UNPACKED: leader, advocate & protector of the public’s health Trudy Larson, M.D.

Dean of the School of Community Health Sciences talks about women in medicine, COVID’s impact on the medical profession and saying ‘yes’ to possibilities in latest podcast

Trudy Larson, M.D.

Dean of the School of Community Health Sciences Trudy Larson, M.D. is an infectious disease expert and former pediatrician. A longtime leader at the University and throughout the state, she is a role model in medicine as an advocate for women, immunizations and public health policy.

UNPACKED: leader, advocate & protector of the public’s health Trudy Larson, M.D.

Dean of the School of Community Health Sciences talks about women in medicine, COVID’s impact on the medical profession and saying ‘yes’ to possibilities in latest podcast

Dean of the School of Community Health Sciences Trudy Larson, M.D. is an infectious disease expert and former pediatrician. A longtime leader at the University and throughout the state, she is a role model in medicine as an advocate for women, immunizations and public health policy.

Trudy Larson, M.D.

Dean of the School of Community Health Sciences Trudy Larson, M.D. is an infectious disease expert and former pediatrician. A longtime leader at the University and throughout the state, she is a role model in medicine as an advocate for women, immunizations and public health policy.

Public health is a term that’s in the news a lot, but it’s a good bet that much of, perhaps most of, the public doesn’t really know all that it entails. Public health includes a wide variety of strategies and programs that help improve the quality of life of communities, and policies that help improve various facets of people’s lives, from health and safety education to the environment to economics to behavioral health – and beyond.

A respected role model in the medical profession, Trudy Larson, M.D., has spent her career spanning nearly five decades as a trailblazer for women in medicine, a dedicated physician and an advocate for public health. She is the guest of the latest episode of UNPACKED, the podcast from Nevada Today hosted by David Stipech (see links or player below).

Today, Dr. Larson is the dean of the University’s School of Community Health Sciences, which became its own entity three years ago (formerly part of the University of Nevada, Reno School of Medicine). Through its Nevada Public Health Training Center, the School is playing an essential role in the state’s battle with COVID. Earlier this year, Dr. Larson was named as one of four members of Nevada Governor Steve Sisolak’s COVID-19 Medical Advisory Team. 

Her journey has been anything but a straight line, yet the broad and diverse experience she has gained by this circuitous path has helped establish her as a uniquely skilled expert in public health, infectious diseases and the vital role and impact of women in medicine.

The School of Community Health Sciences is currently working to become a nationally accredited school of public health, a prestigious designation with the same requirements to fulfill as Yale, Harvard and Johns Hopkins and other top schools of public health.

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Trudy Larson, M.D.: Leader, advocate, protector of the public’s health

For a woman entering the male-dominated field of medicine in the 1960s and 70s, it’s been a winding journey of perseverance and possibilities for Trudy Larson, M.D. With a medical career in northern Nevada and worldwide spanning decades, today she serves as dean of the University’s School of Community Health Sciences and was named by Nevada Governor Steve Sisolak to his COVID-19 Medical Advisory Team. Dr. Larson visits with UNPACKED host David Stipech.

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With hospitals in the early stages of the pandemic operating in crisis standards of care – meaning rationing their insufficient resources – she knows the toll this takes on her colleagues. “I have to tell you that I think my colleagues who work in the hospitals, in the clinics, on the front lines, have been terribly challenged during this time ... I am so worried about how they’re going to come out of this,” she said.

Dr. Larson has seen the impact of COVID on physicians and medical providers. “Many of the practices had to downsize because people were fearful to come into that clinic,” she said. “So their long-term chronic medical conditions have worsened, and so now you know everybody's trying to catch up. There’s still fearfulness for patients to come back and see them. I mean these are longstanding relationships between patients and their doctors; it’s just heartbreaking that that physicians who really dedicated themselves now have to do so many things differently.”

