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
Anti-Colonial Science & The Ubiquity of Plastic
by Max Liboiron
January 9, 2019
This interview with Dr. Max Liboiron was conducted and condensed by frank news. It took place December 4, 2018.
I'm Dr. Max Liboiron. I often introduce myself in Michif. So, I say, Taanishi. Max Liboiron dishinihkaashoon. Lac la biche, Treaty 6, d’oshchiin. Mtis naasyoon, niiya ni. Which means my name is Max Liboiron. I'm from Northern Alberta, treaty six territory, where I'm part of Mtis Nation, and I now live and work in Newfoundland and Labrador in Northeastern Canada.
I'm an environmental scientist and we do anti-colonial, feminist science – which means we draw a lot from the insights of the social sciences and also different traditional teachings and law, to inform our scientific practices. So that they are anti-colonial. So they are feminist. So that they do deal with questions of equity, questions of justice, questions of humility, and do work in a good way, as opposed to just an efficient way or a fact-y way.
Science, and research in general, has long played a role in colonial entitlement to land, both in proving that people deserve to be dispossessed in being the reason for research – we need to research tropical diseases so we can better settle in this tropical place, not our environment. Or, how do we patent different botanies? A lot of those legacies have stayed in science and aren't usually noticed anymore.
They used to be fairly contested, especially when science was trying to move into new places or when race was being scientized. But now people seem to have forgotten about that legacy. So our task at CLEAR, my lab, is to first of all recognize how science is already colonial, and then number two, work very hard to do the practices of science in ways that do not reproduce entitlement to land or universalism, which is actually just self portraiture of Europeans usually. The idea of mastery over nature, or that nature is a resource for use.
Courtesy of: Bojan Furst.
Every moment of science has these sort of legacies. There's lots and lots and lots of room for doing anti-colonial science and feminist science. Those are different things, but they're related in that they both find that science isn't neutral. It is deeply political.
Courtesy of: Max Liboiron. Plastics wrapped around a squid beak found in a Northern Fulmar. 2015
The presentation of your research, visually, is patient, subtle, pretty – completely different from the majority of images I see related to plastics research. Can you talk about the work you’re doing right now?
I'll start with the premise of that, which is that we, I think, look at plastic very differently than a lot of the dominant discourses. Like you said, a lot of the dominant discourse about plastic is that plastic is inherently bad, and it's a bastard child of industrialization, and it needs to be eradicated, and illegalized, and banned, and exorcized.
But also plastic is our kin, it's our relation. It's from ancestors – organic ancestors from a long time ago. And if you neglect your relations to that, then you're bad kin. Even when plastic is misbehaving, which means it's being bad kin, you can still do good kinship with bad kin. And you know this. You have an asshole uncle somewhere. He might be bad kin but you still call him on his birthday, or bail him out of jail depending on what kind of bad kin he is. The same thing is true of plastics. I spend a lot of time with plastics. I do a lot of care work for plastics. I make sure that they are cleaned properly and I look at them a long time, and when I look at them, and I look at them in aggregate, I learn things about where they've been, and how they might have got there, and what their journeys might have been like, and where they might be going, because they're going to go for a long time.
We hang out together a lot, and they have a lot to teach us. Trying to ostracize them as the only sort of relation you can get, misses a lot of teachings that they have for us and also a lot of the respect. Because they are made of the earth. They've been pulverized in various ways so that they're not very earthy anymore, but you still have to respect that.
There's a tension with that in that the research that I do is mostly ingestion studies. Animals that have eaten plastics. Mostly what we focus on are animals that people, especially in Newfoundland & Labrador, use for food, depend on for food. For cultural sustenance, for nutritional sustenance, for economic sustenance. So the contamination of that food web is a form of colonialism. It's based on the idea that land is pollutable in the first place, that it is an okay place to put wastes. And magically, not magically, it's through different power structures, those tend to accumulate in rural, Indigenous, northern communities, which are never the places that benefit from plastic production. Almost never, but pretty much never.
At the moment, we’re doing some ducks, cod, seal, some geese. We get them mostly from hunters and fishers. We have a rule in the lab, all of our samples have to be eaten because what we test is food. We don't test oceans or some abstract fish, we work on food sovereignty. That means we sample food.
Are you consuming it?
Often.
Is that difficulte after seeing what's inside of it?
