Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.

Ashley McMullen

You're listening to The Nocturnists: Black Voices in Healthcare. I'm Ashley McMullen. (MUSIC) For me, home starts in Chicago, living with my grandparents. Home is the collard greens my Medea grew in the backyard. It's church all day Sunday, falling asleep and eating hard candy in the pews. Home is also Houston, Texas, where I was born and moved back to during grade school. It's the sound of rappers like Slim Thug, Mike Jones, and DJ Screw. It's the hottest summers, with the coldest drinks and the best barbecue. The hospital where I took my first breath is the same hospital I learned medicine as a student at UT Houston. And while California may be where I grew as a doctor, home will always be where my family is. As healthcare providers, most of us have had to leave our home states to go wherever our profession takes us. So whatever else home is, home is complicated. This week we asked y'all to reflect on what home means to you. Is it a place, a feeling? Is it people? Is it food? Here are your voices. This is episode three: "Home."

Marla Abrolat

(FOREST STREAM BUBBLING) I woke up this morning to a really loud sound. Looked outside and saw the butt of a bear maybe ten feet away from my tent. It walked by, unfazed. See, home this week for me is out in the eastern Sierras. Home usually is in Southern California. Primary care, medical school faculty, working my ass off. I'm just tired. Home is supposed to be where everything comes together, where you are refreshed, replenished. I used to love singing the song from The Wiz. (SINGING) “When I think of home, I think of a place where there's love overflowing.” I used to sing that with my brothers and sisters, and, man, we'd get into it. But, home–still I turn around and see a computer. And at home I still know that, “Gosh, I gotta write this paper.” And home–“Oh my goodness, I've got these people who are going to report to me!” And home–“Oh my gosh, I've got these administrative reports!” And home–”I've got another diversity meeting to try to look responsible in!” And even with love overflowing, home wasn't home.

So I decided to climb up here into the eastern Sierras. Right now I'm looking up at trees and clouds and stuff I would not see in Southern California because I'd be looking down at a screen. I'd be looking at our COVID dashboard going up, up, up, as the email that just came through on my phone says we're back into surge. Planning, because the ICU again is getting close to capacity. Thinking, “Man, my nurse is going to get pulled to the ICU again, so I'm going to have some float nurse who does not know how to help me.” And how blessed am I that I'm able to pull myself away to find a new home–that I can look out my tent and watch a bear walk by. (BIRDS CHIRPING) And I'm listening to the stream and listening to the air move through these pine trees above my head, watching the ants on the ground. And I know we're all home together.

Tseganesh, Primary care physician

(CHILDREN TALKING AND PLAYING) I am laying under these amazing oak trees that are creating this canopy above me, listening to the breeze while my children are playing in the sand. The thing I was thinking about when I was looking at these oak trees and hearing the wind, is how something that has been stolen from us as Black people is just connection from nature, from the earth, from the thing that grounds us and from which we came. And how camping and natural environments are not places where we feel ourselves to be welcomed and where we just don't take ourselves. And so we miss out on being in nature.

We came back this weekend from a family camp in northern Minnesota. And, I mean, getting there, it's always, it's, honest to God, it's still anxiety-provoking to leave the cities where it's urban and comfortable and there's so many people that look like me, to drive into a tiny little town where I know I'm the only one and where I worry about people's perceptions of me. But as we traveled north and the woods got thicker, we started seeing more pine, and it got quieter, the road signs got less, the mosquitoes got more. We ended up at this lake. We set up in this beautiful cabin where there was a fire pit. It was quiet. We could spend time on the water canoeing and kayaking, or just sitting still, or listening, and seeing wildlife, and fishing. It was so important for me, particularly, to get out there and get away, because sometimes the city can be very oppressive and all of the struggles and the problems of here just feel too much. And so you take a risk and you leave. You get through the small towns, and then you're rewarded by these amazing expanses of nature. And I just think, “Oh, we need to get more of us out there. We need to have camps and resorts and places where every color is there. And every shade of brown and black is there. And we get those moments of respite as well.” So I had a mini-moment of respite myself, in the middle of the city, in a park looking up at these oak trees and just felt so peaceful. I wanted to share that.

