Inside the Harvard Humanitarian Initiative with Dr. Tim Erickson

Living a Life in Full is a conversation you always wanted to have with that person who gave an amazing TED Talk or the author of one of your favorite books, or that inspirational Olympian you always wanted to know more about. It's graduate level conversations with those making a difference in the world and in the lives of others. This show brings you new ideas and approaches so that you can live a life in full. I'm your host, Dr. Chris Stout and I hope you enjoy this episode. This episode of Living a Life in Full is brought to you by my publishers. Some of you may know that I started a non profit center for Global initiatives about 10 years ago to do global health and humanitarian work. And if you're longtime listeners to the show, then you know that a number of our guests have that as a common thread. Humanitarian work or global health or or a combination of the both. So a nice shout out to the publishers of these three books which I'm going to highlight. All proceeds of royalties will go to supporting the center for Global Initiatives. So if you're interested, hopefully you'll get a good read that you can enjoy and also do some good by sponsoring the work that we do through the center for Global Initiatives, which you can find out more about that work@centerforglobalinitiatives.org the three books are the Humanitarian Field Guide, which is a very quick and easy put it in your pocket, take it along with you, kind of guide the New Humanitarians, which I did some time back looking at about 45 different organizations, each chapter being kind of an in depth interview of them of how they started, what their work is, what their wins were, what some of their losses were, and how to kind of start your own depending upon whatever space that's in. We have three different volumes of that focusing in three different broad areas. And then finally, and most recently is why Global Health Matters. We have a website dedicated specifically to it so you can go there and learn more about it or order it, which is called whyglobalhealthmatters.org and we're very thrilled. It's an edited work and the forward is done by Jodi Williams, who is a good friend and as you may know is a Nobel Laureate for her work in landmine issues vis a vis winning the Nobel Peace Prize for that back in the late 90s. And it's a edited work of 60 individuals who are just really experts in their areas and the United thread through all that is focusing on global health. So please take a look, go research them, look at those websites you can buy them at your favorite bookseller or online through Amazon.com in paperback or hardcover. Or some of them. I think New Humanitarians is hardcover and Kindle or digitally as well. So take a look. Thanks very much. A quick show note before this episode starts, Tim and I did this interview via Skype and towards the tail end, like maybe around the last four to five minutes, there were some Skype hiccups where we had some disconnection. So we tried to edit that down and out as much as possible. But there's still a little some pauses there that we couldn't quite tweak out enough. So please bear with us. We can still hear what's said, but it's just not as high quality as the other 98% of the episode. Thanks welcome to another episode of Living a Life in Full. I'm your host, Dr. Chris Stout. Today I'm very excited to have my guest, Dr. Tim Erickson, on. He's an old dear friend who I haven't gotten to catch up with in a while, so today we'll be able to do that together. Dr. Erickson is a Harvard Humanitarian Initiative Core faculty member with expertise in environmental toxicology and crisis in climate change. He is also an active humanitarian physician involved in a variety of different kinds of health projects and in particular right now in conflict regions of Ukraine and Syria. Dr. Erickson is also an Emergency medicine physician at the Brigham and Women's Hospital in Boston, where he serves as Chief of Medical Toxicology in the Department of emergency medicine. Dr. Erickson earned his MD degree from the Chicago Medical School in 1986. He completed emergency medicine residency training at the University of Illinois and his medical toxicology fellowship at cook County Hospital. Dr. Erickson is a Fellow of the American College of Emergency Physicians, American College of Medical Toxicology, American Academy of Clinical Toxicology, and perhaps maybe the most fun one. He's a member of the prestigious National Geographic Explorers Club, which we're going to do a deep dive into. Previously, Dr. Erickson served as the Director for the UIC center of Global Health, where he was the founder and professor of Emergency Medicine and Medical Toxicology at the University of Illinois at Chicago. Dr. Erickson also served as the Associate Dean for Faculty Affairs, Graduate medical Education and Continuing Medical Education. He was an acting and interim head in the Department of Emergency Medicine and the Emergency Medicine residency training program. Dr. Erickson has been a member of multiple editorial boards and has a prolific academic history, including publishing over 120 original journal articles and book chapters, as well as editing four major textbooks. He's presented over 100 national and international invited lectures related to emergency medicine, toxicology, humanitarian global health and wilderness expedition medicine. He has extensive international experience in Africa, including Rwanda, Sudan and Kenya, in Asia including India, Vietnam and Nepal, and South America including Brazil, Peru and Argentina, and also in Europe in Kosovo, Ukraine and France, and even in Antarctica. And I want to know what he was doing in Antarctica. So with that, I'm afraid we're out of time, Tim. And we've really enjoyed having you on now. It's great to have you on. Good to reconnect, man.

It's good to be on Chris and I appreciate all the great work you've been doing and definitely been following your illustrious humanitarian career. So it's a pleasure to be on and to chat about things and try to make the world a little better place.

Thanks. I have said to many people if I weren't older than you, I'd want to grow up and be you. So how long have we known each other? Has it been 15ish years? I was trying to do the math. Does that sound sound possible? Does that sound right?

I think that's about right, yeah.

Okay.

Because the second decade.

Yeah. And I think it was back in the day, I think I was specifically on faculty in the Department of Psychiatry at the College of Medicine at University of Illinois at Chicago. And I guess like most strong brotherhoods, what brought us together was terrorism or bioterrorism. Was that it? Do you recall?

I believe it was, it was during the weapons of mass destruction era scare, the global scare of that which some of it was legitimate, some of it was probably a little over dramatized. But be that as it may, we were involved in some educational initiatives and some HRSA funded research with the weapons of mass destruction. You need a really good mental health expert

and you need a really good toxicology bioterrorism expert. So. And I have to say I, I guess it's gotten. Gotten retired now since you're not at UIC anymore and now at Harvard. But I, I have to say and I think this really kind of speaks to who you are. Your wasn't your email talksboyic Eduardo that's right, Chris.

