Tonight when we sat I closed the door behind me. As I sat comfortably the bell chimed, my mind quieted, and then there was a cat shrieking outside the door and the bap, bap, bap of his paw on the door asking to be included.  Cats don’t like to be excluded any more than people. Crockett’s (the cat) view was I could never hope to be holy without recognizing the importance of community and family which necessarily requires open doors and open hearts.

I loved being an officer in the U.S. Public Health Service. Teams became families and together we always knew the mission was bigger than any one individual or even group of individuals. We knew that each member was of equal value and together we succeeded or failed. While we had ranks we didn’t treat them as exclusive clubs. We knew that whether we were responding to a disaster, or an epidemic, or working in a prision we depended on each other.

When we staffed national security special events to provide emergency care we knew the risk was small, but the worst case scenario would require us all to have complete faith and trust in the other. There was one deployment where we were asked to do a task that had some significant danger and rather than one or two of us going we all went. Teams stick together. We worked together, we celebrated together, and we grieved together.

I miss that comradery in academia. There is too much us and them. There are those that are paid a small amount to teach a class here and there, those that have annual contracts and are not eligible for tenure, and those that sit at the top in the tenure track. Then there is the staff that makes all other work possible, those with head or dean in their title that keep the ship functioning and are often resented for their efforts, the upper levels with Provost in their title that have to make hard decisions that will impact the future of the university, and the people at the very top who have to keep everyone else happy while playing the necessary political game and are held responsible when anything goes wrong on campus.

Above all, love each other deeply, because love covers over a multitude of sins. Offer hospitality to one another without grumbling. – Peter 4:8-9

When I first retired to move to academia I started at a small Catholic university that believed in the equality of all faculty. Everyone with a terminal degree was eligible for tenure. The faculty cared so much about the staff that they voted to forgo pay raises so the staff would all have a livable wage. They also had a common dining room for students and faculty and everyone socialized there. It was so egalitarian that all faculty were expected to use their first name and know all students by their first name. I see that as an ideal environment for creativity, innovation, and forming young adults.

I’ve always been somewhat uncomfortable with exclusion which may be why that small, egalitarian university was so comfortable to me. I love faculty social events but am uncomfortable when those in staff positions are excluded. I wish I had the skill to create the collegiality and egalitarian nature of that small university. I wish I had in my soul the vision of Mary Frances Clarke, BVM and that special style of leadership.

When you look into the abyss the abyss looks back

I often think of the song All Are Welcome and I suspect everyone has a song that lifts their heart and reminds them how important it is to be inclusive. Crockett wants to know what song is in your heart?

When I left Tennessee to start my career as a new nurse practitioner I thought I was leaving behind racism and sexism. Silly me. While it is less prevalent in some parts of the country it is ever present and I was unprepared.

I arrived at St. Elizabeths hospital the day after graduation to begin work. I had spent two summers working there while I was finishing my Master’s degree so I knew it was in Anacostia, a predominately black neighboorhood and in an area with a significant drug issue. It was where I wanted to be and what I wanted to do. There was little I did not love about being at St. Elizabeths. The neighboorhood was made up of the large, old houses that were suffering some deterioration but still beautiful. Across the street was a Chinese restaurant and down the block was a Popeye’s, which became an addiction I only recently broke.  The campus was 396 acres and 101 buildings many of which were still beautiful and others that were more deteriorated than some of the houses. There were trees from countries around the world and beautiful flower gardens. The room of Esra Pound was even still maintained.

I was assigned to a unit that cared for those that were homeless and had a mental illness. I learned more working at St. Elizabeths than any other period in my life. Part of what I learned was my ignorance of people that didn’t look like me, didn’t sound like me, or for that matter were not from Tennessee. I left a community that was predominately white and middle class and moved into an apartment complex that had a great deal of diversity and took a job where I was in the minority.

It is now common to hear about cultural sensitivity or cultural competency, but it wasn’t in 1991. Because I was too young and ignorant to be embarrassed about what I didn’t know I was comfortable with what I now know as white privilege. The day I arrived the unit coordinator announced he was going on vacation and I was in charge. I had completed an entry level MSN. It was the first week of my first job and I was in charge. About a week after I started work one of the Psychiatric Nursing Assistants ask me something that made her realize I was actually a new nurse and from that day forward everything changed. A more senior nurse stepped in and did what I should have done and spoke to the Chief Nurse. She should have been in charge all along. Looking back I had an MSN, new LTJG bars, and I was white. Rather than holding it against me, I was treated like a new nurse and I absorbed all everyone had to teach me from my supervisory medical officer to the psychiatric nursing assistant. 

At some point, my mother asked me one too many times about the color of the person’s skin I was telling her about. I could feel the slow burn as I lost my cool and told her that unless I tell her otherwise she should assume that everyone I knew was black, all my coworkers and all my friends. Of course, at that time it was fairly accurate but why was it always an issue? Why was it always a detail she wanted? Until the day she died, she never asked again. When I left St. Elizabeths to work in a Federal prison one of the interview questions was how my family would feel about me working in a prison. I said not as bad as they did about me working in DC. It was sadly true. My mother never appreciated me telling her that I was truly part of the team when I walked down the street in DC and someone yelled my name from an ally which may not be the best thing to tell a mother.

