Public Health

Stay or Leave

Should I stay or should I leave? Am I trapped in the barrio or is the barrio an inescapable, yet beautiful part of me from which I should not flee (or even have the desire to leave)? Should the life-taking stories of my barrio take precedence (like they do in the news) or do I privilege only the life-giving (counter) narratives that dignify my city? If I stay, am I being a bad parent, allowing my son to remain in a potentially dangerous environment where opportunity and resources are scant? If I leave, am I being a bad Christian by opting for my family’s and my own comfort and safety?

These questions invaded my mind and the noises of my barrio played a conflicting melody where love, sacrifice, injustice, and pain entwined.

El ruido que amo (the noise that I love)

I love las cumbias, las rancheras y los boleros I hear desde mi ventana. I didn’t exactly request this music pero my neighbors’ music selection is everyone’s delight. Ok, maybe not everyone’s, but I like it. I’ll be hanging out in my back yard and suddenly la canción de Ana Gabriel que puso la vecina gets me going, and I start singing my heart out: ¿Quién como tú, que día a día puedes tenerle? It takes me back to the many road trips I took with my parents when I was a little girl. Ana Gabriel, Juan Gabriel, Los Bukis – those were my jams!

I love el ruido que mi gente makes when they’re hussling. Tamales, tamales, tamales. ¡Tamales de piña, de puerco, de pollo, tamales! I love when my son runs out yelling raspadooo when the street vendors pass by honking their horns announcing la llegada of those delicious raspados we all slurp with such gozo. I love hearing mi pueblo use their voice to try to make ends meet en el swapmeet: barato, barato, barato, pásele; ¿qué le damos, señorita, pásele a lo barato? 

I love la euforia que se escucha cuando la selección mexicana scores a goooooooool!

Whoever said my people have been silenced, has not set foot in my neighborhood.

El ruido que odio (the noise that I hate)

I hate that I can distinguish the sound of fireworks from gunshots. I hate that we have to run inside the house and lock every door when we hear shots fired. I hate that every other day police sirens and the noise of helicopters drown out the sound of my favorite TV show, reminding me that I am not safe. I hate the cries of yet another grieving mother as she pleas with the public to help her find her child’s murderer.

El ruido que amo y el ruido que odio are juxtaposed mainly because “U.S. barrios have been a source of cultural resistance; they function as reterritorialized spaces where it is possible to maintain one ́s culture and to resist assimilation. At the same time, the barrios are social spaces where ethnic lower classes are segregated thus impairing their economic development and creating a subculture of violence and poverty.”[1]

El silencio que mata (the silence that kills)

But the most murderous force in my neighborhood is silent. The culprit hides in plain sight. More than two thousand pounds of toxic chemicals are emitted in Wilmington, California every single day. My beloved city is surrounded by the largest concentration of oil refineries in the state and the third largest oil field in the contiguous U.S., and it is home to the largest port in North America (Grist 2022). Wilmington, which is 90% Latino and 40% immigrant, is a toxic wasteland; the dumping grounds of big oil corporations. The contaminants expelled daily create diseased bodies in a community where the median household income is 40% below the state’s average and where 28% of its residents are not medically insured, a number that represents three times more than the national average. The environmental hazard created by these companies also has an impact on violent crime. Several studies have found a link between violent crime and pollutant exposure: “air pollutants act as stressors, eliciting endocrine stress responses in our brains that lead to irrational decisions and violent tendencies and also disturb the physical, cognitive and emotional health of people exposed to it at high levels” (The Guardian 2022).

Wilmington, CA; they call it a “bad neighborhood” and bad neighborhoods are always bad because of the individuals that inhabit it. A “bad neighborhood” is never thought to be bad by virtue of systemic injustices that include racial and environmental inequalities. My family and I are from a “bad neighborhood,” but I don’t think we’re bad people. Jesus himself was from Galilea, a neighborhood deemed undesirable. Dr. Chao Romero asserts that if Jesus was from California, he would not come from Beverly Hills or Calabasas, but the most marginalized regions of the state, like East LA or the Central Valley.[2]

What we really mean when we say “bad neighborhood” is impoverished, and, often, Brown or Black. The “good neighborhoods” are strictly regulated. Associations determine rules about the colors in which you are allowed to paint your house, how often you’re supposed to do your lawn, and how much noise you can make. “Good neighborhoods” are wealthy, have good school districts, lower crime rates and are predominantly White. Language matters because language constructs truth. The use of “good/bad” as it refers to neighborhoods continues to strengthen the belief that the people who live there are inherently bad and completely disregards systemic issues that have created and continue to sustain the disenfranchisement of our barrios.

I understand the ways in which systemic issues have worked against my community. I love my community for the ways in which it has shaped me to be resilient, humble, and faithful. I am grateful for the ties I have formed there and the life lessons that have been imparted to me: to not judge people by what they have or where they came from. Nonetheless, there is another competing truth: I have witnessed more gun violence than the average American, I attended low-performing schools in the area and do not feel safe letting my teenage son walk alone to the store that is 100 feet away from my house. I have lived in this city for over 30 years and there is a certain level of comfort granted to me by familiarity, but as a mother, I face a conundrum: do I stay or do I leave?

