Emily Smith | Science & Neighborliness

Smith: 

If you remember the story where there’s a woman who had spent all of her money on the issue of bleeding and she had nothing left, and so her last resort was to go and just try and find Jesus. And she did touch the hem of His garment and He stopped the crowd. He centered someone who was very sick and very poor in the middle of a lot of other people that could have taken His attention. You see in His first sermon in Isaiah where He centers the oppressed and the poor and the captive. So I think we’ve got our starting point wrong. But I think that’s the beauty of the Good Samaritan story is the center of that story is on who was the neighbor, but also who was needing the help in the first place.

I’m Dr. Emily Smith, and I am an assistant professor of emergency medicine and surgery and global health here at the Duke University and Duke University Global Health Institute.

Stump:

Welcome to Language of God. I’m your host, Jim Stump. The Good Samaritan is one of those Bible stories you probably know pretty well, have heard a few sermons about over the years. Someone asked Jesus, “Who is my neighbor?” And Jesus tells a story about a man hurt on the side of the road, and after several likely helpers pass by, he’s finally given the care he needs by a stranger from a rival ethnic group. “Who was the neighbor?”, Jesus asks back. As an epidemiologist, Dr. Emily Smith sees this story filtered through her own work, looking at sickness and disease and populations around the world that don’t get a lot of help or attention. People tend to pass by as they’re concerned with other things. This global view of healthcare in the light of this story brings up some hard questions about how we should be good Samaritans to those in need and even how to identify those who are most in need.

Emily started sharing her expertise online as the Friendly Neighbor Epidemiologist at the beginning stages of COVID, mostly to friends and family, writing about what she thought was the application of the Good Samaritan in the midst of a pandemic. The Friendly Neighbor Epidemiologist went viral, garnering millions of followers, though not all of them were supportive, including, painfully, some people close to her. We’ll talk about that a bit, but we focus on the friendliness and neighborliness that endures and how the Good Samaritan continues to provide the encouragement to us to help those in need today. 

Let’s get to the conversation. 

Stump:

Dr. Emily Smith, welcome to the podcast. Thanks so much for joining us.

Smith: 

Thank you for having me. This will be fun.

Stump:

Yeah. So during the pandemic, you became known to a surprisingly large number of people as the Friendly Neighbor Epidemiologist, and we’ll talk about epidemiology and what that entails, but let’s start with science a little more generally. So go back a little ways. What drew you to a scientific career rather than becoming an accountant or a lawyer or a professional athlete or any of the other careers you could have chosen out there?

Smith: 

Well, could have is a strong word. I don’t think I ever could have been a professional athlete. I always have loved science and math. I’ve just been very nerdy. I’ve loved to read for as long as I can remember. And I remember my eighth grade, ninth grade science teacher, one of those, when he talked to me about DNA, I was just hooked. I mean, you would’ve thought it was like Beyonce or something. I was so enamored by it. I don’t know why. So he gave me a textbook, a college textbook on DNA and I read the whole thing on a band trip, which is double nerd points. I was nailing it for sure. So I’ve just loved it.

But I grew up too in the church with parents that were very active in the church, and so we were the home where the missionaries would come and stay in our house. So I just grew up meeting a lot of people who were doing some really great work around the world and wanted to be a missionary, it’s one of my earliest memories. But because of my love of science, I thought, “Well, the only way that you can do that is through medical school.” Because I really didn’t have any exposure to other avenues other than global missions. So I did that. I did pre-med, took the MCAT, got into med school. When I graduated, my husband and I got married and he is a pastor, so his first job was across the country in South Carolina.

Stump:

As you were growing up where?

Smith: 

I grew up in eastern New Mexico.

Stump:

Okay.

Smith: 

Yeah, like 10 minutes from Texas. So it’s technically West Texas culture. Yeah, flat land, great sunsets, good people. But I had a gap year between medical school and when we moved to South Carolina and I decided to just get another degree because that would look good on an application. And it was a public health degree, a master’s of science and public health. And day one of epi was my professor’s describing what epi is and how basically it’s quantifying people who are at risk of something where other groups are not and then doing something about it. And to me, that just clicked as naturally what I’m inclined to do. I think population health anyways. So didn’t go to med school, got a PhD in epi and the rest is history.

Stump:

Well, we’ll talk a little bit more about what that means in a second. But stay on your childhood here and your community of origin for a little bit. Tell us a little bit more about the faith community that you grew up in and then particularly with attention to this interest in science and how that was received in that community.

