PhotoVoice
We are a passionate and competent group of people drawn into a space that doesn’t support us. Through our photos and our words, we will take you on a journey to see what it feels like, how we cope, and our vision for how it can be different…
About PhotoVoice
The following photos and quotes are part of a PhotoVoice project carried out by a group of 15 family physicians of color who also provide abortion care.
Over the course of two months, we met every two weeks to discuss photos we had taken on themes that we chose so we could explore the challenges we face, how we deal with those challenges and our visions for training models and reproductive health care systems that are equitable, supportive, and responsive to the needs of communities of color.
Why family medicine?
"It’s not necessarily the most glamorous...it’s not maybe visible as much...it’s like the roots and the essence of a lot of care...you have that privilege to be able to know people over time and know families over time and know their context, and I think that’s so rare."
“I think it was the patient who said, ‘Wait, you all speak Spanish!’ And then that's when I was like ‘Oh my god, this is amazing. And this is what I want.’...there's a bond with your patients, that they see somebody who looks like them who also may understand the cultural pieces and so that already is a language that is bringing you together. And I think that's part of why we're in this field and why we need more people of diverse backgrounds and not just language but backgrounds in general because that is the language in and of itself. And so I think that is huge. That is huge.”
“I think it represents a lot of...the unlearning of what we learned in medicine and...there's the EKG book randomly put, like I feel like we all need to know EKG and then also I'm learning some of the racist, sexist, stigma-associated things that we've learned in school so that's just one of the parts of my bookshelf.
And I was actually thinking like, well, that also speaks to the ‘abortion care is regular care’, right, in the sense of it's part of what we do. It should be part of what we do, just like an EKG book is part of what we do.
And then the flip side of that is that there are those who say, ‘Well, unless you know your EKGs you shouldn't be doing anything else in medicine’ and so you're sort of saying like, Yeah, and I obviously do that.
And also, there's this additional piece that I know.”
“So the theme was “mentorship” right. It was a little bit of like a trigger word for a second there.
I think because I've had such complicated and traumatic toxic relationships that started off as just the endearing me kind of looking up to these older white women in family medicine and in abortion care and it just became really toxic.
And I remember just a certain point in my training where these mentors, “mentors” - true colors - appeared and I felt like this little berry thing - this bud that’s hanging off... like hanging by a thread.
And I was just like “that is how I felt”... I just thought this was a perfect depiction of how I felt in that moment: just without any support and how - I've seen so many students who are, you know, residents or whatever who are like - they just have these ideas of “I think I need to do a fellowship to do abortion care or just like don't know where to go or who to ask” and are just so thirsting for something, for mentorship, for true mentorship and that's just sort of like what that depiction feels like it's just sort of like “I want to do this. I want to be on this branch.
I want to grow, I want to blossom, but I'm just hanging on.”
“So that is my current desk. Um...my daughter has since woken up, which is a real bummer [laughs]. But that’s just my workstation, it’s a little chaotic. I have multiple things all the time, I guess like choice, right, like my choice to have a family and the realities of being a mother in this country where it’s very poorly supported, generally. And then also have a career, so this is a solution that we have found [laughs].”
“Yeah, so this is just how I feel all the time, right...up against all this whiteness."
"I didn't feel like I had many choices in the road that I took. It ended up being wonderful right and I had so many experiences, but, you know, why wasn't there money for me to finish my college straight through?
Well there were a lot of reasons that I went to Cuba for med school but why did I also feel like going to med school in this country would have been a burden on my family and myself.
You know what I mean? And so I looked for other ways. And then why was it difficult for me to get into residency once I graduated, just because I went to a school outside of this country?
You know, if the school was recognized here, why was it such a difficulty? I feel like racism has a big part of that. Classism, all the isms, all the isms that exists here."
“Yeah, and I also feel like - being pulled in different directions - I sort of think, there's so many times where I'm just like, “I want to invest all this time into mentoring this person” but also it's like “I have all these other things to do” and I wish, you know, there's never enough time, it feels like, to adequately mentor somebody.
It's always these fractions of time where you can take every opportunity to teach and mentor and support. But it does feel fragmented in that sense too so it's not as continuous and perhaps that's - whether it's by design or not - perhaps that's beneficial to have time away and to grow on your own and think and whatever but sometimes it can also feel like, especially in this field where family docs who are looking to do abortion, where it can feel like there isn't enough time because you're, you know, learning about all these other things and you're in training and that's hard.”