Transcript: Trudy Larson M.D., interviewed by David Stipech for UNPACKED podcast (Released September 2020) 

TRUDY LARSON, M.D: The habit in surgery during the surgical rotation, was after the surgery, the surgeons and the medical students and residents would all adjourn to a place to talk over what happened and answer questions. Well, the place that they gathered was usually the men’s dressing room. As we started getting women, it was like, “really?” Two of the women in our class walked right the men's dressing room and then there was this huge realization among the surgery faculty at how ridiculous this was for them to do that. 

DAVID STIPECH: From Nevada Today, this is UNPACKED, backstories of people from the university of Nevada Reno. Their journey, their passions and their impact. I'm David Stipech from Marketing Communications and on today's show, she's among Nevada's Women of Achievement, an advocate for immunizations and a protector of the public's health, and she may have even been your pediatrician. A visit with Trudy Larson, M.D. 

STIPECH: Any list of innovative leaders and pioneers in Nevada medicine would not be complete without a familiar name to many of us, Trudy Larson M.D. Today she serves as dean of the University's School of Community Health Sciences and her team plays a vital role in our region's battle with the pandemic. Earlier this year, Nevada Governor Steve Sisolak named Dr. Larson to his elite panel of medical advisors for COVID-19. For a woman entering the male-dominated field of medicine in the 1960s and 70s, it's been a winding journey of perseverance and possibilities. Today, Trudy Larson, M.D., and the world of public health. 

LARSON:  So you know, public health has to do with everything that touches a person. It has to do with the people who you’re around, your job, your education, and your community or environment, your food, your water. That's all about public health. It's all about the conditions in which you live and how those conditions keep you healthy. So public health is huge. It's hugely interdisciplinary. Public health does their work through program development, so smoking cessation campaigns, helmet campaigns, those are all programs and immunization programs, those are programs, and policy. That's the other piece, where public health informs policy and there are big policy decisions that have been made around public health. One of them, of course, is our no smoking law that was huge when it was passed, which has benefited, you know, millions of people in terms of their health. All the requirements from the EPA that reduce pollution, that improve our water, this all public health policy pieces. It's so broad so we work on the social determinants of health, as well as those more concrete things, in the public and we work at population levels, so this is not on a personal level. Public health advocates have identified buildings that have mold issues and they have effectively gotten lawyers involved to sue landlords to get rid of the mold and suddenly the health of all those people living in that building improved.

STIPECH: As I've heard you talk about public health in the past, really it also includes things like emotional health, economics, anything that affects a person's health, their safety, their wellbeing, a lot of quality of life type of stuff.

LARSON: Yeah, your ability to lead a healthy life and, yes, we are concerned about behavioral health and all the impacts of that and all the economics, and poverty is a big driver of health, so let's talk about COVID. What has COVID really amplified? It has shown us health disparities in a glaring light. Huge, that people of color do not have access and they have poor outcomes. This has been said for years and years and years; same with systemic racism, that's very much a public health issue. Huge, because of our work in health disparities in finding policies that continue to impact people of color women, LGBTQ+, folks that don't have a seat at the table. So COVID is a big deal and as a person sitting in a school dedicated to public health, I would say that this is sort of what we live for, but I think this is a little bit even overwhelming for those of us who understand how public health works with emerging infections and it's a pretty scary kind of thing, so we're doing what we can in a real practical manner, training our contact tracers, helping manage them for the state; they don't have an state people to do this kind of management, so we're helping with that by contract and we are doing a lot of because of the education in the community free so that practitioners all over the state can hook into them. And the topics are different; they're not about how you take care of these folks in the hospital; this is about mental health in COVID and this is about how do we help our tribal communities in the COVID era and how do we care for and find folks who really have needs that don't have voices. Aging. So one of our faculty members is very engaged in our senior population and helped put together that NEST program, our students here, a lot of them, were in this program as volunteers to contact seniors on a regular basis to provide them some socialization because it is just really it has  brought out the worst in us and it's brought out the best in us. Yeah, I think as a challenge, it is a truly a huge public health challenge; we are trying to do our part through research through service through engagement. 

