Creating Community

Pop Brixton, London

What do old shipping containers have to do with creating community? They can be re-purposed to provide sturdy protection for indoor gathering spaces, such as one I visited this past week in London.

Pop Brixton is an indoor-outdoor community space in the heart of the ethnically diverse south London neighborhood of Brixton (of David Bowie and Eddy Grant/”Electric Avenue” fame). Built of shipping containers on a previously empty, unused city lot full of concrete rubble, Pop Brixton is an incubator for community pop-up cafes, music and art events, an alternative school, a shared office/workspace (Impact Hub Brixton), a community garden, and even a community/people’s refrigerator named Freddie.  

“Freddie” the People’s Fridge

One of the Pop Brixton design features that struck me as being most effective was its central dining hall space with large, communal tables. This space was winterized when I visited, being enclosed and well-heated with portable gas heaters. Local artists (along with children from the neighborhood) designed and made the colorful banners hanging overhead, as well as the cleverly-constructed “fireplace” at the heart of the communal space. The fireplace is made of a plywood frame/”flames” with orange paper and lights—shown below in the two photographs. There were a few people sitting around engrossed with the solo glow of their smartphones, but the vast majority of people were talking and interacting in positive ways. 

Upstairs on the second floor (wheelchair accessible), was a lovely open seating area for quieter, more contemplative places for conversations (or nursing babies), surrounded by plants and more banners. 

Out back on the ground floor is the community garden (near Freddie the Fridge), the school, and the office-sharing/community-building space of Impact HUB Brixton. All of the small businesses housed in Pop Brixton are independent, with the majority being owned/operated by local community members. They actively promote social enterprises as well as having a Community Investment Scheme where all members donate at least one hour each week to use their time and skills to support local causes. 

One of the local agencies they support is Skye Alexandra House, a semi-residential home for vulnerable women aged 16-18 who have suffered abuse, imprisonment, prostitution, or disruptive foster care experiences. Pop Brixton supports their “Inspiring Butterflies” program, “a series of workshops that focus on personal development, life skills, awareness of sexual exploitation and domestic violence, bullying, money management, performing arts and enterprise.”

Pop Brixton is inspiring and welcoming and truly is a place where people make (positive, community-building) things happen. Out of boxes. 

Loneliness Kills

Living on my own in the kingdom of loneliness for over three months has made me more aware of the pernicious effects of loneliness on health and wellbeing. It does not surprise me that the U.K now has a Minister of Loneliness, and that Prime Minister Theresa May has recently released a loneliness policy report: “A Connected Society: A Strategy for Tackling Loneliness—Laying the Foundations for Change” (October 15, 2018). May calls loneliness a “great public health challenge” and plans to have GPs within the NHS to be able to refer patients to community programs geared to ease loneliness.

Yesterday, I visited a long-standing (36 years) community cafe in Edinburgh that has been successfully combating loneliness among the elderly and people living with mental health challenges Located near the Royal Edinburgh Hospital, a long-standing mental health facility in the Morningside area of the city, the Open Door Cafe is a most welcoming place. From the high school student volunteer, Hamish, who greeted me and served me a great cuppa’ and scone, to the friendly regular customer/patrons who shared their stories with me, this was a place that warmed my heart. It also gives me hope that we can open the community Doorway Cafe in the University District of Seattle along similar lines. They use a pay-it-forward model and also have a robust group of volunteers to keep the place sustainable. In addition, they receive some funding from the NHS.

It also warms my heart to have discovered that the Open Door cafe was founded by an Edinburgh nurse, Peggy Hunter, all the way back in 1982. She said, “I have a dream to turn loneliness into fellowship, isolation into recognition…” and she has done just that. 

I love their statement on their website in which they succinctly describe their cafe championing of diversity: “Of course, many people who use our services have a variety of support needs, so you may find having a cuppa is a different experience to that of your usual coffee shop. Can you open your mind to share some space with someone who is different from you?”

How the Poor (and Homeless) Die

Homeless encampment, Edinburgh cemetery

A powerful and classic (yet too little known) social justice writing by George Orwell is his autobiographical essay “How the Poor Die.” It should be required reading for all nursing and other health science students as it eloquently describes the experience of death and dying for poor and homeless people. Although the essay is based on his experiences, first as a poor patient on a public ward of a Paris hospital in 1929, and then back in England and Scotland (Glasgow) towards the end of WWII, there are echoes of truths in his observations that are relevant today. 

One of the most poignant parts of the essay describes “old numero 57” (patients were numbered, not named) lying—and dying—on a cot in the open ward next to Orwell. He writes, “They are treated like animals. They die alone, their organs already marked for a bottle in the museum, their bodies designated for dissection.” 

