interviews
Call It What It Is
by LaShyra Nolen
July 1, 2020
This interview with LaShyra Nolen, Harvard medical student, and the first Black woman to become class president, was conducted and condensed by franknews.
frank | You've written and spoken about your experience within a dual reality – of being both a medical student at Harvard, and a person committed to your own identity and equity.
LN | The dual reality is you're training at the best medical school in the world, but there is so much suffering going on in your community. And whatever knowledge you gain still isn't going to necessarily translate to the improvement of the condition of Black people. For example, I could go on to become the best surgeon in the world. I could save the life of a Black patient. But they can go outside, drive home, get stopped by a police officer, move too fast, and get killed.
That is the dual reality. You're learning, but you're not necessarily getting to the root cause of the suffering of your people.
You always have to think about it from both of those perspectives, that of a student and that of a Black person in America.
In addition, you go into class and you are expected to maintain professionalism. You are expected to just talk about the science and to talk about the assignment at hand – when that same morning you watched yet another police lynching of a Black man. You're trying to deal with those emotions, and you have no idea how it's going to be taken if you say, "Hey guys, I'm really not doing that well. Another Black man was killed. Racism is pervasive in our country and we're all complicit in it." It is a challenge that all Black professionals have. You have to walk in and put on this face, even though internally you are dealing with the turmoil and hurt of your community.
What does this moment feel like at Harvard, as a student?
As a medical student, I feel like I can speak out more than my mentors or faculty members who are more ingrained into the system of medicine. Academic medicine is very hierarchical. The higher up you go, the more you have your hands tied, and you can't speak as much truth because you're trying to move up to an associate professor position so that you can finally start to use your voice. I know that there's a risk that comes with speaking up, but I, personally, can no longer just pretend like everything's okay, and allow people to continue to suffer in silence. Even the most brilliant people have been complicit in racism, and some of them genuinely have never even thought about it.
They've grown up in a bubble, their entire lives, and all this is happening and they're just like,
"Oh my gosh, I'm a good person. I'm not racist." And you kind of have to be like, "No, but you really are though."
These brilliant people who are excellent in their field, are just now realizing they're complicit in this system.
Again, I am happy that's occurring, but I'm always just like, look how much it took for us to get here. NASCAR is just now removing the Confederate flag. Suddenly now I have Juneteenth popping up on my Google calendar. I'm like, what?
My classmates and professors have really been amazing actually. We are all from different backgrounds. Some are fourth-generation physicians, and some grew up on reservations and are bringing medicine to indigenous folks. All of them realize that the system needs to change, and they have been so supportive. Beyond just talking the talk and posting the black box on Instagram, they've been reaching out to me saying, “Here are the notes from class today. I got this recording for you because I know you've been putting in work on the advocacy front.” That's true allyship to me. I've really been pleasantly surprised and happy to see the support that I've gotten from my classmates.
There has been a widespread acknowledgment that COVID is affecting communities and people of color at much higher rates. I am curious if you think there has been an appropriate conversation around why that’s the case?
I think that in order to understand that we have to look at our history, and at policy. The original ill was, of course, chattel slavery. This country has not valued Black lives. The policy reflects that, and policy ties into our healthcare. That history of systemic discrimination is important to look at to examine the current landscape of COVID-19.
Redlining decided where people live in this country, and which communities our government and our local city councils were going to invest in. Black communities were not invested in. As a result, Black communities have not had access to the basic resources that they need to survive and thrive. They don't have access to healthy food. They don't have access to safe places to exercise. They are exposed to environmental pollution. They have less access to education. I mean, then you look at who is more likely to be an essential worker - Black people are overrepresented.
It doesn't end there. Once people get into the clinic, they have to deal with the biases and systemic racism in the hospital system. There are studies that have shown there are medical students and residents who still think that Black people have a higher pain tolerance.