Smith: 

Yeah, I grew up in a charismatic church, so science and religion was definitely not something that came up on a typical Tuesday or nearly at all. It was a very small town, and so there wasn’t really a science program either. But in terms of maybe the encouragement of that, it was more of the encouragement to go and help people in the world, again through medical school, but not really as a scientist and certainly not as a female scientist.

Stump:

So medical science perhaps is a little easier to swallow for some of these more conservative Christian communities than other disciplines in science, is that fair? You didn’t experience any sort of conflict or people cautioning you about science and it leading you away from the Bible or anything like that?

Smith: 

No, I really didn’t. I heard that the older I got, especially in college, of where you don’t talk about science and religion at the same time at all. But growing up I just wasn’t really aware of that being a very big deal.

Stump:

Well, good. Well, let’s sort out epidemiology here. You kept saying epi. Is that the shorthand that everybody refers to it?

Smith: 

Yes. That’s the cool kid’s term, huh? That’s what my teenager would say. “That’s a cool kid term mom.”

Stump:

That’s a little easier because epidemiology is one of those words that I always have to pause and think a little bit about because the word cloud in my brain, it’s very close to entomology and epistemology and eschatology and all these other technical E words. But when you stop and think that it has the root word epidemic in there, right? So do you study epidemics? What’s an epidemiologist do actually?

Smith: 

Yes. And it’s funny that you talk about the word cloud of that word specifically. It’s also seven syllables. So throw it in at the Thanksgiving table and it’s lovely to sound like you’re very smart. But before the pandemic, I think a lot of people thought we were skin doctors like epidermis or the bug entomology. We got that quite a bit. Not at all. Medical, MD, nursing and dentists, they are one-on-one helping one doctor to one patient, one after the other. And what we do is we treat communities and populations and groups of people rather than just the individual. So if you want to get technical, epi, it’s the study of the distribution and determinants of disease. So it’s who is at risk of some sort of disease? It could be one like COVID that leads to an epidemic or it could be something chronic. And then who is at risk of that for some type of either intrinsic or external system-wide risk factor?

Stump:

So were you doing anything in your regular day job that was related to COVID during that epidemic that was going on?

Smith: 

During COVID?

Stump:

Yeah.

Smith: 

Not at all. No. My day job is a global health epidemiologist in really impoverished countries like Somaliland and Burundi on children who need cancer or surgical care but can’t get to that. And most of the time that’s because they live too far away. So COVID, I wasn’t doing anything in the lab or risk factors of hotspots here in the US. But my work was very much related to what COVID was exposing, the inequities around the world or vaccine inequities. So it was tangential. It felt like it was a natural extension just because the world became very close within one year for all of us.

Stump:

Yeah. So we’ll talk a little bit more about your day job there then in particular as we get into the book that you’ve written. But while we’re still on COVID here, I mentioned that you became known to a pretty wide audience as the Friendly Neighbor Epidemiologist on social media during the pandemic. So this was just something that in your spare time you decided to start doing, and tell us a little bit about how that got started.

Smith: 

Sure. It was kind of in my spare time. And in the beginning, in March, 2020 when we were all hearing about Wuhan, in the epidemiology and public health space, seeing something like that had been what we had been preparing for for a long time. So it didn’t take anybody off guard. It did make us all go, “Uh-oh.” Because we had watched other epidemics happen and you take those very seriously, but this one looked like it was going to be very different. So I was having real life conversations with my family and friends at church of: what does flatten the curve mean? Do we need to buy a billion rolls of toilet paper? Those questions that everybody was kind of asking. And also, I mean, I make a joke about it, but just remembering how scary that time was for everybody, to be able to speak into it from my expertise to calm fears, but also to say, “Hey, this actually is something to take very seriously.”

So I decided to be efficient and start a social media page for those 10 people. I mean, it was not a lot of people, and I named it Friendly Neighbor. Friendly because I tend to be too friendly. Like I’m so sorry if I sit by you on a plane because… I’m trying not to be as chatty and sometimes it works. But for Neighbor, because I knew that something like COVID was going to mean that we needed to take care of one another. The margins where I worked, the margins of poverty and of lack of healthcare access would be definitely affected more than those with privilege. So we would need to act like a good neighbor. And also the story of the Good Samaritan, which is what the book is about, is so dear to me because I think that’s what epidemiology is. So I named it Neighbor because of that, with Epidemiologist.