STIPECH: You mentioned that the University's School of Community Health Sciences is doing contact tracing for the state of Nevada here in the north. That’s done through your Nevada Public Health Training Center under the direction of Gerold Dermid. Tell me a little bit more about that; we hear that term quite a bit; I know it's part of the COVID effort. How does contact tracing work and what exactly is it?

LARSON: So if somebody tests positive, they are reported to the health department by law and the health department's responsibility is to provide a person, a contact researcher who calls the person and says, “Okay, let's talk about who you have around you for the past 5 days because what we need to do is tell them that they've been exposed to COVID. So once they know they've been exposed they need to go get tested and then we need to quarantine. So quarantine is when you put yourself in isolation and you're not infected. Isolation is when you're infected, so the person who tests positive, goes into isolation so they don't expose anybody else. The contact tracer calls all of their contacts, or at least they try to, and now we're using texting which is very interesting, to let them know they need to go get tested and then they need to go into quarantine and then they check on them to see how they're doing and want to know if they're getting symptoms or not. They want to know if their test is positive or not and then they give them guidance on what to do after that. To hire all these people our HR folks on campus bent over backwards. I've never seen anything go so fast; it was really because of the dedication of our HR folks identifying that this was a critical service that we can provide for our community, so kudos to them. 

STIPECH: All right, so we’ll get a chance to talk more about the school of community health sciences as well as COVID in just a little bit as we go along. Let me go back to the beginning of your backstory; where were you born and raised?

LARSON: I was born here in Reno but I was not raised here; we lived in California. I actually was born at St. Mary's. My mom was a second generation Nevadan and I'm a third; my aunt is Velma Johnston, Wild Horse Annie, so I had a great upbringing with very strong women. My grandfather, who I never knew; he died way before I was born, was pretty chauvinistic and did not allow his daughters to go to college, but they were all very bright and so of one of the things I grew up with is the knowledge that I would go to college; that was like a given. And my mother I think regretted that she didn't get to go, but she still found a lot of amazing things to do through her life, but she wanted to make sure her daughters and there's four of us and I'm the oldest of four girls and then there's my brother. She wanted to make sure all of us had opportunities to make it on our own that she didn't want us to ever be dependent on anybody, male or female. So that was the structure in which I was raised, and then I had an incredibly enlightened dad who thought his daughter should be able to do anything. Now, he's a graduate of UNR; he was in the class of 1950 in electrical engineering when this campus was really, really small. My formative years, which is elementary school, I lived in a small town in New Castle in California; we had horses and chickens; I mean it was sort of idyllic; 650 people when we were there. My parents were raised in the depression and so they were savers we just didn't have a lot of excess anything, except our college education was paid for, we always got our checkups, we had good dental care that was their culture, their ethic moving forward, is that these are the things that you provided. And you say we were in New Castle Intel until halfway through my freshman year; we moved because my dad got moved. We went to Danville in the East Bay; it was Walnut Creek and Danville and Alamo and they're all together, so you know, hundreds of thousands rather than hundreds.

STIPECH: So what was the move to Danville like?

LARSON: Culture shock. I spent my first six months in my room. I would be in my room, I would go to school and I come back to my room. It was it was the worst to change schools when you're 13. I had spent, you know, seven years with people; these were my people that I knew, my best friends, my group, you know, that are really critical in those adolescent years and I was plucked from them to this high school, very sophisticated, you know, people were a little standoffish, clique-ish, they are already had their friends with them it was really, really hard. And, you know, what ultimately but this is like this is a real important part of how I came to be who I am now, is because I had to figure out how to make my way in this new environment at a time when it wasn't easy; it was really hard.

STIPECH: So how did you make your way?

