22 I Latine/Using Community Health Workers to Care for the Undocumented (Dr. Ponce-Gonzalez)

• Timespan: 43 minutes & 20seconds
• Transcription Type: Cleaned Verbatim
• Speakers: ( Dr. Ponce Gonzalez & Raj Sundar)

00:00

Raj Sundar:  “Go back to your own country.” how often do you think that phrase comes into the conversation, when you're talking about caring for the undocumented?

00:08

Dr. Ponce: People always say “Latino go back to your country.”. They always tell me that I am a white person that come from Europe. I don't understand what their intentions are because the white people come from Europe. Nobody owned this land. I never heard a local (indigenous) that says "go back to your country". They pay taxes and approximately 400 million dollars were collected. And this year, who is Canada?

00:35

Raj Sundar:  Hi, I'm Dr. Raj, Sundar, a family physician, and a community organizer. You're listening to Healthcare for Humans, a show dedicated to educating you on how to care for culturally diverse communities, so you can be a better healer. This is about everything that you wish you knew, to really care for the person in front of you, not just a body system. Let's learn together. Welcome to Healthcare for Humans, the podcast that's dedicated to educating clinicians on caring for culturally diverse communities. You just heard from Dr. Ponce, who is the founder and executive director of the Community Health Worker Coalition for Migrants and Refugees. It's a non-profit organization that aims to improve the quality of life of under-served communities, specifically, Latine community. This episode is part two of our Latine series on caring for the undocumented. And in this episode, we address the problems with the current healthcare system, and explore how community health workers can bridge this gap. But it's not just about that, Dr. Ponce also talks about the experiences of seasonal migrant and refugee Latina workers, and discusses our moral obligation to care for one another in this context. Before the episode though, I want to talk to you about being proximate, why it's difficult, and what my request is to you. I heard about the idea of being proximate from Bryan Stevenson. He's the founder and executive director of Equal Justice Initiative. He says that, if you're willing to get closer to people who are suffering, you will find the power to change the world. Wow. The ideas that being proximate and helps us understand the complex and nuanced experiences of those who are marginalized, and excluded from society. It helps us empathize with their pain and struggles. That makes sense, right? And the other important point about it is that proximity enables us to challenge the narratives that sustain injustice, such as the politics of fear and anger. And there's a lot of politics of fear and anger when talking about undocumented immigrants and refugees. Proximity inspires us to stay hopeful and to do things that are uncomfortable, but necessary to create change, because we feel interconnected with somebody else. Ultimately, proximity with others can bring us closer to the margins of the society, so that, as Father Gregory Boyle teaches us, the margins can be erased. Being proximate is an important concept when doing any work, but especially equity or culturally safe care. The truth is, though, it's hard to be proximate. There exists inherent gaps between us and the communities that have historically been exploited. The very ones we talked about on this podcast. These gaps emerge from systemic disparities, unequal access to health care, and obviously socio-economic inequalities. They stop us from truly grasping other people's experiences. And my goal with this podcast is to close that gap, at least a little bit by talking to the people most affected. When I do that, though, I encounter language and communication styles that differ from the dominant culture. When doing the Latina series. I heard from so many folks about the impact of accents. If people have accents in the Latin community, to express to me how quickly people disregard or challenge their expertise and knowledge. You'll hear from Dr. Ponce today who has an accent as well. As a host and editor of this podcast, I take it upon myself to enhance clarity in our conversation through editing, ensuring the key messages are effectively conveyed to you, but also want to challenge you to play your part. It's essential that we actively work to counteract any bias, including language or accent bias. I want you to establish an environment in your workplace where every voice is heard and respected. It demands patience, open-mindedness and a willingness to listen for genuine understanding. Dr. Ponce has a lot of important points to make today. She sheds light on the unique challenges faced by Latina workers whose labor often goes unrecognized and whose health needs are often neglected. It's a call to action, a reminder of our shared responsibility to advocate for change and ensure that health care is accessible to all, regardless of immigration status. Thanks for listening. Here's Dr. Ponce. Dr. Gonzales, welcome to the show.

