As a primary care pediatrician at Odessa Brown Children’s Clinic, I wear a teal lanyard around my neck with the words Hope Care Cure, the mission of Seattle Children’s Hospital, encircling me. While Seattle Children’s is Odessa Brown’s parent institution and the place where I learned pediatrics, I’ve always struggled with the word cure.
One definition states: “substance or treatment that ends a medical condition.” This could be a medication, a procedure, a therapy. Cure implies that not only is there a remedy for an ailment, but that the remedy ends the condition and leads to healing.
There are many medical conditions for which there is a cure and an end to the condition — surgery for appendicitis, antibiotics for an infection, chemotherapy for certain kinds of cancer. And there are many other conditions for which there is no end or cure, but there are medications to help manage the disease, such as diabetes or high blood pressure. And for rare childhood diseases without cures, Children’s has been committed to being at the cutting edge of research to find them.
But what if the condition is poverty, toxic stress or racism?
What is the cure for a boy acting out in school after his mom has just escaped domestic violence? What is the cure for a depressed teen whose parent is too busy caring for a dying family member? What is the cure for the children of two working parents who trade off day and night shifts and work two jobs each and still lack access to enough food? Now add the layer of racism to each of these scenarios — how Black and brown children are treated in school, how Black and brown parents are treated at work, how Black and brown families are forced to navigate housing, food, education, employment systems. Racism, inherent in all these systems, diminishes one’s health, and one’s humanity.
Recent research has demonstrated that early abuse, neglect or domestic violence, adverse childhood events, can lead to downstream effects on physical and mental health into adulthood. What is the cure for the conditions that lead to those health challenges?
When Children’s mission is Hope Care Cure, what is Children’s commitment to all children — not just the ones with exceptionally rare diseases, but to all the children who enter its doors?
It must start with dignity.
Dignity is the capacity to deeply see another person in their wholeness, in the depth of their suffering, in the transcendence of their grace and in the fullness of their humanity. Dignity is listening with the knowledge that everyone is doing the best they can, that we cannot begin to imagine others’ circumstances, what they’ve endured or even what happened to them earlier that day.
Odessa Brown Children’s Clinic was born at the end of the Civil Rights Era for Seattle’s Black community. The clinic’s mission has always been Quality Care With Dignity. Odessa Brown, a community organizer who had experienced being turned away and denied care, envisioned a clinic where children and families in her community would be treated with the respect and dignity they deserved.
My understanding of the word dignity has deepened in my nearly 30 years working at Odessa Brown. The clinic and the families who seek care here have been my teachers. I did not have medication or treatments for many of my patients’ and families’ struggles, and I often felt at a loss for what I could do to help. Fortunately, over time, the clinic has built more capacity for support and social services to address the more complex needs of its community. But I have also grown to realize that what patients and families need and deserve is to be heard, to be deeply listened to. Far beyond hearing the words, what is required is to hear with an open heart the depth of their experience — to bear witness to their challenges, suffering and pain.
To bear witness to another person, to hear their story with an open heart, to hold space for the complexities of their life, to show reverence for what they’ve endured – this is to provide patients and their families with dignity. During these times, when many are experiencing an absence of feeling seen or being heard, our presence for each other’s inherent dignity is a profound gift of healing.
Cure starts with dignity.
Dr. Benjamin Danielson, medical director of Odessa Brown for 20 years, recently resigned in protest of alleged patterns of racism at Seattle Children’s. In the aftermath of his departure, members of the community are calling on health care institutions to take action against racism inherent in our systems. While we reexamine policies, practices and investments of time, money and energy, we must not forget who all this is for — Black and brown patients, parents, families and communities. Their voices must be at the table. Not simply as advisers or consultants, but as equal partners sharing their intimate knowledge about how the system is not working and where and how it can improve, co-creating a way forward where every child receives quality care with dignity.
This time calls upon us as citizens to support equity for all people. This time calls upon clinicians to tap back into the art of medicine, seeing the dignity in each person we serve. This time calls upon institutions to step back and listen to patient, family and community voices, bringing the wisdom of their lived experience to create a health care system that is truly healing for all.