“I know that I'm probably not alone in terms of feeling some imposter syndrome sometimes in moments of leadership and I feel like, not only is it bringing people of color, women of color to leadership in it - but then also really cultivating them when they're in that position because I think tokenism is very real.
And I've certainly - there's many times where I've felt like I was in a position because of the color of my skin or because of being a woman or because of being a family doctor because I was there to represent every single reproductive health thing that was going to be decided. And between tokenism and imposter syndrome. Sometimes it can be crushing.”
“So glass cliffs .... is when you put often women of color in these kinds of positions like director of DEI for a primary care network that has zero intention of actually making...And you set them up to fail, right? You don't necessarily knowingly set them up to fail, but they're going to fail because the system is not set up to - the system is not ready to change right - those in leadership are not ready to change - those in leadership are not ready to give up their leadership to say “right now we're in a time where we need different leaders”. And so, I feel like there's this role in me -
I feel this tremendous responsibility as a mentor to protect other people from the glass cliff and to recognize a glass cliff if it comes in front of me...”
“It wasn’t using tools or anything, it was really just like trying to move like boards and plywood around, I pick up something that slices my hand, and I’m just like, all right, like there are some drawbacks of trying to do things on your own, without help or without expertise, it’s that it’s not all just like celebrating the creative ways that you do things. Sometimes there’s some casualties....like when you don’t have the tools, when you’re trying to do things on your own because systems aren’t built for you, you get hurt.”
“the systems that are not there to help can actually hurt. And I think we see that a lot especially in healthcare, where not only the patient getting hurt, but the provider, because they have, y’know, we have an idea about how to help people and how to provide access and things but we’re like—half of the time we’re fighting the system that we’re working in, in order to deliver that. And I think it’s emotionally—at least emotionally, maybe physically too, but emotionally taxing.”
“And I feel like it comes across like as this marginalized group of people, which I would consider to be part of, right. Like, we’re trying to meet patients where we are, and we’re trying to to give people care because we believe that it’s a right and we believe that there’s justice that needs to be given back to people, and a lot of the times you end up hurting yourself, and a lot of the times you end up getting very frustrated giving care that sometimes feels piecemeal.”
"...this way to be introspective and to rest. And to not always be expanding and building and growing...because we all follow this capitalist religion that is not necessarily the most in tune with our nature, and it feels exceptional to get to rest and be creative and create and do something just for like the sake of teaching your hands skills."
"I feel like nature tends to be something that refills my cup and brings me peace. And I think that's in direct competition with work, like needing to do something all the time. And in nature I feel like I can just be there, and I don’t have to do anything. And it's good to not do anything - it's just good to be present.”
“and [I] really wasthinking about openness in patient care and what it takes to be open when you walk into an exam room for a person and taking a pause and putting - putting your face on - sort of letting go of the thought that might have been there one second ago. And, you know, sort of bringing to the moment, whatever vulnerability you can to be there in that moment for the person you're about to go see.
It's a process, right, that this putting together of ourselves, this preparing ourselves to go into vulnerable situations, is a real process that takes time and putting together so many parts of us. I think, you know, in our current society, to be vulnerable to ask for help, to need help, is so looked-down upon, when actually everybody wins right from helping each other.
The person that's helped gets to have a slightly lighter load and the person that's helping feels good for helping. There's so much to be gained from that experience, and yet it's always seen as a weakness."
"I think leadership can take lots of different forms...to model behavior, to model vulnerability, to model kindness is also leadership, right, and is also forming the next generation and to not perpetuate the toxicity of medicine is, in and of itself, so valuable.”
"Feeling safe knowing that you’re not alone. We really need that daily sort of interaction with another person and the warmth that comes from somebody actually thinking that you have something to contribute, right, and that even if you don’t know, you’re capable of learning"
“when I think about my best teachers, it's always people who acknowledged the difficulty of what I was what I was trying to learn, who were gentle and kind at explaining what I needed to change. And then sort of saw me, you know, really saw me doing something well or doing something incorrectly and then, and then saw me improve or change or and try to integrate that. I think it has something to do with feeling seen right so like you could totally suck at something and that like might be your baseline and that's, that's okay to be that way, because - why would you know anything, you've never done it before - but also being seen and witnessed as someone who's trying and who wants to learn the skill is just helpful to you, to kind of egg you on...”
"And part of what I think this group is aiming to do is...getting people that are underrepresented in the work to not only do the work, but also into those leadership positions. Making sure that our voices are always present. And so people like students and learners always know that there are other people... there is a different way to do this work and there are other people out there..."