Never to be. I never even reached tox teen, let alone man. So yeah, I was tox boy for the longest time and I'm still tagged by that in a good sense. It is interesting every once in a while when you had a prestigious scholar, Nobel laureate and or big donor and saying what's your, what's your email address? And then I would get a few that Went, so, toy boy, can we meet some? That's tox boy.

Get that straight.

So that's even better. Let's still meet.

That's good.

I actually tried to get that handle at Harvard. The scholars said, we don't go not in this territory.

That's too bad.

Little fish, big pond you are no longer talks for.

That's funny.

That's near and dear to my heart.

Yeah, I always liked that. So when we got together, I think it was maybe on the cusp of you getting started with the development of the center for Global Health there at the College of Medicine. So can you walk us through the genesis of that? What started it? How did you start it? What was your role?

Well, it really was a response to not just global issues at hand and a real love and drive to try to make things a little better, at least in a small corner of the world, not many corners of the world, but it was really student driven. We had medical students at the time in Chicago, and by the way, UIC at that time was the largest medical school in the country and very proudly one of the more diverse medical schools in the country. And these students, many of them came as sons and daughters of immigrants, first generation US citizens, Some of them came from international settings and their stories were incredible, how they made it to the United States and what it took to get into medical school. So their stories were wonderful. And yet they really had a demand for making a difference in their world and wanted global health outreach, global health experience. And it was almost, Chris, like a resurgence of what you and I grew up with, with the Peace Corps, which was terrific. It was really a groundswell, a grassroots movement to make a difference. And because of that, the medical school administration really didn't know what to do and said, we really need an initiative which is student driven. And yet look at these initiatives academically, study them, evaluate them, and let's see what we can do with this. And at the time, global health was catching on as a concept across the country. So we kind of rode that groundswell. So to answer the question, it really was student driven. And then really what became exciting is global health is not just global medicine. It's just not about physicians. It's about PhDs and nurses and pharmacists and dentists and public health specialists and just volunteers all across the country that want to be involved. And then it really became. More of a center when you say

so. I didn't really realize that aspect with the groundswell from students. And it seems like when you're talking about Kind of the. That wave. There's also at Feinberg, at Northwestern, now a center as well, and then also at University of Chicago. And then you. The three centers were starting to collaborate and coordinate too. Is that right?

Yes, it is. And those are tremendous institutions, historic institutions, both University of Chicago, Northwestern University. And also a great program was coming out of Loyola University, by the way. I don't think Northwestern, U of I or UFC have ever been to the Final Four, but Loyola had.

There you go.

So, I mean, if we didn't bring in Loyola, we'd be really short sighted. So they were. And the Jesuit global outreach has really been impressive for many decades, centuries. So Loyola was another one. Roche University was yet another one. So we really started looking at many of these universities with medical schools and started to work together, which is the way it should be. And even though we're siloed in many ways, if you think you're siloed in Chicago, just come to Boston. It's an amazing place to be. But there's a lot of collaborative efforts that are really making a difference. But there's also some siloed institutions. So to break those down. And the thing that really broke it down, to be honest, was nothing to do with me or any one person or even a team. It was the disaster in Haiti where people came together for a common good and it just made sense. And I know you're going to have on your show coming up so soon, Dr. Janet Lynn, one of my heroes. And she was really instrumental in driving that. And I give her a lot of credit. You may want to ask her about it. She'll tell the story better than I.

Absolutely.

This was a terrific example of universities working together for a greater cause. And it wasn't just Haiti that made sense. As you know, Chicago is a wonderful tapestry of diversity, incredible neighborhoods, many languages and cultures, religions that are just kind of catapulted together.

Right.

And, and, and what we found is you didn't need to go to Haiti or Angola. Yeah, all Jakarta. You, you could go to the west side of Chicago, four blocks down into the Austin neighborhood, you could go into the Englewood neighborhood to the south, and find humanitarian needs and actually in some cases greater than fraud, tragically. So people started to realize the global, which was a term that was often local initiatives could be made. When people said, I'd love to go abroad, but I really can't because of family issues, because of my education, for whatever reason, we'd always say get involved locally. And there is an international group right around the corner that could use your help. And that seemed to also spur on much more growth, which was terrific and really fun to be a part of.

Yeah, yeah. I really like the thought that you didn't need a passport to be able to do global health. I mean, that's one of the things, I think that's not necessarily unique to Chicago, but certainly one of the interesting things strengths of it as well too. I know we have some specific refugee and displaced people populations and you know, there's a variety of different kinds of medical and mental health and social and educational, you know, needs that those populations have. And it's nice to be able to have a group of people that sometimes share, you know, an ethnicity or share some things in common with them that can then bring, you know, certain kinds of help to them as well. So I, I think that's fantastic on a personal side. So that, you know, it's good to hear. Sort of like your initiation because I know that you're always, you know, doing a variety of things around the world. But tell us your origin story. Tell us about how did you balance raising four amazing kids with another accomplished emergency room doc and professor and have such an adventuresome life, which we're going to get more into, but then also getting involved in the humanitarian work that you did. What's the, what's your origin story there?

Well, it's a great question. I have to give my, my parents a lot of credit. Mom and dad, they always had a really instilled a very kind heart for anyone, regardless of their ethnicity or background or socioeconomic status. My father was a professor at a university in religion, philosophy, Greek and religions of the world, really. So I got a nice lens into how other people believed and was really impressed by his accepting nature and his drive for higher education being such an important investment to make. And that lives in me. In fact, as a college professor, he taught for 51 years and never missed, never missed a class and was always his lectures to try to fit in with the next generation. In fact, I remember once in the 90s, he said, you know that boy band that's kind of popular, Tim, you know, it's in sync. Is that common spelling S I N K? Because I'm trying to update my lecture to connect with 18 year olds.

Wow.

