A Collaboration in Education: A Doctoral Candidate and His Mentor, Lester J. Kern and Reuben Jonathan Miller
In this episode, Associate Professor Reuben Jonathan Miller talks with Doctoral Candidate Lester J. Kern about the Crown Family School’s Doctoral Program. They also discuss Lester’s research and his experiences in completing his dissertation which focuses on alternatives to arrest and incarceration for people experiencing mental health crises, and in particular, emergency psychiatric care. They also talk about their collaboration as mentor and mentee. Learn more about our Doctoral (or Master's) programs.
We'd like to thank Augusta Read Thomas, University Professor of Composition in the Department of Music and the College, who composed the music.
“I think the Crown Family School should maybe seriously consider changing their tag line to “dope people asking dope questions.”
-- Lester J. Kern
Announcer: Welcome to the UChicago Crown Family School Podcast. In this episode, Associate Professor Reuben Jonathan Miller talks with Doctoral Candidate Lester J. Kern about the Crown Family School’s Doctoral Program. They also discuss Lester’s research, his experiences in completing his dissertation, and their collaboration as mentor and mentee.
Miller: Hello. My name is Reuben Jonathan Miller. I’m an associate professor at the Crown Family School of Social Work, Policy and Practice and a research professor at the American Bar Foundation. I’m also faculty in the Department of Race, Diaspora and Indigeneity, so…so my research focuses on punishment and social welfare broadly. I’ve been very interested in how people experience institutions of punishment and care, and I’ve been following people, largely ethnographically, but most recently historically, trying to understand really what life looks like in the shadows of the institutions that we build.
Kern: Hi. My name is Lester J. Kern, and I’m a doctoral candidate at the Crown Family School of Social Work, Policy and Practice as well. My research focuses on alternatives to arrest and incarceration for people experiencing mental health crises, and in particular emergency psychiatric care. My most recent research has looked at how people working at emergency psychiatric hospital navigate their roles and do their jobs amidst organizational change and closure.
Miller: So, we’re here to talk about the doctoral program and about really Lester’s fascinating research, and…and I’ll chime in and talk a bit about my own work and our relationship, how we’ve come to know each other and, what it means to be in a place like the Crown Family School. So perhaps I’ll say something about the doctoral program, which is, of course one of the top programs in the country. Rankings matter in interesting ways. I mean, but what I think makes our program unique and interesting and important is its interdisciplinarity and our commitment to interdisciplinarity, and so that’s reflected both in the faculty and the students that we bring in, the faculty from all across the social sciences.
We’ve had people who are…on faculty who are, you know, really interested in the humanities, who are writers and artists. We’ve had political scientists. We have economists, sociologists, anthropologists, folks in urban studies, folks in geography, you know, and of course social work. we are a social work school. And what we try to do is we try to really focus on the relationship between social theory, and social scientific theory, be that psychology, sociology, whatever the theory is, and applied social research, because we’re very interested in understanding problems in really profound ways, you know, getting inside a thing, lifting the hood, getting under it, understanding how the thing works so that we can craft timely solutions.
And I think that that kind of approach is more necessary than ever, given the kinds of problems that we face. And I’m sure folks who live in every generation will say the same thing, but, right now there’s a crisis of mass incarceration, there’s a public health crisis we’re in the middle still. We’re on the tail end, hopefully, of a… pandemic.
The rights of human rights are on trial all across the country, be that restrictions on what can be taught, or what kinds of things can be said, whether that’s critical race theory, or whether that’s someone talking about the relationship between Israel and Palestine, or whether that’s relationships between Black and white people, or indigenous folks, or transgender folks, or folks who identify as lesbian or gay or questioning.
So…so…so all these things are…are…are swirling around us, there are new culture wars happening. Social welfare policy has transformed in…in…in powerful ways. The way we administer care has changed in powerful ways. And…and our school is really at the forefront trying to understand what that means so that we can…we can…we can make the world a little bit better from our place, from our place in it. And Lester, I wondered if you could…if you’d be interested in talking a bit about how or why you came to the program, and… your work and interests.
Kern: Of course. So, I mean, maybe to back up a little bit. So, I’m not completely unfamiliar with Chicago. I’m from Milwaukee, which is an hour and 45 minutes north of where I’m currently sitting right now, so Chicago was always a place that was, you know, just as a city, in the background of my consciousness. I didn’t really spend a lot of time in Chicago, unfortunately, as a…as a young person growing up, but it was often the place that we drove through, right, when we were going somewhere else, and I was like, look at this huge city, there’s probably lots of interesting things happening here.