LARSON: During this time when I see. I got to be a real excellent student; I was always a good student but I got to be an excellent student. Because that's what I did I paid attention to, my school work, it was something I was comfortable with I loved it; so for me that was a continuation and enhancement and my ability to sort of be an excellent student; it gave me focus. And that's something that I got noticed for, and you know slowly over the years, I developed friendships with but that scholarship piece was always there. And I heard this years later but it really resonated to me, is that like you never want to shut a door. And so I volunteered for all sorts of things because I wanted to, but it helped me when I went off to college to get scholarships and a lot of other things that made it easier for me as I went through higher education. 

STIPECH: So even in high school, were you stating to see some of the medical interest shaping at that point? I mean, like what were some of the subjects you liked?

LARSON: I loved biology; very interesting to me and said that sort of got me interested in the biological sciences. You know, I was a candy striper and if you remember what that is, I worked in a hospital; it was in the sixties when I was in high school and so as a candy striper and although it was an interesting environment and I knew how to be nice to people, that's where discovered nursing was not for me, but that door was open if I wanted it. You know it's just like I was a good student, ended up taking difficult classes and it kept all my doors open. But it started narrowing, so there's a couple things. I was a huge book reader; I was that classic bookworm; I read all the time and that continued all the way through and one of the books that I read was about [Antonie Philips van] Leeuwenhoek and his creation of the microscope and how that opened up a New World of small animalcules as they called them; I just thought that was so interesting and so I thought, oh well, maybe I should go into research and ndeed that sort of hooked; maybe I will be a teacher and a researche;r this is interesting; I like this idea of looking through microscopes and discovering things.

STIPECH: So what's that we're just saying? Say that again, what is it about the microscope?

LARSON: Animalcules. C. U. L. E. S. right at the end. So, you know that that was what led to the creation of microbiology and everything but I was doing biographies in my in my teens but these biographies provided I think an entree to looking at worlds and I didn't know anything about that might be interesting to me. So I made my way through high school, I knew a lot of people, I was in the band; so I was a band nerd, loved my band friends, such fun people.

STIPECH: What did you play?

LARSON: I played French horn.

STIPECH: And were you good?

LARSON. Well I was ok. I actually started playing piano when I was 8 and so I was a lot better on piano, but I've always liked music and would sing in groups and you know so music was always sort of a background part of my life. My dad was a barber shoper; I don't know if you know barber shop quartet singing. My whole family sings and they all play instruments. I'm going to go on a little tangent here. The research that shows this correlation of math music and science, it is very strong, and so I believe that my interest in music which is quite you know, it's mathematical in many ways, particularly Bach, but it was a wonderful framework to staying connected to those really interesting arts and sciences that sort of contribute to each other. So, yeah, we always had music; that was really important in our entire family.

STIPECH: So as I listen to this, I'm wondering, how do you think the move from the small town and that comfort zone of New Castle to the big city of Danville in the Bay Area, how do you think that shape who you became?

LARSON: So, I’ve thought about that. I have a whole bunch of these; whole bunch of these experiences through my life; things happened and then suddenly I had this rerouting of things; like instead of going there I was going to go here. And so I thought about that in I may not have been as ambitious if we had not moved, where I felt a significant reason I wanted to be able to stand out. I could do that through my scholarly work; the teachers knew who I was; you know I got to give a speech at graduation, so I don't think I would have developed the ambition that I did, it so it was it was very pivotal for me to do that. I hated it; at the time it was absolutely dreadful, but new experiences new friends, new way of looking at things, new opportunities. I didn't think about that early but later, yeah.

STIPECH: So I believe you went to med school at UC Davis and you're in northern California region; what was it like in that era?

LARSON: I would go over to San Francisco and I go see the Grateful Dead and I’d go see the Jefferson Airplane. It was the sixties and the early seventies, so there were protests. Going to Berkeley and San Francisco, going we're all the flower children were; you know, drugs were not very interesting to me; I don't like being out of control, but that was an era of experimentation. It was free love and peace. I mean, what an amazing time to be able to be in college. I treasure that time, because at that time we learned that we had a voice, you know, I was on the protest line, I sat there protesting the Vietnam War. I had high school friends that were in the war; they came back so damaged, it was terrible. So we had causes, so it was an amazing social time to go through college.

