This past Sunday night, I bet that you, like me, did some form of the following: watched one last reel on social media, turned off the kitchen lights, set the morning alarm before climbing into bed. Then maybe it hit you: The next day would be Monday, and your time would not really be yours again for the next five days. Eventually, you fell asleep.
On Sunday, March 13, 2020, Breonna Taylor climbed into bed after what I imagine was a similar routine, with a similar expectation. But she never made it work on Monday.
Two years later, her memory barely counts as trending compared to everything else going on in the news.
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I couldn’t sleep well Sunday night. I tossed and turned, thinking about 26-year-old Breonna getting ready for bed years ago, perhaps wondering what emergencies she would respond to the next day as an EMT, or whether she would get exposed to COVID-19 like her family feared. I imagined her questioning whether she was paid enough to put herself at risk in this way, and then reassuring herself that this job was only temporary because she would eventually become a full-time nurse.
It was not difficult for me to imagine what Breonna’s life may have been like. Like Breonna, I am a Black woman who works in the medical field. Since I was 14 years old, it was my dream to become a psychiatrist. I wanted to be the Black Dr. Sanjay Gupta or Dr. Phil.
My practice consists of mostly Black, female, queer twenty-somethings who also dream of becoming nurses, professors and physicians. Most of my patients’ struggles are what you would expect. They worry about whether they are smart enough, good enough daughters or worthy enough for love. But recently many of them have been struggling with something more insidiously harmful: whether anything they do will make a difference in improving their lives, the lives of their families or the lives of other Black people.
Recently many of them have been struggling with something more insidiously harmful: whether anything they do will make a difference in improving their lives, the lives of their families or the lives of other Black people.
It is hard for them to see the benefits of living day in and day out as a Black person in America. Black people have less wealth and lower life expectancies than white people. School districts with mostly Black students receive less money. They go on about their days, acutely aware that society underinvests in their well-being. After a while anyone would start to feel invisible. That’s why days like Sunday — when the second anniversary of the death of Breonna Taylor, a young Black woman with so much to look forward to, is barely mentioned in the news — are so discouraging.
Never could I have fathomed how difficult it would be to work with Black patients as a Black psychiatrist. Now, I mostly dream of beach vacations to offset the stress of listening to my patients’ painful experiences with oppression, while dealing with my own. I fear it will always be this hard.
It feels demoralizing.
Demoralization, as a psychological concept, is experienced as a persistent inability to cope, with associated feelings of helplessness, hopelessness, meaninglessness, subjective incompetence and diminished self-esteem. Most research on demoralization is conducted among patient populations with cancer, schizophrenia or those who are receiving end-of-life care. It is associated with poor physical and mental outcomes, but most importantly, with suicidal ideation and a will to die.
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Truthfully, I feel just as hopeless about the future as some of my patients. There are times when, while listening to them, I become distracted by my own existential worries: my financial insecurity as a young physician saddled with debt; judgment of my anxiety about my financial security as a privileged individual with a job that has high earning potential; how much money I have compared to my family, including my brother, who is in jail; the lack of inherited wealth I could have had if I was born into a rich, white family.
None of the other trendy words of the day — languishing, burnout or exhaustion — capture what Black people are going through right now, or what they have gone through for generations since they were first brought over to be used as slaves to generate wealth for America’s white forefathers.
For Black people like me, the memory of Breonna Taylor’s legacy does not fade so quickly. We have grown used to the possibility that someone else can decide whether we will wake up tomorrow.
On good days, all I can do is support my patients with what seems like the Sisyphean task of surviving as a Black person in a capitalistic society. I can try to remind them of all the unexpected moments of gratitude that they also experience day to day. I can offer medication to help them sleep, decrease their panic attacks or alleviate their depression enough to get out of bed and interact with an oppressive society.
On the hardest days, I can only remind them that suicide is never an option and reassure them that it is OK to lack optimism about the future. I want so badly to make things better for my patients, for my family, and the community of Black, queer, cis and trans women. When I continue to see their hurt, I wonder the point of trying and I feel so demoralized.
At these moments, all I can do is smile, surprised by how resilient we, as Black people, truly are.
Just when I think my morale cannot get any lower, I have an encounter with a patient that turns it all around. The patient who had recently questioned whether living had any real purpose or value to society reports back in a later session that she “was tripping” and that she would determine her purpose to society, not the other way around. At these moments, all I can do is smile, surprised by how resilient we, as Black people, truly are. These are the moments that pull me back from the brink of demoralization.
Sometimes the victory is remembering that we are alive, unlike Breonna, and that is all we have.