Once a Nurse

Always a nurse, or so the saying goes. Events of the past year, and especially of the last week, have taught me the truth of that saying, at least on a personal level.

I am and have been over the course of my 39-year career (counting from when I first started nursing school), a public health nurse (TB and hypertension control nurse with the health department in Richmond, Virginia), an inpatient stroke/neuro ward nurse, a rehabilitation nurse, an HIV/AIDS nurse at an LGBTQ community clinic, a Health Care for the Homeless nurse and family nurse practitioner. I have been (still am) a nurse researcher, a nursing professor, and a writer who happens to be a nurse. Always a somewhat skeptical/critically-thinking nurse (still am), questioning our healthcare system, our profession of nursing, and our socio-political system as a country.

Ever since the COVID-19 pandemic became a reality over a year ago, like many people throughout the world, I have reassessed my professional roles. What’s essential and what’s not? Essential: teaching population health and health policy as well as possible to our future nurses; becoming even more politically engaged to speak up on important issues like racism in health care, gender-based violence, and hate crimes against LGBTQ people/people living homeless/Asian-Americans; growing my network of politically engaged, progressive nurses across the country; spreading evidence-based public health information about the pandemic/pushing back against the cacophony of mis-information and outright lies; thinking and acting like a public health nurse, which I have realized is the kind of nurse I have always been. Not essential: university internal politics; worry about being productive with the usual expectations of grant-writing and peer-reviewed journal writing. My pandemic mantra has and continues to be: accomplish less, experience more.

This past week, the day after my two-week post second Pfizer COVID-19 vaccine dose, I began volunteer work as a COVID-19 vaccinator at a local public hospital. I asked for and received an excellent nurse practitioner mentor to shadow at first to get up to speed on the proper vaccination protocol, then sat down at my assigned station and began talking with patients and giving them the vaccinations. Yesterday, the vaccination clinic nurse supervisor introduced herself (both of us behind masks, of course) as one of my public/population health students years ago. She said she is an acute care nurse who has been working on the frontlines of the pandemic “since day one.” I thanked her for her work as a hospital nurse and as a nurse supervisor for the vaccine clinic, and gently reminded her that she is doing vital public/population health nursing.

I told my husband and family members (all, except my two-year-old granddaughter vaccinated now), that working as a volunteer public health nurse at the COVID-19 vaccination clinic feels like the most important and personally satisfying work I have done in my entire nursing career. Spread the word: These vaccines save lives and livelihoods. They give us hope.

(Please note: the photograph here was ‘staged’ and contains no patient or provider information.)

My Homage to Seattle’s First Homeless Person

His name was Edward Moore, a 32-year-old sailor from Worcester County, Massachusetts. He was found half-frozen on a Seattle beach in late December, 1854. For the past seven years I have been in search of his story. I tell it in my forthcoming book, Skid Road: On the Frontier of an American City (Johns Hopkins University Press, August 2021). I tell a shorter version of it in my recently produced digital storytelling video, “Commitment.” Thanks to a 4Culture Heritage Award for funding support for this, and additional (to follow) videos related to my Skid Road project. And thanks to StoryCenter for their training and support of my digital storytelling efforts. And if you or someone you know is interested in the topic of health and homelessness, I am presenting on it at a Museum of History and Industry History Cafe event (free and virtual) on Wednesday, March 17, 6:30 p.m. Here is my new video:

One Thing Is Clear: We Are Not All In This (pandemic) Together

A year into this COVID-19 pandemic in the Seattle area, it becomes clearer to me that we live in a deeply unjust society and have a dysfunctional and unethical healthcare system. Of course, many people knew this to begin with, but the pandemic has laid bare—and continues to reveal—the inequities built into our healthcare system. Besides the now well-documented disproportional toll of the pandemic (health, economic, social, and cultural) on communities of color and people from lower socio-economic status, comes the news this week of local hospitals offering ‘invitation only’ COVID-19 vaccination clinics for wealthy (mainly white) donors. These are for-profit hospital systems as well as ostensibly religious (Catholic in this case), not-for-profit hospital systems like Providence. Interestingly, our public hospitals do not have any vaccine to give the public. Seattle Mayor Jenny Durkan has urged the Washington State Department of Health to put a stop to this unfair practice. We knew that there would be people who would ‘jump the line’ in the rough and ready rollout of the COVID-19 vaccine in the United States, but most people erred on the side of trust in our hospitals to be ethical in their role in this vast effort.

