Thriving After a Devastating Loss
Date Published: December 26, 2018
After her brother’s murder, Rosalind Wright, MD, Dean of Translational Biomedical Research at the Icahn School of Medicine at Mount Sinai, channeled her grief into a career in public health, where she has studied the connection between trauma and disease.
Dr. Wright has discovered that living in a high-stress environment can have a direct impact on your immune system and can change your biology to the point where you’re at risk of developing chronic diseases, including asthma. She has also researched the health consequences of poverty and stress and found exposure to more pollution, a lack of nutritious food, and living in housing with mold and rodents can also make you more prone to these diseases. Her work can now pave the way for prevention and solutions.
We've all dealt with the death of a family member or close friend and had to cope with that incredible grief. This trauma can greatly impact your mental and physical health, but you can take this loss and have it positively shape your future.
In this episode of Road to Resilience, we're explaining how you can do this through the journey of Dr. Rosalind Wright. She's an expert in pediatrics and runs our Institute for Exposomic Research. She's sharing her emotional story and how she used active coping skills to deal with her family's traumatic experience, hoping it can inspire others to become more resilient. Welcome Dr. Wright. We appreciate you joining us for this podcast. We're excited for you to share your expertise with us.
Dr. Wright: 00:39
Yeah, I'm looking forward to it. Thank you.
First I want to start with learning more about you. Tell us about your role at Mount Sinai.
Dr. Wright: 00:45
So I've now taken the position of Dean for Translational Biomedical Sciences and what that means is directing a program here at Mount Sinai that facilitates research training as well as developing infrastructure to allow bigger science to be done.
You're involved in some incredible research here at Mount Sinai that focuses on public health and environmental health. That's a new area of medicine that we're really starting to learn more about.
Dr. Wright: 01:11
So initially you think about things like how tobacco smoke and smoking can affect your health, that's an environmental exposure. And then we also think about the social environmental factors, so how you emotionally experience your environment and the things that cause worry and the stress in your environment. And that takes us all the way from understanding a worry about financial issues to experiences of violence and trauma that people may have in their communities and their families in their lives. I think some of the major breakthroughs will be along the lines of how environment gets embedded in the body and causes health, or also causes well-being. So good diet, nutrition, things like that.
We're going to go into your research a little bit more later. I want to talk more about resilience in general. People think of resilience in many different ways. How do you define it?
Dr. Wright: 01:57
Resilience is very important to develop because you're going to experience multiple challenges throughout your life. Learning about how you're going to get through those, how you're going to cope with those, face those challenges and hopefully come out stronger on the other side and start to look at them not as threats necessarily, but challenges that you can overcome.
And you've certainly dealt with challenges in your life. Tell us what happened.
Dr. Wright: 02:29
Well, one of the most difficult periods in my life was I was just finishing my residency in internal medicine and I received a phone call in the middle of the night. I can't understand who the person is talking to me. I didn't recognize the voice, but they're trying to tell me that something had happened to one of my brothers. It turned out it was my mother and she said, your brother's in the hospital. He's gone. We lost him. And I was trying to get my head around, what are you talking about? He was out at a party, a local party in our community. We grew up in a rural area in Michigan and apparently there was some altercation and people had guns. That was also something very common where I grew up, and he was shot and he did not survive.
How do you even begin to process something like that?
Dr. Wright: 03:23
So he was my best friend growing up. He was funny. He was very talented in many ways that I'm not, he could sing, he was in theater and when you lose somebody that's such a part of your fabric, It's very difficult. And then you have to watch your family go through it. My parents lost their son, so it was very difficult.
This had a profound impact on your family, including health. Tell us about that.
Dr. Wright: 03:50
Well, it's things like depression, anxiety for sure. It affected people's ability to sleep. Particularly my parents who were older at the time. Health issues that they already had were exacerbated.
Dr. Wright: 04:05
Well, my mother had already been diagnosed with cancer, so it seemed to take a turn for the worst, not immediately, but this was a couple of years after the event. People who experience trauma even years earlier are at higher risk to develop things like hypertension, diabetes, and more severe disease.
How did you get through that time? Being in med school is so difficult as it is. Then you're dealing with this significant loss. How do you stay resilient and move on?
