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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.

This interview with David Bacon, journalist and author of Illegal People: How Globalization Creates Migration and Criminalizes Immigrants, was conducted and condensed by franknews.

frank | Can you start by talking about your background a bit?

David Bacon | I grew up in Oakland. The racial politics of my youth was centered around Black people and white people. Learning about how the imperial and racist history of this country affects African American people, Asian American people, and Latino people and their migration has been a lifelong learning experience for me. I say that because, I want to make sure that it's understood that I'm a learner, a lifelong learner.

In the 1970s, I was involved in the Delano grape strike - an effort by the workers in Central Valley. I would stand in front of Safeway and try to convince people not to buy grapes. After a while, I wanted to know more about what was going on behind the scenes. I convinced a friend of mine, a lawyer for the United Farm Workers Union, to let me volunteer in one of their offices. I began working at the union, on a ridiculous salary of $5 a week, taking statements from workers who were being fired or beaten up because of their union sympathies. I worked as a union organizer for about 20 years. As time went by, I became more and more drawn into documenting what I was seeing. So I made the transition to the work that I do now, and have done for the last 30 years, as a writer and a photographer.

I look at the process of migration from the perspective of those who are migrating. I ask: What uproots people and sets the process of migration into motion? What is the experience of traveling as a migrant? What happens to migrants once they reach the place they are going to?

How does your work with the unions inform your perspective of immigration?

The union was a school for me - it taught me Spanish, it taught me about organizing, it taught me about immigration. I’ll never forget how one evening, I was meeting with a group of date orchard workers at the union office. The next day, when I went out to talk to them again, they were being handcuffed and loaded into a green border patrol van. I was just floored by it. I didn't know what to do. I couldn't stop it. I chased the van down to the Imperial Valley, trying to figure out how to help them. It was a very brutal learning experience, certainly more brutal for them than for me, but it also taught me something very important.

I realized that this country's immigration policy has a great deal to do with work, and a great deal to do with labor.

I've written a lot about the US immigration process over the years, and I have tried to put an analytical framework around the process. The framework I use is this: The penetration of capital from large wealthy industrial countries into developing countries, displaces people. Those who are uprooted then become the workforce of the countries that displaced them in the first place. It's a singular system. And it is a system that is motivated by producing economic results.

What is an example?

Well, there was an economic incentive in the process that made Walmart the largest employer in Mexico.

Mexico used to buy corn from small producers in states like Oaxaca to help those communities survive. They would then turn that corn into tortillas and sell them at state-run markets in the cities to help poor people.

That system became illegal under the rules of NAFTA. Walmart comes in as being the big retailer of tortillas in Mexico, and the tortillas are no longer made from Oaxacan corn, but corn imported from Iowa. What happens to the farmers who were previously supported by Mexico’s system? They become migrants. About a third of the agricultural workforce in California is made up of people coming from Oaxaca. The irony is that Oaxaca is the birthplace of domesticated corn -those farmers are coming from towns that gave corn to the world, but they can no longer grow it themselves, so they became migrants.

You have worked with migrants for many years. What has been the starkest example of change in the migration system?

The border has become much more militarized. Largely that is due to The Immigration Reform and Control Act of 1986.

Before ‘86, if a hot band was playing in Mexicali, workers from the Imperial Valley would cross the border, see the show, and go back across the border to sleep at the labor camps that they were living in. In many places, even now, the border consists of nothing. For all of Trump's talk about the border, the reality is that it is still hardly marked at all in some places, but the process of crossing has become much more difficult and much more expensive.

At the time that you were organizing within the Unions what was the perspective of the migrant on US immigration?

People generally looked at the United States as a place that they have to come to work.

The Bracero Program from 1942 to 1964 was crucial in shaping this dynamic. Hundreds of thousands of people were recruited in Mexico, contracted a short period to work in the US, and then sent back to Mexico.

