Sunday, May 31, 2020

Coronavirus: Of battered spouses and rioters

Herbert Aptheker, the Marxist historian and author of American Negro Slave Revolts, was my professor in college and I often wrote to him in years after graduation to discuss things that were on my mind. One of these was how to name civil unrest. He always used words like "rebellion" to describe the events of the long, hot summers of the 1960s. As my studies of psychiatry progressed, I resisted such language. I thought that "riot" was a better description of the chaotic events that unfolded on the streets, as tempers boiled over and people took their feelings out on storefronts.

Because "riots," "rioters" and "rioting" are used so disparagingly, there has not been much reason to press the point but it has been rattling around in my brain for a long time. A conversation today with anthropologist Edgar Rivera Col√≥n helped me articulate my thought that those inchoate moments are  speaking an emotional language, asking us to listen with our hearts, not our judgements. I think they convey scream, and we are meant to hear and feel all the terror and impossibility held in that scream. I am writing "scream" in italics to make it a neologism, an emotion word.  To me, the word "riot" -- defined as "public violence, disorder or tumult" -- has a core of scream that the word "uprising" does not contain. 

As a psychiatrist, that scream is the deep and essential communication and it should neither be denigrated nor prettied up. It is, I realized in the conversation with Edgar, like domestic violence, like the moment when the battered spouse picks up a rolling pin and bashes in the head of the abuser. We are supposed to hear the breaking point in the act, the straw that broke the camel's back, "no worse there is none, pitched past pitch of grief," as the poet wrote

If we could hear the scream, and hear in it the years of torment, we would understand that the battered spouse and the rioter are acting in self-defense. We would honor the courage of their refusal -- which I think is what Dr. Aptheker was trying to get at -- and we would see from their acts the structural violence that was and is the real danger threatening all of us.  

I worked with Hannah Cooper for two years on our book, From Enforcers to Guardians: A Public Health Approach to Ending Police Violence. I read a lot about the kinds of brutality that define policing at its worst. The key analysts of the issue, like Shaun King and Paul Butler, have helped us to see the vast and insidious system of support for this brutality, so extensive that it is nearly impervious to change, and hence the scream.  

But we know that this scream at this moment holds much more than the rage at police brutality: the path of the coronavirus has revealed the dense fabric of inequality in a manner we have never seen before, the Grim Reaper striding the paths of social stratification to take the weak, the marginalized, the exposed, while those with wealth and power tweet their derision and deny shelter to the terrified.  If this were all going to end in this tenth week of shelter-in-place we might feel some hope, but we see 40 million unemployed, jobs disappearing not to return, and mass evictions and hunger looming on the horizon.  

This particular scream has risen from the streets to reach into the hearts of all of us.  Maybe ten weeks ago our ears might have been stoppered with the certainty of the next paycheck, but not now.  Now we see, now we hear, now we are so hurt.  In this moment we both feel the scream and see the system that is hurting all of us.  I find, for myself, that it is only in drawing on spiritual resources that I can do both of these tasks.  As Chogyam Trungpa said, "Hold the sadness and pain of samsara in your heart and at the same time the power and vision of the Great Eastern Sun.  Then the warrior can make a proper cup of tea."  

Put another way, in the immortal voice of Odetta, "Another man done gone," a song which is so precise in conveying the pain it has survived decades and crossed cultures, giving us in music an understanding that defies words, yet she holds us to it, helps us face it. In the embracing power of her art, we go deep, which opens time to think.

We need time to absorb these ten weeks of revelation, to digest that we aren't going "back to normal," but to somewhere else, somewhere new. One step forward is to get on the "bus" and go the Poor People's Assembly on June 20th. RSVP now. You can come on the "bus" of 400 Years of Inequality which will board at 9:30am for the 10am rally. You have to bring your own cake, though we will provide recipes. And you have to make your own signs, though there will be lots of models. You could also organize your own "bus" with your friends and relations.  We have to be there, in the space of indignation and planning, so that we can move forward together, in a massive moral fusion coalition, towards a new future that reflects what we are FOR.  

Wednesday, May 20, 2020

Coronavirus: How We Help -- Gifts for the Spirit

Collective recovery is all about knowing that there is an "us" which has been wounded in this period.  We've been wounded by death, by illness, by intense strain, by retreating away from each other, by the failure of businesses and organizations that have anchored our lives.  We have lost touch with one another in ways that we will never know, except in the deep foreboding that "things have changed."

