SEASON 2: EPISODE 11 TRANSCRIPT

Senator Bill Frist

Sen. Bill Frist: I do think, coming to this span of time, that we need to inculcate that transience of life earlier in people's minds so that they know that there is a limited amount of time. And it might be 80 years, and it might be 9 years, and it might be 60, or it could be just 24 hours. And in that, to start with a framework that is value-driven. I'm dwelling a lot on values now just because I see how important it is in business, in medicine, in science, in politics, in policy, and in what's going on nationally and globally.

Dr. Greg Jones: Our world is facing significant challenges, and at every turn, another conflict seems to await. Yet we survive, we overcome, we even thrive by relying on an intangible and undeniable gift, hope. It fills us, connects us, highlights our individual purpose, and unites us in the goal to do more together. Hope fuels us toward flourishing as people and as a community. My name is Greg Jones, president of Belmont University, and I'm honored to be your guide through candid conversations with people who demonstrate what it really means to live with hope and lean into the lessons they've picked up along their journey. They are the hope people.

Today's agent of hope is Senator Bill Frist, who shares his unwavering optimism about global progress shaped by an impactful career in medicine, politics, and public service. Raised with values of humility and community impact, Senator Frist transitioned from being a heart transplant surgeon to policymaking, using his firsthand medical experience to influence global health initiatives like PEPFAR, which has saved millions from HIV and AIDS. Senator Frist's medical mission work in Africa has reinforced his belief that proper healthcare can foster peace, while his entrepreneurial efforts in palliative care highlight the power of innovation to address unmet needs. During this conversation, Senator Frist advises young people to learn from history, to serve their communities, and to embrace purposeful adaptability to create lasting impact. Well, thank you, Senator Frist, for joining us today.

Sen. Bill Frist: Great to be with you.

Dr. Greg Jones: I want to begin by just asking you something about your current life and experience. What's bringing you hope in all the work you do?

Sen. Bill Frist: Just to begin, as I think about hope, I'm a pretty optimistic person. By nature, I tend to look at the glass half full coming in, and I say that because it's increasingly hard. I think what we see in our world today with the chaos and the confusion and the challenges and the misinformation that's floating around, it's very easy to lose hope.

I have the advantage personally of having lived now seven decades, and I've seen the huge progress that has been made in this world. And I think in my own world of medicine and health and healing, I see the great progress that we've made just in the last 30 years. I see the huge progress we've made in poverty reduction across the world, as I traveled around the world, huge, halving extreme poverty over time. I see the increase in life expectancy. And yes, we have fentanyl and we have opioids and we have all of these diseases today, despair that are there. But when I was born, the life expectancy was 65 years of age, and now it's almost 80 years of age, just in my own lifetime.

What brings me hope is in the last 25 years, childhood death, infant mortality, death of kids under the age of five have all radically improved. Right now, the chances of survival of a child being born today to reach five years of age is twice what it was just 25 years ago. So when you look at poverty, you look at how long we live today, when you look at new cancer therapies, and there's been a 30% reduction in cancer in the last 30 years. I remind people that if you look at these big, big trends, we are at an unbelievable time in history, with opportunities before us now that we just didn't have five years ago or 10 years ago or 15 years ago as we look to the future.

Dr. Greg Jones: That's great. You've had an extraordinary career in healthcare, as a transplant surgeon, and then in politics and becoming majority leader of the Senate, and involved in so many different things in public health and global efforts and now with the Nature Conservancy. One of the threads across that distinguished career has been what you describe as having a heart to serve. Talk about what that phrase means to you.

Sen. Bill Frist: A heart to serve. And it is the title I used, my most recent book. Really comes in response to the fact that people say, "Bill Frist, you've had four careers. You spent 20 years in medicine and you traveled for 10 years, learning how to do heart transplants and 10 years of doing it, and that was a medical career. And then your 12 years in government in the world of the United States Senate in Washington DC." And then the 12 years, now 18 years, in the world of starting healthcare companies to solve needs of mainly vulnerable populations, which is what I do in the business world. It's the entrepreneurial world, the creative world to solve these big problems.

And then in the fourth category of the Nature Conservancy, which is a global position in 44 different countries and all 50 states, centered around the importance of nature and our environment and our climate and our trees and our soil and our oceans to our lives.

So the common theme to all that is this heart to serve. So to other people, it's four different careers, but to me it is really one central organizing principle. And that principle is to lift other people up through service. And it came from who I had as parents and the family that I had around me and the values around that. But to me, it just goes back with this heart to serve.

Dr. Greg Jones: Yeah. That's beautiful. I want you to talk a little more about your parents. Your parents had an extraordinary marriage and life and the impact that they had together and the way in which they infused a sense of values in all of you kids, and it's extended down to grandchildren and great-grandchildren. Talk about your mom and dad.