After I finished, or I was wrapping up my master’s program at Wayne State University in Detroit, I was thinking of where to go for my PhD, and I had lots of different potential options, and I had lots of different people, in my ear giving me suggestions on you should go here, I know somebody here, I know people here, and this program gives good funding, and all that type of stuff. And trying to sift through that ultimately led me to the University of Chicago.
And it appeals to me…it appeals to me for some reasons that were really apparent then, but it continues to appeal for me for ways that I just couldn’t foresee, right, when I was, you know, a master’s MSW student applying. But some of the things that appealed to me was the ability to do social science research in a city as well…well studied and well resourced, in some ways, as Chicago.
A city that illuminates both the possibilities of human potential, when people get lots of funding and opportunities, but also highlights the stark disparities that we see in large cities across the nation. And so that part was particularly interesting. I’m looking at, what is this university and department doing that’s just kind of nestled somewhere in the South Side, like how are they responding to their local context, how are they continuing to cultivate scholarship that informs both their local context and then beyond.
Oddly enough, when I was thinking of places to go, University of Chicago was a little bit further down on my list just because I knew a little bit less about it, and I didn’t know any of the faculty there at the time. But once I came to realize I was actually coming and applying to schools at a time in which, in our department, we had a bunch of young, energetic faculty who were doing, you know, criminal legal and criminal justice focused research, then I was like oh my god, this is the place I have to be, right?
I had…I didn’t know at the time that Reuben was coming, but at the time Matt Epperson, Yanilda Gonzalez, there were a bunch of people here at the time that were doing stuff that seemed just so very interesting to my, at the time, more eclectic taste. I’m still eclectic, but, you know, I was a little more unfocused then. And so that part was really appealing, right? I had a lot of people doing kind of criminal legal stuff, and I felt like I could be supported as I developed my own academic interests as an emerging scholar, so to speak.
Once I got here, it became more appealing for some other reasons. The flexibility that we have in developing and kind of designing our own curriculum, and then the freedom and the creativity that that affords somebody as they’re building their own kind of educational experience I think was much more impactful than I think I knew going in, but became super appealing once I was here.
We have one, required class in our doc program, which is the history of social welfare. But outside of that you’re kind of given some guidelines around, these many methods courses, maybe these many substantive courses, but you’re able to kind of pick, and as long as you can kind of justify hey, this makes sense about how I’m thinking about my…my research and my concepts. And so that was a really appealing thing when I realized I was able to take classes in the history department, I was able to take classes in the geography department, I was able to take classes in the sociology department, all building towards kind of my educational bearing?
And that was also reflected in the faculty when I’m looking at, we’ve got social workers, we’ve got sociologists, like we mentioned, we’ve got anthropologists, public policy scholars. We’re right down the street from the law school and the public policy school and we often, have faculty that are kind of cross-listed across sections. And so, this interdisciplinary nature, both reflected in the makeup of the faculty there, but then also just generally in my ability to create an educational experience that encompassed a lot of these different perspectives, was really appealing coming in, but has become more appealing over time.
Miller: Let’s talk about your work for a second. So, when you came in you were one of few people whose interests stuck, I feel like.
Miller: You know, you came in interested in mental health responses. And so…and so can we…can we talk about that? Like how’d your work develop? Can we talk about the kinds of things you’ve been able to work on and what…what that’s been like for you?
Kern: Yeah, sure. Some of this is owing to—and I’ll get into this later,—some of this is owing to the…the change in the educational kind of space that I was in moving from one university to another, and how each of them have their different cultures, and the scholarship that that breeds. Also, some of this is just me growing as an individual, going from a master’s student to a doctoral student, but in my master’s program, I did a thesis where I was doing ride-alongs with officers who were trained in crisis intervention, the crisis intervention team model.
The long and short of it, for those who are uninitiated, it’s a popular crisis response model that lots of law enforcement agencies around the nation, and abroad, use basically to form collaborations or collaborative partnerships between law enforcement agencies and healthcare institutes, and perhaps the most recognizable component is to train law enforcement officers on how to better recognize the symptoms of a mental health crisis, know common medications, and be more cognizant of the resources in their local community so that they can divert somebody, right, to a social service or a mental health resource instead of what we often know happens, right, just neglectful type of policing, right, or maybe even worse, right, this kind of like we’re gonna book you into the jail because there are no beds at the shelter, we’re gonna book you into the jail because we don’t know what else to do and this is what we’re trained for, right?
