Category Archives: Guest Posts

Deferred Maintenance

By Enjoli Hall

How and why I made healthcare my top priority in my first semester

Twenty-nine. The number of visits I made to a doctor’s office during my first semester as a PhD student. In any given week, my Google calendar was a fall-themed collage of classes, advising meetings, on-campus events, and doctor’s visits. Scheduling my doctor’s appointments was akin to a research assistantship—I mapped the locations of Black female primary care physicians. I analyzed what combination of dental procedures I could afford with my insurance benefits. I reviewed literature on the antidepressants recommended by a counselor. I wrote reports detailing my medical history on intake forms. I presented my life story to the six therapists I was forced to meet with in order to evaluate my request for an emotional support animal in university housing. While I couldn’t add these lines to my CV, perhaps I could add a few years to my life.

Some of the appointments I scheduled might be considered “routine” check-ups: annual eye exam, seasonal flu shot, pap smear. But many of the appointments were for managing chronic pain and depression. Sometimes, these appointments were not planned, such as impromptu visits to the urgent care clinic on campus for frequent headaches or toothaches. What nearly all of these appointments have in common is that they were the result of deferred maintenance. In my field of urban planning, the term deferred maintenance is often used to describe the practice of postponing maintenance and repairs on essential infrastructure to save money, balance budgets, or reallocate resources to address more immediate needs. For example, a landlord might postpone fixing leaky pipes in an apartment to save money in the short term. Or a local government might delay replacement of lead pipes in its city’s water system due to budget shortfalls. The cumulative effects of deferred maintenance can be catastrophic—an apartment building that could have been rehabbed now needs to be demolished; a city’s population is poisoned by its water supply with lasting public health problems.

Prior to starting grad school, I deferred diagnostic tests, annual exams, small procedures, and mental health therapy for years. I was a first-generation, low-income college graduate barely making ends meet in an industry and city that people don’t choose to make money. While I am adept at understanding the functions of macro social systems such as racism and the economy, I often struggle to navigate individual institutions and bureaucracies to get my needs met. I could not afford the co-pays, the time off from work, or the transportation to get to doctor’s visits of all sorts. Sometimes I tried to schedule appointments, but would get discouraged when the closest doctor was located over an hour away, open during limited hours, not accepting new patients, or did not take my insurance. These challenges are common when you live in a poor, low-density region serviced by an inadequate public transit network. Or when you grow up in a community that discounts mental illness as laziness or a bad attitude: “You don’t need a doctor, you need discipline. Your problems will go away when you get a better job or a boyfriend.

I internalized my mental anguish as of my own making and normalized my physical discomfort as a fact of daily life. In effect, I deferred maintenance on the mental and physical systems that sustain my well-being. As a result, what were cavities became root canals. The situational depression I developed in college spiralled into clinical depression—a mighty vortex that seemed to grow more intense with each post-grad job, relationship, and life event. And what might have been managed with months of counseling sessions, probably requires several years of regular therapy. At times, it is very difficult to reconcile the access I’ve had to some of the most elite universities in the world with the barriers I’ve faced to accessing basic medical services. I don’t know how to describe the feeling of sitting in a class and knowing your lived experience is the outlying data point of educational success, the case example of why we need multifaceted definitions of “access” that consider affordability, availability, and awareness in addition to physical distance. When your GRE score is in the 99th percentile, and so is your cholesterol level.

I am sharing my story not because I think it is unique, but because I suspect it is quite common in some ways. Despite increasing awareness of the academic, financial, and sociocultural challenges experienced by minority, low-income and first-generation students, I have observed a persistent stigma and silence around health issues. I understand the disincentives and potential penalties that students—especially marginalized students—may encounter in sharing these stories. Or even just saying to someone “I have depression.” Our position in these programs is often marked by precarity and presumed incompetence. We’re constantly expected to prove our basic capabilities to handle the rigors of advanced research to our peers and professors. Our admission was not enough; at best it was a professional courtesy, at worst it was a statistical accounting. We should be so grateful. Talking about mental or physical illness—how it alters the way we process information, the way we move through space, the way we structure our schedule—carries tremendous risk in a profession that rewards intellectual acuity and constant productivity.