We can take maternal mortality as an example of treatment differences. Black women, at all income levels, are dying disproportionately compared to white women. When they get to the hospital, doctors don’t believe their pain. I mean, it happened to Serena Williams. It is safer for Black women to not engage with the healthcare system because of the violence and harm it causes.
How do you think mistrust of the medical system compounded the COVID crisis?
I think it all comes back to this conversation of access, right? When COVID-19 first hit, the testing centers were predominantly located in affluent communities, and a lot of Black communities were left without access to testing. The lack of Black physicians and Black health care professionals means that when Black patients come in and say they have COVID-19 symptoms, they are less likely to get treatment compared to white people.
If you know there are no testing centers in your neighborhood, you know there is no representation in the hospital, and you know that you are going to be discriminated against once you walk in that door, you know your life is being devalued. That knowledge prevents Black people from seeking care from our healthcare system. With anecdotes of horror coming from your community, of course you are going to be nervous to trust the healthcare system.
What does a better understanding of investment into public health look like to you?
I think we need to turn all of the conversations that we've been having into public health initiatives. Racism was declared a public health emergency in Boston. That is the direction I think we should be moving in.
We need to move beyond equality to think about equity. We need to recognize that not everyone is on the same playing field. We need to truly make sure everyone's specific situation is taken into consideration. We do that by investing in those communities, and by looking at how we make sure they have access to good education, access to health care, access to housing, access to good food. Improving the conditions where people live, work, pray, play will improve their healthcare outcomes and our healthcare system.
Of course, we need things like the physical exam, but often patients go into that physical exam with preexisting chronic diseases caused by disparate suffering. Going as upstream as possible will lead to better healthcare outcomes and in the long run, improve healthcare costs. Even if investing in public health didn't improve healthcare costs, I still think that it's the moral thing to do. I think we're too driven by what's going to save money in our country. We need to do what's right.
Everyone deserves to have the basic resources they need, to live out a viable, joyous life. Right now we are doing nothing to guarantee that.
Someone said to me once, we’re too focused on raising the ceiling and not at all focused on raising the floor in the American healthcare system. Do you feel like this starts as a medical student?
I can definitely speak to that culture. As a medical student, I'm really passionate about community activism. I am passionate about making sure that everyone has access to healthcare, and ensuring that we're teaching medical students anti-racism so that they don't go out and further harm communities. I can spend two years doing that – serving on committees, writing up reports, and changing curriculum at my institution. But my peers who are spending the same time publishing papers on very specific proteins and disease processes might have a better chance at residency.
In medicine, you're not incentivized to do work that you don't get credit for. You always want to be able to publish, and activism isn't always publishable.
It has been the responsibility of Black students, students of color, and indigenous folks to improve their institution. They do the work so that they can thrive and survive, and so the next generation can do the same. But at the same time, they still have to do everything they have to do as a medical student to get to the next level. I'm literally trying to improve the very environment that I'm suffocating in, while also trying to handle everything else that medical students are expected to.
There was a letter early on from public health officials advocating for protest as it’s needed to fight racism within the healthcare system. Does that feel new or was it already a part of the conversation?
I think it's always been a part of the conversation for those who have been oppressed.
But that is what is special about this moment. We literally had a global pandemic that exposed the disparate suffering of Black people across the country, across the globe. And then on top of that, you have back to back to back killings of Black people. It's heartbreaking that it took this much for us to start having these conversations, but we are having them, and people can’t run away from them.
There are no distractions. We're not going to get anywhere if people don't name systemic racism for what it is.
We need to say Ahmaud Arbery. We need to say Breonna Taylor. We need to say their names, and we need to name the issue at large.
Big-name organizations are just finally starting to realize that this is something that they need to get on board with. It’s hard to know if it's really genuine or not. I think that people don't want to be on the wrong side of history. Regardless, learning is still happening. I'm very happy that anti-racism is becoming the status quo and that we are having these conversations. We need to continue to push the envelope to get people things they need to live a good life.
interviews
In Conversation with Joe Paul Jr. Part One
by Joe Paul Jr.
