Neighboring – A New Paradigm for Community Engagement

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An Introduction:
“A certain man… fell among thieves, who stripped him of his clothing, wounded him, and departed, leaving him half dead. Now by chance a certain priest came down that road. And when he saw him, he passed by on the other side. Likewise a Levite, when he arrived at the place, came and looked, and passed by on the other side. But a certain Samaritan, as he journeyed, came where he was. And when he saw him, he had compassion…
– Luke 10:30-33 (from The Holy Bible)

There is a recurring set of pitfalls for those involved in community engagement. These include: development of a “savior complex,” where one unilaterally (and often inaccurately) decides what is best for a community; failure to understand the fundamental needs of a community; and, particularly for many medical students I’ve met, feeling ill-equipped to engage with a community that was not originally one’s own. As someone who enjoys learning about and serving others, especially through community engagement, these pitfalls weigh heavily on me. I have spent the past year trying to intensively engage with communities around Philadelphia, and in this piece, I would like to present a framework that has helped me tremendously– a framework I’ve come to affectionately call “neighboring.”

It starts with a story from the Christian Bible called “The Parable of the Good Samaritan,” part of which is quoted above. Independent of religious belief, the story is an exemplar of loving service. It is an allegory expressing the Christian belief that Jesus Christ, who was one with God in heaven, abandoned this position of prestige in order to embrace human frailty as a simple man. He had every right to pass us over, just as the priest and “Levite” did to the naked, dying man. But instead, He showed compassion just as the Samaritan did, generously caring for our every need. The story then closes by calling us to “love our neighbor as ourselves.”

The ramifications of this parable are numerous. To start, the idea that we were all once a dying person in need of help puts us at a level playing field, where no one could be seen as an ultimate “savior.” Next, the incarnational love shown by Jesus Christ inspires me to abandon my relative comfort to engage with the stories of those around me. The parable implies an element of proximity in this call- just as the Samaritan helped the unknown man he ran into, I am called to engage with those around me, from fellow medical students, to my patients, to the servers at a restaurant, to a stranger on the street experiencing homelessness. But at the same time, the example of Jesus Christ pushes us to stretch beyond any chasms of difference we encounter, even if they are as massive as the gap between heaven and earth. Finally, I hypothesize that intentional engagement with the stories of others leads to a deeper understanding of and care for them. This in turn could lead not only to improved service, but also to a fundamentally elevated view of individuals and their communities.

It is these principles that lay the foundation of “neighboring.” Neighboring is an attitude that seeks to discover and celebrate the inherent value of those around us, especially the traditionally marginalized. The goal of it is to develop compassion, more humbly serve others, and lay the groundwork for deeper, bidirectional relationships.

What follows are reflections and principles I’ve gathered over a year of putting this “neighboring” idea to the test in Philadelphia. Many come from personal explorations. Others I owe to a program I started with the Gold Humanism Honor Society called “NEIGHBORS” (“Neighboring, Engaged and Intentional- Gold Humanism Bolstering the Overlap of Relationships and Service”). While I hope you consider any motivations from Christianity with an open mind, my ultimate hope is that, regardless of belief system, you will meditate on the concept of neighboring, and consider what it could mean for how you engage with those around you.


On Drawing Close to My Neighbor, via SEPTA
“…Hatred often begins in a situation in which there is contact without fellowship, contact that is devoid of any of the primary overtures of warmth and fellow-feeling and genuineness…”

“This is one very important reason for the insistence that segregation is a complete ethical and moral evil… it poisons all normal contacts of those persons involved. The first step toward love is a common sharing of a sense of mutual worth and value. This cannot be discovered in a vacuum or in a series of artificial or hypothetical relationships. It has to be in a real situation, natural, free…”
– Howard Thurman, Jesus and the Disinherited

This quote is by Howard Thurman, a Christian philosopher and mentor to Martin Luther King, Jr. whose theology guided much of the Civil Rights Movement. It is an important reminder of how the most mundane activities can actually lead to intimate connections, the kind that form the foundation of neighboring. The following anecdote relates my first experience of this in Philly:

I was a first-year medical student and in the midst of a study session with my learning team. I LOVE gummies, and I liked bringing snacks to my team, even though they generally never took them. So, I brought multiple bags of gummies to the study session to share with my team! And, surprise—nobody wanted them.