So at the beginning it was shared to just a couple of people, but definitely it didn’t really go viral until the pandemic started getting political and weird religious overtones. And I’m a pastor’s wife, so I spoke into that from a perspective of a Christian and a scientist, and that’s really what it caught fire that way.

Stump:

So this is really interesting, particularly there at the beginning where it sounds like the people who knew you trusted you and we’re seeking you out, asking in particular, “What should we think about these things?” And you start sharing from that expertise, both as a scientist and as a Christian. And then it turns out that this blows up and not everybody welcomes the work. And I think particularly because of the way the lines of the culture wars have been drawn, the worst responses, I think I might even say the least Christ-like responses, came from Christian communities to you.

And I know this is painful and traumatic, and I too have been exiled from a Christian community because of scientific work that I pursued that was explicitly motivated by my understanding of the gospel and the greater kingdom. And you never really get over that shock and disappointment. But I wonder if you’re far enough removed from the worst of it now to reflect a little bit on that episode and what you’ve come through. Is it still surprising to you that the people you knew and trusted and loved were responding in the worst ways sometimes?

Smith: 

Wow, and I don’t know if I am far enough removed for it not to still be tender. The part of the book, that is the middle section of the book, the book has three sections and the middle is cost, and it’s the shortest of any of them. And that’s for a reason. There are just some things that I can’t just talk about yet. But also I read the audiobook version of the book and I realized when I did that, those chapters are still a bit messy to me. You can tell they’re not tidy, the sentence structure is fine, but the other chapters the flow is so much better. Those two chapters were just messy. Which maybe that’s good because it’s what was happening, yeah.

Stump:

It’s a reflection of the emotive character of that episode.

Smith: 

For sure. Yeah, and at the time we were in Texas, I mean we were in the belly of the belt loop, whatever you want to call it, of the buckle of the Bible Belt. We were just in the heart of it. My husband was on the pastoral staff there. And we’ve always just loved the church. I mean, we are just church people through and through. So when I started speaking about faith over fear, when that became kind of a conservative trope to not wear a mask because we’re going to have faith instead, I could not reconcile that with what I thought Jesus would want us to do. And the Good Samaritan, like this is the most faithful thing you can do is wear a mask. So writing those type of things. And then the vaccine, I started getting some pretty awful throwback about that. And a lot of it was online from people I’d never met. But then it became more people were sending pictures of guns and holocaust imagery, just really scary stuff that you have to work with authorities with.

But then it came close to home because we started getting some threats at the house. And the threats were against me and my family. And then it was fraught with, “You have the mark of the beast”, and this really weird religious imagery. So you kind of know what groups that those come from. So that’s when it became really rough is when it was from people in your own church or your own neighborhood or at your own house to get threats like that. It’s not even rough. It’s uncentering. It’s destabilizing as a person of faith. And I would say 90% of the threats and harassment I came from people in the church. It was really odd. But I think we all saw it from an outside perspective, certainly in the science field, but I think my double role as a pastor’s wife at an evangelical church plus the scientist, it was pretty daily for a while.

Stump:

I’m so sorry that you went through that, and despair a little bit at what it says about our communities. At the beginning of the pandemic, some of us BioLogos wondered, “Will this be an occasion that actually brings science and Christian faith together in a way that it hasn’t before?”

Smith: 

Me too.

Stump:

And that just looks so naive now, doesn’t it?

Smith: 

Yeah. I thought the same thing. I thought, “Gosh, this is going to be our time for the Big C Church to shine, to show real faith and works and deeds.” And yeah, I was right there with you.

Stump:

How has that experience changed you?

Smith: 

Well, it’s made me braver. I’m not naturally one to just be a leader or love a fight or one of those types. I’m more of a peacemaker. I like behind-the-scenes type of work. But I think I’m just braver and more courageous than what I thought I was. It has also made me much wiser, which is why I put the cost section in there. Well, one, because I think people can resonate with some sort of loss during the pandemic. But also I wish that I would’ve known a couple of things before I went into equity type work or being very vocal about it. And so I’ve got some wisdom there now on what fight to go to or what fight to not go to.

