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A Moment to Pause

August 28, 2020

Through this note, by offering a reflection on the remarkable spirit of the nearly 6,000 DPH and UCSF staff, scientists and clinicians contributing at ZSFG, we intend to highlight our collective efforts to becoming the best place to work.


A month or two after I started my work at ZSFG, I was shadowing the AOD to learn more about the operations of the hospital. As we were chatting, the AOD got a call to come to the ED, where a Black mother was brought in overnight on an ambulance with two kids. The girls were five and eleven months. The attending wanted to keep the mother for 2 nights for observation but per our hospital’s policy the children could not remain. If no other family members were available to take care of the kids, we would call Child Protective Services if the mother wanted to remain in the hospital. As the AOD and social worker explained this to the patient, I watched the girls. The eleven-month-old was drinking milk, smiling and curious, while the older girl's face was crunched up in fear. She was standing next to her mom, hands on her legs ready to protect. After letting the AOD and social worker know that she did not have anyone to help take care of her daughters, the patient decided that she would like to be discharged that day, and we left.

Until today, I continue to dwell on what happened in that 5 minute exchange that exposes how as a structure, we continue to penalize people who come to us to seek help, forcing them to choose between taking care of their health and giving care or earning an income. The historical trauma that many parents from Black, Indigenous, Latinx and other communities of color have had from Child Protective Services is well documented, yet that seems to be the only source of support we could provide. And in doing so, we continue to erode our patients' trust in us, as the institution that is supposed to care for and heal them. What are we teaching that five year old who already felt that she has to protect her mother from us? What would she tell herself when she grows up and has to seek care?

I was brought back to that moment on Monday, when news came out about Jacob Blake, a Black man from Kenosha, WI who was shot seven times in front of his three children. I was brought back to that moment when I learned that his son asks his father, “why did the police shoot my dad in the back?” I was brought back to that moment when I read in the newspaper that he was handcuffed to the bed in the hospital where he underwent extensive surgeries but nothing short of a miracle would allow him to ever walk again.

What would his children feel if they came in to see him lying handcuffed on a hospital bed? What are we, as society teaching them about the systems that are supposed to protect and heal them?
In a moment of despair, I turn to poetry and Audre Lorde reminds me that:

“When the sun rises we are afraid
it might not remain
when the sun sets we are afraid
it might not rise in the morning
when our stomachs are full we are afraid
of indigestion
when our stomachs are empty we are afraid
we may never eat again
when we are loved we are afraid
love will vanish
when we are alone we are afraid
love will never return
and when we speak we are afraid
our words will not be heard
nor welcomed
but when we are silent
we are still afraid
So it is better to speak
we were never meant to survive.”
A Litany for Survival, by Audre Lorde

Anh Thang Dao-Shah
Director of Equity and Wellness

To speak up, learn more:
Race and Class in the Child Welfare System
Why the Black community mistrusts medicine?
For more learning materials and opportunities, please visit the ZSFG equity resource guide

Artist: Pia Langfeldt
Share Your Submission for A Moment To Pause

To continue to have A Moment To Pause highlight the humanity in our work, its grace and our vulnerability, we invite you to co-create future issues.  You can participate in a number of ways:

  • Send suggestions or reflections we could write about here.
  • Send a short, beloved poem or passage written by another or one written by you here.
  • You could submit an original piece you wrote here
  • Upload a link to a song that brings you joy here.
  • Share a photo of what has brought meaning to you during this time here.
Guidelines for submissions:
  • Less than 600 words.
  • All submissions may be edited by the A Moment To Pause team.
  • Include links or references for readers to dive deeper into the topic as appropriate.

We intend to continue this letter, into and beyond the Pandemic. Please join us in cultivating this narrative, by, of and for one another.

With great respect for your caring work. With gratitude for your caring self.

Jeff Critchfield | Aiyana Johnson | Margaret Damiano | Brandi Frazier | Shannon Smith

Resources & Support for Employees

In support of your reflections we encourage you to engage partners at the DPH and UCSF employee assistance programs at the links below.
Employee Assistance Program

Our Employee Assistance Program for tele-counseling is now available for DPH employees 24/7.
For UCSF Colleagues

Faculty and Staff Assistance: Explore diverse counseling services here.

UCSF Department of Psychiatry

The UCSF Department of Psychiatry created a website listing multiple resources.  Some are available only on the Parnassus Campus, others for UCSF employees.  The majority are for the whole San Francisco community.

Issue #1: Gardening Pause (March 31, 2020)
Issue #2: Unmasking (April 7, 2020) 
Issue #3: New Rituals (April 14, 2020)
Issue #4: Roots (April 21, 2020)
Issue #5: Hello In There (April 28, 2020)
Issue #6: Thresholds (May 5, 2020)
Issue #7: To The Nurturers (May 12, 2020)
Issue #8: Remembrance (May 19, 2020)
Issue #9: The (TBD) Generation (May 26, 2020)
Issue #10: The Purge (June 2, 2020)
Issue #11: The Multiple Worlds of Black Health Workers (June 9, 2020)
Issue #12: Sometimes Soldiers Wear Scrubs (June 16, 2020)
Issue #13: Showing Up (June 23, 2020)
Issue #14: Garden Poetry (June 30, 2020)
Issue #15: Good Trouble (June 21, 2020)
Issue #16: Photo Exhibit Series, Part I (July 29, 2020)
Issue #17: Music Exhibit Series, Part I (August 12, 2020)
We welcome your feedback about A Moment To Pause.

Please share your thoughts, comments, and suggestions. Click here or scan the QR code below to share.

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