As April begins, change is in the air. Spring has finally graced Milwaukee with multiple days of sunshine, we finally started our vegetable garden, and the city is buzzing with people emerging from hibernation.
Amidst the newness of this spring is the new reality of health care. April 1st marked the beginning of full Medicaid coverage under the Affordable Care Act in Wisconsin. This means many things to our clinic and patients. Most of our patients are now insured. This reality didn't really hit me until I started the goodbyes last week. I had been pushing people to sign up since October and repeated the speech about how they couldn't come back to the clinic hundreds of times. We can no longer care for our patients who are covered by BadgerCare (Medicaid) because we don't receive any federal payout. And, more importantly, they are now eligible for many services that we could not provide. As this process was beginning in October, I was excited and hopeful for the future of American medicine. As I hug some of my favorite patients goodbye, I feel conflicted and sad and also a little skeptical about the future.
Many patients say to me: "but Miss Abbey, my doctor is here, and you are here. I don't want to leave. Even if I do have insurance, those people don't treat me with the respect that you do here. And they don't know my story like you do."
This is one side of the coin. I can't argue with the fact that we are asking people to leave behind a familiar place they enjoy, and starting over somewhere new. And in reality, having insurance in no way guarantees you find a doctor you like or that you will be treated with respect. Like many government funded safety nets, Medicaid has it's many hoops to jump through, overused help-lines, and long waits. I still hold the belief that this will be a good change in health care policy, and that it creates necessary safety nets for the poorest people in our country. But, I still find it hard to say goodbye.
As I was falling asleep this week, I discovered another side of this coin. I struggled with how upset I was that I won't see some of my patients again. I began to explore this emotion further and realized an interesting reality about myself. On paper, I should really be happy to see them go! People I care so much about can now receive G4OVG3 surgeries, important prenatal care, dental and eye coverage, and the list goes on and on. I had spent months advocating for some of these services for people, but as I became consumed in my own emotion, I have been unable to prioritize the realities of the people I claim to serve.
I think this is an interesting reality of non-profit work. What do we do when the system we want to change actually starts to do so? We spend our days trying to give people the tools to care for themselves and advocate for themselves, but are we actually rooting for them to succeed? As I hug people goodbye, I struggle with this. I have become defined this year by my work as a nurse for people without insurance. Now they are insured. How do I fit in now? It would be naive to say that all need has been abolished by the ACA. In fact, it has created new holes and new margins that push people out. But I still struggle to define myself amidst the change.
This week is going to bring many hard goodbyes and conflicting emotions. I feel sad, but also so lucky to be able to engage with people in this period of change. My prayers turn towards the clinics that will be absorbing thousands of new patients this month. I know many people whose lives will be changed, and I am grateful for the doors that are now opened to them.
Sunday, April 6, 2014
Friday, February 28, 2014
The Challenge
My job offers me the unique gift of getting to know my patients very well. Because we see them on a 30-day schedule, I interact with most of them at least once a month, if not more. Many of them offer to me their stories of success and also of failure in health, relationships, jobs, finances- you name it, I usually hear about it. I often leave work full to the brim with the experiences of my clients. I am often left to ponder my own privilege and life experiences in the context of theirs. I spend a lot of time trying to immerse myself in this reflection personally, with my housemates, and with those I serve.
I recently decided to embark on a personal simple living challenge to explore some areas of my privilege more fully. Many of my patients live on fixed incomes. Often times the end of the month poses a challenge financially. This manifests itself in my experience in multiple ways. The food pantry and meal service that shares our space on Wednesdays is overflowing at the end of the month, many people cancel their appointments because they can't afford bus fare, and lastly I have an especially difficult time getting a hold of patients who have to turn off their phones at the end of the month because they can no longer afford to pay for the minutes.
I decided last month, as an effort in solidarity that I too would turn my phone off the last week of the month. This proved to be a much different experience than I had expected. I told most people who I talk to regularly on Monday night that they could reach me on the clinic phone or my house land-line if there was some kind of emergency. The response varied among those I told of my challenge. The response I wasn't expecting was one that asked that I do not participate in this challenge and to please keep my phone turned on. I reluctantly turned it back on and was inundated with various alerts.
My initial response was disappointment. I had been looking forward to this challenge for weeks. My next response was to think a lot about the role technology plays in making sure we are always available to people's needs. We have become a society of instant gratification..forcing ourselves and each other to be constantly connected. Is it is really neccessary? Or has it become a kind of security blanket for us to know we can always reach someone?