Dante, Community Health Educator/Researcher

So for me, home is when I'm trying to relax and my three year old asks me to play Connect Four. Or perhaps it's when my wife feels like she can rock her head wrap. Or wherever I wake up on a Sunday morning and smell pancakes, even though you know I said I wanted waffles. I was born in Chicago and I lived there. And I also grew up in North Carolina. And then I moved to Seattle. And the West Coast is different. And I often feel like I have no friends here, so I do, in part, feel like home is back east. And, but then I'm looking at things that, how the Pacific Northwest is reacting to the current situation of social injustice versus the deep south. And I think, “Well, I'm glad I'm not home right now.” It's, it's more progressive out here, I guess. And yet, I still find myself missing the South sometimes, in an area that is intent on doing stuff like raising the Confederate flag or to show me that I don't belong. And this really isn't my home. So why do I miss home? And that's just weird to me. Maybe I don't have any friends out here. And so I would say to me, “Home is a place where you can firmly place yourself and your identity and who you are and not be judged for it.” I mean, can Black people really do that in America? I mean, even when we are trying to help other people as, like, in my profession calls for it. I'm way out here and I miss, like, my Auntie's house in the country and eating her mac and cheese. Or the smell of good chicken and biscuits in the morning. Or going to sleep without street lights surrounding my house at night and cars driving by. I mean, I'm not a complete country boy, but, Lord knows, a lot of us feel like incomplete Black people. At least I know I do, sometimes. And I'll tell you this: when I taste good barbecue, that connects me to home. And when I see people of color doing great things, for example, in the medical profession, or achieving things, that feels like home. And home is such an abstract thing to me in times of civil unrest, because I feel that we are fighting to call a place home that doesn't always want us here.

Anonymous Physician

(SINGING) “But the things, often knowing…” I wish I could sing like Stephanie Mills. When I think of home, I think of Sunday dinners. I think of being that family that no one believes, that sits around the table and eats dinner together. When I think of home, I realize I am so blessed that love and home are four-letter words that match in my life. When I think of home, I think of holidays. I think of times, sitting together as a family, laughing and joking and not needing a television, a video game–just each other. When I think of home, I think of food. I think of the very first time that my mother trusted me to cook the fried chicken for Sunday dinner. When I think of home, I think of how much I miss being there, of knowing I had someplace to go, where I was safe, where I could sleep. When I think of home, I think of the home that I've created away from home. I think of beaches and sunsets and sand, the sounds of the ocean. I am grateful that love has found me in every one of my homes.

Naomi, Medical Student

I'm originally from Cameroon. My parents are from the Democratic Republic of Congo. For the first part of my life, I grew up in an area where everyone around me was Black. Being Black was something that was celebrated. You looked around, you saw other smiling Black children. Your neighbors were Black, your teachers were Black, the doctors were Black. It wasn't something that made you an outsider, and it felt like the norm. And then, when we moved to the US, we first moved to a suburb of Atlanta, Georgia. And even there, you know, there were a lot of Black people around. But there was this new sense of tension that I didn't really understand. There was a tension between, you know, the white people in my neighborhood and the Black people in my neighborhood. And I remember our neighbor, in our house, was actually a white male cop. And my parents were very hesitant and very strict about where we were allowed to play outside because they wanted to make sure that we had as little interaction with him as possible. And at the time, when I was little, of course, I didn't understand. But now I see why they were so scared to have us playing outside or making noise or screaming or really having too much contact with this man–why they were so scared to be living next door to a cop. So when I think about home, it’s, like, where exactly do I belong? You know, do I belong in the US? Or is it back to my first home, back in Cameroon? Or my parents' home back in the Democratic Republic of Congo? You know, I'm from these countries, and I fit in in terms of my appearance, my name, my sense of culture. As an immigrant, you're kind of torn between, “Have I lost too much of my cultural identity to ever really call myself, you know, a Cameroonian or Congolese?” But then, also, “Do I have too much of that and too much of, you know, my sense of self to really call myself an American and feel like this is home?” In a sense, my only home, really, is within my own body. And then outside of that, I don't know where I have a place.

