Note: The Nocturnists is an audio-first experience with emotion and sound design that can be difficult to fully capture in text. Transcripts are provided to support accessibility and reference, but may contain minor inaccuracies. If quoting in print, please consult the audio when possible.

Emily Silverman: This is The Nocturnists. I'm Emily Silverman. Today's episode is a little different from our usual format. We'll be featuring two stories instead of one. Alicia Ashorn and Anthony Thigpen are both community health workers with the Transitions Clinic Network, an organization that employs people who were formerly incarcerated as community health workers who support others as they transition out of prison. Earlier this year, both Alicia and Anthony told personal stories on stage in Los Angeles at a Nocturnists satellites event hosted by TCN with the generous support of the California Healthcare Foundation.

That evening featured stories from six community health workers, all drawing on their personal histories and their work alongside patients who navigate addiction, re-entry, illness, and survival. Today, we stay with Alicia and Anthony a little bit longer. We talk about what their day-to-day work actually looks like, how they think about trust, responsibility, and care with their clients, and what it meant to stand on stage and share their stories with a community of peers. Before we dive in, take a listen to Alicia and Anthony's stories.

Alicia Ashorn: Hi, my name is Alicia. I'm a addict and alcoholic. I never thought I could have the courage to say that out in public and let alone in front of work people, but it's something I'm proud of now. When I was a kid, I never thought I was going to grow up to be an addict. I wanted to own a ice cream truck or be an interior designer, but I was always kind of an awkward kid, and I never really felt like I fit in anywhere until in 10th grade, when I started drinking, and I felt at ease. I started hanging around with people that did the same thing as I did.

By the time I graduated, I was a full-blown alcoholic and meth addict. Shortly after high school, I hooked up with my drug dealer and got pregnant. I had my son at a young age, and when his father went to prison, I was left on my own to take care of him. At this point, I was unemployable, so I did things while on drugs that I never thought I'd be capable of doing, but I was making money, and everyone around me was doing the same thing, so it seemed normal. Then, when my son was two, I was locked up for a year, and then again, when he was seven, I went away for two years.

I finally started growing up and getting my life together when I was 30 years old. I got a job with a really good university as a research assistant. I stayed there for 11 years, and I really loved the job. They liked me, but somewhere along the line, I started going out with them after work and having a drink. Then I thought I wasn't an alcoholic, and I could drink like a lady this time. That was not the case. They finally had to let me go because of my alcoholism. Then the pandemic happened, and when the pandemic was over, and all that free pandemic money ran out, I found that I could not go to work without drinking.

If I didn't have a drink, I would shake so bad. Eventually, I started having seizures, until it got to the point where the only thing left for me to do was to get sober. When I got sober at 90 days, I started applying for jobs, and I had a few interviews. There was three different interviews, three different jobs. They all hired me until my background check came back, and then all of a sudden, they weren't interested anymore. Then I got a call from the clinic or the Transitions Clinic, and this was the first time I ever had a job interview where I was proud to say that I've been to jail.

[laughter]

It's like, that's me, yes. It was the perfect fit, and I got that job. I was so excited, and they were so excited to have me on board. I was never trusted with anything before. They gave me a key to the office. I had access to money. I could go buy somebody work boots if they needed them, and to see the smiles on faces from giving a bus pass, buying some work boots and being trusted to do that is just amazing. I work in the same community that I grew up in and did drugs in, and all that stuff. There's been a couple of patients that come in, and I've used with them in the past.

Just being able to talk to them without judgment, and them being able to look at me and see you don't have to live like that, because I was just like them. It's just amazing, and

I'm just so thankful for this opportunity. If anyone else is in recovery, those nine-step promises, they really do come true. This job is just one of them. It's just, I'm just thankful.

Thanks.

[pause 00:05:36]

[applause]

[music]

[laughter]

Male Host: Are y'all ready for the next storyteller? Say yes.

Audience: Yes.

Male Host: All right. Our next storyteller is from Rhode Island. He's always wanted for his community what he wants for himself. Let's give a warm welcome to Anthony Thigpen.