Sen. Bill Frist: Yeah. No, it's interesting. And the older I get, the more I think about it. I've got nine grandchildren, happily married, have three children of my own. And then I'm the last of five children, all of whom are alive today, and we all live within three miles of each other today, which is pretty remarkable. Mother and Dad, born in 1910, grew up very humbly, Mom out of Hopkinsville, Kentucky, went here to what was Ward-Belmont back in the late 1920s and early 1930s. Dad came up out of Meridian, Mississippi. Dad lost his dad when he was 10 years of age in a tragic train accident.

This humility that colored their lives I think colors the lives of subsequent generations and a lot of what we have done in service to community and to neighborhood and to our country and then globally. Dad was a doctor. He served people locally. He grew that intimacy, that trust of taking care of people around him, into a large practice. He identified needs along the way. So he always stayed open to challenges, looking around him, what is needed. And the examples are many. Globally, around the world, through the Presbyterian church, he saw a need and started the Medical Benevolence Foundation. He had patients here in Nashville in the 1950s and 1960s who were addicted to alcohol, and some to drugs at the time, but mainly alcohol addiction. And there was no addiction treatment center anywhere in Nashville, anywhere in Tennessee. And so he started and founded, with some other community leaders at the time, Cumberland Heights and the whole addiction treatment movement that was here.

And then of course with HCA, he saw there was a shortage of beds, affordable healthcare to people, giving them clean surroundings with excellent healthcare, not just here in Nashville, but all over the state. So he would identify these needs, staying observant. Mother came up raising five children. Started here, as we talked about. Her value system was built very much around teaching and around helping other people and also identifying needs in the communities themselves.

So that's the world that we grew up in and we saw as young children, and we've tried to probably ... That was imprinted on us. And then we've taken off in different directions, doing the things that hopefully do make our community a better community. But it does, in large part, come back to those early years and the values of humility, of honesty, of character, of integrity, and of service that they instilled in us.

Dr. Greg Jones: One of the lesser known features of your life that doesn't quite fit in any of those four careers is that for many years you've done medical trips to do surgery in Africa and in South Sudan and other countries. And that's been a key part of your vocation and that heart to serve. I mean, that embodies hope, to go into those settings that are often very difficult and aren't staying in a Ritz-Carlton when you're there. How did that come to be, that inspiration to do that work, and what have you learned from it?

Sen. Bill Frist: Dad always would say ... And he didn't say, "Go into medicine," but he probably knew that we would because he always said the field itself opens up the opportunity to help other people, lift them up, have them live better lives, healthier lives, spiritually, mentally, physically, in ways that no other profession does, that intimacy coming in.

As a young boy, I remember him coming back from a medical mission trip that he did. He didn't do a lot of them, but he'd gone to Mexico. And he came back and I was probably 10 years of age, 9 years of age, and I remember seeing him and talking about what he did.

So then years later, when I'd gone to finish college, pre-med, medical school, internship, residency, fellowship, I had the opportunity to go with Franklin Graham and Samaritan's Purse and a fellow by the name of Dick Furman, who trained with my brother, back to Sudan in the mid 1990s. And at that time, Sudan was a war-torn country, five million people displaced, three million people had died in an active civil war. And we went in, and we went in the first time for about three weeks. And I was on the ground. I felt like anybody would be uncomfortable, a lot of fighting going on within two or three kilometers of where we are. We had to be dropped off. Plane couldn't stay on the ground, so you were just dropped in. And then we started doing surgery, with the good guys and the bad guys, with the Sudanese People's Liberation Army, with the government of Sudan, with local people. And they were all fighting each other.

But what we noticed, as we started doing surgery and helping people, that the fighting would stop around us. It would stop within several hundred yards of us initially, and then within several kilometers of us. And as we went back year after year after year, fighting would stop within 50 miles of us.

And what that taught me is that medicine and healing and caring and lifting up other people can serve as a currency for understanding and empathy. And ultimately, when I went to the United States Senate, it translated into my involvement in using medicine and health and USAID and the goodness of the heart of the American people as a currency for peace. So health is a currency for peace. Medicine is a currency for peace.

And so I learned a lot from it, but I did multiple trips there, probably 20 different trips, from a week to a month, in Sudan and Kenya and Tanzania and Ethiopia and South Africa and Haiti, around the world, and was involved a lot in responding to these international catastrophes, whether it was Katrina, going on with medical mission groups, doing surgery on the ground with people within days, the Indian Ocean tsunami in Bangladesh, the earthquake in Haiti back in 2010. Have been involved in all of these in a very personal way, a very quiet way, and just going and doing the work itself.

And it comes back to the heart to serve that you mentioned, but also I had been given, because of good medical training and the opportunity that my parents gave me and that my family gave me, to learn tools and medicine and of surgery and participate in that way.

