people's pain of certain kinds does not concern us and not only does it not concern us but it scares us and it frightens and upsets us and so we need to remove it from public eye and from our communities in general and so by putting people into prison and into jail for very long sentences for simply for the act of choosing to put a substance in their body that will alter their consciousness, that fundamental decision has really transformed the world that we live in for people who use drugs but it's also created a sort of a perfect storm in which we've built up so much momentum around this particular system, our prisons are so large and our criminal justice system employs so many people, that because of the economic system we rely on, there are very few incentives to do anything differently. And so, in fact, we are incentivized to continue moving forward with this idea that some people's pain is unfathomable and some people's pain is inappropriate or deviant and bad and therefore we must remove these people from our community and put them in a place that's out of sight and not only do we do that but we make a lot of people make a lot of money off of that very process and once individuals are released, there's really no hope for for repair, for healing, or forward movement, people are largely just caught up in the cycle of- and remain in the criminal justice system for most of their lifetime. So in a lot of ways you couldn't design a system that is more perfect when it comes to perpetuating underlying pain and suffering that people experience that can lead to substance use, especially in its more problematic forms. In many ways their examples in the world today there are much more dramatic and are supported by President Trump in other parts of the world, people who possess a small amount of substances can be, can, can be tried with the death penalty, but in in some in the Philippines, the president of the Philippines has called for vigilante justice against people who use small amounts of substances, so encouraging citizens of the Philippines go out in the streets and murder people who are suspected to be addicted to substances and so that is I think it really if, if that's not apocalyptic and I am not sure what would be the next worst stuff to happen in, in this this world for people who use drugs. So it's a bleak picture and fairly depressing but I think it offers on the other hand a lot of opportunities for help because in recognizing that things cannot really get much worse, there are many many many opportunities for things to get better. VRS: That leads into my next question of what gives you hope?SZ: Yeah I-I think about this a lot because um, the work that we do can be very heavy and there is a lot of suffering and a lot of death that people are exposed to when they work in this field or not just when people work in this field but when people are surrounded every day by this as their personal world too and not just the professional world and so for- in the work that we do fundamental to our goals is the desire to work with people to create a feeling and sense of empowerment. So rather than just going out and deciding that we're going to deliver services to people, we're working to engage people in our process and working to bring people in to a community and to participate in something that's bigger than themselves, and offering people an opportunity to create meaning and connection is-is sometimes what people will identify as the heart of community organizing and community building and it's not traditionally seen as the fundamental heart of public health. But in the work that we do all of it is about building connection with people and then encouraging them to stay and then watching what happens from there is is the most helpful of all. And so there's so many people that have come into our program that arrived and said that I-I witnessed an overdose and I need more Narcan for the next time that happens and the first question I ask is how many people do you know that are like you how many people do now there are using heroin on a daily basis or people that are overdosing and we'll give people as as much naloxone as they want based on the number of people that are in their network. So some people will say okay I could use a hundred doses of naloxone, some people say I could use eight hundred doses, and we’ll say okay and so watching those individuals go out into the community and transform themselves from having an idea of themselves as someone who is worthless or powerless or worthy of being in prison and not worthy of having experiences and relationships in the world then offer them an opportunity for connection, watching people dissolve those ideas those falsehoods in their thinking. Then gain very real proof that they are valuable by distributing this medication and watching as other people use it to save someone's life, that leads to a really great sense of personal power, being instilled in people. And so even though at the start of the day we never set out to say we're going to stop people from using