>> hello everyone. welcome to our event this evening. to beautiful beautiful day here in sacramento. i'm sorry if you are not run here. we are experiencing snow because we had an absolutely gorgeous day here today and a lot of people are out shopping. safely for covid of course. my name is heidi and i'm the owner of capitol books in downtown sacramento.

i am here to excitedly host kate washington a sacramento author and food writer who currently serves as a dining critic for the "sacramento bee." her work has appeared in many publications including the "washington post," catapult and nix internet tendencies. she is the author of "already toast" which is a book about how being a caregiver is all-consuming and how it can run you into the ground and how to navigate that and recognize it. she is going to be interviewed and i hope i don't adjure your name, ray -- did i get that

right? >> no. >> sorry. >> she is going to be interviewing kate and i'm going to act as you emcee for the evening. as i mentioned i'm really excited to have kate here today not only did she began writing this book pre-covid and it was about being a caregiver for her really ill husband and how women tend to get pigeonholed into that role and men can to but it's an exhausting role to have. i thought that it also was relevant in this day and age of covid and homeschooling children and everybody working at home and a lot of the times women

have gotten the role of taking a step down or a step back from their careers and having to help children in at-home learning and/or daycare because we all lost that during this last year of covid. i think her book covers more topics than what you originally been wrote it for just kind of exciting. it's probably going to become like a history book after this. [laughter] the other announcement i wanted to make is kate has generously provided a gift certificate to grubhub for one lucky winner for this evening and the reason she

chose grubhub was because probably many of you watching this broadcast are a caregiver right now and not only need to hear these words in this next hour but you could probably use a break and just having to cook a meal. at the end of the evening i will be randomly picking one person to receive this gift from kate. as soon as i get things going here i'm going to put in the chat the link to purchase "already toast" if you haven't already. we have that the at the bookstore. copies are selling quickly. if you don't see one available on our web site or if you come in and we don't have it, more are on the way i promise. we also if you live in

sacramento and you come to the bookstore we can deliver the book for you. if you are not from around here we do shipping all over the nation. so don't hesitate to support a local bookstore because we sure appreciate it. with that any questions you have for ray orford kate please put it in the chat and we will get to that at the end of the event. welcome kate and i'm going to talk a little bit with. now. >> i will toss it back to kate. we are going to open with kate reading a selection from "already toast." >> thank you. thank you all so much for coming. i'm really excited to see the faces of people i love and new friends that i have not yet met and its wonder -- wonderful of

all you to spend your saturday here so thank you so much for making the time. i have to put on my reading glasses and i hope the glare won't read too bad but i will take them off afterwards that i'm going to read a short section from the beginning of the book. it is about getting the initial diagnosis of my husband's lymphoma after a long time of seeking a diagnosis. it begins with a reference to a holiday party that we had that felt like the last normal party we did as a family and its possible a few of you might have been there. so i will read now. a few days after a big blowout 2014 holiday party we got a message on my health portal.

it was the results of the biopsy. he was anxious heart pounding at the login. the results came up and go inclusive no cancer cells have been but it sampled was too small to -- they recommended a core biopsy red then i find it a want in other words more test. we went on with her christmas with crab and sourdough bread for christmas eve presents the next morning but i need to us -- to be decided not to tell the girls until we knew something for sure. the hematologist had been assigned to asked about his plans. the core biopsy was ordered. we waited and waited and waited. family and that there buried the results came in. he had led cancer type of lymphoma so we are the doctor it

didn't have the name of that song. he didn't need to know those the oncologist said. it was too long. with obvious reluctance there is some ambiguity in the best way to describe it is the -- then came the workers. the spots were slow-growing raid a word about lymphoma they are around 70 types and here i go into detail about lymphomas that i will skip in this reading. in general t-cell lymphoma is are not as well understood as others and harder to treat in part because their rarity means fewer medical trials and double-blind studies. i went to google for all the