We still have programs that are very much like the Bracero program today, such as the H-2A. People have very conflicting feelings about those programs. On the one hand, people want to come here to work. They know the wages they can get here, and they see the programs as a possible way to get US jobs. On the other hand, people know that those programs do not offer you the ability to stay in the US permanently or the ability to bring your family to the US. We literally have thousands of migrants in California who live under trees, and I've talked to many of these folks. They often say, “Well, it's just for a while. I can put up with it for now while I send money home. In a way, it's better for me - if I don't have to pay rent, I can send more money home.”

How does that affect worker organizing?

That sentiment is very important to acknowledge in worker organizing. It means that migrants don’t have much to lose, but they don't have much to gain either. If somebody comes to them and says, let's go on strike here because the wages are too low, they may not be willing to risk their job if they know they are only in the US temporarily. The more someone lives here, as they start to pay rent, as they start a family, the more they come to think of themselves as part of the community. They have a greater stake in trying to change things.

What is interesting is that very often people come to the US with a lot of organizing skills. I remember one man spoke to me about how his father had participated in land reform struggles in Baja, California. He burned down the mansion of the Hacienda owner and redistributed the land in this worker's upsurge. Migrants come with organizing skills. If you can combine those skills with a stake in labor conditions, change can be explosive. We are seeing the results of that in California and in Washington right now.

And how does the opposite work? How do anti-union and anti-immigration sentiments work in tandem?

US immigration policy makes workers vulnerable, which makes it harder for people to organize.

There are many mechanisms by which this happens.

The most obvious is that people come here without papers. Out of a workforce of about 2.5 million farmworkers, 1.25 million of those folks have no papers. They don't have permission to work, and the employers or labor contractors who hire them, generally speaking, know this. They exploit this vulnerability and to keep wages low. They tell workers, explicitly or implicitly, if you stir up trouble, you can be deported.

Under the Employer Sanctions in our immigration law, it is illegal for an employer to hire undocumented workers. Employers who are facing an organizing effort by their workers can say, “We've discovered that you don't have any papers. We're not legally able to keep you. You're fired.” Sometimes immigration authorities will initiate that vetting, but sometimes not. In theory, employers should be punished and fined because of who they are hiring, but that seldom happens. It is the workers themselves who pay the price and lose their jobs.

The guest worker programs also have adverse effects on migrant workers' rights. Through these programs, employers can hire foreign workers on temporary visas. The migrant’s visa, and their right to be in the US, is dependent on the job. Through the H-2A program, which is specifically for temporary agricultural work, about 250,000 people, mostly from Mexico, are recruited. A report recently came out about this program. Every single worker interviewed spoke about the abuse of their labor rights, and sometimes these violations were egregious. The precarious nature of workers on these programs results in workers who can’t afford to complain.

Despite the political rhetoric and speeches that you hear, the function of US immigration policy is not to keep people out. Rather, it is to control the status of migrants when they're here, in order to make their labor available to employers at a price that they want to pay.

The mechanisms differ, but the results remain the same.

A lot of people think about immigration through this lens of sort of opportunity. How would you encourage a reframing of our current view on immigration?

Well, we need a reality check.

There are 40 million people in the United States who were born somewhere else. Why do people come here to begin with? The decision to migrate, often, is not a voluntary one, it is a survival tactic.

It is not just that opportunities exist in the US, it is that the opportunity shrinks in people's country of origin.

We have to look at our own responsibility for that. What kind of policy does the US government pursue in other countries that lead to the displacement of people? We have to look at trade policy. We have to look at NAFTA.

I think that a lot of people do get that that NAFTA hurt people. They often think of it in terms of how NAFTA hurt us, because jobs went south. But people here also, in many cases, are able to think about its impact in other countries and the way in which policies have displaced people too.

This movement of people and this process of displacement between the US and Mexico is not going to stop. You can build as many walls as you like, but it's not going to stop people from coming here. The things that are pushing people are to migrate much stronger than a wall. The need to survive is stronger than a wall. The desire to reunite the family is stronger than a wall.