Grad school is hard. But for someone like me, it means improved access to care such as on-campus, free and subsidized providers, health screenings, and wellness services that I could not obtain for the last several years. The services are not comprehensive and my stipend is not enough, but it is more healthcare and more income than I’ve had for years. So, I am making my health my top priority. I cannot afford to defer maintenance of my mental and physical health any longer. Because the grim reality is, if I do not attend to these issues now, I might not survive to the end of my PhD program. I know this is only the very beginning of months and years of chronic pain, frequent appointments, and unforeseen consequences, but I am grateful for the opportunity to repair. My pain might not be my fault, but I am responsible for my healing.


Enjoli Hall is a PhD student in the Department of Urban Studies and Planning at the Massachusetts Institute of Technology (MIT). Enjoli’s research is focused on racism, social inequality, and urban policy, and the impact of these forces on local government planning, policy, and finance. Her work focuses on cities and counties facing chronic poverty related to deindustrialization. Enjoli’s research draws on over five years of experience working with non-profits, foundations, and research centers in her hometown of Buffalo, New York. She has worked in a variety of roles in community development, ranging from adult literacy tutor to youth advocate to program officer to regional planner.

 

Writing While Bilingual: English and Graduate School Writing

I am bilingual.

That sentence was one of the hardest to write. But harder still was coming to the realization that yes, I am indeed bilingual. See, I grew up in Uganda, a former British colony in East Africa. From the time I was three I spoke both English and Luganda. One way colonialism works is it destroys indigenous languages, by forcing the colonizer’s language onto the colonized. In the case of Uganda, the official language is English. And though I can fluently speak Luganda, I struggle with reading Luganda and writing it is even harder. But Luganda is such a huge and very important part of my life, and it affects the way I think and view the world.

But just as Luganda has been a part of me, so has English. My entire academic career has been in English; beginning in kindergarten and now in graduate school. Thus, I have written and spoken English, the Queen’s English, I’ll have you know, for the majority of my learning. But my introductory writing lessons in English were in Uganda. I was taught to write in English, specifically creative writing, but in a Luganda way. This meant much of my writing was telling, what I like to call wandering stories. When I think about the way I write and tell stories, Amos Tutuola’s novel, The Palm Wine Drinkard, comes to mind. Because the way I grew up involved hearing stories told with a lot of details, tangents, and with multiple characters, some of whom had a tendency to just disappear without having advanced the plot of the story much. So, I learned to write stories the way I heard them told, even though I was writing in a foreign language.

Graduate school writing, I believe, is a form of storytelling.

Graduate school writing, I believe, is a form of storytelling. And when I started my graduate school career, I had not written for over five years. I had been working and having a child. I quickly learned that writing is a muscle– one that if you do not exercise, will quickly atrophy. But never having been one that shies away from exercise, and because I am now a graduate student, I began to collect books on writing. And I learned some good tips such as write your introduction last, use simple English, write an outline, know your audience, and edit, edit, edit. The idea of simple English has always worried me. As a child who read Chinua Achebe’s No Longer at Ease, I am forever stuck on a particular scene in that book where Obi Okonkwo’s character returns home from studying English in the United Kingdom– a decision that had already disappointed the community that fundraised to send him to school. Upon his return he gives a speech which further disappoints his community because he uses “is” and “was” English instead of using big words. I have already disappointed my Ugandan family by not being a doctor, (though I am attempting that with a PhD, it is just two letters after all), a lawyer or an accountant. I am not going to disappoint them further by using “is” and “was” English too.

