A 30-year-old man fell from a ladder while he was cleaning out the rain gutters on his two-story house. He tore several ligaments, was bruised up, and had x-ray results that were inconclusive. He was in a great deal of pain, having trouble walking, and later went to a hospital emergency department as a precaution. The emergency physician went over the x-rays with him and explained the evidence for various hypotheses about what his injuries were. Medical personnel assumed he had fallen because he was on a ladder and lost his footing. Period. There was no mention whatsoever of his age. He was hospitalized a couple of days as a precaution. His pain was reasonably well-controlled by medication, and he was given medication to help him sleep. Two days later, when the discharge planner was getting things in order so that he could be released from the hospital, they asked him for his ideas about what arrangements he needed for going home. He left the hospital with a referral to a physical therapist at his own discretion. There was no discussion of nursing home placement.

An older woman fell while hurrying across a gravel parking lot. She tore several ligaments, was bruised up, and had x-ray results that were inconclusive. She was in a great deal of pain, having trouble walking, and later went to a hospital emergency department as a precaution. She was admitted for a couple of days “because she wouldn’t be able to care for herself.” Age was cited repeatedly as a causative factor. When she asked for better pain control and something to help her sleep, she was told it wasn’t possible to provide it because of her age. When she asked to see the x-rays, she was told they “couldn’t do that.” An alarm was attached to each ankle in case she tried to get out of bed. Two days later, when she was to be released from the hospital, the discharge planner did not consult her, and the only option offered to the woman was nursing home placement. She was told she absolutely could not return home because getting into the house required climbing stairs. She was also told that, due to her age, she would need to use a walker for the rest of her life. Nobody asked her what she thought about what she needed. Throughout the experience, hospital personnel usually talked with other people about her, rather than involving her in the conversation. There seemed to be a presumption that because she was older and disabled by her injuries, she was not competent to make decisions for herself. Fortunately, the woman was more mentally incompetent than people assumed. She refused nursing home placement, left the hospital and returned home, climbed the stairs into her house, and used a walker only when she herself felt it was necessary.

Let’s compare our two people. The individual in the first hypothetical scenario was male, young, and aside from having tumbled off a ladder, physical-abled. The second individual is female, older, had similar injuries, and was every bit as mentally competent as the man. If these stories were unique, I wouldn’t be telling them. The stories—and the contrast between them—are in fact all-too-common.

I’ve become increasingly aware lately of the ways in which cultural biases, prejudices and injustices intersect and play off one another. Racism, for example, usually isn’t just racism. It’s racism as it interacts with sexism, classicism, ageism, ableism and so forth. The various ways people are “out-grouped” in this culture pile up on each other. Similarly, white privilege is also about class privilege, ability privilege, national heritage, and young privilege. These things interact in such a way that the combined impact is far more harmful than the sum of the separate effects. People who face discrimination usually face it along more than one dimension, and the more dimensions that intersect, the more dire their situation.

Formally, intersectionality refers to the interrelated nature of social categorizations as they apply to a given individual or group. It is not about who people are, but about the meanings the dominant culture ascribes to who they are. Together, they create complex, overlapping and interdependent systems of discrimination and disadvantage. It is the compound, cumulative way in which the effects of multiple forms of discrimination (such as racism, sexism, ageism, homophobia, ableism and classism) combine, overlap and intersect in the experiences of marginalized individuals or groups. To be effective, we don’t have to address all these various dimensions and more all at once, but we must be aware of them and of the ways in which they reinforce and complicate each other.

The two dominant factors in our stories were age and sex. The situation would have been even worse had there also been racial, economic, or gender differences.

We will not change this situation quickly or easily. It’s too multifaceted for that. What we can do is address it at whatever points it speaks most to us. We can stand alongside those affected by it in their struggle to overcome it. We can also work to make our own beloved community a sanctuary for those whose lives are caught up in these interlaced patterns of discrimination. We can offer a place where people can let down their guard, knowing they are safe, whoever they are.

~Rev. Julia

[Note: the two medical experiences described at the beginning of this article occurred outside of Muncie.]