August 12, 2014


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I'm glad the Lord hears their cries, because we do our damnedest to shut them out.

But we work hard to romanticize poverty. We hold bake sales to raise money to board a plane to fly off to exotic places to treat the children that we expect to run up to us on the tarmac, rather than driving three miles north of campus to work with a community-based agency as tutors or mentors. We follow the fashions of children who are adopted from developing nations by Hollywood celebrities and good will ambassadors. We have eating contests, pub crawls and fashion shows to drum up funding for programs to help the less fortunate. And so we keep using our own lenses and our own vocabulary to keep poverty at a distance.

But the cries of the poor aren't pretty. They have been making me squirm for twenty years. Working with patients in the County jail and juvenile detention, at area homeless shelters and at children's homes, I have been inundated with choruses like those coming from Ferguson. I hear tales of institutionalized violence, preferential expulsion from schools, and discrimination in accessing health care. I hear the frustration of black mothers who don't know how to keep their sons safe, white mothers who don't know how to keep their sons away from heroin, and grandmothers who have to raise their grandchildren. I care for children in detention who tell me that they don't trust the police because they have seen friends and family beat up, shot and dragged away.

There is nothing romantic about their cries. I want to shut them out. I want to rationalize them away as inaccurate, uninformed, biased, or just one-side-of-the-story. It is certainly tempting, and sometimes a daily temptation, but it's not a sustainable practice. I couldn't care for my patients if I didn't listen. So I work to maintain a habit of listening-especially when they tell me what has happened to them. Knowing well that I cannot fix things for my patients, I tell them I have one foot in primary care and one foot in outside systems. I tell them I try to make things better. I tell them I teach, in part so that I can retell their stories, and they often smile in return. I tell them I work with the Regional Health Commission and the Integrated Health Network to retell their stories, and they ask questions. I tell my frequent flyers and my patients who are mothers and fathers about my reentry planning work with the Criminal Justice Ministry, and they are often startled that someone really is working to break the cycle of recidivism.

While I am not implying that all the citizens of Ferguson and the surrounding municipalities have been incarcerated or homeless, or that they live in poverty, or that they have no health insurance, I know--we all know-- that people in these communities have fewer resources and greater challenges to security, health and economic stability than those in the surrounding Saint Louis Metropolitan area. Their cries-and their posters and their protests-speak to ineffective and unjust program and policies decades old.

We are in volatile days. It is difficult to promote public safety; it is difficult to police. It is difficult for citizens to safely move about their communities that are rife with fear and tension. And all of us are surrounded by the cries of the poor.

Ignatius has told us to "speak little, listen much". We would all do well to follow this advice over the next few days. For many of us, that is enough-for now.

- Fred Rottnek, M.D., Associate Professor of Family and Community Medicine

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