The writing advice was all good. But there was the messy case of the subject matter of my graduate work; sex and reproduction among women and girls from Africa living in America. Women and girls like me. I am well aware for whom the university was built for, and it was definitely not someone like me. I wanted to write for us; for women and girls that had taken that journey from Africa to settle on this “shining city on a hill.” I wanted this story, the story I was attempting to write during my qualifying exams, to be for us. And I found I couldn’t. Because to write it in the way I wanted to, English, I found, was inadequate. I knew the mechanics of putting together a sentence. I knew a first draft would always be terrible and that it would be the fifth maybe even sixth draft that I would finally send to my committee. But the content and the way I wanted to write that content; English wasn’t working out. In my head it was in Luganda, because Luganda allowed me to say what I wanted to say in the way I wanted to say it. But because I never learned to write it, but only to speak and think in it, English was all I had. And when I wrote in English attempting to fit Luganda into English, my paper was incoherent. I was frustrated and confused. How could I still be struggling with this god awful, clunky language, that I had been using for over twenty years?

While I in my own little world struggling with writing in English, Dr. Toni Morrison went home. And my literary world turned a little darker. A world that I had always found solace in when the real world got too much. I wanted to sit quietly in a corner for days and pore over her work. Read every novel and essay she had ever written word by word, sentence by sentence and turn it over and over again in my mind, and just glory in its beauty. I wanted to reach out to my black women friends and just talk to them about what she and her work meant to us as black women and as mothers. I wanted a month to collectively mourn her passing. But I couldn’t because deadlines.

So, I did the next best thing, I searched for audio and videos of her speaking. And I took a few minutes throughout my day to sit quietly and listen to her voice. And that is how I came across Dr. Morrison’s 1993 Nobel Prize in Literature lecture. That speech was exactly what I needed, and it made me furious. Because it spoke to everything I was struggling with and at the same time I felt there was no answer to my writing dilemma. I saw the whole of academia as those young people who set out to question what I was writing. But I was also the young men, holding language in my hand. A language that had been forced onto me before I was even born. But even though this language was forced onto me I still had all the responsibilities of that came with holding that bird, language in my hands. I wanted to ask Dr. Morrison what to do but she had gone home. But she had graciously left us a whole library of answers and so I went looking for an answer in her words. I picked up another of her books. I picked The Source of Self-Regard, though I prefer the visual painted by the European title, Mouth Full of Blood. And again, because every time I worry about writing, I return to Obi Okonkwo, I went straight to the essay on Chinua Achebe. And there, Dr. Morrison answered my question.

I am bilingual. I write in two languages but mostly I write for myself and those like me.


J. Nalubega Ross is a Ugandan American living in the dry dry desert of Arizona. She is currently pursuing a graduate degree at Arizona State University. Their graduate work is concerned with how people from Africa living in the United States look for information about sex and reproduction. And once they find that information how do they use it make decisions about having or not having sex and whether or not to reproduce. When not reading books for graduate work and avoiding writing, Nalubega spends time watching and commenting on cartoons with her toddler and ranting to her partner about sex and reproduction in the United States.

On Graduate School and Loss

by Letisha Engracia Cardoso Brown

Graduate school. Those two words were a tough road for me. I am a young black woman, first-generation PhD, seven months post-graduation. I wrote and defended my dissertation, yet this piece feels infinitely more difficult to write. It’s been a year since we lost you and committing that to paper hurts. I only hope that by sharing my own experience, it reaches someone and encourages them.

I don’t know exactly how to begin, so I guess it’s best to go to the very start. One of my earliest and most vivid memories of you is your first birthday. You were sitting in your high chair, brown, big-cheeked, and smiling at the small crowd and the sugary cake sitting before you. I’d watched you grow all those months before, curious, bright, and the most beautiful baby! The cake was like a puzzle you needed to figure out. You plunged your hands inside and brought it to your cute little face. Perhaps it was the shock of so much sugar at once, but immediately you recoiled; then, like a child, you attempted to taste it again. Baby’s first cake. That’s how I think of you now. That’s how I will always remember you. Curious, precocious, beautiful, bright. That’s who you were. And as I sit to write this now, it’s who I wish you still were. But you’re gone now. To where? I can contemplate and imagine, but I won’t know for certain until I leave this plane myself someday. But wherever you are, I write this for you, little cousin (little sister). I’ll carry you always.