That same day, still a little sad that no one wanted to share my gummies, I boarded the Market-Frankford Line (MFL) of SEPTA to shadow at Esperanza Health Center in Kensington. And on the MFL, I saw a fellow passenger with a load of candy bars. He was talking to everybody around him, trying to share his candy bars- and of course everybody regarded him as a weirdo and turned him down. I thought, “What’s up with this dude? Did he really think these people would want his candy?” And then the connection went off in my head- this man was my brother! He was my comrade in nonsensically dealing out sweets!

This story may sound silly, but its implications were groundbreaking for me. This small acknowledgement of our similarity evoked the feelings of “warmth and fellow-feeling” Thurman refers to in the quote above, in turn leading to recognition of his “worth and value” as he generously tried to share candy with those around him. Put more simply, empathy converted my judgment of the man into humility, compassion, and respect.

I have come to see this as an essential aspect of neighboring- the humbling acknowledgement of a universal and irrevocable human worth. It can start from anything– from connecting with someone about being the child of immigrants, to commiserating with someone at a wedding reception about my lack of cool dance moves. No matter how deep or superficial the link, the possibility of my similarity to others can be used as a pointer to our fundamental and inherently precious shared humanity, which opens my eyes to their essential worth as a person.

Understanding this also gave me new insight into the benefit of “community engagement opportunities.” As Howard Thurman indicated, the acknowledgement of our common humanity is best done in real situations- not only in clinics and hospitals, but also in barber shops, in health fairs, in neighborhoods, on public transit, in spaces of worship, over meals, and in all those quotidian spaces that for each of us hold such quiet yet profound meaning. This engagement is especially great for showing us the communities that have such an impact in shaping the lives of individuals. My hope is that once common ground is found, it can allow more fruitful exploration of the differences that make us unique– as the next story begins to illustrate.

 

On Seeing Our Neighbors More Wholly
“Tom Cornell tells the story of a donor coming into the New York house one morning and giving Dorothy [Day] a diamond ring. Dorothy thanked her for the donation and put it in her pocket without batting an eye. Later a certain demented lady came in, one of the more irritating regulars… one of those people who make you wonder if you were cut out for life in a house of hospitality. I can’t recall her ever saying “thank you” or looking like she was on the edge of saying it… Dorothy took the diamond ring out of her pocket and gave it to this lady. Someone on the staff said to Dorothy, “Wouldn’t it have been better if we took the ring to the diamond exchange, sold it, and paid that woman’s rent for a year?”. Dorothy replied that the woman had her dignity and could do what she liked with the ring. She could sell it for rent money or take a trip to the Bahamas. Or she could enjoy wearing a diamond ring on her hand like the woman who gave it away. “Do you suppose,” Dorothy asked, “that God created diamonds only for the rich?””
– Jim Forest, “Dorothy Day: A Saint for Our Age?”

By calling us to look carefully at those around us, and look past the barriers that divide us, neighboring allows us to see one another more comprehensively. A story submitted by a classmate begins to illustrate this:
“On my ultrasound rotation, I received a request to place an ultrasound-guided IV in a patient who was a ‘difficult stick.’ I walked in and didn’t get off to a great start when I used the wrong name for him. He was in immense pain (uncontrolled since we didn’t yet have IV access) due to chronic pancreatitis and was understandably not in a great mood. As I shoved a needle around in his arm, I left a bloody mess and failed to cannulate the vein. Eventually, my teacher placed one in the other arm, and we got ready to exit the room, our work finished (and my learning solidified). Yet I looked at the patient, visibly frustrated, bloodied (because of my poor technique), and still in pain. I realized that while my technical responsibilities as a student did not extend beyond that moment, my ethical obligations as a human being, or “neighbor” if you will, did.


