Homelessness: Native Seattle

E23611D1-BEFE-4A2D-AC70-C0BD4D09CA1EI offer these images of Seattle Pioneer Square from my Skid Road street hauntings, alongside powerful quotes from Coll Thrush’s important book Native Seattle: Histories from the Crossing Over Place, second edition (Seattle: University of Washington Press, 2007). Even though it is not specifically about homelessness, it is essential reading for a deeper understanding of homelessness in Seattle.

“In 1991, The Seattle Arts Commission launched an ambitious program called In Public, a citywide set of installations designed to inspire dialogue about the role of art in everyday life. (…) In Public was edgy and controversial. One of the most confrontational pieces, by Cheyenne-Arapaho artist Hachivi Edgar Heap of Birds, was installed in Pioneer Place Park alongside the Chief-of-All-Women pole and a bronze bust of Chief Seattle. Called Day/Night, it consisted of two ceramic panels inscribed with dollar signs, crosses, and text in Whulshootseed and English that read ‘Chief Seattle now the streets are your (sic) home. Far away brothers and sisters still remember you.’ Dedicated to the city’s homeless Indians, Day/Night challenged Seattle’s other place-stories.” pp. 173-4.

Note that the images included above are two photographs, a juxtaposition of a “modern” street art image of Chief Seattle from a Pioneer Square alleyway, as well as one panel of Day/Night in English and reads “Chief Seattle now the streets are our home.” The day I took this photograph the second ceramic panel of the Day/Night art installation was not there. Vandalized? Being repaired?

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The second image and quote from Thrush’s Native Seattle have to do with the earliest days of the white American settlers/Pioneers who staked land claims on what is now Seattle’s Pioneer Square—an area that was known as the Little Crossing-Over Place by Chief Seeathl (Seattle). The Little Crossing-Over Place had a source of fresh water and had been an old Indian fishing village. The photograph above is of a Pioneer Square saloon alleyway doorstep (and nighttime sleeping place) located near the Chief Seattle Club, a terrific multi-service agency “providing a sacred space to nurture, affirm and renew the spirit of urban Native people.”

“Indeed, well before the day when Bell, Boren, and Denny decided that Little Crossing-Over Place would be their new home, the indigenous world of the Duwamish, Lakes, and Shilsholes had been irrevocably transformed. The ruined longhouse at Little Crossing-Over Place, overgrown with wild roses (and, according to oral tradition, only one of several that had once stood there), spoke to the abandonment of towns in the wake of epidemics and slave raids. In Whulshootseed, similar words described both houses and human bodies: house posts were limbs, roof beams were spines, walls were skin. Just as sweeping a house and healing a body could be expressed with the same verb, related words spoke of illness and the falling down of a home, and so the ruins were testaments of loss.” p. 38

Below, is a photograph of the native plant, the Nootka Rose, mentioned in the quote above. I took this photograph recently while walking through the University of Washington Botanic Garden’s Union Bay Natural Area— which is built on top of a large Seattle landfill that long ago had been an important Native American fishing village. Thrush concludes his book with these words:

“… in every college diploma earned by an Indian, in the restoration of urban nature and in the willingness to challenge narratives of progress, there is hope that Seattle’s Native past—or, more accurately, its many Native pasts—can be unearthed. These place-stories, linked to urban and Indian presents and futures, will not simply be cautionary tale, smug jokes, or nostalgic fantasies but will be dialogues about the transformations of landscape and power in the city and about strategies for living together humanely in this place.” p. 207

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Homelessness Visible

IMG_4667Our latest point-in-time count of people experiencing “absolute” homelessness in King County tallied 12,112 homeless individuals on January 26th, 2018 (see the All Home King County‘s 2018 report “Count Us In”). By the term “absolute” I refer to the fact that they use the strict HUD definition of homelessness, which excludes the considerable number of people (especially teens and young adults) who are couch-surfing, doubled-up with friends or extended family members and who do not have a safe, stable, affordable place to live. In this respect the HUD definition differs from the official definition of homelessness for healthcare services funded through the U.S. Department of Health and Human Services (see the various definitions compared here by the National Health Care for the Homeless Council).

