Listen.

Any who have stayed with this page from the outset may remember that its grammatically incorrect name, "Tell It Good," came from an encounter with a patient and her daughter many years ago. Longtime residents of Chicago's Cabrini-Green public housing development, they had watched its rise and (eventual literal) fall, and ultimately had been relocated to a newly constructed apartment adjacent to the site of the old "projects." Albeit clean, bright, and critter-free, with an absence of drunks in the hallways and drug dealers outside the front door, the new place came with its own set of problems, ranging from tenant-paid heat that they couldn't afford to rules against congregating in common areas, which left them isolated and without both their former community and their usual ways of meeting people and making friends. Reminiscing, they told me that for all the problems in the Cabrini of old, were it possible they'd give up the new apartment and go back in a heartbeat. Listening to their poignant, witty accounts I told them they should write a book, that their story should not be lost, and when I pressed they told me, first one speaking and then the other, "You write it." "You tell it." "Yeah, because you tell it real good." Ever since then I have striven to tell the stories that have played out in my work as a nurse, because stories teach as nothing else can. Stories touch hearts and build bridges, and remind us of our common ground. And sometimes telling a story itself births good; from a new understanding or realization of shared humanity goodness grows such that "telling good" is less bad grammar than an actual movement of energy from words to being in the world. But we must not be so busy telling our own stories, often over and over to those whose stories are similar, that we fail to heed the stories of others, to listen.

"Roshell" was a single mom caring for her young children and for her own disabled mother, "Myrtle," who had suffered a stroke some time before I met them and had several other health concerns as well. They lived on a high floor of a Cabrini-Green high-rise; did I climb six flights of stairs to see them, or was it nine? I don't remember, but it was a considerable vertical trek with a heavy backpack, casebook, assorted supplies, flashlight, and police escort. There were drug dealers outside and often more "working" in the stairwells; we'd ask which stairs we should use so as not to disrupt their "business." It was dark and smelly; often there was human waste or vomitus on the stairs, and always there was trash to be skirted. Occasionally we'd come upon rodents that had met their demise; more frequently live ones scurried out of our way.

Things weren't much better in Roshell's apartment. Cockroaches prowled about in broad daylight, and our shoes stuck to the floor as we walked from room to room. The first time I saw Myrtle she was lying on a sagging double bed in urine-soaked linens and clothing, unable to turn without help, much less stand or walk. "She's wet, Roshell. If you'll bring some clean clothes and linens I'll help you clean her up," I said.

Roshell sighed. "I just did that yesterday. Maybe I can do it again tomorrow or the next day, but I'll help you push her over where it's not so wet."

"How often do you bathe and change your mother?" I asked.

"A couple times a week usually," came the response.

A licensed professional nurse, I am a mandated reporter of any abuse of children or vulnerable elders I encounter. It's the law. And here was an old woman, unable to move about or care for herself, living in filth and left lying in her own waste for days on end. It would be time for me to pick up the phone. Once I made that call an investigator from the state Department of Aging would follow up, and finding what I found no doubt would pursue legal recourse to remove Myrtle from the home and send her to a nursing home where she would be cleaned and changed promptly and also assured the food, medications, and other basic care she needed. Of course what that would do to her spirit and to her family is another matter. So I asked Roshell to tell me about taking care of her mother.

Most of us pee several times a day, and Myrtle was no exception. But Roshell had a limited supply of linens and clothing, and doing laundry entailed taking two buses to the nearest laundromat, after carrying the soiled items down the same dark, dirty, gang-infested stairs up which I just had come. This could happen only when someone turned up to be with Myrtle and any of Roshell's children who were home at the time. Frequent trips to the laundromat were expensive, between bus fare and the cost of the washers and dryers, so laundry days had to be limited for financial reasons as well. And because the old mattress was wet and never had time to dry before being wet yet again, clean linens became wet and dirty as soon as they were placed on the bed. The best Roshell could do was try to push her mother from one side or corner of the bed to another so she lay on the cleanest, driest possible spot.

On hearing this my judgment shifted from Roshell-as-abusive-daughter to Roshell-who-made-heroic-efforts-to-do-the-best-she-could-with-what-she-had, and who was as loving and devoted as she could be given the resources available.