Anonymous, Physician

Home. It's always been tough for me. Not because I never had one, because I've always been kind of ashamed of it. But it's weird. You never know what other people think about your home until you meet people from other places, consistently. I had been a Maryland lifer up until medical school. I went to undergrad there. I went to medical school there. I remember when I was at College Park, you know, meeting friends from DC who would casually take jobs at Baltimore. But I never really thought very much of it. It was really only until I started going on residency interviews around the country, and I started to hear what other people thought about Baltimore, that I really had to confront the perception that people had of my home.

I still remember my first residency interview not in Maryland. This was in Drexel University. I was intentionally early, because everyone's always early for all these residency interviews. But I was intentionally early and I found a seat. Other applicants started sort of pouring in. And the question of, “Where are you coming in from,” which is honestly a harmless question in most cases, you know, as it started getting passed around, and everyone wanted to know where everyone was coming from, just to get an idea of, you know, who's applying to this program. So, you know, one girl starts, I'm from Rochester, New York. She's all bubbly and stuff. And a couple other people were, like, you know, I'm from Houston, Texas, Charlottesville, Virginia, Hershey, Pennsylvania, and then it was my turn. So I said, "Yeah, I'm, I'm from Baltimore, Maryland." "Oh, yeah. Yeah. Man, Baltimore. Tough, tough city, huh?" Or another dude was even like, "Oh, hey man, I you know, I, I, I got an interview at Baltimore. And I'm just kind of worried about the city. You know, what, what's the security like there?" Yeah, I didn't realize how common this would become when I started my interview trail, but I quickly noticed just how common it was. The way that people viewed my home as this dangerous, crime-infested city that needed to be more heavily policed. It's taken me a while to actually appreciate coming from a tough city because, you know, that kind of hardship or that kind of toughness molds you, or creates you a certain way. Now I take pride in that. I take pride in being from Baltimore.

Corinne April Iolanda Conn

I'm going home this Friday. Home seems like a world away. Just thinking about it brings me right back into my mother's kitchen, where she's got Andy Grammer playing in the background, and we're all trying to keep our heads up. And just smelling chopped onion and cilantro and garlic–I swear, if you cut me, I bleed curry. It's, it's been so long since I went back, all the way on the east coast, and I'm terrified. I have a lot of homes. With my immigrant upbringing and pretty fortunate background, where travel was a big part of what my family thought was both necessary to keep us all united, and also part of good, becoming a good human. I've, I've managed to find home in a lot of different communities all around the world. But this, this is the first time that I'm scared about returning to the home I spent most of my childhood in.

I grew up in Virginia. It's July, so this time of the year the, the cicadas will be buzzing nonstop in the trees. You won't be able to sit outside in the garden unless you're willing to get sucked dry by mosquitoes. And if you're lucky, if you're lucky, you might be able to outrun the fattest raindrops that fall in sheets from summer storms. It smells like swamp mixed with flowers mixed with, I don't know. It's just glorious. But they say Virginia is for lovers and I really believe it, and when I think of the place I'd love to bring my, my partner to meet and be in one day it's home to Virginia. I want to take her through the hikes and the streams that I used to run around and come up with all sorts of imaginary characters and friends with. I want to take her fishing with my dad in the wee hours of the morning, sit in our sunroom with the cat curled up in one of our laps while watching something that makes us all geek out. And it's, it's just the center of love that has made me, my beautiful mixed-up self, so possible.

But I can't bring her right now. My home is not ready. My garden is not cultivated to the point where I feel proud to bring my queer partner back to meet my very, very conservative and religious family. I honestly have found so much unconditional love and community out here in the Bay Area. And at UCSF, it's mind boggling how quickly I felt myself becoming all of me. And how safe I feel, continuing to discover more of me out here. The place, the place that housed me, fed me, nourished me, sustained me, taught me right from wrong, gave me everything, everything that has made it possible for me to defy all the odds and get into UCSF, come out here to start this part of my medical career and my healing journey, the place that has literally kept me breathing every day–I want to bring the other half of me there. And I can't seem to integrate these two worlds. Not yet. And I'm trying. I love them. I know they love me, I feel it. We have our own work to do. We have our own weeds to pull at home all around. Assumptions, ignorance, and bias exist right here in my own sphere of influence. I'm all mixed up. So you'd think, you'd think home would have felt like a safe space to really talk about the things that have made me feel like I don't fit. Because I'm black, and white, and queer and hella proud of my body, but sure as hell don't always feel it serves me in the best way in this world. But I'm working on that. So honestly, at this point, I just want to go home and remind them of who I am. All of who I am. Because they seem to have forgotten. They have taken my queerness and put it under the spotlight. And that's just one part of me. My capacity to love and everything I do with that is so much more than who I choose to sleep next to. But that matters too. My life, my entire life matters.