The 12,112 homeless individuals counted for 2018 represent a 4% increase over the 2017 homeless count (which represented a 19% increase from the 2016 count). Some politicians claim that the slowing percentage increase in people experiencing homelessness can be counted as progress—although as a reality check, the 4% increase in homelessness is much larger than the total population growth for King County. The most recent published statistics show a 2.3% population growth for King County for 2016-17 (source: Washington State Office of Financial Management). As another significant reality check, the homeless count survey methodology changed considerably for 2017 such that comparisons with 2016 numbers should not be made.

Significantly, the 2018 homeless count found that over half (52%) of homeless people were unsheltered the night of the count, with many people living outside in tents and in vehicles. Having participated in the survey this year, I can attest to the difficulty of finding and assessing whether or not parked vehicles are being lived in between the 2-5 a.m. timeframe the day of the count. It is much easier to count the number of people staying overnight at an emergency shelter. And homeless people living in tents tend to find thickly wooded areas in which to live—and not, as in the photograph above, more visibly along well-lit streets and bike paths. But for all of us who live, work, study, and play in Seattle and throughout the rest of King County, we didn’t need the official homeless count to tell us we have a growing problem. We have homelessness, abject poverty and despair, quite visible.

Note: In a series of subsequent posts I will address intriguing, intelligent, and excellent questions which I have received lately about our homelessness crisis. They were too numerous and complex to address in one post.

 

 

The Hospital on Profanity Hill

Version 2When Harborview Hospital in Seattle opened its doors to patients in 1931, advertising posters portrayed the striking fifteen-story Art Deco building as a shining beacon of light, the great creme-colored hope on the hill overlooking the small, provincial town clinging to the shores of Puget Sound. “Above the brightness of the sun: Service” is what one poster proclaimed; in the bright halo behind the drawing of the hospital, were the smiling faces of a female nurse and her contented-looking (and either sleeping or comatose) male patient with a bandaged head.1

Harborview Hospital—King County’s main public charity care hospital—was built at the top of Profanity Hill, on the site of the former King County Courthouse and jail. Profanity Hill got its name from the steep set of over 100 slippery-when-wet wooden stairs connecting downtown Seattle to the Courthouse. One wonders if it also got its name from being at the top of the original Skid Road—now named Yelser Way—where in the early days of Seattle, freshly felled logs, mixed with a considerable number of public inebriates, skidded downhill together into the mudflats of Puget Sound.2 The term ‘skid road’ soon became synonymous with urban areas populated by homeless and marginalized people.

Counties are the oldest local government entity in the Pacific Northwest, and King County, which includes the City of Seattle, was formed by the Oregon Territorial legislature in 1852. From the beginning, the King County Commissioners were responsible for such things as constructing and maintaining public buildings, collecting taxes, and supporting indigents, paupers, ill, insane, and homeless people living in the county.3 Seattle, with its deep-water shoreline and rich natural resources, was built on the timber and shipping industries, which soon attracted thousands of mostly single and impoverished men to work as laborers. These industries, mixed with ready access to alcohol in the always ‘wet town,’ led to high rates of injuries. Serious burns came from the growing piles of sawdust alongside log or wood-framed houses heated by wood fire and coal. Then there were the numerous Wild West shootings and stabbings. As in the rest of the country at that time, wealthier families took care of ill or injured family members in their own homes, with physician home visits for difficult cases. The less fortunate relied on the charity of local physicians and whatever shelter they could arrange.

David Swinson ‘Doc’ Maynard, one of Seattle’s white pioneer settlers, was Seattle’s first physician and, in a sense, he opened King County’s first charity care hospital, an indirect precursor of Harborview Hospital. A colorful and compassionate man, Doc Maynard built and operated a 2-bed wood-framed hospital facility in what was then called the Maynardtown district—now called Pioneer Square—a Red Light district full of saloons and ‘bawdyhouses.’ Although she had no formal training, Maynard’s second wife, Catherine, served as the hospital’s nurse. Their hospital, which opened in 1857, closed several years later, reportedly because Doc Maynard insisted on serving both Indian and white settlers. Also contributing to the hospital’s demise was the fact that Maynard disliked turning away patients who could not pay for his services. Around this same time, Doc Maynard assumed care for King County’s first recorded public ward: Edward Moore, “a non-resident lunatic pauper and crippled man.”2 The unfortunate patient had to have his frostbitten toes amputated, and then once healed, was given an early version of ‘Greyhound Therapy’ and shipped back East.