 

Deciding to leave our barrios is more than aspiring to a bigger, nicer house with abundant parking, and plentiful green spaces. Leaving our barrios means that our children will have better educational opportunities, access to resources that improve their livelihoods, and the probability of being less exposed to violent crime. Ironically, the dilemma many of us face is similar to the one experienced by our first-generation immigrant parents with one distinction: my socioeconomic status and educational levels have significantly improved while remaining in my native community.

The Christian Community Development Association (CCDA) emphasizes a ministry of presence in which believers are active members of the communities in which they serve. It is a way of doing ministry that decentralizes white saviorism and centers the voices of community members. They invite people to be wholly present in their areas of ministry by becoming (and remaining) a neighbor. As a Christian that understands the importance of serving the socially dispossessed, am I to remain and use my social and economic capital to help my community flourish or should I leave relocating in a city where my children will be safer and have access to opportunity?

I left. It might seem like that was the easiest decision to make, but it certainly didn’t feel that way. I wrestled with this decision for quite some time, asking the Lord for guidance: “Lord, help us; ayúdanos a entender tu voluntad.” Months later, my husband and I received an answer to our prayers that gave us the certainty that we were being called out of my beloved city. In very God-like fashion, he set the pieces in motion and directed our steps.

So, should you stay or should you leave? I don’t know, and I don’t think there’s a generic right or wrong answer. God directs our paths in unique ways in different seasons of our lives (Ecclesiastes 3: 1-8). For people of color, these decisions are especially difficult as we encounter survivor’s guilt. Dr. Piorkowski explains that survivor’s guilt, or success guilt, is prevalent amongst first-generation college students from marginalized communities. We often ask ourselves – and God – questions that are filled with remorse: Why did I succeed when so many others in my neighborhood didn’t? Why am I alive when many of my classmates aren’t? Why do I have the opportunity to live in better conditions when many of my family members don’t? How is it possible that I love my barrio, but still want to leave it?

Guilt and gratefulness collide, but this guilt is crippling because it doesn’t allow me to faithfully receive God’s blessings. Instead of viewing the earth as a punishment that we must endure to buy our way into Heaven, we must understand the earth as a good place created by God (Genesis 1:18; Genesis 1:31) and our salvation as a free gift from our Lord (Ephesians 2:8; Romans 6:23). Perhaps God is indeed calling you to stay, but the decision to remain should not be guided by guilt. Conversely, if we are being led to leave, we must not do so developing a posture where we see our former neighbors as less-than, or inherently lacking, because of their socioeconomic status, and in doing so, engaging in the further dehumanization of our barrios. Remember that “You will always be Esperanza. You will always be Mango Street. You can’t erase what you know. You can’t forget who you are” (The House on Mango Street). 

About Dra. Meduri Soto

As an academic from el barrio, Dra. Meduri Soto strives to engage in scholarly work that honors and gives visibility to her community. Her faith drives her passion for justice as she seeks to reveal the ways in which certain language ideologies are constructed to operate unjustly against our communities. Her work acknowledges language as a powerful tool and promotes linguistic diversity in its different manifestations. Bicultural and bilingual identities are at the center of Dra. Meduri Soto’s work. She is a Spanish professor at Biola University where she teaches second language and heritage language learners. To learn more about her work, follow her on Instagram: @la.dra.itzel


Footnotes

[1] Views of the Barrio in Chicano and Puerto Rican Narrative (Antonia Domínguez Miguela)

[2] The Brown Church: Five Centuries of Latina/o Social Justice, Theology and Identity (2020) 


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Poor Because They Are Lazy

Richard Delgado’s words stunned me. Putting his essay down, I meditated on this unsettling passage: 

[U.S. Latin@s] suffer disproportionately from poverty and school drop-out. A U.N. study showed that if all Latinos residing in the United States were considered as a separate country, that country would rank thirty-fifth in the world in a combined index of social well-being that included income, education, and access to health care.

Delgado was citing the UN’s 1993 Human Development Report. That same document noted that “In the United States, with the HDIs of white, black, and hispanic populations separated, whites rank number 1 in the world.” The U.S. Latinx community was thirty-fifth; the U.S. White community was first. And as Delgado observed, “the racial disparity noted in the 1993 report has widened and deepened.” The UN’s 2001 Human Development Report revealed that whereas U.S. Whites remained near the top of the world’s HDI index, U.S. Latin@s had dropped to sixty-eighth.

Seeing the suffering of Mi Gente

Reading these grotesque numbers carried me back to my first experiences with Puerto Rico’s poverty. Mi abuela was driving. I sat in the passenger seat. As we rode through dilapidated communities, my young eyes, raised in a middle-class New Jersey neighborhood, poured out tears. I had never seen such catastrophes. These were mi gente, my people. And they were languishing in extreme destitution. 

“Mira, Nathan,” mi abuela said. “Ellos son muy pobres y están sufriendo; they are very poor and are suffering. God calls us to love and care for the poor. We cannot look away.”