Being in graduate school is a struggle, one that is hard to navigate even in the best of circumstances I presume. As I sit and write this, one year removed from the initial trauma, I still struggle to find the words to describe all I went through. However, I recognize the importance of talking about my experience, not just for myself, but for others as well. So, being vulnerable and honest, here I go:

It was January of what turned out to be the final year of my graduate study. I was in the midst of waiting to hear back from positions I applied for and dreading rejections, as well as the possibility of offers, as those would come with interviews and job talks—both of which terrified me to no end. It was just a few days after my 31st birthday when my phone rang, a call from your dad. There was nothing unusual about that. Your dad was (is) like a second father to me, so I answered hoping maybe for a second birthday surprise. But it wasn’t. Instead, he asked if I was sitting down, told me to sit down, and immediately I felt my heart stop. Rarely does anything good come after someone asks if you’re sitting down, so I’ve learned in my experiences. Unfortunately, I was right. Your dad called to tell me you were gone, that you had hung yourself, that you had died. An instant after the words left his mouth I went numb. I was devastated, disbelieving, heartbroken. You were thirteen years old. Exactly what it was that caused you to leave us as you did remains unclear to me, but whatever it was removed a light from my heart, a light from this earth.

That you could’ve taken your own life is still unfathomable to me, but perhaps it is not my place to understand. Nevertheless, I realize that there is no easy way to lose someone, a child no less, of that I am sure. But losing someone to suicide must be among the most painful. You weren’t my child to lose, you were my cousin, my little sister, but still my love, and I lost you. I lost you at one of the most difficult points in my adult life, and even today, a little after a year later, I am not sure how I am standing.

Writing a dissertation is not an easy feat, at least it wasn’t for me; yet, somehow in the wake of losing you, I somehow had to manage to put words to paper while dealing with the meaning of losing you. Advisors expected chapters and job applications expected responses. Yet I could barely breathe. All I could think about was the you in that beautiful dress, looking as if you were asleep within the coffin. Looking like yourself, but not at the same time.

How could I think about my next steps, knowing that you had taken the last of yours? How could I write, apply, or try, knowing that you’d never have the chance?

So I didn’t. For days I did nothing but cry. Remembering your face, your smile, your laugh. Days went by and the darkness around me grew. I was lost. Deeply and utterly lost. It took someone else to pull me out of the hole I had fallen into, one shrouded in pain, hurt, darkness. But her hand held mine, pulled me back to myself, back to happier memories of you. The you who supported me, the you that looked up to me, made me see things in myself that I may have otherwise missed. So slowly, but surely, I picked up a pen again. Put pen to paper and wrote. I dedicated my dissertation to you, the light in my darkness. My little Elira.

There is no easy way to write a dissertation through grief. The only advice that I can give, the only words that I can say, is that it doesn’t happen alone. Rely on your village, your person (or people) to help guide you through. Remember yourself and what you came to do. Pick up a pen, open a laptop, and let the words flow (even if they don’t make sense). I did. Eventually I found my way in words, using my writing as a way to remember you, as a way to move forward. It wasn’t a smooth process. It was rocky, marred with sleepless days and nights, tears, rewrites, curses, a trip to the hospital for insomnia driven psychosis, and feelings of hopelessness. But I wrote. I went to dissertation boot camp and I wrote. I went to write in sessions with my best friend and I wrote. I punched pillows, and cried for hours, but I wrote.

It was painful. Moving forward. Breathing. It hurt. It still hurts.

But with the help of my village I finished my dissertation, defended it and graduated in July 2018.


30412161_10105763080272873_6484055218454528000_nLetisha Engracia Cardoso Brown is a Presidential Pathways Postdoctoral Teaching Fellow in the Department of Sociology at Virginia Tech University. Her research focuses on social relationships and food practices, as well as media representations of black female athletes. Her work can be found in the South African Review of Sociology and the Palgrave Handbook of Feminism and Sport, Leisure and Physical Education, as well as the online publication The Shadow League.