So, so incredible with a charitable heart. And then my mom is, I guess you're always a nurse, you never retire. But she was a nurse and a night nurse for a surgical ward where the nursing to patient ratio was 30 to 1. Now it's 4 to 1. You hear nurses saying, it's a little heavy handed. So she really had a really amazing influence on me to pursue not just health care, but a humanitarian sector. And then kind of fast forwarding to my career after emergency medicine training, which was in the inner city of Chicago and very international, as we've discussed. And I really love that patient population and meeting them, trying to meet the needs of those individuals from diverse backgrounds. But also did my toxicology training, as you mentioned, at Cook County Hospital, which is. You talk about international. And there was one point in time, I think it was Maybe in the 1970s, where they said nearly 40% of all health care providers in the country, the US had at some point done some type of training at Cook County Hospital. I mean, it was an incredible place to learn not only medicine, but toxicology, the drugs abuse, the psychologic effects, the environmental effects, pharmaceutical agents. And one of my favorite is the natural venoms and biologic issues. With that fellowship, we got a cry for help from the Amazon of all places, through a mutual friend where a physician named Fernando branches. He's a cardiologist that trained in the finest universities of Brazil and Rio, but wanted to go back to his roots, his origin in the areas of the Amazon basin, and give back those he grew up with. Very accomplished man. And he called us and he said, I have a need for an environmental toxicologist. He said, well, what can we do to help you out? And he said, well, I think I am dealing with gold poisoning or toxicity. I have these gold miners, the Amazon basin, all with symptoms, neurologic symptoms, psychologic symptoms, and I think it's from the gold mining industry. And could you come down, analyze this and also do some gold levels? And interesting about this. He said, well, Fernando, also with the gold industry, are they using anything else? And he said, well, yeah, they mix the gold amalgam the gold or with mercury and they fire off or steam off the mercury and that gets released in the environment. But I think it's more the gold. And truth be told, he's a cardiologist and saw many of these individuals just again, as a humanitarian physician who had a calling to help all those. And so we went down there to make a long story short, to analyze environmental mercury poisoning and the effects of gold mining. And we found enormously high levels not in gold miners, but in the surrounding villages. And of course, as you know, with mercury poisoning gets into the water system, the food supply, and then starts poisoning downstream. And we actually found elevated mercury levels in Yanomani people considered to be some of the most remote, pristine last corners of the world where you'd expect to see environmental poisoning. So because of his life and because of his outreach, we had a window into the gold mining industry which we never would have had that opportunity without him because they trusted us. They trusted him to allow us to take urine, blood samples, hair samples and start documenting this. And if you fast forward to present day, there's gold mining all over the world. And unfortunately most places like in Africa, Indonesia, the Philippines, Peru, Brazil, they're still using mercury. And it's really having a cost not only on the environment, but on those that are vulnerable. The women, the children. Many of the children are forced to do mining. Many women, often pregnant, are told to use the mercury in the amalgam. And it's become a real problem. And it was Dr. Branch's that gave us this opportunity and turned me onto the possibility of making an impact environmentally from a humanitarian viewpoint. And also being in the middle of the Amazon was just my dream as a boy to be dealing with wildlife and venoms and snakes and spiders bigger than the size head and the snake wonder in a Buick saber. I guess I'm myself do make a saber anymore.

I think it actually made a comeback. You know that was, that was actually my first car. So I, I, I, I know the size of it in the 60s I know what that was like.

So well I, I pictured you driving an El Camino.

Oh yeah, I still picture that.

We all hope that we can be diving into the horizon. So no his and, and the last thing I'll say about Fernando, he lost his life. He himself became mercury poisoned because so closely with this and felt he needed to help these people and he lost his life. So he, he's one of these unsung heroes that you never hear about that really made a difference and had a huge influence on me. Launched me into not only environmental work, but humanitarian work and a big picture of sustainability in a small area of the world where you can make an impact.

Wow, that's quite a story. I think it really blends together because I was always kind of curious about the environmental kinds of things. And I was too naive to exactly understand because I thought well, is it the toxins that would be in venomous animals or whatnot versus just pollutants like you were talking about? And I was curious, I mean I'm so sad to hear about his demise. But I think oftentimes when healthcare providers and people in risk areas by virtue of environment or by virtue of war or trauma or whatever, oftentimes are in harm's way. And sometimes it's through this kind of a scenario that took his life. And I think probably some of the things that we'll get into here in a few minutes of some of the risks that you and your colleagues, Michael and others have experienced. But on a lighter note, before we go into that, how did you envelop me?

Yeah, well, first of all, my wife, Valerie, last name Gobia, is definitely my better, smarter half. So I often tell people I did marry up. She and I continue to work together. We're both emergency physicians. I'm very proud of her. She does a lot of wonderful impact work with women's global health and vulnerable women and children populations, and also as a tremendous emergency physician and educators. So it's been nice that we've had dual careers that cross over. A lot of people say, well, you work together, you live together, you raise children together. How does that all work out? I don't know if I could work with my spouse or partner or significant other. I think it's terrific. It complements each other. And then when we go to international destinations or globally, we can go together. I have a lot of colleagues who travel without their family or their spouses or their significant others. And it takes its toll because you really do have to spend a lot of time in the field to make a difference and to have a sustained program and to build capacity. So I'm really blessed to have her not only my life, but to have a similar career. And she allows me to think outside the box and to come up with harebrained schemes. And oftentimes she'll roll her eyes and say, okay, go for it. Some of the stuff you throw against the wall sticks. A lot of it doesn't. But she's been really supportive of me thinking big and trying to be unique.

That's great. I would think that she has a, you know, a very fine grain understanding of those kinds of things. I mean, the academic side of things, the training side of things, the medical school, the travel, the humanitarian. I mean, it really seems like the. The two of you are very complementary. Yin and yang kind of, you know, duo, which is. Which is wonderful and I think quite rare. So I think that's really terrific.

She'll laugh at my jokes, too.