“So I stayed. For a long time. A long time. And we chatted. Well, mostly, he chatted. He opened up. Turned out he worked at Penn Medicine in what would not be considered a prestigious job. But remembering that there is dignity in all helped me as I worked to discover it in him.

“A week later, an employee in a green shirt greeted me in the hospital, and I paused for a moment. ‘You don’t remember me, do you?’ At first I thought ‘why is this guy talking to me?’ and then ‘where in the world do I know him from?’ I realized it was him. He looked so different. He was cleaned up, smiling. He looked stronger, though I couldn’t quite tell why. With an employee lanyard instead of a patient wristband, a uniform in place of a hospital gown, he just looked more dignified. I would see him at various places in the hospital and be the only member of the clinical team who greeted him- my way of acknowledging the dignity he had possessed this whole time. When I asked ‘how are you?’ I tried to communicate it in a way that made clear I knew what I was asking- ‘How are you?‘ In the end, this ended up going both ways- he acknowledged my dignity despite my lowly role as a medical student by helping me get supplies, directions, and swipe access. And as we spent time together, I realized how many of his coworkers were still invisible to me- how much more there was to discover.”

The ability to appreciate one another more fully is a core ideal of neighboring. In fact, I’ve found that it gives me great insights about how to better serve those around me. One example evoked by both the Dorothy Day quote and this story is that the needs of others often go beyond the material. “Poverty,” as a broad term denoting need, is multifaceted—not merely financial, it also extends to more ethereal matters such as dignity in the above stories, as well as poverty of social relationships, mental wellness, and power. Because of this, holistically learning about others is key for comprehensively engaging the materially poor, such as those experiencing homelessness. But even more, the multifaceted nature of poverty must be acknowledged in order to recognize poverty more broadly in our neighbors, such as our classmates and co-workers– and even in ourselves.


When Our Neighbors Are… Complicated
“For I know that good itself does not dwell in me… for I have the desire to do what is good, but I cannot carry it out. For I do not do the good I want to do, but the evil I do not want to do—this I keep on doing… What a wretched man I am! Who will rescue me…”
– Romans 7:18-19, 24 (from The Holy Bible)

Despite the beauty of connecting with others, I’d be remiss if I spoke as if everything we discovered in others was beautiful or encouraging. I think of a time when I was talking to a community member about support of the Black community in West Philly. They were inspiring—they spoke of the struggles they and other Black people had faced, their belief in how community organizing around common values could move the community forward, and some of the effective organizing they had already done. Then, just as swiftly, they expressed anti-Semitic sentiments that appalled me.

I was astonished that such vile words could come from the same source as such inspiring thoughts. But, on further reflection, I realized it tracks with other experiences I’ve had- including in my own life. My same mouth that gently corrects the errors of first-year med students as a teaching assistant, regularly and harshly berates my mother for “annoying me” when she only means to help. As noted in the quote above, we often know what is right but repeatedly fail to do it. Human beings are complex- there is at once a beautiful dignity to be explored and celebrated, capable of heartwarming kindness; and a broken, terrifying nature that is capable of heartbreaking harm.

Why do I say this? If neighboring is about love, then we must acknowledge that to love someone without knowing and acknowledging the totality of their character is superficial. What made Jesus Christ’s sacrifice for us so moving was that we were utterly undeserving of it. To know this and save us from our deserved condemnation anyway, in belief that we could be something more than our worst selves, is the apogee of love.

Another duality I’ve seen can help demonstrate this. Many perceive Kensington to be a dark and dangerous area in Philadelphia, and I indeed have walked through the area trembling with fear about rampant drug use on the streets or violent arrests. But, I also recall taking long walks around Kensington where I looked lost, and multiple people (including people actively using drugs) graciously volunteering to help me find my way. I recall multiple conversations with people with substance use disorders who just wanted to have a safe home situation, or be a good family member, or have their best health, or otherwise live their lives to the fullest like anyone else.

