Dr. Erin Jospe of Kyruus: “Seeing Light at the End of the Tunnel; 5 Reasons to Be Hopeful During this Corona Crisis”

Destigmatize their anxiety- acknowledge that feeling anxious is normal and appropriate and pervasive. There is a lot of uncertainty, and a lot of change to our daily lives; feeling anxious is a normal response to those stresses. It is OK to not feel OK.

As a part of my series about the things we can do to remain hopeful and support each other during anxious times, I had the pleasure of interviewing Dr. Erin Jospe.

Erin Jospe, MD is the Chief Medical Officer and SVP of Account Management at Kyruus where she oversees the development and implementation of clinical strategy. Erin is board certified in internal medicine and has remained clinically active with over 15 years of experience as a practicing internist. She received her BA at Haverford College, earned her MD from the Johns Hopkins School of Medicine, and completed her clinical training at Beth Israel Medical Center and Harvard Medical School.

Thank you so much for doing this with us! Our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?

My parents instilled a strong belief in the fulfillment that comes from serving others, and becoming a doctor provided an avenue for that kind of social good, combined with the mandate to always be learning. I think it is that aspiration, to combine empathy and curiosity in my work, that has afforded me the privilege of working with patients for so many years, and then pivoting to work more with clinicians themselves from the health IT side. I enjoy the diagnostic side of my job, to listen and tease out the problems people have, and come together to find solutions that they find meaningful and actionable. It holds true in the intimacy of an exam room, but also when confronting the operational and systemic challenges in providing healthcare at scale. And I was incredibly lucky to have mentors and supporters along the way who encouraged me to pursue opportunities that deviated from the traditional vision of a career in medicine.

Is there a particular book that made a significant impact on you? Can you share a story or explain why it resonated with you so much?

I cannot say there is any one book, there are too many that have challenged, moved, inspired or quite simply provided an escape when I needed it most. I suppose the easy answer is the Faerie Queen by Edmund Spenser, because that was the book that was my gateway to becoming an English major, having brilliant and exceptionally nurturing advisors, and meeting my husband in Junior Seminar. But I don’t see too many people going on to pick that one up. A few years back, I read A Gentleman in Moscow which was a lovely immersive escape, and the joy of that book lingers fondly. Given that it is about the rich life that our protagonist creates while under house arrest for decades, it is perhaps even more resonant given our collective confinements.

Ok, thank you for all that. Now let’s move to the main focus of our interview. Many people have become anxious from the dramatic jolts of the news cycle. The fears related to the coronavirus pandemic have heightened a sense of uncertainty, fear, and loneliness. From your perspective, can you help our readers to see the “Light at the End of the Tunnel”? Can you share your “5 Reasons to Be Hopeful During this Corona Crisis”? If you can, please share a story or example for each.

1. Mental health will get the attention it warrants — historically there has always been tremendous resource constraints, poor access to services, and stigmatization around seeking mental healthcare. Before COVID, 1 in 5 Americans was affected by mental illness in a given year, but more than 50% received no treatment, and the anxiety and trauma of living during a pandemic will significantly add to the numbers in need of care. Everyone will have a story of the stress and toll this collective trauma is taking if they don’t already, and we are becoming more adept at both owning how we are feeling and asking for help. It has become socially acceptable to “not be OK” and I think that authenticity and honesty is a really healthy first step, and a far cry from the social media pressures of presenting a perfect life.

2. Constraint (and boredom) breeds creativity and innovation- I think we will see significant experimentation and innovation as we navigate living in a world with COVID. That will hold true in how we expand our opportunities in healthcare delivery mechanisms, like virtual care, but just as meaningfully, I think we will see it in artistic expression, in the technology we create, and in the ways we will communicate, build communities and find meaningful connection. I believe with fewer potentially judgmental eyes upon us and in the safety of our homes, we are willing to take more risks, explore things for no reason other than because we find them fulfilling and give us a personal sense of mastery and purpose.

3. We are surrounded by stories of goodness and kindness, and human beings rising to the occasion- we can see it all around us if we are inclined to look and pursue it ourselves. Witnessing and performing acts of kindness produces oxytocin, serotonin, and endorphins, while decreasing our cortisol levels. We literally feel better and stay healthier by being kind. There are so many opportunities, both large and small, to lend a hand to a friend, neighbor or stranger. Especially during the COVID pandemic, I really wanted to find a way to contribute in a healthcare-specific way, so I have found it incredibly fulfilling to work with MasksOn.org. The purpose, to keep healthcare workers safe by providing them with snorkel mask PPE, resonated strongly with me. And I found an entire virtual community through that work, and those relationships have become really important to me. But volunteering or the kindnesses we can perform are not by any means limited to COVID, and frankly, it is the spontaneity of the daily micro-kindnesses that can be the most meaningful. To acknowledge another’s need and to try to fulfill it is a remarkable and beautiful thing for both the donor and the recipient.