Later that visit, I spoke with a family member about the poverty I’d seen. “Oh yes, there are many poor people here in Puerto Rico. But they are poor because they are lazy. You see the same thing in the mainland.”

My relative’s callous tone and comments jarred me. Abuela had said nothing about laziness while we witnessed our people’s misery; she spoke about our divine call to love and care for the poor. Granted, abuela never explained mi gente’s poverty. But the contrast between her focus on neighbor-love and this relative’s reductive explanation for severe poverty shook me.

Returning to the Present

Chills jerked my body as I recalled these experiences. I picked up Delgado’s essay and reread the arresting passage. How to understand these truths, the poverty I witnessed, or what my relatives told me?

This multi-faceted question becomes more pointed when you engage updated data. Ed Morales writes that “on average, prices [are] about 21 percent greater in Puerto Rico than in the United States.” Though this percentage is like “major metropolitian areas like New York and Miami,” those cities only have poverty rates of “12 percent and 24 percent, respectively” whereas Puerto Rico’s “41 percent poverty rate (compared to the United States’ average of 14.3 percent) represented a much higher percentage of the population that has a difficult time just grocery shopping.” Morales presses the point. “This high rate reflects the concentration of poverty you’d expect to see in peripheral areas of US cities, showing how “American” socioeconomic problems are reproduced in an isolated island territory.” Morales wrote two years ago. Now Puerto Rico’s poverty rate is 43.5 percent—over two times higher than Mississippi’s, which has the highest poverty rate among US States.

These ghastly percentages testify to profound human suffering. And they force us again to ask: How to understand these truths, the poverty I witnessed, or what my relatives told me? Let me offer three biblical reflections that should inform every Christian’s answers.

Biblical Reflection One: Laziness and Want

Scripture identifies laziness as a cause of poverty. As Esteban Voth writes, “the book of Proverbs states that one of the causes which had contributed to the existence of poverty is laziness.” Consider the following passages.

Laziness brings on deep sleep;
    an idle person will suffer hunger. (Proverbs 19:15)

The lazy person does not plow in season;
    harvest comes, and there is nothing to be found. (Proverbs 20:4)

Do not love sleep, or else you will come to poverty;
    open your eyes, and you will have plenty of bread. (Proverbs 20:13)

The craving of the lazy person is fatal,
    for lazy hands refuse to labor. (Proverbs 21:25)

Three verses link laziness to hunger; one links it to death. Thus, these texts reveal their agrarian context. Thus, they establish laziness’s lethal consequences.

Yet each of these passages address individual poverty, not its communal form. Three verses specifically reference a lazy “person.” The “you” of Proverbs 20:13 is singular. This limited scope matters, for as Ibram X. Kendi argues, “Individual behaviors can shape the success of individuals. But policies determine the success of groups.”

When Isaiah and Amos chastise Israel for its oppressive treatment of the poor, they highlight how Israel’s anti-covenantal policies and practices—in this context, those opposed to the Mosaic covenant and law—produce or perpetuate poverty. Isaiah writes:

The Lord rises to argue his case;
    he stands to judge the peoples.
The Lord enters into judgment
    with the elders and princes of his people:
It is you who have devoured the vineyard;
    the spoil of the poor is in your houses.
What do you mean by crushing my people,
    by grinding the face of the poor? says the Lord God of hosts. (Isaiah 3:13-15)

The LORD condemns an elite group—elders and princes—for establishing and exacerbating poverty through their practices and anti-covenantal policies. Likewise, Amos declares:

Thus says the Lord:
For three transgressions of Israel,
    and for four, I will not revoke the punishment;
because they sell the righteous for silver,
    and the needy for a pair of sandals—
they who trample the head of the poor into the dust of the earth,
    and push the afflicted out of the way;
father and son go in to the same girl,
    so that my holy name is profaned;
they lay themselves down beside every altar
    on garments taken in pledge;
and in the house of their God they drink
    wine bought with fines they imposed. (Amos 2:6-8)

Israel’s elite exploit and oppress the poor, gorging themselves upon this community’s limited resources, and so worsening the poor’s plight. None of these condemnations come in an individualist key. All focus on groups and group dynamics. And each echoes texts in Proverbs.

Biblical Reflection Two: Injustice and Poverty

Though Proverbs identifies laziness as a cause for individual poverty, it also identifies societal level injustices as a cause for communal poverty. As Esteban Voth observes, because the same book “proposes that many times poverty is caused by injustice,” its readers “cannot generalize and attribute the existence of poverty to laziness alone.” Consider the following verse

The field of the poor may yield much food,
    but it is swept away through injustice. (Proverbs 13:23)

Whereas verses from Proverbs we considered in the previous section linked individual laziness to individual poverty and hunger, Proverbs 13:23 links the bareness of poor people’s fields to societal injustices. Thus, Proverbs 13:23 bears a striking resemblance to the texts from Isaiah and Amos we considered. 