But the true roots of Harborview Hospital began in 1877 in the marshlands along the banks of the Duwamish River on the southern edge of Seattle. There, on an 80-acre tract of fertile hops-growing land, the King County Commissioners built a two-story almshouse, called the King County Poor Farm. They built the Poor Farm in order to fulfill their legislative mandate. Not wanting to run the Poor Farm themselves, they posted a newspaper advertisement asking for someone to take over operation of the King County Workhouse and Poor Farm, “to board, nurse, and care for the county poor.”4 In response, three stern-looking French-Canadian Sisters of Providence nurses arrived in Seattle by paddleboat from Portland, Oregon. The Sisters began operation of the 6-bed King County Hospital facility in early May 1877.

In their leather-bound patient ledgers, the Sisters of Providence recorded that their first patient was a 43-year-old man, a Norwegian laborer, a Protestant, admitted on May 19th and died at the hospital six weeks later. The Sisters carefully noted whether or not their patients were Catholic, and in their Chronicles, they recorded details of baptisms and deathbed conversions to Catholicism of their patients. The hospital run by the Sisters of Providence had a high patient mortality rate, but the majority of patients came to them seriously injured or ill. Also, this was before implementation of modern nursing care: the Bellevue Training School for Nurses in New York City, North America’s first nursing school based on the principles of Florence Nightingale, opened in 1873.

In their first year of operation, the Sisters realized that the combination of being located several miles away from the downtown core of Seattle and the unsavory name ‘Poor Farm’ was severely constraining their success as a hospital. So in July 1878 they moved to a new location at the corner of 5th and Madison Streets in the central core of Seattle, and they renamed their 10-patient facility Providence Hospital. The Sisters designated a night nurse to serve as a visiting/home health nurse and they accepted private-pay patients along with the indigent patients, whose care was paid for by King County taxpayers. The Sisters of Providence agreed to provide patients with liquor and medicine, both mainly in the form of whisky, a fact that likely helped them attract more patients.2

The Sisters’ list of patients included mainly loggers, miners, and sailors in the first few years, later mixing with hotelkeepers, fishermen, bar tenders, police officers, carpenters, and servants as the town grew in size. Many of their early patients were from Norway, Sweden, and Ireland, echoing the waves of immigrants entering the United States. Diagnoses recorded for patients included numerous injuries and infectious diseases—including cholera, typhoid, and smallpox—along with ‘whisky’ as a diagnosis, which later changed to ‘alcoholism.’ Their patient numbers grew, from just thirty hospital patients their first year, to close to two hundred patients by their fifth year of operation. The Sisters expanded their hospital to meet the increasing patient population.

Growing religious friction between the Catholic Sisters of Providence and the county’s mainly Protestant power elite, contributed to the King County Commissioners assuming responsibility for re-opening and running the King County Hospital in 1887. The King County patients were transferred from Providence Hospital back to the old Georgetown Poor Farm facility. Then, in 1906, the King County Hospital was expanded to a 225-bed facility at the Poor Farm site. It remained there until 1931 when the new 400-bed Harborview Hospital on Profanity Hill was opened. The old Georgetown facility, renamed King County Hospital Unit 2, was used as a convalescent and tuberculosis center until it was closed and demolished in 1956.5 The area where the King County Poor Farm was located is now a small park surrounded by an Interstate, industrial areas, and Boeing Field.

Harborview Hospital, now named Harborview Medical Center, still stands at the top of Profanity Hill, although the area is now officially called First Hill and nicknamed Pill Hill for the large number of medical centers now competing for both real estate and health care market share. Harborview Medical Center is owned by King County, and since 1967, the University of Washington has been contracted to provide the management and operations. Harborview Hospital has served as the main site for the region’s medical and nursing education. Since 1931, it has been the main tertiary-care training facility for the University of Washington’s School of Nursing.