Ty Elliott

I've met several patients who've expressed that they want to die at home. I don't understand it. There are probably a thousand ways to die. But the one thing that I've heard most patients request on their dying bed, hooked up to several IVs, several machines, several tubes–exposed, vulnerable, dying, hypoxic, dysthymic, gasping for air. No matter what, the one thing that I've heard more times than not, is that the patient wishes to die at home. And when I hear that, I will go above, beyond, under, and around to make sure that that patient's dying wish is fulfilled.

What is it about home? Why, why is home what it is? Why is home safety for some people, nauseating for some, frightening for others? What defines a home? Is it a roof and four walls? Is it, is it a home-cooked meal, is it your parents, is it a familiar space? Is a hospital home for me? I know the hospital well. I know the ICU. I can see those ventilator numbers from across the hall. I know where the ventilation goes. I know where to look for the flow loop. I can look across the room and tell you what mode, what rate, what the PEEP is. Does that make the hospital home for me? Because I'm, because I'm so well-adept there? Because I'm, I'm familiar with it? I don't know what a home is. I think it's different things for different people. But I guess for me, I would define home as being familiar, reliable, dependable, like, you know what to expect. Maybe that's why the people who are dying in my ICU, maybe that's why they, they request to die at home. Because they can anticipate better. They've never crossed over, they've never died before, but they know home. That's a familiar spot, right? Because I know what it feels like–the familiarity of the space. I don't want to die in a foreign space.

Carrie Francis

Home for me is a glance in the hospital. It is members of our janitorial staff, members of our OR staff, members of our anesthesia tech teams or room turnover teams, that acknowledge me. Not just with a "Hi, how are you?", a "Good morning" or a "Have a great weekend," but those that see me in everything, as everything that I am. As a Black woman, as a surgeon, as a physician, as a comrade. That is what reminds me of who I am, that I belong, and that I am safe.

Erica Farrand

Being a physician and a mom is perpetual caretaking. And sometimes when I'm transitioning between those roles during the day, I just, I really need to take a minute. Often that means taking the long way home so I have time to listen to a podcast or two. And sometimes it's getting home and finding myself just sitting outside on the stoop watching cars go by for a few minutes, just daydreaming. My kids, who are incredibly adept at vocalizing and asserting their needs, have, to their credit, learned to just give me that space. And when I do finally come in, greet me with such enthusiasm and love that--although it doesn't erase the weight of, of simultaneously filling those roles of physician and mom and feeling like I'm constantly ping-ponging between the two–it certainly does fill my bucket. This is my daily homecoming:

Kids

Mommy!

Erica Farrand

Hi, guys.

Kids

Mommy! Mommy!

Erica Farrand

Hi! Hi! How was your day?

Older Child

Good. We went on a bike ride.

Erica Farrand

Ooh, where did you go, tell me!

Older Child

Well, we went up the hill. And then we went on this dirt path.

Erica Farrand

(TO YOUNGER CHILD) Whoa, did you go on your bike too, baby?

Younger Child

Mmm hmm! Then I got...

(PIANO AND CELLO MUSIC)

Ashley McMullen

This has been The Nocturnists: Black Voices in Healthcare. I want to thank our core team: executive producer Kimberly Manning, The Nocturnists founder, Emily Silverman, podcast producer, Adelaide Papazoglou, sound engineer Jon Oliver, and medical students Rafaela Posner and Lauren Wooten, who is also the outstanding cellist you hear playing in the background. Thanks also to executive producer Ali Block, and program manager Rebecca Groves, and communications intern Cora Becker. Our illustrations are by Ashley Floréal, and our theme song is by Janaé E.

*Black Voices in Healthcare is made possible by the California Medical Association, the California Health Care foundation, and people like you, who've donated through our website and patreon page. Thank you for supporting our work in storytelling. If you'd like to add your voice to our project, visit our website at thenocturnists.com. We'll be back next week. Until then, remember: Black lives matter, black health matters, and black stories matter.