June 6, 2018
This interview with Joe Paul Jr., the Vocational Services Administrator at SHIELDS for Families, was conducted and condensed by frank news. It took place May 23, 2018. This is part one of an ongoing conversation between frank and Joe Paul Jr.
How did you find yourself here, working at SHIELDS for Families?
Alright. I’m a formerly incarcerated person, E-22-8-4-2. I went to California State Prison. Sentenced June 22, 1989 for voluntary manslaughter; it was a drug related murder. I came home December 2, 1992 and that whole experience was the transforming moment of my life. Prison literally saved my life with no cliché. I found myself, I found the initial portion of my identity in that place. I recognized how disenfranchised my people, black men, were at that moment in time, and Latino men too. How blind we were to this deterioration we were in the middle of. I had the moral guilt that somebody died as a result of actions I was involved with. The converging of all these circumstances put me in this place where I said, "every day in my life moving forward I will do something to make a difference in improving the quality of life not only for myself and my family, but for the people around me –my community" – I was 24 years old when I came home. I'm 49 years old now and I've lived up to every single promise in terms of making sure that every day I'm doing something to improve the state and quality of our community.
I've always been involved from the time I came home with some sort of volunteerism. Typically this has been around church, supporting ministries in the African-American communities in South LA; I still do that to this very day. Not only do I work here at SHIELDS For Families as the Vocational Service Administrator for all of our adult programs, in the sidebar we have about 38 programs; we're a 25-million-dollar non-profit operation.
I've been here for the last six years. This is a twenty-seven-year-old organization that evolved out of the crack epidemic and everything subsequent to that.
In that last 10 years, I've been challenged in the field of nonprofit work to take on this issue of mass incarceration. When I first got into this field from a workforce development professionals point of view, I came into it at the precipice of the mortgage meltdown and then the Great Recession. At the same exact time California was in the throes of this three judge panel that told Schwarzenegger, and ultimately Jerry Brown, that you got too many people in prison. This is a constitutional violation, it’s cruel and unusual punishment: You're not providing adequate healthcare, you're not providing adequate mental health, you're not providing adequate housing. You've got to drop the population in prison. The advent of Assembly Bill 109, a reform bill around changing the status of felons from the traditional prison felony to now this county jail felony thing. We went through all of this transition and watched the subsequent reform bills along with it.
We were working in that climate, and now I feel like a veteran because we're in one of the most robust economies we've been in in a long time. There's construction across the whole state. There’s opportunities for people to relatively make living wage jobs with very little skills or education, and we still are at a crisis level when it comes to social dynamic. That's what keeps me moving and thinking about policy and legislation, and really closing the gaps where they've been created. Even with the best intentions we couldn't foresee the collateral consequences as a result of the effort that we saw the need for at that time. That's the front we're working on now.
What were the collateral consequences of that work?
I'll give you an example around a very salient point, and that's "Ban the Box". Ban the Box is the policy and intention to remove the question of: "Have you been convicted of a felony?", from employment applications. It was a foreign notion in L.A. and in California ten years ago; we were fighting for it. Now, we have statewide laws, we have one of the most robust Ban the Box laws in the whole country right here in L.A.
We didn't close the gap on how do you sell yourself and verify your work experience the way everyone else is going to? A very well intended, hard fought victory, to get the boxes removed, but now that the box is removed, these other complications are exposing themselves that we don't have a remedy for. On the CDCR, the Department of Corrections and Parole side, unless you have a very motivated parole agent, they're not going to focus on the employment verification for this dude who just spent 20 years in prison. All of his work experience, although credible, although valuable, although more qualified than someone else, won’t be provable. We’re working on that now.
What about extended and collateral consequences in the community?
