Gratitude and Health Justice

Lightly edited 1/16/17.

There’s a lot of injustice in the world. For example, one of the side effects of my chemo cocktail is crazy dreams–malaria-level dreams–and yet in these dreams, I imagine I’m at faculty committee meetings. Truly, that is injustice.*

Fine. There are deeper injustices than that. And today, I realized I have different threads of thought running through my mind, and it turns out they are woven together.

I have been thinking a lot about gratitude. And about Dr. King.

Gratitude: I’m always grateful for the love of the good people in my life. But it’s usually a sort of steady, abiding awareness, not a bomb cyclone of gratitude. I have been aware of feeling actually physically lifted by the incredible outpouring of love, and while every fiber of my being wants to say “I’m NOT WORTHY,” the truth is we are all worthy of it. So instead of deflecting, I’m basking in it, and am deeply, deeply grateful. I’m facing a few months of grossness (hopefully wrapping the cancer cruise up by mid-summer), but I’m facing it with a mom who brings me my favorite pillow from her home, a husband who cheerfully brews me a fresh pot of coffee even when we both know I’ll only have one sip of it, a daughter who has perfected the exuberant gentle hug, a mother-in-law who is making an afghan, friends who make me jigsaw puzzles or make me laugh or both (and some friends who let me lose at Trivial Pursuit even when each victory could be my last and they should let me win because cancer). I have clients praying for me–and one client’s mom is praying for me from her own hospital bed in France. I have students reminding me of all the good that is being done in the world. I have colleagues who are letting me focus on my health and allowing me to work only to the extent it’s good for me.

So much gratitude. And so much awareness that it’s not like this for everyone. The love and support transcend class and race, for sure. One of Dave and my favorite moments of the cruise so far involved an older gentleman wearing a cap that Dave thought was  armed services -related, and he struck up a conversation with the man. (Side note: when Dave goes away for unexpectedly long times, he is always, literally always, having a fascinating conversation. Will tell about the poitín-maker another time.) Anyway, it turned out the cap was from a very old African-American congregation, and they chatted, and the man talked about how much he loved his wife who is going through the same cancer as me, and how he had been to every appointment over the past year, and when his wife showed up a few minutes later, the man just glowed.  So love and support transcend all.

But more practical things do not. And my treatment is in a city hospital where, despite the greatness of Chocolate City and the Gold Coast and Howard and Duke Ellington and more, poverty is highly racialized, and even in the legal profession, white salaries are a shocking $35,000 higher than African-American salaries.

The cancer I have is most common among African-American women. And as I look at the warm waiting rooms where I get my treatments, racial disparities smack me upside the head on a regular basis.  Health outcomes for African-American women are so much worse, across the board, than for white women. I’m no expert on this, but Lindsay Wiley is, and she has written compellingly about how health law is a social justice matter. (Lindsay is one of those brilliant people you can trust because she is also incredibly funny.) (It is possible my indicia of trustworthiness are a little weird, to be fair.)

Anyway, my own personal observations are these:

  • Good outcomes depend upon being able to access care. Insurance? Check. Transportation to medical centers? Check. Ability to wait around for a prescription to be filled? Check. I have all these things, easily, but I suspect each of these is a challenge for some of the women I share these waiting rooms with.
  • Good outcomes benefit from being able to rest and work less. Medical leave? Got it. Flexible work schedule? Oh yes. Colleagues who can pick up my slack? Yep. Family and friends pitching in so there are just plain fewer chores to do? Yep again. But medical leave is too much of an exception in our workplaces, and paid sick leave continues to be a legislative battle, even in friendly, progressive jurisdictions. So people like me who can rest and let the medicine do its work are going to do better than people who cannot take time off work.
  • Good outcomes probably benefit from education, and definitely benefit from language access. Doctors give patients a lot of paperwork. I love paperwork. It’s an excuse to buy a binder and fancy tabs, and do some hole-punching. It’s a justification for making spreadsheets which, next to planning and hole-punching, is my major hobby. [I need better hobbies.] But it’s a mountain of information, and a daunting amount to read–and it’s just got to make a difference that processing information is what I do for a living, that reading is a joy and not a burden. And that I speak English. While most of my sisters are African-American at Washington Hospital Center, there are a fair few Latinas whose first language is Spanish and whose English ability varies a ton. Yes, they have a right to interpreters and translated information. But I know those rights are unevenly realized, and sometimes, when they’re tired–and we’re all tired–I bet they just go along to get along and take the incomprehensible sheafs of papers in English.

I don’t assume everyone I see at Washington Hospital Center is poorer than me. I only know the stories of a few of the women I’ve talked to, and mostly we talk about family. Most of the women dress better than me, for starters (admittedly not difficult since I wear Takoma Park “fashion”) and the parking lot is plenty full of cars I could never afford. But poverty is also everywhere, and I would be foolish to wish it away. So all my gratitude is accompanied by profound appreciation for the things that I have that make this easier for me than for many others.

So, Dr. King. We remember him often as the visionary. And he was. But he was also fiercely unpopular in his day for demanding justice. Not something better, but something equal, something that respected the inherent worth we each have as individuals, no matter our station in life. For people who approach the world as zero-sum, where African-Americans being treated as fully human means white people actually lose something, that idea was toxic. And he died for that idea. Sometimes I think we forget that. He’s moved into a realm of inspirational quotes, and away from the ugly reality of that motel balcony in Memphis, where someone hated him enough to kill him. Hated him because of Dr. King’s love of humanity.

I went to Mass yesterday (let’s call it an unexpected port excursion on the Chemo Cruise), and Father Patrick Smith brought me to tears with his words about how Dr. King answered the call with “your servant is listening.” How none of this–the national holiday, the monument, the Nobel Prize–was part of his plan. He just listened to a call, said yes to it, and changed his plan to follow the call. And changed us all in the process, making us want justice to roll like waters. Father Smith asked us to listen and say yes, too. And that whether it results in greatness or some beautiful tiny thing that we never even understand happened because of us, that is how we move forward.

All I can do is be grateful for what I have. And heed the needs so many others have. And say yes to finding small, tiny ways–and maybe big ones if that’s how it goes–to bend the arc toward justice. I’m used to doing that when it comes to immigration law. It’s new for me as I think about health. But I’m listening. I’ll learn. And because Dr. King said yes, I’ll keep finding ways to say yes, too.

Today, and every day, let justice roll like waters.


*Small exception when the dreams involve the dream committee of Margaret, Natalie, Garrett, Audrey, Will, Dave, Chris, and Mike–people I spent 12 hours a day in a room  with more than once this fall, and still adore.

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