information i could find about what to expect read in the early stages of caregiving i was good at research and i like to find out information and i'm a planner. much of a determining the next steps as an abducted while supporting him emotionally per at all of this was scary. with my pen and notepad pushing for more answers i could feel like i was in control and succeeding at this new job. i didn't realize how hard it would be later as the challenges ramped up. his oncologist assured us that the disease was not reticulated urgent to treat appeared some of the most common forms of lymphoma never require -- the plan for now he said was watch weight and resist treatment options. he seemed reluctant to. at all. we left a office and joked that redhead lazy cancer and what it

might mean to care for him. i knew cancer would affect their lives but at that point it was still possible to be in denial about how much. the weekend after the diagnosis was the fifth anniversary of my mother's suicide. we drove to my hometown for the day on the anniversary of our mom's death we had a get-together. ..

>> because he was coughing so

much. looking back it's not clear why nobody suggested the pet scan which is the gold standard for cancer detection. if i had known then what i know now as i care girl give i would've thought to the nail which i've only had to do on occasion since then but i'm still naïve and not as a patient advocate completely comfortable so we waited. i remember it increased the severity was some trepidation if we should travel far for usual medical care we went to the spring break trip to hawaii before the diagnosis. we were told later when she saw the pictures on facebook if it's a trip you take when everything is about to change. but was upset that kind of trip.

and a friend who asked me that was race and now i turn it back over to her. >> i'm just listening to you and thinking. it has been so long now but yet this time it's infinity but yet it has gone by in a second. i can't believe it's going on seven years ago. i have had the pleasure of seeing the pages of this book come to be over many years. i have had the distinct pleasure of watching them transform from in the moment material to retrospective and reflective material to

argument. i don't know if it is that common brother people to necessarily have such intimate relationships with other people's manuscripts but it has been fun for me to prepare for this event and to think about the kinds of questions we could talk about that would be interesting to folks who have not read the book or know you personally or have a personal interest in caregiving but not the same breath or her perspective that i do. i'm so happy to be here and participating in this. i want to start about how the writing of this book was sparked. because i remember so well that so many books that i have watched being written over time that it was born out of ask of reading and rereading that is so much in the genesis

and wanted to see if you would talk about what it is other books had to do with setting this one in motion. >> i love to talk about that. he may not know. you are writing and workshop leader and teacher i will part of this during his illness so that is how she came to see a lot of this unfold so intimately. one of the ways that did unfold and i should clarify and was a writer before was a caregiver i will keep being a writer my whole life i have been a reader my whole life and a passionate reader. and during this of his illness i found myself going back to comfort read things i loved as a child like little women and of green gables and those that

were in graduate school by like to revisit. so things that felt that give me solace. there was a strong literary thread that runs to the book that have written because of what happened when i returned to the classics and old favorites that i started to notice those caregiving figures were in the shadows. never thought about caregiving in classic literature even though it is they are and in particular the victorian. they were caring for family members at home. that shows up intimately and jane eyre there is a woman trapped in the attic and cared for by a paid caregiver. that on march their instances of illness people have to make tough choices how to care for other characters.

so as i kept rereading those different elements of the plots and the dilemma that spoke to my own experience which at the time i was feeling quite isolated like i didn't have points of connection with other care go on - - caregivers and i have dear friends that i have met through caregiving that were important touchstones but it is very lonely work. a lot of caregiving takes place in private behind closed doors and reading does also in reading into situations of caregiving was an experience that turned me toward my first published material that made its way into the book with

consideration of the caregiving and was reading about in literature in a stolen moment. not like i had a lot of time to hang around and read. but the reading i was doing i was starting to see that in places i never really noticed it before and i will note here that i know a good number of those essays are linked on your website. [laughter] is somebody wants to read them they are there for the finding. >> let's do a little vocabulary lesson from as possible only one here that's read the entire thing. but just in case as we continue to talk some of the terms that come into the air

in case it would be useful for them to hear you talk about them today caregiving lands specifically. burnout is in the title of the book took caregiving and burnout in america. how would you describe that quick. >> it's in the title because it is common among caregivers and something that happens when people are taxed. so far in particular in my framing in a capacity to care for other people come it fizzles out past their ability to empathize and burnout robs people of the emotional capacity to keep going. it's the state in the title of