5:37

Dr. Ponce: Thank you. Thank you for inviting me. I am honored.

5:39

Raj Sundar:  Yeah. And should we call your doctor Gonzales or Dr. Ponce Gonzalez? What do you prefer?

5:45

Dr. Ponce: I heard that question. First, I wanted to thank you, because you're asked me. When I was in the hospital, my colleagues there, Dr. Rodriguez, Dr. Solis, but, Ileana Wesleyan. And then, this is why it's important for Latina to get an education. Because not many women can get an education in our country of origin. And this is why we say Doctor Ponce-Gonzalez will be the right word. Because in Latine, Ponce come from the father and Gonzalez come from my mother. Back the majority of Latine people that know me, they call me Dr. Ponce and that is okay.

6:26

Raj Sundar: Okay. Dr. Ponce, thank you. Let's start with your story. Because I know you were born in Nicaragua. And part of this series that I like to clarify with folks is how complex the Latine identity is. And the community itself is very diverse. And part of you holds the Latine, Latina identity but part of you holds that Central American slash Nicaragua and identity. So tell me your story of how you ended up here in the US.

6:55

Dr: Ponce: Most of the people that are coming  came from Mexico. Some people didn't honor us as Mexicans. But no honor of being a Mexican is okay. In fact, the population of refugees from Colombia, Nicaragua, and Venezuela are increasing. So the conflict that we have, I come to this country and they ask us what my country is. We have a war for Sandinistas and contrast, when America was involved, and then was very tense. We have a very bad memory. I was a student of medicine at the time. Many of the physician have to migrate to America. And then as a student, we play a very important role in ffamily health . Because we have to educate the new generation. We have no physician. And then we still have trolling and Nicaragua.

7:48

Raj Sundar: Daniel Ortega?

7:50

Dr Ponce: Yes, certainly. We coming as a refugee but when you came to this country refugees are ready perhaps. Most of us have an education in our country. I was a physician on Sunday at the  University of Chile. When I come to USA all of my family came here as refugees handling, we were separated for seven years. Can you imagine all this suffering are very tough? I felt culture shocked because my family was living in a room with five people. My parents had very poor health. And my brother was working two to three times. And that was not the time for me to react into this and I was depressed for two years crying in a room. And I didn't want to see the sun and those were my worst years. My mother and brother come inside and told me "you know you are a physician. Why are you like that?" I said "I don't want to come here. And I don't like this country. I don't like the weather. I can make nothing.". I was in a shock. I left my passion in Nicaragua but I shouldn't be guilty. And one day they told me to wake up. And I remember when they have open-housing at John Hopkins University. I'm still learning English every day. And I went to John Hopkins University there was an open house and I showed my document and everything. And they asked me what you wanted to study. I said I wanted to study family health. And she said "Why do you want to study family health"? I said because family health give me the perspective to do research and I don't know how to do research. And also I wanted to bless the community to know patient and you I miss my practice in Nicaragua and I did not come here to see rich people. Luckily America was something for rich people.

9:41

Raj Sundar: Thank you. There's so many things I want to follow up on. I want to first talk about your story. One point that stuck out to me was when you came to the US and felt depressed, and then you had to figure out what is the next step for you? I could hear this drive that was awakened in you when he saw the injustice of wanting to help create a better community. When you are going through depression, did you interact with anybody about your health? What could have been different for you to feel like you could have approached somebody to talk about your mental health?