That's a key thing. That's a key. That's a very key thing. My kids don't get my humor, but thank goodness my wife does, so that's good. So the next set of questions I couldn't really organize because I think it's sort of like a big Venn diagram with a lot of overlaps and things. But I know that you have a history of mountaineering and climbing, obviously a lot of international travel that's, you know, for work and for humanitarian and for pleasure. I know that you're very involved in the area of wilderness and expedition medicine, which makes a lot of sense, I think, also vis a vis emergency and then your humanitarian work. So we may bounce around a little bit. So I hope this will be a little organized in some way, but.

So I actually have attention deficit disorder and right along my personality to be tangential and bounce around much more comfortable in that chaos.

This will be very fun then for both of us. So you and Valerie both were recruited to come out to Harvard. Was that because of your residency pal Michael? Did he convince the two of you to make that move or what? How did you wind up in Beantown?

Yeah, a lot of it did. Mike Van Royen, who is a dear friend and is a dear friend, he trained with in residency at University of Illinois in Chicago after he developed an international program there. And we always saw him as a difference maker and a leader. In fact, his personal statement going into residency described basically what he's doing now. And he left Chicago to direct programs at Johns Hopkins and then went on to Harvard where he is the department head of emergency medicine, but also directs hhi, which is Harvard Humanitarian Initiative. And he's been great. I did a lot of work with him internationally in our early careers in areas of conflict like Rwanda, Sudan, Kosovo, Somalia. And we always wanted to work together and he's been trying to make that happen. And he did a great job recruiting us. And obviously it wasn't just me he wanted to recruit Valerie and and once our four beautiful, amazing children, Camille, Isabel, Celeste and Julian were through college and thriving and doing great and on to graduate school. We figured it was a good time with our empty nest to give it a whirl. And if we weren't going to do it now, when are you going to do it? So we made the transition and interesting. We were so used to Chicago. Chicago will always be home in our hometown. It was tough to make the transition. I've never lived outside of the great state of Illinois. I'll be darn until then. Established in 1818. By the way, Chris,

you. I'm never playing against you in any trivia game,

but we came to the not the state, but the Commonwealth of Massachusetts. Massachusetts. Don't you dare call it a state.

State right

out. Take you by your ear. But no, we came here and just developing a new system, a new health care system was more of a challenging than I thought. But the opportunities here are amazing. The people here are amazing. We are warned that people are going to be standoffish and rather pompous. We haven't found that to be the case at all. Wonderful people here, very collaborative, real difference makers. And it's just not on the health side. I mean working with people in law and architecture and business and public health and nursing, it's just been an amazing experience and a neat part of the country to be in with its colorful history and Nor East.

Yeah, yeah, that's. Yeah. You guys have really been getting walloped this year.

So you know we're from area from Chicago,

no big deal. So. So then you're. It's. Is it sort of like a joint appointment at Brigham and Women's as well as participation in the humanitarian initiative?

Yes, it is. It's. It's both happy to be members of Brigham and Women's Hospital. I also am faculty at Boston Children's Hospital with the Poison center and then the Harvard Humanitarian Initiative. And we do a lot of work too with Dana Farber Cancer Institute. So it's been great. And they do allow us do old triple quadruple appointments to do that kind of work. And Mike has been, Mike Van Royn has been terrific. And about allowing autonomy and for us to create and try to build these big out of the box type of

project, well, that's the kind of innovation I think that you know all this just as a hand in glove kind of fit for you and Valerie and Michael as well. So is there an overlap between Partners in Health and Paul Farmer in the, in the humanitarian initiative or is that pretty much. Is that one of the silos?

No, I don't think it is. I think Paul Farmer's work is tremendous and Mike Van Helen and get along really well. Very joke. And it's a little different. The humanitarian side is more in conflict and war, a lot of humanitarian rights. And it isn't that Paul Farmers Global Health Shop Partners in Health doesn't go into that arena but they're more in sustainability capacity building. Certainly they had a really significant and impactful response in Haiti crisis and they continue to work in Rwanda. No, we have great respect for Paul's program and there's a lot of cross pollinization and mutual respect.

That's great. Excuse me.

The.

I think this is a true story. I had heard some years ago at a conference that Paul and. And his colleagues at Partners had been invited by the city of Boston to come and help develop a HIV initiative based upon the work that they had done in, in Haiti. And I thought it was just such a wonderful opposite of the traditional, you know, west knows best kind of thing. It was like the west saying, you know, hey, how, you know, resourceful Haiti, you know, how can, how can we learn and what can we do in scale in Boston of, you know, what you've been able to do in Haiti? I just thought that was amazing.

Yeah, it is. You, you really. We don't know all the answers and oftentimes the country, countries we work in and help us. We're doing project in India now, working with my UIC partners on still India Heart rescue. Heart Rescue India. And the level of cardiovascular disease in India far exceeds what we're seeing in the United States. Believe it. And we're learning India how to best myocardial infarction, sudden cardiac arrest in the US from lessons learned in India. So I think we have all the answers. And the best ways of approaching things is not only wrong, it's naive. And it's not how you enter into a long term project. You really have to find out what they need. I remember a speech by the Rwandan Minister of Health, extraordinary woman, who said, I wish people would quit telling us in Rwanda what we need. And if someone would just ask us, what do we need? That type of attitude goes a long way.

Yeah, I think, sadly, I think this has evolved. I think it's much, much better than years or decades ago. But there's such hubris from the stereotypic west knows best approach of coming in and we know how to do it so well. It's like, man of all things, we know how to do health care well. So we certainly have our own difficult times with it here stateside. So, speaking of Michael, I have to ask, didn't you and Mike summit Acon Kongwa together? Is that right?

Yeah, we climbed Acangagua. It's fun to say Aconagua.

Yeah, you can say it better than I can.

I don't know. I don't know. Yeah, some Argentinian would tell me butchering it, but no, it's. We've had some fun times together in South America and also in Nepal. And as you know, Chris, you're a mountaineer. Mountaineering isn't necessarily a spectator sport as much as nova and the 3D movies would like you to think. It's very slow, methodical, and oftentimes it's not technical, but it's just adapting to altitude and Climbing with yourself and. Yeah, we've done climbing. I love the mountains as you do. I love with my oxygen, my pulse ox goes into the low 60s to use it drugs. I mean, who needs hallucinogens?

