Do Better

by Rachel Ricketts

  Being the badass bitch that my mom was, I thought she could just make up her mind and that would be that. Ya know, the old “wish yourself to death” trick. But no such luck. Day in and day out, over the course of three months, I stayed by her bedside. I fought with the doctors about my mom’s care, sleeping on the pullout to help her feel secure for the first week. As the only Black folx in the whole hospice, it was immediately apparent to me that we were treated differently. My mom was out of her comfort zone, and the medical staff didn’t help her feel safe. After merely a week into Mom’s stay the white head nurse suggested that it was perhaps the wrong place for “someone like my mom.” The fuck you just say?! To tell a sick, disabled Black person in unspeakable pain that she didn’t belong in the only place she had left in the world was appalling. My mom’s home was now gone. Her possessions given away. That hospice, that room, it was all she had left, and goddamn it, she was going to die in it.

  I took on the role of researcher, trying to find some way I could confidently end my mother’s pain. End her life. Including searches like “how to kill your mom” (which I do not suggest). In the depths of despair, I considered it all. Considerations that took time and energy I could have otherwise spent at my mother’s bedside, supporting her through her pain in her most dire time of need. Had we been treated with adequate care and concern, I could have. In the chasm that is her absence, that’s perhaps what angers me most. Finally, the head of palliative care, one of the many all-white doctors, sat me down to mansplain that they couldn’t simply drug my mom into oblivion. It wasn’t allowed and, even if it was, he wouldn’t do it.

  “Your mom’s not dying,” he said. “She could live another ten years. Most of her organs are healthy. Strong even. She’s just in constant pain.”

  “Yah,” I responded, “and that’s not living.”

  The hospice wanted nothing to do with me, my mom, or our sitchu, and I had some compassion for that. Some. But white supremacy, ableism, and misogynoir, they can all get in the way of supporting a patient, her family, and helping them do what’s right and best for them. Especially when the patient is a Black disabled woman subject to medical racism and an onslaught of dangerous stereotypes about her mental capacity and tolerance for pain.

  THE RACIAL EMPATHY GAP

  Numerous studies have shown that there is a pervasive racial empathy gap throughout the medical system, where Black folx are perceived as experiencing less pain than white folx. Some studies have found that the same doctor will prescribe less pain medication to a Black patient versus a white patient exhibiting identical symptoms. White folx from the age of seven years old have been found to exhibit a strong and reliable racial bias concluding that Black people feel less pain.17 Which leads to us receiving less compassion and inadequate medical care.

  It took decades to confirm my mother had MS, her white doctors routinely disregarding her symptoms and ignoring her welfare. And then they misdiagnosed her. At thirteen years old, I was told my mom had Lou Gehrig’s disease, a fast-onset degenerative disease, and only had a few years to live. Had she been properly cared for, her MS would not have gotten to the point it did, and now that we were out of options and simply seeking support to help my mom die with dignity, we were once again being brushed aside.

  A few mornings after the head nurse had more or less told us to leave the hospice, my mom told me about a white night nurse who yelled at her and refused to change her diaper, once again leaving her utterly helpless and forced to sleep in her own shit. Black folx seek out medical attention to support us in healing from physical and emotional traumas, as anyone would, only we frequently face more harm and oppression under that same system’s “care.” At my godfather’s funeral (which I attended the morning after my mother died), I met a head nurse from another hospice. She had heard what my mom and I endured and expressed that it never should have happened—we shouldn’t have had to fight to be treated with basic decency. But we did.

  * * *

  “It’s not physical pain your mom is experiencing. It’s emotional pain,” I was told by the hospice counselor as another justification for refusing to increase Mom’s pain meds, “it’s trauma.”

  “Yah, cool, I know. It’s manifesting as physical pain, so what’s the damn difference?!”