Already being cynical about the US healthcare system, this adds to my cynicism and desire for a more just, cost-efficient, and effective public option for health care. And clearly, our public health system is a shambles, not only with its continued underfunding, but also with people doing heroic work during the pandemic and getting death threats because of it. What will it take to fix these problems?

On a personal note, although eligible now (and for the past month) to receive the COVID-19 vaccine, I have managed to sign up on a waitlist managed by the King County Medical Society which promises to contact me if and when any open vaccination slots become available to me. I am not holding my (double-masked) breath. And being a longtime patient of Providence—Swedish medical system and knowing the history of Providence in the Seattle area (the Sisters of Charity of Providence ran the King County Poor Farm and Hospital which split off to become Harborview Medical Center), I keep asking myself, “What would Mother Joseph of the Sacred Heart have to say to the Providence administrators and board members who gave the vaccine to rich donors ahead of the elderly and the sick?”

Dr. Ben Danielson: Standing Up to Institutional Racism

Dr. Ben Danielson, photo by Josephine Ensign, 2015

The new year brought hope for a better year ahead. Also, it brought sorrow and anger in Seattle at the news that a beloved physician and community advocate, Dr. Ben Danielson, recently resigned as medical director of the Odessa Brown Children’s Clinic. Odessa Brown Children’s Clinic is a pediatric clinic run by Seattle Children’s Hospital. It began in the late 1960s in the traditionally Black Seattle neighborhood (because of redlining/racial restrictive covenants) of the Central District. It began from a combination of the Model Cities Program and community calls for improved healthcare access and quality for marginalized urban communities, including communities of color. Seattle Children’s Hospital was—and still is—located in the upscale, mostly gated and white neighborhood of Laurelhurst. Then, as now, there were accusations that the powers that be at Seattle Children’s Hospital were racist, that children and families of color were subjected to racist treatment–as were nurses, physicians, and other healthcare staff members of color. (Also, Seattle Children’s Hospital has been accused of not supporting LGBTQ staff and patients; see my posts on the suicide of nurse Kim Hyatt who was openly gay and who was treated poorly by administrative staff. This showed up clearly in the redacted hospital personnel files I reviewed and in conversations with her friends and co-workers who contacted me.)

According to the independent newspaper, Crosscut, which broke the news of Dr. Danielson’s resignation after twenty years as medical director, “Danielson felt marginalized and alone as the rare Black voice in a position of authority…He said Seattle Children’s would gladly place Odessa Brown, which serves mostly low-income and people of color, on a pedestal to raise money, but would not show that same level of interest when it came to daily care”

I worked alongside Dr. Danielson in the early 2000s when I was a nurse practitioner at the ‘sister’ community clinic, Carolyn Downs Family Medical Clinic. Carolyn Downs is one of our country’s longest surviving clinic begun by the Black Panthers. As a nurse practitioner who had worked at a majority Black community clinic in East Baltimore, I knew about sickle cell anemia in terms of crisis management but not longterm, chronic management. One of my teenage patients at Carolyn Downs had sickle cell anemia and Dr. Danielson helped me manage his care more effectively. Subsequently, when working on my Skid Road oral history project for my forthcoming book, Skid Road: On the Frontier of Health and Homelessness in an American City, I had the please of completing an oral history interview with Dr. Danielson. An edited version of my interview with him is available here. (The audio quality on this one is much better than the video since I wrestled with the equipment that day.)

At the end of my oral history interview with Dr. Danielson, stated, “Diversity and cultural humility and improving the lot of people who are marginalized, that happens when you do it intentionally. Waiting for people to just do it out of generosity, or out of some sense of enlightenment all of a sudden that hasn’t been there for 20 or 30 years, that won’t cut it. We have to be intentional, and we have to be creative, and we have to work hard.” He spoke of being energized and having renewed hope because of the work of young people in the Black Lives Matter movement and because of the social justice work locally of the people of El Centro de la Raza. “You’re reminded that people stepped up. They occupied. They talked about oppression and racism, and they stood up to it and made a difference.”