There is no amount of individual therapy that can heal "us."  This is something we have to do together.  People know this intuitively, but when we articulate collective recovery, we can do it faster and more thoroughly.  Here's what we need to know:

  • Heal the suffering of the individuals;
  • Heal the fractures among our communities;
  • Undo the inequality which has intensified this catastrophe and hobbled us from managing it.
  • Our organizations are key to getting it done fast and well;
  • Our organizations must reconnect in three directions -- from each organization to its constituents. from the organizations to the other organizations, and from the coalition of organizations to our policymakers;
  • Every organization has a role to play, from those as small as the Youth Choir in a church to those as large as the American Medical Association.  
What I want to do in a series of posts is to share stories of organizations that are doing their part.  There are an infinite number of ways organizations can contribute. Let us start with GIFTS FOR THE SPIRIT, because we need this to keep up the motivation for the long haul of safe transition, possible new waves of infection and rebuilding what has been damaged.

The formal and informal networks of musicians of New Orleans, activated by Wynton Marsalis, recorded a second line for all of us. My friend Sarah Townley texted some of us in her network her prayers for Dr. James Mahoney, who died while tending patients in Brooklyn.  I shared the Second Line link with her and she wrote back, "Thank you for this -- this got Cecilia and I doing a kitchen dance. So moving. So necessary."

Our Lady of Hope Catholic Church took to the streets of Queens to bring church to the people.  Rev. Peter Purpura with a small procession walked the neighborhood of Middle Village and met with parishioners who have set up small tables with worship items to meet with him.

The Poor People's Campaign's "Stay in Place, Stay Alive, Organize and Don't Believe the Lies" has asked artists to make posters with those slogans.  This one arrived in my inbox today.  Its coherent, joyful message lifted my spirits, assuring me that I am NOT alone is hating the injustice that permeates our nation and has made this pandemic so horrible for us.

Tuesday, May 19, 2020

Coronavirus: "Play with fads, work with trends and live by principles"

NY Week 9 and the talk has turned to re-entry.  I don't know about you, but I am just getting used to managed retreat.  I have great new hobbies and so many things happening in the zoom-o-sphere that I can enjoy!  There's a huge national med school graduation with all the people who play doctors on TV, a production of "King Lear" by Theater of War, and UofO Digital Campus which is growing everyday.  So I'm set for a while -- no matter, re-entry is coming.

But re-entry to what?  Going "back" is a fiction, as we know that much has changed, including each of us.  The naming buffs will surely get on that, although I'm still waiting to learn what to call the first decade of the century -- "oughts" seems not to have caught on.  Let's call it "not-back" for the moment.

The main characteristic of not-back, as far as I can tell, is uncertainty and this is just not attractive.  There is nobody in the whole world who knows what's next.  That's always been true, but the relatively slow pace of change has allowed us to think that we knew what was next.  So what can help us feel our way forward?

I had the good fortune to serve on the National Board of the American Institute of Architects with Futurist David Zach.  He never talked about the future as "a thing."  He always presented wildly evocative pictures and talked about "might," as in, what might happen.  He has pointed out that we should "play with fads, work with trends and live by principles."  Here's how he defined those terms. 

Fads are "all about being in the moment."  Baking is a fad of this moment, and a very pleasant one, at that.  [I made shortbread cookies last night--Mark Bittman's recipe, but next time I'm trying Melissa Clark.]  

Trends are about movement -- "they are like the current that moves the boat."  Trends are very important for the future, because they are enduring and leave their mark.  We can, with attention, discern trends, which can serve us like channel guides.  A trend in this moment is for new diseases to arise because of human abuse of the ecosystem.  This is a trend that will continue and might accelerate.  

"Principles," Zach noted, "are about the eternal. Things that don't change, shouldn't change, can't change." [He loves to be silly, so he quotes Groucho Marx on this point: "Those are my principles. If you don't like them, I have others."]  Principles, therefore, are like the stars, the constants of our navigation.  "Respect for all living beings" is a principle that we can use in planning for a future that is just and sustainable.  

In the Zachian future, we enjoy fads, forecast trends and stand by our principles.  We do this, for the most part, in small increments of time -- this moment, this day -- because we can manage what's in front of us.  I think this is powerful advice for moving forward.  

Tuesday, May 12, 2020

Coronavirus: Ora et Labora

Week 8 of Sheltering in Place (SiP).  Being at home is not novel anymore.  It's not as irritating as it was a couple of weeks ago.  And I find, that having got the hang of it, a loose "schedule" has developed, with time divided between ora et labora, prayer and work, as the monastics put it. 

My schedule of labora (labor) is not a rush-for-the-train schedule, but more like what farmers followed, back in the day of small farms, dictated by the chores that have become due.  These include washing clothes, baking bread, making meals, exercising, being entertained, virtual visits.  And now hobbies!  Mine are learning cello and gardening.

