Dr. Rita Brock: “Say ‘yes’ to hard things”

I actually am as hopeful as I’ve ever been. There are many crises affecting our country right now — the pandemic, economic challenges, racial injustice, climate change — and I feel like people are really paying attention to all of them. People want change and they are pushing for that and as someone who’s been an activist for most […]

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I actually am as hopeful as I’ve ever been. There are many crises affecting our country right now — the pandemic, economic challenges, racial injustice, climate change — and I feel like people are really paying attention to all of them. People want change and they are pushing for that and as someone who’s been an activist for most of my life — I feel like many of the things we’ve been fighting a long time for have a real chance of happening now as a result because of new generations of activists who are stepping up.

As part of my series about people who stepped up to make a difference during the COVID19 Pandemic I had the pleasure of interviewing Dr. Rita Nakashima Brock, Senior Vice President of Moral Injury and Director of the Shay Moral Injury Center at Volunteers of America.

Dr. Rita Brock is a leading national expert on moral injury — the internal crisis and suffering that results when you see or do something that goes against your moral code. She is the Director of Volunteers of America’s Shay Moral Injury Center in Alexandria, VA, and is also an Asian American feminist scholar, Protestant theologian, activist, and non-profit organization leader.

Dr. Brock has long worked to raise awareness about moral injury, a concept originally linked primarily to military veterans. But since the start of the COVID-19 pandemic, she has expanded her moral injury work to encompass frontline healthcare workers. She is now working to build awareness of this concept and develop programs to address it in doctors, nurses, EMTs and other care providers who are going to work every day despite the fact that they may be exhausted, fearful for their own safety, worried they’re putting their loved one’s health at risk, and emotionally frayed from making agonizing decisions like who gets a ventilator and being the only one with an isolated patient when they die.

The first Asian American woman to earn a doctorate in theology, Dr. Brock is co-author of Soul Repair: Recovering from Moral Injury after War and Proverbs of Ashes: Violence, Redemptive Suffering and the Search for What Saves Us. She also knows personally about the devastating, profound, and lasting effects that moral injury can cause. That’s because she witnessed it at the age of 18 in her own father when he returned from fighting in the Vietnam War. It wasn’t until many years later, however, through her work with moral injury, that she was finally able to truly understand the trauma in her father’s life — and how it affected her own.

Thank you so much for doing this with us Dr. Brock! Before we dig in, our readers would like to get to know you. Can you tell us a bit about how and where you grew up?

I was born in Fukuoka, Japan, 60 miles from Nagasaki, and five years after the nuclear bomb was dropped on it. I was raised by my mother and grandparents because my birth father was a Puerto Rican U.S. Army soldier who was sent to Korea when I was 6 months old. My mother erased him from my life when he failed to write to her. My family was poor like everyone in our village, but I grew up in a stable, supportive, and caring environment, and I felt deeply loved and safe.

My mom was a nurse for the Japanese Red Cross, and she met and married a U.S. Army soldier from Mississippi when I was almost three. He had fought in the First Infantry at Normandy and was ordered stateside for two years after he married my mother. He was finally able to return and take us to Okinawa. I was 6 when he was transferred to Fort Riley, Kansas and we went with him. Suddenly, I was in a very different and bewildering society and I experienced racism for the first time. People called me “dirty Jap” and I was once stabbed in the back of the head with a pencil. I didn’t understand the meanness. I developed nightmares for the first time in my life. It got better as I got older and when I was thirteen, we moved to Landstuhl, Germany, for three years before my father was ordered to Barstow, California, to train as a medic for Vietnam. I had just graduated from high school when he came home from his second combat tour, but he was never the same after that. He became very difficult to live with, so once I went to college, I only returned home for holidays.

I went to college intending to become a neurosurgeon. But when a white supremacist group threatened to assassinate the black students at my school, I realized you can’t be a bystander to violence and racism. I joined protests and small groups that escorted black students safely around campus. Fighting injustice felt so much more compelling to me than math and science, so I abandoned pre-med.

Is there a particular book that made a significant impact on you? Can you share a story or explain why it resonated with you so much?