the book and i should explain it comes from me taking a quiz on caregiver burnout. i came home from a tough doctors appointment and googled resources that found a quiz on caregiver burnout then the result popped up you were already toast with a smoking piece of bread telling me i was passed where i could continue to effectively care for somebody. >> invisible labor. >> this is big broad wine i thought a lot about and i think it's a hot topic these days it can encompass everything from the mental load of running a home, childcare, domestic work, i've seen the term emotional labor used for this a lot. memory work, fostering social connections, it's highly

gendered set of roles that is invisible labor i chose that that it would incorporate all of those not just the emotional piece or the work of picking up the socks and nobody else's noticing or weeding out the clutter from people's houses to donate. all the tasks it doesn't seem big but together they make a huge load of work. >> the third one i imagine we all have our own relationships but i feel like you have faced interesting things in the book particular to your perspective. self-care. >> yes. that is a term that has gotten

nevada currency during the pandemic and before. it has become commodified starting with radical routes for self-care for revolutionaries. would never claim to be or for that reward. the idea of attending to yourself to make space to continue to flourish by yourself and as many things do in our capitalistic society were picked up and commodified and sold back to us as pedicures or buying girl merchandise and it's important to think carefully about what we are asking and prescribing with the notion of self-care. truth lies somewhere in

between. as a caregiver spending a lot of time caring for other people i found being told to focus on self-care challenging because it was like a to do list item. i'm caring for others. have time to care for myself. were to be called to community care or societal level care and one of the things that was important to me was a broad system and a critique of how paid care giving operates in our culture. and while i'm talking about caregiving it can have a lot of meanings but for me specifically i talk about an ill family member or friend usually an adult.

>> vicarious trauma. >> this is a interesting term that comes from medical care and trauma work and i adopted it to talk about in the book in the context of posttraumatic stress. caregivers can pick up not being directly traumatized but pick up vicarious trauma to be traumatized to be in this difficult, painful, stressful situation. and having that reverberate through and after the experience there is a research showing the trauma of caregiving can linger and can cause ongoing symptoms of stress of course that is true

for the ill person who is cared for as well there is tremendous trauma and strain associated with that and now it shows a quick carry over to the caregiver as well. >> one of the things that i think is a valuable message in the book is just how the cost of caregiving can evolve and change for the caregiver over time. of course as you are telling the story of a particular situation from diagnosis through treatment into recovery and the new normal for you and your family, you narrate that progression from

the acute emergency to caregiving over the long-term. one of the things i felt i learned a lot about from the book is how it is a role that initially can seem clear can gain or lose definition and ways over time what the book makes me think about and wondering if you would like to talk about how it is you way to describe the cost of the caregiver being different over time through the caregiving cycle. and what you would say about coping and methods for coping and managing burnout to get

the big question. it's multipronged to think of the cost of caregiving as you suggest. i will bracket and set-aside we may touch later on this , there are significant economic cost which i covered in my research, caregiving can be a huge financial hit to caregivers and families. i will bracket that and talk about the emotional cost and the kinds of caregiving. there can be the short sharp shock of the emergency situation. that is very challenging but also comes with the adrenaline burst that keeps a lot of character on - - caregivers going through the early stages. then can be deflating experience when that ends.

many people end up being in caregiver roles for years or decades i have heard from many caregivers and i'm sure there are many in the audience as well who have been in caregiving situations with people with very long-term illness and declined particularly in the case of dementia caregiving and that slow grind has a long-term cost. it's really important to guard what time and space you can. the longer the experience goes on, the more and more challenging it is i wary at the same time to say take breaks. because obviously that is not always accessible. one of the reasons i wrote the

book is to make the systemic critique why aren't those things accessible why is there such a severe economic cost for families and individual caregivers trying to do the best they can for their loved ones? why is there not a broader system making that possible? why is it up to us as individuals to look out for our interest and find the time to take the walker getaway? that is something that society needs to step up and offer to keep the cost lower. because it leads very quickly to burnout. i was very fortunate that my caregiving situation, which eased as my husband has regained functional

independence, although still chronically ill, for many many people, the journey ends in grief. that can be really hard to come back from here in morning and in grief especially after a long and really difficult experience with caring for the person. it can be hard to process that because the instinct is to move past after a really hard experience. i wanted to point that out i am fortunate that was not my experience in caregiving but can be an extra strain on the individual. >> we got together last week.