So, I did a thesis focused on that where I was following officers who were trained in that and officers who weren’t trained in that in Michigan. It was a really particularly interesting experience, where I got to not only ride along with officers on a daily basis, right, but I also got to see the different kind of organizational partners that they work with. I got to see why somebody would be taken to the private hospital, the well-resourced private hospital, and why somebody kind of had to go to the public kind of, you know, clinic, so to speak.
Miller: You can’t move on past that. So, what…what was it, like what were the indicators? What were the tells about who would go where, about the sorting that was happening?
Kern: Yeah, there…there was a lot of things that went into that. One of the most maybe unsurprising factors that went into that was socioeconomic status, by proxy insurance? Who has the private insurance that allows them to have options, right, and who doesn’t, and is forced to kind of accept whatever the officers decide to…to give them that day.
There were other, some other things that kind of like affected that sorting—officers’ personal preference, or past experiences with certain places. If the officer had to wait five hours when they went to one hospital or one clinic, and they got in and out within 30 minutes at another one, they were more likely to go to that one, regardless of whatever type of care that might have provided.
Miller: Like not [comparative] based on care—
Kern: Not comparative based on care sometimes. Sometimes it was fortuitous and worked out that the place that was most convenient was the best place for that person, but that’s not necessarily, the thing that was at the forefront of the mind, right? Sometimes the place that was closest, right? Somebody didn’t want to drive 30 minutes to go somewhere further, and having somebody kind of in their constitutional care at the time, they wanted to drive to the place five minutes away.
Miller: How did race matter? Did race matter? Did race play—
Kern: Well, you know, where I was in in Michigan was a largely Black and brown space—
Miller: Yeah, yeah.
Kern: So, you can imagine race mattered in really interesting and unfortunately familiar ways, right? The place that I was at was not this utopia that had transcended race, transcended, you know, classism, transcended ableism, transcended patriarchy, right? We still saw many of the same patterns, where lots of the Black folks who were with, like interacted with by the police were more likely to be arrested.
But we also saw, in some surprising ways, that sometimes plenty of people who were not the…the…the demographics that you would expect were still treated in a certain way by law enforcement in ways that at least I find kind of unsettling. So, this is a, this is my long superhero origin story, so to speak, or like the…the mid…the midway of the origin story. But so, I did that thesis, and I was really struck by some of the things that I was learning there, particularly like this 24-hour specialized crisis facility that officers often took people to.
It was a peer run or peer staffed kind of—or partially peer staffed facility that had a psychiatrist there and also had peer support, where they could try to stabilize somebody who was having a crisis, maybe get them hooked up on some medication, and give them referrals to other places. And, you know, if nothing else, right, we were in Michigan, and at the time I was doing this research was December and January, it offered a warm place to be, which, you know, don’t underestimate the importance of that.
But when I started thinking about what to do for my own dissertation, I wanted to look a little bit more inward for a location that I had some experience with, and I looked a little bit north of Chicago to Milwaukee. I’m from Milwaukee. I felt a little bit more comfortable with some of the dynamics. But I took my understanding of these organizational dynamics that I developed in my master’s program and thought how can I apply this knowledge to my dissertation, how can I apply it to Milwaukee.
Luckily enough, Milwaukee also had kind of an analogue to that 24/7 crisis facility that I mentioned in Michigan in Milwaukee called Psychiatric Crisis Services, a county run psychiatric emergency department where something like 70% of its population came from just six high poverty and predominantly Black zip codes in the inner city of Milwaukee, right? So even so it’s supposed to be a county resource, we’re still seeing some of the same kind of dynamics that push poor brown and Black folks into this county run, often underfunded resource. And so that’s…that’s…that’s kind of how I arrived at that.
The difference, though, that I think that the University of Chicago made in many different ways is prior to coming to the doc program I was doing a lot of intervention research, a lot of intervention research for funders, for county governments. And they’re not necessarily super concerned about the theory, right? The understanding of the theory of change is somewhat backgrounded. We’re not talking about how our understanding of the [ecological], approaches are affecting how we do the job and how it affects what we see.
