I originally wrote this post in my hiking journal, and decided to make a blog post of it. I’ve added some links throughout and at the end. I edited it a bit, I’m happy to share the rest with anyone who is interested and wants to have an uncomfortable yet honest conversation. I know this is imperfect, because I am imperfect. I am not going to let my imperfection prevent me from saying what I want to say.

I sit next to a seasonal stream, rushing with snowmelt, as I write this. It’s an idyllic spot. The sound of the water coursing by and crashing over rocks, the smell of the duff and the surrounding forest of pines, the puffy white clouds against a deep blue sky, the sound of birds all around, a faint chorus of frogs in the distance. There is no one but me around.

When I am out in these spaces I always find myself pausing, tilting my head up to the sky, taking in a slow, long breath, eyes closed, exhaling the tension and stress that has built up since my last foray into nature. And I always think, ‘I can just breathe’ and it’s always a revelation. 

Today that exhale was not enough to release all of the sorrow, the outrage, the pain, the suffering, the grief, the worry, the fear. Today, I hear George Floyd saying, pleading, ‘I can’t breathe’ as he lay dying under a white man’s knee, under the gaze of three other police officers as he took his last, strangled breaths. I can’t breathe. Please, I can’t breathe. Begging for breath, for life. Murdered for the crime of being a black man outdoors.

Another gentle giant falls. 

I hear Eric Garner saying ‘I can’t breathe’, dying within a white man’s chokehold, again under the gaze of other officers who are supposed to protect and serve. I ask, protect and serve who? It surely doesn’t seem to be our black citizens. I can’t breathe. Begging for breath. Murdered for being a black man outdoors.

Another gentle giant falls.

And I think of all the others. Ahmaud Arbery and Breonna Taylor, still fresh wounds on our breaking hearts. Of Freddie Gray and Michael Brown. Of Sandra Bland and Philando Castile.  Of Tamir Rice and Aiyana Jones. Of Emmett Till. Of those killed in the Tulsa Race Massacre. Of so many others whose names we know and whose names we don’t.

Why have we let this go on for so long? Why have I never written about these injustices in this blog before today? Why has it taken so much trauma, so much suffering, so much violence against black people, so much inequality and inequity, so much racism – including explicit racism, which is only enabled and encouraged by this current administration, and systemic racism, which may be even more sinister because it is implicit, baked into our structures and systems and harder to see, yet informs so many of our policies and practices – for me to finally write this post?

Why haven’t I stood up on this platform and shouted that racism exists (and why do we still have to prove that it exists? Or that it affects health and well-being? Seriously, WTF?) and that it is a public health issue, a human rights issue, and that we must do something about it? Why, in my advocacy work, have I not talked about racism and how the generational and ongoing trauma of slavery, segregation, redlining and inquitable housing policies, Jim Crow, mass incarceration, police brutality, discrimination, the KKK, white supremacy, the underfunding of education, the denial of opportunity, food deserts, inquitable health services, lack of safe places to recreate and lack of safe environments to live in affects the health and wellbeing of black people and that we must do something about it? 

I can say it’s because it’s a blog about my pain, about pain science, about narrative and the power and stories. But that’s a lame excuse. There is more than enough science and data to know unequivocally that racism affects the health of black people, including in pain care (read Higher Pain Ratings in African Americans Rooted in Discrimination by Stephani Sutherland). Not race. Racism. And there are so many stories of pain and suffering in the black community. So many stories that too many of us have not paid enough attention to. So many stories we have not acted on.

I can say I didn’t speak up because I was worried about offending people in powerful positions, worried about losing opportunities, worried about losing friends. What a privilege it is to have such worries. To have the choice to remain silent. To have an option of avoiding discomfort.

Well, fuck that. I’m standing up now. And I apologize, much too late, for not standing up sooner in this space.

It is not anyone’s responsibility to forgive me. 

It is heartbreaking and gut wrenching that there is and has long been so much pain and suffering in the black community. And isn’t it part of the problem that these are burdens we’ve made the black community bear alone? Why is it not ALL of our pain and suffering? Why is it not pain and suffering in OUR community? Why do so many not feel their pain? Not even not feel it, why do so many not even ACKNOWLEDGE their pain? Their traumas? Their suffering? That part I don’t get AT ALL. The denial I see in some corners of healthcare fills me with dread and despair.