Yeah, just little, little blue lips and fingertips and you're all set.

Yeah, that's right. That's right. It's better than lsd.

I think so. And you, you've done Everest Base Camp a number of times too.

Well, I thought you've done lsd.

No, no, we're not going there. That's. That's a different show.

Okay. Yeah, yeah, I've been in Everest Base Camp a few times. And in fact we were there. Right. We had just gotten off the mountain when earthquake hit a 15. And you look back on that, we were. It was fresh fallen snow, beautiful blue bird type sky, sunshine. It was a setup for an avalanche. Fresh snow and hot sun.

Sure.

And then put on top of that an earthquake. It was unbelievable and it was interesting. We had just done a conference the week prior in Kathmandu on how to prepare for earthquakes and disasters. Oh my gosh, people, they knew it was coming. That area gets an earthquake every 75 years. You can almost set your sundial to it, really. And It'd been around 80, 81 years. So they knew this was coming. Thank God it didn't hit a major urban area, at least the epicenter, but it did tragically take a lot of life and a lot of Sherpa friends. We had lost their lives. So yeah, it, what you realize is those people that live in that austere environment are amazing. They're wonderful, sweet, spiritual people. And as you know, you climb these mountains, you go a million miles an hour at work and in life and leading up to the expedition or climb and you finally get a chance to slow down and take it all in. And I know you've done a lot of this and for good causes and I applaud you for that. But there's nothing better than and being above the clouds. So it's been a terrific slice of life and we're blessed with the opportunity because quite frankly, it's not a inexpensive sport.

Right.

And it's always been great to climb with Sherpas and porters and people from the area and really get to know them as individuals. They're incredible athletes.

That's actually one of the. How the I did Kilimanjaro in 92 and one of the porters there in Africa was a person that we've kept in touch since 1992. We helped, worked with them to found a kindergarten. We still consult with them through the nonprofit that I started at two hospitals in the Moshi region. So you really do you spend that kind of time and, and in a sense, you know, sort of self inflicted hardship, but you really get to know people and you really develop long lasting relationships, which is a wonderful sort of side benefit of doing that. So I also. Speaking of thin air, my daughter and I went to one of the Big Sky Wilderness medicine conferences a few years back and yeah. And I and she feel she fielded one of your rubber snakes, if you recall.

So so and well deserved. She's, she's smart. The apple doesn't fall apart. Young woman. And I was very impressed with her, her serpentine knowledge. She didn't. That wasn't a lob or she actually answered the question correctly. She deserved it. She.

And I think that, I think I even know where that snake is today. So our. Her mother wasn't too happy with it, but it served a lot of fun in our house since then. But how did you get involved? That was such a wonderful conference. And just for people that aren't familiar with it, my little sound bite of it, there's a lot of, you know, Tim did the work on like all the toxicology aspects of all the, you know, creepy crawlies and, and aquatics and you, you name it. If it can sting you and hurt you, that's what, you know, Tim covered with wonderful PowerPoints and slides and stories and just, you know, all the other kinds of just wonderful experts that came to it for us adults. But then there's also a youth program where Annika learned how to escape from a hotel if there was like a hostile circumstance or some kind of, you know, earthquake or something like that in a hotel. She learned how to like Jimmy, a hotel, sealed window and just all sorts of, you know, just really wonderful practical things. So it was like one of these conferences where it was perfectly fine, you know, to bring your family or bring your kids or whoever because there was things for people to do. I just thought the whole idea with that conference was terrific. Can you speak more about that or how you got involved in that?

Oh, sure. Well, first of all, it's a wonderful group like family. Eric Weiss in Stanford, Gene Allred, who we just lost colon cancer, God rest his soul this year.

I didn't know that.

Oh God, yeah. Lost. Fortunately, his son Kyle has kind of taken over his responsibilities. He's doing a wonderful job working with Eric Weiss, people like Joe Serra, Paul Auerbach, some wonderful people in wilderness medicine. Have got that whole subject matter going. And what's amazing about it, as you said, Chris, it's not just emergency physicians and doctors. It's people in pediatrics and obstetrics, gynecology, internal medicine, psychiatry, psychology, paramedics, nurses, nurse practitioners, physician assistants, pathologists, dermatologists. I know, I believe. But everyone comes and they just want to be part of the great outdoors. And what we've also put on this is a touch of global health and humanitarianism and not just going and exploring Austin firemans and saying, been there, done that. Check it off my bucket list, actually giving back to the community, giving back to a healthcare system and really making a difference and leaving it in a better way than how you found it, at least not making it worse. So it's been a wonderful group. I got an opportunity to lecture there in the 90s, and it went well enough where they asked me back, and I've been there for about 20 years. And the snake one is interesting, actually. Giant in the field. One of my heroes is Finley Russell. And if you know herpetology and nature, Finley Russell is like the Jacques Cousteau of snakes, really. Best thing I can, Best analogy I can come up with. He had written hundreds of articles and books on snakes, and I had listened to him talk, and he really treated everyone with respect. I was a student at the time, and he gave me the time of day. He was like my idol. And Finley was well into his 80s and 90s and started tiring out of it. And I was lucky enough to be asked to kind of start giving some of his talks. And I never could hold a candle to him, let alone a forked tongue,

little talks, humor there, right?

Carrying it on. And anyway, he's another one of those iconic individuals I was lucky enough to know and just carry on some of his love for snakes and some of those animals that a lot of people would rather not have on the planet. But they serve a very important function in our ecosystem and they're misunderstood, like, and some of the other things that we just feel we should have control over. But again, they were here first.

Right.

They're much needed and fascinating creatures. So that's another way I kind of got roped into doing this because of Finley's legacy.

Wow. It seems like a perfect, perfect fit. So with some of the things that we've been talking about, I guessing that's kind of shot you towards the. Or put you on the trajectory towards the National Geographic Explorers Club. But how does. How does one gain membership in that. And once you're in it. What, What's. What's involved in that?

