Monday, August 06, 2007

notes from the bronx

Last Friday, my work included salsa dancing in the street. I’m doing a rotation in the South Bronx for the month, and one of the agencies I’m working with held a health fair, which was really more like a block party, taking up 2 whole blocks of a warm busy street that cuts through the middle of the Mott Haven neighborhood. Old men from the neighborhood played salsa music at one end of the street; young men from the neighborhood spun hip-hop and breakdanced at the other end. Grandmothers brought homemade chicken and rice and beans, and a multigenerational crowd danced in the middle of the street, which was lined with mobile vans from different healthcare organizations in the community.

My favorite moment was when the door to the mammogram van opened and someone poked her head out and called into the crowd, “Amalia! It’s your turn, honey!” And one of the dancing women spun away from her partner and said, “I’ll be right back,” and jogged over the van to get her mammogram, and then came back out and kept on dancing.

I loved that block party. I love the combination of dancing and good food and people of all ages coming together, and mammograms and hepatitis C testing and little kids handing out packets of information about HIV. I love witnessing people’s creative work to embed healthcare into a community.

Last week the 20-year-old grandson of one of our patients died from complications of asthma. To me this was a shocking travesty. A 20 year old boy dying from asthma? I know this happens, that this occurrence, while tragic, is not unique; that actually young folks between the ages of 15-24 are the most likely to die from asthma… but I’d never witnessed it before. What a sad new low we have sunk to, I thought. The South Bronx has the highest rate of asthma in the country, and some of the worst environmental indicators in the world. My patient whose grandson died is also taking care of 2 other grandkids, and she’s also struggling with her own diabetes and hepatitis C.

“I wish I could have a whole day to just cry for him, but there’s no time,” she said.

I expected to be blown away by the differences between New Orleans and New York City during my time here, and I am, but what’s more amazing to me, ultimately, is how similar so many of the struggles are. I did outreach this afternoon with someone who’s lived in the Bronx her whole life, and I asked her to tell me what she thought I should learn about, as a visitor to this community. “One word,” she said. “Gentrification. AKA, they’re pushing us all out. It’s starting here. That’s what you need to know. The day I see a Starbucks on 149th Street—oh, girl. Get ready.”

It’s the same in New Orleans, I think: the continued displacement of so many of our people after Katrina. Who gets to live someplace and who doesn’t. How even in this world where we learn that we’re more mobile than ever in human history, our connections to our homes are still such vital, practically physical parts of us.

Since the US Social Forum a few weeks ago I’ve been thinking almost nonstop about land struggles. About how, especially in so many low-income communities and communities of color across the country, people’s struggles are so tightly bound to place: to geography and the histories and communities and cultures that have been impacted by the connections with the block or neighborhood or piece of land they’re happening on. How that’s not just true in post-Katrina New Orleans; how wherever we’re from and whether we acknowledge it or not, our geographical context is a part of us, and how land struggles and fights against gentrification and the work toward justice in the Gulf Coast are all actually parts of the same battle for cultural survival and community intactness, against all those same tides beating against our various communities with such epic volume and intensity.

I’m talking about land because that’s where everything begins. And because for me it’s important to centralize context in our work. To remember that whatever messed up system we’re working in, or receiving healthcare in, or building change around, that it comes from somewhere bigger that’s connected to the rest of our lives in myriad ways. And how it makes my healthcare work both easier and harder, but also more honest, when we locate it within the larger fights for justice taking place all across this country, which are ultimately about nothing less than people’s rights to live full, connected lives that honor our humanity.

It means that for me, sitting on a cracked vinyl chair with a grandmother from the South Bronx, being part of someone’s healthcare is about diabetes and hepatitis C, but it’s also about what it means to be a woman of color in the US raising two young children with very few resources; it’s about the conditions that have made the air in the South Bronx some of the deadliest air to breathe in the world; and it’s about the fact that all of this is happening in a community whose very identity is being threatened with a fortitude perhaps unmatched in history. All of this comes into that room with us, those worn chairs, that curling linoleum. In that room, it’s our job to move over and make room for all that history.

Tonight I had dinner with some longtime teachers of mine who’ve been doing Undoing Racism work for about as long as I’ve been alive. We talked about the long and inspiring history of grassroots community-run healthcare in New Orleans, most of which is unknown to me and the people I work and learn with; we talked about the importance of continuing to find and resurrect and honor our histories; we talked about student organizing within professional institutions, how it’s been students who have historically been the driving forces for substantive radical change within fields like medicine, education, social work, and law; and we talked about the importance of keeping these voices up, especially nowadays.

Toward the end of the night, one of them turned to me and said, “The best thing to me about you going into medicine is that you’re also going to be around in that institution as an educator.” This wasn’t a prediction of the future; it was a call to accountability. “That is also your job,” is what she was really telling me.

Great, I thought. I don’t know if I’m good enough at anything for people to be having those kinds of expectations of me. And I don’t know enough to be an educator! And I worry about messing up, all the time.

But whether they knew it or not, they actually hit on one of the biggest things I’ve been struggling about for the last few months, which is the sweeping sadness I’ve started to feel whenever I think that my commitment to being a doctor might take me away from my communities of people working for justice, who I rely upon so I can stay grounded, so I can exhale in that true way we relax when we get to be around people who speak our language.

No, this longtime gentle mentor was saying to me. “Our world sets things up for us so that we believe we have to make choices between things that are equally vital to us. But we don’t. You don’t have to choose between being part of a medical community and part of a social justice community. In fact, it’s your job not to choose. It’s your work to figure out how to be creative in making sure you’re doing both of those things at the same time.”

Oh, right, I thought. I knew that. And then I remembered: people have walked my path before me. People understand my struggles and see them probably much more clearly than I do. People are willing to be patient and understanding with me as I learn and grow. I started breathing again.

Sometimes it makes all the difference in the world to sit at the feet of elders. Walking home last night, I remembered something else: that human beings are totally amazing! That in the face of all those dismal and disheartening connections I was talking about earlier, that’s nothing compared to us. The world’s got nothing on us, on our ability to live and be creative about surviving and finding each other and staying connected and joining together and resisting and creating spots of beauty in the most unlikely places. Remembering those dancing grandmothers in Mott Haven last Friday, I found my hope again. I started grinning and couldn’t stop. We’ll get it, I thought. One foot in front of the other, walking through the Bronx in that dark breezy night, my smile was ear to ear.