drugs in Iowa, oftentimes as a by product of the things that we do, like distribute naloxone, people will come back to us and say because you gave me this naloxone and because you taught me how to teach other people to use it, I felt a sense of value and myself and when I felt that way I wanted to become more accountable to the other people in my life who were telling me that my substance use was causing problems in our relationships, I wanted to modify the way that this drug shows up in my life so that I can give out more naloxone, this can become my career so that I can do this every day and save more people's lives. And so we see a lot of times we see people cease their drug use or dramatically dramatically reduce their drug use as a result of engagement in the types of programs that we provide. And so I think, just to answer your question, watching other human beings go through that evolution of recognizing their own value and power is beautiful and even though it's a very small thing that happens one person at a time, it's extremely helpful because it's such a profound change and it offers so much more opportunity for for other people too, beyond just ourselves but for all the people that exist around these other individuals as well. VRS: thank you that is really hopeful. Is there anything else I should have asked?SZ: No I don't think so. I really appreciate you having me and for the thoughtful questions and the opportunity to discuss. VRS: Thank you so much Sarah, your work is so crucial and so needed and I really enjoyed our conversation.VRS: This is the number at the end of the world with Vero Rose Smith. Tune in next week to learn about another way in the world might end. The music for this podcast was written, performed and produced by Gabi Vanek. You can hear more of her work at her soundcloud which is linked in the show notes. Thanks Gabbi, and thanks all of you for listening.2. The End of Microbiology and Immunology with Lilly Radoshevich, PhD
23:33||Season 1, Ep. 2THE WORLD IS ENDING! Again. Doomsdayers and apocalyptic prophets have warned of coming calamity for millennia. Still, humanity persists. This podcast invites entrepreneurs, scholars, community leaders, artists, and many others to envision the end of the world according to their expertise.Art at the End of the World is a hybrid class and public program series supported by the University of Iowa Stanley Museum of Artand the University of Iowa School of Art and Art History, and taught by Associate Curator of Special Projects, Vero Rose Smith.Today’s guest is Lilly Radoshevich, PhD. Lilly is Assistant Professor of Microbiology and Immunology and Assistant Professor of Molecular Physiology and Biophysics at the University of Iowa, and runs a lab dedicated to exploring listeria. She also has a very cute dogMusic was written, performed, and produced by Gabi Vanek.Transcript edited by Ellie Zupancic, University of Iowa Class of 2020--FULL TRANSCRIPT--THE WORLD IS ENDING! Again. Doomsdayers and apocalyptic prophets have warned of coming calamity for millennia. Still, humanity persists. This podcast invites entrepreneurs, scholars, community leaders, artists, and many others to envision the end of the world according to their expertise.I’m Vero Rose Smith, your host, and this is Art at the End of the World. Today’s guest is Lilly Radoshevich, Assistant Professor of Microbiology and Immunology, and Assistant Professor of Molecular Physiology and Biophysics at the University of Iowa. Lilly received her BA in biology and French at Grinnell College, also in Iowa, and her PhD in biology and biomedical sciences at the University of California San Francisco. Our conversation was recorded on Wednesday, April 1st, 2020. S: I’m really excited for your answers, and I’m sorry we have to do it in this format, but I appreciate your being flexible. If you could introduce yourself and tell us about your current role—R: My name is Lilly Radoshevich and I am currently an assistant professor at the University of Iowa. I am a scientist and I have teaching duties with the College of Liberal Arts and Sciences, but my primary role is to run a research laboratory. We work on the host—that means us—and cell response to bacteria; in particular, the bacterial pathogen Listeria monocytogenes, which you’ve probably heard about in the context of food recalls. The idea behind our research is to try to learn more about cell stress pathways, including pathways that are normally antiviral, in order to see whether or not we can target them. But, right now in this unprecedented time, I've actually switched some of my work to working in collaboration with Stanley Perlman and Wendy Mauri on Coronavirus; so that's kind of exciting.S: Wow—I know you're really passionate about Listeria because you have a dog whose name is Lister; that’s lovely.R: Yeah, that is after Dr. Joseph Lister, so equally nerdy; but he was really important for our times currently because he figured out that doctors were giving their patients bacterial infections. He was one of the first to figure out how to sanitize operating rooms and to instill in doctors to wash their hands, which is a very relevant and timely topic.S: Is it ever. Could you tell us a little bit about how you got to where you are professionally? What is your background and your training?R: Yes; I actually went to college in Iowa, at Grinnell College, just an hour away. At that point, I was really interested in human health. Initially what I thought I wanted to be was a medical doctor, but then I realized I was really more fascinated by scientific questions associated with human health, and that I was better suited to being in a laboratory. So, at Grinnell, I was given the amazing opportunity to do a summer abroad where I worked in a lab at the Pasteur Institute—which is one of the birthplaces of microbiology—and that inspired me even further. After that, I went and did my PhD in biomedical sciences at the University of California San Francisco, and after my PhD in which I was working on host cell stress responses that are altered in cancer biology, I switched back to working on host-pathogen interactions during a postdoctoral fellowship at the Pasteur Institute. So, because of that early exposure I had, I ended up applying and working for six years abroad at the Pasteur Institute. Then, after that, I applied for my own laboratory and the University of Iowa hired me—and that's how I found myself here.S: Thank you; and for anybody that might not know: where's the Pasteur Institute located?R: The Pasteur Institute is located in Paris, France, and it was initially established by Louis Pasteur himself. Right now, it's a very vibrant research campus in the fifteenth arrondissement of Paris, so there they currently work on lots of bacterial pathogens; they also work on the current Coronavirus and lots of emerging pathogens. The emerging pathogens are typically viral infections, so there's a laboratory currently working around the clock on Coronavirus there, too.S: To work and live in France did you need to also have fluency in the French language?R: Yeah; in general, science is very international, so many people do a postdoctoral fellowship abroad. We’re lucky, with English as our first language, that the language of science currently is English, so we publish and present in English. But, you don't just interact with your colleagues and labmates when you're living abroad. I actually was a French major at Grinnell as well, and that helped me a lot in my day-to-day interactions. You can imagine that some people work in a lab who might not have ever lived abroad—so interacting with my colleagues and labmates, speaking French, was really, really useful. But many of my American colleagues in that laboratory didn't speak French initially when they arrived—they took classes and developed the language during their postdoctoral fellowship.S: Amazing. Before college how did you get interested in this work? What originally drew you to this interest in the human body?R: I think at the most fundamental level, I'm something of a hypochondriac—and it is not a good time to be a hypochondriac right now—but very early on, in high school, I did the International Baccalaureate program. I had really excellent teachers in biology, and at that point, because we didn't we didn't have opportunities that people do today, a lot of it was looking at the world around us and at ecology. I also had great middle school teachers that inspired me to get into science early on—in terms of looking into native animals, for example. I'm from Colorado. There was a teacher at that time who got us involved in tracking bighorn sheep, and that was really exciting. But I was really always interested in this question about how viruses and bacteria make us sick; I've always been drawn to that kind of interaction, and I wanted to understand it at a molecular level. But I also wanted my work to give back in some way. So, my ultimate goal is that hopefully, down the line maybe thirty to forty years, some of the stuff that we're working on in my lab, and some of the questions that we’re working on, could be actually applied to human health—whether that is in the context of infection, or—one really cool thing is that you can learn things, using the bacteria or the virus as a tool, about our host cells that might be important in other human pathologies, such as Alzheimer's, Parkinson's, and cancer; so one other thing is that fundamental research can, in host-pathogen interactions, actually help us learn about other really important human diseases. S: Could you give us a little bit more information about what exactly microbiology and immunology are? R: Yeah! Microbiology is the study of microorganisms; this is loosely determined by the size of the organisms that we work on—that could be bacteria, viruses. That could also be parasites. Immunology is the study of our immune system. So, broadly speaking, each one of our cells has the capacity to detect foreign intruders and that would be innate immunity. Then there's a number of cells that can come in and help protect our body from infection, and those are our innate