It's a secret Teddy Roosevelt handshake that I can't say anything about.

Well, you can tell me. I'll edit it all out. No one else will learn.

No. It's been around since the Roosevelt administration and some amazing people like Sir Edmund Hillary and Buzz Aldrin and Picard, who's well known for flying balloons around the world, and Sylvia Earle, who, you know, it's not just an old boys club of explorers. She's one of the great scientists who has dove to the depths of the sea and just some amazing individuals. And basically you have to be nominated by some members and have made an impact in a corner of the world or discovered a new species, or been to a place that's never been explained, explored. And it really stemmed from my original work, thanks to Fernando branches in the Amazon with mercury poisoning and the alertness that he had to make this a global issue, not just issue in the village in the Amazon. He saw this as something that was a real tragedy to Mother Earth. As he put it, we're harming Mother Earth, not just the Amazon and affecting lives. So because of that work and working with him and bringing that into the medical, health and public eye, that's I guess the way I got in and then learned the secret handshake. And what's really exciting is my daughter Isabel, who's a marine biologist, eco evil biologist. I got to bring her last year was at Ellis Island.

Oh, wow.

And brought her along. And they're really pushing for young members and female members and trying to hand it off to the next generation. So I'm trying to get her involved.

That's great. Well, how, how fitting for the both of you. That's. I was just so curious about that. It's like one of those things that never just sort of comes up in a conversation. Oh, hey, Tim, by the way, how'd that work? So just. That's a wonderful story and just quite fitting and really kind of a respect to the legacy of your mentor too. That's fantastic. Well, I suspect this may not be quite similar, but tell us about Toxicon. Is that like Comic Con or what's Toxicon all about? Do you dress up and you Spock, or how does that work?

Yeah, we dress up like venomous creatures, claws and rattles, and we recite the periodic chart of elements backwards, blindfolded. You know, things like that. The number PI out to 990 decimals. So yeah, that's what happens. You have it. Next question. That's toxic. No, my mentor in toxicology, Dan Rochek, who I'm doing a lot of work with right now in Ukraine in the conflict zone. It was really his brainchild and it was bringing Chicago based programs together into a common cause, knowing that poisoning is an issue, it really harms the environment, particularly children. And putting together an initiative where different institutions in Chicago, similar ones that we mentioned with the Haiti crisis earlier, coming together to make Chicago a safer place in terms of poisonings. And it's an initiative that was his brainchild and it's really lived on. Steve Axe, a dear friend of mine, is overseeing it now in Chicago. And it's a model that we're trying to bring to Boston as well. A lot of great toxicologic minds are here, but getting them to work together in a consortium model is a real dream. So it's still going strong and making a big difference. And Mike Paul is the current Poison center director. He does a terrific job. So there's really a lot of important people that carry on that Toxicon dream. But it's pretty cool. Toxicon is Greek for arrow. The tip, a poison tip of an arrow, like a cure. So it's pretty, pretty cool name. And I do like your Comic Con analogy.

I saw some pictures on the web that we'll put in the show notes. Oh, that's good. Well, good. Thank you. So you got to work on the secret handshake with that one too. I suppose so.

Yeah. That, that one's like a secret poison and then an antidote.

Yeah. No, no, no, no, no. Well, I want to circle back to Mike Van Royen for a second and some of the travel kinds of things. I read Mike's book, the World's Emergency Room, and I thought it was really a wonderful book and just, you know, share with him that, you know, I just was really inspired by it and, and, you know, taken aback by some of the stories. And I know that, you know, there's a mention of you in there as well. And I guess for people that maybe aren't familiar with the book, I highly recommend it. We'll put a link in the show notes or people can get it. But that historically, you know, you sort of think of the red crosses were sort of like the safety zones and back in World War II or, you know, other points in time that, you know, you didn't bomb, you know, hospitals and you, you know, there was just sort of like a certain sets of rules that seemed to be sort of thrown out of the window these days and not in A matter of just accidental kinds of things. But in the sense of what his book talks about is that humanitarian aid workers are really even being the targets of violence. And oftentimes I know that in humanitarian work there's a maybe historically, you know, it's an inadvertent kind of thing. But now it sounds like, you know, that people that are involved with that in certain regions, certain situations really become the targets or the proxies for violent focus. And I know that you've been in some pretty dicey situations. And you know, from Mike's book, he, you know, describes a number of his as well too. Can you share a few stories about what your experience has been like that in conflict zones trying to provide services?

Oh, yeah, it's. You look back at the TV show mash, where every once in a while the MASH a little under fire. And also the issues do you take care of in that particular show, both the south and the North Koreans and there was this neutrality type of initiative where if you had the Red Cross, if you were a hospital, you were a health care worker volunteering your time or being told to care for the wounded civilians, that you were protected, that there were Geneva Convention rules established some in the 1800s, some 1949, I believe, that predicted health care workers. But now, as you alluded to, Chris, they're a target. And not just those coming in in humanitarian NGO volunteer organizations to help, but, but those in country, physicians, nurses, paramedics are under fire. And hospitals have not become collateral damage. We meant to hit this infantry, this tank, but we accidentally hit the hospital. They're targeting hospitals. Syria has been a prime example of that being a strategic means of warfare because if you take out those who are wounded and those trying to heal them, taking out the next set of infantry that might come back in. And it also, when you take out the health care system, you're really causing a brain drain. And that country will take years to come back. We see. So you see the fleeing of health care physicians. You see those physicians that don't want to come in and volunteer because they're under fire. And this is even different than say the Ebola epidemic where an infectious process was life threatening and really drove a lot of healthcare providers from not going here. This is to the point now where underground hospitals are having to be created. Paramedics are driving units at night without their lights on, covered in mud so they won't get. And women and children are being taken out as a message. So it's changing. And you say, well, wait a Minute this is in violation of human rights laws, it's a violation of the Geneva Convention rules. And yet people that are doing this in a strategic sense, maybe some of it accidental, but some of it's strategic. Don't care about Geneva.