Stump:

Well, let’s turn to a cheerier topic. You’ve just written a book we’ve alluded to a couple of times already, and it has just come out titled The Science of the Good Samaritan. And in it you relate some of what we’ve been talking about already here. But the bigger goal of the book I think is captured in your subtitle, Thinking Bigger About Loving Our Neighbors. So here as an epidemiologist, you have this unique perspective on the question put to Jesus, “Who is my neighbor?” And you’ve already said, as an epidemiologist, you’re not focused so much on individual people as the trends and the structures that emerge and the story that those tell. So start maybe generally here, what is that story? Who are the neighbors? How do we love them in general terms? And then we’ll try to drill down into some of your specific proposals.

Smith: 

And the science of the Good Samaritan is about that neighbor story that you alluded to. And a lot of people are familiar with that story of the Good Samaritan where a man went up to Jesus and asked, “Who is my neighbor?” And instead of answering him with a question, Jesus did His typical non-answer answer where it’s either a question or a parable. And He tells the story of the man on the side of the road who is very sick or hurt or something where he can’t help himself. And two people end up walking by him. And those people, He says, are the religious people. And in that day, that would’ve been people who were of power and a privilege.

But one finally stopped. It was a Samaritan, a third man who walked by, and he stopped and he bandaged the man up, but he also took care of his wounds, took him to a place to recover and then paid for all of it. So you see this visual, almost a holistic representation of what I think health and what I think equity is. And then Jesus turns to the man who had asked the original question and says, “Who was the neighbor?” And I think getting from, “Who is my neighbor?”, that question almost to me seems like it’s a posture of, “What is good enough to be good enough? How much do I need to give? Is giving 10% and donating food to a food pantry is that fine?”

Stump:

Sounded like he was just looking for a checklist of some sort to make sure that I conform to the letter of the law here somehow.

Smith: 

That’s right. Yeah. And the question, well, Jesus tells a story and then He said, “Who was the neighbor?” After someone had already done some sort of action. And so the book is predicated on how do we get from being a person of just good enough to being a person where we really embody what neighboring looks like.

Stump:

Yeah, so there are a few phrases that really stuck out to me that came out I think in chapter seven that really typify your approach and your message in this. And I wonder if you might talk through these and just where they came from and what they mean, how they have guided and oriented your own thinking for this. So the first one of these was in solidarity. What is that phrase and how is it significant to this story of the Good Samaritan and how you’re applying it to your own work and to what we’re called to?

Smith: 

Yeah, the first time I heard the word solidarity was by Dr. Paul Farmer, and most people listening probably know who he is, and if you don’t, then definitely go look at his work. But he’s a once in a lifetime global health legend. He was my hero when I heard about someone doing his type of work and global health work. When I was getting my master’s at USC, he came and spoke. And so I took all of his books. He has five. He’s also an anthropologist, which means that his books, there are a lot of pages. So he’s very gracious in me bringing all of them in. And he signed it, “In solidarity, Paul.” And I remember that being, well, one, “How in the world could someone like Dr. Farmer think that he was in solidarity with just me? I’m just a 20-year-old student. And two, what does that word really mean?”

And that word to me seems like you’re accompanying someone side by side with honor and respect in probably a time of need. There’s a lot of compassion, a lot of empathy instead of judgment or othering or shaming that you see a lot either to poverty itself or to poor countries or people that just are living in dire situations. So solidarity, living like a Good Samaritan means you don’t walk by anymore, you stop on whatever the proverbial road is for us, we don’t look away. So it’s such a powerful word for me. It always has been since I first heard it with him.

Stump:

Yeah, and the next one will amplify that a little bit more. The next of these phrases that stood out to me from chapter seven, the sacred ground of the other.

Smith: 

Yeah, I love that quote, that’s by Pope Francis. And when we recognize the sacred ground of the other, we recognize to take off our shoes. I didn’t get that perfectly right, but that’s the gist of it. And I think that goes back to the honoring the divine in each other, regardless of who each other are. And I tell a story on that one specifically, when I was in Honduras, there was a man who had died of HIV and their family couldn’t afford a coffin for him. So he was just laying there. And once we heard about it, our team pulled the funds together to give him a proper burial. And at the burial and just watching from the outside, I couldn’t speak the language, so I just observed, the people that were taking care of the family and the children and of him, it was such a sacred moment. It was like they were honoring what was happening with a lot of empathy and dignity. And as an epidemiologist, I think if we can do that to populations, then we can honor the sacredness and other countries or cultures or religions. So I love that quote by him, by Pope Francis.