Dr. Greg Jones: That's beautiful. I love the image of the work you've done as a healer being connected to spreading peace, and you described that. And there was something very intimate about you being there in a relational mode with individual people. And then as majority leader of the Senate, you were able to help, with President Bush, implement PEPFAR, which had a scale of influence and impact in improving people's health and helping people get out of poverty. Talk about how you took that personal experience on those medical mission trips and then used that to help shape policy that affected millions of lives.

Sen. Bill Frist: Yeah. Yeah. It started just that way. I ended up going to the Northeast for school, came back home as quickly as I could, and then ended up in Washington DC. But I went to Washington DC as the only physician in the United States Senate. There had not been another doctor in the United States Senate in 65 years. The last one was elected in 1928. And there were like 60 attorneys there. There were a lot of attorneys in the room in the United States Senate.

But I saw that I was looked at in a little bit different way, that I was trusted. People knew that I would be committed to confidentiality, to being trusted, the intimacy of dealing with problems that were personal. And with that, went from 100th in seniority to 90th, to 50th, to 40th, and ultimately elected majority leader by my colleagues.

So that was one track that was very much affected by medicine, of the basic tools that the medical school here teaches, of making a diagnosis with sometimes a limited amount of information, making a decision, being held accountable for that decision. And that's not that unusual in Washington, relying on a body of facts. Not misinformation, but facts. Making a decision, sticking by it, being held accountable. And so people respected that.

The parallel track was I had a body of information about health and hope and healing, and I knew what HIV/AIDS was. I'd been on the ground. I had treated hundreds of people who were dying in Africa of wasting disease. And then all of a sudden, I found myself on the floor of the United States Senate. And at that time, we were doing nothing globally for HIV/AIDS. Again, this was in the 1990s and early 2000.

And I'd spent six years with President Clinton, and then when President Bush came in, our conversations began. But when I started bringing pictures back to him based on the medical experiences, based on my life as a doctor, he asked questions, and then he sent people of his team to Africa. And then he realized that there were three million people dying every year of a single little virus that was a cagey virus, would keep changing, that we still today have no cure for. But he basically said, "We're going to do something about that."

So then ... This was all in 2003. He basically said, "I'm going to make the single largest commitment that has ever been made to fight a single disease in the history of the world." And people will say that sort of thing, but will they really do it? But then we had to do it. And so it's hard to do that. HIV/AIDS, remember, it used to be ... You had people like Jesse Helms, the iconic leader of conservatives, who basically said, "HIV/AIDS is morally damning and we should do nothing for it." And so we had to convince people like that, people like Jesse Helms. When he learned about the 10 million AIDS orphans caused by a virus, which for a dollar a person we could treat, he said, "Okay, we're coming on board."

So we built the constituency there piece by piece. And it was the progressive left. It was a conservative right. It was the icon people like Jesse Helms. We worked with Bono from U2, pulling all that together for something that people thought was impossible to address. We all came together and passed a piece of legislation. There are 26 million people alive today that would not be alive without the generosity of the American people. Everybody listening to us has contributed to that. 26 million people alive today who would not otherwise be alive without the story that I just told. The amplification, the pulling people together, the alignment of interests, the unselfishness of using taxpayer dollars of people here in Middle Tennessee going to Uganda or Kenya or Tanzania or Rwanda. And it takes that sort of big thinking built around values, the unselfishness, and the world is a better place.

Dr. Greg Jones: Indeed. And what's extraordinary is that so often we pit either the local or the global, the personal or the systemic, and what your story shows so powerfully is how they can be a both/and rather than an either/or, that it was your personal relationships in Africa that helped to fuel your imagination for how to address something that affects 26 million lives in a really powerful way. That's just beautiful.

One of the characteristics you talked about yourself is an optimist and as a basically hopeful person. Investing in those companies that can really improve healthcare has had a huge impact in Nashville and this region, but across the country and around the world. Why is a focus on the future and anticipating the future as an entrepreneur so important to improving communities and healthcare and broader opportunities for all people?

Sen. Bill Frist: Yeah. No, it's a great question. And I think that's what's so neat about it. You can take these local issues, figure out if they work or not, and if they work, you can amplify them to a neighborhood, to a state, to a country, globally. And people say, "Well, I can't go after these big global things." You don't have to go after it if you can do the more local things well, and other people can amplify.

Well, one of the things I did, I went to government because I said that's a good way of amplifying it. So I was doing the heart and lung transplants around the corner from here at Vanderbilt. From doing that, treating people one-on-one, I could take that knowledge to the United States Senate, which was a risk, to run for the Senate, but that gave me a platform to be able to take that medical training and apply it to HIV/AIDS globally coming in. It had nothing to do with me. I'm just the conduit, happened to be in that situation.

