“Good morning, my future doctors!” the crossing guard’s joyful daily greeting echoed across the intersection, her customary grin lighting up her face. “Have a wonderful day!”
The crossing guard at 20th and Catherine began greeting us this way back in October. Without question, this is now my favorite part of our morning walk from Graduate Hospital to JMEC. The first time she noticed three young women walking up 20th Street in matching HUP scrubs, our mis-sized cornflower blue outfits standing out against the mural on the brick wall of the school, she stopped us. “Are you nurses?” she asked out of curiosity. “We’re medical students,” we replied. “We’re in school to be doctors.”
“Doctors,” the crossing guard repeated with awe. “Can I call you one day if I get sick?” We all laughed together, and thus began the jovial greetings that have continued to brighten our mornings for the past several months. “Have a wonderful day, my future doctors!” She began to transform from the neighborhood crossing guard into a source of daily encouragement. Being new to Philadelphia, I felt more connected to the community thanks to her words. I looked forward to our crossing guard’s reassuring smile each morning.
But at the same time, I knew she wasn’t there for us. The crossing guards in our neighborhood were hired for the students at Chester Arthur, a local public school in Graduate Hospital. Our favorite crossing guard called out her greeting to us every morning as she helped the elementary students cross the street, shepherding them from their parents to the schoolyard, colorful backpacks dancing with energy. Now that I’ve lived in Philadelphia for a year, each day as I watch her usher young children across Catherine Street, it reminds me that we are transplants. In a way, the existing community has been suppressed to accept us, to prevent rejection. We are a foreign body. The borders of Graduate Hospital appear well-circumscribed—South Street, the Schuylkill River, Washington Avenue, and Broad Street—but we are not benign. Often, I feel infiltrative, breaking through the basement membrane of the university and spreading beyond our borders.
The history of this rapid gentrification only begins to scratch the surface of the complicated roles we assume as transplants to Philadelphia. In the 1960s, the city planned a crosstown expressway running along South Street. Anticipating a barrier between center city and the neighborhoods to the south, longtime residents left their properties in Graduate Hospital, leading to widespread abandonment of the South Street business corridor. The loss of jobs and residents caused the neighborhood to decline as buildings were left to deteriorate. In the 1990s, Universal Community Homes capitalized on this abandonment, promoting the “revitalization” of townhomes sold at unaffordable prices for many previous residents. The Black population in Graduate Hospital dropped from 90% in the 1990s to 35% today. This community shift has begun to spread beyond the “basement membrane” of Washington Avenue and into Point Breeze. The zip code of 19146—familiar to many of us—is now one of the top ten most gentrified neighborhoods in the United States. There have even been calls to rename Graduate Hospital “Marian Anderson Village” in honor of its roots. This year, conversations around gentrification in University City across the Schuylkill have also escalated as the “Save the UC Townhomes” movement strives to protect inhabitants from impending eviction.
These are the thoughts that tug at my mind as I pass our crossing guard. The young parents pushing strollers, the golden retrievers and labradoodles on leashes, the residents in scrubs and Patagonia jackets, the work-from-home people on their runs, the townhome inhabitants sipping cappuccinos at corner coffee shops, the families taking children to Igloo on a Friday afternoon for a Yogarino. It’s idyllic—almost dystopian. With smiles on the surface, I can only speculate how original members of the neighborhood truly perceive us. The power dynamic of medicine and academia seeps into the roots of the pre-existing community, spilling over the Schuylkill and into the lives of those who inhabited it before. The murals on the sides of the brick townhomes remain, telling a story of the lives that once defined these streets. In the second week of June, the annual ODUNDE Festival—the largest African celebration on the East Coast—reclaims a dozen-block radius in Graduate Hospital with performances and street vendors. Churches at the corner of 20th and Christian persist as hallmarks of community, clinging with conviction to dwindling congregations.
“Look, see? They’re going to be doctors.” As my roommates and I crossed Catherine Street one morning in February, our favorite crossing guard pointed her finger at us, a gaggle of young girls encircling her. “Don’t worry, ladies,” she called out to reassure us. “I’m just pointing you out to these students.” I smiled back politely, happy to inspire young women to go into medicine and chase their dreams. However, this encounter nagged at my conscience. It seemed to further underscore the separation between “them” and “us,” transplants hastily grafted into an existing intricate system of life. The crossing guard pointed at us with the positive intention of motivating children of the community, but it unsettled me to imagine this gesture in reverse. Too often, we “point at” communities to study and operationalize equity and history, a well-meaning intention of partnership and reparation put forth by universities that may unintentionally foster implicit paternalism.
We endeavor to collaborate with our neighbors through needs assessments, vaccine canvassing, and free clinics. We discuss history, race, and community dynamics in Doctoring and walk through North and South and West Philadelphia as part of orientation. We debate policies and politics in the sleek classrooms of JMEC, and we engage in neighborhood greening projects to study the effects of built environments on health. While all of these are carried out with the best of intentions, it still feels as though we are separate in some way. Just as the crossing guard pointed at us, we point at them. We mean well, but we may create new challenges as we attempt to solve others.
However, this does not mean that we should stop our efforts of partnership. There may not be a perfect solution—we cannot integrate seamlessly into existing communities, nor should we force ourselves to attempt to do so, and we cannot repair relationships we have damaged in one fell swoop. We must remember that original community members may not want to see a future with transplants to the area. We may be rejected. We cannot expect to be woven into the fabric of relationships and history without pausing to re-evaluate, listen, and learn. Integration of any transplant takes monitoring, titration, and time. Importantly, it relies upon horizons.
They say it takes seventeen years to build meaningful community engagement, but we may only be here for four in medical school. Our community members are leaders and experts, and beginning to know their narratives both as individuals and as an integrated whole offers a first step, an opportunity to transform circumscribed borders into horizons of possibility. As future physicians, whether in Philadelphia or elsewhere, our words and actions will carry weight, and it is important that we use them to listen intentionally to the community and direct our efforts toward their priorities.
Walking home from the hospital one afternoon, I saw our favorite crossing guard boarding the bus with her arms full of groceries. It occurred to me then that I know nothing about her—I do not even know her name. She and I live wholly separate lives, but for thirty seconds each morning, our paths cross. For me, this interaction, however small, is where promise is held. While I know that it will take decades and centuries to repair, renew, and restore, and that this work will never be fully completed, our efforts of iterative partnership—of pausing to listen and learn—enable us to look toward a horizon of humility and hope.
Aidan Crowley is an MS1 at the Perelman School of Medicine.
Image by Yvonne Su, an MS1 at the Perelman School of Medicine.