Stump:

I wonder if that starts to get at another aspect that comes through loud and clear in your book related to sort of systemic injustices, and from the perspective of the Good Samaritan again, the Samaritans and the Jews were not exactly on the most friendly terms, and so who was the neighbor, was the one who was crossing those clans, those markers that have been set up and still recognizing the sacred in those other people? Is that a fair interpretation of what you’re doing here?

Smith: 

Oh sure. Yeah, I mean it goes back to, if you look in Ephesians 3, it’s like there’s level ground at the cross. And if we are people of wanting to bring heaven on earth and what that looks like, which in heaven there’s not poverty, there’s not systems, there’s not hierarchies, at least how I read Revelation there’s not. So I think there is a recognizing that sacred, I’ll go back to that one again, when we just can do that on a community level.

Stump:

And then there’s one step further, I think in this third of the phrases I’m pulling out here, the preferential treatment of the poor, which now is not quite the same as saying everybody is the same. But rather there is a preference, but it doesn’t go in the way it typically goes in society if we say the preferential treatment of the poor. So where does this come from and how does it affect the way you see global health and epidemiology?

Smith: 

Yes, and that is another quote from Dr. Paul Farmer. That means our starting point of where we center or what we do should start with the poor. I have another chapter called Trickle Up Economics and how we should start from the margins and then work our way out rather than the capitalist type of way or the individualist type of way where we hope that the $100 from Jeff Bezos’ mailbox will somehow trickle down to whoever needs it more. That doesn’t quite work. And I also think that it’s a faith issue because in the Bible you see Jesus center on little children, He stops entire crowds and He pulls little kiddos near Him. He also stops for the medically impoverished.

If you remember the story where there’s a woman who had spent all of her money on the issue of bleeding and she had nothing left, and so her last resort was to go and just try and find Jesus. And she did touch the hem of His garment and He stopped the crowd. He centered someone who was very sick and very poor in the middle of a lot of other people that could have taken His attention. You see in His first sermon in Isaiah where He centers the oppressed and the poor and the captive. So I think we’ve got our starting point wrong. But I think that’s the beauty of the Good Samaritan story is the center of that story is on who was the neighbor, but also who was needing the help in the first place.

So preferential option for the poor means we start there. It also means we have to look, I think, as a globe. I get told all the time, “I think we need more resources or we need more money.” And I don’t think that’s true. I think we need more equity because the distribution of the resources and the money are so dis-allocated into certain sections and not other people.

Stump:

So you say, I’m on page 113 now, “The Good Samaritan story gives us an opportunity to stop missing the reality of the world.” Can you unpack that a little bit more just in terms of what you’ve just been saying here? How does taking this Good Samaritan story and centering it into your work give you a better, more realistic picture of the way the world really is?

Smith: 

Yeah. And I think that’s particularly hard to do as an American because it’s most people around us look like us and they talk like us, and it looks like this bubble that we’re in is the rest of the world, until you start learning about the rest of the world and who has what or who doesn’t have. And so I think it can broaden our imaginations when we see problems and then choose not to walk by.

[musical interlude]

Stump:

Well, there are lots of stories you tell in the book that are specific examples, I think, of this. And I’m really drawn to everything you’re saying here, and I loved reading your book. Part of my job is to find some hard questions in the midst of this and poke a little bit at them.

Smith: 

Yeah.

Stump:

I found myself wondering how well the message or the moral of the Good Samaritan parable translates from individuals to collectives or to groups. So Jesus tells the parable in response to an individual who’s asking who his neighbor is, who he’s supposed to love. And I wonder whether we can take the answer given by Jesus and extrapolate that to communities, even to governments. So much of the problems that you encounter, that you are uncovering in global health are not the sorts of things that I as an individual can do a whole lot about. Right?

Smith: 

Right.

Stump:

But certainly governments can, can the government in a democratic pluralistic society be the Good Samaritan? How does that work? How work for governments to willingly give preferential treatment to the poor? You get the question I’m asking here?

Smith: 

Yes. Yeah.

Stump:

Let me let you answer it then.

Smith: 

Yeah. And I think they can do a lot and individuals can as well, because we vote for people who are in power. So it might not be where we can make the policies, but we can certainly influence those in a certain way with whoever we vote for. Maybe I could tell it in a story form of how governments, how I think they cannot walk by. Because I do think these are global neighboring issues. The book is not a practical book of how to love your neighbor in 10 simple steps. There’s a lot of these deeper, higher level questions.

