- When Russian forces invaded Ukraine earlier this year, today's guest was outraged like a lot of Americans.

So he traveled to see firsthand the human cost of this war.

He's Dr. Michael Fine.

This week on Story in the Public Square.

(uplifting music) (uplifting music continues) Hello, and welcome to Story in the Public Square, where storytelling meets public affairs.

I'm Jim Ludes from the Pell Center, at Salve Regina University.

- And I'm G. Wayne Miller with the Providence Journal.

- This week, we're joined by Dr. Michael Fine, an author, physician, and public health expert.

He spent time earlier this year on the Ukraine Poland border, so he could see firsthand the results of Russia's invasion.

Michael, thank you so much for being with us.

- Great to be here.

- We had you on the show pre pandemic.

You're our first guest back in the studio in this new reality we're living in, so thank you for being with us today.

- Great to be here.

- So, I mentioned you spent time earlier this year in Ukraine.

As so much of the Ukrainian population is trying to get out, you were trying to get in.

What led you to take that journey?

- Well, I sort of, couldn't not go.

When I heard about the war, when I heard about the invasion, it was really clear to me that the Ukrainians were on the forefront of the defense of democracy, and what was happening there reminded me way too much of Hitler and Stalin, and so I just couldn't sit still.

And did everything I could to get there for about a month until I made the arrangements that made it possible.

- Yes.

I'm curious about that, that journey itself.

So it's like, you don't fly into Kiev, right?

How do you get into Ukraine in the middle of a war?

- Well, I ended up flying to Warsaw and then to a nearby city called Chekhov, which is the airport closest to the border.

And then, I worked with an Ahmadiyya Muslim organization, which picked me up and brought me to another closer city and then to the border at Medyka.

- So you were part of impromptu field hospital that I think, as I understand, is where you were stationed.

Tell me what you did there, and then tell us also about the people you talked to who were fleeing Ukraine cause you did speak with a lot of them.

- [Michael] Sure, sure.

Though, by the time I got there, much of the Exodus had diminished.

But I was in a field hospital, or sort of little medical clinic that had been assembled at the border by an organization called Humanity First.

And, what we did every day was meet people as they were coming over the border.

There was a sign out front that said, in Ukrainian, "Doctor Here".

People would come in and tell us about things they needed or ask for things.

And we would try to deal with what they needed as they came in.

Everything we had was donated.

So we had medicines from every country in the world in a zillion different languages.

We were actually pretty well equipped.

We had a couple of ventilators and a defibrillator, which thank God we didn't need to use.

We had surgical supplies and so forth.

So, most of our days were just meeting people as they came across the border.

And being part of an international response, I mean at the border, there must have been 20 or 30 different non-governmental organizations from all sorts of different countries, people providing all sorts of services.

There were actually three groups doing medical care, people would serve pizza and pancakes and coffee and tea.

There were people who were meeting folks as they crossed the actual border and helping them carry their luggage.

There was about a, I don't know, maybe a 500 yard walk from the border to where the buses were, so there was kind of this great outpouring of volunteers helping folks who were leaving the Ukraine in any way possible.

The other thing that I got to do was go into the Ukraine, a couple times, four or five times, almost every day to schools which had become the places that people who were refugees from Eastern Ukraine were staying.

There would be groups of 50 to a 100 people fleeing the actual fighting, and they were put in schools, because the schools in Ukraine had closed, and all the learning was distance learning at that point.

So we did the medical care for people who were coming through.

- Did you hear from Ukrainians the trauma that they were experiencing?

Even anecdotally did -- - Yeah.

- Folks talk about that.

I mean, I guess it would've been through translation, but what were you hearing?

What were you even sensing?

- [Michael] Well, we sort of began to be, I mean, we were all pretty clear that the mental health aspect was gonna be huge, that the stress and the fear and the worry were huge, so everybody who sat down with us, whether we were in the school, inside the Ukraine or at the border, we specifically said, "Well, tell us what your life has been like for the last couple of weeks", to give people a chance to talk about it if they could or wanted to.

And some people would tear up and just, "I don't want to talk about it".

Some people would tell us about, they had spent three weeks in a basement in Mariupol.

Or there was a guy who was on the platform at the train station in Kamianske when the missile hit and saw the person in front of him go down, and the person behind him go down.

And, he was kind of an interesting guy, because he came in to say that he couldn't hear.