Similar commonalities also hold. Voth argues that “In contrast to the wisdom literature, for the prophets the true cause of poverty was found in the presence of injustice. This injustice had been institutionalized in royalty as well as in the clergy.” We noted such institutionalized evils in the previous section. Here we note proverbs that echo what we and Voth read in the prophets.

A ruler who oppresses the poor
    is a beating rain that leaves no food. (Proverbs 28:3)

Those who oppress the poor insult their Maker,
    but those who are kind to the needy honor him. (Proverbs 14:31)

Oppressing the poor in order to enrich oneself,
    and giving to the rich, will lead only to loss. (Proverbs 22:16)

Do not rob the poor because they are poor,
    or crush the afflicted at the gate;
for the Lord pleads their cause
    and despoils of life those who despoil them. (Proverbs 22:22-23)

Isaiah and Amos chastise royalty for perpetuating poverty. So does Proverbs 28:3. Isaiah and Amos rebuke Israel’s elites for exploiting the poor. Proverbs 22:16 and 22:22-23 anticipate this rebuke. And Isaiah and Amos highlight how Israel’s elites have insulted God because they oppress the poor.

Reflecting on the totality of Scripture’s witness, Elsa Tamez argues, “For the Bible oppression is the basic cause of poverty.” Tamez has communal poverty in view. She continues: “The oppressor steals from the oppressed and impoverishes them. The oppressed are therefore those who have been impoverished, for while the oppressor oppresses the poor because they are poor and powerless, the poor have become poor in the first placed because they have been oppressed.” In a prophetic, proverbial register, Tamez concludes, “The principal motive for oppression is the eagerness to pile up wealth, and this desire is connected with the fact that the oppressor is an idolater.” Isaiah and Amos do not rebuke Israel’s poor for laziness; they do not exhort them to try harder and pick themselves up. Instead, they rebuke Israel’s ruling elites for unjust policies and practices that bear the mark of idolatry.

Biblical Reflection Three: Legal Injustice and Poverty

Rulers and ruling-class elites often promote exploitation and poverty through law. Isaiah condemns Israel’s elites for this very sin.  

Woe to those who make unjust laws,
    to those who issue oppressive decrees,
to deprive the poor of their rights
    and withhold justice from the oppressed of my people,
making widows their prey
    and robbing the fatherless. (Isaiah 10:1-2)

These unjust laws stand in sharp contrast to the laws God instituted in the Mosaic covenant. There we read:

When you reap the harvest of your land, you shall not reap to the very edges of your field, or gather the gleanings of your harvest. You shall not strip your vineyard bare, or gather the fallen grapes of your vineyard; you shall leave them for the poor and the alien: I am the Lord your God (Leviticus 19:9-10);

For the Lord your God is God of gods and Lord of lords, the great God, mighty and awesome, who is not partial and takes no bribe,  who executes justice for the orphan and the widow, and who loves the strangers, providing them food and clothing. You shall also love the stranger, for you were strangers in the land of Egypt. You shall fear the Lord your God; him alone you shall worship; to him you shall hold fast, and by his name you shall swear. (Deuteronomy 10:17-20

God establishes laws to care for the poor and remediate poverty. Loving and worshiping God involves knowing that he executes justice for the marginalized and opposes oppressive, poverty-inducing regimes like Egypt’s.

Concluding With Puerto Rico

We return to the grotesque data about Puerto Rico’s poverty and our multi-layered guiding question: How to understand these truths, the poverty I witnessed, or what my relatives told me? In reverse order, we see that mi abuela was right to stress God’s call to care for the poor. We must love them—and so love their and our Maker. In contrast, we see that my relative’s linking of laziness to Puerto Rico’s wide-spread poverty is biblically dubious. Whereas Scripture links such societal level poverty to societal injustices perpetuated by ruling elites, my relative settled for a reductive and false linkage with individual behavior.

Biblically speaking, we must evaluate Puerto Rico’s poverty in terms of systemic evils perpetuated by ruling elites and the policies and practices they promote. This requires us to analyze and chastise elites on the island. But it also requires us to analyze the elites of Puerto Rico’s colonizer: The U.S. What Delgado says of Latin@s generally applies to Puerto Rico particularly: Latin@s require freedom from “the badges and incidents of conquest, including loss of ancestral lands, destruction of culture, suppression of their native language, and a public school system that systematically renders their history invisible.” And as I’ve written elsewhere, White U.S. elites crafted the laws governing US-Puerto Rico relations to solidify these badges and their accompanying poverty. These laws and the economic structures they protect trample Puerto Rico and Puerto Rico’s poor. Moreover, scholars such as Ed Morales and Teresa Delgado have shown that Puerto Rican elites like Ricardo Antonio Rosselló added cronyism and domestic domination to these evils. And unlike Zacchaeus, the island’s oppressive elites never repaid what they stole. Decolonizing this multi-sourced catastrophe requires confronting Egypt- and Rome-like exploitation and idolatry.