we have seen each other since the pandemic may be three times? >> 38 think? >> and when we cite other last week we got to talk about again the evolution of the book and the shape and has come to as a highbred memoir and the cultural criticism and we also talked about some of that particular challenges of writing a story that is not a unique story. and what it feels like and when it means when you get to the point you realize the story you are telling is bound up in your individual experience and connects you to

many others. so talk about what it is like to write a book that bridges between those two kinds of writing. the two types of discourse. and what your thoughts are on it now, now that it is out. >> that's a great question. it's important to me this book not just be a memoir strictly of my own caregiving experience. i don't think it would have that much to teach anyone in a sermon on - - similar circumstance. one of the things i learned in my research aarp does a lot of demographic research on caregivers in the most recent there are 53 million americans caring for an adult or family member who needs assistance so

there are 53 million other people out there with a story if not the same as but analogous to mine and many many more grueling caregiving tales out there. i'm sure many of you in the audience have family experience with the challenges of caring for somebody that you love to. and what i really started thinking about was the tension between the individual and the broader society that in the united states, our culture leans to individual explanations problems are the individuals to solve, family care crisis is the families to work out. not toward bigger systemic solutions. i wanted my book in some ways to be a protest against that.

that would show how we need to integrate that systemic analysis as well as an individual story what i hope my story will do in the book is illustrate the urgency and one small way of a bigger problem. i was a very privilege caregiver. i had a lot of family help my in-laws were with us for a long time providing assistance i probably would have drowned without. i had other family help, friends are you in the audience offering to run errands, dropped off meals, the community did step up and help me. i think on a broader social

level we need to replicate that act to help all caregivers. one of the narrative of my book to bring those strands together to try to make that argument in a broader way that spun out from my own individual experience. >> you just started in the direction i was going to ask, what if anything you were particularly surprised to learn about caregiving statistically or otherwise during the time period of writing with your research and speaking from a more systemic perspective. >> yes. start by what i was most surprised by as an individual caregiver and then give

statistics i was most surprised by as an individual caregiver just how much medical work the medical system expected me to do at home with almost zero training. there were things he's coming home on iv antibiotics so you'll be learning today in the next 15 minutes how to administer those. are you kidding me cracks i don't know how to do that. it is terrifying. i might introduce bacteria. it needed to go into a central line. that's a low level task compared to what many family caregivers are asked to provide to their loved ones every day and to vulnerable ill people. i was shocked at the care gap that family members were expected to fill up and that was something i'm actually

seeing some nods as i talk about that in the audience. i suspect many have had experience with this. but intelligence put on you, it didn't really occur to me. i thought they will send a nurse. they do not send the nurse. you become the nurse. in terms of bigger surprises are things that i learned some of those economic statistics shocked me with the impact on women caregivers. i should say my book takes a deliberately feminist analysis depending on the analysis between 61 and 75 percent a family caregivers are women. not trying to discount the contribution of men which is significant but it is

disproportionately female. i would argue that the undervaluing of care generally is connected with a connection that women's labor is expected to be free in the situations. that has negative effects for mail and female caregivers. and immensely proportion of caregivers have to reduce hours or leave work entirely. women who have been family caregivers and had to reduce work hours are two.five times more likely to live in poverty in old age than their peers who are not family caregivers. that is one statistic that would leap out at me. not just you left a few years of income but companion, social