He'd lost his hearing.

And first I thought it was because of the impact.

And then as we talked, I realized that he could hear, that he could hear perfectly well.

What he was telling us was that his emotions were overwhelming his experience.

And he was telling us that he didn't wanna remember, and think about it.

So we would hear stuff like that, a fair bit, as people talked about what they had to do to get out, and how they had lived.

- Michael, so you were there for a couple of weeks.

The situation in Ukraine remains fluid.

Although it seems like the bulk of the fighting now has shifted to the far east of the country.

Is the effort that you were a part of on the border.

Is that still ongoing?

Do you know?

- [Michael] As I understand, it has significantly shrunken.

Poland, as a nation, really stepped up.

They took two million refugees, and they basically took anybody who wanted to come.

I think what happened a few weeks after I was there was that they started pulling back a little bit, in part because, so many people who were in Poland went back to Ukraine.

As soon as things in Kiev stabilized a little bit.

I don't know how many, but hundreds of thousands, perhaps a million or two people went back.

Anyway, Poland said that they weren't open to people unless they had some other country to go to.

And so, as I understand it, the volume of people coming across at Medyka has shrunken, and many of the organizations, the presence of that international response is much reduced.

- In the green room, you were talking about a medical school in Ukraine that was destroyed relatively early in the war.

And, if I recall correctly, and I do, you said about 5,000 medical students suddenly had no place to continue their studies.

Tell us about that and efforts to relocate, or bring some of these young people to America to continue their education.

I can't imagine anything more important than having future doctors in Ukraine.

- [Michael] Yeah.

Well, it was kind of amazing.

One of the people that we met at the border was a medical student, who was there volunteering as part of the group of people who would help people carry their luggage from the border to the buses.

And when I realized that she was a medical student, we got the organization I was working with to kind of adopt her, and she became our translator.

Her English wasn't perfect, but it was way better than my Ukrainian.

(All laughing) But, it was fun because we put a stethoscope on her, and made her feel medical again, which was kind of cool.

And she told us that her medical school, the National Medical University of Kharkiv had been destroyed by the Russians in the early days of the war, which put 5,000 medical students out of medical school.

And so, I've been working a little bit, not as effectively as I'd like, to try to find a place for her to continue her education and for as many of her fellow students as possible.

But it's really difficult, because the systems don't crosswalk.

The medical education in the Ukraine is an undergraduate degree.

In the United States it's a graduate degree.

So, you can't really apply to medical school here if you've been in any medical school in Ukraine, because you don't have a baccalaureate degree.

It's all technical stuff, but really getting in the way of helping us find places for kids.

One of my colleagues has found a medical school in India that has a cross walking kind of education.

And we're trying to get a hundred medical students from Ukraine to India, but we'll see how it goes.

We're looking for the resources to do that and so forth.

- Sounds like a hugely important issue.

Michael, earlier you had sort of couched the conflict in really historic terms.

You mentioned Hitler's history in that part of Europe, Stalin's history in that part of Europe.

I think we've talked a little bit about this on the show, and you and I sort of had a brief exchange before we even started recording, about sort of this moment in history.

And, as a physician, as an educated American, someone who's aware of the world, can you put this in some broader context?

What's at play here?

- Oh, think democracy is at play at bottom.

I mean, Putin doesn't buy into what's sometimes called the Rules Based System of International Diplomacy.

He doesn't care about the rules.

He cares only about conquest and domination.

And he wants what he wants and he's not gonna let anybody get in his way, unless we get in his way.

I kind of got more involved when my daughter who's 30 called me and said, "Dad, I'm afraid there's gonna be a nuclear war.

What can you do about it?"

Knowing that I was close to somebody named Dr. Bernard Lown, who won the Nobel Peace Prize in 1985 for creating an organization called International Physicians to Prevent Nuclear War.

And for me, the way to prevent nuclear war is really to stop Putin.

And, like what he's doing and how he's going about it is exactly like what Hitler and Stalin did.

And it was really clear to me then, and it's clear to me now that if we, as Americans, don't stand up to it and support the Ukrainians who are taking the brunt of this.

Well, today it's Ukraine, tomorrow it will be the Nation of Georgia, then it will be Poland and then Hungary.

And then we're in a very different place where democracy has no place to stand.