About Dr. Nathan Luis Cartagena

A son of the US South (Mom) and Puerto Rico (Dad), Dr. Cartagena is an Assistant Professor of Philosophy at Wheaton College (IL), where he teaches courses on race, justice, and political philosophy, and is a fellow in The Wheaton Center for Early Christian Studies. He serves as the faculty advisor for Unidad Cristiana, a student group working to enhance Christian unity and celebrate Latina/o cultures, a scholar-in-residence for World Outspoken, and a co-host for the forthcoming podcast From the Underside. He’s also writing a book on Critical Race Theory with IVP Academic.


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Believe Me When I Say it Hurts

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I saw her smile slowly disappear. She pressed in hard, frantically gliding the ultrasound, searching for a heartbeat that would never again beat. “Keep trying!” I screamed at her.

“I’m sorry,” she said, “there’s no heartbeat.”

“Keep trying,” I sobbed.

The well-intentioned doctor offered me several explanations that were intended to extinguish my sorrow. She explained that this was a normal occurrence, that it happens to nearly 1 in 4 women, that I was young, and that I would surely become pregnant again soon. She said that miscarriage was a protective mechanism that the body uses when disposing of unhealthy organisms and what I heard was, “You should be grateful that your body is so smart.” She tried to bury my pain in scientific reasoning and normalcy. Normal, normal, normal. Normal, as in trivial, as in my life should not be altered and my heart should not ache. Her words felt cold, the type of cold that burns.

I was convinced that my doctor was not Christian, or she would understand the meaning of sanctity of life and surely know why I was in so much pain.

“She’s desensitized,” I thought. “She’s had to deal with so many miscarriages that she has convinced herself that these are not human lives but a conglomeration of cells with little to no human value.” I believed that her lack of faith had caused her insensitivity so I instinctively sought refuge in my community of faith. To my dismay, Christians also minimized my pain. They wanted to subdue my pain and transform it into something nicer, like hope or gratitude, as if hope and gratitude were the only sentiments allowed to be felt by a Christian woman who had just experienced great loss. “At least you are already a mother,” “You’re young, you can have more kids,” “At least you were not further along,” were some of the comments that pierced me open.

The legitimacy of my pain came into question and I was led to believe that I was foolish for carrying this pain. I only carried my child for nine weeks, yet I carried this pain everywhere I went. I carried it to my bedroom, to my office, and to my car. I carried it in my dreams and in my prayers. The pain accompanied me everywhere and filled spaces that my child could no longer fill. It’s true that your heart physically aches when the pain is too overwhelming, but the heart is not the only part of your body that suddenly feels too heavy. Walking, even the shortest distance, absorbed all of my energy, and eating became a laborious task. It’s odd how the heaviness can be accompanied by an emptiness. The pain becomes so unbearable that your body turns numb, but it’s not the type of numb where you feel nothing; it’s the kind of numb where you feel everything.

My pain was slowly being coupled with something even more isolating – shame. The general perception was that my pain was rather unreasonable or exaggerated. I could hear it in their tone; nine weeks wasn’t enough for me to feel this sorrow. My loss was being compared to the suffering of a woman who lost her baby girl to SIDS[1] and of another whose daughter was stillborn.[2] I think people assumed that this would give me “perspective” and alleviate my pain. I’m sure they weren’t trying to hurt me – they thought these stories would help me heal, but shame is no antidote to pain. 

“I should feel better because someone else’s tragedy is worst” was the message being conveyed by people who truly thought were helping me.

Toxic positivity is defined by therapists Samara Quintero and Jamie Long as, “the overgeneralization of a happy, optimistic state that results in the denial, minimization and invalidation of the authentic human emotional experience.[3]” This seemingly helpful mindset, actually produces more harm and trauma because it encourages silencing and transforms pain into a “dirty secret.” In Christian circles, toxic positivity disguises itself as faith and hope and can make individuals feel inadequate in their faith.  

One in four women have suffered a miscarriage.[4] “Because it’s so common, medical professionals tend to dismiss pregnancy loss, and friends and family members often fail to register its impact,” explains Dr. Janet Jaffe, director of the Center for Reproductive Psychology. However, the fact that so many women experience miscarriages does not mitigate the suffering. A recent study found that 29% of women who had experienced a miscarriage before 12 weeks, suffered post-traumatic stress disorder. The study also showed that 24% of these women had moderate to severe anxiety and 11% had moderate to severe depression.[5] I soon discovered that several of my own family members had suffered miscarriages. They quietly shared small pieces of their stories with me, almost hesitantly and I wondered if shame had silenced them too. I suspected that the lack of empathy that their stories had been met with transformed their accounts into a hasty narrative. They recounted their experiences in a way that seemed rather frivolous, though their glistening eyes revealed a different truth. “This is what pain looked like under submission,” I thought.  

Our sufferings are often placed on a hierarchy constructed by cultural understandings that determine which events should hurt more. Certain tragedies are automatically considered more sorrowful than others. Some griefs are “top-rated,” while other losses are rendered unimportant or are even stigmatized – the pain caused by a son being incarcerated or the death of a loved one due to drug overdose, for example. Society invalidates certain pains at the expense of the sufferer, and we don’t tend to pains that we think do not or should not exist.