The investigatory nature of neighboring will, with enough time, naturally unveil the complicated layers of those around us. In these times, we must remember that these people are still our neighbors, full of value even when it’s hard to see. Let the recognition of your own complicated nature give you compassion to the less appetizing parts of the people around you. While we can never condone wrongdoing, we can correct it in love, acknowledging that not only does the same propensity for wrong exist in all of us, but also the same hope to be something more.

 

On Entering a Community That Was Not Originally Your Own
“Neighbors are people who are close to us, and friends are people who are close to our hearts.”
– Mr. Rogers, “Won’t You Be My Neighbor?”

To get more practical, a question I’ve grappled with, and in fact the same question that Jesus was answering with the “Parable of the Good Samaritan,” is: “Who is my neighbor?” I find it counterproductive to dwell on this question– often, the implicit question behind it is, “What’s the minimum I can do to satisfy this requirement?” when I think the heart behind it all matters most. I also think that, despite my focus on community engagement, neighboring as an attitude can and should be demonstrated in various settings with all kinds of people- literal members of your neighborhood, family members, co-workers, and so on.

That being said, I’ve had some medical school peers express a specific fear worth addressing. As Mr. Rogers says in the above quote, “Neighbors are people close to us”- meaning that mere proximity to someone creates a responsibility to engage with their lives (whether or not they are “close to our hearts” like a friend). So, when my peers moved to Philadelphia, they were given an implicit responsibility to engage with those around them. The fear I’ve heard about neighboring is that actively trying to engage with the day-to-day life of a new community can inadvertently exacerbate gentrification. This led me to consider several models for how a person can enter a new community, with “neighbor” actually being the best way to do it:

  • The imperialist/White savior- people of relative privilege that enter a community and intentionally try to change native practices, believing their own practices to be superior.
  • The gentrifier- people of relative privilege that enter a community and, while not trying to change native practices, do so inadvertently by introducing their own practices without acknowledging native ones, thus crowding them out.
  • The pilgrim- people of relative disadvantage that don’t seek to affect the status quo because they only plan to be around temporarily. They choose instead to keep to themselves unless forced to interact with the larger world, in which case they try to follow the rules around them as faithfully as possible.
  • The immigrant- people of relative disadvantage that enter a community and often feel pressed to abandon their former practices in order to conform to native ones.
  • The neighbor- people of indeterminate privilege that acknowledge and even welcome the inevitable introduction of their practices, while also actively trying to discover the heart of the new community and its practices in order to coexist with, respect, and even synergize with the practices.

I found this paradigm especially helpful when considering the “No Arena Chinatown” movement. In brief, this movement wants to prevent the creation of a 76ers basketball arena in Chinatown that many residents fear will destroy the area. It’s an unfortunately common story in Philadelphia- to borrow the language from above, “imperialists” and “gentrifiers” enter and, knowingly or unknowingly, crush native traditions.

While I’m sympathetic to the cause, I asked organizers of the movement if they really thought that they could resist change in the area. To ask that no one ever enter their community in a world of constant migration of peoples seemed unreasonable. And, given that the people who entered would often have privilege (e.g., students, young professionals, business owners, etc.), them entering as a “pilgrim” or “immigrant” who wouldn’t change anything seemed unrealistic. In fact, one could argue that the unique identities of the new community members could strengthen the community, and that to deny this would be its own travesty. The organizers acknowledged that change was inevitable, but that they would like the ability to advocate for themselves on how the area changed. I believe that the concept of “neighbor” optimizes this bidirectional conversation, keeping the heart of the native group while also allowing positive change as people enter the area.