And so that was a…that was a really refreshing and surprising thing to come to the University of Chicago about, in the Crown Family School especially, where all of my…my professors and mentors were talking about how theory informs their work in ways that I just, at the time, had not fully really considered both the importance of, but also the importance of stating clearly, right, and not just assuming that the audience, whoever that is, kind of gets what you’re trying to say about how the world works, but making those claims explicitly and directly.
Miller: Yeah, that’s powerful to me. I mean, I think about the continuities between your experiences as a master’s student and what is this kind of homecoming study, in many ways. You know, you’re in a place that’s very familiar to you, but you’re seeing patterns that you see in a state that’s similar, but very different. Michigan and Wisconsin are, you know, different states, different politics, the racial demographics of Milwaukee.
And, we could think about the major cities in…in…in…in Michigan, but Detroit is so Black. I mean, I’m not saying that you were in Detroit, but I’m saying if you were anywhere near Detroit, Detroit is so Black. Detroit is 70 something percent Black, used to be 80 something percent Black, before its so-called comeback. But anyway, [unintelligible] 00:18:18.
Miller: So…so…so, you know, Milwaukee is not 80% Black. I mean, you know, Milwaukee certainly has a large Black population, but Milwaukee’s got its own kind of the un…the industrial story, you know, its own labor story, it’s got its own…its own story about race and how race plays out, so it’s unsurprising that so few people come from so few zip codes, because Milwaukee, like Chicago, is among the most segregated, or has been among the most segregated cities in the country. It quite often is in the segregation index that come out each year.
And so, you see these similar things because you’re looking at people. You know, you’re not looking at alien life forms that are gonna operate differently somehow. You know, context matters, but we’re talking about human beings. And so, put under certain circumstances you get things, some that are surprising, some things that aren’t so much.
But what interests me most nowadays about your dissertation is the wealth of experience that you bring to bear on it. And some of that comes from you having worked on so many different kinds of projects, and some of that comes from your own just sort of intellectual development over the last, you know, say decade or so, but certainly over the last six years, and your own like moral impulse.
I’m thinking particularly about like your concern with the rights of people who are labeled mentally ill. You had a whole moment where you were exploring things like gun rights for people who are mentally ill. I’d love to hear you talk a bit about, your intellectual trajectories, and the kinds of things you’re interested in, and how those things intersect with, for example, your moral compass, and you want to make the world better. In other words, how theory and practice sort of work in your own work to try to…to try to make sense of the world, but also to do something about the things that we see.
Kern: Yeah. Man, that’s a—what a wide-ranging question.
Miller: Well, it is. It is.
Kern: I would expect—
Miller: It’s what we do.
Kern: —I would expect no less. You know, those…so, you know, I mentioned dissertation stuff, I mentioned master’s stuff, but a good chunk of my, how my thinking on how we interact with people deemed to be mentally ill, or people who have mental health diagnoses or people experiencing mental health crises has actually been informed by some of my work that I did with you, in ways that maybe I have not told you. I mean, here’s the conception, right?
Miller: Very [cool].
Kern: I worked on two different projects, two different evaluation projects with you,
Kern: I worked on one project around a youth violence prevention, and then another program around kind of gun violence prevention? And on the gun violence prevention project I was really struck by how everybody that we were talking to, they’re in the program because they’re at the highest risk of shooting or being shot? It’s the reason why we’re like, you know, take the guns out their hands, let’s get them a job, or something like that, right?
But I was struck by the fact that even though some of these folks were perhaps more likely to be pulled over, like by Chicago Police Department on any given day, than maybe they were to use…to use a gun, they still carried the gun despite the fact that they had like legal restrictions in many cases that prevented them from carrying the gun, or that they had, in some cases, mental health diagnoses that the average person might think should disqualify them, right, from being able to protect themselves, even though they’re living in an area in which, they’re experiencing higher levels of potentially being a target.
And I thought what does that mean, right? What does this mean about our…our assumptions of capacity, right, what does that mean about our assumptions of…of life and what it’s worth?
Kern: And to what extent people have the ability or have the right to try to save their own lives, right, in direct ways, when it’s a group that we’re particularly uncomfortable with. And I found lots of different kind of parallels with that when I was doing my dissertation research. You know, you have many different legal distinctions that inform our understandings of whether or not a person is supposed to be fit to take care of themselves or whether or not we assess them to be dangerous in the moment, imminently dangerous—are you threatening yourself, are you threatening harm to others, are you threatening harm to yourself.