  I was told repeatedly by the nurses, doctors, and counselor there was nothing that could be done. No way to help my mother hasten death or alleviate her suffering, and any thoughts I had to that end were sadly mistaken. Except that wasn’t fucking true. My mom’s family doctor, a South Asian woman and fucking legend, raised the option of voluntary cessation of eating and drinking, which is fancy terminology for starving and dehydrating yourself to death. Assisted suicide may have been illegal, but straight up suicide was not. The trick, though, was to get the racist jerks at the hospice to move past their oppressive perspectives and help keep mama bear as pain-free as possible during the process. But, because they were racist jerks, they wouldn’t make that promise. So, we called in a medical ethicist, someone specialized in helping solve medical ethics dilemmas—and, folx, we sure as fuck had a dilemma on our hands! In the most important and profound use of my legal training to date, I convinced the ethicist that my mom was absolutely entitled to terminal sedation (in regular speak: to be kept sedated on pain meds until she died). As I walked out, I felt triumphant. Kiss my sweet Black ass! If the medical establishment had just done its job and shown some fucking compassion, it could have saved us from this whole fucking fight. Medical racism struck again. But we. Showed. Them. Or so I thought. I passed by the room next to Mom’s and saw that the patient who’d been there since we first arrived months before was gone. There were no feet poking out, no sheets or blankets on the bed. There was just nothing. And then it hit me. I had spent so much time and energy fighting, I had barely stopped to settle into what it was I was fighting for. My mom would soon be dead. Gone. And I would be alone.

  * * *

  Over the next twelve days, I watched and guarded as my mom slowly slipped from this world into the next. It was painful, harrowing, and heartbreaking and simultaneously magical, beautiful, and transcendent. I sat by her bedside in total silence and basked in the glow of a soul that was half in this world and half in the next. I could sense something far, far greater than myself, and over those weeks any doubts I may have had about “the other side” were vanquished. Sometimes Mom was lucid, and she sounded strong and entirely in her body. On one such occasion she asked for her hand mirror, and I held it up so she could see her face. She moved her cheeks around, furrowed her brow, then exclaimed, “Shit. I may be dying but I still look pretty damn good!”

  The next day she was unable to speak despite her best efforts. Those were heartbreaking days. All she could utter were unintelligible sounds. I did my best to fulfill my duty as a guardian and gatekeeper to her transition. I played Deepak Chopra recordings and her favorite songs… all Celine! I burned incense (wasn’t allowed, but fuck all y’all) and brushed her hair. I did anything and everything that I hope a loved one will do for me when my time comes.

  Between her now zombielike state and the burnout from all the running around and managing and guarding and witnessing and fighting—I was at my wit’s end. If I’d been exhibiting trauma symptoms before this whole hospice ordeal, you best believe I was in the thick of it now. For twelve weeks I had been living as though every moment could be my mom’s last, and for two decades I spent every moment worried about her welfare. I went home that night and debated whether to go back. I had always been the hyper-responsible, dutiful daughter and most of my life I lived under the acute fear that my mom would die well before either of us was ready. I made the hard decision not to go. I was near the brink of something bad, and who knew how much longer this all would last. I went to bed and awoke at two a.m. I felt something odd and contemplated calling the hospice but decided not to. I put my head down to go back to sleep, and eleven minutes later, they rang: “Rachel, your mom has died. We’re so sorry.”
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br />   OPPRESSION KILLS

  In the weeks and months that followed, I endured grief unparalleled. It felt like the weight of a lifetime of pain fell down on me all at once. Like a ton of bricks. Not only from physically losing my mom, but from all the losses, oppression, and pain both I and we had endured along the way. I relived the many lifeline alerts I had received in the middle of the night to rush to her aid and how I lived across the street from her social housing unit in order to do so. I remembered all the times we barely had enough to eat. I could hear the scream she made before I found her lying on our living room floor, the white carpet stained with the blood spilling from her head wound—just days before my first-year law exams. I recalled the way our justified anger was routinely used against us. I reflected on the time I was nearly kicked out of university after my mom drained my student loans to pay rent because she didn’t qualify for disability payments and was scared to be subjected to the “Black welfare mom” stereotype. The times I had to call the paramedics when she stopped breathing at four a.m. and then work eighteen-hour days on million-dollar deals to make rich white men richer. I was left to endure the cavernous ache of her absence but also the fact that had white supremacy not forced so much trauma upon her, had she been diagnosed earlier and/or treated with equitable health care, she never would have had to end her life at all. And I wouldn’t have had to help kill my own mother. I was mired in pain that comes from combating a racist, misogynist, ableist system that made her dis-ease, her death, and my grief all the worse. With no one to constantly care for anymore, the thick haze of my own trauma, the burden of carrying a lifetime of white supremacist harms, descended upon me. Within three months I had suicidal ideations. Had it not been for my connection to Spirit, the support of a few close friends and my (now) husband, and a stint on antidepressants, I’m not sure I’d still be here. The compounding isolation of my loss and having my experiences constantly invalidated by misogynoir made me want to end my own life.