Within a day I had a hospital bed, disposable underpads, adult diapers, and Physical Therapy in that home. Next came a bedside commode, and before long the therapist had taught Roshell to transfer Myrtle from the bed to the commode. Later Myrtle learned to do this by herself. Wet linens became largely a thing of the past, and trips to the laundromat decreased to once weekly, with less expense because there were fewer items to be washed. Somewhere along the way the sticky floor was cleaned, perhaps because Roshell had more time for that part of housekeeping, and gradually as we addressed Myrtle's other health issues the home overall became brighter, cleaner, and calmer. A year or two later Roshell and her family were moved from Cabrini-Green to a nearby new apartment and their old building was demolished. Myrtle died a year or two after that, in her clean home surrounded by her family.

Had I knee-jerked and done my legally mandated duty when I first found Myrtle unable to move, lying in urine-soaked clothing and linens, and in the care of a daughter who didn't seem to think this was a problem and who appeared to clean her mother and do laundry only when the stars aligned to allow it, the outcome would have been very different. I wish I could say that I just was savvy and wise and so knew to elicit and respond to Roshell's story, but the blunt truth is that my early days in "the projects" had brought me up short so many times, so often leaving me feeling helpless and at a loss for how to proceed, that all I knew to do was go back, show up, and see what happened, see what avenues for some, any, kind of progress might begin to open. And so, having shown up and encountered what was there, I had asked Roshell to tell me her story.

No matter how overwhelming the situation, every. single. time. I simply showed up, often without a clue what I'd do once there, an opportunity presented itself. It may or may not have had anything to do with a patient's "diagnosis" or why I might have supposed I was going there in the first place, but a way to begin to make an inroad appeared. I learned to show up, to be as authentically present as I could be, and to listen.


Today approximately half of our country is reeling from the outcome of yesterday's presidential election. The other half is celebrating and hoping that urgently needed change is on the way. In about an hour from now there will be a massive protest downtown in my city, with similar ones taking place across the country. Had the election gone the other way we're told the other side would be plotting a revolt. I have heard many wonder if women, people of color, non-Christians, and those born in other countries would be safe in the new administration. All over social media I see people on both sides declaring that they'll have nothing to do with supporters of the other candidate. Physical, psychological, and financial violence all have been threatened.

But the scariest thing of all is that no one is saying that it's time, indeed, way past time, to show up, be as authentically present as possible, . . . and to listen to the other side.

Writing about problems with healthcare financing some weeks ago I told of a mid-career physician colleague struggling to make a living in private practice and resisting joining the ranks of corporate medicine, to the point that he now works for the government in remote outposts of the western USA, two weeks on, two weeks off, leaving his home, wife, and children behind when he goes. We spoke last week. In the heart of a rural "red state" he just had finished a grueling night shift. There had been a serious accident on a nearby highway, with one fatality and others badly hurt. He had been up all night and was ready to collapse into bed, except that the post-crisis adrenaline rush persisted and he was wired. Exhausted, but still running in overdrive, he wanted to talk. "It's crazy here, Sue, crazy. These are Trump people. There are Trump signs everywhere. It's scary. I have two daughters . . . But the farmers are having a terrible time. It's really bad. The farmers come to the hospital here and talk; I'm telling you, the farmers are screwed. And the government's done it to them."

Between home visits of my own, standing at the side of a busy road next to my bicycle and knowing my next patient was waiting, I tried to cut the conversation short. "When will you be back home?" I asked.

"Tomorrow morning," he replied.

"Good. Let's talk then."

"Done. I'll call you. But these farmers are screwed. I don't know what they can do, and they're mad. And all for Trump. They think he's going to save them. Crazy, man!" Eventually I managed to nudge him off the phone and towards some much-needed sleep. But I wondered. The farmers are screwed? What has happened to our farmers? They're that angry? When was the last time I talked with a farmer? . . . When was the last time I talked with a supporter of the now President-elect . . . and really listened?

Once over the course of ten years I lived in two small towns. But that was almost 35 years ago, and I've been an urban dweller ever since. The farmers are screwed? Now, I'm not totally ignorant of the plight of agricultural 21st century America, but the farmers are that "screwed" and that invested in a Trump presidency?

As election returns came in last night political analysts I respect were stunned, and as I flipped between channels I heard many say, "We were wrong. Our polls were all wrong. We missed this entirely. How did this happen? We need to rethink completely how we poll and report." One who long has struck me as being never at a loss for words, a skillful and determined but courteous and thorough interviewer, sat mutely staring into the camera.

I suspect he and his colleagues haven't been talking with the farmers either. Or with the non-urban natives of the deep South.