And if so, the state tends to have ways of trying to confine and constrain your abilities to do certain things because we assume that you are not necessarily operating in a full capacity, right, that you have some type of diminished decision-making ability in that moment. There’re many different valid reasons, right, to kind of take that approach or to at least have a stance somewhat sympathetic to that, and I get that.
But one of the things that was also particularly interesting to me is that we also had, when I was at the, my research site, we had many different interesting cases came in, often brought in by law enforcement, where they were essentially saying okay, this person has this in their history, they have previously had a trip to this psychiatric hospital—okay, something’s wrong with them now, all right, it’s most likely a psychiatric issue, right? Without necessarily taking into account context, what’s currently happening?
Before any of that, before they even get to the scene they’re looking in their computer database, they’re seeing that a person has had a mental health episode, or a trip to a psychiatric facility, and making kind of value judgments about what they then deserve based on this past experience.
And so for me those kind of things are really similar because in one case you have somebody’s psychiatric history or kind of legal distinction in some ways affecting their ability, or at least what we evaluate their ability and deservingness, right, to protect their own life, at the very base level something that you would think is something that a lot of people of wide-ranging political and sociopolitical ideologies would understand hey, you at least have the right to like defend yourself from attack. Not necessarily depending on who you are, and not necessarily depending on how we feel about your identities.
And so it was a similar thing when we were talking about people coming into the emergency department because we’re having lots of conversations between, you know, disciplines that in some ways are really very different … and kind of like assume capacity of a person in very different ways.
We have nurses, we have psychiatric staff, we have psychiatrists, we have law enforcement, we have security guards. We have all these people kind of making these evaluations on somebody’s capacity and ability. And I still saw that there were still sometimes really jarring and unsettling evaluations made of a person’s capacity based on that in the disciplines that you would expect to be the nicer ones, the more benevolent ones, right?
I think sometimes we can fall into the trap of thinking that law enforcement is bad, right, and that healthcare folks are often good. But what I found is that I often saw some of our healthcare staff moving in ways that were increasingly carceral, in ways that at least were surprising to me as, you know, kind of a stranger in that space and being, inasmuch as I could, being a newcomer to that space I was surprised that, in many ways, the nurses or doctors were operating in ways that were more punitive than the police that brought the people in.
Miller: Well, that’s powerful and interesting, and it makes me think about two things. So…so the first [are] the power of social categories, the power of the, like what difference, how the construction of difference shows up in the experiences of people and also, you know, shows up in what they do, too. So, I produce someone as sick—you know, it’s like old school sociology, like sick role and all that stuff, and then people might start acting like they have this. You know, so I’m not saying that precisely, but I might produce, I might make the category mentally ill and then slot somebody into that category, and then every time the police interact with them out of so-called benevolence, they route them into this emergency room, which is always understaffed, always underfunded, always under resourced, always, always, always.
Where they are met and greeted by nurses who, through the relationship, which is supposed to be a relation of care, developed in such a way that would provide care begins to look like institutions of punishment because of the relationships that we’ve built and forged, because of, at the end of the day, the presumed need of this person to be treated in a particular kind of way. And then that shows up in them, it shows up on them, and shows up in them. It shows up in their bodies, it shows up in their…their…their reaction, it shows up in their perhaps feelings of paranoia, it shows up in their perhaps resistance in a given moment to a certain sort of medical regime or something like that.
So anyway, that, to me, is fascinating, interesting, it’s all the stuff that you’re kind of working through—
Kern: And this…and this is why I came to Crown Family School, right, having a chair who’d have that reaction to the tangent I just went on.
Miller: No, but… [Laughs.] But the second thing, man, is…is…is the power of asking really cool questions. You know, so I’m thinking about my brother Desmond Patton, who’s a professor at…at Penn. he’s the highest endowed chair at Penn. He’s also a graduate of our program, and he’s in social work, communications and psychiatry. And he was asking questions about youth resilience when he began his career, very interested in, for example, high achieving Black boys who live under the shadow of community violence.
And so, he kept asking like why is it that they succeed? How do they manage to succeed? This was a wonderful question, and these were really interesting. And then he started following folks who were getting killed, you know, and all the social media stuff happened, and he coined a term, “internet banging,” and sort of developed the whole field. There’s a field of work that Desmond has developed. He’s a, graduate of our program, and, we’re very close, and, you know, he's a good brother.