STIPECH: So with the so much going on on the social side of things, how was it going with your college studies?

LARSON: So I just took my good student habits straight into college as a very good college student as well. I always took too many courses and, you know, we could take one pass fail course every single semester, so anyway, I took all those courses; there were a lot of science courses as you might well imagine in math and chemistry and organic chemistry, which I like a lot, I loved those classes. But I took the history of movies and I love Shakespeare, so I actually took an entire year three courses a Shakespeare because I love Shakespeare. Pivotal for me was I volunteered to be on the crisis call line; on the crisis call line we got trained on how to do de-escalation, to listen, a very active listening process of course, and what I discovered is, I really like that helping people, really like that social interaction. It was like, okay maybe I don't want to be in a lab; maybe I don't want to be all by myself in my lab doing my lab experiments. Maybe I want to do more with people, so that really got me interested in medicine. It was truly this melding of on this great science I still enjoyed in and seeing how that would inform my decision making around issues of health; it was pretty late in my college career when I decided I wanted to go into medicine.

STIPECH: Now you said a few minutes ago that being a candy striper in the 1960s was what made you realize that nursing wasn't for you. So what was it about that experience that turned you off to nursing?

LARSON: Bed pans. Okay. That was like not for me. You know, I liked the talking, I liked the delivering the food. But that was like “no.” And, you know, I think there wasn't a really good definition of that nursing role during that period of time in the sense of independent decision making or you know that they were part of the team; that's really developed a lot more recently but it was really, you know, here's what you do and you and your orders and I did not take kindly to that, just saying. I mean even then because this has been a theme throughout my career, there is no reason why I can't do that just because I'm female; there's like no reason. So I took the MCATS somewhat naively because I didn't study very hard, and then I applied to medical school. It did not hurt that there weren't a lot of women in medical school because I sort of took it on as another challenge and it was like, okay. And I had my dad and my mom just sitting there, especially my dad, because I think you know that influence is a very powerful one, the father influence on daughters, in terms of what they end up doing. I can always hear back there going, yep, you can do that, just go for it, you know, so I did. And I got into medical school and I went to Irvine and we were the biggest number of women ever admitted. We were 20 percent of the class and we had a dean who was very progressive and in fact he recognized that if more women didn't go into medicine we would not have enough physicians and it was very critical that women get into medicine and, you know, be well trained and move into practice and in academics and so we had a direct line to the dean.

STIPECH: So, remind me where we are on the timeline; what year is this now?

LARSON: So, I went to medical school from 73 to 77. So, we have these great friendships and we, at least I, didn't feel that that there was a differential ever, but I have to tell you there was some latent discrimination going on. I'll tell you a funny story because it’s one I will never forget. This is about a systemic kind of an issue. The habit in surgery during the surgical rotation was after the surgery, the surgeons and the medical students and residents would all adjourn to a place to talk over what happened, to answer questions. Well, that place that they gathered was usually the men’s dressing room, so as we started getting women in, it’s like, “Really? We're getting cut out of this very important debriefing.” And so two of the women in our class said “all right,” And they walked right into the men's dressing room and then there was this huge realization among the surgery faculty at how ridiculous that was of them to do this. So that totally changed; debriefing was held in a place where everybody could attend and be comfortable. That's what happened. On rounds, when I was a student, I would not be able to present my patient to the attending physician in favor of a male intern. And I was told that I was taking a place that should have gone to a of a male who would work their career. Blatant. I look back on this horrified, but I went through it and figured, I really didn’t understand until later that actually could have spoken up but I didn’t. I wasn't empowered yet to really recognize how wrong that was. It was really bad going through it but I think it steeled us; I think that group support really helped and so I think as we went through we were able to make some big changes in the way things are done.