And, you can see Putin working social media and creating these false narratives all around the world, pushing nations into a kind of almost fascistic sense of things.

The government in Italy just fell, the government in France hung on by just a little bit.

Who knows what's gonna happen in Britain, cause things are unstable there.

And, Putin's no idiot.

He's a chess player and is playing, he is pulling every string he possibly can and playing the long game.

And I just don't wanna see us repeat what happened in 1939, 1940 and 1941, where we pretended it wasn't there until it was too late.

If you look at Ukraine, Ukraine feels to me like Spain in 1936.

Too few Americans remember that there was a Civil War in Spain in 1936 in which one side was a side of democracy and the other side was supported by Mussolini and by Hitler.

The Mussolinian Hitler side won.

And that sort of sent a message that the Mussolinian Hitler side was not gonna be opposed too much by the democracies of the world, until we had a world war, and then, we were gonna lose 60 million human beings.

- [Jim] At great cost.

Yeah.

- So Michael, what can ordinary Americans do in the face of this?

We live in a very politically divided time, both at the congressional and national level and and regionally, what can ordinary Americans do?

I mean, your daughter came with a question.

What would you say for people watching this show?

- Well, I think as many people as possible can go there and help, or can go to the border and help.

Show their solidarity by putting their feet on the ground.

And find ways to help and support.

Obviously, people can send money.

That's a good thing.

I actually think we all need to do some real looking and thinking at our own choices.

And this is not gonna sound direct, but I think we should start talking about boycotting goods from China, because China's supporting Russia in this, and we get a tremendous amount of stuff from China.

That stuff we get from China goes to subsidize their support of Russia, and my guess is, if we stopped buying Chinese stuff tomorrow, the Chinese government would change its tune, and change its support.

And it would also help protect Taiwan, because it looks like China's looking at what Russia is doing as a pathway for how they're gonna approach Taiwan itself.

- [Jim] These are dangerous days, indeed.

I wonder, going back to your time in Ukraine, do you have a sense of the resolve of the Ukrainian people?

- [Michael] It is fantastic.

I mean, the Ukrainian people became my heroes.

They are in there.

They're getting battered every single day.

If you look at what the Russians are doing.

They're not choosing military targets, they're blowing apart schools and apartment buildings.

They're trying to intimidate and to destroy.

And the Ukrainian people are sort of shifting and changing, and doing everything they can to resist.

Most Americans don't know that there are seven million displaced people inside Ukraine itself.

So, five million people left Ukraine in the early days of the war.

I think a million or two have gone back, but many people from Eastern Ukraine, from the places that have been destroyed, have come to Western Ukraine and are camped out in villages, and in schools waiting for the war to end.

And I gotta tell you that, some of the time I got to spend in Western Ukraine, it was like seeing what looked like heaven to me.

The life in those villages was incredibly beautiful.

I was there when the cherry trees were in bloom.

And in the villages, people live, they have common ground for grazing.

Everybody's got chickens.

They have fish ponds that they share.

It's a kind of vision of rural life, rural village life that seemed incredibly beautiful to me.

That's what Putin is trying to destroy.

And that's what we need to stand up and help defend.

- So, Michael, you were here three years ago to discuss your book, Healthcare Revolt, which is a tremendous book.

And, we would urge our audience, if members have not read it to go read it.

That was three years ago before the pandemic.

And then the pandemic hit.

You were the Chief Health Strategist for the City of Central Falls here in Rhode Island during the pandemic.

And for those who might not be familiar with Central Falls, it's a small city, it's a low income city.

It's a city with many residents who are people of color.

And it was particularly hard hit during the pandemic.

But it wasn't the only such community in the country like that, that was hit.

Talk about first, what you did in Central Falls, and then the larger picture.

Why were communities like that so hard hit during the pandemic?

- Well, Central Falls, as you said, is small and densely populated.

I'm gonna answer your second question first if I may.

- Sure.

Yeah.

Yes.

- It was hard hit because of policies that governments chose.

So, it is a place where people have to go out to work every day.

What we decided to do in Rhode Island, during the early days of the pandemic, when everything closed down was to say factories could stay open and should stay open.

And in Central Falls, people live in triple deckers, the sort of houses that have three apartments in them, old wooden frame houses.

And they sometimes live four, six, eight, ten, or even 12 people in a two bedroom apartment, sharing one bathroom and one kitchen.

