The Dignity of Accountability with Michelle Bernabe

In this conversation, Michelle Bernabe shares her journey from being a Columbia-trained nurse to her experiences in psychiatric emergency rooms and prisons. She emphasizes the importance of dignity in healthcare, the need for accountability in relationships, and the implications of cancel culture. Michelle discusses how moral health is intertwined with physical health and the necessity of community for healing. She advocates for a contemplative approach to understanding one's role in accountability and the importance of learning these processes to foster healthier relationships and societies.

• Resources
• Michelle Bernabe on LinkedIn
• Moral Health
• We Will Not Cancel Us by adrienne marie brown
• 32BJ Health Fund
• The Dignity Lab: Restorative Justice with Dan Green

Takeaways

• Michelle's journey into nursing was shaped by her experiences in psychiatric emergency rooms.
• Dignity in healthcare is crucial for both patients and providers.
• Accountability is more than just saying sorry; it involves taking steps to prevent harm.
• Shame can be a teacher and lead to personal growth.
• The healthcare system often lacks accountability, affecting patient care.
• Cancel culture can be seen as a form of exile, lacking rehabilitation.
• Community is essential for health and healing.
• Moral health impacts physical health; accountability is fundamental.
• Individuals must engage in self-reflection to understand their role in accountability.
• Learning accountability processes is vital for personal and societal growth.

Exploring what it means to live and lead with dignity at work, in our families, in our communities, and in the world. What is dignity? How can we honor the dignity of others? And how can we repair and reclaim our dignity after harm? Tune in to hear stories about violations of dignity and ways in which we heal, forgive, and make choices about how we show up in a chaotic and fractured world. Hosted by physician and coach Jennifer Griggs.

For more information on the podcast, please visit www.thedignitylab.com.
For more information on podcast host Dr. Jennifer Griggs, please visit https://jennifergriggs.com/.
For additional free resources, including the periodic table of dignity elements, please visit https://jennifergriggs.com/resources/.

The Dignity Lab is an affiliate of Bookshop.org and will receive 10% of the purchase price when you click through and make a purchase. This supports our production and hosting costs. Bookshop.org doesn’t earn money off bookstore sales, all profits go to independent bookstores. We encourage our listeners to purchase books through Bookshop.org for this reason.

Transcript

Jennifer 

Michelle Bernabe, welcome to the Dignity Lab.

Michelle Bernabe  

Thank you. I'm so excited to be here. 

Jennifer

We'd love to hear about how you came to this present moment.

Michelle Bernabe 

I was working in oncology- adjacent things before nursing school, and I fell in love with pediatric oncology. I worked with Camp Ronald McDonald for Good Times. I fell in love with that population and I wanted to go become a nurse so I could do that type of work full time. In my journey of nursing, and I thank Columbia University for this, we got to spend one hour at a psychiatric emergency room in our rotations. And I had just never seen anything like that, acute psychiatric emergencies. And I was curious. I was, even in that hour, devastated what I was seeing. I was just like, what is this? The doors were locked, you know. That was different from anything else I had been seeing in the hospitals. And the other special thing was there was a real team, sense of team at this little emergency room. And they all seemed to like each other, which wasn't always the case that I was seeing in New York City hospitals. Not only did they like each other, they were collaborative on all levels. So like the psychiatrist was asking advice from the nurse's aide. there was dignity there. Every level of the team had dignity and their input was respected. And I think the care was really good and it was very hard work. And I just, I was like, I need to be here. I think mostly I was attracted to the dignity. I think I was curious about what I was seeing in terms of acute psychiatry, but I found a home, you know, in this little hour with these people. I had a great preceptor at Columbia and she helped finagle this psychiatric emergency room to take their first student. And so her name was Rose. And so I attribute my life's trajectory to Columbia preceptor Rose.

I would stay there for a little under 10 years and it eventually kind of broke my heart. And, you know, I went from excited and curious to then seeing, know, then learning to see how hospitals aren't always helpful.

And what it, and yeah, I mean, to keep tying in dignity, how they aren't dignified and how sometimes I was even getting in trouble for trying to fight for dignity when it kind of got into the way of some of the other priorities of moving patients quickly. and eventually I would see, over the span of years, kind of this community of patients, you know, some of them disappearing, some of them completing suicide and...yeah, I think I then left with a lot of moral injury. And a big question for me was how do I bring dignity to psychiatry?

Jennifer  

Tell us more about your relationship with dignity.