10:19

Dr. Ponce: Yes, that is an exterior inside of me, my trauma. And people with trauma are can have difficulty to live in order. This is why many people have addiction to drugs. Because the way they are feeling is so terrifying and you don't see hope. I totally knew we were living in one room with five people. When we come in from Nicaragua, we have everyone in the room. I was a physician. I have my clinic. I work for different illness.  I see my family, my daddy comes in diabetes. For children, they can access help but always in English.  Then when he got to ask for help, he didn't have a translator. He didn't know the word translator. They don't help him there. And then although I was very depressed, it was happening in my family. And I say I need to work hard. I need to do something for them. I really need to. They seem to see my family, the poverty, the lack of knowledge for the lack of resources in this country that is so rich. Because the chop when you come in here is very sad for you because you are never welcome. I don't want to do a comparison but what I wanted to tell you for the refugee, is how is to come here. Or imagine this coconut in a coconut tree in Latine America. We might call  from other B. I'm very happy. And then I was pull out and I'm planting in Washington DC. And yes, a snow in December and the coconut I notice didn't have the root.s The coconut wasn't there. I lost my identity. I was here in America I didn't have help because the system will see me like nobody. I was a physician and have a tremendous experience. Hi, the leader is sick the children a day. I didn't know English. I cannot communicate with people. I didn't have a car. We didn't have public transportation where we live. And that was Oh my god. And this is why we need community health workers in our community. Health workers in my community, my mom couldn't say anything to the community health workers. My daughter is extremely depressed. What can I do? Because for my family, either I am a physician, they said you cannot be depressed. Because depression is for patients. And you are a doctor, you should  know how they feel.

13:06

Raj Sundar:  Yeah, that makes so much sense. So there's a point here of where the immigration process doesn't support the people who come here, training resources, all of that. So you're left on your own. And then once you need health, health care is not accessible because there's such a big gap. And I love this idea of community health workers, which we'll come back to because people know about it. But I want to hear you because that's what you're working on. The other point that I want to touch on what you were saying was faith in God. And I don't think we talk about that aspect enough in healthcare or health. Because in that moment of depression, you are looking for hope. And something that will get you through that into something that's bigger than you something helping the community. And then the last point is about this hierarchy of power, that people respect doctors and will do anything they tell them. And we have to take that seriously because there's a thing that happens there where people always say they're doing what you're telling them to but they're not actually because they don't want to question you. Yeah, I'm of course taking the medicine every day. And I'm taking everything that you're telling me to and my diabetes isn't controlled. I don't know why.

14:20

Dr. Ponce: You had a very good point of self-management because sometimes it is not what the patient says. And we were trying to look at the patient from the beginning they come to us but they also looked at you before you come into them. For example, you come in with your attitude. You look so tired and then you looked into their eyes and you say "Hello". And say tell me what you have. And what time did you arrive in the computer. Because Sorry, I was one hour waiting for you. And when you come in, didn't look at me. You don't know what I have. And the Lord called you. Why did you come here? So some people know nothing. Because if they haven't admitted they have problem. I went with my daddy to the doctor, and I told them that he have blood in the urine. He doesn't remember he said, "Ah". But the person that asked you,  what did you tell him? Headache? When the physician came and ask whether you have a headache or low blood pressure? Or do you think you're feeling anything? Okay, we are going to create a dosage. Thank you.  Or maybe you have been waiting three months to get the appointment. This is why we are in the place to talk with a person. And this is not because you are white and black or Latino. They do it with everybody. But if they know you are Latino, its even worst because this is a universal understanding.

15:54

Raj Sundar: How you suddenly go here about this idea of treat to target protocol, especially with hypertension or blood pressure, while we need to do is increase the medications enough, add enough medications and we'll get a blood pressure goal. And we're that's what we're doing when the patient is here to feel like they're feeling cared for the doctor cares that they waited so long. And they want you to be a little more patient. Even if they said headache first say is that all? Are we talking about a headache? Or is there something else? That relationship component is so important for every single human being and healthcare doesn't surprise and allow enough space for clinicians do that? Yes, but also for different cultures where we're not so let's get to business right away. Right? This idea of, hey, I want you to ask me about how I'm doing how my family is. Because that's important to me. And that's how I know we care about each other people have official lingo about that. They call it context cultures where we're mostly focusing on the relationship, not the problem. But focusing on the relationship will help us deal with the problem better. But I think here sometimes we're so problem oriented, we want to get to the business, right? I'm going to ask you how you are, but I don't really care what you say, because we're gonna get to the high blood pressure.

