Rev. Denise Dunbar-Perkins: Marginalization and the Patient's New Normal

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Rev. Denise Dunbar-Perkins uses her life experiences with marginalization as a Black woman to meaningfully connect with hospital patients who often struggle with marginalization and the loss of their normal lives in the hospital.

Reverend Denise Dunbar-Perkins worked as a staff chaplain at Abbott Northwestern Hospital in Minneapolis for 13 years and retired in 2017. She was interviewed in 2013. Her office was on the third floor of Abbott Northwestern, in the Palliative Care and Pharmacy section. As doctors in brightly colored scrubs and plain white coats hurried by in the hallway, Rev. Dunbar-Perkins directed me to a cushioned wooden rocking chair in front of her desk. Her office was warmly lit with a large floor lamp and contained several small-framed pictures, a dream catcher, a handmade ceremonial broom, and a Ghanaian symbol that hung gently from the wall.

"And so you're in the hospital and you're in here suddenly. And all of a sudden, people are saying, 'Oh you can’t do this because it will make you sick' . . . And all those [things] that they're naming are the things that give you pleasure."
—Rev. Denise Dunbar-Perkins

Rev. Dunbar-Perkins discussed the loss of control that hospital patients experience and how it can marginalize them.

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For many people, there are two different scenarios I see here—and this doesn't include everything—but you're in a hospital, you don't have control over what you eat, when you wake up, even when you go to the bathroom. You know, the basics, what you wear. Well, the only thing you have control over is what you watch on television. You know, gee whiz, that's all you get. And so, you're in the hospital, and you're in here suddenly. And all of a sudden, people are saying, 'Oh, you can't do this because it'll make you sick. Oh you can't do this it'll make you sick.' And all those "this" and "thats" that they're naming are the things that give you pleasure. Or the things that you've always found is something you want to do. And so, you get those basic rights of a human taken away.

A self-described "Bapiterian," Rev. Dunbar-Perkins is a Presbyterian minister steeped in the African American Baptist tradition. She shared her story about how she came to serve as a chaplain at Abbott Northwestern, describing how her life experiences first cultivated her interest in ministry.

This is my third, or technically my fourth career. And I come out of the corporate arena and moved into education and then moved into ministry, but I think it would be helpful to backtrack. I originally [was] born and raised on the South Side of Chicago, one of the children of the Great Migration of the 1930s and '40s. My parents came up from the South, so we have a connected history to that part of our country's history and I'm just old enough to have experienced a lot of issues with segregation and Jim Crow: not being allowed to drink water, not being allowed to sit in certain places, so I have an active history with that. And I bring that experience with me. I brought it through my corporate experience, I brought it through my teaching experience, which was very helpful because I worked in, intentionally worked in schools where the students had been literally kicked out of the mainstream schools, the high school students, and was able to connect them to the history of who they were and to give them a sense of being more than what they were labeled as. And I think that was the beginning of my interest in ministry.
—Rev. Denise Dunbar-Perkins

Rev. Dunbar-Perkins continues to discuss marginalization.

Show Transcription

And even us in the health care profession, we think when we say, 'Oh no, you can't eat that bacon, it's gonna make your blood pressure go up.' But you know, you live for having that bacon and eggs every Saturday morning. And it's the ritual around it; it's not just the eating of the food, it's the people that you're with and what you're talking about, and now you've been told you have to get rid of that. So people are marginalized, they're grieving. They're in a constant state of grieving, loss. Because of the changes that they have. And it takes you to a deeper level. And we know that we're trying to help people by saying, 'You have to change your life to be able to survive.' But that change is grief. And in chaplaincy, we get to recognize that, we get to lift that up. And say, 'Yeah, we get that. That is loss.'

Rev. Dunbar-Perkins explained her path through seminary, her intention to enter ministry, and how she ultimately found hospital chaplaincy as a meaningful career.