My last response asks me to question how I treat those people I serve whom I can't get a hold of whenever I want to. This challenge happened during a week where I had to respond to a critical issue with one of our patients. He did not have a cell phone and is living at a shelter in the city. My inability to get a hold of him right away meant I had to drive to where he was staying after hours and deliver the message in person. As I was driving there, I realized that I was really angry that I had to drive there. How interesting that I so quickly forgot what I had attempted to do this week. I was quick to think negatively of this person for not having a privilege I had become too accustomed to having.
The disappointment has worn off. I now feel empowered to change my perspective slightly and remember to remain grateful for my constant blessings and privilege.
I recently decided to embark on a personal simple living challenge to explore some areas of my privilege more fully. Many of my patients live on fixed incomes. Often times the end of the month poses a challenge financially. This manifests itself in my experience in multiple ways. The food pantry and meal service that shares our space on Wednesdays is overflowing at the end of the month, many people cancel their appointments because they can't afford bus fare, and lastly I have an especially difficult time getting a hold of patients who have to turn off their phones at the end of the month because they can no longer afford to pay for the minutes.
I decided last month, as an effort in solidarity that I too would turn my phone off the last week of the month. This proved to be a much different experience than I had expected. I told most people who I talk to regularly on Monday night that they could reach me on the clinic phone or my house land-line if there was some kind of emergency. The response varied among those I told of my challenge. The response I wasn't expecting was one that asked that I do not participate in this challenge and to please keep my phone turned on. I reluctantly turned it back on and was inundated with various alerts.
My initial response was disappointment. I had been looking forward to this challenge for weeks. My next response was to think a lot about the role technology plays in making sure we are always available to people's needs. We have become a society of instant gratification..forcing ourselves and each other to be constantly connected. Is it is really neccessary? Or has it become a kind of security blanket for us to know we can always reach someone?
My last response asks me to question how I treat those people I serve whom I can't get a hold of whenever I want to. This challenge happened during a week where I had to respond to a critical issue with one of our patients. He did not have a cell phone and is living at a shelter in the city. My inability to get a hold of him right away meant I had to drive to where he was staying after hours and deliver the message in person. As I was driving there, I realized that I was really angry that I had to drive there. How interesting that I so quickly forgot what I had attempted to do this week. I was quick to think negatively of this person for not having a privilege I had become too accustomed to having.
The disappointment has worn off. I now feel empowered to change my perspective slightly and remember to remain grateful for my constant blessings and privilege.
Monday, January 20, 2014
Repetition
It's been quite some time since I have had anything I felt was relevant or interesting enough to write a blog about and ask people to read. It's still winter, and it's always cold. I still go to work, and there's always too much to do. I come home, and still have 7 roommates. Each day feels the same as the one before it. I absorb the stories and experiences of each of them, and attempt to understand and relay them to my community.
This past week I was pushed to a breaking point at work. I felt the pressure of handling people's lives in a way I have never felt before. I didn't sleep much, as I was always thinking about something I could have done differently or a patient I needed to call and check in on the next day. I felt distant and scared and overwhelmed. But still, I felt as though each day was a carbon copy of the next. I woke up every morning knowing I would be the same kind of exhausted I was when I fell asleep the night before.
Yesterday, the Jesuit who presided the mass we attended gave me a much needed outlook on how I've been feeling the past few months. In Ignatian tradition, repetition is an essential component in prayer. A retreatant is asked to repeat words, phrases, and feelings during various parts of St. Ignatius' Spiritual Exercises. Repetition, according to Ignatius is how we:
Find God differently in the same place.
Boom. Finally some newness. This translated to me as: In the sameness of each day, find new ways to love or relate to my patients and community members. In repetition, we are able to see something more deeply or love more deeply. There are subtle differences that reveal beauty and mystery. Each day is an opportunity to perfect a skill, conversation, or teaching tool. The old saying is "practice makes perfect". Repetition is practice. Rather than dread it, Ignatius tells us to embrace it because there is always more to learn.
Find beauty/God/love/mystery differently in the same place.