2018 is midterms for the feds, it's statewide election, we're electing a governor in California, in L.A. we're electing the sheriff. You have 30 percent of the incarcerated population returning to L.A. County, and a huge percentage of that group coming to the city of L.A. Those who've been formerly incarcerated, and are felons and think that they're disenfranchised still, think they can't go to the polls and vote. If you're already a minority group, where it takes everybody's voice to stand up and say we agree with this piece of legislation, or we want this elected candidate in office, and everybody showed up without any restrictions, we still would have a challenge electing somebody.
You don't even scratch the surface of what change looks like. Those are blind consequences to the effect of mass incarceration on communities of color, and these disenfranchised communities like South Los Angeles.
For the last 20 years let's say, the police department, the DA, all of these different government bureaucratic systems, are more willing to work with you as the voice of the community, but the communities themselves are not so open to them.
What does that relationship look like right now?
It's almost like the community is saying, ‘too little too late’. It's like, ‘we were ready to work with you after the riots. We were ready to engage healthy dialogue after Rodney King’. We go through all of that, and not only do we have to suffer through the consequences of that experience, but then you put gang injunctions on our communities and the police come in and terrorize community members and criminalize innocent people inadvertently, and call them gang members. And then the criminal system puts enhancements on charges because now we label innocent people who weren't gang members as gang members and, yeah they sold drugs, or maybe they got caught with a gun, whatever the case may have been, but now I'm labeled a gang member because I grew up in this community and I get an extra five or six years on top of a sentence? These mothers are saying he's not a gang member, and he’s saying I'm not in it — you create this distrust. To the point where we don't want to deal with you.
The community is not in a place where they have been as forgiving as others. My position is, I wish that we – I hear Rodney King in the back of my head: "Can we all just get along?"
Right now the community is playing the biggest part of the problem in my opinion. A murder may happen in the community and the community itself knows exactly who did it, the detectives are doing this full blown investigation with no leads and nobody is saying anything. If you have individuals who consistently find themselves in a place where there's no consequence to their behavior because of the street code, or the community is intimidated by the perpetrator, whatever the case may be, we only end up hurting ourselves. We have to find a balance between those two extremes right now.
What allows you to trust government institutions after your own experience in the system?
And it doesn't take a whole lot. A few years ago, 2012, we worked closely with the sheriff's department and the county Registrar's office with our inmate voter registration. There were approximately 20,000 folks incarcerated in the county jail system at that time. We registered approximately 1,200, 1,250 folks. We didn't hit 10 percent of the total population for a lot of reasons. I felt we didn't do the best job we could. County Board of Supervisors, City Council people elected from the state touted the effort. "Oh my God, look what you guys did!" About 900 of those folks cast their ballot in custody. I've come to realize 900 additional votes could swing an election. I didn’t know it at the time. What I've learned is that we can mobilize and demonstrate that we can do this with intention, and purpose, and have a lot of weight in the power we bring to the table.
You got the power to say “nah not to you, you, but not you". If we all come together, they have to come to us to have a conversation, to get our opinion on what best practice looks like if they're elected. It's been like herding cats to get people into a place to see this potential power. It's apathy. It's almost too little too late. If you had asked it of us ten years ago, maybe, but we don't hear it now. You hear I don't care. Even if it hurts me to avoid this opportunity
Are you optimistic?
I am. You've got to be! I mean there's a verse of Bible that says a living dog is better than a dead lion. As long as we're alive there's hope.
I'm tired of going to funerals; I'm tired of burying kids. I'm tired of visiting domestic violence programs where women are abused simply because of the residual trauma and anger that community members have that are displaced.
I made a commitment as I said in the beginning, that I'm going to do my best to serve my community as long as I'm alive. I see no victory to believe. I'm a firm believer in the word of God that says a little leaven leavens the whole lump. So we can have a little bit, and sustain that little bit, it has the potential to grow into something bigger. I feel I've got other partners across the state who have a similar idea that we're not done yet. I do have optimism towards it.