Anyway, so he’s asking like why these kids keep, like what’s happening to make the kids die like this, you know what I mean? Like why aren’t they thriving, like what’s happening? And then it occurred to him that he…that he needed to ask a different set of questions in order for him to understand what was happening. So, he’s looking at social media. So, someone will post something on social media, this will rile somebody up, and somebody will go and shoot. And then he started asking different questions. He wrote an op-ed called “Asking Different Questions.” I was asking the wrong questions, he said.
And he…and he decided to…to think about who these people were—they were children—and what it meant for children to be expressing these things on social media, and what was it, if I viewed them as children and not as, you know, sort of categories of risk or something like that. And what he found was that what the children were expressing were very normal feelings, given the context in which children live. In this case the children were expressing grief before any act of violence ever took place. And so, a dude would get on the internet, and he’d put up a bunch of emojis that I don’t understand, and he’d be like you, you know, you know, my guy got murdered trying to cope, trying to deal with this.
Miller: And so, he found grief first, then violence, and then started developing interventions, because he asked different questions, started developing interventions, started working with formerly gang involved youth, computer scientists, set up a whole team to decode the tweets to identify moments of intervention where he could marshal resources of care instead of, for example, the police, or before some violence would pop off.
I mean, this dude has literally saved lives. He’s literally saved lives by asking really good questions, is what I’m coming to. And this, to me, is the…is the power of…of a holistic education, you know what I mean? It like helps us ask the questions we need to ask in a given moment in time. So, you right now are asking incredible questions, in my mind, to my mind, about what it means to be these people traveling through this system. And I wanted to come back now and talk about this system. I mean, the place where you conducted research closed.
I mean, so you were following emergency department that’s in the middle of neoliberal decline, that’s in the middle of a spiral, right? Where funding is changing and it’s transforming. Can you talk a bit about what’s happening in the place that you were observing and what it means to be a person moving through a system like that?
Kern: Yeah. Before, I don’t want to forget, the irony, right, of Dr. Patton using tech to humanize folks.
Miller: Yeah, yeah. [Laughs.]
Kern: But I—
Miller: He’s a brilliant brother. He’s…he’s just… a brother, but a magnificent human being, and…and he’s literally saving lives because he’s asking great questions. And, you know, to me, is the warrant for the kind of work that we do, right?
Kern: Yeah. Man, so I guess to your question about, the site that I was at. So, it was closing. I was there in its kind of last six months of existence. And depending on who you talk to in that organization, the place had either been closing for a year or 40 years, right?
But some of that was super interesting—a side tangent, right—just the importance of history, right? I’m really excited—I don’t want to say overwhelmed—but just kind of…overwhelmed is the best word I can think of right now, but overwhelmed by the role to which obviously history is affecting all the things that we see now, but how taken for granted we take it when we’re doing some social science research, right?
We assume that we’re doing kind of like these lab studies where we’re in an isolated vacuum, and we can change these small bits of variables and figure out what happens on the other end, right? But when I was doing my research at this place, right, I came to realize that many of the things that I was seeing were the result of a decision that had been made ten years before I ever stepped in the door. And so that part was particularly interesting, but that’s something that I got not only from looking at documents, right, looking at archives, but also just talking to people who had been there?
And so, being at that place that was about to close was made, my understandings of what were happening were made more beneficial by talking to people who had kind of a variety of perspectives, but particularly people who had kind of like this longer institutional memory, right? When I’m asking questions about why do you all have these copiers, why does this thing not work, or why do X people do this thing instead of the other people, when to me that makes it seem like it would make more sense, right, as opposed to somebody who just got there three weeks ago and was like I don't know?
In some ways that was also really valuable because they’re also in the same position that I’m in, still working, not really understanding why things are the way they are, but in some ways it was really valuable talking to somebody who could say oh yeah, man, 15 years ago we used to be able to do that, but then the union got busted up because So-and-so got elected, and then he like messed up the labor union relations, and then now we don’t have the ability to bargain for X, Y and Z because we couldn’t do that now, X, Y, Z, and I’m like oh man, I have to start my timelines sometimes for certain things a little bit further back. There is a danger in that, right, in how far back am I going, how far back in the history books are things relevant—do I go back to the dawn of time?
But it was particularly interesting watching this place continue to function, right? It's an emergency department, right? Even though there were concerns about capacity, whether it be, that hospital, like many different kinds of like healthcare entities has been experiencing staffing shortages, which kind of incentivize places to use agency workers, agency staff, kind of locum tenens physicians, which are kind of like an analogue for psychiatrists.