This past week I was pushed to a breaking point at work. I felt the pressure of handling people's lives in a way I have never felt before. I didn't sleep much, as I was always thinking about something I could have done differently or a patient I needed to call and check in on the next day. I felt distant and scared and overwhelmed. But still, I felt as though each day was a carbon copy of the next. I woke up every morning knowing I would be the same kind of exhausted I was when I fell asleep the night before.
Yesterday, the Jesuit who presided the mass we attended gave me a much needed outlook on how I've been feeling the past few months. In Ignatian tradition, repetition is an essential component in prayer. A retreatant is asked to repeat words, phrases, and feelings during various parts of St. Ignatius' Spiritual Exercises. Repetition, according to Ignatius is how we:
Find God differently in the same place.
Boom. Finally some newness. This translated to me as: In the sameness of each day, find new ways to love or relate to my patients and community members. In repetition, we are able to see something more deeply or love more deeply. There are subtle differences that reveal beauty and mystery. Each day is an opportunity to perfect a skill, conversation, or teaching tool. The old saying is "practice makes perfect". Repetition is practice. Rather than dread it, Ignatius tells us to embrace it because there is always more to learn.
Find beauty/God/love/mystery differently in the same place.
Monday, November 18, 2013
Perspective
In my last posting I approached the topic of allowing my work days to become a "grind' or an assembly line of sorts. I've recently been thinking about this topic as it applies to other areas of my life in Milwaukee.
I had the privilege of hosting one Claire Siegel in my home for 4 days last weekend. It was not only a wonderful slice of home and love and happiness, but also forced me to have a little bit of perspective on my life here. We were talking one night about some of the nuances of community life and how we are all getting along etc, etc. I found myself in a state of discontent with the way some things were going and had a fairly negative tone to my voice. Her response to me however (after a few minutes of what I thought was complaining) was this:
"Wow, what a beautiful group of people you live with"
With a very simple statement, my perspective shifted. Isn't it true that sometimes it takes an outside voice to help you see beyond the daily habits that might annoy you or small personality traits that build up until you can't stand them anymore? With this conversation I started to notice again how beautiful indeed the people I live with are. Even in the habits that annoy me, there is so much love and intention in these people.
After this conversation, I started to notice other places where a new perspective caught me off guard. One of these places is in the changing weather in Milwaukee. It snowed for the first time last week, and I most certainly took a break from work to run around in it. It was a beautiful day that followed with sunshine and snow. Our house was freezing cold when I got home from work, and I turned the heat on as I walked upstairs and put on comfy clothes and made a cup of tea; a ritual that has become commonplace for many of us as the winter approaches. I came to work the next day and started chatting with one of my patients about how cozy the weather was. Her response to me was this:
"I'm so happy you are enjoying Wisconsin! We can't afford to turn our heat on until it gets real cold. I'm hoping I can find my grandbabies some winter coats so they can sleep."
Again, a simple statement with no hint of disdain or frustration. Just the facts. Now, I think of her each time I turn my heat on, go upstairs, and drink warm tea. I hear myself complain about being cold sometimes. It's like a habit. Weather gets cold, cue complaints. Perspective. I have heat, tea, warm clothing, warm hugs, warm food. A reminder to break that grind and live in habits of gratitude and awareness instead.
One more perspective shift to add to this mix. Climate change and natural disaster are buzz words that are thrown around often, especially with a Jesuit education. Each time destruction hits, I engage in the same pattern: Think and pray for the people affected, express frustration with global warming, and engage in the conversation about relief efforts. This year has offered a new perspective recently, starting with the typhoon that devastated the Philippines last week. One of our roommates has multiple family members who live and work in a town that experienced much devastation. The numbers suddenly became cousins, aunts, and uncles. The relief effort from our house will be funneled directly to a place where someone we care deeply about has childhood memories and people he loves. It is so easy for us to allow suffering that don't personally affect us to become a routine. I often forget that every time disaster strikes there are aunts and cousins and memories. This week has been a humbling realization that I have really never taken enough time to stop and think about what it means for a storm to wipe out a city. Even more recently tornadoes hit the Midwest and destroyed multiple towns this weekend. We were all sitting in the dining room when emergency alerts were sent to our phones and the tornado warning sirens started going off on our street. We were perfectly safe and in all honesty didn't even move to our basement or take any precautions, but it was a small reminder to keep some perspective. For many people close by, those alarms meant total destruction of their homes and neighborhoods.