Orwell’s essay came back to me yesterday as I went in search of pauper’s grave sites in Edinburgh. From my research, it seems that there are thousands upon thousands of pauper’s graves in many of the town’s oldest remaining church cemeteries—such as St Cuthbert’s just below the Edinburgh Castle. They are buried in communal ( or, rather “mass”?) graves that are, of course, unmarked, and typically located in the now grassy central parts of the cemetery as shown in this photograph I took yesterday. There are older laws banning the grazing of sheep or cattle on these churchyard fields; current laws are posted banning all animals, including dogs (except for certified service animals). 

St Cuthbert churchyard

Edinburgh is infamous for its early to mid nineteenth century grave robbers, body snatchers, or “resurrection men” who dug up recently buried bodies of people and sold them to surgeons of the University of Edinburgh Medical School for their anatomy dissection. And then there were the body snatchers (and complicit surgeons) who took it even further, murdering poor and homeless men and women on the streets and in flophouses. People who died in poor/workhouses and public insane asylums and whose families did not claim (and pay for) their bodies were sold by the Overseers of the Poor to the medical schools for dissection. Is it any wonder that poor and homeless people have a well-founded fear of public hospitals and related institutions? 

No Time to Be Silent: On Radical Nursing

P1020860There is a time and place for silence, but only when it is freely chosen, not imposed. But now is not the time for silence. Now is the time to step us, speak out, and, at least in the United States, to vote. It is time to remember that progress on human rights and social justice issues in our world is not a given. That basic respect for girls and women is not a given. That universal abhorrence of gender-based violence is not a given. We all have to work for it—even when (and especially when)—our lives are turned upside down.

Nurses are the most trusted professionals in both the U.S. and the U.K. (although tellingly, nursing was only added as a legitimate profession to these polls in the U.K. two years ago). As nurses, we have always prided ourselves on being truthful, for speaking out and advocating for our individual patients or communities. But for various reasons (including a lack of contemporary role models or inclusion in nursing curricula), nurses have not be so good at political advocacy and activism.

Historically, nursing does have some amazing examples of nurses who bucked the status quo, spoke truth to power—who were radical nurses. Florence Nightingale in the U.K.—and especially her work after the Crimean War in bringing nurses to work in poor/workhouses in England.  And in the U.S., my favorite historical role model is Lillian Wald in New York City. Lillian Wald founded the Henry Street Settlement in the poorest section of New York City, and she founded public health nursing. Public, community, population health nursing is what drew me to nursing in the first place and it continues to be my passion. Public health nursing work is always political work.

In the U.K. in the 1980s there was the short-lived but influential Radical Nurses Group (RNG). Some of their archived material was the subject of a (again, short-lived) blog, “The Radical Nurses Archive” written by a former NHS nurse using the lovely pseudonym, The Grumbling Appendix (with another blog on nursing and politics in the U.K. that ended in 2015).  Where have the radical nurses in the U.K. gone? I am currently on a quest to find them.

Back in the U.S. we have the NurseManifest website and resources on nursing and activism co-founded by Sue Hagedorn, Peggy Chinn, and Richard Cowling. Beginning in the summer of 2018, they have added the Nursing Activism Project with a growing list of historical and contemporary nurse activists “Inspirations for Activism.”  In addition, they have a dynamic list of resources for nurse activism.

No excuses. All you nurses out there in the world: Get informed. Get inspired. Get active.

I include a recent interview I had with my colleague here at Edinburgh Napier University School of Nursing and Social Care, Dr. Peter Hillen, on nursing and activism.

 

Reflections on the Poor Laws

P1020893.JPGWater of Leith, Edinburgh, bench beside Saint Bernard’s well with a statue of Hygieia, goddess of health

The largely impenetrable layers of history and how we humans are so prone to repeat past mistakes.

That is what occurs to me today as I walk these ancient paths and sit beside an ancient, pagan well of healing—mineral waters—overlaid, of course, by Christian (Saint Bernard) and ancient Greek (Hygieia) symbols. After a morning of reading ancient British Poor Laws—weeks of researching them and tracing their repercussions today, not only in the U.K. but also in the U.S. and in Seattle/Washington State. The worthy and unworthy poor. The deserving and underserving poor. The impotent poor. Paupers. Vagrants. Ruffians. Charity and its attendant ills. Solidarity and its limitations.

Beige mud puddles surround me here as I sit on this bench, barely staying dry underneath my umbrella. What sort of stone is all this beige-ness? (note: ancient sandstone, over 300 million years old.) The entire city of Edinburgh is composed of beige stone. And what minerals are in this water? (note: Sulphur, magnesium, and iron it seems.)