4. We are relearning the value of connectedness- for years now there has been a great deal of hand wringing about the time we spend on our devices rather than physically connecting, so of course it is ironic that we are now embracing those same devices to deliver social connectivity. And we’re enthusiastically running at it with platforms like Zoom, FaceTime, Google Hangouts, etc…! But we are also having more meaningful acknowledgment of the digital divide, as well as the accessibility and limitations of the technology that is now necessary for participation. More of us are realizing that loneliness is exhausting and hard, but also can be devastating to health, both physical and mental. It is also relatively easy to fix. Wouldn’t it be wonderful to leverage that new found empathy to confront the loneliness epidemic (even before COVID, 30% of adults reported loneliness)? To tackle it head on by applying our collective creativity, as well as our penchant for kindness to engage more with our friends, family, neighbors and loved ones? And it does not have to be digitally mediated; a letter, a note, a phone call all go equally far in bringing us together, even when we must be physically distant.

5. The pervasiveness of gratitude- we have begun to appreciate the many people that help us to function in our day to day with heartfelt appreciation. The grocery clerk is someone who deserves to be seen and acknowledged and thanked, as are the teachers that are pivoting to engage and educate our children in novel ways, the healthcare workers who treat us, and the public servants who protect us, clean up after us and keep us safe and supplied at the most basic levels. Essential roles we took for granted, and those that perform them, were all too often invisible. We have not devolved into chaos from COVID due to the ongoing commitment of these people, and we are beginning to embrace them with grace and genuine gratitude.

From your experience or research, what are five steps that each of us can take to effectively offer support to those around us who are feeling anxious? Can you explain?

1. Destigmatize their anxiety- acknowledge that feeling anxious is normal and appropriate and pervasive. There is a lot of uncertainty, and a lot of change to our daily lives; feeling anxious is a normal response to those stresses. It is OK to not feel OK.

2. Assist them with getting help- it is OK to feel anxious, but it is something else if that anxiety is impacting their quality of life, their health, their functioning. Tell them you are concerned that they might be feeling overwhelmed, and that if they are suffering, they deserve to feel better and get help. Offer to help them find their way to a clinician, whether it is a primary care provider or a therapist. That said, if you are worried about their immediate physical safety, call the suicide prevention hotline or 911 for guidance.

3. Ask them how they want to be supported- give them the space to tell you what would be most helpful to them. Be comfortable with the silences and pauses as they consider their answer. Let them know you care and want to help without dictating the specifics or proposing solutions.

4. Be an exercise buddy- physical exercise has consistently been shown to reduce symptoms of anxiety and depression, but it can be hard to be motivated to do on your own. Offer to be a buddy, to check in with them to hold them accountable for getting some exercise if that would be a meaningful way for them to connect as well as pursue some self-care.

5. Be there, be present, and listen- the act of saying you care, of listening, of checking in is both meaningful and effective. Without badgering, remember it can sometimes mean asking more than once.

What are the best resources you would suggest to a person who is feeling anxious?

Therapy and/or contacting their doctor is something many people wait longer than they need to before pursuing, thinking their anxiety isn’t that bad, or that somehow it would be wasting the clinician’s time. I’ll say it again that if you are suffering, you deserve to feel better. There are resources through telehealth platforms, their own PCP, their health system’s website, and their insurance company. If it is a sense of anxiousness, but not to the point of being significantly disruptive, there are many ways to provide self-care that are effective. Journaling, exercising, meditation and breathing exercises are all no-cost means of self-care. Avoid the perpetual exposure to news media which is known to be anxiety provoking. There was a fascinating study that people with repeated media exposure in the days after the Boston Marathon bombing had more anxiety than those people who were physically there. Take a break from the news cycle for a day or even a week. Self-care and non-acute resources aside, It’s important to say again that if a person is not feeling physically safe from their depressive or anxious thoughts, they need to call 911 or the National Suicide Prevention Hotline at 1–800–273–8255.

Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?

I heard Stephen Carey speak, and he said that one of the most powerful principles was that “your yea should always mean yea, and your nay always nay.” The simplicity and importance of that statement really stayed with me since that day; that leading with integrity, no matter your chosen career or path, is the foundation of your moral compass. It’s aspirational to be sure, but I try. It’s what I would want my children to believe about me and value in their own lives and relationships.

You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

Reading, and in particular, reading aloud to others. There is something so beautiful and restorative in listening to stories. Storytelling, and hearing those stories, is atavistic. Record the stories of your family and tell them to one another often, escape into the stories of other people both real and imagined. Studies repeatedly show that children who are read to thrive with greater cognitive, social and emotional development and reading fosters social connection, delays the onset of Alzheimer’s and dementia, and reduces stress. In the words of C.S. Lewis, “we read to know we are not alone.”

What is the best way our readers can follow you online?

Readers can follow me on LinkedIn at www.linkedin.com/erinjospe-md. They can also subscribe to the Kyruus blog, which I contribute to on a regular basis.

Thank you for these fantastic insights. We wish you only continued success in your great work!