Be it climate change, community life, privilege, etc., I find it difficult to approach each with a fresh sense of perspective everyday. It is extremely exhausting to allow things to affect and shape us everyday. Most of the time I'd rather let it sit in a pile and build a wall around me so I can keep moving from one thing to the next.
Here's to some fresh perspective making that pile a little smaller this month.
I had the privilege of hosting one Claire Siegel in my home for 4 days last weekend. It was not only a wonderful slice of home and love and happiness, but also forced me to have a little bit of perspective on my life here. We were talking one night about some of the nuances of community life and how we are all getting along etc, etc. I found myself in a state of discontent with the way some things were going and had a fairly negative tone to my voice. Her response to me however (after a few minutes of what I thought was complaining) was this:
"Wow, what a beautiful group of people you live with"
With a very simple statement, my perspective shifted. Isn't it true that sometimes it takes an outside voice to help you see beyond the daily habits that might annoy you or small personality traits that build up until you can't stand them anymore? With this conversation I started to notice again how beautiful indeed the people I live with are. Even in the habits that annoy me, there is so much love and intention in these people.
After this conversation, I started to notice other places where a new perspective caught me off guard. One of these places is in the changing weather in Milwaukee. It snowed for the first time last week, and I most certainly took a break from work to run around in it. It was a beautiful day that followed with sunshine and snow. Our house was freezing cold when I got home from work, and I turned the heat on as I walked upstairs and put on comfy clothes and made a cup of tea; a ritual that has become commonplace for many of us as the winter approaches. I came to work the next day and started chatting with one of my patients about how cozy the weather was. Her response to me was this:
"I'm so happy you are enjoying Wisconsin! We can't afford to turn our heat on until it gets real cold. I'm hoping I can find my grandbabies some winter coats so they can sleep."
Again, a simple statement with no hint of disdain or frustration. Just the facts. Now, I think of her each time I turn my heat on, go upstairs, and drink warm tea. I hear myself complain about being cold sometimes. It's like a habit. Weather gets cold, cue complaints. Perspective. I have heat, tea, warm clothing, warm hugs, warm food. A reminder to break that grind and live in habits of gratitude and awareness instead.
One more perspective shift to add to this mix. Climate change and natural disaster are buzz words that are thrown around often, especially with a Jesuit education. Each time destruction hits, I engage in the same pattern: Think and pray for the people affected, express frustration with global warming, and engage in the conversation about relief efforts. This year has offered a new perspective recently, starting with the typhoon that devastated the Philippines last week. One of our roommates has multiple family members who live and work in a town that experienced much devastation. The numbers suddenly became cousins, aunts, and uncles. The relief effort from our house will be funneled directly to a place where someone we care deeply about has childhood memories and people he loves. It is so easy for us to allow suffering that don't personally affect us to become a routine. I often forget that every time disaster strikes there are aunts and cousins and memories. This week has been a humbling realization that I have really never taken enough time to stop and think about what it means for a storm to wipe out a city. Even more recently tornadoes hit the Midwest and destroyed multiple towns this weekend. We were all sitting in the dining room when emergency alerts were sent to our phones and the tornado warning sirens started going off on our street. We were perfectly safe and in all honesty didn't even move to our basement or take any precautions, but it was a small reminder to keep some perspective. For many people close by, those alarms meant total destruction of their homes and neighborhoods.
Be it climate change, community life, privilege, etc., I find it difficult to approach each with a fresh sense of perspective everyday. It is extremely exhausting to allow things to affect and shape us everyday. Most of the time I'd rather let it sit in a pile and build a wall around me so I can keep moving from one thing to the next.
Here's to some fresh perspective making that pile a little smaller this month.
Tuesday, October 15, 2013
The Grind
There are many reasons I haven't taken some time to blog lately, but the one that seems to have hindered me the most is that I have felt completely exhausted lately. Physically and emotionally drained. I come home from work and sit down with the intention of never standing again. I have recently said I will never ever make fun of my dad for falling asleep on the couch every single night (sorry, Dad!) because now I get it.
Last week felt more exhausting than most. I saw more patients in a day than I ever thought was physically possible in our tiny clinic. I was here extra long hours and felt like all I was doing was working, sleeping, and eating. My boss took me out for brunch Thursday (the best boss), and confronted my fatigue head on. He said something along these lines:
"Abbey, you've let it become a grind. You see patients and just want to keep them moving and get the next one ready."