Dr. Wright: 04:35
I had just had our daughter, she had been born that April, so she was about three months old when this happened. And actually it was having her more than anything that made me first stand up and say, I need to be present. I need to be there for her. I remember looking at her and she had the brightest eyes, the biggest smile and thinking all that trust and love, and she was looking to me, that was it. But it was really that three month old looking at me who needed me that made me start to think, I gotta find a way out of this.
But she faced some great challenges along the way. She had to sit through a criminal trial for the man responsible for taking her brother's life.
Dr. Wright: 05:19
This was someone we knew from growing up in the community. It was somebody from our community, so that was very difficult. Just a trust had been betrayed in some way that you can't describe. To me, it became more and more evident that this was just something senseless. It just was being in the wrong place at the wrong time. The other thing that I noticed sitting through the trial, people were there because of the social circumstances that brought them there. What I mean by that is we grew up in a rural community. We didn't have a lot of money. Clearly they were there because of a lack of opportunity. I started to understand a little bit more how social circumstances put you at risk.
As time went on, I started really thinking back to what I learned through that experience and how I had observed in myself and in those close to me how experiencing a traumatic thing like that and loss like that of someone that you really care about and is close to you, affects your mental well-being, but also your physical health and I couldn't shake that. Then when I started thinking, I think people need to understand how trauma not only affects emotional well-being and it can lead to things like post-traumatic stress disorder, depression, anxiety, but how it actually can embed itself in the body, change how you biologically are, and it actually relates to increasing problems like hypertension or diabetes or obesity, asthma.
Dr. Wright became intrigued with this topic and determined to learn more about it on a scientific level. So she applied active coping skills to persevere after this tremendous loss. She made a big decision to switch gears from studying genetics to pursuing a career in public health.
Dr. Wright: 07:05
It's been a very fascinating career path that I never would've had the courage to take if it wouldn't have been for this loss, this tremendous loss for me. And I actually oftentimes when I'm working on some of this, I'll light a candle, my brother's right there next to me. It's his career just as much as it is mine. It's a way for me to keep him here with me.
You turned your situation into a positive. This prompted you to pursue some groundbreaking research about community violence and health. You focused on inner cities, urban populations where poverty was prevalent. Your study shows that community violence can actually have a negative impact on both health. What exactly did you find?
Dr. Wright: 07:55
What I thought was well, community violence or living with that kind of worry all the time can get into the body and change key stress response systems that are supposed to help us manage the day to day challenges that we face like our immune system, hormonal systems like cortisol that we all hear about, and then adrenaline, things like this. Once you connect that to immune disruption, it's not a big leap to say, well let's start looking at it in relationship to immune mediated diseases like asthma or allergy.
We talked about 500 women and their young children and we measured how much violence had they themselves experienced, witnessed or knew about in their neighborhoods and that was all the way from hearing gunshots in your neighborhood to witnessing fights and arguments to witnessing stabbings, shootings. And then we also measured their physiology and we measured things like how much cortisol they produced or how their immune system functioned and then we linked it ultimately to higher risk of asthma. Then you can get into prevention. You can say, okay, well we need to understand what's causing these communities to be more high in crime and and violence exposure so that we can fix it and that's where public health comes into play. That's where I thought I needed to go back and take more of a public health approach to this than a basic science.
You also went on to find that air pollution as an effect as well?
Dr. Wright: 09:21
We learned when we went out to the communities they weren't only concerned about the crime and violence. They were also concerned about the high levels of pollution, the traffic patterns that were coming through there and the type of housing that they were living in and that there was mold on the walls and there were rodents and things like this. Well, when you're thinking about asthma, these are factors that are known to affect the disease as well.
But you found that there are definite health consequences of poverty and stress.
Dr. Wright: 09:53
What about poverty makes you sick? You know, there's the obvious you can't afford nutritious foods and things like this, perhaps. You can't afford quality housing, but what is it really about poverty that's making you sick? It's your exposure to all these adverse environmental factors. So there might be more air pollution consequently to where you're living. There may be more indoor allergen exposures in the type of housing that you have, but there's also this emotional domain and aspect of it that there are also stressors that you experience uniquely and all the way to the crime and violence that might be happening in your community. Again, that happens because of lack of opportunity and lack of resources put into communities. And we have to take that broad view to really improve health going forward.