Harborview Medical Center continues to fulfill its mission of providing quality health care to indigent, homeless, mentally ill, incarcerated, and non-English-speaking populations within King County. It is the largest hospital provider of charity care in Washington State. In addition, it serves as the only Level 1 adult and pediatric trauma and burn center, not only for Washington State, but also for Alaska, Montana, and Idaho, a landmass close to 250,000 square kilometers with a total population of ten million people. Harborview Medical Center has nationally recognized programs, including the pioneering Medic One pre-hospital emergency response system, the Sexual Assault Center, and Burn Center. In addition, Harborview provides free, professional medical interpreter services in over 80 languages, and has the innovative Community House Calls Program, a nurse-run program providing cultural mediation and advocacy for the area’s growing refugee and immigrant populations.

Harborview remains a shining beacon on Profanity Hill, rising above the skyscrapers of downtown Seattle. At night, it is literally the shining beacon on the hill, with blinking red lights directing rescue helicopters to its emergency heliport, built on top of an underground parking garage on the edge of the hill. Sharing space with Harborview’s helipad is the narrow strip of green grass of Harbor View Park, with commanding views of Mount Rainier to the south, and of downtown Seattle and Puget Sound to the west. In the wooded area below Harbor View Park, extending down to Yesler Way, along the old Skid Road, are blue tarps and tents of the hundreds of homeless people living in the shadows of the hospital. Construction is underway to add a new public park, mixed-income public housing, and a new—and hopefully less slippery—pedestrian walkway connecting downtown Seattle to the Hospital on Profanity Hill.

Note: This was published in the “Famous Hospitals” section of Hektoen International: A Journal of Medical Humanities in Spring 2015. Since researching and writing this essay, I have continued research (including conducting oral histories) for my project “Skid Road: The Intersection of Health and Homelessness.”

References:

  1. Seattle’s First Hill: King County Courthouse and Harborview Hospital. http://www.historylink.org/index.cfm?DisplayPage=output.cfm&file_Id=7038. Priscilla Long, curator. Published March 22, 2001. Accessed November 5, 2013.
  2. Morgan M. Skid Road: An Informal Portrait of Seattle. New York, NY: Viking Press; 1951.
  3. Reinartz KF. History of King County Government 1853-2002. http:your.kingcounty.gov/kc150/service.htm. Published July 31, 2002. Accessed December 12, 2014.
  4. Lucia E. Seattle’s Sisters of Providence: The Story of Providence Medical Center—Seattle’s First Hospital. http://providencearchives.contentdm.oclc.org/cdm/ref/collection/p15352coll7/id/1651. Published 1978. Accessed October 1, 2013.
  5. Sheridan M. Seattle Landmark Nomination Application—Harborview Hospital, Center Wing. http://www.seattle.gov/neighborhoods/preservation/lpbcurrentnom_harborviewmedicalcenternomtext.pdf. Published May 4, 2009. Accessed November 21, 2014.

(No) Home for the Holidays

bed13b6f-4b6b-4041-8baf-3581fe5f737aThe holidays are festive, fun, frantic, frolicsome, fleeting—frankly fickle affairs. The sheer number of holiday-themed, family-times-gone-wrong Hollywood movies attests to this fact. And then there is the endless loop of the still popular Christmas song, “I’ll Be Home for Christmas,” first sung by Bing Crosby in 1943 as WWII raged on. Supposedly, major record company executives at first refused to record the song, due to its final line, “I’ll be home for Christmas, if only in my dreams.” They felt it was a downer of an ending. But, of course, it tapped into the reality for many people—not just soldiers—who couldn’t go home and were left with only nostalgic dreams of snow and mistletoe.

It continues to tap into the reality for many people. Not just for people displaced from their homelands by wars, such as the current one in Syria. (For an excellent in-depth article on this for a Syrian refugee family in Canada, see the NYT article “Wonder and Worry, As a Syrian Child Transforms” by Catrin Einhorn and Jodi Kantor, 12-17-16. This makes me love my neighbor country to the north.) And not just for people who never had a safe, warm, protective home to begin with. Dr. Nancy Goldov of the Washington State Psychological Association talks about this, pointing out that some people “find the pressure to be merry and happy difficult,” and that a particular trigger this year is the “highly fraught political situation that’s polarized some families.” (see the Seattle Times article, “Alone for the holiday—and loving it” by Christine Clarridge, 12-16-16.)