He was referring especially to a conversation he overheard between me and one of my favorite patients in which she was sharing with me some really difficult news that she had received that weekend. I was unable to engage with her, because I was so exhausted that I was barely listening. I was initially taken aback by his statement thinking. "How the heck do you expect me to engage with everyone when we see 50 people in one day??" But as I thought about it the next day at work and over the weekend, I realized how true it really was.
I'm currently reading, Tattoos on the Heart, an account of gang life in LA as told by a Jesuit priest Fr. Gregory Boyle. The chapters are full of stories of his work with current and former gang members and the neighborhoods of LA. He tells the story of one girl who had been locked up for awhile and was really difficult and gave him loads of attitude. She comes to his office one day and he recollects a certain sense of annoyance that he felt that she was there. She began to tell him a story, at this point I don't really remember what it was about, and as she is talking begins to feel shame because he had seen her as an interruption to his day.
How true is it that often times our days become a series of assembly lines and to-do lists. We grumble at the people who interrupt our routine and make us stray from this path we have created with the idea that it is the best and most productive way to get us out of work and back home to the couch. This is how we let our days become a grind. This is how we let fatigue take over and put our bodies into autopilot.
This week I have attempted to slow down and re-engage. Allow conversations with patients to last longer than I think they should. Let charts sit in a stack for 5 more minutes so I can ask someone about their day, and actually hear the response. I feel much less tired today. Part of it is that I sleep better at night, but more importantly I think it's because I spend less energy fighting off the "interruptions" in my day. My conversations feel more genuine, and for that reason, much more life-giving and energizing.
Here's to fighting the grind this week and every week. Because in reality, what's more important than building relationships and having genuine interactions? Certainly not my couch or the nap I've been dreaming about that's for sure.
Last week felt more exhausting than most. I saw more patients in a day than I ever thought was physically possible in our tiny clinic. I was here extra long hours and felt like all I was doing was working, sleeping, and eating. My boss took me out for brunch Thursday (the best boss), and confronted my fatigue head on. He said something along these lines:
"Abbey, you've let it become a grind. You see patients and just want to keep them moving and get the next one ready."
He was referring especially to a conversation he overheard between me and one of my favorite patients in which she was sharing with me some really difficult news that she had received that weekend. I was unable to engage with her, because I was so exhausted that I was barely listening. I was initially taken aback by his statement thinking. "How the heck do you expect me to engage with everyone when we see 50 people in one day??" But as I thought about it the next day at work and over the weekend, I realized how true it really was.
I'm currently reading, Tattoos on the Heart, an account of gang life in LA as told by a Jesuit priest Fr. Gregory Boyle. The chapters are full of stories of his work with current and former gang members and the neighborhoods of LA. He tells the story of one girl who had been locked up for awhile and was really difficult and gave him loads of attitude. She comes to his office one day and he recollects a certain sense of annoyance that he felt that she was there. She began to tell him a story, at this point I don't really remember what it was about, and as she is talking begins to feel shame because he had seen her as an interruption to his day.
How true is it that often times our days become a series of assembly lines and to-do lists. We grumble at the people who interrupt our routine and make us stray from this path we have created with the idea that it is the best and most productive way to get us out of work and back home to the couch. This is how we let our days become a grind. This is how we let fatigue take over and put our bodies into autopilot.
This week I have attempted to slow down and re-engage. Allow conversations with patients to last longer than I think they should. Let charts sit in a stack for 5 more minutes so I can ask someone about their day, and actually hear the response. I feel much less tired today. Part of it is that I sleep better at night, but more importantly I think it's because I spend less energy fighting off the "interruptions" in my day. My conversations feel more genuine, and for that reason, much more life-giving and energizing.
Here's to fighting the grind this week and every week. Because in reality, what's more important than building relationships and having genuine interactions? Certainly not my couch or the nap I've been dreaming about that's for sure.
Tuesday, October 1, 2013
An Education
Today is October 1st which means two very important things in my life. Number 1: My favorite month has just begun and the leaves are changing colors which made my walk to work this morning extremely enjoyable. The calendar is already full of fall activities and outings. Also, my house is decorated for Halloween (thanks lyss), so again, October is starting out on the right foot.