 

Five Quick Tips on Talking to Strangers New Neighbors
“There are no strangers here; only friends you haven’t met yet.”
– William Butler Yeats

Neighboring often requires speaking with people with whom you seem to have no baseline connection- “strangers.” This is a skill I’ve been working on a lot and that people have asked me about repeatedly, so I thought I’d share some tricks that have been helpful to me. I hope that, in the spirit of the William Butler Yeats quote above, these tips are helpful in viewing these “strangers” merely as neighbors you haven’t met yet:

  1. Acknowledge the person- mentally remind yourself that every human is special and worth your time, and show this through things like facing your body toward them, using good eye contact, and learning and using their name in the conversation (“You know, David, you make an interesting point there…”).
  2. Find common ground in something- something you share, like clothing or interests; or something you appreciate about their appearance or behavior; or something you both found funny in the world around you– anything! This helps point to your common humanity, and then helps you explore the interesting differences between you.
  3. Remember the golden rule of improv: “Yes, and…”- whatever they start talking about, be curious and open-minded and run with it. You’ll be surprised by the amazing things you can discover.
  4. If you’re new to this, have a buddy with you- that always smoothes out potentially awkward interactions.
  5. Just… do it!- The more you do it, the more you’ll figure out how to do it well. 🙂

 

A Whole New World of Neighbors to Meet
“…when I was moving to Philly, a lot of people told me to not go past certain streets, and I think for everyone, the “why” was pretty straightforward- it was because of crime, violence, homelessness, and addiction. But to me, this just meant so I wouldn’t have to look poverty, inequity, marginalization, and human suffering in the face… stepping beyond boundaries of where people deemed “safe,” I’ve found that beyond these boundaries are usually the most resilient and caring people you’ll meet…”
– Connie Yu, first-year Penn med student

I conclude with this quote from Connie, a member of the inaugural pilot of the “NEIGHBORS” program I mentioned at the start of this piece, because it expresses the essence of neighboring. Neighboring is an attitude that seeks to discover and celebrate the inherent value of those around us, especially the traditionally marginalized. The goal of it is to develop compassion, more humbly serve others, and lay the groundwork for deeper, bidirectional relationships. This requires intentionality and great effort to live out. Nevertheless, I can assure that the fruits of it are worthwhile. To encourage you in this, I’ll close by mentioning some Philadelphia neighbors that I’ve encountered, beyond the “boundaries” that Connie refers to in the quote above:


– Dr. Walter Palmer, Pastor Cedric Jones, Darryl Thomas, and Jack Drummond, who I have known since my first year of medical school; whose communities I have been able to aid through education, health screenings, and other public health events; who have offered me education, meals, and encouragement over the years; and who regularly express how proud they are of me, just as I have come to admire them.

– The employees of Esperanza Health Center, who over the past four years have shown me what it means to provide loving care to a broken world with hope of something greater. I am especially grateful to my physician mentor Dr. Charlene Chen, who first helped to put this “neighboring” concept on my heart.

– Nick, who struck up conversation with me on the MFL while I was reading a book and not in a “neighborly” mood; who ended up teaching me valuable lessons about the desire of many in Kensington for a life free from danger; and who, in what seemed to be a mundane conversation, gave me paradigm-shifting compassion for a part of the city too often condemned to shame and judgment.

– Dwayne Wright, a sanitation worker at Pennsylvania Hospital who was encouraged by seeing a Black doctor in training like me, and who encouraged me with his constant jokes and check-ins.

– Margaret Jane Smith (name changed for confidentiality), a patient with lupus who gave me my first, last, and greatest memories in the cardiac ICU; whose life story, faith, warm interactions with her family, inspiring recovery, and shocking death changed how I will view medicine forever; and who I was honored to walk with in life and in death, and hope to love as neighbor in a next life that will never end.

– My medical school peers, above all the students who piloted NEIGHBORS with me and the members of my entering class who engaged in so many conversations and adventures as we reflected on the meaning of loving one’s neighbor, always challenging and encouraging me along the way.

– The members of Risen Christ Fellowship, my church of unified faith with members of diverse socioeconomic, ethnic, and geographic backgrounds, who demonstrate what it means to celebrate both unity and diversity without any sense of contradiction, thus showing me neighboring at its finest.

 

Victor Ayeni is an MS4 at the Perelman School of Medicine.

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