Neglecting pain based on prejudices is a phenomenon that is also present in the medical industry. Pain bias negatively impacts women as their pain is often dismissed or minimized.[6] Gender bias in medicine leads to a dismissive attitude that often times, causes misdiagnosis. Christin Veasly, director at the “Chronic Pain Research Alliance,” explains that, “women have been more often referred to psychologists or psychiatrists, whereas men are given tests to rule out actual organic conditions.” A study revealed that women are 50% more likely than men to be misdiagnosed following a heart attack.[7] Maya Dusenbery, author of Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed and Sick (2019), identified two principal reasons for which women experience significatively higher levels of misdiagnosis than men: 1) there’s a long-standing legacy of women being underrepresented or completely excluded from medical research, which means that medical professionals do not know as much about the female body as they do the male body and 2) women’s accounts about their pain are often met with distrust.

Gender bias contributes to the idea that women are hysterical, making it easy to dismiss their pain, and racial bias insists that certain bodies can withstand more pain. A 2016 study revealed that, “a substantial number of white laypeople and medical students and residents hold false beliefs about biological differences between blacks and whites and demonstrates that these beliefs predict racial bias in pain perception and treatment recommendation accuracy.[8]” These beliefs date back to the 19th century when Thomas Hamilton, a plantation owner and physician obsessed with medically justifying the enslavement of Black people, conducted torturous experiments on John Brown, an enslaved Black man. Hamilton claimed that Black people had thicker skin and less sensitive nerve endings. This myth, plagued with racist conjectures, seems to persist in today’s medical community. According to a 2019 study, Black and Hispanic patients are significantly less likely to receive pain medication, compared to White patients[9]. In short, medical practitioners are less likely to believe us when we say it hurts if we happen to be women or people of color.   

The lack of empathy expressed by people changes the manner in which you are able to tell your story. Truth and transparency become marred and you are left with remnants, carefully curated words that vaguely resemble what you feel. The way we listen to people’s stories can help them heal or it can cause more trauma. L.J. Isham describes listening as, “an attitude of the heart, a genuine desire to be with another which both attracts and heals.” To exercise sympathy and compassion and to adopt the type of listening described by Isham, it is not a requirement to have experienced every single type of pain imaginable to the human condition. We don’t even have to agree with the pain, its cause, duration or intensity. Our holy responsibility is not to rate each other’s pain, but to listen lovingly and to believe one another when we say it hurts. 

The way we listen to those in pain can have life-altering consequences. Pain is a real, intense sentiment that is often difficult to characterize using words, and culture can also influence the modes of expression adopted by each individual. This is why, it is important to listen with an open heart. I felt that my pain was delegitimized to such an extent that, even as I write this now, I have the lingering impulse to justify my pain to you. I am tempted to convince you that my pain was real. I want to explain what this pregnancy meant to me and detail the agonizing moments with such rawness that you would not be able to sanitize my pain. However, I will not do that. That is too much of a burden for a suffering person. I wrote this piece, not with the intention of putting my pain on display, allowing readers to dissect it and examine it thoroughly until they can recognize its validity, but to address the fact that we should believe people when they say it hurts. We can stand with people in their pain without understanding it. We can come alongside suffering people without having had to experience that specific pain ourselves. We can accompany people in their sorrow and console them without any “words of advice” or proposed “solutions.” We can pray for these individuals without even knowing the full story. The Bible tells us that when one member suffers, we all suffer (1 Corinthians 12:26). It is pain that unites us, and that propels us to love one another as we understand our interconnectedness in God.

We have a tendency to run away from pain and in reality, it is all too easy, especially if it is not our own pain. We look away and cover our ears and hearts with much ease. Indeed, it is much more difficult to stand with someone who is in pain. However, pain is not alien to the human condition, nor is it unfamiliar to Jesus. Our Savior experienced immense pain. In fact, it was the shortest verse[10] in the Bible that brought me the greatest consolation in my moments of sorrow; “Jesus wept” (John 11:35).  I was reminded that He didn’t weep because he was overwhelmed by joy and gratitude; He didn’t shed happy tears. He wept in suffering. He wept in loss. Profound pain caused those precious tears, and it was His pain that ultimately brought salvation to the world. Pain, generated by His everlasting love, is central to the gospel message, yet we often try to disguise it or swiftly move past it in our understanding of Him. In fact, “in early Christian times, the belief that Jesus Christ suffered pain was usually not accepted […] freedom from emotion was something to strive for at that time. Only after the acceptance of Christianity as the state religion of the Roman Empire in 380 AD did the pain of Christ again stand in the centre of the Christian doctrine of salvation.[11]” When all trace of pain is removed from the gospel, we are left with an anemic version, one that represents God as just a happy character, incapable of being in the midst of our grief and our suffering. When we attempt to alienate our pain from God, we are inadvertently supporting a theological vision that believes that God is incapable of understanding our pain. When we try to hide our pain away from our Creator, we undervalue His love and grace for us. In The Problem of Pain, C.S. Lewis wrote, “Pain insists on being attended to. God whispers to us in our pleasures, speaks in our conscience, but shouts in our pain.” The Bible does not say that God ignores our pain and pretends it does not exist; Psalm 147:3 reminds us that, “God heals the brokenhearted and binds up their wounds” (NIV). Our pain does not condemn us or separate us from God; on the contrary, it draws us closer to our Maker and to each other. 

