Tuesday, April 10, 2012

The Whole Person: Making Critical Connections Across Fields

          In the field of education, Wade Boykin of Howard University and Pedro Noguera of New York University presented together at ASCD’s annual conference last Saturday. The topic was closing the achievement gap. The solution calls for a whole child education, a term meant to encompass the latest approach to schooling. But is this really new? Talking about the “achievement gap,” in schools frames our understanding of achievement and data around race & ethnicity. This framework is not new, nor is teaching the “whole child.” In fact the premise that it’s all about belief and expectations, that all children can learn has been part of the education narrative for decades. But they argue— it’s not about belief alone. We must put our beliefs into practice. We must build supportive relationships with students, protect and advocate for their health, engage in meaningful and relevant activities, provide an emotionally and physically safe environment, and ensure students have real opportunities to be academically challenged. What children are we speaking about when we say all children? If we want to close the achievement gap, according to this framework, only some children, some schools need fixing. Then, who is to do it? Who is in the know?
          In healthcare, there is an equally urgent call for cultural and linguistic competence training in response to persistent healthcare disparities amongst Latinos and other minority groups, as compared to their white, European descent counterparts. The term minority, by the way, is still being used to describe the lump set of groups that are non-white, non-European—in spite of the fact that “minority” groups as a whole are really the majority globally and in some cases even locally as we see drastic demographic shifts across the United States. The solution in healthcare is similar; fix the disparities by providing culturally congruent care which centers on addressing our beliefs. We need to believe and expect that every person should have access to quality healthcare. In the health care field, this means building trusting & supportive relationships between patient and physician. It’s also about protecting and advocating for quality health services, making decisions that are relevant and address the needs of the patient , providing a safe, clean space and ensuring patients have access to medicine, treatment and information. Sound familiar? If so, ask this: Is quality health care a problem for all human beings? Or is it only that some of the population needs fixing? If we want to address disparities in health care, according to this framework, only some services, some people require our immediate attention. Then, who is to do it?
          Maybe there’s absolutely nothing wrong with this premise. If something looks broken, then fix it. Find the problem, the weakness and intervene.
          Except— something feels strangely off balance to me. After delivering a successful and very rewarding training on intercultural and linguistic competence for residents at a Connecticut hospital, the very premise that I speak about here began to gnaw at me. I began to think about the following. We spend a lot of time grappling with how to put a handle on this melting pot we call diversity, how to equalize the different outcomes amongst groups. Those of us with privileges in society take a critical look at data, we are stretched and pulled, determined to fix the disparities, close the gap, do something for the other half of society, the less fortunate half, the ones who don’t speak English or who have no money, the ones who are often marginalized in main stream society. We ask ourselves, how can we give more, do better, be better providers? And then we get to work, and most of us get paid. Some of us get paid to do the work of fixing things.
          No one can argue that culture, language, ethnicity, religion and class are all critical factors that can easily be perceived as being barriers to attaining the “standard,” providing “good work” or quality care and so on and so forth— and rightly so. Professionals are faced with the everyday reality that if a child or patient doesn’t speak the same language or holds alternative beliefs about what it means to be healthy, smart or happy—it is a challenge to teach them or in the case of a physician provide them with effective care.
Yet, something’s just not right and maybe it’s because there’s this pattern I’m observing and maybe it’s got something to do with what Richard Sennett writes— “we live in a time in which a small number of skilled people control society and that they make regular folk feel inadequate or useless.”
          What bothers me is that it just feels easier to talk about “the self” verses “the other” dichotomy rather than talk about ourselves as one community, one system in which there is no disparity, no gap because there are no two halves. I want to know if it’s necessary to split us into two, the haves and have-nots, in order for us to evolve, change, grow, and improve? Is it necessary to have comparison groups? Then if I go a little further down that line of thinking, I might ask: Are we polarizing the conversation on purpose to maintain the status quo?
          Speaking about the achievement gap polarizes the conversation around race & ethnicity, the same as talking about health care disparities polarizes the conversation around race & ethnicity. It occurs to me that maybe there is something wrong with that, that maybe we’re caught up in a conversation that in itself perpetuates individualism rather than community, perpetuates the notion that some folks are inadequate while others will always have the skills to fix things. Have we all fallen victim to a compartmentalized, polarized, you vs. me way of thinking?
           If we are to talk about the “whole child” or the “whole patient,” then why are we not talking about the “whole system” or the whole society in a way that does not juxtapose one side against the other but rather looks at the human experience as one organism?
          Is it possible to remove the notion of gaps and disparities? Is it even possible to remove our groupings based on race? What would happen if we stopped dividing human kind by the illusory color of skin or the language one speaks—how would we engage in a conversation about what we’d like to improve upon in the field of education or health care— for one nation, one global community?
          I’m not sure if people, including myself, would know how to have a conversation like that, but I bet it’s relevant to how we perceive our global crisis. Maybe how we frame our conversations diverts us from getting at the real issues.
          There’s an argument that it’s natural, human nature to group and compare, the survival of the fittest. Without comparison, who are we? But if that were the case, then why doesn’t it feel natural anymore and why are we repeating things? Is it possible we've been asking the wrong questions, that we shouldn’t talk about how to close the gap or challenge disparities but rather take the time to consider what we should be teaching children in the first place? Or what it means to live a healthy, balanced life? And I mean— for all children, all people—not just the ones that we’ve decided are broken or faulty or weak. Are the people on the flip side, the ones that we deem educated, healthy and happy, are they what we really want the whole world to be?
          I’m curious what a conversation like that would look like.

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