Get Your Words Out

Having completed reading and grading close to 150 nursing student personal narrative policy papers (based on the Narrative Matters series in the health policy journal Health Affairs) for a public/population health course, I am energized by what they wrote—and by how well they wrote about compelling and timely public health issues they have a personal connection with. The ongoing and worsening opioid epidemic and diseases of despair, immigrant and migrant health, eating disorders and other mental health issues made worse by the COVID-19 pandemic, racism, environmental justice/climate change, elder health, vaccine hesitancy, and the occupational and safety fallout from the effects of how poorly our country and healthcare system have dealt with the pandemic.

As I read many of these student personal narrative policy papers, I thought of the wise words I heard recently from the author and environmental activist Terry Tempest Williams. She said, “Anger is polemic and no one wants to hear it. Rage is a story. There’s something behind rage. Anger is a shout; rage is a simmer. A piece written out of sacred rage lasts, while an op-ed is usually anger and people wrap fish in the paper the next day.” The most effective and powerful student papers tapped into that river of controlled, simmering rage. The nursing students who wrote these papers give me great hope for not only the future of nursing but also for our collective future.

I’ve promised to help them carry their words into publication of some sort should they choose to do so. Their lived experiences, their words, their perspectives are important. Of course, some students may not have the time or energy to revise their papers and submit them for publications. Others may have personal stories and perspectives that they are willing to only share with me. That is fine and I honor their decisions. Others have written to tell me that my feedback and encouragement to publish have motivated them to pursue that. Several have told me that they are so ‘on fire’ with the content and messages of their papers that they want to work on revision and publication over the holiday school break.

So here is my advice for them and for any of you readers, nurses or otherwise, who have compelling stories to tell to a wider audience.

  1. Ask yourself if you are ready to share your personal stories to strangers—and if you are ready to receive feedback, good or bad (or indifferent) on your story, not just by reviewers/editors, but also by readers once your story is published.
  2. Ask yourself if this is your story to tell and review the ethical guidelines provided by different publishing venues. As a general rule, altering patient or institutional identities is required.
  3. Read content and become familiar with a wide variety of publishing venues to see what sorts of things they publish before deciding to submit a piece of writing to them.
  4. Sometimes it is easier to start small, with submitting a shorter piece of writing to a publishing venue you like, are familiar with, and that has a track record of providing a kind and timely response and review/decision. One of my personal favorites is Pulse: Voices from the Heart of Medicine out of Montefiore Medical Center, Albert Einstein College of Medicine. For students, submitting work to a student-led narrative medicine/health humanities journal can be a good idea. At the University of Washington we have Capillaries: The Journal of Narrative Medicine.

Dr. Alexander de Soto: Friend of the Homeless

Thanks to Hektoen International : A Journal of Medical Humanities for publishing my essay, “Gospel Argonaut,” about Dr. Alexander de Soto who was one of Seattle’s more interesting physicians and “friend of the poor and homeless.” This essay stems from the chapter, “Ark of Refuge,” included in my forthcoming (July 2021, Johns Hopkins University Press) book, Skid Road: On the Frontier of Health and Homelessness in an American City.

Gospel Argonaut

Josephine Ensign
Seattle, Washington, United States

Photo of the Wayside Mission Hospital founded by Alexander de Soto
Entrance to Wayside Mission Hospital housed on the steamboat IDAHO, Seattle, circa 1900. Photo: University of Washington Libraries, Special Collections UW6573.

Short of stature and tall of tales, Alexander de Soto was by some accounts a highly educated, skilled, compassionate physician and surgeon, and by other accounts a charlatan, medical quack, faith healer, and quixotic dreamer. Born on July 24, 1840, in the Canary Islands to the Spaniard Alexander de Soto and American Elizabeth Crane, Dr. de Soto claimed to have been a descendent of the sixteenth-century Spanish explorer to America, Hernando de Soto. He told people that as a young man in Spain he had studied for the Jesuit priesthood, fell out with the Catholic Church, and completed his education at the University of Madrid.1

In 1862, de Soto moved to New York City where it does not appear that he tried to practice medicine of either the faith or conventional sort. Instead, he became a professional gambler and a morphine addict. He lived in rooming house tenements and police station homeless shelters. De Soto cured himself of his addictions in 1890 through the Holiness Movement at the Bowery Street Mission, one of the first such missions in the country.