Home, not just for the holidays but anytime, is also just a dream for so many of our community members who are home-less. I know this at a personal level, yet yesterday it took on a new level of poignancy. Working in sub-freezing, snow-flurry weather, we helped move in residents of Tent City 3 to a corner of the University of Washington (UW), Seattle campus. Community volunteers helped Tent City residents sort tarps and tents and cans of food. Others moved wood pallets into a line and hammered  plywood on top to serve as partially dry and unfrozen “ground” for the tents that residents will sleep in for the next three months. Tent City 3 is part of the organization Seattle Housing and Resource Effort (SHARE), which is self-governed, democratic, grassroots, and led by homeless and formerly homeless people.

I am proud of the dedicated work of many of our UW students, faculty, and staff who have advocated for UW to host Tent City 3. I am proud of our public university for living up to its stated institutional values, including:

  • “World Citizens We are compassionate and committed to the active pursuit of global engagement and connectedness. We assume leadership roles to make the world a better place through education and research. We embrace our role to foster engaged and responsible citizenship as part of the learning experience of our students, faculty and staff.
  • Being Public As a public university we are deeply committed to serving all our citizens.”

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Homelessness Visible: A Photo Essay

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House not for sale. Photo credit: Josephine Ensign, 2015.

The story of homelessness, visible, in my hometown of Seattle, told through photographs and a few accompanying words.

Here, on my daily walk in my neighborhood. Derelict housing, seemingly deserted, unless you know what to look for. Scattered clothing. A tattered backpack.

And this, a most unusual lawn ornament. The 700 metric ton glacial erratic ‘Lone Rock’ now known as the ‘Wedgewood Erratic.’ According to the City of Seattle, it is illegal to climb this rock. But I don’t think it is illegal to camp near it. Hence, this recent living room armchair. And a tent (removed during the day). In the background (the boxy building to the far right), note the supremely ugly new construction ‘single family home’ on the market for a mere $1.4 million dollars. In one of Seattle’s ‘working class’ neighborhoods.

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‘Lone Rock’ and Lone Chair, Seattle. Photo credit: Josephine Ensign, 2016

Yesterday, during a fierce windstorm, there was this homeless encampment in the doorway of an empty store at a busy intersection near my home. A man and a woman were working hard to keep their belongings from blowing away. Note the new (upscale) apartment buildings and the large crane in the hole that will be the new Roosevelt Light Rail Station.

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Homeless in a Seattle Doorway. Photo credit: Josephine Ensign, 2016

And then there are the numerous unofficial ‘tent cities’ and other temporary shelters that all combine to make homelessness in Seattle very, very visible. In follow-up posts I’ll critique the current ‘state of emergency’ of homelessness declared by Seattle Mayor Ed Murray four months ago.

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Man asleep in chair by Seattle city park. Photo credit: Josephine Ensign, 2015
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Homeless encampment on Seattle sidewalk. Photo credit: Josephine Ensign, 2015

Framing Homelessness

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Rough sleeping in the U-District. Photo credit: Josephine Ensign/2016

Homelessness is in the news almost every day here in my hometown of Seattle. Unless you happen to live in a gated community and never go outside your protected home, there is scarcely a city block you walk without distinct signs of people living rough outside or in cars or RVs. It is no surprise then that our One Night Count of homelessness by the Seattle/King County Coalition on Homelessness last week found 4,505 people homeless/without shelter, a 19% increase from the One Night Count in January 2015. And this is despite the fact that the One Night Count volunteers (including a group of our UW Seattle nursing students) being unable to enter and count homeless people in ‘The Jungle,’ a longtime homeless encampment area in an I-5 greenbelt area of Seattle–and the location of our impressive Depression Era Hooverville. There had been a mass shooting in The Jungle the night before, resulting in the death of two homeless people and the hospitalization of three others.

Just two months ago, in November 2015, Seattle Mayor Ed Murray declared a state of emergency over homelessness, saying this in the official notice: “The City of Seattle, like many other cities across the country, is facing a homelessness crisis. The region’s current needs outweigh shelter capacity, leaving too many seniors, families and individuals sleeping on the street. More than 45 individuals have died while homeless on Seattle streets in 2015 alone.” His declaration of a state of emergency supposedly helps “deploy critical resources more quickly to those in need.”

