So my five year old came home about a week and 1/2 ago and said to me, Mama, I learned today that long time ago people couldn't be friends with each other based on the color of their skin.
And so she said that it made her really sad because that means she could be friends with her bestie.
So she put her hand immediately next to mine and sighed with relief, because we're pretty similar in color.
And then I looked at her and I told her how stupid that kind of thinking was.
Now, before you judge my parenting, I you stupid deliberately.
That's the S word in our family.
And so I told her how her dad and I wouldn't have been allowed to get married, that we would have had any kids, and she and her sister wouldn't even exist today.
And so she teared up and said, That makes my heart really sad, and it brings tears to my body.
And then she whispered, I'm really glad it was a long time ago, because it's too.
Even a five year old can understand that that's the dumbest thing to come between people.
Yet somehow we've managed to make a culture of it.
Structural racism is like an invisible force that has spread its poison through every conceivable part of society, including health care.
Yet health care professionals are not trained consistently to understand the impact racism has on health was.
Yet we're not even having that conversation.
And so for starters, equity and equality are not the same thing.
It kind of challenges the very foundation of where we grew up, where we've learned that everybody should be treated the same way.
Equality means applying the same rules for each person, and that makes us just and fair people.
The idea of equality does call for that.
But equity talks about meeting people where they are that there could be things inherently different about individuals that are beyond their control.
And so the idea about health equity means that any person should be able to attain the highest level of health, regardless of their social position or any other socially determined factor.
We know, however, through a large body of evidence that social determinants of health, so places where we live, eat, work and play all have a huge impact on her health and part of the reason this exists is because in this country, unfortunately, we've had a pretty long history of some pretty racist policies all the way from 3/5 of a human to suppose that emancipation after the Civil War, Jim Crow laws, redlining and de segregation in schools, all of this has seeped into the fabric of the health of our communities.
For example, infant mortality rates in black women living in the U.
Versus white women are twice as high.
And so what's interesting is that even after researchers have adjusted for socioeconomic status, these disparities keep showing up.
What I find interesting is that African women coming to the U.
Have pretty comparable infant mortality rates to those of white women.
And so it begs the question.
When we students start seeing these disparities through other things, like heart disease or life expectancy, what are we to do is health care professionals and when health care professionals air ignorant to this, they make recommendations that really aren't helpful to patients.
So they tell you to make healthier lifestyle choices, not recognizing that one patients choices who has maybe mostly fast food restaurants accessible to them in their neighborhood and one supermarket are very different from another patient who can choose between a very $11 Bujji water from Whole Foods and other gourmet markets in their neighborhood.
Whatever we don't struggle with becomes invisible to us.
And so how do we bring these conversations?
Thio places where they're not existing.
How do we break down the barriers so these conversations can take place at all?
So I've been doing this work a long time before this topic became sexy, and what I realized was that when I talk about structural racism, most people sort of just withdraw into their own insecurities about looking or feeling like a racist.
And they resist these conversations and overcoming resistance.
To have really honest and brave conversations means creating spaces so that we can show up with our most authentic sells and examine our own troops and confront our own assumptions.
And so in pursuit of this, if I want my students to be responsible, clinicians understand structural racism in equities, implicit biases.
I need to create the environment that allows them to show up and have these conversations, and so we talk.
We talk about all sorts of privilege.
We talk about internalized racism and a lot of other triggering words that I don't have time to get into right now.
But in pursuit of that, I have learned three truths about myself.
I make people very uncomfortable.
I dropped words like racism and white privilege in casual conversations about game of Thrones or mass incarceration.
Super light topics.
I also make them cry mostly through good things and powerful transformations, and I model vulnerability again before it became cool.
And so what I realize in pursuit of this is something that I call the dark room methodology an iterative process of self examination where we create the space and time to confront our own truths.
So photography, like art.
There's no absolute truth in art each artists or to see something they experience something, and based on their own experience, they go to the dark room and develop a photograph.
Now, in this dark room is when they start seeing that perhaps they wanna overexpose some detail or underexposed detail.
They can control that.
They may also see some blemishes and imperfections.
Some may be good and very artistic and some not so desirable.
Similarly telling your story or owning your narrative is an art, but you can't tell a story unless you realize what it iss.
And for this, the dark room serves as a reflection piece.
My students can enter the dark room and understand that their life is a series of photographs, not just one stagnant picture.
And the circumstances that created these photographs can often be complicated.
And so in the dark room you come to recognize and appreciate those blemishes, learn from what they are and discover what truth emerge.
You can see that your life is a collection and evolution of sorts, from where you've come to where you are, all the narratives and the thinking.
That kind of shape your brain and shape your experiences that that's how you see the world today and the people in it and in the dark room.
You also realize that this process is not perfect.
You might revert back to a technique you may have mastered some, but not so much so others that you cannot change the photographs of the past, but you may be able to do something about the ones in the future, And so in my own darkroom I've unpacked a lot as the first generation immigrant moving to the U.
Growing up in Washington Heights before it was a hit musical.