STIPECH: So how do you end up pursuing pediatrics?

LARSON: Interestingly, I was a very good medical student as well in terms of my grades and folks said, “Why are you going into pediatrics? That's a traditional female role. Why are you doing that? With these grades, you can go off and be a surgeon and, you know, an internist.” Okay, now we're talking about my career and where I think I will want to go to work every single day. Here's what makes me happy, right. And so that was a time I did not take up the challenge, because I said that's not what I want, to be a surgeon; I don't like that culture, I don't want to do that. I feel best here. So, I went through my residency, my three years, and I learned a tremendous amount. We were just really starting to learn a lot about neonatal intensive care so I learned a lot about how to care for very sick newborns. And I had my first hero; her name is Christy Halstead; she was one of our faculty and she was a pediatric infectious disease physician. For her it was always about the best care the children, so she modeled so much great behavior; and so she was a big influence and she was when my very favorite attending [physician]. So, I did locum tenens; I don't know if you're familiar with that, where you go and you take over practice for a physician so they can go on vacation. These were solo practitioners in the Central Valley of California for the most part and they just needed to get away and so I would come take the practices over. So I learned what it’s like to be in private practice, the only pediatrician for miles in private practice. It was scary to be on my own I had a great background and I felt very good about the care I delivered, but it allowed me an opportunity to say, maybe this is not what I really want to do, it wasn't quite right. So, I said, you know, really what I is to be in a group practice where I could work with people as a team, so I said okay I'm going to apply for fellowships. And my significant other was applying for fellowships as well so we did this as a dual couple; he was going into vascular surgery and I thought, okay, well, why don’t I do adolescent medicine. I like teenagers; that'll be interesting, and so we went to Arizona and interviewed there and we went to UCLA and interviewed there, and I walked in and she goes, “Oh, I'm so sorry, but we just filled the position.” Oh. And then she said, however, I know that they still have an open fellowship in pediatric infectious disease, and so I thought, yes, I could do that. Here's one of those major pivots. I walked upstairs and I talked to my second hero, Yvonne Bryson, and we just hit it off.

STIPECH: So that's another term that we might hear a lot around the medical profession: fellowship. What exactly is it? How does it work?

LARSON: Fellowships train their fellows to become an academic faculty; so you still do your practice, you know, you still see patients, but you learn these other skills: research skills and the education skills. And in my first month as a fellow at UCLA is when I went to grand rounds and heard about the young gay men in Hollywood who had pneumocystis carinii pneumonia (PCP), that ultimately turned out to be AIDS, and so that's where I started my career in in HIV/AIDS before we knew a name for the virus, before we had anything to treat with, that was it. If I had not been there, I have no clue what my career would have looked like. But that launched me.

STIPECH: And as I understand, it wasn't too long after that that you moved to Reno. Your husband at that time I had some family roots here and you also had some relatives here. How did that go?