17:13

Dr. Ponce: You say, Oh, he's having headache and immediately or whatever telling them one word, why don't you come in to break Tuesday night, you are only one thing and then ultimately, I have to hear my Wow, he before because you'll be following up to see this special will be a community health worker talking. Because community health worker will say "Hello. How are you?" And they gather more information because the patient identify with more problem.  And then, up to this point with the community is part of the team. We have people say, Oh, no, this is something that I normally do that really nobody has time, maybe as a doctor you want it to do, but you don't have to turn.

17:54

Raj Sundar: Yeah. And I think we focus too much on doctors and clinicians, as you said, they don't need to be the one who's spending a lot of time community health workers can also be that person takes time, who builds relationships, who helps people understand, because this other day, a patient told me because I was increasing the blood pressure medication. And he said, for you, I'm just like a chicken. I'm just in a farm. You just keep feeding me things just like I'm an animal. Nobody has told me why I have this way I need to do you just keep giving me more and more is that all I am to you? And I said, Well, yeah, I can totally understand how you feel that way.

18:31

Dr. Ponce: And this is a reflection and I love it that you as a good doctor recommend that. And then you say how we can improve and it's true, because you're part of the system. You are back on the system because the system like that is not ours.  You're starting to think: How can I be better? This is the country and they have a bad habit, especially Latinx. We are dying of high blood pressure. We are dying of diabetes. We are dying of obesity. There is something wrong with the system. And we have documented and undocumented. And I need to talk about that because my organization is working with undocumented. Okay, that's not popular. They are calling us alien. Man we are "July 4", They are calling us illegal in human rights say everybody has the right to have a state to live in any way that they can leave. When God gives the war they give in to humanity. When people say Latina come back to your country. They always told me that I am a white person that came in from Europe and don't understand.

19:44

Raj Sundar: Yeah.

19:45

Dr. Ponce: Because all the white came from Europe. The intention of the people that own this land. I never hear an indigenous tell me to go back to your country. But I say the system point of view, document and document. Doctor, you know that this study of rich for undocumented people they are in  training, they are in the factories, they are in the agricultural industry. They pay taxes 400 million and taxes were collected. And this year, who is given that? The undocumented and the people that receive benefits from the government have Social Security. Here if they had children. The children have  documents and are documented. But children was brought here. You're denied a full US citizen but her mother died early? Because she didn't have a screening from cancer or a mammogram. And then because she's undocumented. And the mother has three jobs. She's working at 10 to 12 for picking iPad, then she goes cleaning. Chang is in the back. Okay. Okay. That is that. Today, the government HERSA give, 3.3 million for training community health workers. And somebody sent that to me, and I said, What is this? When I saw that the requirement for community health worker should be a US citizen. You know, how it's shaming. We are in 2023 and you are going to deny education to the community that needs the most because they don't have documents. You are denying the community health workers to educate parents. The children had better health outcomes and better pleasure. The Latin family here is dying. The children, they were two children who died ecause of fentanyl in our rural area, they are Latina. The children, don't have access to health, because the mother didn't have access to health. They get this trauma they inherited the trauma that we carry from coming from duty. And then who are in the gym, with the children need to go to war because they cannot continue to pay because they do calculus only for US citizen. Okay? Then they go to jail because they stole something.  Because they are young, they don't stay there. And then, they can come outside and put again in the jail. This is what is happening here. And all of us don't do anything. And try not to listen, not to hear. And to stop, we have to fight the problem. And then planting the seed for my community, a man in the sea to turn in your house right to ask for education, you will have to ask for help. Especially  you are here working for a year. Do you know what they do doctor? They come back to Mexico to die of cancer and HIV and everything. When they normally don't get sick. They have a broken bodies. When you have the children Hanson Tony, because the oxycodone were the only solution for them because the pain, the chronic pain, or pick tag of being in this position. Or they  are women that have 30 40 years and they look like 60  because of what are they doing? And the sound and the call of this.

23:42

Raj Sundar: Sense of injustice at so many levels. Including how much they're working, paying taxes and still don't get better education. How people I think, have this incorrect view that they're not "contributing to society" when they are the reason a lot of things run and core part of how we get food. Let's focus on farm workers because we haven't talked about that enough. Tell me more about farm workers because he also mentioned the Mizo American indigenous populations. Because people have this view of people coming in to do farm work. And I want to understand that a little better. When we talk about farm workers tell me the process of how they're recruited, what their current condition is receiving care living and what it means to support them.