security, pensions, salary increases, a lifetime economic effect. it can rob whole families of the opportunity to build wealth. >> leaping into the future, i was going to ask the question, where do the solutions like? not enough words for the biggest question i feel that i can ask what that is the best version i could bring into focus this afternoon rereading your book and preparing for the conversation. and in what direction do they lie? >> i thank you can look at it two ways. and as a culture change that drives policy change or needing policy change that can

drag the culture along kicking and screaming into a better way of treating people. i think especially right now when the pandemic and the issues of care are such prominent issues, we have a window of opportunity for policy change to help support caregivers. and support other people besides look at three particular areas. the most obvious something that is unbelievably overdue it is shameful that we don't have universal paid leave for family caregivers and sick people as well but the fact united states does not have paid leave and essentially have made no federal progress on this issue since the clinton era in the nineties with the unpaid family leave is pretty shameful.

we should change that. originally it was paid leave with the coronavirus relief bill and it faded one - - fell out. but a policy would make a world of difference to people with employment and offer other protections along those lines. some form of economic compensation for caregivers is important that exist in patch works through medicaid for caregivers that are more economically challenged it is not so much for middle-class caregivers for the tax credits. personally i would love to see a draft pay program which a favor over tax cuts because and it requires you to have income to claim it that

anything is a step in the right direction. i would also point to universal basic income could be helpful here. i mentioned for the end of the book there was an experiment down the road in california some of the results have just come in and the results really point to people being better able to take care of their loved ones with the extra margin in stockton it was $500 a month it was spent on family care, ways to make their lives better and the ill family members better. and then i would also say, these are pipedreams. these are big things, that universal healthcare. in the us without that

families are vulnerable. caregivers spend inordinate amount of time just arranging for care. and it makes for a lot of vulnerability and instability for people who are ill , leading to bankruptcy and worse outcomes. that is a broader look at health. and also if there was universal care there would be fewer gaps with more integrated care and possibilities to get people help when they needed that is not 100 percent rely on just the caregivers filling in the gaps. i saw a question that are there models of this to other countries. >> others are looking at this

and doing a better some states bring in new policy changes. the state of washington has passed some measures. japan is an interesting example to contend with the aging population much earlier than we have and they have piloted some really innovative programs like a system of caregiver credits and i talked about this in the conclusion to my book but also all the countries with the social safety net have a version of some of the things that i spoke about. >> has a copy of already toast been sent to the white house? [laughter] >> not that i know of but i

will tell my publicist. [laughter] >> there is a question can you talk more about what you learned as a caregiver about advocating and healthcare system and how caregivers learn that skill besides the hard way? >> yes i learned the hard way. i really tried to go in and look professional or at least put together who is trustworthy with my notebook to get the respect so i would see mike partner and not just a lady who was along for the ride. because i think for me, i encountered allied of being taken for granted you are here

to do the things that need to get done. we will tell you what those are any will do them. that was unstated and pushing back was challenging. it's hard to push back against a big system. brad was treated in sacramento at uc davis medical center. that places bureaucratic maze it is a teaching hospital which is great with access to amazing care and incredibly hard to figure out what is a hospitalist? what do they do that's the most important person to know about on the unit where your husband is staying because they decide who gets discharged when. there's all these critical things that for me it was important to find a nurse or somebody that was friendly that i could walk through and

figure it out but one of the things that i talk about in the book that we need more proactive caregiver education more social workers are patient navigators and people doing outreach to make that learning curve for new patients and new caregivers. it is very intimidating. they are entering into a vast and unknown system. it can be really hard to get the courage to speak up. >> ac a question who would love to hear you talk about the process of leaving the research into your personal story. >> that's a great question.