Right, right.

They even know where Geneva, Switzerland is. And yet they feel there's a higher calling. Sometimes it's for national pride, patriotism, sometimes in the name of religion. So it's a different era. And right now they say the most dangerous job in the world is not being a crab fisherman in the Bering Strait off Alaska and a dangerous catch. It's actually being a health care provider in Syria. More dangerous jobs in the world. And you talk about my mentors and humanitarian care internationally, like Fernando Branches. I've worked with a surgeon, a true hero, one of our Harvard scholars at risk, who's now back. Mahmoud Harari, a general surgeon who became a trauma surgeon, who now is trying to bring back the health care system of Syria and a lot of the besieged areas. A remarkable man that's given his all his career and put himself and family in danger trying to protect innocent victims of these bombings. And I've had the chance to work with him the past two years, and he's another one of those amazing people that doesn't give enough recognition, but is in the field doing the work and doing it because it's the right thing to do.

Yeah. Wow. It just, it's. It really is a different world. I mean, I understand the realities of those kinds of situations, and it just, you know, I've always highly respected people that have, you know, put themselves in harm's way. And just even now, the, you know, the, the heightened risk and the, you know, in the sense, informed consent that they understand that, you know, the rules are out the window or the rules are different or the rules don't exist anymore. And nevertheless, you know, specifically train and get involved and do those kinds of things is just, you know, just to the highest in my, you know, level of esteem and respect, so. Well, I know we're starting to run out of time. I still have a few more questions I want to kind of go through. So what got you to Antarctica?

Well, a dream. A very slow moving boat.

Yeah, I was going to say, but I'm pumped. Very slow moving boat.

A Russian icebreaker going. Yeah. They say the choppiest ocean in the world are the Drake Passes. Oh, yeah. And we went on a wilderness medicine expedition. Valerie and I were fortunate enough to go and lead a group in and spent quite a bit of time There, going into the Antarctic Peninsula, which was just teeming with wildlife, and yet you could see the effects of climate change, global warming, our ozone layer, all those things. Wow. And it was fascinating trip. Fascinating trip. It didn't quite go the way we thought. There was a ship that was in distress past the Antarctic Circle, and there was a maritime distress that went out. So our ship, we left what we were doing, looking at wildlife, and along with a Argentinian naval ship to rescue this boat, which probably steered off a little too far. And it was filled with other people looking and exploring Antarctica, mostly British. So we took them on board, and it was just really interesting to be in that type of austere setting with the really horrendous winds and weather, and you can realize how quickly things turn in that environment. And it's really not meant for human habitation.

So the boat. Their boat got in trouble.

Yeah, they did. Their boat got in trouble. It got stranded, it started sinking. So we were able to get there enough to pull them out. And it turned out we had a historian on board. Their historian was Shackleton's, I think, great nephew.

Oh, my gosh.

Of the Ernest Shackleton expeditions. And as you may know, the first person to reach the South Pole trivia question was not Scott, Admiral the Scott, the Falcon, the Brit. It was actually Roland Edmondson, a Norwegian.

Oh, man.

It was a Norwegian, and it was not Scott. In fact, the historian would not admit the Norwegians beat the British to the South Pole, even at that point. So that was quite a story. So he and I got in a couple of arguments. I'm of Norwegian.

I was gonna say the Ericsson probably came out in you. Right?

That's. Yeah, you get an explorer's nerd fight.

Well, fortunate for them, I guess. It didn't sound like necessarily anyone was injured, but I mean, how fortuitous a to be saved and be saved by a boat full of emergency room positions, you know? So emergency position, good news, bad news. Oh, that's great. Wow, what an adventure.

It's just like another planet. And most of the days are rather gray, and we see a lot of grays and black and white, obviously, with the snow. But at sunset, it is spectacular. And because of the location you are on Earth, you see every color imaginable. And as you know, when you're in the US and you're watching a sunset, you go, hurry up, hurry up. Take a look. It's going down and sinking. And you can watch it maybe a minute there. The sun setting just hangs. It just hangs there. And for Hours. You see this symphony of colors that you just don't see anywhere else on earth. Just a fascinating, fascinating place that we're really, we're losing, we're slowly losing this amazing chunk of land that is so misunderstood. Boy.

Well, it was an adventure in a variety of ways. It sounds like so. Well, like I said, you know, I, I want to grow up and be you, Tim. But for listen, for listeners that also share my desire, what kind of advice would you give to someone interested in doing the kinds of work you do? Be it the academic side, the research side, the, the, the gung ho humanitarian side, you know, where, where would someone start? How would you deconstruct it? And for others to follow your lead.

Well, you find your own path, definitely. You don't need to follow mine. Follow your heart also. If you're going to go international, pick an area of need, a region of need, or a country maybe you have connections with. Maybe it's your cultural. Sure. And what I'd really encourage you to do, for those of you interested, it's okay to pick one country. You don't have to go to 17 or 90 different countries. Those that go to one country and sustain a program, I really have a lot of respect. There's a family practitioner in Chicago that only goes to the Philippines. He's not a Philippine descent. He just felt a calling to the Philippines and what he does, he brings toothbrushes and eyeglasses every year. And he's made a huge impact on dental hygiene and eyewear. And that's what he does. That's what he's decided to do. And he's done it for 20 plus years like that I just have so much respect for. And also, if you're going to do it, find someone in country that can tell you, like our Rwanda example, what they need and respect them and listen to them. And also the programs I've been involved in that have been the most successful have had not only someone from the US who's very motivated and someone in country, say in Vietnam, who's very motivated to make a difference in their country, but someone that has their foot in both soils. Maybe they're natural Vietnamese citizens. I think of two individuals that we know at uic, the Holtermanns, they're pediatric surgeons. She's a Vietnamese descent, Aishwan, and Mark Halterman is of us, but they're a married couple that go back to Vietnam two, three times a year. And because Aishwan has her foot in both soils, she fled Saigon, Ho Chi Minh City in 1975.

