Being then Doing

By Mary Isaacson, RN, Ph.D., Assistant Professor of Nursing

“Mom, you HAVE to DO something!” Six simple words from my sensitive, 16-year-old daughter initiated my journey toward appreciating who I am. As a nursing professional, I have born witness to the joys and sufferings of humankind. Joy in sharing with a family that a biopsy was negative for cancer; and suffering as another family says good-bye to a loved one. These encounters with joy and suffering occurred within an environment and with a population that I considered familiar; when at the end of the day I simply returned to the safety and security of my private life.

My daughter, Anna, wanted me to venture into the unfamiliar, the unknown; she was urging me to enter the abyss. Doing so required that I relinquish my preconceived notions about others, recognizing that I was no longer the expert. Crossing the chasm demanded that I leave the safety and security of the familiar and establish relationships with strangers. It necessitated that I become the other.

Becoming the other and entering a stranger’s world entailed contemplating my personal and historical horizons. My personal horizon recognized that I am a white, middle class female, as well as a wife, mother, and a pediatric nurse educator. My historical horizon elicited childhood experiences of poverty and loss of a father. Yet these historical experiences paled in comparison to the tragedies that the Lakota experienced at the hands of people that looked just like me. My past was a petty mark in the shadow of the current abject poverty of the Lakota community.

The more I learned about the Lakota, the greater my sense of urgency became to DO something. And yet, with this urgency I continued to be plagued with doubts and questions about my ability to DO anything. Would my East River otherness prevent me from being accepted? Would the Lakota see me as another curious white stranger coming to “DO good?”

Wrestling with how the Lakota might view me increased my self-awareness and was essential to keeping my horizon of understanding open to new possibilities. Before jumping into the abyss and becoming the other, it was paramount to consider how many in contemporary society view the Lakota. This acknowledgement of our otherness according to Gadamer (2004) would facilitate my ability “to look beyond what is close at hand — not in order to look away from it but to see it better, within a larger whole and in truer proportion” (p. 304). I felt I was now ready to see.

Deeply etched in my memory is my first journey onto the Pine Ridge Reservation. Shrouded with doubts of acceptance, I did not notice when we officially entered the reservation. However, as I became aware of my surroundings, my fears began to subside. Many of the news articles about the reservation depicted an awful place — full of trash, broken down or abandoned vehicles, and unkempt homes. Did I see these concerns? Yes. Yet, in spite of the unmistakable signatures of poverty, the vast openness and changing topography filled me with an overwhelming sense of serenity. I felt at home.

This feeling of coming home continued throughout my visit. The other, the Lakota, welcomed me, the stranger. Even then, my initial encounters were awkward. I had to temper my normally warm, two-handed, hand “grasp” and be content with a brief, impersonal touching of hands. I needed to consciously mitigate my talkative nature and actively listen to their stories about living on the reservation. I began to listen “not with a sense of personal power to ‘straighten things out’ but with a sense of God’s presence which alone can heal” (Palmer, 1994, p. 134).

By replacing my need to DO something to simply BEING, I balanced my earlier sense of urgency with patience (Johnson, 2000). I reflected on the many stories — about struggles to stay sober, to feed families, to keep their children safe. I marveled at their delightful sense of humor and questioned how they could laugh when faced with such adversity. I realized that the Lakota weren’t asking me to DO anything. They simply wanted me to hear and to appreciate what life is like on the reservation.

That epiphany left me wondering if I would have the fortitude to continue if I were in these same circumstances. I wondered why we allowed people to live like this in the United States. I wondered: Would I have the courage to act upon the horrific situations that I had just discovered?
My time to leave the reservation arrived before I was ready. I came as a fearful stranger and learned how it felt to be different; to be vulnerable. I learned the meaning of being the other. I discovered that facing the stranger means coming to know who you are — seeing your weaknesses, your scars laid bare. As I faced the stranger it was no longer about DOING something, it was about BEING. It was about developing relationships and acknowledging on a personal level that others exist. I knew that I needed to translate this experience of becoming other to nursing students.

As nurse educators, we teach our students about vulnerable populations. We describe to our students the powerlessness that exists within these populations; but do they ever truly understand what it means? How must those that we consider as strangers feel when they walk into our healthcare system and we do not acknowledge or appreciate their uniqueness; instead we try to mold them to fit into our cookie cutter models of practice? How do I teach students the importance of seeking the relationship first? How do I model authentic presence? How do I teach the importance of BEING then DOING?

Teaching BEING then DOING came with the help of many members of the Lakota community. One memorable occasion occurred when our hosts told us to “Bring the nursing students to the church to eat and enjoy the conversation.” The dinner was held in a pastoral church setting, nestled on one of the many vistas overlooking the Badlands. As we neared the church, the van that moments earlier had been buzzing with conversation was now still. Causing the angst was the scene before us — a pasture, now turned parking lot, filled with vehicles. I remember looking in the rearview mirror and smiling at the group, trying to send nonverbal cues of reassurance. We walked into the guild hall, filled to capacity with Lakota from the area. The delicious aroma of soup, chicken, and fry bread filled the air. One student writes,

I felt vulnerable when we first entered the building near the Episcopal Church to share our midday meal with the church members. All of a sudden, we were surrounded by all of these Lakota people, a people of a different culture, and we were not able to sit next to one another … I was nervous about how I really needed to focus on demonstrating proper respect … I felt my actions would be more noticeable in such a small space. I then was struck by the thought that this must be the way they felt off the reservation. They must feel like the stranger, awkward and out of place, afraid of making a move that the local people might see as offensive. Then I reflected on the warmth and kindness that I had so far experienced … and realized that I just needed to relax. I was able to cope after thinking about this to become completely comfortable Part of me knew that people appreciate consideration of their own unique needs and background, but the way that the Lakota people reached out to make us comfortable in their homes made me realize just how comforting even small gestures of familiarity and acceptance are.

Teaching students to BE so that they can DO is not something I can show them with a textbook. Learning to face the stranger teaches students the importance of BEING then DOING.

Gadamer, H.-G. (2004). Truth and method (J. Weinsheimer & D. G. Marshall, Trans.). (Rev., 2nd ed.). London: Continuum. (Original work published in 1960.)
Johnson, G. S. (2000). Beyond guilt: Christian response to suffering. Cambridge, MA: Adventure Publications.
Palmer, P. J. (1994). The company of strangers: Christians and the renewal of America’s public life. New York, NY: The Crossroad Publishing Company.