De Soto was living and working at the Bowery Street Mission when he caught gold fever. He led a proselytizing expedition, setting out on foot from New York City to Seattle, hoping from there to take a boat to the gold fields in the Yukon. He planned to preach on the sins of greed and debauchery in Alaska. He called their group the Gospel Argonauts.2 Upon his arrival in Seattle, likely in early June 1898, de Soto sought out local newspaper reporters to cover his missionary work.

In a half-page article titled “De Soto’s Descendant and His Proposed Christian Work” in the Seattle Post-Intelligencer on Sunday, July 31, 1898, Irving Safford described de Soto as “a little blue-shirted man” with a “cultured Castilian accent.” De Soto had plans for a floating hospital he called Christ Hospital that he wanted to have built in Seattle, transported to Dawson City, and established there as a mission hospital. “The work, it needs me you know,” he is quoted as saying, with a parenthetical addition by Safford that “he himself is a physician”—as if it just occurred to de Soto that he could become a physician as well as a captain.

At that time throughout America many people could and did become physicians, not through formal, then termed “regular” medical school training, but through apprenticeship and by simply presenting themselves as physicians. Regulation and licensing of medical practitioners were rudimentary at best, even in older cities like New York. In Washington, which had only become a state in 1889, physician licensing was just beginning.3

De Soto decided to stay in this frontier city of Seattle. He moved into an abandoned barn in the Skid Road area at the mouth of the Duwamish River. The marshy area where Dr. de Soto and his homeless patients lived was called the Lava Beds for its numerous brothels and saloons. De Soto began a Robin Hood sort of medical practice. He charged high fees for medical consultations on rich people in their homes and then provided free medical care and food for the homeless and poor in Skid Road.

By February 1899, de Soto had moved to a rented basement in a tenement building in the heart of Skid Road. He turned the basement into the Wayside Mission, presumably named for its location along the waterfront as well as for the mission’s focus on health care and other services for people who had become society’s castoffs.

After a wealthy Seattle woman died under the care of de Soto, a group of Seattle physicians accused Dr. de Soto of being a faith healer, a Christian Scientist, and not a regular physician. They pointed out that he had no documented medical education and that he had not applied for a medical license in Washington State. De Soto claimed that these physicians were picking on him because he was successfully caring for Seattle’s “unfortunate souls” when they were not.

Dr. de Soto met wealthy Seattle philanthropists and a Seattle judge who supported his idea of opening a hospital mission on a boat along the Seattle waterfront. They formed the Seattle Benevolent Association, convinced city officials to rent space to their association at the City Dock, found and bought the decommissioned former opium-smuggling side-wheeler Idaho, and proceeded to convert the boat into a hospital. De Soto likely knew about and had seen the “fresh air” boats and floating hospitals for babies and for tuberculosis patients in New York City. The Wayside Mission Hospital in Seattle opened in early April 1900.

The June 1900 United States census for Seattle Precinct 1 in Skid Road records Alexander de Soto, physician, as head of “household” of the Wayside Mission Hospital, accompanied by forty-nine “lodgers.” Of the nine female lodgers, two are listed as nurses, including head nurse, Irene Byers. Dressmaker, servant, cook, and hairdresser are listed as professions for the other women. For the men, there are six “seamen” or sailors, lumbermen, carpenters, cooks, day laborers, a steamboat captain, a saloon keeper, and a druggist.

In a late October 1900 newspaper article, Dr. de Soto is described by his “soft, feminine, gentle hands.”4 The reporter adds that de Soto’s detractors accuse him of having an “oriental imagination,” emphasizing his exotic “otherness” and perhaps Moorish influence to the majority white Seattle population. But the reporter counters this with the doctor’s “systematic plan of applied Christianity,” which had attracted many supporters of his mission work to provide medical care to those in need but “not to harbor ‘hobos.’” He is described as a “practical mystic.”

