Julia Marcus, PhD on Covid national media attention and organ performance

Julia Marcus, PhD, infectious disease epidemiologist, tells us what it feels like to be suddenly receiving near-constant national media attention for her message encouraging a nuanced approach to Covid-19 risk reduction. She also talks organ performance, quarantine sweatpants uniform, and more!

Transcript

Copy Transcript Copied

Julia Marcus:

I did a podcast yesterday. Oh, my God. My life is so weird right now.

Lisa Bodnar:

What podcast were you doing yesterday?

Julia Marcus:

Ezra Klein. A 90-minute podcast with Ezra Klein in my closet.

Lisa Bodnar:

Ezra Klein? And now you're on my little fucking podcast. Are you kidding?

Julia Marcus:

This is so much more fun. He didn't tell me to get a glass of wine. This is how all podcasts should be.

Lisa Bodnar:

Hi everyone. Welcome to Shiny Epi People. I'm Lisa Bodnar and I'm an epidemiologist, a professor, nutritionist, mother, daughter, sister, friend, mentor, mentee, exerciser, YA novel reader, tweeter, sometimes to my detriment, meeting avoider, boundary setter, horrible car parker, someone who cannot pay attention in seminar, and a very amateur podcaster. Today in the world of Shiny Epi People, I'm sharing a conversation I had with Julia Marcus. Julia is an infectious disease epidemiologist and assistant professor in the Department of Population Medicine at Harvard Medical School and Harvard Pilgrim Healthcare Institute. She studies HIV prevention, but recently she has been speaking, writing and tweeting about communicating public health guidance in the COVID pandemic.

Lisa Bodnar:

Julia's message centers around the importance of harm reduction. That there's really no binary here with either staying at home all the time or acting like everything is normal, that we can find a middle ground to reduce harm, and that our public health messages need more nuance. And they need to recognize people's humanity first and foremost, if we're going to change behavior and policy. Since May, Julia has been all over the media, including a lot of appearances on national TV, and she's now a regular contributor to The Atlantic. I really wanted to talk with her, because she's become this very public facing expert in just under four months. And I had to imagine that this change comes with some big complicated feelings, and I do love big complicated feelings. And I also just wanted to talk to her, because she seemed like a very open and cool person. And spoiler alert, she is. I hope you enjoy our chat. Julia, I'm so happy you're here.

Julia Marcus:

I'm so happy to be here. Thanks for having me.

Lisa Bodnar:

I've never met you. I was obviously following you on Twitter and I know who you were, but our worlds weren't intersecting that much beyond that. And then, the COVID pandemic happened. And then I was hearing your name and seeing your face. And you were publishing articles in The Atlantic, and then you were on the fucking national news. And I was like, "Holy shit." I was so happy that you were this wonderful ambassador to epidemiology. You were so bright and articulate and had so much conviction and were such an expert. And I was like, "Yes, you go."

Julia Marcus:

I think we need to [inaudible 00:03:28] now. Here's how I feel.

Lisa Bodnar:

Right. Now that I've seen you unimpressed, so is my impression as a non-ID epi person correct? That you rocketed into fame, quote unquote, that quickly?

Julia Marcus:

Well, first I want to go back to the first thing you said, which is that we've never met, which is true, but we have definitely been on a sweaty dance floor together.

Lisa Bodnar:

No way.

Julia Marcus:

Multiple times. Yes, last year and the year before.

Lisa Bodnar:

I get a little bit overwhelmed at those parties.

Julia Marcus:

Totally, as do I.

Lisa Bodnar:

I meet people and I'm like, "Are you having fun? Here's a glow stick." [inaudible 00:04:10]. So tell me about rocketing into fame.

Julia Marcus:

So I don't know if that's an accurate characterization of what happened.

Lisa Bodnar:

Yeah. Tell me.

Julia Marcus:

But there was an overnight thing that happened in early May, which was, I was quietly tweeting in my little Twittersphere, tweeting to my followers who care about HIV. And I didn't have that many followers. And I was starting to notice in April, just some things that were really resonating based on my own experience in the HIV world, specifically around stigma and shaming that were really worrying me just in the way that they were playing out during COVID. And playing out very quickly on an accelerated time frame. And so I started casually tweeting about that. And there was a particular tweet in early May where I tweeted about quarantine fatigue and how I felt we needed to shift toward more of a harm reduction framework for COVID and talked about HIV a little bit.