Michelle Bernabe  

I know I'm very empathic. And so when there's not dignity, I feel that. And when others don't have dignity, I feel that and I feel that more than maybe the next person. And sometimes I could get confused of, you know, taking on someone's lack of dignity as my own being empathic, right? So being...very porous, has led to me,  it's given me a sense of fight, fighting for dignity for others. I think that's why I chose the nursing career, is how do we bring dignity to health? And when I wasn't seeing the hospitals doing that, I tried to fight with the hospitals, but then the hospitals...are really big and I'm very small. So it's very hard to fight with the hospitals. So now my goal is how do I maintain dignity with health? Dignity is important for me, I feel, when other people don't have that. And my best solution is how do keep people out of hospitals? think dignity within healthcare is mostly found outside of the hospital setting.

I can't wait to be proven wrong and anybody from a hospital system that's listening to this, contact me and tell me what you're doing differently and let's talk. so my relationship to dignity is I feel deeply when other people don't have it. And I want to try to build systems that help give dignity to others while they're healing.

Jennifer  

You've also done work in prisons.

Michelle Bernabe  

I have, yes. That's a funny story. I was  a bit of a literalist. I grew up Catholic and Christian, and I was a bit of a literalist when it came to the Bible. And, you know, my favorite passage, there's, I even remember, I'm gay now, so less of a literalist when it comes to the Bible, but there's a classic passage in Matthew, “Where were you when I was hungry? Where were you when I was sick? Where were you when I was naked? Where were you when I was in prison?” And so it was like, you know, and these are the people who went to heaven, right? The whole point of Christianity, when we are used to get to heaven, you know, so Jesus does this big reveal and the people who thought they were Christians, right? They end up separating from Jesus So, you know, maybe going to hell. And then it was this group of people who were surprised, …they didn't even know they were Christian, one may argue, but they were feeding the hungry, clothing the naked, visiting the imprisoned. So I had done everything on that list except for going to prison. So I had to figure out how to get to prison. So I went to the Christian groups. The Christian groups did...at this time… did not want females. They didn't think it was appropriate for females to be volunteering in prisons. 

So I was out with the Christians and then I hit up some other groups and eventually it was the Buddhists. The Buddhists were like, yes, you want to help facilitate meditation in prisons? Sure. And I was like, yes. So then they're like, this was probably 20 years ago now. They're like, do you know how to meditate? And I lied, which...maybe counterintuitive to trying to get to heaven, which was the backhoe of this whole story. And I said, I did know how to meditate, but I figured it was like something you could learn quickly, easily, I don't know why. And then she was like, come meet at my house and you know, whatever, there was a screening. I eventually was co-facilitating meditation in a maximum security prison and I mean, it was still, I think, one of the closest I've ever felt to God. So I do think I got to heaven and it was just being with those inmates, meditating in that prison. I think there was one  defining mirror of a moment where I really kind of got to see myself more clearly as a result of a comment one of the inmates said. I was so nervous being in the prison. There. was a no hostage release form you would have to sign every time you went in, which said, just so everyone was on the same page, they would never negotiate your life for the release of a host, for the release of a prisoner. I know they're not, everyone knows that's not gonna happen. So I was a little nervous, especially when I first started and I, you know, I would rarely meditate with both eyes closed. I was definitely anxious and my body was moving. And at the end of one of the meditations, this guy came up to me, he goes, you know, I see all your movement. I was like, I guess I'm nervous. And he's like, it's so funny. You're, you're not at peace. And I'm like, huh. And he's like, I'm in prison and I'm more free than you. And then he just kind of walked away. He's right. You can be in prison and be more free than the person co-facilitating the meditation.  It was a piece of heaven on Earth.

Jennifer  

I know that accountability is one of your favorite elements of dignity. How has accountability shown up or not shown up in your work, in your life?

Michelle Bernabe

How has accountability shown up? Maybe it is taken for granted. Most people with a grip on the English language would say, I know what accountability is, but could they tell you an accountability process? And I think once I was so fortunate enough to kind of stumble upon, I think probably 10 years ago, I've seen Adrienne Marie Brown, who is a a kind of queer godmother of accountability, talk about restorative justice and really lay out a framework of accountability.

Yeah, think learning that accountability is more than just saying sorry, that it is, that's part of it, right? But it's also how are we taking the steps to ensure the same harm doesn't happen again? And I think people think, people equate accountability with I'm sorry, but the acts were like, juice of accountability is what steps are we taking to ensure the same harm doesn't happen again. And that's a lot. That's very hard.