[applause]

Anthony Thigpen: The story. I'm about to tell you guys, it's you guys are probably the first people to actually hear the story. I lost one of my patients about five months ago. When I first started this job, I would go up to the prison, and this young kid, he would see me, my tattoos, and my jewelry and stuff like that, and he would just stare at me. I'm one of those guys I hate for people to stare at him. I would say, "Yo, say what's up. Say you like my sneaker. Say something. Don't just stare at me." When he got out, the doctor brought him to me and said, "Yo, I really think that he could use you."

He was very a part of my days. I would call him, "Yo, what you doing? What you eat today?" Or he'll call me and be like, "Yo, get me out the house. I'm feeling down," whatever the case may be. He really trusted me. He really tapped into me. Actually, we tapped into each other because he was my little brother. He became my little brother. He was doing so good to where he had an income. I was able to get him to stop hustling and moving and shaking in the streets, to the point where I actually missed the signs of him relapsing. One day, I didn't hear from him for a couple of days.

I'm texting him. I'm threatening him. "Yo, listen. If you don't answer, I'm going to show up to your house with the police to do a wellness check." He don't answer, so I show up to his house with the police. The police go in, they come back, they like, "He's there. He got a sign on his door that says he has COVID. He's like, you could go upstairs, just don't go in." When I go up there, he has a mask, and he's like, "I knew you was going to come." He was like, "I actually been waiting for you to come." I'm like, "Damn, why you ain't answering your phone?" Whatever, whatever.

He's like, "I lost it." I said, "Look, I got my other phone downstairs. I got you." Go downstairs, give him my other phone, give him the password. That was probably the first sign that I didn't recognize that he had relapsed. He had a girl that he was dealing with, and me and him experienced some of the same things, family-wise, betrayal by our brothers and stuff like that. He told his girlfriend, "Yo, if you don't hear from anything, call him. He's the only person I mess with, I trust. Call him." His girl starts calling me, and she's like, "Yo, have you heard from him?"

I'm like, "Nah. I brought him some food the other day, but it was just the first. I'm sure his kids was on his back, and it's around school time, they on his back. We need this. We need that." I'm like, "He's probably in the crib, mad it's only the 3rd. The 1st was two days ago. He's broke." Then someone text and was like, "Oh, he sold me the phone." I'm like, "Nah, he ain't sell the phone. That's my phone. He ain't going to do that." Now I'm going back to where he live, get the people on the first floor. "Yo, you remember me. You see, I be dropping him off," whatever, whatever.

I'm like, "When he come, let me know." Dude calls me and says, "Yo, he came back." He goes knock on the door, act like he's bringing him some stuff. I pop up out of nowhere. "Yo, what's up, man?" He's like, "Oh, man." I'm like, "Yo, what's going on with you?" I'm like, "Yo, you sold the phone?" He's like, "Yes," so I knew right then and there. You sold the phone, you ducking my calls. I said, "I'm going to give you a couple of days, man. Hola at me, give you a couple days."

I know him. I'm like, "In a couple days, he going to call me like, 'Yo, bro. I'm sorry I was tripping,'" whatever the case may be, Those couple days go by, and I don't hear from him. One of my colleagues calls me in the morning. Neither one of us is from Rhode Island, so things that happens, we look at as weird. She's like, "One of these weird Rhode Island moments just happened." I'm like, "What's going on?" She's like, "I'm on the phone at my kid's daycare, some girls walking by, and she said, 'Did you hear so and so died?' All nonchalant."

I'm like, "Nah, somebody would have called me. That ain't true." I said, "When I bring my son to daycare, I'm going to go by there." I go by there. I knock on the door. I'm like, "Yo, I'm here to do a wellness check." See dude's face, he's giving me the look. I'm like, "Listen, fuck going to your office. Is it true?" He's like, "Yes." Now I'm crushed, this my little man that just passed away. Every day, man, I reach for my phone around lunchtime to call him, to be like, "Yo, what you eat today? You know what I'm saying? The thing that bothers me the most is, man, I can't figure out how did I miss that he relapsed because he was with me so much.

You know what I mean? That every day I'm like, "How the fuck did I not know that he was getting high?" It made me think about how highly they look at us, to the point where they afraid to disappoint us. I wrestle every day with that gift and that curse. Some days, I think that if Dean didn't look so highly on me, he probably would have came to me and said, "Yo, I'm struggling. I'm getting high." I think about it every day, man. How did I miss those signs? Please, man, let your people know, man, that you're human and that you make mistakes like them, so they won't hide those signs from you.