A soft purple Scottish thistle—late blooming ones in the midst of a large patch of blackened, dried up plants with thistle heads. There seems to be a prickly and a not so prickly version of thistles here. Why is the thistle the national flower of Scotland? (note: no one seems to know although there is a story about it that involves Norwegian invaders by sea who stepped on the thistles and alerted the Scots to their presence.)

Why aren’t nurses taught more about the history of social welfare and of the legacies of ancient pauper laws? Are they taught that at all here in Scotland or elsewhere in the U.K.? How much of it are even social workers taught either here in the U.K. or back home in the U.S.? It seems so important and puts many things in perspective, especially in terms of addressing the current thorny question, “What to do about the homeless?” And my own ongoing work in the vicinity of that question. I almost feel cheated in not having known about it much earlier in my life and my career as a nurse.

The deep layers of the histories of places and peoples are important to acknowledge, to know, at least at some more than superficial level. Is this something that can only be appreciated as one ages and takes on a proper sense of time?

A beechnut exploded, scattered on the ground along the river walk path wending its way beneath an old tree. They look like flowers but are hard. I try to press one between these pages and it breaks through the paper. Only the seeds remain.

 

Students Rock

IMG_4490This is why I continue to love my academic work: smart, creative, compassionate students who see what is needed in our world and find ways to ‘just do it.’ They ask the hard questions, like “well, why not?” and they help keep us honest about what we are supposed to be focused on within higher education—and especially at public institutions in our country. As the University of Washington Vision and Values statement puts it, we educate a diverse student body “to become responsible global citizens and future leaders,” and “we discover timely solutions to the world’s most complex problems and enrich the lives of people throughout our community, the state of Washington, the nation and the world.”

This past academic year I’ve had the pleasure (most days) of directing the Doorway Project, with the aim of creating an innovative community cafe/navigation hub for young people (including, unfortunately, many of our own students) who are homeless and/or experiencing food insecurity in the University District of Seattle. It has not been without its many challenges, but also satisfactions and delightful surprises. It is swamp work, as in real work on real-world problems. (see my previous blog post “Life in the Swamp: Float, Don’t Flail” from April 28, 2018 for an explanation of the swamp work reference.)

What gives me hope in terms of the real-world wicked problems like homelessness? I was asked a version of that question recently in a Seattle Growth Podcast with UW professor of business Jeff Schulman. “Our students and young people,” was part of my response.

Here is a hot-off-the-press news article “Student volunteers help expand UW’s outreach to homeless youth” by Kim Eckart (UW News, August 20, 2018). Enjoy a ray of (smoky here) sunshine and hope for the future. And here is the latest new and improved design for the Doorway Cafe (design credits: Hope Freije and Delphine Zhu).

IMG_5326

 

Trauma Mastery

IMG_0253Note: This is an excerpt from my essay “The Body Remembers” in my book Soul Stories: Voices from the Margins (San Francisco: University of California Medical Humanities Press, 2018).

Early in my career as a nurse, I worked for a year in a “safe house” emergency shelter for women who were escaping intimate partner violence. Before my work there, I did not understand the concept of trauma mastery and how this plays out in the lives of women caught up in the cycle of abuse. I sided with the common misperception that the reason so many women return to their abusive partners is because the women are psychologically damaged and weak.

I learned that there is the not-insignificant role of addiction to the thrill of trauma and danger—to the effects of the very activating yet numbing fight-or-flight neurochemicals—which can bring at least temporary relief to the bouts of fatiguing depression that often accompany trauma. And there are also unconscious attempts to return to the previous trauma to “get it right this time”—to do what we wish we could have done the first time, to master our trauma.

Seattle social worker Laura van Dernoot Lipsky points out that these unconscious attempts to master our traumas often backfire and simply reinforce our old traumas. She says that many of us in health care and other helping professions are often using our work as a form of trauma mastery, and that by doing so, we may set expectations for ourselves and others that are “untenable and destructive.” (1) She advocates ongoing efforts aimed at self-discovery and self-empathy, and points to the many positive examples of “people who have been effective in repairing the world while still in the process of repairing their own hearts.” (2) Eve Ensler, with the combination of personal work and “world repair” work that she describes in her powerful book In the Body of the World, is one of my favorite examples of this sort of balanced approach. (3)

 

Sources:

1 and 2, Laura van Dernoot Lipsky with Connie Burk, Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others (San Francisco: Berrett-Koehler Publishers, 2009), page 159.

3, Eve Ensler, In the Body of the World (New York: Metropolitan Books, 2013).