  In the end, I was empowered to get a hold on my situational depression before it caused me or others grave harm, but I wonder how many other Black women+ have died and continue to die as a result of the tremendous trauma systems of oppression inflict on us and our families. Women+ like Erica Garner, who died of a heart attack at twenty-seven after her father, Eric Garner, was murdered on video by NYPD officers who never faced indictment.

  As a queer Black woman living in a white supremacist world, the traumas I endure and the impacts on my health are never-ending. The consequence of inherited traumas like PTSS and the daily, lived traumas from enduring misogynoir have had atrocious consequences on both my family’s health as well as my own. I suffer from anxiety and adrenal burnout from being forced to live in a near constant state of hypervigilance. My immune system is compromised. My stress hormones have been shot to hell, and it’s hard to rest or digest because my body has been in fight or flight for decades if not a lifetime. Black and Indigenous communities around the world are diseased and dying from the impacts of white supremacy. For example:

  Black American women are 7.5 years biologically “older” than white women because our telomeres (ends of chromosomes controlling aging and key biological functions) are shrinking as a result of excessive chronic stress factors, including racism, classism, and sexism.18

  In Canada, Black folx have a 60 percent increased risk of psychosis compared with non-Black folx and are most likely to face racism from the medical establishment, increasing their risk of self-harm.19

  In South and Central America, Indigenous people endure the highest rates of morbidity and mortality, with the least access to health services compared with the non-Indigenous population.20

  In the UK, Black women are the most likely to suffer from psychological distress, depression, and anxiety, while Black men are ten times more likely to suffer from mental health issues than white men.21

  All the foregoing health issues are exacerbated in times of global pandemic, like COVID-19, as Black folx who, due to white supremacy, have higher rates of underlying health conditions and are more likely to die when hospitalized. It’s no surprise (or mistake) that we’re dying at disproportionate rates.22 Indigenous folx are all too often disregarded by white medical “professionals” and left for dead, much like Joyce Echaquan who was murdered in a Quebec hospital when medical staff administered the wrong drugs then called her dumb and “only good for sex” as she wailed for help.

  This is just a glimpse into the health consequences of systemic oppression on Black and Indigenous folx, and we haven’t even covered the deaths caused by police brutality, the criminal justice system, or other state-sanctioned murders. Every day, in every way, white supremacy kills. In the midst of the COVID-19 and Black genocide pandemics, government agencies around the world declared what Black folx have known for centuries: anti-Blackness is a public health crisis. I know firsthand how the stress from oppression can kill, and yet I can never fully divest my nervous system from the same systemic web of lived and inherited stressors. I cannot help but wonder: Am I destined to suffer the same fate?

  TOWARD HEALING

  White supremacy creates trauma and causes havoc on the health of humxnity as a whole: BI&PoC as well as white people, LGBTTQIA+ as well as straight folx, both trans and cis beings. No one is impacted more than the most marginalized, who are traumatized by oppression then further oppressed because of those traumas. Still, we all have harms in need of addressing. When we are not undertaking our inner work, these harms go unacknowledged, unaddressed, and ultimately unhealed. If we repress our emotions, especially our rage, they may very well manifest as dis-ease if not death. Especially for Black and Indigenous women+ who also face systemic oppression, including medical racism and misogyny. For white and other dominant groups, the inability to honor and tend to your inherited and social traumas is not only of great risk to your own health but to the health of Black and Indigenous women+ and other oppressed groups who suffer at the hands of your unhealed wounds. Trauma is not only an experience; it is a structure of oppression.