A few years back, I rented a wonderful cello from the University of Orange instrument library.  Then I tried to get lessons, but those kept falling apart, largely because of my ridiculous schedule.  In SiP, I have time, and a friend referred me to her teacher, Sarah Carter, who was willing to teach on Zoom.  I've had three lessons now, and I can play Twinkle, Twinkle and French Folk Song, three scales, and can read the notes pretty easily.  I'm gripped by possibility.

I have also made progress on gardening.  Stephen Panasci, a landscape architect, took my sketchy ideas and make a full garden plan.  He has installed two raised beds in the backyard, which will soon be my Farm.  And later this week will install flowers and shrubs around the Property. This will create many new outside chores.  Happily, I am NOT spending my summer writing a book, so I will have time for this.  I'll have lettuce and radishes pretty soon.

I think the idea with prayer (ora) is that it punctuate the day, alternating with work.  In this category I count meditation, exercise, my classes in spirituality, reading the papers thoroughly and actual prayer (Dear God, Please give us all the strength to see the truth and learn to respect the ecosystem.)

I count "reading the papers" as prayer, because I'm trying to understand God's will, which many define as "what is in front of me."  Therefore, I need the news to help me in my discernment. A vast truth is unfolding that asks of me that I spend time with it -- some hours every day -- stretching my mind and my understanding to encompass this vast experience.  And I have great need of Their (God's) help in having patience with all the people who annoy me -- the deniers, the one-issuers, the live-and-let-diers -- as I read the news.  My judgements get in the way of taking in all the information, so I need to let my opinions go (not easy).

I never imagined being cloistered in this way.  For today, I am moving through my new routines with sun and wind and spring blossoms.

Sunday, May 10, 2020

Happy Mother's Day!

From Just Love Audio:

Mother, Mom, Mama, Mommy

Long term, team players needed, for challenging permanent work in an often chaotic environment. Candidates must possess excellent communication and organizational skills and be willing to work variable hours, which will include evenings and weekends and frequent 24 hour shifts on call. Some overnight travel required, including trips to primitive camping sites on rainy weekends and endless sports tournaments in far away cities. Travel expenses not reimbursed. Extensive courier duties also required.

The rest of your life. Must be willing to be hated, at least temporarily, until someone needs $5. Must be willing to bite tongue repeatedly. Also, must possess the physical stamina of a pack mule and be able to go from zero to 60 mph in three seconds flat in case, this time, the screams from the backyard are not someone just crying wolf. Must be willing to face stimulating technical challenges, such as small gadget repair, mysteriously sluggish toilets and stuck zippers. Must screen phone calls, maintain calendars and coordinate production of multiple homework projects. Must have ability to plan and organize social gatherings for clients of all ages and mental outlooks. Must be willing to be indispensable one minute, an embarrassment the next. Must handle assembly and product safety testing of a half million cheap, plastic toys, and battery operated devices. Must always hope for the best but be prepared for the worst. Must assume final, complete accountability for the quality of the end product. Responsibilities also include floor maintenance and janitorial work throughout the facility.

Virtually none. Your job is to remain in the same position for years, without complaining, constantly retraining and updating your skills, so that those in your charge can ultimately surpass you.

None required unfortunately. On-the-job training offered on a continually exhausting basis.

Get this! You pay them! Offering them frequent raises and bonuses. A balloon payment is due when they turn 18 because of the assumption that college will help them become financially independent. When you die, you give them whatever is left. The oddest thing about this reverse-salary scheme is that you actually enjoy it and wish you could only do more.

While no health or dental insurance, no pension, no tuition reimbursement, no paid holidays and no stock options are offered; this job supplies limitless opportunities for personal growth and free hugs for life if you play your cards right.

Saturday, May 9, 2020

Coronavirus: Why fighting inequality will make you feel better

When have I ever seen so much information about inequality in the media?  Basically never.  The surprise is NOT that the fractures in society are the crevices along which the epidemic is flowing.  The surprise is that we are given such detailed and honest reporting about every facet of it.  We are not left in the dark to wonder about injustice: we get the headlines every morning.

When matters are so clear, people can take positions with confidence and indeed, the pressure to take a position mounts.  Acting NOW becomes important, but it is attended by fears and risks.  How, then, does it make us feel better?

Fighting inequality makes us feel better in quite a number of ways.  Here are just three that I find very important.

First, you shed lies, and this is very good for mental health.  In the ecology of inequality, everybody is caught in the trap of lies.  Either you think you're a victim of inequality or you think you're not.  Neither is precisely true.  "Victims" are victims+winners -- winners because they are spared the need to believe in all the lies that justify inequality.  "Non-victims" are non-victims+losers -- losers because they may profit but have to buy into the lies.  Buying lies is bad for your psyche and your character.  Recognizing the simple truth that we're all caught in the same system is profoundly liberating.