It was a children’s novel I read when I was 8 or 9 called The Witch of Blackbird Pond by Elizabeth George Speare. It’s about a girl who grew up in the Caribbean and was raised by her grandfather and when he dies she’s sent to live with Puritan relatives in New England. She was ostracized there, and people thought she was a witch because she could swim. It felt like my life — was0

taken from a beautiful, faraway place and a loving family and dumped in a harsh unfriendly environment where I had to adapt. As a child, I really related to that book and it stuck with me for a long time.

Do you have a favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life or your work?

My favorite college professor, a seventy-year-old Bible professor who was raised by his suffragist aunt, used to say — ‘Just keep on keeping on,’ and that advice has guided me through many hard times — in college and beyond. When I was fired from my first full-time teaching job for being a feminist, that phrase and support from friends kept me going when I thought my career was over before it had really started.

OK, thank you for all that. Now let’s move to the main focus of our interview. You are currently leading a social impact organization that has stepped up during the COVID-19 Pandemic. Can you tell us a bit about what you and your organization are trying to address?

As soon as this crisis began we could see the problem of moral injury coming like a tidal wave. People working on the front lines without proper personal protective equipment, facing a mysterious and lethal virus, and seeing catastrophic numbers of deaths is something no one can be prepared for.

We know, from years of working with veterans, that such deep and life-altering trauma doesn’t just go away, even if you’re trained to work in stressful environments. We also realized there was a huge risk to the medical community in particular, given the long-term nature of a pandemic, because we know that moral injury can make people leave their jobs in many ways — whether it’s giving up and quitting, beginning to drink too much or committing suicide.

So, I immediately began collaborating with others to set up webinars to talk about moral stress and moral resilience. We’ve worked with partners at two universities to apply for a major research grant to adapt our evidence-based program for moral injury in military veterans into a program for healthcare workers, and we’ve launched a free online peer-facilitated pilot program to help healthcare workers talk about their moral distress. I’m also trying, whenever I can, to build awareness about this concept so people recognize it when they see it and even more importantly — know what to do about it, which my family did not when it happened to my father.

People whose work is caring for others tend to be idealistic and have high standards. But in a major life and death crisis, they cannot meet their moral expectations, so they can experience moral stress. If it accumulates unprocessed it can become a moral injury. Because there is often a stigma to seeking mental health support in medical careers, we offer a peer specialist approach to moral injury that makes trust and sharing easier. It is not treatment; it is moral resilience strength training. The research on our program for veterans showed it was effective. While medicine and the military have many differences, I believe the intensely painful feelings that result from moral injury are the same. When people get a chance to reduce the emotional pain that is causing their suffering, they can get to where the experience can become a source of wisdom for their lives.

In your opinion, what does it mean to be a hero?

My six years in Japan, which is a group-oriented culture, trained me to avoid the word ‘hero’ so I don’t think in those terms. But when I think of the people and organizations I admire, respect, value and learn from, they are compassionate, care about others, and advocate for justice and equality.

In your opinion or experience, what are “5 characteristics of a hero? Please share a story or example for each one.

I think heroes are often not famous, but they:

  1. Notice when people are harmed by injustice and work for change. For example, all the many young Black Lives Matters protesters marching in the streets today for racial equality and justice.
  2. Keep on keeping on, even when the future is uncertain. Example: Nelson Mandela
  3. Say ‘yes’ to hard things. Example: JoAnne Kagiwada, who led an international initiative to get churches to boycott Nestle for infant formula abuses in the 1970s and worked to make sure that in addition to the apology built into the Civil Liberties Act of 1988, payments of 20,000 dollars were made to each living Japanese American who had been held in an internment camp.
  4. Stand up for people who cannot stand up for themselves. Example: Maud Booth who was a co-founder of Volunteers of America in 1896 and created halfway houses for prisoners as well as being a social reformer.
  5. See their life purpose as serving others, not as personal success. Example: I see this every day in public school teachers, in public servants, and in the people who work at VOA.

What was the specific catalyst for you or your organization to take heroic action? At what point did you personally decide that heroic action needed to be taken?

We know that in the face of crises, particularly unrelenting and unceasing ones — that some people will come through it okay but many more won’t.

Crises like COVID-19 compel us to ask what we can do to help. VOA has an evidence-based program we know works to help veterans with moral injury. So, it was obvious very early on to us that we needed to adapt our moral injury program from a military context to a medical context to meet this moment. We aren’t claiming to have the only solution. But we do know that we have a good one and we know that more people need it now than ever so we are committed to doing all we can to get it to them.