  Right now, we have the privilege and opportunity to help heal ourselves from the inside out, across time and space, for ourselves, our ancestors, and future ancestors. Healing is possible but it requires a deep examination within. As you move through this work, and through the world, pay close attention to the ways your body is talking to you. And your body, if not your ancestors, will tell you when you are in stress—through sensations such as headaches, fatigue, indigestion, insomnia, and more. Do your best to notice when you are disconnecting from yourself and why. Pay attention to the triggering pieces and show yourself care so the emotions they evoke don’t lodge within your physical self. Racial justice requires massive upheaval of the mind, body, and Spirit. It demands illumination of not only our own pain, but the pain that has passed down our families for generations and perhaps lifetimes.

  We must acknowledge our ancestral history—whatever that may be. However hard that may be. Address the harms your ancestors endured or inflicted, or both. Examine what wounds you have learned, absorbed, or perpetuated. And begin to identify their stories and your feelings. Stop repressing and start expressing. Your life, my life, all of our lives, depend on it. Because white supremacy is killing us all, both internally and externally, Black and Indigenous women+ in particular. And because no one else should be forced to die like my mom did, and no child should be forced to bear witness. Until we do the inner work to address our personal and collective traumas and eradicate white supremacy, more Black and Indigenous children most certainly will.

  Spiritual Soulcare Offering/Call to Action

  REFLECT AND JOURNAL ON THE FOLLOWING:

  Do you have enslaved ancestors or ancestors who enslaved others in your bloodline? If so, have you acknowledged it? Is it acknowledged in your family? How or how not? How does it make you feel? How can you acknowledge it now? (Note: If you don’t know your ancestry, you can research, or tune in and ask them.)

  Is there a history o
f known trauma in your ancestral line? If so, what? How has it shown up in your family line? Has it ever been addressed?

  How has your race, gender identity, and/or sexual orientation impacted your health (negatively or positively)?

  When you’ve finished, find a quiet space where you can be in solitude for at least ten minutes for the following meditation.

  Ancestral Meditation

  As this is our first meditation together, let’s take a moment to note that we will be partaking in these practices in a culturally informed way. This begins by acknowledging and honoring the ancient peoples of present-day India, my ancestors, who cultivated and shared the potent practice of meditation with the world so we can partake in it today. If it is available to you, extend gratitude to the Indian community for the gift of this practice by supporting them in some way (financially, energetically, or otherwise).

  Now let’s begin. Find a position that feels most comfortable for you in your body right now. It can be sitting upright with your feet on the earth, lying down, or otherwise. If it feels sufficiently safe, close your eyes. Or lower your gaze. Take a long, slow inhale through your nose, filling your belly and back body with air. Then take a long, slower exhale out through your mouth, emptying the belly completely. Take two more breaths in this manner. Begin to notice where you may be holding on to tension, perhaps in the shoulders, jaw, or brow. Breathe into those spaces.

  When you are ready, bring your ancestors into your mind’s eye. Ask them to come forth and present themselves to you. You may perceive them through sight, sound, or sensation. Just notice. Ask your ancestors what they most wish for you to know. Perhaps they want acknowledgment of the pain they endured at the hands of oppression. Perhaps they wish to express their apologies for the oppression and harm they inflicted on others. Perhaps both. Tune in, observe, and surrender. If it feels aligned, ask them to help release you from whatever ancestral patterns or stories no longer serve—whether you are aware of them or not. Feel free to share whatever you wish with them as well—affirmation, forgiveness, simply bearing witness. Ask them for support as you move through this work, which offers healing for them as well as you. Then call on all the ancestors of the land you live on, which may include the original Indigenous stewards of the land and/or Black folx kidnapped, enslaved, and brought to your region. Listen to what they have to say.