Dr. de Soto received funding directly from the city of Seattle for the care of patients addicted to morphine, as well as care for indigent patients. At the time, Seattle and King County had an agreement that the city would care for “ill paupers” if they had been in Washington State for less than six months.5 In addition, the city agreed to take care of all emergency cases since King County Poor Farm and Hospital south of Seattle in Georgetown was too far removed from the city and was not equipped for emergency care.

A Seattle area newspaper, The Commonwealth, carried an article by Malcolm McDonald on May 23, 1903. Titled “The Samaritan Spirit—Seattle’s Pharisees,” McDonald reports that the city wants to develop the land and dock where the Wayside Mission Hospital is located. “It is the only hospital in the city ready at all times to receive the poor—the utterly poor who in sickness know no relief but death or the help of the Good Samaritan.” McDonald points to the high commercial value of land along the Seattle waterfront and asks, “Is any land too valuable for the saving of a human life? Is there no room in Seattle for an institution that has pity and not profit for the motive of its existence?”

In July 1904, Dr. de Soto was forced out of his work with the mission by the city and by members of the Benevolent Association because his management became unsatisfactory. The specific concerns are unclear. Whatever the reasons for Dr. de Soto being forced out of the medical mission he had dreamed of, started, and run for four years, the floating hospital, now called the Wayside Emergency Hospital, was turned over to Fanny W. Connor and Marion Baxter, social reformers. Under their leadership, the renamed Wayside Emergency Hospital continued to operate much as before onboard the Idaho along the Seattle waterfront.6

De Soto continued to work in Seattle as a physician. At age ninety-three he married Irene Byers, mother of his two children and a former nurse at the Wayside Mission Hospital. Three years later, he died of injuries sustained in a fall in Brooklyn, New York.7

In 1907, the Idaho became too leaky to repair and the Wayside Emergency Hospital was moved to the Sarah B. Yesler building. The Wayside Emergency Hospital continued to function until 1909 when Seattle opened its own clinic and hospital downtown along Yesler Way in the Public Safety Building. On the last day of March 1909, nineteen patients were moved from the Wayside Hospital to the new Seattle City Hospital.8

Dr. Alexander de Soto and his Seattle waterfront floating mission hospital are much more than just quirky side notes in the medical history and legacy of care for homeless people in Seattle. The Gospel Argonaut, the practical mystic, through his medical mission work, forced the citizens of Seattle to not only confront the reality of an increasing number of ill homeless people in their midst but also to find innovative solutions for their care.

This piece is excerpted from Skid Road: On the Frontier of Health and Homelessness in an American City, forthcoming from Johns Hopkins University Press.


  1. Irving Safford, “De Soto’s Descendent and His Proposed Christian Work,” Seattle Post-Intelligencer, July 31, 1898.
  2. “Klondiker’s Souls,” Evening Journal, November 9, 1897.
  3. Nancy Rockafellar and James W. Haviland, “The Broad Sweep: A Chronological Summary of the First 100 Years of Medicine and Dentistry in Washington State, 1889-1989,” in Saddlebags to Scanners: The First 100 Years of Medicine in Washington State, ed. Nancy Rockafellar and James W. Haviland (Seattle:Washington State Medical Association, Education and Research Foundation, 1989), 1-26.
  4. “Dr. De Soto and His Work,” Seattle Post-Intelligencer, October 28, 1900.
  5. King County Washington Commissioners, Beginnings, Progress and Achievement in the Medical Work of King County, Washington (Seattle, WA: Peter’s Publishing, 1930).
  6. Katharine Major, “Nursing Seattle’s Unfortunate Sick,” American Journal of Nursing 6, no. 1 (1905):32-34.
  7. “Dr. De Soto, 96, Dies after Falling into Bay,” Brooklyn Daily Eagle, November 12, 1936.
  8. King County Washington Commissioners, Beginnings, Progress and Achievement.