Who are your heroes, or who do you see as heroes today?

My grandparents, Keio and Hosei Nakashima, are my personal heroes — because, even in the ashes of war and the struggle of poverty and survival, they showed me, a mixed-race child, love, and care and gave me a safe home for my first 6 years. Today, the veterans I have worked within our moral injury program at VOA are people I respect for their enormous emotional courage and generosity in participating in an untested pilot and trusting us, and in their wanting to serve their country. They, like me, tend to avoid the word hero, so I will avoid offending them by imposing the word on them.

Let’s talk a bit about what is happening in the world today. What specifically frightened or frightens you most about the pandemic?

I am troubled by the opportunistic use of the coronavirus crisis to install militaristic and fascist forms of control by leaders, the same ones who have failed their people by not listening to experts who knew what to do about the pandemic.

Despite that, what gives you hope for the future? Can you explain why you feel that way?

I actually have so much hope for the future right now. I think what we are seeing around the planet right now is an uprising of viral moral injury related to the police murder of George Floyd and many others. There is a mass moral outrage movement against racial disparities and injustice, and this level of outrage and trauma could lead to cynicism or despair. It is so very powerful instead to see so many people join together to demand change, despite the risks. I believe we have reached a major positive turning point in the shift to a multi-racial Black Lives Matter Movement that seeks to end racism.

What has inspired you the most about the behavior of people during the pandemic, and what behaviors do you find most disappointing?

I’m disappointed and deeply saddened because the federal government’s pandemic response was gutted before this crisis — leading to a slow response across the board, especially in providing PPE and doing appropriate testing. An incompetent, ineffective, and evasive response from the White House, coupled with ungrounded wishful thinking and dangerous advice, has cost many unnecessary lives.

But I am deeply awed by the sacrifices that so many healthcare workers, essential workers, and their families are making right now to help others. I’m also very inspired by the many big and little ways that people across this country are stepping up to do what they can in this crisis. Whether it’s sewing masks for others or wearing them yourself, thanking first responders in your community by sending meals to the hospital or clapping for them at an appointed hour, transitioning your business from creating products to producing much-needed supplies or handing out sanitizer and masks at a protest march — people are looking out for each other in a myriad of ways right now and that is a beautiful thing to see.

Has this crisis caused you to reassess your view of the world or of society? We would love to hear what you mean.

No, not at all. I actually am as hopeful as I’ve ever been. There are many crises affecting our country right now — the pandemic, economic challenges, racial injustice, climate change — and I feel like people are really paying attention to all of them. People want change and they are pushing for that and as someone who’s been an activist for most of my life — I feel like many of the things we’ve been fighting a long time for have a real chance of happening now as a result because of new generations of activists who are stepping up.

What permanent societal changes would you like to see come out of this crisis?

I think COVID-19 has exposed so much that was wrong with our healthcare system so I would like to see a lot of that slowly start to improve. I don’t know if it will happen in my lifetime, but we have to stop linking healthcare to income. Healthcare should not be related to a job or how much money you make. I believe healthcare should be a human right. And our economic inequality system needs a major overhaul.

If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?

Get involved, take action, and keep at it because your life depends upon it.

You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I’m not sure I need to start a movement right now. I trust this younger generation and their instincts on activism. They know what they are doing. I think what they are pushing for in this country right now — with more equality and justice — is exactly what’s needed. I will be there with them, but they can lead.

Is there a person in the world, or in the US, with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. 🙂

I would like to have lunch with the Secretary of the Army because I think I have a way to help people make the transition out of the military that will reduce the suffering veterans experience after they are discharged. I would welcome the chance to persuade the Secretary to let VOA and our partners at the Durham, NC, national VA center do a pilot program to prove that moral injury and resilience and strength training works. We have a way to alleviate some of the tough transition veterans go through when they turn in their uniforms and return to civilian life. I think our veterans deserve better than the current transitions that are clearly not adequate.

How can our readers follow you online?

They can learn more about VOA and our unique moral injury initiatives and the work we do at www.voa.org/moralinjury.

This was very meaningful, thank you so much. We wish you only continued success on your great work!

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