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Nashvillian of the Year: Dr. James Hildreth

After a long and remarkable career, the Meharry Medical College president is at the forefront of Nashville’s battle against the pandemic

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Dr. James Hildreth

On Feb. 26, 2020 — less than a month after the first confirmed case of COVID-19 in the United States — Dr. James Hildreth, president of Nashville’s Meharry Medical College, tweeted an update on the global case count and death toll, along with a warning: “This is in fact a global epidemic, a pandemic and we need to prepare for its consequences.”

Two weeks later, the World Health Organization made it official, and now, going on two years later, the pandemic is still with us. So is Hildreth. The doctor has long been working for the public good, whether as a leading HIV researcher or as leader of Meharry, and the latter role made him a prominent Nashvillian. But the pandemic thrust him into a new role as one of a few spokespeople for the science that was — or was supposed to be — underpinning our response to the virus’s horrible march across the globe. 

The fact that we know his name at all is remarkable. Spurred by the untimely death of his father, who succumbed to renal cancer after receiving little if any medical care, Hildreth has amassed a list of accomplishments that are as significant as they were unlikely. As he told the Scene during an interview in late November, he decided as a young boy to become something he’d never seen before — a Black doctor — and went on to attend Harvard University and become the first Black Rhodes scholar from Arkansas. At some point, he fell unplanned into the study of immunology, unwittingly preparing himself for the public health crisis of a lifetime.

In 2020, Hildreth was a regular presence at Mayor John Cooper’s COVID-19 briefings, trying to put science into layman’s terms and urge Nashvillians to heed its wisdom. Meharry set up drive-thru sites, offering COVID-19 testing to anyone in the community for free. Soon they were running three locations for Metro. 

As vaccines became more widely available in early 2021, Hildreth became one of their biggest boosters, urgently spreading the message that high vaccination rates were the best way out of the pandemic. In February, the White House announced that Hildreth would serve on the Biden administration’s Health Equity Task Force, a group aimed at reaching traditionally marginalized populations and addressing health disparities amid the pandemic. He is also part of a 20-person U.S. Food and Drug Administration committee assessing the efficacy of COVID-19 vaccines, including those recently approved for children ages 5 to 11. Throughout the year, his Twitter feed has been a constant source of scientific updates, analysis of the pandemic’s current state and earnest cheerleading for Nashvillians to persevere and look out for each other by getting their shots. 

But he hasn’t just been a leader when it comes to medical interventions. Earlier this month, Hildreth surprised Meharry medical students by announcing that the school would be using its CARES Act funds to give them each $10,000 each, no strings attached. It’s a potentially life-changing gift for students, many of whom had been volunteering at Meharry’s testing sites throughout the worst of the pandemic

Public health officials have been front-and-center since COVID’s arrival and have caught more than their fair share of criticism as a result. But without them, without people like Hildreth, who have devoted their lives to become experts in their field, we’d be flying blind in a hellish storm. We’re not out of it yet, but we can see the way through. For shining a light and blazing a trail where there wasn’t one before, Dr. James Hildreth is our Nashvillian of the Year. 

Read our recent interview with Hildreth below.

 


 

Can you tell me a little bit about how you grew up and how you got into all this? 

I’m from a small town in Arkansas — Camden. Camden is about two hours’ drive south of Little Rock. About 45 minutes north of Louisiana. So I’m the youngest of seven children. I had four sisters and two brothers. There are five of us left now. 

Anyway, when I was 10 years old, my dad got really sick. He worked at the paper mill. And when I was 11 years old, he passed away in January of that year, 1968. And as an 11-year-old, I didn’t really understand why — there are hospitals and doctors — my dad didn’t really get much medical attention. So that was January. Then, April of 1968, on April 4 at 6:01 p.m., in Memphis, Tenn., a shot rang out that changed the world and certainly changed my world. That’s when MLK was assassinated. And he had kind of become my superhero. I had an uncle who was a minister, who would come to the house on weekends and play his recordings. He loved him. … To me, he was a superhero. 

