Interview with Alisha Moreland-Capuia: "Change does not happen in the context of comfort"

Feb. 14, 2018

In December 2017, Stephanie Radu, M.D. Class of 2021, sat down with Alisha Moreland-Capuia, M.D., assistant professor of psychiatry, OHSU School of Medicine, and director of the Avel Gordly Center for Healing to talk about advocacy, politics and the role of physicians (and medical students) in social justice. These are highlights from their conversation.

Dr. Alisha Moreland-CapuiaSR: Do you still believe that environmental justice has a place within physician advocacy? Do medical professionals have ground to speak on these concerns on a political platform?

AMC: Absolutely! These issues still remain very important to me today, especially now as I do work around trauma. I see that the conditions that some people live in and the impact that environment has on those conditions. Not just the sociopolitical environment but truly the physical environment.

I do believe that it is very important for physicians to educate the community and their patients on the potential risks of the environment. There is a clear connection, and that is evident by the organization Physicians for Social Responsibility taking up global warming as one of their core working objectives. They want to educate on it and believe that physicians should be more aware of the environmental impact on health. 

SR: Can you talk about your experiences in Portland's political context? Have you seen any changes in the city during your time here, and where do you think we have the most room to grow?

AMC: I have seen tremendous transformation. Portland is an example of what has happened in cities and neighborhoods across the country, for example in Detroit, Harlem, and Brooklyn. Commissions apply for urban renewal dollars with focuses on neighborhoods considered to be eyesores. These neighborhoods inevitably and undoubtedly contained persons of color, so once these dollars came in, these community members were shifted outward (as housing and businesses were torn down and rebuilt) without any plans to bring them back in. 

Now, what you will find after the urban renewal missions took place in communities, is that areas that contained people of color actually ended up excluding those same people. They were also less likely to return due to increase in cost of living, home prices and rent. These systemic forces made it harder for people of color to get home loans and other factors that lead to cities becoming less diverse and homogenous, not just in terms of race, but also in terms of class. Due to forces that welcome only cohorts of people that could afford it, places like the northeast of Portland and cities that once were occupied by people of color now have residents predominantly not of color with signs that read "Black Lives Matter" in their front lawns. 

SR: In medical school here, I have seen a lot of efforts to educate on structural complexities, racism, and bias. I've watched these movements lead to a lot of discussions stemming from discomfort. Is this a sign of progression? Should we continue to push through this discomfort or should we be focusing on using a different platform to evolve?

AMC: I think it will be a combination. Change does not happen in the context of comfort and convenience. There needs to be a great deal of discomfort, and it is through sitting with that discomfort and working through it that creates the birthplace for change. Change does not happen outside of that discomfort. 

SR: How can the majority both be better and do better on these issues? How can white medical students, for example, or truly anyone that comes from privilege, check this privilege and use the voice we innately gain from majority platforms to advocate for these issues?

AMC: One quick, relatively easy, way is to simply speak up when you see things happening!

These opportunities happen every single day, whether it comes from a patient being rude or from seeing others and stating, "We don't do that here." Ally-ship is not just saying, "I am standing with you," but it is saying "I am going to speak up when it is appropriate" when looking at any injustices, whether it be in a classroom or in person.

I believe that systems don't change if people don't change, and people don't change if they don't feel something. So, what I say to folks is this: To impact a system, you must impact people. Impacting systems comes from causing people to confront their own humanity.

A comment made post-election by U.S. Supreme Court Justice Ruth Bader Ginsburg really resonated with me. She recognized that a lot of people weren't happy with the results and said that the real American symbol is not the bald eagle, but that it is actually the pendulum. When the pendulum swings, it swings so drastically, and that has been the history of our country. She said that rest assured (the pendulum may have swung heavily today), but it will swing again. I found so much truth and solace in this statement.

Sonoman Joe with student Stephanie RaduSR: How do we keep hope?

AMC: Do not grow weary of doing good and do not grow weary of positivity. Eventually, that pendulum will swing again towards positivity and the one thing that we can never afford to abandon is hope.

Even in the midst of darkness, we are still called to be the light. The light will shine on the path for many to come behind, and we cannot fade into the darkness. This light is supporting each other through speaking up and also using it to see the importance of understanding our history.

It is important for everyone to know that they have a sense of agency and can move from where they are. Everyone has something important to contribute. Do not be afraid to lead from where you are.

Top photo: Alisha Moreland-Capuia, M.D.

Bottom photo: Stephanie Radu, M.D. Class of 2021, is committed to understanding and becoming a voice on social justice issues. Here, she measures Sonoman Joe's blood pressure at the student-run Bridges Collaborative Care Clinic, a partnership between OHSU affiliated health professions students and the nonprofit Transition Projects.