 
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About Dra. Itzel meduri soto

As an academic from el barrio, Dra. Meduri Soto strives to engage in scholarly work that honors and gives visibility to her community. Her faith drives her passion for justice as she seeks to reveal the ways in which certain language ideologies are constructed to operate unjustly against our communities. Her work acknowledges language as a powerful tool and promotes linguistic diversity in its different manifestations. Bicultural and bilingual identities are at the center of Dra. Meduri Soto’s work. She is a Spanish professor at Biola University where she teaches second language and heritage language learners. To learn more about her work, follow her on Instagram: @la.dra.itzel



Footnotes

[1] Sudden Infant Death Syndrome

[2] “A still birth is the birth of a baby who has died any time from 20 weeks into the pregnancy through to the due date of birth. The baby may have died during the pregnancy or, less commonly, during the birth” (Pregnancy Birth & Baby).

[3] https://thepsychologygroup.com/toxic-positivity/

[4] American Society for Reproductive Medicine.

[5] “Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study” American Journal of Obstetrics and Gynecology (2019).

[6] “‘Brave Men’ and ‘Emotional Women:’ A Theory Guided Literature Review on Gender Bias in Health Care and Gendered Norms Towards Patients with Chronic Pain” Pain Research and Management (2018).

[7] “Impact of Initial Hospital Diagnosis on Mortality for Acute Myocardial Infarction: A National Cohort Study” European Heart Journal – Acute Cardiovascular Care (2018).

[8] “Racial Bias in Pain Assessment and Treatment Recommendations, and False Beliefs about Biological Differences Between Whites and Blacks” Proceedings of the National Academy of Sciences of the United States of America.

[9] “Racial and Ethnic Disparities in the Management of Acute Pain in US Emergency Departments: Meta-Analysis and Systematic Review” The American Journal of Emergency Medicine.

[10] It is the shortest verse in many translated versions. 

[11] Markschies C. Der Schmerz und das Christentum. Symbol für Schmerzbewältigung? [Pain and Christianity. A symbol for overcoming pain?] (2007). 


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For the Abuelas en el Barrio

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This week many church leaders made the hard decision of going virtual these upcoming Sundays. More so, it was made clear through official statements made by the World Health Organization (WHO) and the US Center for Disease Control and Prevention (CDC) that we have not yet reached the height of medical or financial devastation in the US or the world. Many are getting the sense that things are going to get worse, before they get better.[1] Anxiety and fear are pervasive among our friends, family, and congregants.   

Only a short scroll through social media makes it appear that we as a country have lost a sense of cordiality and neighborliness. The videos of people stampeding over one another to grab rolls of toilet paper would seem comical, if not contrasted to the images of our elderly standing in a picked-over grocery aisle empty handed. In times like these the Church must ask: “How do we respond faithfully during this pandemic?”

Moving to a virtual format is a valuable first step, as it recognizes the need for “social distancing” to keep safe the most vulnerable of our communities. However, while this is a good first step, I would argue it is still simply just the first step of a potentially long journey. A good next step is to reflect on our society’s current actions and rhetoric and ask, “What do these tell us about how we understand our world”?

“Every Man for Himself” | Counteracting an Economy of Scarcity 

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Then the Lord said to Moses, “I will rain down bread from heaven for you. The people are to go out each day and gather enough for that day. In this way I will test them and see whether they will follow my instructions.”
— Exodus 16:4

The sense of not having enough, or eventually coming to a place of not having enough is arguably what is driving the mania that has people flocking to the stores to buy items in bulk. The anxiety of not enough is a tell-tale sign of a culture that exists in an economy of scarcity. These mentalities and sensibilities don’t just happen overnight, they come from years of formation. Within Western culture, individuality is a virtue. It is good to look out for yourself. While this comes with benefits, like the ideals of democracy and of individual voice, it also comes with pitfalls.

The Christian faith has a history of counteracting the economy of scarcity. In the wilderness, the people of God had to submit to vulnerability, believing that God would provide day by day. And despite disproportionate collection, “some gathered much, some little,” (Ex. 16:17) God always made sure his people had enough. In fact, it was the hoarding of goods that produced rot (Ex. 16:20). Unlike the rest of the world, ours is an economy of enough.

If we are going to make it through this time, with some semblance of sanity and good-will, it is incumbent upon the Church to innovate and implement systems that counteract the current economy of scarcity. This could look as simple as encouraging your fellow congregants and friends to take only what they need to last them for the next two weeks at the stores, in order to reduce hysteria and defy this sentiment of scarcity.

We find that acting based on scarcity eventually produces scarcity. The economy of scarcity is a self-fulfilling prophecy. When individuals decide to take beyond their need, someone else suffers disproportionately. This is currently reflected by the desperate positions of many of our elderly.