But this abundance of staff who, while probably very well trained, right, in their own respects, maybe have not necessarily worked in a psychiatric environment, or worked at least in a psychiatric environment dealing with people maybe experiencing some of these kinds of acute presentations are an increasingly sizeable chunk of the workplace staff there. People who maybe are from somewhere else and came to Milwaukee accepting this contract, but maybe don’t necessarily have that institutional knowledge, or the understanding of this kind of like ecosystem and some of the…the history behind these relationships or lack thereof.
And so, as the place kind of inched closer towards closure, it was really interesting watching more and more unfamiliar faces staffing the room. Granted, you know, I didn’t work every minute of every day, so it’s possible that some people were just there and I wasn’t working on the shifts that they were. In some cases that was the case.
But I started to see turnover happen a lot more, right? Who’s building the future at a place that already has an expiration date? And so, as people started to make kind of moves to different positions, as other people started to plan for their future, I saw not only staff turnover, but I also saw the effect on this on morale, right, as we see staff—I mean, we had this conversation before, you know, like is this a study of work, right, like really? And I…I’m not sure, right, but at least certain parts were particularly interesting, right?
Think about all the workplace things that anyone has to experience. Think about all of the emails that you get, think about all the requests for meetings, all the stuff that the average person who is working somewhere with or for other people just is annoyed by on a…on a…on a daily basis, right? Things that may be necessary, but things that, you know, people…people get peeved by. Watching this happen while they’re still also tasked with providing emergency psychiatric care to people who are coming in who, it doesn’t matter whether the place is closing tomorrow or today, I still have something that I’m here for, right, that’s affecting me now.
But I think there’s a particular message that you send when, for example, you’re having people sit on Zoom webinars about…about certain types of like sensitivity trainings or something about two days before it closes.
Kern: And watching the staff kind of deal with some of these different dynamics in their own workplace. And then turning around and expecting to provide care to somebody who’s perhaps having the worst day of their life, but for them it’s a Tuesday, and they’re maybe annoyed at their boss or sick of their coworker was a particularly interesting thing as we watched that kind of morale shift. I mentioned the agency staff piece, with staff who…who weren’t necessarily employed by this place, but kind of employed through a contracted agency.
And I saw a little bit of the tension between this, like, workplace staff dynamic, between agency staff who maybe don’t have the same experiences, but are still getting paid the same amount, and in some cases more, and the tensions that that causes within a staff. All that stuff was particularly interesting. But I think one of the most interesting pieces that I think that I found revolved in how the staff made sense of their different options when a person came in, and how their…their interactions with…with patients were also informed by their interactions, or by the entity’s interactions with other organizations in the ecosystem.
As the place gets closer to closing, right, we have EMTALA, which is a long acronym, or relatively long acronym for a law that talks about essentially whose responsibility it is when somebody shows up to an emergency department or an emergency kind of like medical center.
And hospitals get really particular about the idea of, you know, quote, unquote, “dumping,” or the idea that a patient who may be perfectly able to be serviced at one particular medical facility for some reason is not and then finds themselves at another one. There’s a lot of assumptions, right, about who tends to get refused service at places, and then quote, unquote “dumped” onto other places. That type of thing was present the entire time that I was there?
But people’s feelings of wanting to hold other organizations accountable for these kinds of perceived slights felt like it dwindled the closer that it came, right? At a certain point they didn’t have any teeth. Whether or not they had any teeth in the first place as a county resource that’s underfunded compared to a private corporation is a conversation for another time, maybe? But their kind of understanding of what they had the autonomy to do, what they had the power to do, and what they had the ability to even hold other organizations accountable for what they viewed as mistreatment of patients, particularly most likely poor uninsured or underinsured and mostly Black inner-city patients, right, even their ability to hold people accountable seemed to dwindle as I was watching this place close.
This is to say nothing about, like, the continued shortages of just the number of beds in the upstairs inpatient unit, the changes in staff and who’s gonna be there, so how many people you’d have to actually take care of the people that come in, and other resources. I could go on a long tangent. But I saw resources dwindle, and I saw people have to make really quick and sometimes difficult decisions on how to make do with what they had. And in some ways that was not always in the best interests of the patient, but watching people make sense of like this, I know this sucks. I know this sucks for everybody involved, but it is what it is and this is where we are was something that…that was a refrain that I heard commonly.