Wow.

Her connection to Vietnam and the US and she goes back and forth. Those programs really work. So you want someone in country, someone in our country, but you really want someone that has an idea of what life is like in the Western world and really what it's like in country. And if you have that combination, it tends to work quite well. The other thing I would say is you don't have to go six months, you don't have to go for a year. If you can, God bless you, that's great. And not everyone can do that with family and career or finances, even if you can go for a week or two. I think short term mission work is important. Sometimes it relieves those who are working long hours and months and years, but it also gives you a heart for this type of work, this humanitarian work. So maybe when your life settles down a bit, you go to the next stage of your career, then you can give more time. And it also just increases awareness. And then, as we talked about before, never think that local outreach is uncool. You hear my career and you think, oh, my God, you know, you got to go to Madagascar and save the lemurs. No, go to your neighborhood, go to your food pantry, go to a shelter, rebuild the infrastructure of your.

Whoops. I think we've lost Tim for a little bit here. Bear with me.

How about now?

Yeah, you're good? We're good. Just had a little Skype hiccup there, so.

Okay.

Yeah, I think.

Yeah, I faded out there a little.

Yeah. I think you're making the point that, you know, again, back to the. You don't necessarily need a passport to do good in the world, that there's, you know, plenty of need down the street just as much as, you know, around the globe. So I guess maybe kind of last couple of questions. What's next for you, Tim? Do you have a bucket list or what's on your agenda? I think we're having another Skype hiccup here.

Is that bad right there?

Yeah, you're good. You're bad. So it was just one of my last questions of kind of, what's next for you? Do you have a bucket list or what's coming up?

I'd like to continue the work we're doing in conflict areas, particularly personally in Syria. Going to be a country in need for the next 10 to 20 years. And before the war, it really was a well developed medical care system. So hopefully to bring that back. Awful situation there currently. And then also work in Ukraine. I think Ukrainians are wonderful People, very strong people, but they're getting a lot of push in the eastern conflict zone. And I think that area of the world in Eastern Europe with the ongoing and some of those countries that were part of the former Soviet Union is a really important part of the world these days. And also continuing on my love of nature and natural venoms and toxins. There's a concept of one health, which you've probably heard of, where it's the inner action of human and bio life and how is so important in the spreading of disease and understanding of disease states and looking at the importance of climate, animal life to how that interacts with human health is another thing I'm really interested in. And I'd also like to continue

my.

What I think is a Guinness Book of World Records for having the highest elevation. Wiffle ball game is another goal.

You'll have a lot of people being contenders for that. Now that you said that,

I love it because the whiff, it's easy to carry and it breaks down cultural barriers. I bring one wherever I go. I've played on all seven continents and I have, I think 20,000ft. So I do think I have the highest wiffle ball game. So.

But that's probably a record that will, will stand a long time. So that's. That's pretty impressive, man.

Yeah, we'll see. So that, that's a lofty goal, but no, it's. It's been a great life. I'm really blessed. I come from really good family, good stock, so I have no excuse. Dad, Norwegian, my mom Danish. They're very happy people, but no great opportunities. And pointing back to you, Chris, I'm really impressed with your career and your humanitarian heart and the good work you do in helping out those that are vulnerable. So shows like this are fun, but hopefully they motivate some people to take on a career like this and make a difference in other people.

Thank you for saying that. You're always, you know, such a kind, kind gentleman and I think, I think so again, I think people, if they get to know you a little bit better, know about the kind of work that you've done. I think you're quite the inspirational figure. And, and I just, you know, really value our friendship. I guess in closing, if people want to learn more about the work that you're doing or what's going on at the humanitarian Harvard humanitarian initiative, or if they want to contribute time or talent or dollars or whatever, what are the best ways to learn more about that or to connect?

Well, if you go to the Harvard humanitarian website, hhi. You put that on the Google browser, it'll come right up. You can see some of the programs we're doing in there. By far, it's not just me and Mike and Valerie. It's a lot of people doing urban resilience and a signal program and satellite image, Women in war. Just some amazing programs that are going on here. Also, we're raising funds for our Harvard Scholar at program. These are getting scholars who are in countries where their life is threatened, where they're unable to do their work. We've had scholars at risk from Yemen, from Syria, from Iran, from Iraq, from Libya. I'm probably missing a few, but it's interesting. It seems to be all the seven countries that have troubles getting into the United States. States, wow. They're sc. Not just in health, but in the arts, in literature and economics, business, architecture. They're amazing people who want to be in their countries, but their life is threatened because they really are brilliant. And those that may dictate in that country feel they're a threat, try to not only annihilate them, but their families and their programs. So we have a program where we give them asylum, in a sense, for a year or so until it's safe for them to return. So there is a way to give to the Harvard Scholar.

Well, we'll make sure our Skype is breaking up again, but we'll make sure, Tim, that we get that in the show notes. So people that are interested in getting more involved with or being able to learn more about these various incendiary initiatives. And I know there's also a periodic set of courses and things, too, that the initiative sponsors. So I think there's a variety of ways that if people are interested or have gotten inspired by today's conversation, that they can reach out and get more involved. All right, well, my Skype is saying that we have a poor network connection and very much appreciate being able to have you on, Tim. I look forward to maybe being able to have a round two and get into some other things. So thanks so much for being a guest today. I really appreciate it.

Yeah, my pleasure, Chris. Thanks for your great work. Let's climb a mountain together soon. And let our daughters. Let's bring all our kids. Let's make it a family. There, you're on.

It's a deal. Take care, my friend.

All right. So much of pleasure. Thank you. An honor to be on your show. Thanks.

You bet. Thank you, Tim. Bye. Bye. Living a Life in Full is a production of Stout Media, a subsidiary of Gordian Knott, LLC Assistant Gracie Wong Music Dan o' Brien Sam Rude Graphics Larry Newberry Executive producer and host Dr. Chris Stout to learn more, stop by our website alifeinfull.org for show notes and please recommend us to your friends and leave us a review on itunes. Thanks.