immune cells that patrol all the time. These would be cells like neutrophils or macrophages that eat up pathogens and could be thought of as first responders to an infection. Then there's a branch of immunology that studies our adaptive immune response. I think, probably, you've been hearing a lot about the idea of seroconversion—that means when your body has started to make antibodies to a pathogen. Another test that we can use in the Coronavirus example is whether or not people have actually been infected, but didn't realize because they are asymptomatic—their adaptive immune system will make a response that can be detected through a blood test. S: Follow-up question: has studying immunology and microbiology helped you personally address your hypochondriac-isms?R: I am not sure. I would say that, especially during our stay-at-home, shelter-in-place mandate, every day I think seasonal allergies might be the Coronavirus. I'm sure I'm not the only one.S: You are definitely not.R: Even though I understand it, I would say the really difficult piece of this particular disorder is that you could be carrying the virus, infected for many days, before you show symptoms. For influenza, that period is a lot shorter, so you can know when you're infected—so I think Coronavirus is maybe worse for a hypochondriac. S: We've kind of touched on one way the world might end according to microbiology and immunology, because we're all living it right now, but can you either expand on our current potential world ending or tell us some other ways the world might end according to your expertise?R: Yeah. I just want to also highlight what a timely topic you picked with this podcast and this series preceding the current epidemic—or pandemic, rather. I would say that, generally, we are worried as a community about two specific things when we're talking about the world ending in our field. One is the emergence of viral pathogens, so you've all heard a lot about that—and I just, at this point, want to say that there's a lot of really great information coming out of the University of Iowa; so if you want to hear more, there are at least four labs working on SARS-2 currently, the virus that causes COVID-19. Those are the labs of Stanley Perlman, Wendy Maury, and Balaji Manicassamy, and a little bit of my lab in collaboration. They were on River to River and everything. If you want to hear more, we actually have a world expert on Coronavirus at the University of Iowa. So, the idea is that, with air travel, the emergence of a virus in a particular area wasn't necessarily confined to that area—that it was spread rapidly and that we would have a major pandemic as a result—and the other really scary scenario, which might be related, is about bacteria becoming resistant to antibiotics. You've heard a lot about this in general and that's because not only do we overuse antibiotics in the clinical setting, but also a lot of our foods, when animals are in large processing plants, for example, are given antibiotics to grow faster in a bad situation. That leads to a lot of bacteria in the soil, contaminating the animals that become resistant. This can easily be transferred to humans that have bacteria on their microbiome (which is the term for the bacteria that colonize us and are helpful) with antibiotic-resistant properties, and then they can pass it to pathogens. So, one thing that might emerge is that, in this current pandemic like in 1918, some of the people that are the sickest, they might actually also have bacterial infections. That seems to be a large comorbidity. Sometimes these are hospital-acquired, and we might find out later that antibiotic-resistant bacteria contributed to this viral pandemic. I would just like to say that I would hope industry- and funding-sources for laboratories emphasize being ready for that, as opposed to reacting after the emergence of an outbreak.S: That's very scary. How are you working to avoid these world endings, or to address our current pandemic? You've talked a little bit about the collaborations your lab is currently undertaking, but I'd love to hear more.R: One of the pathways that we work on in our lab—and, just so everyone's on the same page, you all know about DNA: DNA can be transcribed into a message which is called mRNA, and that mRNA can be translated, just like a language, into a protein. So, one pathway that we work on is an antiviral pathway that's also, we say, upregulated or produced following a bacterial infection. There’s about three hundred of these proteins that are made in an initially-infected cell and by cells in the immune system; what my laboratory does is try to establish some kind of a repertoire of what this particular protein—called ISG15, and that means interferon-stimulated gene of fifteen kilodaltons which is just it's size, it's mass—is doing during both bacterial and viral infections. One thing we've done is we use a technology called mass spectrometry to identify other proteins that this protein is binding to. It's kind of like a molecular tag, and so our idea is that we don't