No. It's delicious. In the area we're researching, we do find plastic, but we also find them in smaller numbers than we find them in other places. Up in the north, we're fluent in things like the breast milk debate. In the 90's there were these big debates where scientists found really high PCBs in breast milk, and there was this huge protracted debate as to whether or not mothers could be considered abusive for feeding their kids that breast milk. A lot of stigmatization, ostracization, really screwed up relations within science. It turns out after multiple years, scientists decided, and medical practitioners decided, that actually, it's better to feed your kids contaminated breast milk than it is to feed them formula for their entire lives.
That being said, we have some of the least contaminated food in the world at this moment. Maybe not going to stay that way, but we consistently find lower ingestion rates in say, cod or ducks, than in other places. Part of that is the water that surrounds the province that I work in comes from the Arctic. There are certainly plastics in the Arctic, and that number is increasing, but it's not like the Gulf Stream which is filthy, where a lot of people get their fish.
Courtesy of: Max Liboiron
What state is the plastic in when you find it in animals?
The vast majority of what we find are microplastics, smaller than five millimeters, that are fragmented from larger things. You can't usually tell what they're from. Most people don't eat the guts of animals, so we don't usually ingest those plastics. There are some exceptions. People here eat seal intestine, and if you eat the fish called capelin or sardines, you eat the entire animal.
The concern that we have is that we know plastics absorb oily chemicals. Like when you have your tupperware that's stained orange from your chile or your curry, that's because plastics is really good at sucking in oily chemicals. If you want to wash that orange color out, which is really hard, you would put it in hot, abrasic, acidic conditions, like a stomach.
My dogs eat plastic everyday and there's no crisis of the dog species. Most dogs eat plastic.
The albatross on Midway Island, Chris Jordan's photographs, drive me crazy because those birds did not die of plastics. In fact, albatross are one of the only marine bird species in the world that is increasing in population and range. They are the healthiest bird species literally in the world. Albatross die a lot because they're what's called an R-species. They live a really long time and have a baby every year, and the vast majority of those babies die. While those babies are dying and starving, they eat a lot of things that aren't food, including plastics. When you find an albatross that's dead with plastics in its belly, the incorrect assumption is that it died because of plastics, not because it was dying and thus ate plastics.
That’s a revelation & also cause for pause about what we’re panicking about.
I think we need to be concerned, but differently than we're currently concerned.
Right.
We're really concerned about objects that are plastics, and that is a concern. But more concerning are all the chemicals that originate in plastics and get absorbed by plastics, many of whom are built by the same industry. The petrochemical industry makes plastics, makes gas, makes plasticizers, makes fragrances, makes flame retardants. Those are the same companies. Those are the same set of products. And the plastic parts are like the vehicles or the vectors, and that's not great, especially because it assumes disposability and therefore access to land, which is a form of colonialism, to dispose of. But the health concern is really these chemicals.
Are you optimistic about the future of plastics? In our ability to innovate, or participate in change?
No, because I don't believe in end of pipe solutions. At all. And that's because I fully understand the scale of plastics. It's like trying to bail out a boat, but you haven't plugged the hole that's sinking the boat.
How about if we stop top of pipe? How about if we stop the production of disposable and ubiquitous plastics? People like GAIA, or Break Free From Plastics, which are these large coalitions that not coincidentally are global coalitions with a lot of people from the global south in them, those are the groups that are like, screw your end of pipe, because they're the end of the pipe. They're where American corporations are building their incinerators. They’re where the people are shipping their recycling to. And they're like no, these solutions clearly don't work. They just defer and shuffle the problem.
What you need to do is stop the pipe. That's what I believe in. This isn't a technological problem, this is a problem rooted in colonialism that assumes you get access to other people's land for your solutions, whether it's storing your pollution or your recycling or whatever. I'm really interested in things like China's recycling ban, which ripped a hole in the world's recycling program because the entire world's recycling programs depended on the idea that things went away, and away was China.
People are looking for other ways. They're like oh, let’s ship our recycling to other places in Southeast Asia. Oh, Vietnam. And you're like, no, no. China taught us something, folks. What it taught you was you're going to run out of aways, and your aways are going to get tired of you, and folks in Malaysia right now are fighting, fighting, fighting not to be the next away. That's colonialism. That's just waste colonialism. That's just the newest frontier in waste colonialism.