LARSON: I completed my fellowship in 1983 I was there from 81 to 83 and so in the summer of 1983 I moved to Reno. And I'm trying to think about it, I think was early on when I moved here that I was asked by the ACLU to come to a debate with the Eagle Family Forum around the gay rodeo. I was pretty naïve and it was held here in the old Jot Travis union, where they had the big auditorium. As I walked up, there were cars everywhere, there were television stations everywhere, and I'm here, I'm new to town, I don't know anybody, but I’m the expert, right? And so I walked in and it was packed. And the debate was really about the gay rodeo how is HIV transmitted and we already knew how HIV was transmitted; it was really clear message; the science was already there. I was sort of blown away. I came from Los Angeles and I came to Reno and, “Holy cow, these folks are a little biased.” The next day I was on the front page of the newspaper with a little picture. My grandmother calls me in she goes, “Talk to me about being on the front page of the newspaper. What is it that you were talking about?” So my grandma and I had this great conversation, and I will tell you every time I had a public engagement after that, my grandmother sat in the front. But it launched me in Reno as a person who knew about HIV/AIDS and that was it; that just took off from there. I started seeing patients in my practice; I was seeing patients in the hospital.  I'm learning so many things as the whole scientific process came along as drugs started coming out. We started our clinic in 1998 with the health department based on an early intervention model that I'd heard about at the international aids conference. And we got funded from because the people at the country wrote the best grant end and that ultimately became HOPES: HIV Outpatient Education Service, that's how the HOPES clinic came about, that’s the acronym and HOPES still has that funding for HIV aids care today.
STIPECH: So I’m looking here at your resume for Dr. Trudy Larson. it is a long list of roles, positions, titles, a lot of educational pieces and certifications. And just some of the titles here: University of Nevada Medical School assistant professor, associate professor, professor, chair of pediatrics at the Med School, associate dean of Primary Care Research, assistant chancellor for the University system statewide, associate dean of the University of Nevada Med School, director of the School of Community Health Sciences starting in 2011 and now since the school of community health sciences has become its own entity three years ago, you're the dean and those are just the highlights. So how do you explain all that? 

 

LARSON: I thrive on creating. That's my happy place. I like to say, “Okay what do we have, where can we go? Let's get these ideas together let's see what we need. Let's move it forward.” So that's where I like to be. I like to create. I'm not much of a maintainer and so this change in positions, in changing responsibilities, has always been welcomed. I got very involved in some international work in Kurdistan, Kazakhstan, Uzbekistan. That was a five-year project working on curricular change for the medical school in Kurdistan. It was fascinating. And then I was a consultant, all the while I'm a faculty member at the School of Medicine, teaching and doing my practice in Ukraine and in Russia around HIV/AIDs and training and their providers to care for children and adults with HIV/AIDS. 

STIPECH: So now as the dean of the School of Community Health Sciences, the role you've been in for the last three years, you've told me that you and your team are now working to earn national accreditation as a full school of public health. What's the vision there? Why is that important?

LARSON: There are certain things that benefit being an accredited school of public health. One real practical thing is are some grants that only come to schools of public health that are accredited, so that's one thing. We've worked really hard. This gives us a sense of prestige that we are now on par is an accredited school of public health with Yale and Harvard, just to give you an example, or Johns Hopkins, which is a huge school as well. We don’t have the resources, but we have the same criteria that we have to fulfill as they do. Everybody believes this prestige is really automatic when you become accredited as a school of public health within the public health environment people will know that now. And that's a big deal having an accredited school of public health identified as a school public health with a broad range of disciplines, a robust research portfolio, and significantly engaged – we are more engaged with our community than a lot of accredited schools of public health. In part it is because of our [Nevada Public Health] Training Center. We are networked everywhere. You know part of what we looked at is being the go-to place for public health. I mean our health statistics are terrible; we have a long way to; go we want to follow them and make them better and so that'll be a more national story that will be able to roll out, is how our programs directly helped improved our health statistics from the state.

STIPECH: So as you've just mentioned, Nevada has had a huge challenge bringing up his health indicators year by year, and you're doing your part there with the School, then COVID comes in and basically wreaks havoc with the medical system and puts a tremendous amount of pressure on your colleagues, the health care providers everywhere. How do you see that?