Between my father passing and MLK being assassinated, I was just a really angry young boy. As a matter of fact, my mother says I didn’t say a word to another human being for a couple of months. It’s hard to describe being locked up in so much rage. And I think I’m fortunate that I was living in a small town in Arkansas and not Chicago or Los Angeles or D.C., because I would have been caught up in the response. But my mother is the one who challenged me to channel my anger to something. She always asked me, “What are you gonna do about it?” And what I decided to do about it was to become a physician myself — try to make sure that no other 11-year-old went through what I went through. The problem is that I had never seen a Black doctor, didn’t know you could be a doctor if you were Black. So there was all this. 

And then when I was 13 years old, I started doing research on medicine, doctors, how you become a doctor. And I don’t think this happens anymore, but back then, some of the major magazines were ranking universities as to your chances of becoming a doctor if you’re a pre-med student at those universities. So there was one university that was head-and-shoulders above all the rest, that if you’re a pre-med at this institution your chances of getting into medical school were going to be very good. And since I thought my chances were remote, I figured I’d give myself the best chance if I went to this university. It was Harvard. So at age 13, my life’s work became doing everything I could do to get into Harvard University, without ever knowing that anyone who looked like me from where I was from had ever done that. So I had a teacher and my mother who wouldn’t let me let it go. Although there were a lot of times when I would tell people of my ambition and they would laugh at me or tell me that I should rein in my expectations and go to trade school or something like that. But my mother and Mrs. Washington wouldn’t let me change my mind. So long story short, I got into Harvard, and all the Ivy League schools — Stanford, lots of other places. But since my research had said Harvard, that’s where I went. 

And given my ambitions, two of my roommates — there were seven of us who went to Harvard together from various parts of the country, Ohio, California, etc. — they convinced me that getting a Rhodes scholarship would be a great way to open some doors and do the things I wanted to do. So at the last minute, I applied for the Rhodes. And back then you could either apply from the state you were from or the state that you went to school in. I decided to apply from Arkansas, and I became the first Black Rhodes scholar from Arkansas. I really think the basis for the award was my ambition to go into medicine or medical research and try to change the plight of folks who look like me in terms of having access to health care. Because back then, I think there are 75 counties in Arkansas, and 90 percent of all the physicians were found in two of them. Pulaski and [Garland], those were the two. That was it. I met a professor who convinced me that immunology was the best thing in the world. I was a chemistry major, but Dr. Williams was the only person I knew of who was also from Arkansas. I got a job at the medical school, and he is the one who turned me on to immunology. So I decided to do a Ph.D. in immunology as a Rhodes scholar and came back to Johns Hopkins Medical School. And you know the rest of the story.

 

Did you ever imagine that going into immunology would become as relevant as it is now? 

I tell people that I could have scarcely imagined that I would have to deal with two pandemics in my career, because keep in mind there’s an ongoing thing that we haven’t completely solved — that is HIV/AIDS. And there’s still 30-plus million people living with HIV. But no, the research I’ve done in immunology and how the body responds to virus infections, you’re right, I could not have imagined that it was preparation for something like this. And I’ve been witness, though, to how remarkable it is that all the things that have happened over the last three decades positioned us to get vaccines done so quickly. 

These past two years have been a blur in some ways. But do you remember when it became clear to you that we were going to have a global situation here? 

Yes, I remember that when the WHO declared this a — I don’t know, an epidemic of global concern. I remember tweeting that they should have called it a pandemic back then. They declared a pandemic on March 11. It should have been declared pandemic at least a month prior to that, because we already had evidence that it was making people really sick in lots of countries. It was caused by a virus, a new coronavirus. Then I remember when they finally did declare it a pandemic, in March of 2020, I think I sent a tweet out to say that life is about to change for Nashvillians in ways they could scarcely imagine. Because the only way to deal with a virus for which you have no treatment or vaccine is to do what was being done, which is to have people stay in place to limit the spread and do other things that were gonna do damage to the economy and all this. So it was pretty clear from even some of the research that I was privy to in February, March of 2020 that this was gonna be a serious problem. And I started reading about SARS, which happened in 2003, and I got even more concerned. … 

But you know, the good news is, the fight against HIV prepared us in ways people can’t even imagine to respond to this as quickly as we have done. And I think the research on HIV in terms of vaccines really did play a key role in getting us the vaccines in 10 to 12 months, because we had this infrastructure that had been in place. It’s a global infrastructure. Scientists, facilities, protocols. And probably in February, March of last year, there was a pivot. All that infrastructure that had been focused on HIV turned its attention to COVID-19 to great effect. I think that we owe a lot to all those individuals who devoted decades of their lives to HIV. I mean, I’ve played a small role in it. But I’ve been studying HIV since 1987. So I kind of have a perspective on this to say wow, really, it was impactful. Even though we don’t have an HIV vaccine, wow, didn’t it make a difference.