Second, you acknowledge relationship and can bring it into right relation.  The deep global crisis of our times is about relationship -- relationship with the environment, with other people, with other countries, with the future.  This simple diagram is designed to show that "inequality" is a relationship between two people.

This is a relationship built on harm.  By getting rid of the harm, we release a lot of energy that can be put to good use.  This is wonderful for mental health.  And this is something pretty much all of us have experienced, as when we used our strength or power to harm a weaker person, maybe a little brother or sister.  When we stopped doing that, it was better all around.

Third, you prevent even worse harm.  Having recognized all facets of the ecology of inequality in our society, we turn a blind eye to it at our own peril.  The system is not working to equalize resources and opportunity but rather to concentrate them in the hands of fewer and fewer people.  If we want to fix this, we must act.  NOW is a good time, before things get even worse.  It is a great feeling to know that we're contributing to a better future.

If you want to feel better and you're ready to act NOW, that's great.  If you're wondering how to start, here are some ideas I have:

It's always good to get the big picture.  Over the next few days, find all the articles in the news about different kinds of inequality that are showing up in this pandemic.  What's happening to racial minorities?  What's happening to women?  What's happening to immigrants?  What's happening with low-wage workers?  What's happening with the food supply?  What's happening to hospitals in poor neighborhoods?  There are many parts to this struggle which are in evidence at the moment -- good to know how big and complex the problem is. There are also a plethora of webinars going on now, teaching about the effects of inequality on the pandemic and helping people think what to do about it.

Think about what you'd like to see in the future.  What should it look like when we emerge from the this painful but necessary managed retreat?  This is what I call "finding what you're FOR."

Start at home.  How can there be equality in your house, block and workplace?  Who does chores?  Who gets paid how much?  These are issues in the lives of all of us.

Join an organization that's working towards the goals that you're FOR.  There are lots to chose from.  I think the Poor People's Campaign is in the forefront.  I am also really proud of the work my former student Jacqueline Martinez-Garcel and her colleagues are doing at the Latino Community Foundation.  Maybe it's your block association or Black Lives Matter that calls to you at this moment.  Whatever it is, go for it.

Together, we can win a future for all of us.

Wednesday, May 6, 2020

Guest Post: Covid-19 Conspiracy Theories and Public Health by Robert Fullilove

Vera Zakem’s highly informative New York Times Opinion piece of April 22nd, Pandemic Propaganda Is Coming, Be Ready for It, sounded a very important alarm about a predictable outcome of the Covid-19 pandemic. She notes, We are likely to see conspiracy theories and false narratives from state actors such as Russia and China, news outlets and advocacy groups, and individuals ranging from partisan activists to white supremacists, and even our friends and neighbors who may inadvertently share conspiracy theories without malicious intent.” The question of who and what to believe now has an element of life or death decision making attached to it. With no less an authority than President Trump wondering about the use disinfectants as a treatment for Covid-19, health care workers and public health officials have cause to worry about how their messages are being processed by the general public.

But what can be done about it? Twenty-years ago, when I was the co-chair of the Federal Advisory Committee to the Centers for Disease Control (CDC) for HIV/AIDS and STD Prevention and Treatment, I published a series of articles about the importance of understanding conspiracy theories about the origins of HIV. I described it as the elephant in the room because while it was a widely acknowledged challenge in our efforts to communicate with the public, there were few ideas about how to confront such theories effectively.

As an African American professor at an Ivy League medical center, I did my fair share of lecturing about HIV/AIDS in the Black community in a wide variety of community settings from churches to drug treatment programs. I noted that invariably, and almost without exception, the first questions that I’d be asked was, “Doc…where does AIDS come from? Is this a man-made bug that was created to destroy minorities, gay people, drug users, and others?” My public health colleagues were well aware that such thinking existed, but their typical response was to try to simplify the message, that is, put it in language that the scientifically challenged might better understand. Then as now with Covid-19, such thinking completely misses the point.

Beliefs in conspiracy theories about diseases often arise in part because their explanations fit the facts and the lived experiences of the believer. Twenty years ago, the fact that 70 percent of the HIV pandemic worldwide was centered in Africa as well as in Black communities from the United States to the Caribbean to Brazil was a topic of heated discussion.  HIV/AIDS, it was repeatedly noted, follows the path of the international slave trade from Africa to the New World. “Everywhere you look,” I recall one Haitian American audience member pointing out, “we are the ones with highest rates of infection and mortality. Am I supposed to believe that this is an accident?”