So I work in the country of Somaliland, and it’s technically part of Somalia. It is an independent state though. And if you go north, there is Yemen, and if you go south, there’s Somalia and Ethiopia. It has a GDP per capita about $600, $700 per year. It also has some of the highest maternal mortality rates and babies dying in the whole world, including compared to neighboring Ethiopia. So if you go back to 1885, that’s the time of what’s called the Great Scramble. And there were 14 high income countries that came together around this really large round table. And in the back of that table, there’s this huge map of Africa. And the point after that meeting was to splice and dice the continent between those 14 countries, basically who was going to go and colonize what section?

At the beginning of that document, it says, “In the name of God Almighty.” I mean, there’s a lot of these awful religious overtones of conquest and proselytizing, just that mess of colonialism. The problem with how it was spliced and diced is it cut through 10% of the cultures and ethnic groups that was already existing within the continent. So when you fast-forward to today, those countries or tribes that were cut up have a 25% increase in civil conflict.

Stump:

So you mean they ended up being split between different countries the way the colonizers—

Smith: 

Yes, right.

Stump:

So part of a tribe or a group would be split up, and that leads to more internal conflict, is that what you’re saying?

Smith: 

Right. Internal-external conflict, development dollars are not given as much. There’s a lot of corollaries, poverty. Somaliland was one of those countries that was cut. And so British and Italy, Italy got Somalia, and then British colonized the upper part of it. And so I think the point of that from not only a government but a community, a United States type standpoint, people within the US, is to recognize that there are systems and structures in place on a global level that have been put in place for a long time due to colonialism and just really bad otherings of people that still matter today.

And so when I work there and there’s the mothers and the babies that are dying of preventable causes, it’s of no fault of their own. It’s the systems and the structures that surround them. So I do think that everyday people, like all of us who are not in government, can recognize that and change our language to just be more empathetic and have some understanding of what we do matters. Another example I think is climate change. And when the Paris Accord was given, I can’t remember the exact date, it’s in the book, but the US pulled out of that in 2016.

Stump:

Yeah, 2015 was the agreement.

Smith: 

Okay, excellent. Thank you. It has severe ramifications of how we tackle that problem, how we talk about it. And we’re seeing now some of the results of not talking about it. So I think it’s a both and, it’s an and also question.

Stump:

Okay. So this brings us to some territory and some particular words that are triggering for some of these communities that we have been part of and we continue to love. But systemic injustices, systemic racism that you bring up explicitly in the book here. There have been, I think, some Pavlovian responses to those by some people that I just don’t understand. And particularly when I read through your work and you see the statistics of, say, birth rate mortality around the world, and do we really think it’s because of those people themselves? No, it’s because of the systems that have been set up.

Or even if we look closer to home and not necessarily health issues, but incarceration rates. Is it because of those people who have the high… I mean, that’s just straight out racism, right? As opposed to saying no, there were these decisions made by governments, there are decisions that have been enacted that lead to these kinds of things. Am I missing something in how obvious that these systemic injustices are? Or is it more complicated than that in some way? Or is this just really obvious to somebody like you who studies it all the time?

Smith: 

Well, I think it’s the proximity, it’s the accompaniment part of who we are around, what stories we’re hearing. If you haven’t really been exposed to systemic racism or structural violence or poverty, you just don’t talk about it. It’s just not a normal thing that you would talk about or have to wrestle with. And I think that is something that COVID did, is it exposed a lot of the racism, the structures, the violence that had already been there but people just hadn’t seen before because of privilege or power or it’s just not in our orbit. So I definitely wanted to write a book, not about COVID, because I just can’t talk about it for 200 pages, but about what to do since you’ve seen it. Because then we have a choice. Once you see systemic racism, we can either choose to walk by or stop and wrestle with it and do what we can with what we have.

So I wanted to help people understand those trigger words, those hot topic words for what they really are. Because systemic racism or universal health coverage or solidarity, they can seem triggering, but I think if we would understand them and hold them up to the sky, I think they reflect heaven because they’re an equity issue. So I definitely wanted the book to be a non-threatening way to talk about those issues in very story form, like structural violence, I talk about me having my own children and hopefully some really funny stories in there. But then going to the equivalent of had I been born in Burundi, I probably wouldn’t have lived from having preeclampsia, which I had here in the US because I had good healthcare and I had insurance, and I could go to the hospital very quickly. But in Burundi, that’s not the case for a lot of women, and it’s not their fault. So it can help us not shame people or countries. So I wanted it to be challenging on those words, but non-threatening.

