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Every month More Voices invites readers to contribute short nonfiction prose pieces of 40 to 400 words on a healthcare theme.

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Paul Gross

In the wake of recent events, many speak about the need for conversations about race. In our country, the implications of race are a moral issue, a humanitarian issue, a justice issue and, yes, a medical issue. (One need only examine how racial categorization affects rates of death.) But what would this conversation about race look like?

Today, Pulse's editor provides one offering. In August, we'll invite all Pulse readers to join in with their stories, when Race will be the theme of More Voices.

I grew up in Stuyvesant Town, a middle-class housing development just north of Fourteenth Street on the east side of Manhattan. Built after World War II, Stuyvesant Town was a leafy and desirable place to live. There was a long waiting list to get in, and priority was given to World War II veterans, like my father.

Although we think of New York City as a bastion of multiculturalism, African-American veterans were not allowed in Stuyvesant Town--a policy upheld by the courts until the mid-1960s.

When I was a boy, black families hoping to live in Stuyvesant Town were directed to a separate-but-equal housing project in Harlem. This policy had a practical impact on how I viewed African-Americans, which was with some degree of suspicion. If I saw a dark-skinned man wandering through Stuyvesant Town, I'd wonder, uneasily, what he was doing there and what he might be up to.

My fears weren't confined to African-Americans. I was also uneasy about Hispanics. Fourteenth Street separated Stuyvesant Town from a neighborhood I was afraid to venture into. Now, of course, that area is a quintessentially hip neighborhood known as the East Village. At that time, however, the aging buildings were occupied by recent immigrants from Puerto Rico. "There's a lot of PR there," I would hear grownups say, a phrase that implied poverty, lawlessness and menace.

As it happened, my own father was from Cuba, and our Spanish-speaking relatives visited us regularly. I suppose I might have viewed Puerto Ricans as kin, but not so, probably because my father didn't. From him I picked up that they were different somehow, and that my dad identified himself first and foremost as an English-speaking mainland American.

As I came of age, I read a lot and came to believe that we--as individuals and as a nation--needed to rise above our prejudices, to find the humanity that connects us all. At the same time, I felt aware of my own lingering sense of unease around people who were different from me.

In my twenties I moved into a northern Manhattan neighborhood called Inwood. I remember one conversation with a neighbor, a friendly Puerto Rican mother of two. She began to talk about Dominicans, the next wave of Caribbean immigrants, who now occupied the neighboring streets.

"Dominicans?" she said, shaking her head. "They're crazy."

At the time, I didn't know any Dominicans, so I had to wonder whether she knew something that I didn't. Or could it be that she was just doing what countless immigrants before her have done--turning with alarm upon the next group to touch our shores? Still, her words stayed with me.

I now work as a family physician in the Bronx, taking care of all the people I used to be frightened of. Many, if not most, of my patients happen to be Dominicans. Many others are Puerto Ricans and African-Americans.

Why do I find this work particularly gratifying?

I think of my two daughters. When they were little, they were scared to go down the big corkscrew slide at the water park. Then, one summer, something clicked. They'd gotten older. They were less fearful. And--wow!--wasn't it fun to do something that used to terrify you?

There's something thrilling about being liberated from a fear. For instance, to meet Dominicans and discover that not only are they not crazy, they're actually as charming and likable as, well, as any other nationality you might name. What better sensation than feeling nameless apprehension give way to relief and pleasure?

Because I had Cuban grandparents, Cuban uncles and a Cuban aunt, I feel as if the chasm between me and my Dominican and Puerto Rican patients is not huge. I have muscle memory of having known, intimately, relatives who look and sound similar to them.

With my African-American patients, it's a little different. I don't have such memories. All I have are bits of knowledge gleaned from books, from college courses, from magazine articles, from autobiographies, that convey to me how large the chasm is between my life experience and theirs.

For that reason, I feel profound joy when a patient who is African-American looks me in the eye with a relaxed smile that says, "I trust you." Isn't it amazing, I want to say, that in spite of everything, here we are, feeling connected with one another.

At the same time, I've come to understand the limits of this connection.

About two decades ago, I cared for Andre, an African-American boy a few months younger than my first daughter. As he grew, I couldn't help but compare his progress with Cara's. At age six, he was reading as well as she was. He was bright and active.

At some point, the active part started getting in the way. Andre had trouble controlling his impulses. He became disruptive in school. His working mother tried heroically to get him the help he needed. She fought the public-school system to get him into a class that could address his needs. She brought him to doctor appointments. And when psychiatrists recommended pills, she medicated him even as these pills caused enormous weight gain.

Throughout, Andre remained an affectionate kid who would throw his arms around me (“Doctor Gross!”) when he came to our health center. He was exuberant and irrepressible. I liked him, even as I reacted with dismay to his mom's recounting of his escapades in school (He hit the teacher?).

Andre's dad came in for an appointment when he was released from jail--a bright, engaging young man. If he'd only had some decent opportunities, I thought at the time, he could have been somebody.

I left that health center when Andre was about thirteen. I wish I could say that I stayed in touch. I wish I could say that, when I left, I was hopeful about his chances.

A few months ago, I Googled Andre's name and learned that he's in prison. It gets worse. When he was sixteen, Andre pleaded guilty to killing a cab driver. Oh my god.

I felt heartbroken.

I'm looking at Andre's face right now, online, as he stares back from my computer screen. I'm looking at a mug shot, but seeing an eleven-year-old boy. That boy is shouting, "Doctor Gross!" He's flinging his arms around my waist, his head pressed against my chest.

I can't help but feel that I've participated in playing out some awful legacy. Even while I was caring for Andre, I had some sense that we--his mom, his family and I--were up against something bigger than ourselves: a challenging child, yes, but also a system that required superhuman struggle for his mother to get the help he needed, help that was still never enough, and a society that is willing to tolerate a child's dwindling chances for success when that child is of color.

Looking back, I have to wonder whether I myself didn't succumb to those limited expectations.

If Andre had grown up white, in a middle-class home, would his fate have been very different? Without a doubt. My daughters have friends who have suffered difficult circumstances and emotional volatility, who have received medication and counseling. No one would dream of giving up on them. They've all gotten whatever help it took. They've graduated from college. Prison was not remotely on their menu of possibilities.

My conversation about race has to do with the joys of connecting with the other--the person you grew up fearing. Sadly, it also has to do with recognizing that, however gratifying my connection with Andre, and however sincere my attempts to give him good medical care, these were not enough to protect him from society's collective fatalism when we had the chance to steer him out of harm's way.

And, sadly, I'm aware that I may have shared in that fatalism.

How much does race play into Andre's story? Is it ten percent? Twenty-five? Fifty? Ninety?

I don't know. But whatever the amount, I believe that it made all the difference.


About the author:

Paul Gross is editor of Pulse.

Story editor:

Diane Guernsey

Comments   

# June Rose Dowis 2016-08-13 11:15
This is a beautiful heart-wrenching piece.
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# Andrea Gordon 2016-07-31 20:00
Thank you for sharing this beautiful piece. I so appreciate your honesty and reflections.
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# Joanne Clarkson 2016-07-27 19:53
I once taught a creative writing class at a men's prison. All the students except one were young Black men. Most of them were very poor writings and attended mostly to get out of their cells and have something, anything, to do with their time. But one was a brilliant writer. His stories were coherent and compelling. I gave him some leads about where to publish. He wanted to stay in contact with me but sadly, I never responded to his letters or messages after the class. I had young children and I didn't know what crime he had committed and I was afraid just like you. I don't know if he kept writing or published his work. I don't know if he is still in prison.
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# Ronna L. Edelstein 2016-07-26 19:19
Paul, I have known and valued you as a member of the Pulse family for years. Now, after reading your beautiful essay, I know and value you as a special person--one who cares deeply about all people. Knowing you is a privilege and a pleasure.
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# Muriel Murch 2016-07-24 07:45
This reminds me of singing to a Down's Syndrome 11 year old girl in order to change her knee dressing. Why did that work and allow her Romany family to let me touch and hold her? It did, it was enough - but only for that necessary few weeks of time.
What can make the difference? Being 'aware' just doesn't seem to be enough. How well can we 'know' each other? As best we can and if we try for best and then take another step or two forward, will that help us all? I do so hope so dear 'Dr. Gross,'
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# Hilton Koppe 2016-07-24 01:58
Thanks Paul for sharing your story. Sadly, the same story occurs here in Australia all the time within Aboriginal communities. Social determinants of health! Aren't our 2 countries rich enough to do better?
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# Molly Moynahan 2016-07-23 11:01
This is a powerful story told by someone who did so much good but wonders whether it was enough. I have a son who went through the Chicago Public Schools and we had this conversation when his friends, African-America n mainly, began to struggle. He too struggled but the outcome was different, he was protected by race, money and connections. As a teacher I know I inspired some students but was that inspiration enough to offset how many things were weighed against them, poverty, race and neighborhood. I just don't ever want to stop trying and hoping and looking for better ways to find equal opportunities for all children and adults.
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# Marilyn Hammick 2016-07-23 04:42
Gratitude for your honesty.
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# Linda Berghen 2016-07-23 04:20
Thank you Paul for sharing your thoughts and feelings. What you experience is universal and - I'm afraid - also human. (Remember the ' ueber race ' ,..not so long ago ....) But as humans we also have our mind which implies that we can learn and 'adjust' ourselves to become better persons. That is also an everlasting process of which the first step is the hardest.... Also to be aware that religion throughout history and allover the planet often was a bad adviser. The actual time we are living makes it an even bigger challenge to pursue our way on the right path : awareness is key , more than ever !!!! All living creatures deserve to be treatened with respect and all humans should have access to equal means of development and care. Let's hope that with the next elections in your country people will make the right choice ! With kindest regards to Diane and yourself. you and your family had breakfast in our garden while you were visiting Europe and your niece Jacqueline.)
Linda
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# Betsy Kates 2016-07-22 22:51
What a beautiful piece, straight from your honest heart, Paul. I know so well that feeling of helplessness as student after student tugs at my heart while they are "mine" for ten months, hoping that in that short window, I might help do something - any tiny thing - to help break a cycle of poverty,too-you ng pregnancy, substance abuse, violence and incarceration. I'm sure you do way more than you know in your practice. Thank you for reminding me how urgent it is that we all confront and learn from our ingrained biases so that we can move beyond.
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# Madeleine Mysko 2016-07-22 21:03
Thank you for this thoughtful reflection. I'm hoping a helpful conversation ripples forth from it. It's hard to really talk about race and privilege. Even harder to look back and have the courage (not to mention the clarity!) to admit that one may have shared in some part of a problem--dare I say some part of the injustice? Andre's story and the questions you ask yourself now--thank for that modelling especially.
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# Catherine Wallace 2016-07-22 19:45
Dr Gross, you are modeling for us what this conversation might look like, feel like, sound like. Thank you. These are necessary and difficult conversations. Cate
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# Linn Brown-Ford 2016-07-22 19:06
Paul,
As the inequities repressed and denied for hundreds of years erupt into main stream society, your essay is most appreciated. Until we can each claim responsibility for the past we can not expect to open a dialogue that includes a sense of equanimity and offers hope for everyone's future.
Warmest regards to you and Diane,
Linn
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# Jeff Blaine 2016-07-22 17:54
Paul,

Thanks so much for this very thoughtful memoir. I learned some things about you that I did not know from our time at Stuyvesant High School together.

Hour after hour in my psychotherapy practice, my clients are struggling with current events that feel as though we have entered a time tunnel to the past. Unfortunately, what I suspect is more accurate is that we are really just seeing how things always have been. It's just that we did not have the 24/7, cell phone videoed evidence confronting us, as is now the case.

One can only hope that the shattering of our denial can lead to some good. But, for now, reflecting honestly on our own racism and inaction, subtle and not-so-subtle, seems to me to be an essential first step in altering our thinking and behavior. Thanks for sharing and encouraging others to take that step.

Stay well in all things, Paul.

Jeff
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# Ron Banner 2016-07-24 15:26
Thanks for sharing such a personal reflection, Dr. Gross, and for so many wonderful replies.

As an Internist practicing for over 40 years, I have learned so much from being open and listening to my African-America n patients and their experiences and what they wanted to teach me.

We are blessed do what we do and be able to grow from our patients.
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