JOSEPHINE ENSIGN, DrPH, ARNP, is professor of nursing and adjunct professor in the School of Arts and Sciences, Department of Gender, Women and Sexuality Studies at the University of Washington in Seattle. She teaches public health, health policy, and health humanities. Ensign is the author of Catching Homelessness: A Nurse’s Story of Falling Through the Safety Net and Soul Stories: Voices from the Margins. She was a 2018 U.S.-U.K. Fulbright scholar, based in Edinburgh, for research on the history of English and Scottish Poor Laws. Her book, Skid Road: On the Frontier of Health and Homelessness in an American City is forthcoming (2021) from Johns Hopkins University Press.

The Psychology of Public Health Messaging

Source: Salt Lake County Health Department PSA

The stark, in-your-face COVID-19 public health messaging from the Salt Lake County Health Department has begun to stir controversy. In the image above, a large, white, presumably Mormon extended family is sharing Thanksgiving dinner. They are all maskless and not socially distancing. We are told that the man at the head of the table has no symptoms of COVID-19 but has had the infection for nine days. Instead of the obligatory “cheese!” or “turkey!” the woman taking the family’s photograph says,”Everybody say: I was just exposed to COVID!”

Other public health messaging in this series targets a more racially/ethnically diverse group of young people socializing together at an indoor party, and a grandmother seeing her (unknowably COVID-positive) grandson (we are told she ends up in the ICU with COVID-19 less than a week later). This series of public health images and messages brings up fascinating issues related to the effectiveness and ethics of public health messaging. These ‘ads’ are professionally produced and appear to be well thought out in terms of target groups and influential messaging to motivate people to follow public health guidelines. Thankfully, there was thought given to avoiding reinforcing negative (and false) stereotypes as to the ‘vectors’/sources of the disease, since no person of color was labeled as the identified source.

The November issue of the American Journal of Public Health includes articles on the rise of mental distress across our country stemming from the COVID-19 pandemic, the negative health effects of COVID-19-related racial discrimination of Asian Americans, and one titled “Reimagining Public Health in the Aftermath of a Pandemic” (sources below). The authors of this latter article make the case for advances in public health infrastructure, effective ways to counter misinformation, and improvements in risk communication. They state, “We already know that researchers are adept at communicating with other researchers but less skilled in reaching non-research audiences. Skilled spokespersons are needed. Generally, the public health community can learn much from business and social marketing, which tailor messages and target audience segments.” (p. 1609)

Anxiety and fear of disability and death from contagious diseases or natural disasters can be powerful motivators for individual behavior change up to a certain point. But tapping into that anxiety and fear through targeted public health messaging can backfire when it becomes too much for people to take in or becomes nagging, nanny-state background white noise.


“Mental Distress in the United States at the Beginning of the COVID-19 Pandemic,” by C. Holingue, et al, in the American Journal of Public Health, November 2020, vol 110:no. 11, pp. 1628-1634.

“Potential Impact of COVID-19 -Related Racial Discrimination on the Health of Asian Americans,” by J.A. Chen, et al, in the American Journal of Public Health, November 2020, vol 110:no. 11, pp. 1624-1627.

“Reimagining Public Health in the Aftermath of a Pandemic,” by R.C. Brownson, et al, in the American Journal of Public Health, November 2020, vol 110:no. 11, pp. 1605-1610.

Nurses, Vaccine Hesitancy, and the COVID-19 Pandemic

University of Washington Special Collections “Pioneering Medicine” exhibit, 2016

Nurses are the most trusted healthcare professionals in our country. Nurses are the largest component of the healthcare system here in the United States and worldwide. Nurses have an enormous ethical responsibility to keep up to date on and apply evidence-based practice in their work and in their personal lives.

The American Nurses Association (ANA) recently released results of a study from October, 2020 showing that only thirty-four percent of nurse members surveyed said they were willing to receive the COVID-19 vaccine once it is approved for use. Seventy percent of nurses reported that they had mistrust in the COVID-19 vaccine approval process, and sixty-three percent said their main source of information about the vaccine was from mainstream media. (source: American Nurses Foundation, Pulse on the Nation’s Nurses COVID-19 Survey Series: COVID-19 Vaccine, October 2020.) With the first COVID-19 vaccine due to be released for nurses and other frontline workers as early as next month, clearly, we have a problem.