To be a pain patient advocate, as I claim to be, I can no longer ignore on these pages the pain and suffering caused by anti-black racism. Especially that caused by systemic (or structural or institutionalized) racism that directly affects policies in housing, healthcare, employment, education, and policing and that affect access to clean air and water, nutritious food, and equal opportunities. (Read Structural racism and health inequities in the USA: Evidence and interventions)

The health and wealth inequities we see in this country that so negatively affect black people are not individual faults, they are societal ills. And we, as a society, can change them. We can make things more equitable, more equal, more just, more fair. (Watch this talk with Ibram X. Kendi and Mona-Hannah Attisha on why ‘antiracism and fighting for the most vulnerable is more urgent than ever’ to address the inequality health crisis in America today.)

Access to housing, nutritious food, education, opportunity, clean air and water, green spaces, and safe places to live, work, and recreate IS healthcare. Being free of racism, discrimination, stigmatization, marginalization, and harmful implicit and explicit biases IS healthcare. 

I recently wrote a blog post for the Environmental Physiotherapy Association about how reconnecting with nature was so healing for me. That connection, that ability to go out and explore nature and exalt in the great outdoors, is a privilege. I did nothing to earn it and it is a privilege not granted to everyone, especially to black people, and especially especially to black people who live in urban centers with limited access to green spaces in the first place.

I recognize, much too late, that I can ‘just breathe’ in these wide open spaces – without fear, without worry, without being considered a threat – because of my middle class white skin. 

My heart is so heavy. I am weary. I am filled with outrage and sorrow. I know the same is true for many of you. For those of you who are white like me, imagine what it is like for those in the black community. Imagine what it is like to have the white man’s knee upon your neck, holding you down, robbing you of breath, of freedom. It is all too literal, yet has metaphorical weight and truth as well. Imagine having that knee upon your neck your whole life, your whole history, and that you are descended from those who had the white man’s noose around theirs.

The tactics have changed, the same racism is still here. 

Times up. 

We have real work to do in this country to get at the root cause of George Floyd’s death. Of Breonna Taylor’s death. Of Ahmaud Arbery’s death. Of Christian Cooper’s inability to watch birds in Central Park. Of a long history of violence against black bodies and oppression of black people.

We have real work to do to root out and lay bare racism, personal, systemic, and otherwise. We must work to end police brutality, which is a public health issue. We must work toward equitable community-driven solutions. We must addresss health and wealth inequities. We must right wrongs. We must do the work to know our real history. To confront our own biases, our own ignorance, our own silences.

We need to stand up. Fellow white people, we need to stand the fuck up and do this work. It is not enough to not be racist. We must become antiracist.

We don’t have to do this hard word alone, but we must do this work.

I’d love to continue the conversation. Contact me in the comments below or reach out via the contact form.

I have included some links throughout the post, please check them out. Here are a some more:

Here is more on How The COVID-19 Crisis Is Making Racial Inequality Worse from NPR.

This is an excellent COVID-19 press briefing by LA public health director Barbara Ferrer where she speaks about the death of George Floyd adn the protest and says : “We know that black Americans fare worse than other groups on virtually every measure of health status and it has become all too common to blame this on individual behaviors, when in fact the science is clear. The root cause of health inequities is racism and discrimination and how it limits access to the very opportunities and resources each of us need for optimal health and well-being.”

Here is more on Racism and Health from the American Public Health Association.

An article on The Impact of Racism on Child and Adolescent Health from the official journal of American Academy of Pediatriacs

How To Be An Antiracist, book by Ibram X. Kendi

What the Eyes Don’t See: A STORY OF CRISIS, RESISTANCE, AND HOPE IN AN AMERICAN CITY, book by Mona Hannah-Attisha

The Road Not Taken: Housing and Criminal Justice 50 Years after the Kerner Commission Report – an update of a report on racial inequity from 1968!

From 1993! Urban Violence in Los Angeles in the Aftermath of the Riots: A Perspective From Health Care Professionals, With Implications for Social Reconstruction

I’ve recently started taking Mockingbird’s History Lessons for Adults (I’m a Scout)

I am obviously not an expert in this area but I am happy to share more resources and point you to people who are experts.

I have made a lot of mistakes. I am going to make a lot of mistakes. I have surely made mistakes within this post. But I am not going to let fear of doing this wrong stop me from trying to do what’s right.

I promise to keep listening, keep learning, and keep failing forward.

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