So the entrepreneurial aspect. Another way of doing that is business, hardcore business, corporate America, for-profit, all that bad stuff. Hospital Corporation of America is an example of that, that my dad and my brother have done. Right now, it's all over the country, treats millions of patients every single day. Well, that started with the values of Dad treating people here in Nashville. Business, for me, palliative healthcare. So we have 26 companies now. We invest, we take outside money, we put the money into it to do good. We do concentrate around needs that people have, vulnerable populations, healthcare disparities.

For me, because I ran the transplant center here, I was taking care of people who were referred from around the country in the early 1980s, 1990s at Vanderbilt. People would have to be predicted to die within six months so they wouldn't come to me, because I didn't want to do a heart transplant on somebody because I had so few hearts to put in people. And so they'd only come to me if they were going to live six months or less. What I noticed was if I wrapped teams of people around people referred in who were going to die, that they would live for eight months and then a year and then two years, if they got better food, they got better exercise, they worked with physical therapists, they worked with occupational therapists. And that's not the way our healthcare system was designed then.

So then I said, "Well, this palliative healthcare ..." You're still treating people. It's not hospice. It's not the last few days of life, but it's the last six months of life or the last year of life. It could be for younger or older people, that if we could take care of people with a different model, they could live longer, happier, see their children get married, go back to work, even though they were supposed to die.

The problem with that, care is not being given anywhere. So I said, "Let's start a company, and it's going to be a palliative healthcare company." So by taking that idea, seeing a need around a vulnerable population, people who were going to die unless it was done, we would create a company. And the company, you need fair reimbursement for that, and you need a business model for that. But with that, because you're delivering a service that other people had never ... It's so simple. It's so straightforward. It's so common sense today, 15 years later. But at that time, nobody had ever done that.

So vulnerable population, an idea that makes sense based on experience at a very local level. It was me doing heart transplants here. And being able to amplify it through capitalism, raising money for profit. Now, there are millions of people across America because that one company, Aspire, was the first community-based palliative healthcare company in America.

Dr. Greg Jones: What advice would you have for young people who are coming along today who want to be hope-filled, they want to be people of impact to make the world a better place? What advice do you have for young people?

Sen. Bill Frist: Well, even now at my age, I'm trying to figure out how best to serve and still be able to have the great relationships and family and spend time ... And allocation of the time that's there. So I struggle with it every day. So it's not like I have any of the answers coming in.

I do think coming to this span of time, that we need to inculcate that transience of life earlier in people's minds so that they know that there is a limited amount of time. And it might be 80 years, and it might be 9 years, and it might be 60, or it could be just 24 hours. And in that, to start with a framework that is value-driven. I'm dwelling a lot on values now just because I see how it plays out, how important it is in business, in medicine, in science, in politics, in policy, and in what's going on nationally and globally, in Washington and elsewhere.

But I think the way I look at things now is you've got to know the past. You have to study it. And if you don't get it in high school or K through 12, you need to get it in college. It's hard to get later. It's just hard to read it, to understand it, to feel it, not for its own sake, but to be able to apply it to today, to get that connectedness to what went on before.

And it might be an appreciation of old houses, it might be an understanding of battles that have been fought. It might be the history and civics of the United States. But to connect, the connectedness between the past to the present. This is not the future yet. The present gives us the sense of identity of who we are, the why, the questioning, the insecurities that we all have. We all have. But that understanding the past and connecting it, that other people in this big arc of life, other people went through the same thing, and maybe even more challenging times coming in.

So number one, understand the past. Number two, connecting it to the future. Number three, using that to give you a sense of identity of who you are. And that gives you the foundation to look to the future, of the lessons learned, of the direction you want to play, of how you want your life to have an impact. Service isn't for everybody. It's not the end all and be all. It's just the track that I've taken. And then not planning it out, but having a goal, and a one-year, and a five-year, and maybe a 20-year, knowing those goals are going to change the next day and six months later, but at least think in those terms, that life is one big arc.

And if you want to, if you want to be a part of something much bigger than yourself, sometimes it doesn't mean shooting for global issues or national issues or a statewide issue. It means doing things in your own neighborhood, the service things that are within a block of your house, a block of your home. The simple things in life. Other people can amplify them, but just by doing those, doing them well, letting other people do them, see that you're doing them well, gives them the inspiration to amplify, to take them to larger levels. And to me, that's how we have a better world for ourselves, a better world for our children, and better world for our grandchildren as things move forward.

Dr. Greg Jones: Thank you for participating in this conversation with the Hope People. Our aim is to inspire you to become an agent of hope yourself, and to help us cultivate a sense of wellbeing for all. To join our mission and learn more about this show, visit thehopepeoplepodcast.com. If you enjoyed this conversation, remember to rate and review wherever you get your audio content.