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Renée
On finding balance when fighting the system
I’ve always fought against the system in one way or another. Even as a rebel, I’ve always been practical. These two sides of me have been in conflict and harmony at various points of my life.
I spent the first eight years of my life growing up in Jamaica surrounded by my extended family. I stepped into adulthood early on as the eldest sibling of a single mom household. I had more responsibilities than the average kid and I acted like the second parent for my younger brother by helping him learn how to read and teaching him other developmental skills such as new words or colors; I was a caregiver before I hit puberty and in many ways I never felt like I had space to dream.
On top of that, Jamaican culture has very outdated ideas around gender, and sexism is a bit more stark compared to the rest of society. For example, in school they’d separate the boys and girls and all of the girls would have to take a sewing class. I remember thinking, “Wait, boys rip their pants too so why am I here?” I resisted Jamaica’s gender norms as much as I could. I’d often get called a tomboy, but all I wanted to do was climb trees and jump off of them like everyone else. As a result, I was disciplined pretty heavily, mainly because my mom and other elders didn’t think girls should be doing stuff like that.
We had school uniforms that had white undershirts and a pink tunic for girls and I’d always come home covered in dirt. All I wanted to do was roll around on the ground and look at bugs and other cool organisms in the earth. My caregiver always yelled at me. She’d say, “Girls aren’t supposed to do this” and all I’d wonder is, “Who cares about this ugly pastel thing?” It seemed so silly for adults to get upset about clothes just because I was a girl.
One of the reasons why I love the city so much is that, quite literally, no one gives a shit about you. I’m not noticeable.
TweetWe moved to the United States, specifically Pennsylvania, when I was eight. My brother has an injury that he sustained during birth called Erb’s palsy, it’s an injury to the brachial plexus; his left arm had no range of motion. For years, he and my mother would travel back and forth to the US for healthcare. When the opportunity arose for a surgery that would address the underlying cause my mother decided that moving closer to the surgeon would make everything easier for us.
While we had a few distant relatives nearby, it was a pretty stark transition from Jamaica. I went from being in a place where almost everyone looks like me to being dropped into a predominantly White neighborhood with predominantly White schools. I struggled to adjust and I honestly still feel that way as an adult as I continue to occupy predominantly White spaces. As a kid, I did my best to blend in. This meant adjusting the music I listened to, changing how I spoke and changing my hair. I eventually reached a point where I told myself, they’re going to notice me anyways because there aren’t many folks like me here. It was the rebellious side of me coming back out and being confident enough to stop pursuing conformity.
I moved to New York City for college and that was a game changer. One of the reasons why I love the city so much is that, quite literally, no one gives a shit about you. I’m not noticeable. I can walk down the street and no one’s going to stop and look at me because I’m the darkest one there. I’m not different because everyone is different. All of this anonymity brings a sense of safety and it enabled me to release some of the mental trauma of always feeling like I needed to be on. I used to work so hard to convince people that I wasn’t the stereotype they’d framed me as. New York City helped me gain space from my past behavior and enabled me to question it. Why did I ever pretend to not like hip hop? Why did I ever feel burdened to prove that I was a person to anybody? It took me so long to realize that I'm not responsible for other people's stereotypes about me. It’s a constant battle but I now lean much more into erring on that being their problem, not mine.
As a child, I had a really big imagination and always dreamed about becoming a physician. As trivial as finances can be, they can dictate your life. My reality was that I didn’t have the financial freedom to spend 12 years in school without an income. So instead, I pursued a career that would provide stability, which led me to tech. While my career has certainly afforded me stability, I’ve set myself on a path where I’m usually one of the only Black women in the room. I’ve grown past the posturing, but the little things people do to remind you that you’re different still weigh on me mentally. We call them microaggressions, but really they’re just aggressions. It’s things like a person imitating how a Black person might speak when they speak with me (the “oh hey girlfriend!”) even when I don’t speak like that or people asking questions about my hair. For a really long time I’d just straighten my hair and leave it alone. To this day I’m deathly afraid of wearing my afro to any workplace because of the way people will behave. I’m not over the trauma associated with being in a predominantly White institution, and that feeling won’t go away for as long as I live in the United States. I’m a minority here and part of a marginalized group of people. I have to find my own source of happiness, even if there are other forces out there that are hell bent on ensuring that doesn’t happen for me.