I have been fortunate to spend the majority of my adult life living and working in very diverse environments. When I retired from the U.S. Public Health Service and moved to Iowa I was surprised that the majority of the faculty and students were white. In my professional life that was a first for me. One person in the city told me they used to be a Catholic town, but now they are only 80% Catholic. I think it was the first time that I truly realized how different life is when there is limited diversity. I wish I had the words to describe it, but it is a feeling that is hard to explain.

I was only in Iowa for three years before moving first to San Antonio and then to St. Louis. It was in St. Louis that the difference between diversity and inclusion was glaring. The university had demographics similar to the community at the undergraduate level, but yet there were significant issues. While we had 20-30% underrepresented minorities at the undergraduate level we did not at the graduate level and it was not because there was a lack of qualified students? The college had recognized the problem and instituted holistic admission and still no change. It wasn’t until we blinded the admissions that we went from 7% to 29% in one year. Fortunately, we had a dean that was supportive of the effort and stood with me when some faculty said we were implying they were racist. We had a positive outcome, but it was evidence that implicit bias existed in the admission process. Where was it unrecognized? My guess is that there hiring and promotion suffered the same bias.

Diversity doesn’t mean inclusion as was the case in St. Louis. I look back and wonder when it was that I found my voice and my courage to stand up. It wasn’t at St. Elizabeths where I dare say I didn’t recognize my white privilege. It certainly wasn’t when I was told I couldn’t hire any more Hispanics for the Cuban Mafia. I think it was when I was told that I couldn’t promote a black officer and if I did “when she fails and they all do I will hold you personally responsible.” That was the day I ordered my boss out of my office and said I will take that responsibility and hired the officer. I was grateful when I was transferred a few weeks later because I knew that there would be hell to pay.

I still would not say I’m culturally competent and I certainly can’t understand what it must be like to be the officer that was expected to fail. But I do realize that it isn’t enough to count numbers, 7 – 29% and call that success. It isn’t enough to hire the person and not report the blatant discrimination. It isn’t enough to increase the diversity of students and do nothing to address the bias in teaching evaluations or to even use them knowing the bias exists and it will harm professors of color and women. It isn’t enough and so we should make it part of the curriculum to include content on diversity and inclusivity. Students should not have to learn how to address racism on the job or that diversity doesn’t mean inclusivity. We can’t continue to send students out unprepared to address real-world issues.

The summer of 1990 was my second summer in the Junior Commissioned Officer Student Training and Externship Program (COSTEP) of the United States Public Health Service (USPHS). I knew what I would be doing and where I would be going, unlike my first year which was filled with surprises and challenges that started with a tire that was destroyed by something sharp in the street and cost me $70 of the $200 I had to last me for my first 45 days in DC.

In 1989 I was in the second year of a non-nurse Master’s program when someone came to class and handed out applications for the COSTEP program. It was a competitive program and I thought I had little chance of being selected but it paid approximately $1800 per month for the summer. When a call came asking me if I was interested in being a COSTEP I immediately said yes to which the Commander on the other end of the line ask me if I wanted to know where the job was located. I replied that would be nice. A few months later I was off to St. Elizabeths Hospital in Washington, DC for the first of four times moving to DC as a USPHS officer.

A few days after July 4, 1990, Mitch Snyder, the founder of the Center for Creative Nonviolence (CCNV) and the best known homeless advocate in the Nation committed suicide. My goal after graduating had been to work in healthcare for the homeless. I had visited CCNV and they had taken the time to discuss the healthcare needs of their residents with me and my fellow students. I would remember the discussion and the funeral as I worked on my theses that year.

My master’s thesis was on health care beliefs and self-care practices of homeless men, my volunteer work had been with those that are homeless, and I worked on a unit that treated those that were mentally ill and homeless. I saw Mitch Snyder as an icon of compassion and action. It wasn’t until many years later that I considered the aspect of his life that involved policy and the role that the failure of Initiative 17 may have had in his loss of hope and sadness over his relationship.

The nurse manager on my unit suggested I attend the funeral. I was sad and in awe of this man that was what I wanted to be.  The city had turned out and Rev. Jessie Jackson officiated and then lead a procession through DC. The list of celebrities present was long and people like Phillip Berrigan were being asked for comments. He had referred to Mitch Snyder as a “true shepherd”. That is high praise coming from anyone, but a special honor coming from Phillip Berrigan. As I stood behind a gaggle of the press I wondered how much the world lost that day.

The nurses that supervise students during summer externships should always recognize that the students are there to learn. The goal is not to use them as nursing assistants, but rather to help form them as future nurses, professionals, and engaged members of society. My nurse manager did not have to send me to the funeral. She recognized my passion as a nurse, nurtured the passion, and helped to ensure that I chose a career that focused caring for the poor and underserved.

I returned to St. Elizabeths Hospital as a Nurse Practitioner and a USPHS office for three years after graduation. I continued to volunteer in shelters and work with the homeless until 1999. The nurse manager that sent me to the funeral probably had no idea the impact her decision would have on my future choices, my continued desire to work with the poor and underserved, or my view that nurses must be engaged community members. If you think your summer externs forget you they do not. You forever influence their career choices and how they engage with students in the future. Those summer externs are your legacy.

I believe God has a path for me. He’s always had a path for me, and I’ve always been in the right place at the right time – not because of my efforts, but because of my preparation and because of the guides that I have, the mentors that I have, the spiritual walkers that I’ve had all my life. — Judith Jamison