LARSON: So again, this is a challenge like none other and there are some unforeseen circumstances here, that I think will have long-standing impact for the medical profession as it has been practicing. Number one, telemedicine. It will be here to stay. The same philosophy as having education at-demand, this is going to be having medicine at-demand, so it's here to stay. None of my colleagues were ever trained do this and so they've been trying to do the best they can. Hugely uncomfortable. So this whole learning curve around how to do this work in a different fashion, it's been really hard because they’ve had to do it while doing it or else risk losing their entire practice. Because patients were coming in. And so there's a cascading effect here that's really hard. Many of the practices had to downsize because people were fearful to come into that clinic. So their long-term chronic medical conditions have worsened, and so now you know everybody's trying to catch up. they're still fearfulness for patients to come back and see them. I mean these are longstanding relationships between patients and their doctors; it's just heartbreaking that that physicians who really dedicated themselves now have to do so many things different. And have to have such sick patients at the same for those with COVID; they've had to understand how to do this medicine. And when they were in crisis standards of care – I don't know if you're familiar with what that means when you’re in crisis standards of care – it means that you lack resources to operate as you usually do. And our hospitals were in crisis standards of care and that meant that they had to look at allocation; they had to do rationing. So I have to tell you that I think my colleagues who work in the hospitals, in the clinics, on the front lines, have been terribly challenged during this time. And so they deserve hazard pay; they need at least two years of paid therapy for PTSD. I'm just thinking these are practical solutions. I am so worried about how they're going to come out of this. 

STIPECH: So, let me set aside for a moment just the role of Trudy Larson M.D. and tell me what you're experiencing personally. What is your view on getting through this?

LARSON: There are so many unknowns, that that's the other piece I think scares people, is that we are we're not sure; we're doing this for the first time right now. We're going through it, we need to give ourselves permission do not always have to be excellent at all the things; we do is we just need to do things good enough. And somebody the other day just simply said, you know what we just need to be kind to each other; seriously, we just need to be kind to each other and make it possible for people to tell their stories or to, you know, say how they're feeling and for people to say, “Geez, that's terrible; you have my sympathy.” You know, “How can I support you?” instead of blaming. Because I see shaming and blaming all over the place and that is not a good dialogue. So, it's unprecedented; we've never gone through this before.

STIPECH: So before you wrap up here in just a moment, real quick let me just ask you, you've got so much on your plate and I know you enjoy your work, but are there other things you'd like to do for fun or to recharge it from time to time?

LARSON: I love baseball. I cannot tell you how happy I am to be watching the Giants. I wish I was out at Aces Stadium cheering them on. I really like that. This is my second husband, so I've actually gone through a divorce in the middle of all of this as well, and so he's gotten me into NASCAR racing and so like we actually go to NASCAR races, seriously. There are some other experiences I want to have in my life. I love travel. I love it and we want to take our travel trailer and tour the United States with a book on history and go see it. And you know, I have not read history for so many years, I forgot it all and so to me that's a rich field to re-explore. 

STIPECH: And I know you have some new additions to your family.

LARSON: I have grandkids now, two little girls, so that's another whole thing, like how do I learn how to do that as well?

STIPECH: So, let me just say congratulations on that, that's a lot of fun, and just congratulations on your entire career. There’s no way to tell the entire journey of Trudy Larson M.D. in 40 minutes or so. We've touched on many things. As we wrap up, you have students, you have young people early in their careers. What’s some of the advice or the message that you have found in your career that's had a lot of impact, a lot of jo,y a lot of adventure, a lot opened closed doors; what would you say to the younger people who might be listening right now?

LARSON: These opportunities, they came about because I said yes. And when I talk to classes about like, where you’re going, I've said don't hesitate to say yes if it's even a little thing that goes, ooh, that might be Interesting, I think I'll do it, that’s me. Oh, that sounds interesting, okay. I have had the most interesting  career because I saw possibilities. 

STIPECH: Dr. Trudy Larson, dean of the School of Community Health Sciences at the University of Nevada, Reno. I'm David Stipech with University marketing communications and I hope you enjoyed this edition of UNPACKED, the new podcast from Nevada Toda. You can find out more about the School of Community Health Sciences online at unr.edu/public-health, and for daily and weekly news from the University, be sure to subscribe to the University's news source, Nevada Today at unr.edu/Nevada today. That's also where you can listen to the latest episodes, or find UNPACKED wherever you get your podcasts … and be sure to like share and subscribe to the UNPACKED podcast.

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