Given that this movement of people is not going to stop, what do we want our immigration policies to do? Do we want them to make people more or less vulnerable? For working people, it is advantageous to fight to make migrants less vulnerable. If migrants do not have rights, it affects the entire workforce. If you want to organize a union in your workplace, and people are working in your workplace are terrified, and unwilling to be part of that process, that's going to hurt the worker. It makes it harder for the worker.

What sort of policy prescription or framework would you suggest?

We have to find where we have common ground: Where does an unemployed Black person in the US find common ground with a Mexican immigrant?

Congresswoman Sheila Jackson Lee tried to find it in, what I think, was a really effective policy proposal. About a decade ago, she proposed an immigration bill that simultaneously considered both of those groups.

She proposed a legalization program for people who were currently undocumented here, and, at the same time, new jobs creation programs for people living in communities of high unemployment. Who pays for it? Employers who benefit from the immigration system. All of a sudden, you have both interest groups advocating for the same immigration bill, because both people stand to benefit from it. Instead of pitting people against each other in a competition for scarce jobs, we need to unite to garner political power.

That is the big question about immigration policy in this country: How do we promote unity and mutual interest?

How do we look across the obvious dividing lines here and recognize people as people on each side? And not just from a moral point of view, but so we can mutually advance our material interests.

We also have to address voter disenfranchisement. A huge percentage of the working population cannot vote or elect people. If they were not disenfranchised due to their immigration status, maybe we would have more worker-friendly policies. We should look past what's often presented as a moral question “Why should those people be able to vote?”, and ask, “How will we benefit as working people?” If everybody who worked had the right to vote, then we would be able to change politics much, much more easily.

I think the conversation has found some new urgency amid the Coronavirus pandemic because we have had to look clearly at who our essential workers are, and how they’ve been treated or mistreated.

Yes. We're in the process of unpacking that. Essential means yes, your labor is necessary, but essential also means that you can't say no.

So on one hand, we are acknowledging that picking fruits and vegetables, working in meatpacking plants, or working in hospitals is socially necessary work. We are recognizing that we need to value that work and the people who are doing it.

On the other hand, essential is also being used by the administration and by employers as a way of saying your work is essential, and therefore you may not withhold it. You must go to work regardless of what the risks are. We are getting a good education about what actually happens to these essential workers as a result of their immigration status, their poverty, and their lack of rights as workers. We can look at the meatpacking plants. People are being forced into working, with the knowledge that a percentage of them are going to get sick and die. That gets underlined when they passed the relief bills. Not only did people who were undocumented not get relief money, but anyone who was married to somebody who was undocumented or did not get the $1,200 in relief payments. That removed any kind of support that might enable people to decide whether or not they want to work tomorrow.

If you can't get unemployment, and you can't get any relief, what other choice is there but to work?

That this is not lost on people. I've interviewed a lot of farmworkers who say, "This is really a slap in the face. First, you call us essential. You tell us how important this work is. You come outside and eight o'clock in the evening and you clap your hands for us. And yet what does that do for us? We're working the same job, with the same low wage as before, and now we have no choice but to go to work.”

Are you hopeful for meaningful change past this sort of rhetoric?

In the end, I think I am an optimistic person. There have been a series of strikes where immigrants are demanding better protective equipment, demanding social distancing to be put into place, and demanding hazard pay.

One result of the pandemic is that people are being forced to look at their situation and determine how far they are willing to go. Previously, it was a question of whether you were willing to risk your job for a wage raise. Now it is a matter of survival. When the threat is death, the question has become - How can we afford to not take action?

A heavy realization.

A heavy realization, but it produces activity. Crisis teaches people something. I think change is coming. How? I'm not sure. I can't predict the future, but I can see it coming. You feel the rumbling under your feet, right?

frank news is dedicated to storytelling across all mediums. A space for debate, discussion, and connection between experts and a curious readership. Topics are presented monthly with content delivered daily.

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On Media Responsibility

by Michael Sheehan

October 16, 2019

Call It What It Is

by LaShyra Nolen

July 1, 2020

The Right to Remain

by David Bacon

June 29, 2020