Did it surprise you how quickly this became a sort of polarized political issue? 

Well, I do think that the political polarization was an important part of this. And I also think that when you have the biggest megaphone in the country and you are espousing misinformation, in fact, that’s antithetical to the science — that’s a problem. And I think that created lots of problems downstream for us, that we had a president who was doing that.

What people may not know and remember, is that there’s another parallel to HIV. HIV was discovered in 1981. In fact, the first cases were reported in 1980. Ronald Reagan did not mention it publicly for six or seven years because the social construct at the time was, this is a problem limited to gay white men. And since being homosexual back then was thought to be a sin, more or less, the elected officials thought that they could just ignore this because it wasn’t really an important problem, because it’s limited to these people. So, we lost at least five or six years of research and a focus on this because we had a leader who thought it not important because it affected a certain group of people.

Another parallel from my perspective is that here is a problem, COVID-19, that at one point seemed to be disproportionately, and still is, affecting brown and Black people. And I honestly believe that if the impact were different, if it were flipped, the sense of urgency would have been different. So there’s these parallels between HIV and COVID-19 that are really striking in terms of the political contexts, as well as some of the science.

And we’ve seen that in Nashville — some of that disparate impact, especially early on. How do you think we’ve done in Nashville? We’re almost two years into this. 

Well, I think we’ve done pretty well. I think that one of the things that made a difference for Nashville is having a mayor who at least was willing to use science as he made decisions about mitigation steps. We also, I think, did a good job of communicating to the community about what’s going on. My role, of course, was to talk about the science, to try to make the science accessible, with a thought that if people understood the science behind these things we’re doing, that will make it more acceptable to them. That is not a political thing, or that we’re just trying to wing it. There was a sense that, “Here’s what the science says, and here’s why we’re asking you to do what you’re doing.” So that was kind of my role. I think that Nashville did a really good job, to compare it to some other cities our size. But my biggest concern now, though, is we seem to have come to a point where vaccinations are slowing or plateauing. That’s the last thing we need. We’ve got to get to a much higher percentage of folks vaccinated locally, nationally and globally, actually.

It seems like one of the most universal experiences of this pandemic has been people trying to convince people they know about this. Have you had that experience in your life? What do you think works to get people over that hump? 

My experience has been, you’ve got to have a trusted messenger. You’ve got to have someone speaking to those who are hesitant or reluctant that they will listen [to]. First of all, they’ve got to listen. A lot of people are only seeking sources of information that reinforce their misgivings or the information they’ve gotten that’s not scientifically based. So if you’re just going to those places that will reinforce what you were thinking, whether it’s true or not, then of course that’s a problem. And social media, oh my God, how do you combat the incessant messages by people who have lots of eyeballs and ears every day, that are speaking things that are just totally false, right? I mean, it’s one thing to have some misgivings. But it’s another thing to just say things that are patently false, based on the science that we know.

But I think the one thing that seems to work is engaging community members with the right information. So they can engage their fellow community members to give them the information that’s correct about COVID-19 and the vaccine. I think that has worked. And that’s one of the main recommendations from the Health Equity Task Force that I was a part of that the president put together. One of our strongest recommendations: You’ve got to empower communities to solve the problems that they face.

Looking forward, how do you feel about where we’re headed? 

What it really comes down to is that we’re in a race. We’re in a race with a virus that, when given the opportunity, it’s going to mutate and become a different version of itself. Some of those versions we’ve already dealt with. Delta is a great example. Delta is a result of mutations that cause the virus to replicate more efficiently, and to bind less well to antibodies. If we don’t get enough of the global population vaccinated quickly enough, opportunity will be there for the variant to arise that these vaccines don’t cover, and that’s the last thing we want. So we’ve got to win this race. We’ve got to get as many people vaccinated as quickly as possible, or there’ll be another variant that will set us all back to square one. 

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