24:32

Dr. Ponce: We need to support anybody that is at the disadvantage. And I don't say that because I am Catholic. I say and I believe we need to love people like you that wanted to find the difference. Because I believe, they are many people and we need to be unified. Farm workers have been here for a very long time, like in the 60's. Farmers who came with visa is not above 10%.  Coming back to their point. They are seasonal farm workers. Seasonal farm workers stayed here and in the seashore and then they get all kinds of jobs. When we don't have an option, for example in the winter, farm workers can be working as cleaners and market, and simulator. And they are part of the minority that are migrants. They came through North Carolina, to Washington to Oregon to California, and they still do that all year. And now I say refugee beause nobody is saying  refugee migrant. They came because there is a lot of need for farm workers. And these are jobs that are easy for people looking for asylum when they are in the transition to get a status or refugee to work and get a morning to eat. Because they don't require you see to be seen by other people. They don't know exactly who are legal and who are not. But they also receive funding from them. They will never be deported, including the former President, he sorted the documents. Then is it horrible and brutal how they use some people. They know where they are, where they live and that they need passes. But they are in poverty and they are thinking how will they get so rich. Because they have a three people working in justice. Now the same, for example, they use prostitutes and they criminalized people to keep their power. They are the criminal, because they are the ones that keep people to work with no insurance, with no help. This is why they are rich. And the system is like that. We need to little by little try to change the system. For example, some people say they want to offer training for communities with US citizens only. I want to know why she's doing that and what who is she going to serve because the community health workers are mostly undocumented. Yeah, I don't know why it is like that.

27:25

Raj Sundar: I agree. there's just so much to talk about here.

27:27

Dr. Ponce: I didn't focus on the indigenous so much because they don't speak Spanish. They speak different languages. They have more than this to be humiliated. And we're talking about what disparity but I wanted to take you to what is really  happening in the scene. Latinos are sometimes the supervisor or the owner sometimes, right? There is a migrant woman who cannot say anything and should not speak up.  And then they don't have to seen by people but I want to share this This is a violation and rapist and this woman is undocumented. They live in domestic violence. Imagine, you can see the man that used you and you can't do anything. They are drinking on weekends they go to drinking and who can leave this state when they get 50 dollars per week. Please. Yeah, I think that they are my children and they are children culture shocked.  And this is some of the reason why this person has high or low blood pressure or they have headaches.  Maybe because in the day he or she is only eating junk food with a lot of salt. We are people living with challenges. And we come here in a society that is very traumatic and has many criminals. We are not criminals. If you give them a chance to these people they will become our future. If you give them the opportunity to be educated, it will not only benefit them but also the community.

29:08

Raj Sundar: That's good. Thank you. So I think, the construction workers and similar anything else to add for that?

29:13

Dr. Ponce: With the construction workers, this is like all the Latinx with space in the same barrier who lack of knowledge of the system. They are another resource of the community. I have 51 families, a migrant, and a refugee that has been experiencing or having depression from problems or pregnancy. And they don't know all the resources because whether they have depression or not, they are not getting medication. Somehow, depression can be temporary. But what we need is a support group for mothers, may it be single mothers or not, and those who are alone.  or alone or They didn't do anything else and it's not good. You don't read that, because it's fun to put in tanura.  The children of construction workers, its same scenario, they are from the Latine family. They may be living in a house with five single people and the only thing that is good is that they have a better salary. A construction worker's salary per hour can be 40 dollars. But it's a very heavy job. And some people ended up thinking that they will not come back. Okay. But they have the same issues, he has a problem because he didn't tell the Washington employment that they have those employees. Because the system allowed that. And the system is created for the people who have power to keep their power.