In many ways I feel like I’ve been railing against the system my entire life. My entire existence is defined by it
TweetI’ve reclaimed happiness in various ways. My hair is now mostly in braids. I want folks to recognize and understand that I’m not my hair. Therapy has been formative in helping me unpack what happens in predominantly White spaces. I’ve dedicated energy to learning how to not be angry at all White folks as a result of my experiences, but it’s been challenging. When the experiences become predictable and begin repeating themselves it can be exhausting to keep going. So I take breaks and remind myself that I don’t have to be a “strong woman”. That phrase is often a burden that’s placed specifically on women of color and it’s unfair. It’s important for me to say, “No, I’m not a strong Black woman. I am a person, I have feelings and I get tired.” Setting boundaries with both my employers and my personal relationships has been a critical part of my journey. We’re taught that happiness can be a permanent steady state, but that’s unrealistic. Instead, I try to remind myself and others that healing is constantly happening and we’re all processing on our own timelines. The most important thing is to be ok in giving yourself space to feel a range of emotions.
As I’ve grown through these experiences I’ve begun to rethink my future. A few years ago I wasn’t fully committed to pursuing medicine but I knew that I had to at least get close to the field, so I became a volunteer EMT. I don’t get paid for that work; what matters most to me is being able to help people however I can and with whatever tools I have. I especially wanted to practice in Black and Brown neighborhoods because it’s important for folks to see people who look like them taking care of them. It puts them at ease and unfortunately there are a lot of biases associated with groups of people and how they get care. Ultimately, I just want to be one more person working towards making healthcare a bit more equitable.
I have a better sense of the problems that patients face now that I’ve been an EMT for three years. For most patients, EMTs are their first contact with any sort of medical professionals because we meet them in their homes. We can look around and see how they’re living and that really affects what their health outcomes look like. I’ve witnessed what life is like for patients experiencing homelessness, food insecurity or having limited to no access to fresh food, which all contribute to their illnesses. Diseases like high blood pressure and diabetes aren’t specific to certain communities, they just happen to affect these communities as a result of their surroundings. While I have no idea what kind of physician I’ll be, my hope is that I don’t lose the empathy that I have now for these patients when I become a doctor. Medical training is exhausting and grueling and I can see the overwhelm and fatigue of the resident physicians when I greet them in the ER. The entire healthcare system is structured this way and as a result patients don’t always receive the best care.
Sometimes inequitable care comes from the overload, but it frequently stems from bias. I regularly saw the harmful effects that implicit bias has on patients. In one instance, we were treating a sickle cell patient and my EMT partner told me, “The patient mentioned they were allergic to a few medications but they’re just saying that because they want the hard stuff.” This is often referred to as “drug seeking behavior”. That term should be relabeled as a slur and we should strike it from everyone’s language. We have literature that states the biases of doling out pain medications and here it was just slapping me in the face. To think that someone with sickle cell didn’t need proper pain medicine to deal with their disorder is unbelievable.
There were many scenarios like the one above, but there is one that will always stay with me. I arrived at a patient’s home and she had chest pain, nausea and radiating pain up her neck. I remember thinking, let me treat this person as if they’re having a heart attack. I brought her to the hospital and told the nurse what I thought was happening and then asked her to set up an EKG. They seemed hesitant and when I kept insisting they told me, “Put her in bed 8.” I pushed back and urged them to get a cardiologist but they wouldn’t do it. I had to leave but right as I left the patient grabbed me and said, “Thank you for believing me.” When I asked what she meant, she responded, “I get these pains all of the time and no one pays attention.” I almost lost it. How is it that an entire medical system has failed you? When I came back to the hospital I went to look for her to see how she was doing. I asked the nurse where she was and she told me that they’d moved her to the ICU because she was having a heart attack. She didn’t make it. There’s no reason why she should have died. When heart attacks are caught pretty early, they’re very treatable. Instead, this patient was failed by everyone; she was failed by the physicians who repeatedly ignored her, the triage nurse, the entire hospital. How could all of these people think that she’d call 911, get in an ambulance and show up at the hospital with fake pain?
If anything, these experiences have helped me realize that my dreams of becoming a physician are so much broader than a love of science. I’m actually railing against the healthcare system. In many ways I feel like I’ve been railing against the system my entire life. My entire existence is defined by it. It’s exhausting but I know I have to do something. I often wonder if I should just focus on my corner of the world and pour as much as I can into helping these people feel heard and seen or if I should invest my energy into a bigger push for legislative change. I haven’t found my answer yet, so I continue working on my personal narrative and finding balance where I can. I don’t want to kill myself doing this, but I’m passionate about fighting for long lasting change and I’ll continue to do so for as long as I can.
Thank you for reading this story from the Transcend Collection.
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Shoutouts
Medical Apartheid by Harriet A. Washington