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Dr. Leana Wen tells Baltimore stories in her new book: ‘LIFELINES: A Doctor’s Journey in the Fight for Public Health’

Former Baltimore Health Commissioner Dr. Leana Wen has become a household name during the coronavirus pandemic, providing regular public commentary that nudges — and sometimes more bluntly pushes — public officials and the public to “follow the science” on masking, testing and vaccinating.

Wen is now out with a new book available Tuesday: “LIFELINES: A Doctor’s Journey in the Fight for Public Health.” It takes readers on a path, directly through her adopted hometown of Baltimore, that shows her transition from a poor young immigrant with a stutter to medical school student at age 13 to positions in emergency medicine, public health, academia and punditry.

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The book began as a guide to public health, but Wen couldn’t avoid weaving very personal details of her life that contributed to her core principles. She describes sometimes heart-wrenchingly vulnerable moments, including her mother’s death from cancer and her postpartum depression, but also warmer times such as when a Utah church left her winter boots so she could walk to school.

The book has won endorsements from people ranging from Wes Moore to Dr. Sanjay Gupta, according to Metropolitan Books, its publisher.

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“Dr. Wen shows that she is not only one of our great medical minds — she is also one of great storytellers and change-makers,” said Moore, a Baltimore author and former nonprofit executive who’s running for governor of Maryland as a Democrat.

“Dr. Leana Wen is a public health superhero,” said Gupta, CNN’s chief medical correspondent.

Dr. Leana Wen has published a book titled "LIFELINES: A Doctor's Journey in the Fight for Public Health," that is part memoir, part public health guide.
Dr. Leana Wen has published a book titled "LIFELINES: A Doctor's Journey in the Fight for Public Health," that is part memoir, part public health guide. (Karl Merton Ferron/The Baltimore Sun)

Here is an abbreviated conversation Wen had with The Baltimore Sun about what became her memoir.

You describe a number of hardships in the book. Which affected you most?

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I tell the story about seeing a neighbor’s child die in front of me from an asthma attack because the grandmother was afraid to call for help for fear of immigration authorities deporting her family. Since that moment, I felt drawn to ensuring health care was something available to everyone regardless of how much money they have or where they happen to come from.

It was more of a gradual awakening that health is not just about health care, that housing is health care, the food and water and education we get matters.

I intended to write about success stories from Baltimore’s health department as a guidebook for others working in public health. But I realized my story is also a story of public health. I cite [late Maryland Rep.] Elijah Cummings a lot in the book, and he used to say, “Turn your pain into your passion and make it your purpose.”

Two successes from Baltimore you write about are the violence-reduction program Safe Streets and the program to distribute the overdose reversal drug naloxone. Murders and overdoses are spiking in the city and country, so how do you keep faith in the programs?

Sometimes we have decision paralysis because we face so many problems. It’s important to set goals that are longer term, but at the same time there is something we can each be doing now. Each program can make a difference in someone’s life right now.

The number of overdoses may be climbing, but look at the individual lives saved because of the naloxone program. In my time at the department, we recorded over 3,000. Are there still people who succumbed to overdose? Yes. But let’s not forget the individuals alive today because of the program.

Same with public safety. It’s hard to tabulate how many are alive today because there was a violence interrupter who stopped a shooter.

This is the difficulty of explaining public health. You need people to attest to the value of the program. There is no face on public health, so we have to put a face on it.

You write about leaving Planned Parenthood after a high-profile disagreement over the group’s direction. Do you still feel strongly that the group’s mission should transcend abortion access?

I left my dream job of being a health commissioner in Baltimore because I was concerned about women’s health care. The average woman is more likely to die today than her mother during pregnancy. Black women are three times more likely than white women to die during pregnancy.

Women’s health is not being attended to, and I felt strongly we needed to expand access to health care, and it’s not solely about reproductive health. Those going for reproductive health care should be able to get their blood pressure checked or diabetes monitored and screened for depression.

My goal was to reposition Planned Parenthood from progressive politics to mainstream health care. Turned out not to be good timing or vision. I continue to be a supporter of what Planned Parenthood does and what the health centers do to provide care to women and families.

You’ve become an influential voice during the pandemic, which is where you end the book. Have your views of public health evolved during this time?

The way I’ve understood effective advocacy has changed over time, becoming a lot more nuanced. When I was in medical school, I understood advocacy to mean an obligation to speak on issues affecting patients. When I became my mother’s caregiver when she was undergoing breast cancer treatment, I saw advocacy as a means of bridging the disconnect to families. When I became health commissioner in Baltimore, I was making change from within, and I recognized that I had to view advocacy through that lens. Now I have a different role. I’m not an insider. It’s quite the opposite as someone in the media.

"Sometimes we have decision paralysis because we face so many problems," Wen said.
"Sometimes we have decision paralysis because we face so many problems," Wen said. (Karl Merton Ferron/The Baltimore Sun)

In the Trump administration, federal health authorities were silenced, science was literally changed for political aims. Many outside government saw it as a duty to step up. The Biden administration is different. I’ve worked with many in the administration over the years. Calling them out publicly is not of great interest to me or very effective. People are trying to do their best under challenging circumstances.

That said, they have policies that are not always the most beneficial, and I’ve been navigating this new dynamic. How can I be supportive of their work while also being an advocate pushing them to better policies? The CDC came out for fully vaccinated people not needing masks and that led to an end of mask mandates overnight. I’ve called out the CDC for this poor decision, not because I wanted to criticize the CDC but I wanted them to do better.

How do you restore trust in government and science after all the attacks from the conspiratorial far right, but also criticism from legitimate sources?

I draw a distinction between criticizing a policy and criticizing science. I never said the CDC got the science wrong. They got the science right. Their policy was wrong. You can have the best science in the world, but if you don’t win hearts and minds it will fail.

I think about this in terms of how I’d be advising an individual patient. When I talk about vaccines, I don’t come with judgment but compassion. If someone isn’t vaccinated I ask why and try to give answers to their questions. A tenet of public health is meeting people where they are. Public health hinges on public trust.

What’s next after the [virtual] book tour?

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I love the work I’m doing. I’m at George Washington University working in the Fitzhugh Mullan Institute for Health Workforce Equity, newly named after my longtime mentor. I’m now at the Brookings Institution doing research on health disparities and inequities and laying out an agenda for public health.

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I’ll continue writing a column for The Washington Post and writing and doing on-air analysis for CNN. The third thing I’ve been doing is advising businesses, cities and colleges on return-to-work protocols.

And most importantly, I’ll continue raising my family. As everyone in Baltimore knows, I have two young children. Being a working parent every day is full of decisions around work-life balance and trying to navigate this. Having been in jobs that were all-consuming and I was away for so much of my son’s life, I feel fortunate to be home nearly every morning when they wake and nearly every evening when they go to bed.

“LIFELINES: A Doctor’s Journey in the Fight for Public Health” is published by Metropolitan Books and is priced at $27.99 hardcover.

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