What's the solution?
Dr. Wright: 10:44
Well, that's the big question. Exposure to violence and crime in several of our communities across this country as well as people experiencing trauma. You just see it. I never expected it to happen to me. It happens to people. It's very prevalent in people's lives and if that's driving some of this health effect, we have to understand it just as we have the environmental protection agency thinking about how do we reduce exposure to air pollutants that we know affect our health. Well, what resources do we have to put into community to decrease things like crime and violence exposure in the community? What infrastructure do we have to put in place or legislation or what have you to keep guns out of the hands of people that are going to do harm? Those are the kinds of interventions that we need to talk about when you think it's violence and gun violence in particular that's driving some of this.
Violence can be prevalent in these impoverished communities, but it's something that affects the entire country. Recent data from the CDC show every day on average, 96 Americans are killed because of guns, seven of them are children and teenagers. This is certainly something that resonates with you. Do you think this is a health crisis?
Dr. Wright: 12:02
Absolutely. I think what people need to understand is that it can affect all of us. It's not any one particular group. It's not only associated and linked to things like poverty. It's a crisis in that we've let guns become so ubiquitous in our environment in that the access to guns is not as controlled as we know it could be. So we need to address that and linking it to health outcomes and costly chronic disease outcomes, not just mental health. That's important and they are certainly intertwined, but the fact that this is driving some of the chronic disease problems that we see in this country, which are very costly, we need to think about that in the cost to our society.
What did your research find when it comes to resilience and these communities?
Dr. Wright: 13:02
They're very resilient. We've actually shown that if you do have strong social supports and social networks, it mitigates the effects of lots of these different stressors, as well as can mitigate the effects of the of the chemical pollutants. It's growing up in a supportive, loving homes, families. Also having social support from your community elsewhere, whether that be your religious community, spiritual community, or what have you. It's really remarkable what people can tolerate when they have those sorts of resources around them. They thrive in this setting.
Talk to us about the importance of resilient communities.
Dr. Wright: 13:43
Well, you find strength from your community and you find strengths by coming together to create something that helps grow your community or shore up your community or help you face a certain challenge together. It's so important to reach out for those resources when you're trying to help yourself get through a particular experience, but also to effect change in a positive way.
How can communities build resilience?
Dr. Wright: 14:19
Things that enhance social interaction, building trust in your community, engaging with your community, participating in social events or networks in your community, coming together around a particular issue can help you build that resilience.
You've been through so much on a personal level, you were resilient and found personal success as a result. What did you learn about yourself through your own experience?
Dr. Wright: 14:48
I learned that you need to reach out to others to find strength and I had to learn that a little bit to reach out to people more, but it's so important. Unfortunately, that experience and I think more than anything else in my life taught me that and that's been another positive that's, that's come from it.
What can others learn from your experience?
Dr. Wright: 15:11
You'll get through it. When you face things like this in the immediate aftermath, you can't see a way through it and there's a light at the end of the tunnel and that does come. Your life is going to be changed forever, but try to find ways that it can be positively changed and the more that you do that and you live for the positive, seek the positive in tragedies like that, all of a sudden, it's amazing actually the good that can come out of it, the growth that can come out of it.
What's next for you and your research?
Dr. Wright: 15:56
This is going to more than anything in my career in medicine finally have great impact reducing the growth in chronic diseases that we're seeing. This is the first generation that is thought to be likely to live shorter lives than their parents. Usually life expectancy gets longer with each generation because we improve health, right? But now this is the generation where we think maybe that won't be true because of the environmental exposures that have accumulated over their lifetime. So we really need to figure this out now so we can help people that already have been impacted. Right? Get them back on track. We know that your past exposures have been affects your health, but if we can understand that in a comprehensive way, we can actually also understand what kind of factors might push you back on a healthy track. That to me as a clinician is very exciting. That it will translate and impact on improved health, not only for those now, but particularly for the next generation.
So great possibilities lie ahead?
Dr. Wright: 17:07
Great possibilities lie ahead. Absolutely.
Good luck with your research. We look forward to hearing the results and the changes that you could be implementing.
Dr. Wright: 17:16
Hopefully. Yes. Thank you very much.