One evening I was sitting with a woman in labor at the private hospital where I used to work. I am a nurse midwife. I live in the San Francisco Bay Area, and I am Black. In the hallway, I saw a woman with a man and two children. She seemed poor and tired—tired in the way women often seem tired when they are in labor. She was Black. I could make out some confusion at the nurse’s station about whether this woman had a Medicaid card.
The woman told the nurses that she had not had any prenatal care. And there was an undercurrent from the nurses and from the obstetrician: “You didn’t take care of yourself. Why should we care for you now?” Like many of the other prenatal patients, this woman might have had to take a bus, with her small children, for two hours to get to this hospital. But no one asked her whether she lived anywhere near a place where she could have gotten prenatal care.
After the obstetrician read the monitor strip and said that the woman’s contractions were very far apart, the nurse told her that she would have to go to the county hospital to deliver her baby. Without insurance, she could not be served in this hospital.
No one asked her how she would get across town to the county hospital. She and her family simply left.
An hour later the telephone rang at the nurse’s station. The obstetrician on call at the county hospital wanted us to know that the patient we had sent had arrived and that the baby was dead.
The county obstetrician promised she would make this “dumping” of a patient and the subsequent death a public matter. Based on this event, the laws of the state and the country have been changed. It is now illegal to “dump” a patient from a private hospital to a public one because of a lack of ability to pay.
I think of this event often. I tell myself the story of what happened, and I try to imagine what it was like for each of us who was present. I believe that if we had tapped into our natural selves and acted out of our fundamental compassion, the woman would have never left the hospital like that. I know that none of us saw ourselves as evil or mean spirited. Why did we let her go?
When I examine my own role, I realize that I did not see this woman as “my patient.” I was only observing her rather than intervening in her care. I was held back from acting with compassion by underground voices that I am now beginning to let myself hear. This woman, the members of her family, and I were the only Black people in the labor and delivery unit that evening. Perhaps I wanted to make sure that the staff did not connect me with this family. I did not want to be identified with this woman who was poor, did not seem to care for herself, and was so vulnerable. Moreover, as a Black nurse midwife, I did not want to contradict the White obstetrician who had completed more schooling than I. I did not count on the people around me to listen to me and stand beside me if I challenged what was happening, and I did not want to be humiliated. I did not ask for an ally, and an ally did not offer herself to me.
I’ll just guess as to why that woman didn’t protest being turned away. She had probably been turned away from so many institutions that by the time the hospital dumped her when she was in labor, such behavior was routine in her life. If I was intimidated by the ranking of education, it’s easy to assume that she was too.
Hospitals are such huge and important institutions, with many regulations that are difficult for patients as well as staff to understand, that racist and classist rules go unchallenged. Institutional racism and its effects are so routine in hospitals (and everywhere else) that we often do not see how our action and lack of action perpetuate the status quo.
The story of this woman and the death of her baby has become my personal koan; it guides my life. My need to find my way from anger and self-hate through forgiveness to compassionate action led me to the workshops of Ricky Sherover Marcuse. Ricky was a European-American Jew who developed workshops on unlearning racism. She was the first person who helped me see how racism hurts all of us. For me, feeling and acknowledging that pain is the first step on the path to resisting injustice. Ricky taught me that all people are natural allies to each other because we have all been hurt and therefore know what it means to need and want help.
Ricky Sherover Marcuse died in l988 of breast cancer, leaving me no choice—as one of the people touched by her—but to continue and develop her work. That same year I started leading workshops on diversity with Yeshe Sherover, Ricky’s sister. At that time I also started practicing Buddhism.
The premise of the diversity workshops is that we are born wanting and needing to be connected with each other. I am with many babies as they come out of their mothers into the arms of others. As each baby is born into the world it is clear that they only want to be treated kindly, to be nurtured and loved, no mind as to who is doing the nurturing. As the months go by, these young humans smile and reach to anyone who is willing to be kind. What has happened to the babies we all were? By the time we are four or five, we know that there are many with whom it is not safe to offer or receive love.
Buddhism gave me the courage it took to look at the causes and conditions of the hurt that comes from closing ourselves off one from the other. The first long sitting I ever did was a ten-day vipassana retreat with Jack Kornfield. Every morning at seven, when we had already been sitting for several hours, a bird would begin to sing. The first time I heard the bird, I thought, “How nice!” Then somewhere in the middle of the retreat I dreaded hearing its song. I knew that it was a quarter to seven and the bird was about to start singing. And I hated that bird. Not only did I hate the bird, I hated its song. I thought, “How can it do this? How intrusive!” Then at some point, the song became absolutely beautiful to me. I had been able to watch my anger and hate arise and go away.
The experience of that retreat let me know that I could sit through my own discomfort, my own hate, my own anger. I sat with that bird long enough—paying attention to both the song and my response—that I could see that it wasn’t a good or bad song, but it was there, absolutely part of my life. That was a turning point for me. I have found that simply sitting with my experience—and sitting with it and sitting with it—allows love to be there. Or maybe the love was there all along and was covered up.
And I am learning that I can be liberated only if I pay attention to my own suffering. Even though I grew up in a country that was segregated by race and class, I had felt I was supposed to ignore my own suffering and attend to the suffering of others. But through Buddhism I began to see that by experiencing the pain I was suffering at having to argue for the humanness of my people, I might be able to free myself from that pain and also forgive those who felt that their humanness came from denying me mine.
My spiritual home is Green Gulch Farm Zen Center. It’s a place with deep dharma practice, beautiful gardens, acres of flowers and vegetables. As an institution, Green Gulch is passionately involved with ecology. The people there are, with some exceptions, European Americans. I want them to care for and work for the health and beauty and safety of human diversity as passionately as they do for biodiversity.
I have facilitated a number of workshops focused on diversity and the barriers to compassion at the various centers affiliated with San Francisco Zen Center as well as at other places. In one of the group activities central to these workshops, we explore how we have all suffered as a result of the ways we have characterized one another and ourselves and treated one another as less than human. I ask everyone at a workshop to stand together. Then I call out categories. I ask that if the category applies to you to please cross to the other side of the room and face the group you have left. There are many groups—gays, lesbians, African Americans, differently abled, raised poor, raised in an alcoholic family, raised in a family of abuse, and so forth. I ask everyone to think about what they know about that group across from them. I ask the people on both sides of the room to do this in silence. A group of Jews will be looking at a group on non-Jews and vice versa. I ask the people standing across from each other: “When you were a child, what were you told about the group across from you? What were you told about your group? What are some of the names used to refer to that other group? To your group? Do you have friends in the other group? What would it be like to be allies with people in that group?”
The point emerges that we have all been hurt because of power imbalances in our society. The fact that we have all been hurt is the essential link.
Later in the workshop, everyone is asked to explore a particular instance when she or he was hurt and to fantasize what an ally might have done for her or him at that time. It is from our own experiences that we know how to be an ally because we know what an ally might do for us.
As a midwife, my job is to sit with a woman in labor and watch and protect her as she does the most difficult job we humans do—birth another human being. In my role as a diversity workshop leader, I also sit and protect and watch as the workshop participants do the challenging work of facing the truths about themselves. Like birthing, facing these truths is difficult work. And also like birthing, it is just difficult; it is not impossible.