And so what was happening in Central Falls was, people worked two and three jobs.

They had to go out to work every day to support their families, because they often didn't qualify for the kinds of unemployment that other people have, cause many people are not documented.

So they went out to work every day.

There are some Jitney buses that leave the city early in the morning.

People would get into these packed Jitney buses, go out to work in the fish houses and the meat packing plants and the garment factories all over new England.

They'd work sort of right close to other people.

So the disease spread at the workplaces.

Then they came back in the Jitney buses, went back into these densely packed houses, and then spread the disease, unknowingly and unwittingly into their families.

So Central Falls became, a couple of times as we measured it, the most infected place in Rhode Island, the most infected place in the nation, and for a bit, the most infected place in the world, because of these social conditions, which we allowed to happen.

Now, what do we do?

The governmental response was call your primary care doctor and your primary care doctor will get you a test.

Now, one of the most interesting things was in the early days, there were four testing places where people could go for a test, and all of them were in a wealthy suburb, and none of them were in Central Falls.

So one of the things we did was argue, argue, argue for access to testing.

Though, I wasn't convinced the testing itself was gonna make all that much difference, but we wanted that kind of equal access.

But then we built something called Beat COVID 19, which was a group of volunteers that got together, and dealt with the fact that, of the a hundred thousand people between Central Falls and its neighbor city, Pawtucket, likely only 50,000 of them had access to a primary care doctor at all.

So, we created an 800 number.

People could call the 800 number.

They would get consultation with a physician, nurse practitioner, or midwife.

They'd get counseling about how to go in isolation, and stay in isolation.

They'd get, sometimes funds, money to be able to survive for a couple of weeks, if they had to be in isolation.

They got food and they got disinfectants, and they got coached for how to take care of things.

We built inside of about two weeks, a whole little healthcare system to take care of that population of people, who didn't have other access to care.

It was fantastic.

It was all volunteer, led by the mayor of Central Falls.

And to a certain extent, the mayor of Pawtucket.

The governments got involved and we really did something.

It was pretty spectacular.

- [Jim] That's a remarkable story.

You've got a new book coming out on Medicine as Colonialism.

And, in the preface to that, you said something that struck both Wayne and I. COVID claimed more than a million lives so far in the United States, but on a per capita basis, you note that that puts the death rate in the United States at three times that of Canada, more than eight times that of Australia, and 10 times that of Japan.

Why did America do so badly?

- Because we're so divided.

Because all we did was fight with each other about this stuff.

This stuff is not hard as other countries have showed us.

We lost 900,000 Americans, unnecessarily, when you compare us to other countries, because we couldn't agree on simple stuff like wearing a mask or sort of staying home, or not going out to bars and restaurants, or when there was lots of disease spreading, or getting vaccinated.

I mean, it's a heartbreak.

We developed the vaccine, and didn't understand how to use it correctly because we were fighting with each other over stuff that to me seems relatively trivial.

And I wonder, in the back of my mind, about the extent to which our friend Vladimir Putin wasn't egging people on, using the social media process.

Cause he wants to see us divided.

He wants to see us fighting with each other.

He wants to see us weakened, so he can do stuff like take over Ukraine, and then Georgia, and then Poland.

That's his game plan.

And we seem to be playing right into it in a way that seems like heartbreaking to me.

- So we're almost outta time, but very, very briefly.

I'm wondering if you can talk about your fiction.

You write non-fiction but also fiction.

What can fiction do in terms of telling stories, or not telling stories that are important?

Why do you write fiction?

- About a minute.

- Okay.

First, I think fiction gives us the ability to see the inner lives of people who are different from us, and by seeing those inner lives, and by seeing the whole story as it were.

It lets us use our moral imaginations to be connected, and to show up, sort of in a way that makes democracy real.

When you see other people as like yourself, when you see or connected to other people, then you come out and defend them, and they come out and defend you, and you get to argue, discuss and decide in the public square.

And in that way, make the nation, the state, your local community as strong as possible.

- That's a powerful place for us to leave it.

Dr. Michael Fine, thank you so much for being with us.

That is all the time we have this week, but if you wanna know more about Story in the Public Square, you can find us on Facebook, and Twitter, or visit pellcenter.org.

Where we can always catch up on previous episodes.

For G. Wayne Miller, I'm Jim Ludes asking you to join us again next time for more Story in the Public Square.

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