At some point, through a series of meeting different people, being involved in different city projects, that I ended up getting involved with the Presbyterian Church and from there I ended up in seminary and most people who end up in seminary don't know how they got there, they just wake up one morning and you're in seminary! So I went to seminary and my intention was to become a minister at a, probably an African American church . . . in Minnesota [but] . . . There's only one African American church and, a Presbyterian church, and they already had a pastor that I was involved with hiring . . . I was actually the first African American woman or man who was ordained into the Presbyterian Church in Minnesota, and I felt the weight of that. What type of responsibility did that mean? Well, it turned out that I took a residency at this hospital after I graduated from seminary because I wasn't sure if I wanted to commit to a church or leaving . . . But when I came here, my intention was to be a parish minister. However, in my journey through this hospital, the connections I made with people, I saw around me a parish being created for me to respond to that looked nothing like what I had envisioned.
—Rev. Denise Dunbar-Perkins

Her life experiences, particularly of racial marginalization, prepared Rev. Dunbar-Perkins to connect with patients, who face marginalization of a different kind.

And . . . my longer assignment as a resident was with the oncology group, and because I have a background in science and did research in sickle cell anemia back in the '70s, what this particular unit, the oncology unit, also works with blood disorders, and there is a population of sickle cell patients. So we're talking about like a 35-year cycle coming to pass where I had this semi-medical background in understanding the disease and then the population, the population is 99% African American and I was being drawn back into people who have been extremely marginalized for whatever reason, just like my students, and came to the realization that anybody that's in the hospital has a sense of being marginalized; no matter how much money you have. I've seen some of the most powerful people in the country here, and people [who are] very rich, people who have nothing, people who are pushed aside because of ethnicity, where, what country they may come from, what type of religion they practice. And I realize as I look back on my own experience of being marginalized, and even my life being in danger sometimes because of my ethnicity, that I could relate to that sense of being disconnected and that's what my true calling was as a chaplain.
—Rev. Denise Dunbar-Perkins

The marginalization that Rev. Dunbar-Perkins referred to is the experience of a patient in a medical institution. She described what this marginalization might look like for a patient.

For many people, there are two different scenarios I see here—and this doesn't include everything—but you're in a hospital, you don't have control over what you eat, when you wake up, even when you go to the bathroom. You know, the basics, what you wear. Well, the only thing you have control over is what you watch on television. Well, you know, gee whiz, that's all you get. And so you're in the hospital and you're in here suddenly. And all of a sudden, people are saying, 'Oh you can't do this because it will make you sick' . . . And all those [things] that they're naming are the things that give you pleasure. Or the things that you always found were something you want to do. And so, you get those basic rights of a human taken away.
—Rev. Denise Dunbar-Perkins

To illustrate this explanation, Rev. Dunbar-Perkins discussed how medical treatment can be marginalizing and how, as a chaplain, she tries to provide comfort.

And even us in the health care profession, we think when we say, 'Oh no, you can't eat that bacon, it's gonna make your blood pressure go up.' But you know, you live for having that bacon and eggs every Saturday morning. And it's the ritual around it; it's not just the eating of the food, it's the people that you're with and what you're talking about, and now you've been told you have to get rid of that. So people are marginalized, they're grieving. They're in a constant state of grieving, loss. Because of the changes that they have [to make]. And it takes you to a deeper level. And we know that we're trying to help people by saying, 'You have to change your life to be able to survive.' But that change is grief. And in chaplaincy, we get to recognize that, we get to lift that up. And say, 'Yeah, we get that. That is loss.'
—Rev. Denise Dunbar-Perkins

Rev. Dunbar-Perkins also stressed that the hospital itself does not explicitly marginalize patients, but rather the experience of being hospitalized is what can be marginalizing.

I don't want to say that hospitals marginalize but that the hospital experience, the illness itself, creates marginalization. Either by having the illness or having the treatment plan that feels like it's limiting to the patient. All of this is done with good intention but now we're recognizing that even our good intentions have this spiritual effect on people.
—Rev. Denise Dunbar-Perkins