understand what it's doing without figuring out what it's binding to. We've done this in the context of Listeria infection, and we recently published that paper. Now what we're doing is applying that to Coronavirus infection—first in a mouse model for Coronavirus, mirroring Coronavirus, and hopefully then we will be able to work with actual Coronavirus in collaboration with Stanley Perlman and Wendy Maury.S: Can you tell us more about the mouse modeling system?R: Yeah. In general, not all pathogens can actually infect mice readily so, some of the time, when we're looking at the immune response, we have to use a mouse model of infection, because we don't want to just look at tissue culture cells—let me take a step back. A lot of the things we can do can occur in vitro, so that could be cells that are grown in a dish, in the laboratory; but, unfortunately, that doesn't incorporate how an immune response can react to that infection. So, sometimes we look for coculture models or models in a mouse model of infection, but as is the case for this current virus, the human virus does not infect mice, unless they express a version of the receptor, which is ACE2, that is, quote – unquote, humanized. So, using genetic techniques to mimc DNA, some researchers, including Stanley Perlman at the University of Iowa, have made a mouse that expresses the human receptor for the disease, and then the mice would get sick with the Coronavirus. In my laboratory, we have other genetic models that we look at. We can delete the protein that we're working on, and we can use a model in which the protein and its activity are enhanced, but we would have to cross this mouse model to the humanized mouse model—so, what we're doing, at first, is using a Coronavirus that is called Mouse Hepatitis Virus, and this affects the liver and lungs of mice, and is a natural mouse pathogen that doesn't affect humans, as a model for what we will then do with the Coronavirus, the SARS2 virus.S: Thank you. Is anything giving you hope right now?R: Yeah, I actually wanted to tell people a little bit about the publishing process, and how science works. S: Please.R: Yeah, if we have some non-scientists in the audience. Like any field, typically what we do is work for years—and one misconception about science is that it's easy; well, it's not really easy to do this—so most of the time our experiments fail. Part of these long training processes is learning how to design the best experiments so we can move knowledge forward. The way we share our results is in the form of research papers that synthesize our data in the form of figures, and we talk about it and communicate it to the scientific community. Typically what happens is everything that I talked about, for example, would be put into a paper and that paper would be peer-reviewed. Then I would have to address the comments of my peers and make the paper better for it to then be accepted and published; however, one really interesting thing that gives me a lot of hope is this new system called bioRxiv (pronounced “bio-archive”), which has been taken from the mass community in which peer review takes a really long time—because mathematicians have to do proofs themselves of the same data—and it's a way to publicly share your unpublished data as you submit it to a journal. One really cool thing about this was that scientists in China, where the pandemic started, were sharing their unpublished data about Coronavirus in real time—and that allowed scientists all over the world to share their data as well. The one caveat is that sometimes the studies haven't been seen by peer-review; there was an issue in which some people probably overstated the effect of chloroquine, for example—that paper came out of France. So, on the one hand, you don't get peer review, but on the other hand, scientists are literally sharing, very openly, all of their data. And it is a competitive field, so the fact that people share openly for the greater good of everyone in the community gives me a lot of hope.S: Thank you. Anything else I should have asked?R: That's a good question. I don't know—I would just say be sure to take a look at my colleagues’ interviews if you want to learn more about the Coronavirus work going on at the University of Iowa. And, I just want to say thanks to your students for adapting to remote learning. I'm sure it's not easy, and hopefully we'll all get through this together.S: I think we will. It's always nice to hear from experts who are producing new knowledge in the world. You have such a different perspective from both my students, myself, and our entire broader audience because of this new platform. Thanks so much for your time.R: Thank you for asking me. I had a great time. This has been Art at the End of the World with Vero Rose Smith. Tune in next week to learn about another way in the world may end. The music for this podcast was written, performed, and produced by Gabi Vanek; you can hear more of her work at her Soundcloud, which is linked in the show notes. Thanks, Gabi, and thanks, all of you, for listening.