30:48

Raj Sundar: Thank you, Dr. Ponce. I have a few more questions if you still have time. The community health workers, I want to dig deeper into what your model is, and how you find the right people. What does it mean to provide them education, and how that helps connect with the community workers? We've touched on so many things of relevance to community health workers in ways healthcare systems that clinicians fall short. So I want people to be really paying attention and paint this picture of what community health workers look like and make that vivid for them.

31:21

Dr. Ponce: Yes, the community health worker, I said we pay education for family health. You are not earning today and you are losing money. And they say why are you losing money. Because community health workers are very useful, more than you can imagine. I wanted to start with depression, I investigated on the USA and the state on what resources I have for depression. Because I have severe depression. For women in these days, there are migrants and refugee and undocumented and they had nowhere to work with this population. There were many models, one of them young and English, running for white people. This is a problem. I try to make a connection with a solid game, and funny they have the power, they have the money, and millions. And they asked me about the organization and they said they wanted to work with me and I explained my work. They took my money and it's okay, but they don't want you to pay for some volunteer. Because I don’t need volunteer. Because if you can do a job, you can get money. Okay, you're rich, you can volunteer your army, we can volunteer, I don't want to say for working the $150 for week volunteer because this is inhumane. But my mother coming out of junto working together and you sent different model or the community health worker, they're like seven model community here. My approach is three squared, okay, the population there are very group. This is them more than and this can be a bridge between you and the health services and the community. And the last model, they say care coordinator, I say Community Coordinator. They call the community to have Deniro as a person dedicated to find and look for   all the learning resources that our community have. But the people doesn't know the system, as you said for the documented and undocumented. And then this is the person that is going to call these people that is depressed. When you are depressed, you don't want to pay the charge, you really want to make a phone call. And somebody will answer with anger either they say that number you are calling is not correct or they say they don't understand or they whine if you say anything. The perfect community health worker is not a US citizen. Then you work with a population that is undocumented. The perfect community health worker must be undocumented because a person that work here, isn't a Latina that speak the second generation. They don't know nothing about the first generation to say I understand you and wanted to talk with diabetes patients. They say they can understand to struggle of having a diabetes because they have some experiences. For example, all the people in the community come to the community health center are all living with pain and depression. They went to the community and you think you can train them? No you have to educate them in the language that they can understand. They went to consult with physicians, oncology, psychology, clinician, and healthcare. Community health worker are giving quality education. When I said this, my father said, Well, this is too much for them. They are not going to be okay. No, they're not stupid. I say. Yeah, I said, let their brain work. You need to know what's wrong with me. When we don't give the this workshop, the mother said, Oh, now we understand why I hate my child. I always get very sad because I believe I was a part Mama. No. You have this feeling because your child is precious and you love your child. I have no worship in my community have worked on this project. They have been taking many courses for peer counseling, how to manage a group, how to have a conversation, how to deal with people that are living with trauma for counseling. Learn about confidentiality, about a meaningful conversation and all of that. And then they meet together, and they speak together. And then they start looking for resources. And we have this beautiful little community coordinator. For example, sometimes you are depress because the mother is alone and his father is working. She's not working but she's pregnant, and they don't have food and they feel humiliated to go to the food pantry. Then we will go with them and will make the appointment and be sure that nothing will happen. They don't want to go to the federal funding file center. Because they don't have to pay. But if they have programs that can be given to them, then we tall them to make the appointment. Then we will check if they made the appointment and they will say “No because when I called, they said they don’t understand me.”. and I said “I can make the appointment for you. I will help you.”.

36:55

Raj Sundar: So many things are heard from you. One is the education, making sure that is appropriate, and not diminishing people's intelligence being thorough in that. Second is identity. Identity, not just oh, they're Latino, so they can treat their community, right, meaning they have similar experiences. They have similar cultural backgrounds that sometimes they even have had depression to that levels. So there's peer support and understanding what somebody's going through there. And at third is the community coordination to help people understand the resources that are available to them. Honestly, it's like intensive case management to on by community health workers. Yeah. So they care when I think we don't prioritize that enough. I think when healthcare does, quote, unquote, support, we just give them a list of places to call, oh, you have depression, here's a list of 10 places that you can go to go ahead. Good luck. And we don't make that call. We don't try to troubleshoot. And that's hard when something especially like depression, when your motivation levels already low and suffering in so many ways.

