Discerning a Life Committed to Health Equity & Social Justice

It’s 3:00 AM on Saturday morning, and my four-month-old daughter is nursing at my breast in the dim moonlight of her nursery. I am slowly learning her cries—the ones that signal hunger versus those that mean I missed an early sleep cue and those that indicate she is in pain.

It’s 4:00 AM. I am sitting in an Uber en route to Logan airport in Boston to catch a flight to Chicago where I’m facilitating a panel for the Social Medicine Consortium Conference. Preparing my remarks and remembering the names and titles of the panelists is on my mind, but seemingly more central than those thoughts is the feeling worry. As we make our way through the dark streets, I wonder if I am leaving my daughter too soon.

Will my husband be able to take care of all three of our children alone? Has he learned her cries like I have? Will our older boys fight with each other all weekend? Am I being selfish to leave?

Over the course of my time in the airport and on my flight—time to myself that I feel I haven’t had in weeks—some clarity emerges. The panel I’m leading called, “Discerning a Life Committed to Health Equity and Social Justice,” will track the experiences of individuals who, like me, are discerning a life based on a mission to accompany and serve others. We’ll hear their stories:

A mid-career doctor at a refugee clinic who in his medical director role felt the pressure to pit financial sustainability against social justice, which began to erode his love of a values-based practice of clinical care.

A social worker who after beginning to close herself off from the pain of her work comes to discover her true self and what is most important to her as she mourns the death of a client who fought her way into healing from trauma and yet passed due to complex and life threatening chronic illnesses.

A young doctor from Uganda who finds no space for his values as he searches for ways to practice patient-centered social medicine in a system that wants him to fall in line by simply diagnosing and treating more patients faster.

And our fourth panelist, also a physician, is, unfortunately, unable to make it to the conference because of a family emergency.

As I contemplate our missing fourth panelist, I try to ask myself what this panel is really about.

What is meant by “discerning a life”?

We all have moments in our lives where we have to determine how our values are going to guide our actions and decisions or not. We have moments where we have to step away from our work to tend to personal matters and moments where we have to step forward into our leadership to tend to others. There are moments where we become unwilling to compromise the beliefs that guide our work—at these times, we are willing to fight hard for those we serve. There are occasions when we realize that we have already compromised some of the values that we bring to our work. And more often than not, we find ourselves wondering what compromises are ok for us so that we can put a roof over our heads or get to a job where we will be able to compromise less.

The day before I traveled to Chicago, after a parent’s support group that I attend, I walked with some moms. We talked about our babies. We talked about our work. I rambled a bit about how I design chaplaincy programs for organizations in an effort to cultivate leadership for justice-based social change.

One of the moms turned to me as I went on about leadership training, and said, “So, are you a good leader?” She was gentle about it, so the question hung non-judgmentally in the air as I quieted myself, really trying to hear what she was asking.

The truth is that I don’t know if I’m a good leader. But I do know is that my practice of listening to people as a spiritual companion and my practice of telling stories as a spiritual teacher have helped me to understand that leadership is not just about our visible actions.

Leadership is also about an inner, psycho-spiritual orientation, and the skill of discernment is the often overlooked but profoundly important bridge between the inner and the outer. Discernment is the bridge between the reflective spaces of our being and the active spaces of our doing.

It’s 7:00 AM. As my flight mates sleep, I’m still reflecting—perhaps stewing—on my reasons for accepting the invitation to the conference, which I remind you has required me to leave my breastfeeding infant at home with my husband (who despite my prayers has not developed the ability to lactate). And it hits me. I’m a mother, yes, and I feel a profound responsibility to tend to, nurture, and love my children. I’m also a citizen of this world, and specifically of these United States of America, and I feel a profound responsibility to tend to, nurture, and love my fellow human beings. 

That is why I’m on this plane.

If we are going to lead a movement for health equity; if we are going to fight to create systems of health care delivery based on a belief that health is a human right for all and not just for a privileged few; if we are going to take down the systems of oppression that have become institutionalized in our hospitals, clinics, prisons, schools, companies, non-government organizations, and community organizations, we must attune ourselves to the cries of those around us—to the cries of the world.

I heave spent nearly twenty years trying to learn these cries and what they mean. There are the cries that I’ve had and know personally, and there are cries that I don’t know.

Being a mother has reinforced my understanding that offering unconditional witness to the pain and suffering of others matters. It matters whether or not I understand the experience of the other. Witness is the foundation of accompaniment. And accompaniment—the relational building of trust, companionship, and connection—is the foundation of social medicine.

A person who has not experienced such witness cannot offer it—someone who feels unseen and unheard will struggle to see and hear others and someone who has stopped seeing and hearing their own true self will struggle to honor the true self within others.

We have created health and human service institutions and organizations in this country and around the world that dehumanize and neglect their employees and front line providers, and we seem to wonder why it is so hard to implement justice-based, person-centered care programs.

Discernment, as the link between our being and doing, is a skill that helps leaders in all positions become aware of and name the ways in which their beliefs and values become misaligned with their actions.

Our health and human service institution and organizations are moral enterprises, and until we see them as such, we will remain stuck, spinning our wheels and wondering why our best practices are not good enough to provide health care for all.

Those of us with the privilege and power to attend conferences and leave our children for work must learn not only to witness those we serve but also to witness each other, to witness our colleagues who are not here with us, to witness those who disagree with us, and perhaps most importantly, to witness those who are not being served. We are accompanying one another through this life—all of us together.

So, I’ll pump in an airport bathroom for that.