Number 2: Today, is the beginning of the new fiscal year which means many things for many people, but I'll just focus on how it affects my reality on this Tuesday. At Bread of Healing, we are starting to get our patients signed up for insurance under the Affordable Care Act. We have two full-time staff people newly trained and poised to begin this process when the clinic opens in half an hour. I entered the office today to a flurry of "Happy insurance day!" and physicians with smiles plastered on their faces. A sense of hope is palpable amongst all our staff and many of our patients. We have flyers and power points and other educational material ready to hand out as the questions come flooding in today. In light of recent events in Congress, I imagine that today will be FULL of questions, concern, confusion, hope, excitement, promise, the list goes on and on. Many of the most vulnerable in our midst will gain some form of a safety net starting today if things go as previously planned. There is much to discuss, and be excited about...but for me there is much more to learn.
As the day begins, I am stuck on a conversation that I had with a patient yesterday. It was nearing the end of the day and he was waiting to see a doctor, so I sat down in the room with him to chat for awhile. We talked about what's happening in the news as we usually do, and he started telling me about the information session he went to about the new insurance exchanges in Wisconsin. I sat and listened for awhile, before I realized that I knew VERY little about what he was telling me. His monthly income qualifies him to sign up for the exchanges with co-pays, and he was expressing some frustration about the lack of information he was given about just how much he would have to pay, and how everything would really work. I tried my best to contribute to the conversation, but I was really lost. The questions came flooding in:
"So Abbey, explain this to me, they want me to give up my free care here and buy into something that half of the government doesn't even agree with or face some kind of a tax penalty? Does that seem fair to you?"
"How much is this actually gonna cost me?"
"Is it true that my premium will cost me more because I live in Milwaukee county where there is more trauma like gun shots and gang violence? Are they really gonna tell all the poor people in this city that they should pay more than those people in the suburbs?"
And lastly, "Why aren't you answering me? You don't know?"
Bingo. I don't know. I'm a well-educated healthcare professional who is struggling just as much as my patients to understand these changes. Here's a tip to all of you Seattle U nursing students- ask your professors why this is never talked about in school. We are taught how to work in a system without ever being taught how the system works. We discharge patients all the time without a thought as to where they might be getting their medications when the ones we send them home with run out. Here I was expected to know how to help someone understand their reality and I really just didn't know.
Yesterday, I was very humbled by the fact that I am not that well-equipped for today. I don't have all the answers. In fact, many of my patients have been educating me in the past few weeks. Granted I have spent loads of time reading and trying to understand everything myself, but still anticipate today will be full of: "I'm sorry (insert name here) I wish that I had a better answer for you."
As classes get going this week in Seattle, I am left to reflect on the reality of my education. What I learned in a classroom is a foundation for many things that I do during the day, but has still left me extremely unprepared for the reality in which most of my patients live and receive healthcare. I will work very hard today to teach and serve to the best of my abilities while acknowledging that constant nagging feeling that reminds me that I still have so much to learn and be taught. I sit full of hope as the clinic chatters with change today.
Happy October 1st. I hope we all learn something from the events of today and remember the people whose voices aren't heard in the decisions of many who are trusted to represent them.
Number 2: Today, is the beginning of the new fiscal year which means many things for many people, but I'll just focus on how it affects my reality on this Tuesday. At Bread of Healing, we are starting to get our patients signed up for insurance under the Affordable Care Act. We have two full-time staff people newly trained and poised to begin this process when the clinic opens in half an hour. I entered the office today to a flurry of "Happy insurance day!" and physicians with smiles plastered on their faces. A sense of hope is palpable amongst all our staff and many of our patients. We have flyers and power points and other educational material ready to hand out as the questions come flooding in today. In light of recent events in Congress, I imagine that today will be FULL of questions, concern, confusion, hope, excitement, promise, the list goes on and on. Many of the most vulnerable in our midst will gain some form of a safety net starting today if things go as previously planned. There is much to discuss, and be excited about...but for me there is much more to learn.
As the day begins, I am stuck on a conversation that I had with a patient yesterday. It was nearing the end of the day and he was waiting to see a doctor, so I sat down in the room with him to chat for awhile. We talked about what's happening in the news as we usually do, and he started telling me about the information session he went to about the new insurance exchanges in Wisconsin. I sat and listened for awhile, before I realized that I knew VERY little about what he was telling me. His monthly income qualifies him to sign up for the exchanges with co-pays, and he was expressing some frustration about the lack of information he was given about just how much he would have to pay, and how everything would really work. I tried my best to contribute to the conversation, but I was really lost. The questions came flooding in:
"So Abbey, explain this to me, they want me to give up my free care here and buy into something that half of the government doesn't even agree with or face some kind of a tax penalty? Does that seem fair to you?"