“It’s okay, I’m low-risk.” | Learning How to Honor Lola

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But if anyone does not provide for his relatives, and especially for members of his household, he has denied the faith and is worse than an unbeliever.
— 1 Timothy 5:8

It has been made common knowledge that the most vulnerable of our communities in this time of pandemic are our elderly and those with pre-existing conditions (e.g. those with auto-immune disease, going through chemo, etc.). So, while it may not seem like the disease poses a significant threat to you or your immediate family unit, the same is not true for everyone in your congregation. We must ask ourselves always how we are actively seeking to honor everyone, especially the most vulnerable of us.

In the Filipino culture, it is very common for elderly family members to live among younger generations in the same household. Intergenerational contact is normative; one household could hold up to four generations. The idea of leaving Lola (Abuela) by herself or in a nursing home, is a relatively foreign concept. In addition to this, the elderly in your “barangay” or “barrio” are also met with a great deal of respect. Thus, the well-being of the elderly is naturally taken into consideration. Now, this does not mean that there is no anxiety of scarcity in Filipino/as, but in days like these I find myself reflecting on my culture. I am compelled to stop and consider the ways that my heritage teaches me how to love my community, especially the Lolas and the Lolos of them. 

When writing to Timothy, Paul makes a seemingly indicting statement that to not provide for relatives is paramount to denying the faith. This seems almost counterintuitive to the scarcity mentality that I just described, especially since many are hoarding with their families in mind. Keep in mind that the Biblical context was perhaps much more similar to intergenerational contexts, like that of the Philippines, and less like our Western, individualized contexts. In a Filipino culture, we would read this to apply to the most vulnerable in our family units. Therefore, every action we take during a communicable pandemic is taken with care and always takes into consideration our Lola and Lolo at home.

The Church can learn a valuable lesson from its Filipino members during this crisis. We must prioritize and give special care to not just our elderly, but our most vulnerable brothers and sisters. We must not operate based on an assumption that most of us are "low-risk," but rather keep in mind that among us there are thousands of people, seen and unseen, who are especially vulnerable to this illness. Because we are a body, a family, that includes people who are vulnerable, we are compelled to protect them with our actions as best we can. The Body of Christ must be conscious of every member, including our Lolas y Abuelas. As one Body our identity, and thus our “risk,” is always absorbed in the whole of our community.

What Does It Take to Be a Neighbor?

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When the world is in crisis, it is easy to feel overwhelmed and lose sight of our immediate context.

In times like these, I almost feel like the lawmaker who asked Jesus the question, “Who is my neighbor?” This question, of course, inspired Jesus to tell the parable of the Good Samaritan. What I often forget is how economically prodigal or reckless the Samaritan Man was in response to the hurt stranger on the side of the road. He poured out oil and wine, expensive commodities, to address the man’s wounds, and he paid for the man’s accommodation and any other possible costs. The Samaritan was lavish in his care for a stranger. At the end, Jesus asked his initial inquisitor: “Which of these do you think was a neighbor[...]?”

To which the inquisitor answers, “The one who showed mercy.”

In truth, neighborliness finds its fullest expression when we not only consider the needs of the most vulnerable, but when we consider their needs more important than our own. Ministry at this time cannot simply end at accommodating a mandate of “social distancing,” it must venture on into neighborly acts.

Going virtual is a meaningful first step for many churches, but there is more work to be done. Many church leaders in my area have taken it upon themselves to mobilize the healthy and able in their churches to assist their most vulnerable. They have asked those in their congregations who are over 60+ and most at risk to contact them directly with a shopping list and have made plans to find shoppers for them during this time. This is an innovative way to counteract the anxiety of scarcity, create opportunities of intergenerational partnership, and actively pursue the act of neighborliness. The Church needs more innovative ideas such as these.

What are the ways that you can be a neighbor today for those who are most vulnerable? If you are already living out neighborliness, share them with us using #WOSNeighbor #forAbuela!

Jesus asked: “Which of these do you think was a neighbor[...]?” The expert in the law replied, “The one who showed mercy.” Jesus told him, “Go and do likewise.”
— Matthew 10:36-37
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About Jelyn Leyva

A Second-generation Filipina born in Tampa, FL, Jelyn Leyva graduated Moody Bible Institute in Chicago on May 2017 with a Bachelor’s degree in Women in Ministry and an Interdisciplinary in Theology. She is currently in Los Angeles, CA pursuing an MDiv at Fuller Theological Seminary with her emphasis in Christian Ethics. Having lived in various places in the US, Jelyn’s interest lie in the complex history and multi-ethnic life of the Protestant Church in the US. Her hope is to serve this church and its many colors with the consideration of traditional and contemporary theological scholarship.



Footnote

[1] “Coronavirus: Over 1,000 Cases Now In U.S., And ‘It’s Going To Get Worse,’ Fauci Says,” NPR.org, accessed March 19, 2020, https://www.npr.org/sections/health-shots/2020/03/11/814460233/coronavirus-1-000-cases-now-in-u-s-and-it-s-going-to-get-worse-fauci-says.