38:02

Dr.Ponce: Or the same thing. You have a BDS  and the same thing you have to use your system. Do you need a hand on the petition? I tell you, the future of health is community health workers. And you demonstrated it during the covid-19.  When the government and the workers are not working together with the community, we couldn't control the spread.  All the Latino were dying.  

38:26

Raj Sundar: Yeah, exactly.

38:28

Dr. Ponce: Then, they tell them they are undocumented and criminal. Then I said that because they care for the one making money. We don't want anything free. And I will tell a lot of people that will pay because health is the most important thing that a human needs. But I want to tell you that keeping the population marginal and uneducated is going to affect you and your children.

38:58

Raj Sundar: I think our humanity, we're all interconnected, and our futures bound together, it will be separate each other and don't give resources or education as you note to a certain group of people. And that affects all of us. I end the podcasts with the same question for everybody is, tell me about an experience when you got care where it went really well. Somebody treated you exactly how you wanted to be treated, acknowledge your identity, or tell me about a time that went really badly. And you want to say don't do this to the people listening.

39:33

Dr. Ponce: This is what happened to me, my depression is becoming chronic depression and became the skeleton in my closet. Most of the time I couldn't become honest.  Mosty of the time I cry  for everything. Dr. Jacobson who is my primary physician, and she's spending two hours when we needed it especially when she do the PHQ. Because most of the physician, I fake those response. Because I  want it to ignore it that I don't have depression. This is the problem, right? Either that dominates. I say, I get a nice Zombie. And she's spending with me two hours a day.  And my husband wanted one other physician. He wanted me to be treated because he knew I need that. And I said, I want to do it for you because she's spending two hours with me. And she gave me the two medications, one for depression and one for sleeping. With that, I am managing depression very well. We have it for all ages. Then one mother and this mommy started getting treatment when a doctor explained to her and it made her feel important. She listened to me. She was trying to convince me and I never enjoyed living we had depression. Because of this person, Dr. Jacobson, thank you. The other person have treatment but was not coming to America. I went to a doctor. That was for a gynecologist. They put me in the technical chair for approximately two hours. And then came and put a heat map in my hand and in my stomach. I almost die. And he never answered me and so I never came back. I was feeling humiliated and mistreated. I don't know what to do.

41:32

Raj Sundar: Who wouldn’t?

41:32

Dr. Ponce: And there were many women in that position for two hours. Because he was so unwell with all the patients. One of my worries is to stay with the gynecologist for almost two hours.

41:47

Raj Sundar: Yeah. I want to call attention to the importance of that one person who took time to care enough for you ciphering with lifetime depression in that has given you the stability that you need him and that person tell you enough. And the second. I hope nobody ever does that. But he did that to so many patients probably right this person. And it stuck with you how many years later he said when you came to America and it's within you and it's a form of trauma, of being violated of having this experience with healthcare. And we always ask Why don't people trust us? Why don't people trust healthcare systems? You're like, well, there are so many reasons, including moments like this, that maybe wasn't a big deal to that person who did it. Thank you so much, Dr. Ponce.

42:30

Dr. Ponce: My pleasure that I get to share my history and it can help many people. Then you had your problem. Problem can be solved through education.  okay?

42:42

Raj Sundar: We need to hear the truth.

42:45

Dr. Ponce: Thinking and leaning in a positive way.

42:49

Raj Sundar: Thanks again everyone for joining me on another episode of Healthcare for Humans. If you liked this episode, as always, may I ask you to  please share it with one other person, so they can also hear it. I'll see you next time.

43:04

Speaker 3: This podcast is intended for educational and entertainment purposes only. Views and opinions expressed in this podcast do not represent any of the participants past, current or future employers unless explicitly expressed so. Always seek advice of your physician or other qualified healthcare provider with regards to your own personal questions about what medical conditions you may be experiencing. This Healthcare for Humans project is based on Duwamish land that makes a regular commitment to Real Rental Duwamish.

The transcript ends here.