"How much is this actually gonna cost me?"
"Is it true that my premium will cost me more because I live in Milwaukee county where there is more trauma like gun shots and gang violence? Are they really gonna tell all the poor people in this city that they should pay more than those people in the suburbs?"
And lastly, "Why aren't you answering me? You don't know?"
Bingo. I don't know. I'm a well-educated healthcare professional who is struggling just as much as my patients to understand these changes. Here's a tip to all of you Seattle U nursing students- ask your professors why this is never talked about in school. We are taught how to work in a system without ever being taught how the system works. We discharge patients all the time without a thought as to where they might be getting their medications when the ones we send them home with run out. Here I was expected to know how to help someone understand their reality and I really just didn't know.
Yesterday, I was very humbled by the fact that I am not that well-equipped for today. I don't have all the answers. In fact, many of my patients have been educating me in the past few weeks. Granted I have spent loads of time reading and trying to understand everything myself, but still anticipate today will be full of: "I'm sorry (insert name here) I wish that I had a better answer for you."
As classes get going this week in Seattle, I am left to reflect on the reality of my education. What I learned in a classroom is a foundation for many things that I do during the day, but has still left me extremely unprepared for the reality in which most of my patients live and receive healthcare. I will work very hard today to teach and serve to the best of my abilities while acknowledging that constant nagging feeling that reminds me that I still have so much to learn and be taught. I sit full of hope as the clinic chatters with change today.
Happy October 1st. I hope we all learn something from the events of today and remember the people whose voices aren't heard in the decisions of many who are trusted to represent them.
Monday, September 16, 2013
Getting used to it.
In the space between this post and the last, I have had a very difficult time sorting out how I'm feeling, what is interesting to share, what should be kept to myself, and in the end- what is most necessary for people to know.
Something that has been on my mind a lot lately is the experience of being a woman in Milwaukee. I have grown up and been educated in such a way that I have rarely ever felt held back by my gender. In fact, most of my life it has been just the opposite. I spent a lot of time in college reflecting on the systems of privilege and oppression that are acting in my life (shout out Nick Cubita), but that introspection has taken a very different journey in Milwaukee.
In Seattle, I grew accustomed to taking long walks or drives in my neighborhood at any time of day. I could walk one block and sit in a clean and safe park where I could sit and stare at the sun setting behind the Olympic mountain range. In Milwaukee, I feel uncomfortable walking outside alone at any time of day, and there are no clean parks in sight. I get to work about an hour early most days because it is when I can travel safely with one of my boy roommates. The short walk I take alone between our service sites is frequently interrupted by catcalls or even a car pulling over encouraging me to get in. Keep in mind this is all around 8am on a beautiful autumn day. The frustration in knowing that I can't walk anywhere alone in the area around my house or my job is crippling. I have always coped with the stress of life by walking and thinking and reading in parks. This year, I am almost completely dependent on other people to accompany me in activities that have become intimately connected with the core of who I am. The stubborn side of me likes to push the limits of this dependency and escape alone into our neighborhood. Each time I have been forced home by the uncomfortable feeling that I am extremely vulnerable.
This reality is shocking to me. Every morning and afternoon I have to plan my commute home around someone else. I can't walk to the grocery store to pick up something we forgot for dinner. I am a proud and independent woman who has had to swallow a big piece of humble pie and admit that I need other people to keep me safe. Aside from my stubbornness, admitting to this reality has forced me to think long and hard about the reality of human relationships. Coming into this year, I was looking forward to engaging with a new community and neighborhood. I never once thought that there would be people who didn't really want to engage with me. It has taken me about this long to think that it is okay to pay attention the feeling in my gut that says, "Abbey you aren't safe here". That doesn't have to mean that I am furthering stereotypes or not giving a person a fair chance. It means that I am paying attention to the reality of my situation.
This isn't to say that there aren't wonderful parts about our neighborhood like our next door neighbor who weeds our lawn and brings us tomatoes. It also doesn't mean that Milwaukee is a terrible place to be. It is a beautiful city with so much culture and history.
