Speaking Up

In the past year, I have attended multiple diversity training sessions that have opened my eyes to understanding health equity, social injustice, and institutionalized racism. Prior to this, I had not fully understood or acknowledged my white privilege. And I did not know how to use that privilege to be an advocate for those who have little to no voice and who can be taken advantage of by the health-care system.

Jack’s schizophrenia prevented him from understanding the importance of taking antibiotics for a diabetic leg ulcer. As a student nurse, I was caring for him on the psychiatric unit where I worked.  Based on his olive skin, Jack may have been of Greek descent. Average height and weight, he had thinning black hair, beady eyes, and a hooked nose. Jack’s face remained expressionless, and he usually kept his head down, shoulders hunched.

He’d been found wandering the streets, years ago, so we didn’t know much about him. Jack rarely spoke, and I wondered if he’d suffered a trauma earlier in life.

I was a brand new pediatrician, the most junior faculty member in a medical college in India. The typical diagnoses were different from most that I’d seen in my residency, which meant that every case was like a puzzle. But I was enjoying the challenge, as it led to lots of interaction with faculty in other departments.

I’d been an activist and in protests since college. But this felt “low risk” compared to standing up as a medical student to the hierarchy of medical education.

Atlanta, 2004. I’m seated next to a stranger at a large table at my brother’s home; I know no one there except my brother and his family. My son stayed back in New York with his dad, and my daughter was playing in another room. When the woman next to me hears where I am from, she mentions that she had once lived across the river from me. I knew her town well.

“It was nice there,” she said. “But’”–she lowered her voice–“we had to move.”

I knew why right away, but I had to hear it from her. “Oh?” I asked innocently. “Why?”

“Oh, you know,” she leaned in and whispered. “The Blacks.”

Here was my chance, and I didn’t miss a beat. “Oh, I know,” I replied. “They’re so noisy, and they make such a mess. I have two of them living downstairs in my house. They drive me crazy sometimes.”

She looked confused.

“My children are biracial,” I smiled at her. And I immediately felt terrible for embarrassing her, as she fell over herself apologizing.

But another part of me didn’t feel terrible. “I’m sorry,” I said, “but it  just goes to show you: you never know

I remember my mother referring to me from early childhood on as “stubborn as a mule.” That trait has held me in good stead when dealing with authority figures or doctors who have tried to talk me into doing something I knew wasn’t right.

The event I remember most, though, comes from my grammar school years. A girl in our class was “retarded” (the term used then), as was her mother. She came to school with her hair uncombed, clothes dirty, and wearing no underpants. Each day at recess a group of boys encouraged her to go on the hanging bars so they could run under and look up her dress.

In 1970 I was a twenty-two-year-old first-year medical student riding down from New Haven with my classmates and our medical school dean to Washington, DC to join other medical students lobbying members of Congress to end the war in Vietnam. The organizers had arranged for us students to sleep on the floor of some dorm rooms at Georgetown University, which we did. (The dean, I am sure, did much better than that.)

The year was 1997, or thereabouts. She called on an otherwise slow day in the AIDS service agency I had started and was running on fumes and prayers. Her name was Mary.

Mary’s voice was trembling. She had been raped, and beaten, and feared she had AIDS. I knew she needed medical attention, so I got into my car to find her house, a tiny home next to the railroad tracks.

When I was twenty years old, I read Elie Wiesel’s 1966 book, The Jews of Silence. I learned that silence is a sin—that passively watching something heinous happen without actively speaking out against it is almost as bad as participating in the negative behavior. While this lesson did not result in my joining marches or writing letters to political leaders, it did make me more cognizant of the necessity to speak up when I witness injustices.

Dear Pulse readers,

The July More Voices theme is Speaking Up.

I think most of us would like to be the one who speaks up to right a wrong or to call out an injustice.

I’ve done that on occasion, but I can remember other times when I’ve remained silent.

Here’s a time when I spoke up: