A Visit with Brain & Ethics Expert Dr. Syd Johnson

A Visit with Brain & Ethics Expert Dr. Syd Johnson

by

In May, I had the opportunity to visit with Dr. L. Syd M Johnson, a philosopher, bioethicist,  neuroethicist, and professor in the Center for Bioethics and Humanities at Upstate Medical University in New York. Dr. Johnson is a former film critic, and today she is a member of the National Institutes of Health BRAIN Initiative Neuroethics Working Group and an associate editor for the journal Neuroethics. Dr. Johnson teaches students and colleagues alike about the law, population health, and healthcare ethics.

Her current research in neuroethics focuses on ethical issues related to brain injuries, including sport-related neurotrauma, brain death, and disorders of consciousness. Her work is situated at the intersection of ethics, medicine, and law, and she has published on disorders of consciousness, sport-related concussion and Chronic Traumatic Encephalopathy, reproductive ethics, research ethics, and animal ethics. Her interest in all things with brains/minds includes every kind of critter, zombies, and robots.

We originally visited in the midst of the coronavirus pandemic before the killing of George Floyd and the subsequent uprisings following his death. After Mr. Floyd’s death, I circled back to Dr. Johnson to ask her what opportunities she sees in education to advance ethics, including racial justice, within healthcare.

HF: Tell me about your everyday work, including how it’s changed with the coronavirus pandemic.

SJ: It seems like I am busier than ever these days. There are two major differences in my everyday work. One is that I don’t have to commute into the office anymore. That is, honestly, a benefit. That travel time was not very useful. Before this started, I was already trying to cut back on the number of days I drove in to the office. The other change is that my kids are home. My teenager can look after herself, but my fourth grader needs help structuring her days and her online schoolwork. The frequent interruptions and distractions make it difficult to do anything that requires sustained attention. I’m trying to work like a bee—flitting from one flower to the next, but with a destination and an objective to move towards.

I’m working on a few collaborative projects right now, and between those and work-related meetings, it seems I’m spending a lot of time on video conference calls, just like everyone else.

HF: How did you become interested in brains?

SJ: In graduate school, I was interested in philosophy of mind and consciousness, and also bioethics. I had a postdoc in neuroethics immediately after graduating, so that got me to thinking more about brains, and brain-related issues. I got interested in the specific issues I work on—disorders of consciousness and sport-related concussion—because there were a lot of interesting developments happening in those areas at the time.

HF: What do you see as our most significant cognitive strengths and limitations, as human beings? 

SJ: The most significant cognitive strength of humans is our empathy—our capacity to think about what matters to someone else, to imagine ourselves standing in someone else’s shoes, to feel. It’s a basic capacity that drives us to create and consume art and literature and film, to help others, to keep the world going. Unfortunately, limitations in our empathy are our greatest weakness. We try to carve the world and its creatures (including our fellow humans) into manageable, familiar spheres—the things we decide we have the ability, the means, the bandwidth, and the desire to care about. The challenge is doing that—doing what is practically necessary—while remembering that things outside those spheres are still things worth caring about. It’s easier to turn them into things towards which we have apathy or antipathy.

HF: Tell me about how ethics has weaved its way through your life and career, including how you came to include nonhuman beings among your concerns.

SJ: When I was a kid, my family used to go camping and fishing in eastern Washington. When I was about 12, I was out in the rowboat fishing by myself, and I guess I was right above a school of perch. I would drop my fishing line in the water and immediately hook a fish. This went on and on, but after a while, I started to feel bad about it. I felt like it was unfair, that I was taking advantage of the fish because they didn’t know I was dangerous. That was the last time I went fishing. It would still be quite a while before I stopped eating fish or other animals, but when I did, I went vegan overnight. That was 1986, when I was in college, and it was in the middle of a cross-country road trip. I got pretty hungry for the rest of that trip!

Many months later, I read a book called Radical Vegetarianism by Mark Braunstein, and I learned the world “vegan.” Mark lived not far from me in Providence, Rhode Island, and he was nice enough to meet with me. I was introduced to the local animal rights group—the Rhode Island Animal Rights Coalition—and spent several years working with them before I moved to New York. We had two claims to fame—in 1987 we successfully lobbied the Cambridge, MA city council to ban the LD-50 Acute Toxicity Test and the Draize Eye-Irritancy Test in Cambridge, and we were infiltrated by an FBI agent who investigated us for several months. She got to witness us doing things like dress up in dog suits to protest the use of dogs in medical device marketing. We must have been a pretty weird and boring assignment for her. We never, ever did anything illegal. We engaged in activism-by-theatre and activism-by-annoyance. But I suppose that somewhere in the FBI archives there is a file on me, with a photo of me as Dr. Dog, dressed in a dog suit.

My interest in animal advocacy and animal rights was for a long time something I was philosophically interested in, but I didn’t see a clear contribution that I could make. I worked on it a little, at the margins of my scholarship, usually in conference presentations or in blog publications. I always found ways to work it into the ethics courses I was teaching. But people started asking me to write things—papers, book chapters, blogs, some amicus briefs for legal cases, and eventually a book. Now, it’s a pretty significant part of my scholarly work.

HF: What are you working on now?

SJ: I just finished an edited book called Neuroethics and Nonhuman Animals, which I’m quite proud of. It’s the first book to explicitly consider how neuroethics and animal ethics should be in conversation, and how the extensive animal ethics literature—which has for a long time been marginalized and siloed even in philosophy—can inform our approach to neuroethical issues related to both humans and nonhumans.

Right now, I’m working on my next book, and it’s a project I’ve been working on for years. It’s on disorders of consciousness, and how medical and scientific uncertainty about those disorders should prompt a change in our ethical thinking about them and our approach to other bioethical and neuroethical concerns. I’ve just been working on a chapter on moral status and personhood, where I can really incorporate animal rights and animal ethics thinking—because it’s the same issue, whether we are talking about humans with disabilities, humans with brain injuries, or nonhuman animals. In particular, I’m thinking about how consciousness is often thought to be a criterion for moral status or personhood. I think consciousness might be enough (or sufficient, in philosopher-speak) but it isn’t necessary for moral status. I suspect there are a lot of sufficient conditions for mattering morally, but none that are necessary.

HF: Commonly, I ask about what gives people hope. It would be interesting to hear from you what gives you hope, and what you think of hope as a neurological construct.

SJ: In the midst of this pandemic, one of the things that gives me hope is that we have shown ourselves to be flexible enough to change. We stopped driving and flying and going out. We found workarounds. Wildlife and other nonhuman animals emerged to fill the spaces we left empty. The air and water got cleaner. This year, I suspect, will buy us just a little bit of time to address climate change. Obviously, all of this has had pretty profound effects on human lives, but I hope that we can come out the other side of this with the recognition that we can respond to great challenges and do the things we must do to have a positive impact on the world.

HF: A follow-up question…since we last spoke, George Floyd was killed by police, sparking nationwide and international protests. His death and the killing of other Black people by police has also raised the level of public consciousness about how to better address structural racism and its effects on education, healthcare, and justice. What opportunities in education do you see now to better advance ethics, including racial justice, within healthcare?

SJ: It feels like we are on the verge of a momentous change in public consciousness. I really hope so. And coming in the midst of the pandemic, when attention was already turning to the devastating effects of structural racism on the health of Black people, Indigenous persons, and other people of color, it’s extraordinary to see a clear picture emerging amidst all the tumult. My experience with my students has been that once you lay out all the pieces, tell them the history, show them the effects, they can connect the dots and understand clearly how structural racism and injustice affect health for Black people, Indigenous persons, and other people of color. In my experience, they are astonished to learn about these things. When I taught my students about Black infant and maternal mortality in the US this past spring, they were aghast. So, future healthcare workers and doctors are ready to lead, and they are ahead of their teachers, but they need the information. The challenge, in my view, is to get health faculty onboard, to get them to recognize their moral and pedagogical responsibility to teach about the effects of racism and injustice.

Photo by Denise Rego Bass.

Dr. Emily Peitzman: Pediatrician & Animal Advocate

by

As part of an ongoing interview series with leaders who will join us at our forthcoming Phoenix Zones Initiative Summit, I had the opportunity to talk with Dr. Emily Peitzman, who is a physician and educator at the University of California San Francisco (UCSF) Children’s Hospital. Emily received her medical degree from The George Washington University School of Medicine and Health Sciences and she completed a Pediatric Medicine residency at UCSF Children’s Hospital. She works in both inpatient and outpatient settings as a primary care/urgent care physician and as a hospitalist on the UCSF Children’s Hematology and Oncology Bone Marrow Transplant unit. Emily is passionate about healthcare delivery and outcomes for children with increased exposure to adverse childhood events, particularly children in the foster care system and those with chronic illness. In her time outside of work she is passionate about animal rights advocacy, especially the needs surrounding pitbulls. She is a volunteer at the San Francisco SPCA in multiple programs including fostering and the mobile health clinic which provides free preventive care to animals and their human caregivers in the surrounding communities.

HF: Emily, thanks for talking with me. Can you share how your experiences within clinical medicine, including mental health services, have shaped your view of what children need from their families, friends, teachers, doctors, and society?

EP: Within my general pediatric training I try to incorporate pediatric mental health at every opportunity, such as asking a teenager the right question only to learn that they are thinking about hurting themselves, or wondering why a young patient would have a tantrum during a genital exam. Mental health issues are always present, but sometimes they take a little more directness and digging, which some clinicians find awkward. That awkwardness may prevent clinicians from asking the obvious next question. 

My experiences in clinical medicine have helped me to understand that children’s needs are simple in theory, but made incredibly more complicated by the quantity, quality, and timing of the needs being met. 

Here’s what I mean by that:

Quantity: Children’s needs must be met by a large variety of people in their lives—including immediate family, extended family, teachers, peers, daycare providers, nannies, and so on. 

Quality: Their needs must be met in a way that makes children feel secure and confident, and if the quality is lacking and that goal is not fully achieved, the consequences can be similar to those that result if those needs were not met at all. 

Timing: Where children are developmentally when needs are not met drastically changes the impact of failing to meet their needs. 

HF: How did you come to include animals in your scope of concern, and what in particular unites your concern for children and animals?

EP: I’ve always been an animal lover, growing up alongside rescue dogs. I thank my mom for introducing me to animal shelters and for taking me to visit them at a young age. Seeing the need—animals without homes—left an irreversible impression on me as a child. But my passion and advocacy really matured after my husband and I rescued our first dog, an anxious and loving pitbull named Kai. 

We both quickly learned about the stigma and plight surrounding shelter animals, particularly pitbulls. It happens organically—you watch how the world (including friends and family) judges your animal and you, and it’s hard to look away from what you experience. And these aren’t innocent judgments. Such stereotypes permeate our society, resulting in the [killing] of hundreds of thousands of innocent dogs annually. I believe those who adopt shelter animals must be more than simply owners—they must become tireless advocates too. 

In addition to our two rescued pitbulls, I volunteer at the SF SPCA and my husband and I serve as dog foster parents. 

I see my pediatric work and my rescue dog work along a continuum and they are very much linked. Both [children and animals] are especially susceptible to vulnerabilities. They both require allies with deep levels of empathy, and both also need advocates to give them voices. 

HF: You’ve talked with me before about your future desire to provide a safe place for children and animals. Can you talk a bit more about what you’d like to accomplish in this area? 

EP: There is something about animals that makes them incredible teachers of the intangibles—patience, compassion, kindness, and empathy. They also provide something we all need—companionship and loyalty (especially in a world that is increasingly lonely and isolating). Record levels of adults and teenagers report not having a close friend or someone they can trust. Animals can’t replace human connection, but they can go a long way.

Finding ways to connect youth in need with animals in need combines two problems and creates a [unified] solution. Take the epidemic of dogs without homes in the overcrowded shelter system. These are pack animals that usually sit alone in a small kennel for 23 hours a day. It’s devastating for them physically and emotionally. 

Imagine taking kids in need, such as foster children or children with chronic diseases or mental illness, and pairing them with a dog in need for walks, training, and play. In the short term, each provides the other companionship and a sense of purpose that teaches discipline, responsibility, and the joy of impacting another life. In the long term, kids learn about animal welfare, causing them to be more mindful of the work our society must do to create more just outcomes for animals. 

If kids are raised with a commitment to animal justice, they’ll become the adults that end animal injustice.

HF: You are a great example of living your values, and you appear to do that as a team with your husband. What drives your efforts to translate the political into the personal, and vice versa?

EP: If we don’t live our values, then it’s a stretch to call them “our values.” In such a case, we are merely saying the words, but not doing the work. And values only mean something when they’re backed by action. 

For us that means adopting dogs who may have issues, fostering dogs despite limited space and time, and eventually adopting children. On one hand, this decision is a more uncomfortable path that can come with a lot of challenges and stress. But, on the other hand, it feels far more uncomfortable to know of a need and to do nothing about it. We have to put skin in the game if we want to be true to ourselves and see change. This effort needs to extend to our day to day personal lives, and it means working on systemic change and getting at the root causes of challenges via political action and advocacy.

Photo courtesy of Emily Peitzman.

A Conversation with Dr. Amy Zeidan

by

As part of an ongoing series of interviews with people who are partnering with the Phoenix Zones Initiative, I had the opportunity to talk with Dr. Amy Zeidan. Amy is a trailblazer inside and outside of medicine. She is an assistant professor at Emory University School of Medicine, and she received her medical degree from The George Washington University School of Medicine and Health Sciences and completed an Emergency Medicine residency at The Hospital of The University of Pennsylvania where she was Chief Resident. Amy is passionate about healthcare delivery and outcomes for refugee, immigrant, and asylum populations. Her research focuses on barriers to acute care for refugees, immigrants, and asylum seekers, and she is a cofounder and director of the Society of Asylum Medicine. Additionally, she holds a national position with The Academy for Women in Academic Emergency Medicine (AWAEM) and serves as Finance Co-Chair of FemInEM, and she is committed to addressing gender inequities in medicine. 

HF: You’re trained as an emergency medicine physician but much of your work extends beyond emergency medicine and beyond medicine more generally. Tell me about the balance of professional responsibilities you maintain inside and outside of medicine.

AZ: I was initially drawn to emergency medicine because I view the emergency department as a lens to the social constructs and challenges of our healthcare system and our society. As emergency room (ER) clinicians, we provide a safety net for patients, particularly vulnerable patients who feel they have limited options other than the ER. We see the ugly and the beauty. We see so-called “frequent fliers” who either have multiple comorbidities that require near daily medical support or individuals who have such significant food, housing, employment, or financial insecurities that the emergency department (ED) becomes their most accessible source for social services, food, and safety.

As a result of my “day” job as an ER provider, I feel an urgent need to advocate for patients outside of the emergency department, where many of their health disparities that bring them to the ER start and flourish. My work outside of the ER fuels my ability to engage on shift and it makes me better equipped to support the social needs of patients in the ER. Without my outside work, I think burnout would be inevitable given the challenges we face as physicians navigating the complex healthcare system.

In medical school, I learned about the pathophysiology of disease. In residency, I learned about the pathophysiology of healthcare disparities. Now as an attending physician, I am learning about how structures of racism, sexism, and classism catalyze and perpetuate disease. Since many of the problems I see in the ER start outside of the ER, my responsibilities now push me more toward dismantling structures of injustice and poverty. I think, for me, it is more about integration instead of balance. The ER is a microcosm of our society and connecting the ER to the outside world helps me make sense of things.

HF: How did your early experiences in life influence your career path and your advocacy interests?

AZ: My first month of residency was a one month intensive care unit (ICU) rotation. My first patient was a woman from South America who was five years younger than me. She had a young child, and a concerned family in her home country—none of whom she could see because the sequalae of her disease required her to be isolated. She had spent weeks in the ICU previously and she had showed no signs of improvement. The underlying cause of her illness could have been treated with a lung transplant. When I assumed care for her, I inquired about her status on the transplant list. I learned she was not eligible because of her status as an undocumented immigrant. She wasn’t even on the list. Every day, a new problem would arise and she decompensated rapidly. One morning, she worsened acutely and all interventions had been exhausted except for comfort care (palliative care). The day before, she asked me to take a picture of her without any medical equipment so her son could remember her as close to normal as possible. I told her there was no need as we were planning a surprise for her son to visit the following day….a visit that required multiple hurdles, phone calls, favors, and days of planning. She did not live long enough to see her son. I held her hand and sobbed for hours until she stopped breathing.

While this experience may seem extreme, there are countless other situations in which patients receive inadequate care because of vulnerabilities beyond their control. In this case, citizenship status. We do our best as physicians, but we often don’t truly understand barriers faced by individuals seeking refuge in the United States—individuals who have been displaced and often persecuted because of their gender, religion, sexual preferences, or simply because of where they were born.

There are so many important issues we can and should advocate for as physicians. My advocacy efforts focus on reducing barriers to care that refugees, immigrants, and asylum seekers often face.

HF: Early in your career, you have already become a champion on human rights issues, particularly for individuals seeking asylum. What drives your work in this area and what do you hope to accomplish in this area in the future?

AZ: I am driven by the hope that every asylum seeker has a chance at freedom. That I may play a very small role in an individual obtaining asylum status is beyond incredible. The stories of asylum seekers drive me. I think about how many individuals are currently being persecuted due to factors beyond their control and who do not have the option of asylum. In many of the asylum cases I have assisted with, the fear of return for individuals is debilitating. A forced return is often equivalent to a death sentence. Conversely, the joy of being granted asylum is overwhelming.

Our current asylum process is being threatened unnecessarily and unethically. I hope to not only uphold current asylum standards but expand asylum protections. A lot of great asylum work is possible in progressive states, where communities of advocates are doing great things together. I hope to unite communities in locations where asylum grant rates are less favorable, and to hold elected and appointed officials accountable.

Additionally, I hope to reduce barriers to care faced by asylum seekers and to improve their experiences in seeking acute care. A few years ago, I read a study conducted at an urban ER in New York City in which the authors attempted to identify the prevalence of survivors of torture in their ER. They found that 11.5% of their patients self-reported a history of torture. I suspect this number is much higher given the language barriers and disclosure challenges patients may face when self-reporting. As ER physicians, we are skilled at evaluating victims of acute trauma. But we often forget about how prior trauma affects health and health outcomes of our patients. I think about how potentially traumatizing a visit to the ER may be for patients who are survivors of torture. I suspect that we unknowingly treat survivors of torture frequently in the ED and I push myself to think about a trauma informed approach to care in the ER. My asylum work has helped me think about this approach, and how to identify prior trauma and treat patients with a history plagued by displacement and persecution. I hope to establish standards and best practices in the care of refugees, immigrants, and asylum seekers in the emergency department.

HF: In addition to caring for vulnerable people, you are also concerned about the treatment of animals. How did you come to include animals in your scope of personal concern?

AZ: This is an important question and one I am still figuring out. It finally made sense when I read your book, Phoenix Zones, as you wrote so eloquently about a connection I had been feeling. What I interpreted was an alignment with the mistreatment of animals and mistreatment of humans, and the union of animal rights and human rights. To mistreat a human or an animal suggests the capacity for personal violence with a foundation of structural violence. Only by addressing both can we fundamentally change the pillars of violence that propagate hate. I often think about the existence and development of emotions in species. Do all species feel, and to what extent? How do we know? Our two incredible dogs, Rolo and Bosco, have taught us a lot about both human and animal needs. To be loved and protected, but also to be part of a pack—a community. The community unit seems to be very essential. Rolo was our companion during the long grueling hours of residency. Bosco recently entered our lives and his presence is beyond transformative. He was surrendered at eight years old and experienced terrible anxiety and depression in a shelter. He was rescued and fostered by my incredible best friend and his dignity has returned. He reminds us that the process of recovery is arduous yet joyful and that everyone deserve a chance to recover.

HF: You’re a very calm yet energetic and outwardly optimistic person. It’s a combination of qualities that was apparent even when I first met you years ago. What fuels your optimism?

AZ: I have wondered this as well! The easiest, and maybe somewhat honest response, is I don’t know. Recently I have needed more avenues for recharging my optimism. It is multifactorial but can be broken down into short-term and long-term drivers. In residency, I worked at an amazing clinic, Puentes de Salud. Our patients were primarily under/uninsured, 99.9% spoke Spanish as a first language, and their gratitude was overwhelming. Working at Puentes is what allowed me to return to ER shifts feeling like my tank was full. Many of our patients had significant barriers to care and Puentes gave them a safe and just space built around reaffirming dignity. Along the same lines, my work with individuals seeking asylum restores my optimism. Hearing their stories, witnessing their perseverance amidst pain, and sharing their joyful relief after being granted asylum reveal a real truth that is often overlooked.

But there is more that deeply sustains my drive.

When I was a teenager, my brother died unexpectedly as a result of a hunting accident. While I could write endlessly about personal loss, grief, and long-term sequalae, what comes to mind, in addressing your question, is survivor’s guilt. Survivor’s guilt is the guilt one feels when someone close to them dies because they lived. I remember feeling perplexed for years about why it was my brother and not me. I did in fact feel guilty that he died and I lived. He had so much promise and potential. The manner in which he colored the world was a work of art. So I have tried to transform my guilt into action. To the best of my abilities, I try to do the work he would have wanted to do in the ways I can. Our talents and art forms may be wildly different but I feel a drive every day to live his purpose in addition to mine. It almost seems easy to move forward optimistically when such a purpose is fundamental to my being.

HF: Thanks, Amy, for taking the time to answer my questions and for all you’re now doing for people and animals. I feel privileged to work with you on a variety of projects.

Who Does—and Who Doesn’t—Qualify as a Refugee?

by

Last week, the United Nations High Commissioner for Refugees (UNHCR), the UN Refugee Agency, released its annual Global Trends report on forced displacement. The bottom line: Every minute in 2018, 25 people were forced to flee their homes due to war, persecution, or conflict.

In total, more than 70 million people were forcibly displaced in 2018—the highest level of forced migration in 70 years. About 3.5 million people were listed as asylum seekers, 25.9 million people qualified as refugees, and 41.3 million people were internally displaced within their own national borders. 

Across the globe, the largest numbers of refugees, asylum seekers, and internally displaced persons live in places with the fewest public resources. In 2018, countries in developed regions of the globe hosted only 16 percent of refugees, whereas nations classified as the least developed hosted one-third of the global refugee population. Refugees and asylum seekers comprise one-half of one percent of the population throughout the continent of Africa, and it’s about half that in North America. In recent years, the United States has dramatically reduced rather than increased the number of refugees admitted into the country—even though many historical and modern wars waged by the United States have contributed to forced migration.

Recently I returned from the North American Refugee Health Conference in Toronto, where I spoke about issues including asylum medicine, physician advocacy, and how to integrate health and human rights into the medical education curriculum. Refugee resettlement is always a hot topic at the conference, and this year was no different. It’s also a subject that’s difficult for many people—even experts—to wrap their heads around.

Many of my patients are refugees who have resettled in the United States, and you might be surprised to learn how many people in your community are refugees or families of refugees. You might also be surprised to discover how many famous people came to the United States as refugees—for example, Albert Einstein, U.S. Secretary of State Madeleine Albright, Nobel Laureate Elie Wiesel, singer and songwriter Gloria Estefan, and Google co-founder Sergey Brin, to name just a few. Most refugees who resettle in the United States contribute significantly to their communities, and, contrary to political rhetoric, the typical American is 29 times more likely to be killed by a regional asteroid strike than by a refugee (the chances of which are nearly nil).

As anyone who is familiar with the refugee resettlement process will tell you, it is long and difficult. In fact, the most demanding way to legally enter the United States is as a refugee.

Under U.S. law, the term “refugee” refers to someone who is located outside the United States, is of “special humanitarian concern to the United States,” and has demonstrated that they were persecuted or has a well-founded fear of persecution because of race, religion, nationality, social group, or political opinion in their nation of origin. Typically, in order to be considered as a refugee, an individual must be referred to the U.S. Refugee Admissions Program for Refugees by the UNHCR, a U.S. Embassy, a nongovernmental organization, or the U.S. Department of State. Some eligible family members living in the United States can also initiate a family reunification case— for example, for a spouse or children under the age of 21. Most people must first flee their country of origin to apply for refugee status—without firmly resettling in another nation.

If an individual is found to be eligible for consideration of refugee status, the vetting process can take years. It includes extensive background investigation, a face-to-face interview with a U.S. Department of Homeland Security Citizenship and Immigration Services Refugee Officer, health screening to identify any contagious diseases (some of which can be disqualifying), “sponsorship assurance” from an established community-based organization, and a course on cultural orientation before entering the United States. The process also includes numerous security checks through multiple federal and international databases. (Think Federal Bureau of Investigation, Department of Defense, and national intelligence agencies.) People who are rejected by the Department of Homeland Security cannot appeal the decision.

In all, less than one percent of all refugees are considered eligible for resettlement. Most live in limbo in refugee camps or shelters for years without steady access to education, employment, healthcare, or security. And more than half of all refugees are children—many of whom handle their legal cases on their own. Imagine, even as an adult, navigating such a complex system—for example: providing all necessary forms of identification after being forced to flee conflict; a composed, often intimidating interview with a professional immigration officer; a clean bill of health after living in unsafe, crowded conditions without clean water; and the fortitude to adapt to a new land after living through the unimaginable.

Self-sufficiency is a key principle promoted by the government and within refugee resettlement agencies in the United States, and it is a value commonly embraced by refugees. Refugees who are fortunate to resettle in the United States are expected to find a job within six months of arrival, and they must apply for a green card after one year, which triggers further security clearances. Many become active citizens who extoll the virtues and obligations of a free society. For example, one study found that refugees paid more in taxes than they ever received in benefits. Despite a history of trauma, language barriers, and discrimination, many refugees demonstrate remarkable resilience and independence. As I’ve written elsewhere, they are like spirited phoenixes that can rise from the ashes of adversity if given the chance.

At a time when there is a humanitarian crisis involving historic levels of forced migration, it is critical that we move beyond myths, misunderstandings, and divisive and discriminatory rhetoric. Volunteering, raising awareness, and supporting resettlement within local communities are all ways to get more involved. And—as for everyone—kindness and compassion can go a long way toward helping individuals rise from the ashes.

Photo by Rene Bernal on Unsplash.

 

Connect!