We all need to work to repair the erosion of respect and trust in our public health system, including vaccine research, development, and safe, equitable distribution. Nurses can and should be at the forefront of that work and should be included on President-Elect Biden’s COVID-19 Advisory Board.

Not Playing Indian

November is both Native American Heritage Month and National Homeless Youth Awareness Month. This week (November 15-22, 2020) is Hunger and Homelessness Awareness Week. Especially this year, in the midst of the pandemic disproportionately affecting Native Americans and other BIPOC people, rising joblessness, increasing evictions (despite CDC and other anti-eviction mandates), increasing domestic violence, increasing social isolation and depression among our teens/young adults, increased attention and action related to these social and health issues are important. There are many things we can all do to help. Here is my list of actions for you and your family members to consider doing—not only during November:

1. Become better informed about these national and local issues by reading through the resources included in the links above.

2. Read more books by Native Americans. My current favorites include Braiding Sweetgrass: Indigenous Wisdom, Scientific Knowledge, and the Teachings of Plants by Robin Wall Kimmerer; There There by Tommy Orange, and An Indigenous Peoples’ History of the United States by Roxanne Dunbar-Ortiz.

3. Support Native American/Indigenous owned and run social service programs, such as Chief Seattle here in Seattle. They have health and social services (including supportive housing) for urban Native Americans/Native Alaskans/Indigenous people experiencing homelessness.

4. Support Native American/Indigenous owned and run arts and crafts stores, such as the “Inspired Natives, Not Native Inspired” Eighth Generation located in Pike Place Market, Seattle.

5. Support the expansion of school nurses and mental health counselors in all of our schools.

6. Support upstream policy efforts to prevent homelessness and hunger in our country. National Low Income Housing Coalition is one source of information on these issues. Likewise, for health and homelessness national policy issues, the National Health Care for the Homeless Council is an excellent resource.

Here is a digital storytelling video I made this summer in a StoryCenter workshop. “Honor Their Stories” is about my experience researching and writing a book chapter (in Skid Road: On the Frontier of Health and Homelessness in an American City, JHU Press, 2021) on Kikisoblu, also known as Princess Angeline, who was the daughter of Chief Seattle for whom Seattle is named. In this video, I explore the ethical issues I encountered as a white woman trying to understand more of the life, and death, of a Native American woman.

Healing. But First, Grieving

Individually and collectively we need a time of healing, physically, emotionally, and spiritually. 2020, the Year of the Metal Rat, has been a year like no other. The multiple upheavals and uncertainties have taken a large toll on us. We need a time for grieving all that we have lost and continue to lose. Not only the hundreds of thousands of Americans who have already died of COVID-19, but also the mounting job losses, increases in domestic violence, gun-related violence, and social isolation, especially for our elderly and other high-risk people. As we enter the darkest days of the year here in the Northern Hemisphere, alongside a second wave of COVID-19 infections and deaths, we need ways of staying hopeful, strong, resilient, and resistant.

What we are experiencing is not simple grief. It is complicated grief. As the Mayo Clinic writers put it, “Complicated grief is like being in an ongoing, heightened state of mourning that keeps you from healing.” Risk factors for complicated grief include social isolation, past history of depression and PTSD, adverse childhood experiences, and other stressors like financial hardships. Medical treatment for complicated grief includes, not surprisingly, grief counseling and cognitive-behavioral counseling. But other treatment interventions known to build resilience and lessen the negative effects of complicated grief are arts-based therapies, narrative storytelling, and other meaning-making activities.

The feminist environmental health and justice writer Terry Tempest Williams, said recently in an interview with Pam Houston, referring to both the very real effects from climate collapse (fires in the West and unrelenting hurricanes in the South) and the pandemic, “We haven’t grieved for it, for the people lost, and if you don’t think that won’t come back at us sideways (well, you’re wrong).”

Key references/sources:

Martha Kent , Mary C. Davies, “Resilience Training for Action and Agency to Stress and Trauma: Becoming the Hero of Your Own Life,” in The Resilience Handbook, eds. Kent, Davies, and Reich, (Routledge, 2013), 227-44.

Josephine Ensign, Soul Stories: Voices from the Margins, (University of California Medical Humanities Press, 2018).