I really feel deep down inside, man, if he didn't have me way up here, he probably would have came and told me, "Man, yo, I'm struggling. I'm getting high again." That's my story, and I want to share it. Thank you.

[pause 00:12:36]

[applause]

[music]

Emily Silverman: I am sitting here with Alicia and Anthony, both community health workers who told stories at The Nocturnists satellite event with TCN, the Transitions Clinic. Maybe starting with you, Anthony, tell us about your work. What's a day in the life for you as a community health worker?

Anthony Thigpen: There's no two days the same. Probably, from the moment I open my eyes, my phone is ringing, there's some type of crisis, some type of problem, and I'm ready to go. What does that look like? I might be helping someone that's dealing with a food insecurity. I might be helping someone that's dealing with some justice involvement, housing crisis, not being able to get their medication, just anything. I might have got arrested the night before, so I might have to change my whole schedule to meet them at court to try to smooth things over. Get to the probation officer or the public defender before someone else does. Just very busy, very busy for us community health workers.

Emily Silverman: How many clients do you follow at any given time, roughly, would you say?

Anthony Thigpen: Because I'm the program coordinator for one of the programs, there's no cap on the clients that I have. I'm between three clinics, so I'm servicing anywhere from 2 clients a day to 15. It just depends on what kind of day it is.

Emily Silverman: How about you, Alicia? Day in the life, what is your work like as a community health worker?

Alicia Ashorn: I agree with Anthony, no two days ever the same. Some days are I can get a lot of office work done. I can answer emails. Other days, patients are in a crisis. For example, yesterday. I have one that's living in his car. It's been really hot out here, so he needed assistance getting somewhere to stay, and there's not a lot of resources all the time. Yes, sometimes my phone rings off the hook, getting medications. Luckily, I'm just in my one clinic, but I'm the only community health worker, so on the days when people need a lot, then I'm doing a lot.

I put a lot of miles on my car, getting to patients, getting them what they need. Mondays, we do new patient intake. They go to see their primary care physician, then they come see me to do an intake. Those seem to be the days that other clients just pop up and need something, and we just have to handle it. That's what we do.

Anthony Thigpen: Yes.

Emily Silverman: Did you want to add something, Anthony?

Anthony Thigpen: Nah. She's 100% correct. Our schedules can't be set in stone for the people we serve.

Emily Silverman: Both of you are constantly dealing with stories, and you both had the experience of telling a story at this event. I just wanted to ask about your relationship to story. Did you grow up around stories? Did you have any storytelling experience, or what was your kind of storytelling creativity background, if any, before the performance?

Anthony Thigpen: [laughs] I want to say I inherited from my dad. Growing up, I was one of those kids who kept everything to himself, and ultimately, it got me in trouble a lot. Part of my transformation was pretty much not holding things in and being able to share it, so that I can heal, move on from things like that. As I developed my relationship with Christ, I learned that when you share your story, you're giving someone else hope, and you're asking God to do it again for them. That's how I got more and more comfortable into telling my

story.

For two reasons. One, I didn't want to let my story and things that I've experienced hold me down and possibly get me in trouble. Also, to inspire people, to let people know I'm no different. I made it, and you can make it too. That's what has had me comfortable with telling my story.

Emily Silverman: How about you, Alicia?

Alicia Ashorn: I was a painfully shy kid growing up. The only stories I knew were from books or anything, but I never really shared my story with anyone. I think the beginning of being able to open up was when I was incarcerated, and they had the 12-step programs. I didn't know anything about that, but I would go because it was something to do and something to get out of your cell and outside people were coming in. That's when I started sharing about my experiences. I continued that when I got out, and I still go to 12-step meetings, because those really helped me.

The way I was telling my story originally for The Nocturnists was the same way I do in that kind of group setting. I just froze during the practice night. I'm like, "I can't do this." I had

a coach, all that stuff, and everything I practiced just went out the window, and I just spoke from my heart. Really, to this day, I don't know everything that I said, but whatever it was, was from inside, because I was horrible at trying to write something and remember something.

Emily Silverman: I think sometimes when we try to write our story down on paper and memorize it and deliver it perfectly, it can come out stiff. Actually, just throwing away the script and speaking from the heart can lead to a more powerful performance. Your performance was really powerful, and you didn't sound scared at all. Thank you for following through with it. Maybe I'll stick with you for a minute, Alicia. Tell us about the preparation process. Even if you threw it all out the window at the last minute, I'm sure that some of your meetings with your coaches and some of that development fed into the way that you spoke that night, and would just love to hear about your hopes and expectations for the evening, and working with your coach and the build-up to the event.

Alicia Ashorn: Working with the coach was great. Sometimes when I wanted to give up, and I was like, "I can't do this," she encouraged me. She helped me to dig deeper and think of things. Even though I did throw the script out the window, a lot of it was already in my head. Being able to talk with her and our other-- There was somebody else she was coaching, and me and her became close, too. She's another CHW, and we both have the same fears. Being able to talk to each other about those was great, too. It was a good experience. I'm glad I did it, even though it gave me anxiety for a while.

Emily Silverman: Were there any surprises along the way? Anything that you discovered during the storytelling preparation process, or even the night of, or even people's response or reaction? Anything unexpected or surprising that came up?

Alicia Ashorn: Yes. Afterwards, the response, I wasn't expecting to get a little gift from anybody, and just other people saying they could relate to this or that. Like Anthony said, sharing your story is powerful because you never know who you might be touching a little bit. People have similarities, and you don't even know it unless you tell them what you've been through.

Emily Silverman: What about you, Anthony? What was it like getting ready for the big night?

Anthony Thigpen: I got thrown into that. No coaching. I wasn't prepared.

Emily Silverman: Oh, yes, because somebody was supposed to speak and they couldn't come, or they were sick or something. Did you step up at the last minute?

Anthony Thigpen: I don 't know what happened. We were having storytelling exercises at the table throughout the conference. I think I was telling a story about one of my experiences, and from there, they like, "Yes, you're Perfect. Come on in." Again, as I developed and then took more part in different workshops and things like that, I've learned that storytelling is very important for this work that we do, for the patients, but for us as well, too, because we're the ones who pretty much always have to be strong, and things like that. Throughout different workshops and seminars, and conferences, I realized, I got a chance to realize and see how important storytelling is for this work that we do.

I was like, "I'm game. I'm in it. No one is going to laugh at me. These are my peers. We're all going through the same thing." I think that's something as well that helped me got over. Before, you think, "If I mess up, somebody is going to laugh at me, I'm going to be embarrassed." Realizing I'm amongst my peers, and we all share the same passion to help people, has made it easy, but it's very important for the work we do storytelling.

Emily Silverman: You got thrown into it, and you end up in front of a crowd. What was that like? What was the response after the show, Anthony?

Anthony Thigpen: What was that like? It helped me identify that I was in a lot more pain than I was letting people believe I was in. Just the fact that I know that there were people relating to me, and I had a safe space to be that vulnerable, immediately after I came back, I actually went to a mental health facility for a couple of weeks to unplug and reset.

Giving me that space, God wastes nothing. I think that it wasn't no waste that I got thrown in that because I was able to be vulnerable. I was in a space where I actually recognized that I needed a little more help to cope with what happened to a friend.

Emily Silverman: In each of your stories, there was a line that stuck out to me, so I wanted to read the line for each of you. Maybe we can unpack or talk a little bit about that quote for each story. Starting with you, Anthony, your story is about a bond that you form with one of your patients, one of your clients, a younger man. You talk about mentoring him, getting close in some ways, and just helping him out a lot, and then missing some of the signs of relapse. Then, when that patient dies, when he passes away, really having to grapple with the grief and pain of that situation.

Then, as you reflect on that loss, the quote that really stood out to me is when you said, "It made me think about how highly they look at us, to the point where they're afraid to disappoint us. I wrestle every day with that gift and that curse. Some days, I think that if Dean didn't really look so high at me, he probably would have come to me and said, 'Yo, I'm struggling.'" I just really zeroed in on that idea, the gift and the curse, or the idea that you're there to support, but they almost, maybe some of your patients, some of your clients, look up to you so much that they don't want to let you down.

In some ways, it inhibits honesty and was wondering if you could just speak a bit more about that, because it seems like a really difficult catch-22 and a difficult challenge.

Anthony Thigpen: Yes. The Transitions Clinic here in Providence, Rhode Island, I believe that we were the last people to wrap our arms around some of the patients and their long

history of addiction, mental health, incarceration. When they're finally at a place where they're stable, they really look up. They're thankful for that. We gave them hope. We've gave them the love that they haven't received, especially from an organization, and they see us. They see us thriving. They know our stories. With Dean, in particular, he went through a lot.

He's been through a lot, and where he was at in his life, I think he was finally at a place where he felt normal and human. He had everything going for him. He had the apartment. I was finally able to get him an income, and all of that type of stuff. Providence is a small city where everybody know who's struggling and who's not struggling. A lot of my contact with a lot of the guys is about humanizing them. It's not always about taking them to a program. It's about just, "Hey, man, what's up? Let's go get lunch," and just be a person. Not the person struggling with a substance use disorder, or a person that just got released to me, or anything like that.

Going through that with a lot of my patients, they look up to me. I'm the person who got it together. I'm the person who helped them. They also are aware of how much work we've

put in to get them to where they are. The last thing they want to do is disappoint us. I didn't know Dean was struggling because he was calling me, "Hey, man, what's up? Let's go get lunch. Or, "Hey, man, I'm a little stressed out. Can you get me out the house?" "Yes." That type of stuff, but he was struggling. He wouldn't tell me that he was using again. I don't know why.

Maybe he thought that I would be upset with him, which is, I don't think that was the case. I think it was just more or less the work that he's seen us put in to get him to where he was. I think that he was feeling like he was disappointing us. Sometimes we get called the superheroes, and you don't want to disappoint your superhero. You don't want to let your superhero down, or your big brother down. I think that those are some of the things that I've experienced with my patients. Now, after Dean's situation, I do let it be known more that "I'm safe, bro. Listen, I'm here. Please, man, whatever is going on, I need you to let me know so that we can get through it together."

it has gotten better, but it is something that I wrestle with. I still do, and that's why I'm, I want to say, doing a lot more thoroughly, questioning them and letting them know during that questioning that "It's okay, man. We'll get through it together."

Emily Silverman: I was going to ask you, Anthony, when you get a new patient or a new client, what are some things you do or say to build trust? It seems like in Dean's situation, it wasn't so much that he didn't trust you, it was that he didn't want to disappoint you. We think, I guess we don't really know. You said that one way around that is to just really openly

communicate, "Please be honest with me," and so on and so forth. I'm wondering if you have any success with that. Do you find that if you say that up front, people tend to be more open and honest? Or, I don't know, because you have done so well, and a lot of these folks are still struggling. Even if you have a lot in common, there's that differential. Then, just how do you cross that bridge, or that boundary?

Anthony Thigpen: I think it's the language piece. When we talk about re-occurrence or returning back to use, I talk about that that's normal in recovery, that you are going to

return back to use. There are going to be things that make you feel like, and it's okay to feel that way. You're not a failure. You're not letting me down. I'm talking to patients

more about that. Unfortunately, returning to use or re-occurrence is part of recovery. It's normal, especially the way the economy and just everything is now. You can go into a

program, and it's only for 14 days.

You've been getting high for the last 20 years. Yes, I brought you to the program. I picked you up from the program, and you might have talked to me every day. We might have did things every day. Then there's one day where you could have ran into the wrong person, and that person said, "Hey, come on, yo, this person got a bomb." You join that, but always knowing, "Listen, bro, my phone is on. Two o'clock in the morning. You want to get off that train? Call me, I'm getting up, and I'm going to go get you, and we

going to make it happen."

I think that letting them know that it's okay, it's going to happen. I don't think there's hasn't been a person that I've known that's ever been in recovery, that haven't had a setback for whatever reason, but they come. A lot of times, there's nothing we can do about it besides try to give them that space to be vulnerable and let them know that it's okay, and we got you. We going to push through this together. That's what I've been trying to do a lot more of.

Emily Silverman: Alicia, I'm wondering if you have anything to add there.

Alicia Ashorn: Yes. They do say relapse is part of recovery, but it doesn't have to be. I've noticed the same thing. If I don't hear from a client in a long time, or if it always goes to voicemail when I call, that's usually a sign.

[pause 00:32:15]

[music]

Emily Silverman: I want to talk about your story now, Alicia, and the line that stood out to me. You talk a lot about your personal story, your background, some of the struggles that you've been through, setbacks, achievements, setbacks, and then finding purpose at the Transitions Clinic. Really landing in a place where your past became a strength. There was a line in your story where you said, "Then I got a call from the Transitions Clinic, and this was the first time I ever had a job interview where I was proud to say that I've been to jail. It's like, that's me, yes." Was wondering if you could tell us a little bit more about that interview and about that opportunity, and about that moment.

Alicia Ashorn: Even after I said that in the interview, I was wondering if I should have said that at all, but for the type of job it was, it was necessary. In the past, for any other job, it's something you try to hide. You wonder how many years they're going to go back on the background check, and if anything is going to pop up. That's always been a huge fear, but it wasn't this time. That was very freeing, because not far, actually, a month before getting the call from Transitions Clinic, I was turned down for a job because of the background check. Even though it's been years, some people still will judge you based on that.

Emily Silverman: I was wondering if you could each maybe tell us about a story, an anecdote, obviously de-identified, but a win, a success story. Maybe a favorite client, or a moment that felt especially gratifying, maybe starting with you, Alicia.

Alicia Ashorn: There's a client that we have who actually stayed in prison longer because he was going to be released, and he needed a kidney transplant. He stayed in just to get that kidney transplant. When he got out, he was able to find the Transitions Clinic, and we were able to help him. He calls a lot just because he's lonely, and we have money from a fundraiser that we can do extra things for people. One day, we just went to lunch, and he needed a haircut, so we went to a barber shop and got a haircut. He made a new friend in the barber.

They ended up going fishing one time, and just things like that. There are so many moments where I just have to pinch myself, because you don't realize what something that seems that small can really do for somebody. Even when people are just getting out, and they're confused, and they don't know where to go, especially if they've been in a long time, they need to get their ID. They need to get this, they need to get that. Just being able to sit and listen sometimes without judgment is really fulfilling. I could go on forever.

Emily Silverman: Why don't you? If there's anything else you want to say, we're in no rush.

Alicia Ashorn: There was another one that we were able to get him a hearing aid. He got a job in construction, but he couldn't hear, and he needed a hearing aid. They're expensive. I didn't realize how expensive they were, and Medi-Cal doesn't cover that. I was able to take him to Costco, because that was the cheapest place we could find, and pay for his hearing aid out of our funds. The lady, they were confused, like, "Why are you guys paying for it?" I asked if it was okay if I told her, he said yes. I told her about the Transitions Clinic and what we do, and she embarrassed him, I think, praising him.

"Oh, I'm so proud of you. This is great." It's, I don't know, just something about this job. I really love it. It's not like working. It's just it's disappointing, too, at times. You can't help everybody, but when you do get that chance to help somebody, and it makes a difference, that it just gives you this really good feeling.

Emily Silverman: How about you, Anthony? Any favorite stories?

Anthony Thigpen: First and foremost, I think the programs that came out of myself being a community health worker here in Rhode Island, one of the first community health workers to work with people who were formerly incarcerated and things like that. I sit back, I'm proud of that moment to see what the community health worker buzz and workflow looks like here in Rhode Island. Most recently, one of my guys. I remember first meeting him about six, seven years ago. He told me that he's been on probation his whole life. I just ran into him.

He was actually coming to the clinic to show me his paperwork. He's no longer on probation or any supervision. When I first met him at maximum security, before he was released, he told me that he was been on probation his whole life. I had told him that "If you rock out with the Transitions Clinic and you let us do what we do, you'll eventually get off probation." He did have some minor bumps. I think it would have been a lot worse for him if he didn't have the support of the community health workers in the Transitions Clinic.

Today, he's under no type of government surveillance. That's big for a person who's been under that type of surveillance since they were about 16, 17 years old, but now in their 60s. He made it. He shut that revolving door on the system.

Emily Silverman: Now, there's something that you said a minute ago, Alicia, about when you have the opportunity to help someone, it's so gratifying. You can't always help everyone. There's always going to be things you can't control, but sometimes there are these wonderful moments and that that makes the job so gratifying that it doesn't feel like a job. It feels, I guess, just like being a human. I was wondering if maybe both of you could say a bit about that tension between wanting to help people and make change, while also being humble and recognizing that people have free will and also the world is really chaotic, and we can't always control what happens. If I'm not mistaken, I think that might be one of the mantras of AA is something about what I can control and what I can't control, and the wisdom to know the difference.

Alicia Ashorn: Yes, the Serenity Prayer.

Emily Silverman: The Serenity Prayer, yes. It's so potent. It's very spiritual, and it's all about that, right? The wisdom to know the difference. When do you know to step back? When do you know to lean in? When do you know that you have some control? When do you know that you don't have control? I guess I'd love to hear you both just a little bit on that wisdom to know the difference. Whether you're helping yourself or others, how do you navigate that? Because it's something I personally struggle with, is knowing when to just surrender to the universe, but then I don't want to be complacent. When do I actually lean in and try to make change without working so hard that I'm making myself crazy trying to make change in a world that sometimes feels unchangeable?

Anthony Thigpen: It's tough. For me, I think it's the situation at hand. Sometimes, again, just for a person to know that you are there, versus all right, I have patients who aren't going to stop using. They're just not going to stop using. I had to distinguish to all right, let me use what I got to be able to keep them housed. You're going to use; you get your check. I just want to take you to pay your rent. Make sure that your rent is paid and your bills is paid. You're going to do whatever else you're going to do. I do a lot, I guess, harm reduction.

Harm Reduction kicks in when it's that moment. That's my knowing the difference is you're going to go get high no matter what I say, or I get you out of court right now, and I'm talking to you, you're going to go do what it is that you do. Let me help you reduce the harm for yourself. Let's go check in with your probation officer. Those type of things,

versus your probation officer haven't seen you. You got arrested again, and now he's like, "I don't know where he's been." All of those type of things come into play. Then just being available, letting them know that judgment-free zone, knowing that they can call you when they hit that rock bottom. It's just one of those things for myself. I didn't get it the

first, second, third, fourth, or fifth try. I understand that, and that's the things that I can't control. I try to find out ways to coincide with it.

Emily Silverman: How about you, Alicia?

Alicia Ashorn: Yes, when I first started this job, I would just do way too much off the get. Then Dorel Clayton, he's the CHW trainer at the Transitions Clinic Network. He has this

phrase, how you start is how you finish. That really helped me, because if I start out giving this and giving that, then they expect it all the time. A lot of them will take advantage. I have people that don't make their appointments, but they show up to get a gift card for food or a gift card for gas, and it's a weekly thing, but they won't show up to their appointment.

It's a fine line to know when you can't change it. The whole thing about starting where I finished, I had to remember not to stress off of other people. They're going to do what they're going to do. I could be there to help if they asked for it. Like Anthony said. Just, they know we're there, but I'm not going to go chase anybody down to try to get them to do the right thing, because that messes with my sanity.

Anthony Thigpen: It will.

Emily Silverman: [chuckles] Did you two know each other before this show?

Alicia Ashorn: No.

Anthony Thigpen: No. Was this your first Transitions Network convening?

Alicia Ashorn: This was my second.

Anthony Thigpen: Okay.

Alicia Ashorn: The first one, I was just taking it all in. This is the first one I actually really got to meet people and talk to people.

Anthony Thigpen: Your first one, I left my wallet and my phone in a Uber, so I didn't make it. We actually did our segment through Zoom, myself and the provider from our clinic, and so, nah, we didn't know each other.

Alicia Ashorn: Okay, yes, so this would be the first time.

Emily Silverman: Is there anything that you want to ask each other just about, I don't know, your personal story, or your work with Transitions Clinic? It's an opportunity, or maybe there's nothing that you want to ask each other. I just thought, since there's two of you here, instead of me doing all the questioning, if there was anything that you wanted to ask each other.

Anthony Thigpen: I do. I do want to ask her a question. I know some of your story has something to do with you saying you have a record. Now that you having a record is one

of your superpowers, how does that make you feel?

Alicia Ashorn: It makes me feel it's like I'm not hiding anything. Like, I can just be myself. Before, I would never tell anybody at any job about my time in prison or anything like that, or all the things you can do with Top Ramen. Yes, it's just it's freeing. I still don't go around talking about it, unless somebody asks. I don't lead with that when it comes to working with new clients. If they ask and I can talk to them a lot about addiction, and just my opinion, I can't force them to stop using. This whole fentanyl thing, I don't know anything about that. I wasn't doing drugs when, thank God, it came out later. I don't even remember the question now that you asked me.