i wish i could turn my monitor and show you on the wall i have taken it down but i had a huge wall sized schedule for writing the book when i wrote it. had a lot of personal writings i had been doing through the most intense parts of brad's illness. sometimes diary entry stuff. before i wrote the book proposal, i had backbone of the memoir material. a lot of that was rough. something i would have used in the book the way it was but it formed a narrative arc. when i sat down when the book was under contract and he sat down to really produce the draft, i ended up

getting other pieces of writing i had produced during all of brad's illness leading up to it and made a giant outline in a folder tree form on my hard drive. if you are interested ever go to this quickly. [laughter] each chapter had a raw material folder sometimes like it was a paragraph and paragraph to stitch together and then i wrote the book in word chapter by chapter to have an outline to put those pieces together. some of the writing from the early days is based on a blog that we jointly kept and then as he got ill during the stem cell transplant i was keeping it in communicating for family and friends during the most

intense parts of the illness because one piece of caregiver labor is the labor of keeping in touch with family and friends and keeping them updated which is necessary but can be a very time-consuming and draining part to restate things and answer questions we kept a blog on how he was doing. i had a chronological yes it is emotionally exhausting for sure. i had those writings and rants and then they did the research through the writing process to tie everything and together. is doing it peace peace and trying to leave those in and

out so that each chapter had a balance of the personal and research material and then the third strand was the literary material i didn't want anything to read like a dissertation but i did want the strands threaded through it was taking it chapter by chapter and then the nature of revision so i got a second crack at it and here it is way off i need to get back to the story. >> i just noticed a good follow-up question. what point of the journey did

you decide to write a book? was a way to process what you are going through or did you know you wanted to write and advocacy and policy book? >> i do not always know that. i think it evolved out of the writing it was doing. and also looking for a book like this. in some ways i wrote the book i needed to read when things are really hard. wrote the book i hoped will help other caregivers to be seen and validated especially in the hard and challenging portions which are smoothed over and popular narratives around caregiving if you think about movies of caregiving with a sentimental conclusion there is the nobility and a

sense of noble self-sacrifice. it absolutely can be and it's also hard people will experience negative emotions around something that can be such a draining role and a lot of people need to feel safe with that and also i felt i needed to look at why it was so hard and think about the ways people are not supported and raise a voice for that. as i started to emerge from the intensity of difficult caregiving, i realized one of the reasons this issue is under discussed despite how many people are caregivers is they are too busy to make a

big public advocacy statement about it they are great organizations working in the space. but most people who are caring for family member especially the most print out and stressed don't have time to organize the march on washington or call their congressperson every day or other organizing they can affect policy change. i am not an organizer but i can tell a story. that is what i tried to do to give a voice to this issue. >> i would argue telling a story is one way to think about organization. stories are organization. i'm looking for more questions

because we are getting close to 7:00 o'clock. could you talk about the language of illness and care? >> yes that is from lisa and australia. thank you. she is assuming from the future, tomorrow. [laughter] lisa mentioned talking pain is a battle i will focus on that a little bit because the military metaphor in the fight around care and illness can be damaging for people. adopted a little bit in the book talking about collateral damage as a caregiver but i also tried to have some distance on that to critique that language a little that at the same time.

i think it can be harmful for people to frame and illness as a fight. it's not a fair fight you don't have an enemy you can defeat if you try hard enough and it does a disservice to people who are suffering from the condition to talk about them as if they lost a battle with cancer. it's not something you can win by trying harder. also there is a lot of things we could re-examine in the language we use casually with care and illness had a piece a couple weeks ago in time magazine talking about the language of positivity around care and illness. just a positive. everything happens for a

reason. and if you read the book everything happens for a reason the subtitle is edited and that's what nearly kills me but there is a great scene where her husband comes to the door bring a casserole and everything happens for a reason husband looks at them so tell me the reason. what is the reason my wife appears to be dying? there isn't a good reason. and i think thinking critically about those language choices can be one way of affirming both caregivers and the ill or disabled people they are caring for.

i have been corrected. and i have been loved. i conflated that was something else. >> do think caregivers have difficulty dealing entitled to help quick. >> yes. they can be really hard to accept help and that was for me. that is an area i could have examined even more in the book. we do have this individualist culture we are supposed to stand on her own 2 feet. doing things for ourselves. it can be hard to reframe that and then to relinquish control. and then ask for what you need. it's not easy to reach out and say need you to go to target and get me the sheets but sometimes you need a weird thing and you need the help.