Thank you, Lin Manuel Miranda.
I learned that it was okay for me to blend in the culture I was born into and the culture I grew up in.
They called me the nd recon slash In Dominican, I learned that it was okay to be me and be the generic brown women who learns how to navigate through circumstances, blending in wherever I can but also speaking up, even if I'm the only voice in the room.
I've learned that it's okay to be scared that my brother once again was going to get shoved up against the wall and interrogated for something he did not do just because he's brown.
I've also learned that I as much as I made it in life that people around me looked very different and felt very different.
And sometimes my voice was crushed and sometimes my voice was emboldened.
I've learned that when I navigate these circumstances on fear of being deported or arrested somehow for something I didn't do that it was okay for me to embrace this feisty attitude and this bold attitude that I have, and for that I have created an amazing amount of mentors and friends from around the world who still support me to this day.
When I go to my dark room, I go to them no matter what, how many years I've been teaching or how many years I've lived on this Earth.
I go to them with my own vulnerabilities because that's my support network.
And as an educator, I offer that to my students and my students I hope, will pay it forward.
They will attest to the fact that when I bring them into these conversations, I challenge them pretty explicitly.
I challenge them to confront their own ISMs, their own vulnerabilities, their own biases.
And from my white students, this means really having tough conversations, unpacking what white privilege is what it's meant for them, what it means today and how they want it to mean for them in the future.
You see, before you do any critical reflection.
Structural racism is just a concept.
It's very easy for it to be impersonal, for to have no value or meaning for people.
But if I want my students to be responsible conditions of tomorrow.
I need them to have these brave conversations.
I need them to talk about this and confront their own truths.
And for this and very deliberate in creating some of the brave spaces where we have these discussions.
And what I found is that when I do this, there's some factors that air supercritical toe having this conversation.
My students are provided with a judgment free zone.
See, my students know that when they come in to have conversations with me about vulnerability, that they're at liberty to speak their minds.
And so I create that space for vulnerability, vulnerability for them.
If I want my students to be able to feel, I need to show them that I also feel.
And so we discuss very frankly about the way I grew up about the way my students have grown up.
All of our unpacking in the dark room blemishes and all vulnerabilities welcomed, and it allows us to embrace vulnerability as a strength so that we continue to show up, as are most authentic Selves consistently in every plan behavioral theory in public health, The one thing you'll keep hearing is self efficacy and you can see history for this.
Yes, we can the idea that if change is goingto happen on an individual level, somebody needs to really believe it.
And so I use positive psychology to bring my students into this conversation.
I tell them the truth.
I don't lie to them, but I show up with compassion, and sometimes those truths can hurt.
But I need to make sure that I'm there to support them through this dark room because otherwise they will not evolve with that process.
I also tell my students to embrace a lack of closure.
Racism was not built in a day, and we certainly won't be tearing it down in one.
But what we need to know is how we can steer this conversation for the future so that it's in our control to move this forward and that discomfort that my students feel I tell them to embrace it, cause discomfort is where growth and learning happen.
The most important thing that I've learned in creating this brave space for my students is that I not only need to accept but actually encourage failure, and mistakes are students get judged on a lot of things, and this is not a space where I want that to happen.
I ask my students to show up and they can say incorrect things by creating the space.
They're more likely to feel it, evolved with it and actually be able to correct it.
Better yet, they catch it in themselves and in others.
The most beautiful part of this journey has been that my students have started speaking up in spaces where sometimes they're the only voice and in spaces where they never spoke up before and it has been incredibly powerful to see this transformation.
Now, you can imagine, as we have these vivid conversations, things were gonna come up that you don't want to hear, and sometimes we're gonna have really strong reactions to it.
I've had students tell me I don't want to be white, and any Brown person would like.
I'll take it.
I've had students tell me that I didn't get anything handed to me.
I've worked really hard, so I don't know how to grapple with this cognitive dissonance.
I've had students be scared to bring this up with their families where they can't have an open conversation about this, fearing that maybe they'll discover something about their family.
They don't want to.
I've had students come to me and feel helpless, like I'm only one person.
How am I gonna do anything about this stuff?
And so my favorite is when my students come with that fear.
I promise I'm really not racist.
And all of these statements, these sentiments stem from a place of insecurity and fear.
And like all teachers, I remind my students in a dark place.
We find ourselves in a little more light and knowledge a little more knowledge lights the way I have to remind her students that were all part of a collective that's bigger than ourselves, part of a revolution of sorts.
The resistance, perhaps.
And I have to remind them that rather than letting the darkness and fear alienate us, we need to connect with it and feel it and evolve with it so we can consider how to bring out our own light that connects with our humanity.
And only then can we actually start dismantling some of the structural racism and start having conversations that don't talk about encouraging people to beat the odds Let's change the odds in the first place.
So although my past has taught me that we need to talk about equality and currently we talk about equity for our future, five year olds are Children or society or community.
The patients that we serve to truly do that, let's actually talk about breaking down those barriers all together so we can actually move towards liberation.