Julia Marcus:

And an editor at The Atlantic contacted me and said, "Would you turn that tweet into an article?" And I'm not a public writing person. And he was like, "Yeah. How about in the next 24 hours or so?" And we had no childcare at the time. My husband had a thing planned for the entire day. So we sat down and we were like, "All right. This seems like maybe an important opportunity." And he took the kids and I just holed up. And the whole time I was like, "I can't do it. I can't do it. I can't do it." And then talked to a few amazing colleagues, including Jon Snowden. And yeah, when that article came out, by that night I was on Chris Hayes.

Lisa Bodnar:

Wow.

Julia Marcus:

And it was like, "My life changed in this really radical way." And I've talked to the media almost every day since. It's been bizarre, bizarre. The novelty of talking to the media very quickly wore off, and it became much more of a public service experience.

Lisa Bodnar:

Did you feel like when you wrote this piece, there was a chance that this was going to blossom into something so much bigger?

Julia Marcus:

No, no. I really didn't. I think in retrospect, maybe what happened is that I think two things. One was people who wrote to me about that piece said they felt really heard, because they had been really struggling and people in the public health world hadn't really been saying like, "We know how hard this is." And it had turned into this debate between, "We have to stay home indefinitely, versus we have to just go back to our lives." And there was nothing in between and no acknowledgement of the nuance around any of that. And so I think it just filled this void that I was not expecting at all. And now I'm so grateful to have been able to keep writing for The Atlantic, and it was just something I've never expected that I would be doing.

Lisa Bodnar:

So I saw you on MSNBC that night and I was like, "Oh, my God. That's that woman I follow on Twitter. And there she is, and she's so super professional looking and she's so poised." I was literally thinking, "I could never do that. I would poop my pants."

Julia Marcus:

If you think I wasn't, you were mistaken.

Lisa Bodnar:

The Julia that you presented was this incredibly impressive. And obviously, we're all vulnerable and I'm sure that that felt like a risk to you, but it's often not something that we talk very much about. And so that was immediately the first thing I was curious about was like "What is she really feeling? How did this turn out?" And so I want to understand that more. What did it feel like when they asked you? And did you hesitate at all in saying Yes?

Julia Marcus:

That was one of the most surreal and overwhelming days of my life. I woke up that morning, and I was like, "Oh, the article's online. I should tweet about it." So I tweeted and then it was all I could do the entire day was just sit there and be overwhelmed by watching it. It went viral and I got 25 media requests, and people I hadn't spoken to in years were contacting me one after another. My phone was blowing up. And then the Chris Hayes thing came in. I don't have a TV. I don't watch TV. So I was like, "MSNBC, I've heard of, but who's this Chris Hayes guy?" And the media person in my department was like, "What? It's Chris Hayes." And I was like, "Oh, is he a big deal?"

Julia Marcus:

So in a way I was protected by my ignorance, but I was really unprepared. I didn't have talking points. I've talked to the media before a little bit around HIV research, but not a lot and certainly never national TV. So I really had no idea what I was doing. My kids were here and were doing their bedtime. So I was hiding in our bedroom, like terrible backgrounds.

Lisa Bodnar:

Oh, I thought the background was fine.

Julia Marcus:

Incredibly nervous.

Lisa Bodnar:

I was like, "Oh, she's wearing a cardigan and, I don't know, a nice little collared top." I was like, "Look at her."

Julia Marcus:

So I could never watch that interview again, because I'm sure I would have a hard time watching it after... And now I've done hundreds since then, and now I don't even think about it, but that one was just really scary. Did I hesitate? No, I didn't. I felt this is my opportunity to get this message out to a broader audience. I will say that about two weeks later after I continued to do a ton of interviews and was just completely overwhelmed every day, like, "What is happening? This is so weird," I went on Anderson Cooper and-

Lisa Bodnar:

You did? I don't think I knew about that.

Julia Marcus:

And that one... And I was following Anthony Fauci, which I didn't realize until I was waiting in the Green Room or whatever online. And I heard Fauci and I was like, "I cannot do this. I cannot do this." Yeah. I think after me was like Melania Trump or something. I don't know. It was so weird. But yeah, after that, I was just done. And CNN asked me again the next day. And I said, No. And I had people saying to me, how are you saying no to CNN? And I just was like, "I got my message out. I'm exhausted." I am an introvert. This is not easy, and it's not paid. And it takes up an incredible amount of time. I spend hours a week doing it. And at some point I have to figure out a balance where I feel like I'm saying what I want to say to the world and helping in this current situation, but also taking care of myself and making sure my research doesn't get totally neglected.