Anthony Thigpen: No, you answered it.

Alicia Ashorn: Okay.

Emily Silverman: Alicia, anything you'd like to ask Anthony?

Alicia Ashorn: I would. I remembered now that you guys from Rhode Island weren't there the first year. What are the resources like in Rhode Island? Because I know the county I'm in out here, our resources are scarce. It's really frustrating trying to get people housing, even food, the food banks are suffering right now because there are so many people here trying to get all the same resources. I was just wondering what it looks like in Rhode Island, and are you able to help your patients better?

Anthony Thigpen: Yes, I think that, being that it's so small here in Providence in Rhode Island, and the resources are definitely scarce, we're considered a sanctuary state as well, and so we scrambling for housing for different people. I think what I have seen is that the community agencies and the nonprofits have been coming together, because we all understand that if we being together, there's more, right? We are able to help more people, versus saying, "Hey, this person isn't from this zip code, so they can't come." Now, understanding that we are all we got.

No one is coming to save us but us. Actually, today, a lady called me and just said, "Hey, I have a bunch of boxes of thermals and things like that." I'm like, "What? I'm on my way." I went and got them. I reached out to people that I know from different organizations, and said, "Hey, listen, I got these boxes. I want to bust you guys down here. Got a box for you guys." Just coming together in these times of need. We have to come together more. I think that we're starting to really get it and understand that.

Emily Silverman: Awesome. A lot of people listening to this show are clinicians. We have doctors, nurses, students, and some of them may have collaborated with and worked with community health workers before, but some of them may have not. I was wondering if you could speak directly to our audience. What's one thing that they can do to learn more about community health workers and partner better with community health workers?

Anthony Thigpen: I'll let you go first, Alicia.

Alicia Ashorn: Okay. I think every doctor should have a community health worker. I know the doctor I work under, she doesn't know what goes on in my office, and I don't know anything about what goes in her office, except she sees the patients. She can diagnose and prescribe, but then if a patient needs something, I'm the one that goes running around to get their meds, to help them with their Social Security, make sure they have work boots if they got a new job. I'm the one that does the thing she would like to do for everybody, but doesn't have the time to do it. We do a lot of things behind the scenes.

Emily Silverman: Nice. How about you, Anthony? Any messages for clinicians?

Anthony Thigpen: Yes. I would say, get to know your community health workers and your peer recovery specialists that's in your clinic. They are a very important tool to a person's care. They don't know it all, but we have a superpower called our lived experience, and it helps. It helps. I look at the community health workers as the bridge between the patient and the provider. That's where the patient has the trust in the community health worker, and the provider has the trust in the community health worker. If you approach it as we are all caretakers or care providers, no matter what our title is, it ensures a great relationship, from my experience,

Emily Silverman: Great. Thank you both so much for speaking with me today about your work and your experience telling the story on the stage. It's really fun to meet you after hearing your stories and just to unpack the process a little bit. I'm wishing you both just continued success. Thank you for the really, really important work that you're doing in your communities.

Alicia Ashorn: Thank you for having us.

Anthony Thigpen: Thank you so much. You guys have my information. Anytime you guys want to chat, chop it up, hit me up. See you later.

[music]

Emily Silverman: This episode of The Nocturnists was produced by me and producer and head of story development, Molly Rose-Williams. Our executive producer is Ali Block, and Ashley Pettit is our program director. Original theme music was composed by Yosef Munro, and additional music comes from Blue Dot sessions. The Nocturnists is made possible by the California Medical Association, a physician-led organization that works to ensure the doctor-patient relationship remains at the center of medicine. To learn more about the CMA, visit cmadocs.org.

This episode of The Nocturnists' conversations is sponsored by The Physicians Foundation, which supports physician well-being, practice sustainability, and leadership in delivering high-quality, cost-efficient care. The Nocturnists is also made possible by donations from listeners like you. In fact, we recently moved over to Substack, which makes it easier than ever to support our work directly. By joining us with a donation of $2, $5, or $10 a month, you'll become an essential part of our creative community. I'm your host, Emily Silverman. See you next week.