Suddenly it begins to feel like we’ve entered a 1980s time-warp, with so many people weighing in with competing viewpoints, priorities, and proposed ‘fixes’ for our homelessness problem. I, of course, could add my own voice to the rising cacophony surrounding this latest round of the homelessness crisis. Instead, I offer these words of wisdom and perspective from some of my favorite deep and critical thinkers on the topic of the ‘first wave’ of modern homelessness in the 1980s:

  • “The scandal of homelessness looked as though it could harness a new politics of compassion and shame–compassion for the plight of the dispossessed and shame at the inhumanity of national and local policies toward them. Homelessness, in sum, had political appeal.” pp 132-133, in Donald Schon and Martin Rein’s excellent book, Frame Reflection: Toward the Resolution of Intractable Policy Controversies. Basic Books, 1994.
  • Put plainly, the opposite of homelessness is not shelter, but home. Understood culturally, ‘home’ must entail some claim to inclusion. The principled question underlying homelessness policy, then, is not, what does charity demand? but rather, what does solidarity require? And so it no longer suffices (if it ever did) to ask what it is about the homeless poor that accounts for their dispossession. One must also ask what it is about ‘the rest of us’ that has learned to ignore, then tolerate, only to grow weary of, and now seeks to banish from sight the ugly evidence of a social order gone badly awry.” p. 214 of Kim Hopper’s now classic book, Reckoning With Homelessness. Cornell UP, 2003.

BE Uncomfortable

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Sliding doors/front entrance to the Nelson Public Library, South Island, New Zealand. Photo credit: Josephine Ensign/2014

“BE uncomfortable. That’s how you learn!” was one of the final exhortations to our students by Pepe Sapolu Reweti at the conclusion of our”Empowering Healthy Communities” study abroad in New Zealand program this past summer. She was describing the fact that there are many Pakehas (‘white’/European descent New Zealanders) who do not personally know any Maori people, much less ever been on a Maori marae (‘meeting place’ similar to our U.S. Indian ‘reservation’ except that it is the ancestral home of the Maori iwi, or tribes), much much less ever have been in a Maori home. She pointed out that our students had all been on a marae (several, in fact) and had been inside a Maori community meeting house, and had shared ‘kai’ (a meal–several, in fact). That’s an honor and a privilege and something for us to learn from, to take back home–to apply in our own country, in our own daily lives. If the students learned nothing else from this study abroad experience, I hope they learned this.

I was reminded of Pepe’s words this past week as I listened to Ta-Nehisi Coates talk about his latest book Between the World and Me, written in the form of a letter to his son about being a black man in the deeply scarred and racist modern day America. His talk was in the sold-out 2,900 seat McCaw Hall at the Seattle Center, as part of the Seattle Arts and Lectures literary series. The interviewer asked Coates about his article “The Case for Reparations” in the June 2014 edition of The Atlantic, and why he thought it had ‘gone viral’ and been so popular among white people. He replied that he thinks people like the fact he doesn’t sugar-coat things, that “It’s a sign of respect the way I talk directly about things.” And he added, “Reality is uncomfortable. Period.”

Looking around the packed auditorium in one of the whitest cities in America, I wondered how many of us white audience members were now wallowing in white guilt: white guilt which is itself a white self-indulgent privilege. How many of us white Seattleite audience members are willing to push past white guilt to do anything constructive to confront racism in our country, in our city, in our neighborhood, in our own homes? And what are we as health care educators doing to ‘teach meaningfully to’ the effects of personally-mediated and institutionalized racism?

“…as Americans we are so heavily invested in shame, avoidance, and denial that most of us have never experienced authentic, face-to-face dialogue about race at all.” (“To Whom It May Concern” by Jess Row in The Racial Imaginary: Writers on Race in the Life of the Mind edited by Claudia Rankine, Beth Loffreda, and Maxine King Cap, Fence Books 2015, p. 63.) In this same essay, Row states she once saw a book on classroom management for college teachers with the title When Race Breaks Out. “As if it’s like strep throat, as if it has to be medicated, managed, healed.” (p62.)

We need to allow ourselves–and our students–to be uncomfortable, to confront uncomfortable truths in order to learn any lessons that are worth learning.