It is a constant struggle to give up parts of my independence. It feels almost as though I am giving up parts of who I am and coping skills that I have spent so long perfecting. I get so angry every time one of the boys leaves the house alone and walks to the gym or to play basketball. I want to believe that time and some TLC will make me immune to the reality that I am held back by part of my identity that I have been raised to be proud of. But, everyday when I cross into the four blocks surrounding our house, I still get a sinking feeling in my stomach. I remember walking in silence with my roommate one day last week and crossing that threshold. He broke the silence of my thoughts by looking around and saying, "I don't think I'm ever going to get used to this."
At first, I was saddened by that thought, but after a couple of blocks, I was energized by it. We aren't supposed to get used to it. Our discomfort should be a foundation for conversation and change, not something we get used to. I don't live in fear or anger at my reality, but committed to it. Like I said, this is one of those things that I felt was necessary to share. It is hard to talk about because I don't want to take away from the wonderful parts of our neighborhood and community as there are many, but it is important to pay attention to feelings of discomfort too.
This city has already opened my eyes and heart to realities I didn't know existed. Here's to hoping that I never get used to any of them. .
Something that has been on my mind a lot lately is the experience of being a woman in Milwaukee. I have grown up and been educated in such a way that I have rarely ever felt held back by my gender. In fact, most of my life it has been just the opposite. I spent a lot of time in college reflecting on the systems of privilege and oppression that are acting in my life (shout out Nick Cubita), but that introspection has taken a very different journey in Milwaukee.
In Seattle, I grew accustomed to taking long walks or drives in my neighborhood at any time of day. I could walk one block and sit in a clean and safe park where I could sit and stare at the sun setting behind the Olympic mountain range. In Milwaukee, I feel uncomfortable walking outside alone at any time of day, and there are no clean parks in sight. I get to work about an hour early most days because it is when I can travel safely with one of my boy roommates. The short walk I take alone between our service sites is frequently interrupted by catcalls or even a car pulling over encouraging me to get in. Keep in mind this is all around 8am on a beautiful autumn day. The frustration in knowing that I can't walk anywhere alone in the area around my house or my job is crippling. I have always coped with the stress of life by walking and thinking and reading in parks. This year, I am almost completely dependent on other people to accompany me in activities that have become intimately connected with the core of who I am. The stubborn side of me likes to push the limits of this dependency and escape alone into our neighborhood. Each time I have been forced home by the uncomfortable feeling that I am extremely vulnerable.
This reality is shocking to me. Every morning and afternoon I have to plan my commute home around someone else. I can't walk to the grocery store to pick up something we forgot for dinner. I am a proud and independent woman who has had to swallow a big piece of humble pie and admit that I need other people to keep me safe. Aside from my stubbornness, admitting to this reality has forced me to think long and hard about the reality of human relationships. Coming into this year, I was looking forward to engaging with a new community and neighborhood. I never once thought that there would be people who didn't really want to engage with me. It has taken me about this long to think that it is okay to pay attention the feeling in my gut that says, "Abbey you aren't safe here". That doesn't have to mean that I am furthering stereotypes or not giving a person a fair chance. It means that I am paying attention to the reality of my situation.
This isn't to say that there aren't wonderful parts about our neighborhood like our next door neighbor who weeds our lawn and brings us tomatoes. It also doesn't mean that Milwaukee is a terrible place to be. It is a beautiful city with so much culture and history.
It is a constant struggle to give up parts of my independence. It feels almost as though I am giving up parts of who I am and coping skills that I have spent so long perfecting. I get so angry every time one of the boys leaves the house alone and walks to the gym or to play basketball. I want to believe that time and some TLC will make me immune to the reality that I am held back by part of my identity that I have been raised to be proud of. But, everyday when I cross into the four blocks surrounding our house, I still get a sinking feeling in my stomach. I remember walking in silence with my roommate one day last week and crossing that threshold. He broke the silence of my thoughts by looking around and saying, "I don't think I'm ever going to get used to this."
At first, I was saddened by that thought, but after a couple of blocks, I was energized by it. We aren't supposed to get used to it. Our discomfort should be a foundation for conversation and change, not something we get used to. I don't live in fear or anger at my reality, but committed to it. Like I said, this is one of those things that I felt was necessary to share. It is hard to talk about because I don't want to take away from the wonderful parts of our neighborhood and community as there are many, but it is important to pay attention to feelings of discomfort too.
This city has already opened my eyes and heart to realities I didn't know existed. Here's to hoping that I never get used to any of them. .
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