Our new President-elect ran on the theme, "Make America great again." If one is a "screwed" farmer, which I imagine means one can't make a decent living off the land any more, to the point that one's entire way of being is threatened with no feasible alternative in sight, the prospect of making America great again might sound awfully appealing. And hearing the other candidate affirm, "America is already great!" might sound like a promise of more of the same policies that have destroyed the lifeways of farming. If one has watched factories close and move to Mexico or overseas, shrinking the population and tax base of one's community and leaving economic rubble in their wake, the appeal of making America great again is understandable. If a candidate says, "I understand, because my father was a small businessman," but that father's business thrived and his daughter received an Ivy League education, the struggling shopkeeper in a dying town might find that candidate lacking in empathy.

It's a normal human response to difficult circumstances to become nostalgic for an earlier, happier, more prosperous and secure time. Who among us hasn't daydreamed about previous homes, friends, old loves, past jobs, and good times and thought, "Those were the days!" So if "Make American great again" seemed to portend bringing back industry and shoring up farmers instead of freeloaders, that might sound pretty good. If it seemed to straight, white, Christian men that they had done everything right but all the perks went to people of other colors and/or from other places or to uppity women, the prospect of a return to 1950s America might have strong appeal. If one side is talking about free college, then those who didn't finish high school but went to work, paid their bills, and made lives for themselves might wonder where they fit in the picture, as their expenses rise and incomes fall. College is fine for some people, they might think, but keeping their auto repair shops or hair salons open would be the greater priority. And how they're going to do that and pay a minimum wage of $15/hour eludes them, while refugees from across the globe are lining up for free healthcare while hardworking citizens can't afford insurance, much less copays. When every time there's footage of war on the news or a terrorist attack executed or thwarted at home and the perpetrators seem to be Muslims, it becomes easier to see how the struggling shopkeeper, "screwed" farmer, or laid off factory worker might think it best just to keep "those people" out, and maybe to build that wall on the Mexican border, too.

It appears that half the country is hurting, and those folks haven't been, or felt, heard . . . until last night. Bring back industry, keep out the "foreigners" who are draining our resources, take care of the farmers and other "real" Americans, put God back in the schools, make Christianity the national religion, have women live the life of June Cleaver, and don't mess with our guns or other rights, and life, and America, indeed will be great again.

It won't, of course. As Abraham Lincoln said, revolutions do not go backwards. We are, always have been, and always will be a nation of immigrants. Separate but equal wasn't, and even now the white offender has his hands slapped while the black or brown one goes to prison for the same offense. The cost to the country, much less to their own sanity, of sending women out of board rooms and universities and back to hearth and home for full-time homemaker careers is unfathomable. We are immeasurably enriched by the diversity of cultures, religions, and talent around us; a "white bread" society couldn't begin to compete. The problem of terror is the problem of terror, not of another's religion or heritage. Etc.

But we have failed to listen to one another. If the squeaky wheel gets the grease, then the "screwed" farmers, unemployed workers, and lost non-urban, straight, white men who don't know quite who they're supposed to be anymore and who never seem to catch a break even though they're told they enjoy "white privilege" and see others receiving "handouts," evidently haven't been squeaking loudly enough. Or, they're far enough away geographically and culturally that it's easy to disregard them. Until they rise up, and elect President Trump.

I am so glad I didn't act on my first impression of what Myrtle needed those many years ago, and regret that it was only in the face of defeat ("What on earth could I possibly do here?!") that I learned to show up, shut up, and listen. As our nation transitions to a Trump administration we might do best to protest in the streets and plot resistance a bit less, and to listen more. And as we're urged to volunteer for causes we fear now may be jeopardized, we would do well to heed yet another lesson from the "great" days of old: Keeping "church ladies" in the kitchen, Sunday School, and choir effectively kept them out of the pulpit, off the governing board, and away from the finance committee. Community service is a good thing, but volunteer efforts can be exploited and can deplete energy needed for strategy, coalition building, and leadership.

Remembering Myrtle and Roshell today I am reminded of the power and efficiency that come with understanding, and that understanding never is one-sided. I also am reminded that stories "told good" and heard well build bridges.

Let's make American great in new ways, building both on the historic greatness to which President-elect Trump alluded in his campaign and on the greatness extant in our country today, stirringly cited by Secretary Clinton. And most of all may we show up, be authentically present and open to those around us, and

Listen.