Miller: This is a…a wonderful, I think, place to end our discussion and maybe move into any, like, final thoughts, but just to say it’s been fascinating for me to watch your…your work develop, especially as you wrestle with history.
As you shake off what Julian Go, a sociologist, a brilliant sociologist who, in the sociology department at Chicago who studies policing, among other things, and empire, talks about as a kind of presentist bias, certainly in…in…in…in the social sciences. And we see that. We see, as you said, the taking for granted of sets of social relations at a given moment in time, and the treatment of those social relations as if they’re, you know, kind of everlasting, they just kind of came from on high and that, one might make them a problem. One might… raise questions about how we get here, and why is this the circumstance.
And when does the how we got here, how does that shape the interaction that takes place, which raises questions about what it means to do something different, to see moments of possibility, both in the history and in the now. There’s something quite powerful about what you’re doing, and I think you’re raising really powerful questions. I think—and in my mind it is certainly in the spirit of what we’re trying to accomplish, you know, at the Crown Family School, and I’m just honored to be a part of the journey. Okay.
So, which brings me to just kind of final thoughts. I guess if I had some final thoughts I’d say—which I do—that, you know, we’re a really interesting place, where people ask really cool questions and have dope discussions, and do really interesting work where the craft of doing the work really does matter, where the craft of rendering the work, that is to say the writing, the presentation of the data, where the final form of the thing matters as much as the thing, as the method, you know.
We’re a place where different kinds of people kind of offer a look and where people with different styles, different kind of styles—I mean, I’m hands-off. You go off and do what you do. And there are people who are, you know, much more hands-on, and stuff in between and, you know, and that’s just the faculty and the students who have different kinds of interests, different kinds of politics that show up in their work, different, and they ask all sorts of interesting questions. Some who try to distance themselves from their politics, too. I mean, so there’s just a range of students.
And I think it makes for a really lively, wonderful, and quite, in my mind, stimulating place where people are…are…are making a difference in the world. But I wonder what…what…what you thought, your kind of last thoughts as we wrap.
Kern: Yeah, I think…I think the Crown Family School should maybe seriously consider changing their tag line to “dope people asking dope questions.”
Kern: And make it how you just put it. Make sure they give you credit, though. So, I think similarly—
Miller: Cut the check, Crown. Cut the check.
Miller: Cut the check.
Kern: I would, I guess I would echo a lot of what you said. You know, one of the things that I didn’t mention earlier about attracting me to the program, but I think is a good point to bring it up here. You know, I mentioned that when I was coming here there were a lot of, like—and still are, right—a lot of, like, faculty doing kind of like criminal legal research, or at least research that … was kind of close to that criminal legal kind of like world, or close to that criminal legal sphere that made me interested in it. And as a result … you can imagine there’s a lot of students then who have kind of criminal legal interests, and then want to work with these different faculty … they, like me, saw a bunch of people going here and was like I’m gonna go there, right, because they value that perspective and that potential mentorship and similarity.
One of the coolest things about this is despite the fact that a lot of us do criminal legal work that like has many different ways in which it could overlap, this department, for me at least, as a student, doesn’t feel competitive, like in the sense that, you know, there might be certain departments where somebody’s doing criminal legal research on juveniles, and somebody’s doing criminal research on young adults, and you all are mortal enemies, ‘cause you’re competing over the same small pots of funding, right, or the same potential opportunities.
Despite the fact that I have overlapping similarities with maybe somebody else in my cohort or somebody else in the cohort above or beneath mine, , we don’t take that as an opportunity to compete with each other, we share that as an opportunity to collaborate, share resources, share information and have a dialogue about the similarities and the ways in which our research shows up in different ways? What’s it mean that I’m researching people who have this and you don’t? What does it, what can this tell us maybe about the larger thing that maybe both of us are missing, but we get at when we’re in dialogue with each other?
So that part, to me, is…is perhaps the most valuable, and I guess I’ll leave out with that, you know, dope people asking dope questions. Also having dope conversation. So…so yeah. It’s been a really beneficial and wonderful experience for me so far because of those things and more.
Miller:Fantastic. Well, thanks…thanks for hanging out with me and…and for doing this podcast. It’s been…it’s been…it’s been a blast.
Kern: Indeed. Thank you.
Announcer: If you are interested in learning more about the doctoral program and the University of Chicago Crown Family School of Social Work, Policy and Practice, please visit crownschool dot uchicago dot edu.