Julia Marcus:

At the Anderson Cooper one, if my husband were here, he would tell you that the second it was done, I laid down on the floor and he had to bring me a whiskey. It was so exhausting, and it was five minutes. It was five minutes. Now I've honed it a little bit better where I love podcasts. I never thought about podcasts much as a medium before, and now I'm totally into it. Because it's, obviously, just more fun and you can get much more in depth in a way that just a clip on TV, you really don't. And radio, I think is fun too.

Julia Marcus:

But I've learned I don't like answering caller questions at all.

Lisa Bodnar:

Oh, that's hard.

Julia Marcus:

Yeah, totally. Yeah. Especially in a pandemic when people are like, "Well, what should I do in this situation?" I'm like, "I can't tell you."

Lisa Bodnar:

No. And they're like, "Trump's an asshole." And you're like, "Yeah, should I comment on that?" I don't know.

Julia Marcus:

Exactly. How can I reframe that? When you set these things up, like the CNN one, I improved my background game a little bit. But it required balancing a table on top of a mattress with a pile of kids' activity books on top of that. And then lamps, like precariously balancing on things. You know? And at any moment a kid could come in and then the way it looks, it looks totally fine. Like what they see, it looks like a professional person who has their shit together. And then if you just zoomed out a little bit, everything is about to fall apart, which is such a perfect microcosm of what you're trying to do here. It's humanizing people who seem like they have it together and nobody does.

Lisa Bodnar:

What were you worried most about when you did the first one? And then how did any worry that you had change as time went on?

Julia Marcus:

I was worried about just not having my points tight and saying the wrong thing and seeming nervous and falling off my chair. Like all the things that just sort of the surface worries. I feel like my worries have changed a lot over time. I think that that's partly because of how polarized our discourse has become around COVID. And I think there's a lot of fear that scientists and health professionals in general. And at least for me, I'll speak for myself, fear that I experience in speaking my mind about things now, because it feels like, from the beginning, I've been towing a line. That's like, "Look, this is not as black and white as it seems," and pushing for a bit more nuance and humanity and empathy and some of that and harm reduction, which I think often gets pushed back as you're promoting risk taking. You think people should just be allowed to party in a pandemic, which, of course, is not what I'm saying, but what you say right now can really be used against you in this intense high stakes way. So my fears have definitely changed in that sense.

Lisa Bodnar:

I can imagine that you had pushback from both sides. Is that what happened?

Julia Marcus:

Yes. I get pushback from both sides. And it's disconcerting because I get pushback from people who I would I think I agree with generally. The piece I wrote about masks, I had written that piece around somebody who people found really distasteful, who had spoken out against masks. And I was pushing people a bit to say like, "Look, it's not the job of public health to judge the people we're serving. It's our job to try to maximize public health and be pragmatic and do it without judgment." And I got some pushback on that, especially from feminists and people who felt like, because I had humanized somebody who really embraces toxic masculinity and is really a violent person, his communication to the world.

Julia Marcus:

I understand that I was pushing people and I need to be prepared to take that. But honestly, I've a very thin skin and that's a hard thing to have as somebody who's now in the public eye and is being critiqued very publicly. It's incredibly exhausting. Sometimes it makes me want to crawl under a rock.

Lisa Bodnar:

I was thinking about the criticism because, even if you have a tweet that goes viral, by the time a thousand people like it, some asshole has said something that is upsetting. And in the few times that's happened with me, those little things really stick with me. And I don't often think about the positive that may have come out of it. How have you dealt with that negativity and that criticism?

Julia Marcus:

So I do the same thing where I internalize the bad things and I don't internalize the good things. So I'm trying hard when I get... Because sometimes I get these lovely emails that are just like, "You have made such a difference in my life, and your writing has resonated so much and has helped me in all these ways." And I try to just sit with it and internalize it, because I know that as soon as I get hate mail, which I also get, that becomes the thing that I focus on. And some of it is easy to dismiss if it really is just trolling, but some of it is much more civil and that makes it harder to ignore. And I can't say that I've found a way to really deal with it. I think some of it for me has just been about accepting my process.

Julia Marcus:

But when I put something out there, especially an article, I accept that basically I'm dysfunctional for the next 24 to 48 hours. And then I'm going to have a crisis of self doubt, that I'm going to decide I should never write again. And then I'm going to come out of it. That's just what's going to happen. And I have my husband who reminds me, "Okay, here's where you are in your process," When I'm like, "This is it. I'm done. I'm never writing again." He's like, "Okay, that's because you're on hour 26, and it's going to get better in a day." And it does.