My point is not to advance theories about the origins of HIV/AIDS. What is at issue instead is the assumption that these beliefs can only be met with well-developed explanations of science for the illiterate.

When “dummied-down” explanations of HIV or Covid-19 are provided to those who entertain conspiracy theories or dangerous myths about treatments and cures, we miss the point if we  assume that those who raise such questions are, at best, ill-informed. The problem is not that our explanations are too complex, to borrow a phrase from the film Cool Hand Luke, “what we have is a failure to communicate.” We must understand instead why such theories are so satisfying.

Perhaps the real power of conspiracy theories is that they give us someone or something to blame. In the mystery films of Hollywood years ago, a happy ending followed the naming of the guilty party and the solving of the crime. Covid-19 conspiracies often do just that. In the face of an unrelenting series of pandemic horrors, not surprisingly, the competition between good science and conspiracy theories is less about explaining why we are in this mess than knowing instead who or what to name as the cause of our pain.

But our collective pain is also compounded when we don’t trust the messenger. In the Bronx, New Orleans, or Detroit, lack of access to testing and an acute awareness of the neglect of the public health needs of the Black community is horribly visible in the overrepresentation of community residents in Covid-19 mortality rates. Mistrust of the medical profession in general and of public health officials in particular is rampant and has a long, ugly history. Our challenge is clear. Before we can frame credible messages, it is essential that government leaders and public health officials accept that their first priority is to become credible messengers. The battle for truth, surprisingly enough is not to be fought with science, but in the quest to win public trust. In too many locales, one thing is clear.

We aren’t there yet.

Written by Robert E. Fullilove, III, EdD

Monday, May 4, 2020

Coronavirus: Getting with the program and other things I don't like to do

In my blog post "Getting through this moment," I wrote about five tasks that Lourdes Rodriguez, Nupur Chaudhury and I had identified as tasks of collective recovery in this moment.  These are the five:  
  • Turn on the Love
  • Pay attention to this week’s needs
  • Fight injustice 
  • Extend and strengthen your network
  • Build a personal foundation of spirit
The University of Orange Digital Campus has been examining these tasks, one at a time, and directing people's attention to what each involves.  I want to talk in this post about this week's needs.  

NY Week Seven has  brought to our attention care for our bodies which are suffering in a variety of ways.  Being cooped up in a small space -- with limited interactions with other people and many of those via the digital world -- is wearing on us.  Our bodies are strained.  

Therefore, notes from providers, newspaper articles and newsletters have been full of advice.  I've seen: Get some tech for your "home office,"; Do self-massage at night so you can sleep is another; If you're elderly, walk up and down the hallways while talking on the phone and swing cans of food; and, of course, wear a mask and observe physical distancing when outside.  

We might or might not be in a financial or social position to follow all of this excellent advice, but what worries me is not that we need self-massage, but that our spirits are low, and we are getting irritated with the restrictions the pandemic has triggered.  I was shocked, while driving around the nearby wealthy suburb, to see dozens of people out without masks, or with their masks dripping around their neck.  And I've heard many friends express impatience and irritation with the way we are living now.  Even more than our bodies it is our willingness to accept our dire situation that is being tested in this moment.  

What are we supposed to do about this?

Channeling my parents, who were members of the Greatest Generation and survived the Great Depression, World War II and the McCarthy Era, "Give unto Caesar that which is Caesar's and give unto God that which is God's," which loosely translated meant, "It is what it is."  

The corollary of that was that I was supposed to get with the program.  As a teen I preferred pouting to recognizing such limits.  But with age I've come to see their point.  I get it.  Not wearing a mask does not get me out of the situation.  Nor does getting angry because I don't like Zoom eight hours a day.  But how do I get from "pouty" to "serene"?  I think these are the three steps:  

First, I feel what I feel.  I don't think it helps people to tell them not to feel what they feel.  At least it never helped me.  

Second, I also have to see that it is what it is.  If my feelings are real, so is my reality.  

Third -- and this is the paradoxical part -- I need to thank the Universe for everything, including both my feelings and my reality.  My dear friend Pam Shaw sent me this quote by Chogyam Trungpa: 
Hold the sadness and pain of samsara in your heart and at the same time the power and vision of the Great Eastern Sun.  Then the warrior can make a proper cup of tea.
Just as I was writing this, a parade of cars, blaring their horns, came passing by.  It was Hazel Strong, a parade for the students and teachers of Hazel Avenue School which is near my house.  So this leads me to add a fourth step!

Fourth, Don't be afraid to cry when the parade passes by!  Even Governor Cuomo cries sometimes.