now i'm not in the most intense period of it i want to provide help to people and give a little bit of solace where i can. it can be challenging because caregiving seems like a closed system. also if you have been entrusted with the knowledge base and the specifics of medical care talked about earlier, that can feel risky to relinquish and let that go as well. there is a lot of challenges around that. >> heidi do we have a link in the chat somewhere to help people buy the book? to make i put it up earlier but let me put it in again here.

the winner of the grab of randomly selected by closing my eyes and scrolling, melanie madden. if you could privately message me on this chat your mailing address, i will pass that on to kate. she will get your gift certificate. >>. >> yes she's back. >> if i could i want to answer one more question i sought in the chat and it was a great question i would love to

address from naomi who is another author it was wonderful and talks about i knowledge privilege in the book and how the burdens of caregiving fall not just women but women of color and more marginalized groups and i would love to address that because the research really shows that is very much the case and that can fall into ways. that marginalized families with less access to care and resources are disproportionately economically harmed by the difficult challenges of caregiving capable of jobs where they have to be

present. essential workers are much less likely to juggle the demands of caregiving with their work life and more likely to lose employment. and paid care work with the undervaluing care of all kinds like work in the home is often unstable employment we employed care workers when brad needed 24 hour care when it was not covered by insurance we are paying directly out-of-pocket. those jobs. tend to be disproportionately done by women of color, immigrant women or noncitizens. and very few employment protection for their wanted to address that question because it is a critical piece of the general question of how care operates in our society.

thank you for letting me jump back on that. >> thank you kate. this was informative. i enjoyed it a lot to hear this. not only as a woman, i have not had to be a caretaker other than a mom but my did my line - - my husband had to be a caretaker of me for a while with a series of teethree infections they kept cutting more and more out and he had found himself in the role of having to do stuff that no person should ever have to do with open wounds and all of that. i'm sure he had that caregiver

fatigue. we are over the hump now. for now. but it is a very real thing for men and women i'm glad you are the book about it. >> thank you so much. i'm so grateful to all of you for coming in so great to see so many names i'm sorry i could not shut you out all individually but i'm so touched you are here and asked great questions and have shown up on your saturday night. thank you. >> congratulations. >> and thank you, rae and for interviewing. i enjoyed your laid-back and comfortable style. [laughter] >> probably the first person to call me either of those in my entire life. [laughter] >> if you are from sacramento

jump onto our store it's been open since covid began but in a limited capacity and it has been nice to see more sacramento is out obviously we still require masks we don't let anyone people and then we have probably in early last summer. but it's always fun to visit so we would love to meet you. that concludes our saturday evening. thank you for joining us glad to see a nice crowd here. >>. >> if anybody would like their copy signed with the's

bookplate stickers i will sign them and pop them in the mail. >> message me on social media or wherever. >> kate will come in to sign them when we get back into the store.

>> a couple years ago they treated something like the worst miso outbreak and decades don't worry we are disseminating something along

those lines i am paraphrasing. you kidding me cracks that vaccine hesitancy they were not disseminating pamphlets to get their point across they are sending video of a mother crying to the camera because she is convinced her three -year-old became artistic after getting the mmr vaccine. you telling me with a video like that a person telling a story about a child crying and super emotional can counteract bullet points on a leaflet? that does not meet people where they are. what frustrates me i'm trained in medicine and medical school and we practiced evidence-based medicine but we don't have evidence-based communication even though we know it would make or break coming to an individual

patient but yet there are scholars over here in over here over what works and what does not work and then we just keep repeating what we think works even the one size fits. just goes over the heads it is in the tone for the fact that we in medicine are involved or not a part of the establishment with an unethical history from vulnerable people with medical racism. but if you talk to people who are vaccine hesitant they are more of a fringe that i got my flu shot last year. and to forget my covid vaccine this year. there will be six different

reasons to be vaccine hesitant. we have to meet them where they are with the national campaign. >> good evening good afternoon depending where you are watching from. i would like to welcome you to the launch of the book the hospital. and marketing manager here in the library literally here. membership library founded 1835. anyone can join. it is affordable you can join even if you d