Lisa Bodnar:

Do you take a pause from what you've written and say, "I'm going to put this away. I know that the comments are going to come flying in and I'm not going to look at the comments," or is it better for you to process as things come in?

Julia Marcus:

That's interesting. I think because of the immediacy of Twitter, I would find it very hard to just be like, "I'll come back to this in a few days."

Lisa Bodnar:

Your phone is blowing up.

Julia Marcus:

Exactly. And maybe it would help. I definitely do that with manuscript reviews and grant reviews. I think it helps a lot to just take a step back and put it down. But everything about the public writing process, I have found to be so much more immediate and just compressed than research, both in terms of feedback and just the whole timeline is compressed. Feedback impact, it all is compressed into a week, versus six months or a year.

Lisa Bodnar:

If you had to go back to May with 2020 hindsight, is there anything that you would change?

Julia Marcus:

I have gotten better at saying No to things. I get so many requests every day for all sorts of things. And there's a chunk of my day I spend just saying No and referring people to other people. And I wish that I had done more of that earlier on and that I had been more judicious about what I said Yes to. And I still feel like I'm trying to find a balance. I still say No to so much stuff. And then still sometimes feel overwhelmed and feel like, "Why am I devoting so much time to this?" And start to feel burned out. I will say though, that there is something in every piece that I've written that I regret where it's like, "Oh, if I had just framed this one thing a little differently."

Julia Marcus:

And you never know until you get the feedback and put it out in the world, and then it's out there forever, the way that it's written. And I wish I could just go back and change that thing. And I'm haunted sometimes by that. So I think maybe it's less about the overall experience and more about certain things that I have said where I'm like, "Ah, I didn't get that quite right." And you just can't get it right always. You know?

Lisa Bodnar:

No. And I think that probably nobody knows that but you.

Julia Marcus:

That's probably true. Yeah.

Lisa Bodnar:

How have you been over the last six months? How have you been feeling? How have you been adjusting to this?

Julia Marcus:

I have to say the way that I have been feeling lately and for quite a while now is really angry a lot of the time and really heartbroken and just very strong emotions that are sustained over a much longer period of time than I'm used to. I feel usually like acute anger and acute just heartbrokenness at the state of the world. Those are things that I feel in a fleeting way sometimes, but I'm feeling them a lot of the time and every day. And it's hard to explain to people who are not as much in this world. I think some people are not experiencing that intensity of emotions. Some people are. Everybody's experiencing this differently, but I think there's something about being an infectious disease epidemiologist and watching what is happening right now. And feeling like there should be a way that I can help contribute, but I don't quite know how.

Julia Marcus:

And just watching the discourse around everything just fall apart and the pain that people are experiencing, it's just so much, so much. And then, of course, there's trying to figure out our own childcare crisis and all the personal aspects as well. But I think in terms of action with the world, the main differences is those strong feelings that just don't seem to abate.

Lisa Bodnar:

Can we talk about fun stuff now?

Julia Marcus:

Oh yeah. That'd be great.

Lisa Bodnar:

Okay. What's something I wouldn't believe about you?

Julia Marcus:

Let's see. There are things I probably shouldn't say on a podcast that's going to be out in the world, but one thing I'll say-

Lisa Bodnar:

Will you tell me once we shut it off?

Julia Marcus:

Maybe. I could tell you what profession I would have had if I had not become an epidemiologist. So when I was in college, my college job was as a church organist. [crosstalk 00:21:26]. And I didn't know what I wanted to do with my life. And so I applied to do a masters in organ performance at Wesleyan University, and that's what I was going to do. And then the day before the committee decided whether I was going to be admitted to the program, I was like, "What am I doing? I am not meant to be a church organist. That's just not my path." And I withdrew my application and moved to San Francisco and figured it all out. But that was my almost career.

Julia Marcus:

And I do miss playing organ. I was actually... It's amazing. I'm not quite five feet tall.

Lisa Bodnar:

Really? You're little. I never would have guessed that. I feel your presence is larger in a good way. Right? Like, Oh my God, you're a shorty. Me too.

Julia Marcus:

I'm very, very short. Yeah. I never quite made it to five feet. And so getting to have this powerful instrument, like a whole building is your instrument was such a power trip for me. I loved it.

Lisa Bodnar:

That's such a good answer. What's your pet peeve? What is a pet peeve?