If I'm going to put my optimism somewhere and my change making somewhere, it's in that. It's in people being like no, I'm not going to be your away. Go find your own god damn away. Once we run out of that, or once we take ownership of that – when I say we, I mean industrialized nations mostly. I don't believe in most narratives of “we” because they make it sound like consumers can do something. If you live in Newfoundland, even if you live in other places, there's one fucking store. There's no such thing as consumerism or consumer choice. Reuse is already to the nines because there aren't a lot of resources. So all of the...banning straws? There are no straws.
The straw thing put me over the edge!
A lot of the common discourses make zero sense in the north. It's a handy barometer when someone's like, this is a solution! And you just sort of look around and you say no, not possible. Moving on. Really helps you scale and prioritize the types of things that might work.
What is the alternative to our dependency on mass produced plastics?
The alternatives would mostly come from industry. The number one product category for plastics is packaging. It's not more than half, but it's the largest chunk. Most of that packaging has been necessary only since the 50's. That's living memory. We could circulate goods in ways we remember from living memory differently than totally packaged in plastic. Yeah. They circulate differently. They don't circulate as far. It just means you have different distribution systems. The problem is that oil has just reinvested in plastics big time. Eight months ago they invested more money than they put in the last few years into new plastic production. So that's their call, right?
Why are they re-upping their investment?
I don't know. There was no discussion of why this, like why plastics? I do know, and I have studied historically the reason that plastics and plastic packaging in particular is so attractive to industry is because it is so cheap and it is so easy to turn a profit off of. Part of that is disposability. The fact that you don't have to be responsible for the end of life of your product. Some other country, someone else's land takes care of that for you. It's a huge cost savings compared to other things that are possible.
That's deeply upsetting.
It is. That's why any conversation about plastic, if it also doesn't talk about power, it's missed the boat. If it talks about individual agency and consumers, and it talks about empowerment but not power, it's actually missed the entire structure of plastic production and pollution.
Do you think large government policy can be effective in altering our use of plastic?
Yeah. If government stops subsidizing oil. I look for these things that are not the expected things, like China saying no. Or someone being like, no more corn. No more subsidizing corn for alternative plastic stocks, which makes plastic just like plastic. These unexpected things, because plastic is so dependent on these really extensive networks. Transportation, extraction, production, disposability.
Are more people understanding the relationship and connectedness between plastic and industry?
I don't know about more people, but I do think that key people do. Some of these international global coalitions, get it. A few key scientists get it. The Story of Stuff pretty much gets it. GAIA gets it. Teen Vogue gets it! These folks who have moved away from the end of pipeline story and the recycling story and the five small steps story, and have considered or deeply know power structures. That's increasing, a lot.
I've been working on plastic pollution since before it was cool, and the story has shifted significantly. The recycling and five small things continues to proliferate on its little treadmill, but there's now a lot more variety than there ever has before, especially as people are like holy shit, car tires. Holy shit, clothes. Holy shit. Those are things where you can’t just make a little shift because of their massive infrastructural ubiquity. People are starting to understand scale. Key people are starting to understand scale. Yeah. So that's nice.
How do you work to eliminate plastics but also acknowledge those who will likely become more disenfranchised by a rising cost of plastic, primarily medical items, that are dependent on plastics?
I work with folks who are at the periphery who aren't getting benefits. People who hunt and fish and need that food for all sorts of reasons. The thing is, if you think about anyone who needs plastic medical equipment – medical waste is different than packaging waste. I don't want a pacemaker that's not plastic. First of all, it's not possible. Second of all, I want my fucking pacemaker. But the thing is, there's ways to do that that is not about mass production, that is not about releasing and patenting and circulating chemicals that haven't been tested properly.
The problem isn't plastics. There are natural plastics. There are polymers that decay.
That's the problem. This idea that you either have to ban it all or take it all, you're like no. Those are not the only two things available. And I know this because I live in the fucking north. Concepts of ubiquity don't really work here. The all or nothing doesn't work in a lot of places, and that's obvious.
What would a local plastic economy look like? Huh. No one’s ever asked that question really. If you had to own the plastics, own the extraction of those plastics, own the chemicals that go in the plastics and the extraction of those chemicals, I bet your plastics would look a lot different. I bet you wouldn't have packaging. I bet you wouldn't have BPA. I bet you'd just move to something else half the time. And I bet you'd have plastic pacemakers.