Stump:

Okay, another hard question, and here one that you address explicitly because you have a chapter called How Do We Measure the Worth of a Life? And in this you tell a very difficult story of how some people are left to die and others in similar circumstances we leverage all resources available to save them. And something about that feels very wrong as we’re committed to the inherent worth and equality of all people. But putting that into practice isn’t very easy. And I’ll admit myself that I’m too often unmoved by tragedies playing out across the world or maybe even near home to which I have no personal connection. While if that were happening to my family, to those I’m closest to, I would move heaven and earth to help. Is there any way around this in terms of the value of a life that we can affirm every individual life is of equal value and the reality of us having resources to help some of those and not others of those?

Smith: 

Yes. That chapter on the worth of a life, outside of the cost section, was the hardest for me to write.

Stump:

I bet.

Smith: 

And it opens up with Dr. Khan. This is back in 2016 during the Ebola epidemic that just rampaged through West Africa. And to set the stage, Dr. Khan is the Anthony Fauci of Africa. He’s incredibly well-known, well-respected. He has worked with some global health heroes here in the US to try to advocate for Congress to send more aid of epidemic preparedness or resources for healthcare systems, bolstering and protecting them in case of an epidemic. So he was just a very big deal. When Ebola hit his country, his healthcare system was not equipped to take care of it. So he was on the frontline. He ended up getting Ebola and got very sick very quickly, like one does. And you need good supportive care.

Ebola is not highly fatal, it’s highly fatal without the supportive care. So they moved him to a MSF facility that had a little bit of a better ability to take care of him. It was specifically for Ebola. And he kept getting worse and worse and worse. And so then they had to ask the question of who got ZMapp? And ZMapp is the experimental drug for Ebola. At the time, it was the only treatment outside of rehydration type IVs for supportive care for people. So you go into a little bit of detail on those conversations, and I’m sure it was really heated and hard and emotional, but they decided not to give Dr. Khan ZMapp. And a couple of days after that, he ended up passing away with none of his family there. And they let a friend come in at the very beginning, but that is it.

So if you backtrack a couple of days before he died, there were two other doctors in West Africa that got sick. Oh, I’m sorry, one doctor and one nurse, with Ebola. Same thing, got sick very quickly. They were given supportive care. They were asking about medevac, which Dr. Khan asked about medevac two and they sent a plane, but he was so sick the plane was not equipped to have isolation capabilities, so they just wouldn’t take him. So those other two, the doctor and the nurse, they had to ask the same question or their team about ZMapp. Now, there were only a couple of vials of ZMapp in the world basically. One of them was at that MSF facility that Dr. Khan was at. But the doctor and the nurse ended up being medevaced out of West Africa on the state-of-the-art US plane, it looks like a sci-fi movie. It’s just HEPA filter and full hazmat suits. They ended up getting ZMapp. They also got great supportive care and ended up living and walking out of the hospital some weeks after that here in the States.

So they were both American. They worked for a very well-known mission organization. I was very pointed on who I named or did not name in that chapter to keep the centering on Dr. Khan because the mission organization is Samaritan’s Purse. And I’ve been very vocal and outspoken against Franklin Graham’s response to the pandemic. So that shouldn’t come to a surprise to anybody. But the point I’m trying to make is to come up 30,000 feet from that story and ask who was worth getting ZMapp, and go even further of who’s worth getting healthcare at all? Or who’s worth having oxygen or no oxygen? What’s a life worth basically? And I think when we can talk about that and answer it in solidarity with others, it changes how we spend our money or how we give or hopefully the conversations we have with people around us.

Stump:

I think one of the common responses to that sort of thing is to say, “Well, there just aren’t enough resources around to treat everybody that way.” Does that mean we shouldn’t treat anybody that way? Or do we really have to pick and choose? Or is that response wrongheaded to begin with? Are there enough resources if they were distributed more equitably?