Julia Marcus:

I think one thing that I'm notoriously challenged at handling is filler. Like any filler in life.

Lisa Bodnar:

What do you mean?

Julia Marcus:

I just don't handle that like everything from extra words in a sentence that just don't need to be there to small talk. I can't handle small talk. I don't want to do small talk.

Lisa Bodnar:

What is small talk? You [inaudible 00:22:53] me really well.

Julia Marcus:

No. I wanted to say, but I want to connect with people. And when I go to parties, I'm just like... Don't even bother small talking with me. I'm going to make you talk about something that actually matters, which not everybody wants to do all the time.

Lisa Bodnar:

Yeah, I hear you.

Julia Marcus:

And I would rather be alone than just chit chatting about nothing.

Lisa Bodnar:

What's something everyone knows something about, but you don't know anything about?

Julia Marcus:

There are so many things I could say to answer that question. I feel like I know five things really well, and then I don't know anything else. That's the way that I function in the world. For example, the stock market, I just couldn't possibly explain to you what is going on there.

Lisa Bodnar:

Me neither.

Julia Marcus:

Like money moving around and what... I just don't get it. And I've had maybe 15 different people try to explain Bitcoin to me. And I just can't.

Lisa Bodnar:

Oh, I don't understand that.

Julia Marcus:

I just can't. And I'm sure that if I really cared and tried and was interested, maybe I could figure it out. But there's just certain things where my brain just shuts down, and I'm like, "This could not possibly be something that I need to understand."

Lisa Bodnar:

What is the most common website your work computer visits?

Julia Marcus:

Oh, interesting. Probably Twitter.

Lisa Bodnar:

Me too.

Julia Marcus:

That's depressing.

Lisa Bodnar:

It's all right. It's okay. We can own it. Okay. Favorite dessert?

Julia Marcus:

Oh, you know what I really love? I love flan. I'm a huge flan person.

Lisa Bodnar:

Okay. So if you were to ask me, what's my least favorite dessert, I would say flan.

Julia Marcus:

Oh, no.

Lisa Bodnar:

What's the best thing about working at home?

Julia Marcus:

I really don't miss getting dressed for work. I just don't. I'm completely fine with wearing sweat pants for the rest of my life. And I actually think we should just start a movement really? Does anybody want to get dressed for work? Maybe some people do, but can we all just accept sweatpants from now on? Maybe that explained my anger and heartbreak all the time. Maybe I just need to get dressed.

Lisa Bodnar:

All right. This is definitely filler. Would you rather shoot spaghetti out of your fingers or sneeze meatballs?

Julia Marcus:

Definitely, the spaghetti. I would like to un-hear the phrase movement lost.

Lisa Bodnar:

Well, we're leaving it in. There's no editing that out. Sorry about that, Julia.

Julia Marcus:

I just want to say thank you for doing this podcast, because I think we are in a difficult place as human beings right now, that we have lost some of our humanity in all of this. And I feel you are trying to bring that back and it's so important. So I really appreciate it. Thank you.

Lisa Bodnar:

Well, thank you for saying that. And I will say that... Oh my God, can you hear that stomping? That is my children. I think that the positive response to your work is really also a reflection of the importance of empathy right now, and that people want their experiences validated. We're obviously not getting that from our federal government or many other places that I think we normally look to when there's this collective grieving. And I think that's why I felt so connected to you and wanted to talk to you, because I think we both shared this feelings of, "We need to bring more empathy into the world." That's what really resonated about your work. It made me think a lot because I was sort of on the like, "Goddamn, you people that don't wear masks." And I was like, "Oh, my God. Julia is really speaking to me now. I need to tone this back."

Julia Marcus:

But that response is also completely normal and as much as we can just help everybody get back to a place of seeing each other as human beings first and foremost, before we yell at them about stuff, which is also understandable, but at least first, thinking of each other as human. I think that's so important. So yeah, thank you.

Lisa Bodnar:

This was so wonderful to talk to you.

Julia Marcus:

You too.

Lisa Bodnar:

Thank you so much for sharing parts of yourself that maybe you haven't shared with the rest of the world that you've publicly talked to. So thank you.

Julia Marcus:

Thank you. It's been such a pleasure.

Lisa Bodnar:

Okay, let's keep in touch. Now we're buds.

Julia Marcus:

Yeah, totally.

Lisa Bodnar:

We just drank wine together.

Julia Marcus:

Yes, in our closets.

Lisa Bodnar:

In our closets. I can't say that about a lot of people that I know, we drank wine together in our closets.