Monday, February 13, 2017

Some Things I've Learned about Anger, Grief, and Race

When I worked in hospice, I prided myself on being able to disarm the patients and families I visited, many of whom did not want to see a hospice worker, and especially not a hospice social worker.  This may or may not seem obvious...but the gist of it is that if you're in hospice, you are dying, and most people don't like reminders of that.  And we come into your home at what is most often a time like no other - a time when adrenaline and desperation are coursing through you if you're a caregiver and a time, if you are a patient, when you want to save every small ounce of energy you have for people you love, not strangers.  And social workers are the worst - we ask 'nosey' questions about coping, fear, support systems, and family history.  But, I'm kind of funny and fun and I'm a good listener.  And at that time, I tried my best to pace the personal questions in a way that didn't feel too much like a barrage.

One family I remember consisted of an elderly woman being cared for by her adult son.  I called the son trying to set up my first appointment to introduce myself and help them connect to any resources that might be helpful for her care at home. The instant he answered the phone, I knew this man was pissed.  Pissed about people coming into his home, pissed about her medical care, and pissed off at me for calling.  I remember driving down Hwy 44 talking with him on my flip phone and something in his voice let me know that I could argue back with his pissed-offedness - that if I stood up to him and earned his respect, I could make some progress with him.  And that's what I did.  It was a risk.  He wouldn't let me in that day, but he agreed that I could visit later in the week.

You know what's weird? His mom died later that very day (this happens sometimes in hospice-  people get referred very late in their illness or they take a sudden turn as soon as they know they don't have to go back to the hospital anymore.)  Anyway, I was the hospice worker who got called to that death.  I thought, "Oh, shit.  I hope the son will be ok with me."  He was.  It was like we were old friends when I showed up to help take care of the calls to the medical examiner, and the funeral home, and I was able to have credibility with him and provide comfort to other family members because I'd made this rather argumentative connection with him on the phone in the morning.

Overcoming barriers between people isn't always that easy.  Some barriers run deep and won't be overcome by charm or moxy.

Another patient who let me into her home fairly easily was an 80-ish year old African American lady who was being cared for by her sister.  Though the sister was pleasant enough to me, my patient was cold and non-communicative and I felt suspicion and dislike emanating from her.  It might have been on my second visit, I asked this patient, "Are you concerned for your sister?"  "Why would I be concerned for her?" the lady replied.  This stumped me - I wanted to say, "Because you love her and she will be alone after you die."  But, I knew I could not address death directly with this patient (lots of hospice patients do not want to talk directly about death, and that's OK.)  So, I said something more simple but with a vague openness, "Just wondering if you are concerned this is hard on her."
"I'd like you to leave now," she said.  "And you are not welcome back."

I can't say you could have knocked me over with a feather, but I was certainly stunned and hurt.  And yet I knew a truth deep inside me (something that we have been grappling with much more overtly in the past couple years in St. Louis and in our nation).  This had something to do with race.  I didn't know what, I didn't name it aloud to my patient, but I knew it.

I called one of my hospice co-workers, who is black and told her what happened.  I concluded, "I  sometimes get the feeling that some of my older African American patients don't like me."

You know what she said?  "They don't."

It was a good, honest lesson.  She said, "Katy, you are a young white woman social worker.  You probably seem nosey.  As a social worker, your profession has the reputation of splitting up families, and you are part of the medical community and with Tuskegee and everything else, many older black people don't trust white doctors and medical professionals."

I've come to understand that my confidence in overcoming barriers between people is coming from a place of privilege.  I am given certain leeway, and I am used to being seen in certain positive ways by our larger culture, if for no other reason than I am a white female.  When my black patient didn't like me, maybe just because I was white, it was the ego bruise,  I wasn't used to that because I am white.  And what I needed to understand was that her not liking me was about deep pain, deeper than that moment, deeper than my life history and longer than her life history.

And this is something I understand because, though I'm not an expert in history, or sociology, or law, I am an expert in grief.

My very first social work internship, I helped teach the parenting class for divorcing parents in St. Louis City.  We used to teach, "Anger is a tooth with two root.  Fear and sadness."  I actually think it's very true.  In both these stories from my long ago hospice days, I was the recipient of anger - whether that anger was merited or not at me personally, it doesn't matter to me.  But anyone who has ever grieved probably experienced the part of grieving that is anger - and that grief anger can sometimes not be comforted or changed.  We are angry because something is not fair.  Our loss isn't fair.  What we've been through isn't fair.  We are fearful more unfair things will happen.  We are sad that unfair things have happened and can't be undone.  We experience these feelings uniquely and individually, but it may also help us to know that the world of humanity experiences them also.

Have you ever had anyone try to talk you out of your grief or your anger?  It doesn't work and it probably just makes you more mad or feel more alone.  It's something I try my best not to do, no matter how uncomfortable it is to sit with someone's despair or rage.  What I try my best to do is witness these feelings and perhaps this is the beginning of some healing.