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This Anxiety Is Not New

Compassion & Choices D.C. Campaign Director Donna Smith speaks candidly about racial inequities around and beyond those in end-of-life healthcare.

First of all, I want to acknowledge that everyone is going through something during this difficult time of unrest and COVID-19. Maybe you know someone who is suffering with the virus, or lost a job, or maybe you live in one of the cities that are protesting. I acknowledge that we are all dealing with a lot, but today I want to speak from my perspective. 

I put an article on my Facebook page recently because it captured exactly how I feel. The title of the article is, “Your Black Colleagues May Look Like They’re Okay, — Chances Are They’re Not.” It highlights, in very specific ways, how the pandemic, protests and police brutality disproportionately affect black people. It clearly delineates the experience of some who spend the pandemic trading banana bread recipes from others who are in fear for their lives and dying on the street. It ends powerfully by stating “Your black colleagues are not OK and you should not be either.”

I want to thank all of you who have reached out to check on me during this tumultuous time. I have responded to everyone with the same numb general statement, “I’m OK.” The truth is I AM NOT. I am seething, I am hurting, I am afraid all the time, and if I ever told you how I really feel … you would not be able to handle it. My anxiety did not start with COVID-19 or the killing of George Floyd. It has been there throughout my entire adult life. When I tell you I’m OK, it is an aspirational statement. I hope to be OK one day.

The framers of the Declaration of Independence stated, “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness” Well, clearly 244 years later with the tragic deaths of George Floyd, Breonna Taylor and so many others at the hands of the police, and due to inequities in all aspects of society including and beyond the healthcare system, these “truths” are clearly still not “self evident.”

When I was growing up, I was told if you associate with the right people, go to the right schools, live in the right area, get the right job, you will be safe. Well, I did all of that, and just like the mayor of Atlanta, Keisha Lance Bottoms, I cannot even keep my son safe.

I graduated from George Washington Law School 10 days after giving birth to my only child, my son, Justice. Despite working for the governor of Maryland for eight years as a policy chief in his administration, and working with and knowing almost every legislator in the state for the last six years, I too cannot keep my son safe. 

Last year, I had to leave a Compassion & Choices work event, the Leadership Conference on Civil Rights Annual Gala, early because I got a frantic call from my frightened son. He got stopped by the police while walking home from his Starbucks job in his green apron and was frisked on the side of the road in front of our neighbors, his school friends and his co-workers like a common criminal. The officer stated he stopped him because some kids in the area had stolen a car. Clearly, if he had stolen a car he would not be walking. I cried the whole way home. I felt guilty because I had talked to him about what he should do if he ever got pulled over by a policeman, but I never thought I had to advise him about walking while black. 

Now, I am one of the lucky ones because my son survived his first interaction with the police. However, will he be lucky enough to survive the next one? I fear for his life every day. How do I teach him to protect himself, when he can’t walk while black, birdwatch while black, whistle while black, play while black, jog while black … and even if I could keep him in the house, it is no guarantee of safety because Breonna Taylor and  Botham Jean were shot at home in their own beds by the police.

Systemic racism in this country is so insidious that despite the Declaration of Independence, the Civil War, the 13th, 14th  and 15th Amendments to the Constitution, the Civil Rights Act of 1964 and 1968, the Voting Rights Act of 1965 and Brown v. Board of Education, my people are still not free and not considered equal.

Systemic racism is apparent in the disparities in healthcare, which includes end-of-life care. COVID-19 has just highlighted a problem that is deep-rooted.  Diverse patients receive less care and often worse care for a number of complex reasons: long-standing distrust of the medical system due to incidents such as the Tuskegee Experiment, language and cultural barriers, socioeconomic factors and implicit bias, and discrimination by healthcare systems and providers. The culmination of all these factors have led to less pain management, more intrusive medical treatment i.e. dying in emergency rooms as opposed to dying at home, and lower hospice and advance directive utilizations.

I want you to commit to me that wherever you are, in the ways that you can, that you will fight to tear down systems of racism and oppression, starting right here with Compassion & Choices. We have to do better because we can do better.

Though these last few weeks have been especially dark, the one thing that brings me hope is all the diverse young people leading the protests. When I look at them, I see some of my colleagues here, and I am hopeful. So as we look to improve Compassion & Choices, we need to make sure some of them end up in leadership positions as well.

Thank you.


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