Smith: 

Yeah, I hear that a lot, “There’s not enough money or we just need more resources.” And I push back on that pretty significantly because I think we have the resources and the money in the world. There’s a chapter talking about how those are allocated and distributed really inequitably through the world. So it’s not a lack of money, it’s a lack of equity. And I think the challenge is for us to sit with that for a little bit and not just think we need some more resources, but to challenge, well, where are the resources?

You see that in the COVID pandemic, this is one of the only times I talk about COVID, is that India, their big cases that they had there, and we all probably remember those pictures of the mass funerals. They were just walloped by it. And essentially, the hospitals in the country was running out of oxygen. And so the question is, why is that the case? And there were some who sent oxygen machines that can kind of be a bandaid for the acute felt need of really needing oxygen at the moment. But then when the storm stops, to be able to ask the questions and ask why wasn’t even there to begin with? And it’s because high income countries typically gobble up resources and at least oxygen during that time, for sure.

Stump:

Well, these stories I think are really illuminating to that question of equity. Let me ask one more here as we’re starting to wind down this conversation. I always want to remember that this command to love our neighbor is just half of the command. It’s love your neighbor as yourself. And in this case, I think to love is to genuinely do what is good for that person. And in doing what is genuinely good for myself, I’ve wondered whether maybe what is good for me is loving others in some ways. So somehow this stopping on the side of the road the way the Samaritan did, I don’t see that as just entirely an act of self-sacrifice, but that in some way, in maybe the upside down logic of the kingdom of God, that’s what’s good for me too. And I wonder if in your own work and approaching that work through the sacred ground of the other, have you found that this is also what’s best for you yourself?

Smith: 

What a lovely question. I’ve not been asked anything like that, so that’s such a good question. I think the answer is a wholehearted yes. I mean, I feel after COVID and everything that happened, I got very, very sick. I think my body just said no more to the threats and harassment. I was very sick for about 15 months. And coming out of that season to now, I feel like neighboring makes us live into the life that we were meant to live. It feels so much more natural and joyful. It’s incredibly hard work, but I think I just feel like I’m being true to myself, to my inner self, maybe even going back to that little Emily, the 8-year-old who wanted to do something but didn’t know. And we can’t each do it all, but we can do something. And I guess I just feel like I’m living more into my calling, living into that Good Samaritan story.

Stump:

Well, thank you, Emily, for this work that you do. And want to affirm on the behalf of the Christian community that will listen to you at least that what you’ve been doing is so important and so valuable, and we appreciate it so much.

Smith: 

Thank you.

Stump:

Thank you for writing this book. It’s funny and touching and wise, and I encourage everybody to get a copy. Get two copies, give one to somebody else.

Smith: 

Yeah, that’s right. Thank you.

Stump:

And thanks for the good conversation here. We like to end by asking what you’ve been reading. We’ve talked a lot about the book you’ve written, how about the books you’re reading now. Anything recent you found especially interesting or helpful?

Smith: 

I just finished A Coastline Is an Immeasurable Thing, which was lovely. It’s a woman’s story in three different continents. So I’m reading that. I’m a voracious reader. I typically have four or five going at once.

Stump:

Good.

Smith: 

If you look in the back of the book, I have a list of my top 10 books, but I couldn’t narrow it down. So it’s top 10-ish. So I could give you a lot of what I’m looking at right now.

Stump:

All right, well what’s next on your calendar? You got a big book tour or another book in the works already?

Smith: 

Oh goodness. Well there’s so much that was cut from this book. Apparently I’ve got a lot of words. So we will see what comes of that.

Stump:

All right, well if they make it to the light of day and in print, we’ll have to talk again.

Smith: 

Yes. Thank you so much for having me. This was great.

Stump:

Thanks, Emily.

BioLogos:

Language of God is produced by BioLogos. It has been funded in part by the Fetzer Institute. Fetzer supports a movement of organizations who are applying spiritual solutions to society’s toughest problems. Get involved at fetzer.org. And by the John Templeton Foundation, which funds research and catalyzes conversations that inspire people with awe and wonder. And BioLogos is also supported by individual donors and listeners like you who contribute to BioLogos. Language of God is produced and mixed by Colin Hoogerwerf. That’s me. Our theme song is by Breakmaster Cylinder. BioLogos’ offices are located in Grand Rapids, Michigan in the Grand River Watershed. If you have questions or want to join in a conversation about this episode, find the link in the show notes for the BioLogos forum or visit our website, biologos.org, where you’ll find articles, videos, and other resources on faith and science. Thanks for listening.