Jennifer  

and so powerful.

Michelle Bernabe  

And so powerful and so beautiful. I think that's where the restoration comes from. That's where the beauty comes from. I’m sorry and it won’t happen again. That's where the healing comes from. 

Jennifer: As I said at the top of this episode, the word apology comes from the word to defend oneself, and the word accountability comes from the word for a reckoning.

Michelle Bernabe  

Yes, and I think one of my one of the most other beautiful takeaways and this time it was from a hearing a Jewish rabbi speak about God changing Jacob's name to Israel, right? And that moment was a fight with an angel. And to me, it's this it's what accountability is and what Jacob famously says is, will not let go of you until you bless me. And I think that is the reckoning of accountability. You know, this fight within yourself of a harm that you've done and I will not let go. I will not stop this wrestling until you bless me. And the other side of accountability, I think is a blessing. But it is that reckoning and it is a fight. It's not easy to take accountability. It's hard.

Jennifer 

And somehow for me, it's been incredibly liberating. When I've been able to take accountability for wrongs, I have felt that that's the point at which shame falls away. if I can truly take accountability for my part in something, my own shame, it's like it shrivels up and gets right sized. I don't know if there's a right size for shame, but it...

Michelle Bernabe  

Shame becomes the teacher. Right. And so then it's not a part we're exiling. It's it's informing us because it's leading to this accountability process.

Jennifer  

And our whole system of defend and deny keeps us from taking accountability.

Michelle Bernabe  

It's also our whole health system and in a different way. So those words just kind of rang true of kind of current events in healthcare, which I think a lot of our systems are also, right? We talked about prison too, are defend and deny. And that's not nourishing to the human spirit. It's not rehabilitating. It's not healing.

Jennifer  

It occurs to me when we think about a self defense with an apology that we're pushing people away, right? It's like we're holding our hands up and saying don't come close..

Michelle Bernabe  

Mmm. Yes. Yes.

Jennifer  

I know you've seen things for which people haven't taken accountability in your own life and as a leader. And I'm wondering what your observations are regarding that.

Michelle Bernabe 

Well, I think if I could start with the opposite, you know, I was very lucky to have taken what I thought would be an easy class in college and it was film in South Africa, and where I got to learn about their giant accountability process. Truth and Reconciliation Commission. And I think seeing deep accountability on the scale of entire country when there were harms that were as huge as murder inspired me that accountability is always possible. And so I was lucky at my budding age of 19 to know that accountability is always possible.

And so I think in healthcare, I've also seen a system that's not been accountable, right? So I started this talking about how, you know, in my time in New York City hospitals, I saw unaccountability. And I think we see that in so many different ways in healthcare from prices.

There's no transparency. The insurance companies are intentionally making financials hard to be accountable for. And I've reckoned with what to do with that. So do you walk away from health care? So I was in a hospital as a nurse, but I think I've had such great teachers along my way. So, you know, seeing individual doctors who, you know, two that come to mind, Owen Meir and Carleen McMillan, who were just early adopters of these very innovative treatments in mental health, and I was seeing people get well without hospitalization. To me, that's a form of this doing no harm, right? 

There's a union in New York, 32BJ Health Fund, and they just, man, are just...behemoths and trying to make healthcare more accountable. And you can learn more about if you Google 32BJ Health Fund, we have all these videos and all these resources just helping people. So all to say I have been disappointed by some legacy institutions in healthcare. And had I not had this backdrop of seeing Nelson Mandela lead a whole country through a very hard accountability process, I maybe would have quit healthcare and gone into finance so then I could just live a luxurious life on a yacht for summers or something. I've been blessed to see, you know, fighters and teachers, do right and create accountability.

Jennifer 

What is the role of accountability in healing and repair?

Michelle Bernabe  

It's very intertwined, right? So I have this idea of moral health and it has many meanings. But one of the meaning is if we as individuals aren't morally healthy, it actually affects our physical health.

And so when you ask that question, one of the first of many things that come to mind is if we aren't accountable to ourselves, to our partners, to our families. And that affects our health, our physical health. So our most selfish reason to be accountable is to preserve our individual health.

Jennifer 

Say more about that.

Michelle Bernabe  

I mean, let's just take an example. You have a partner who is lying or cheating and lying, right? That doesn't feel good to anybody, right? Being the liar isn't, you don't feel healthy, right? There is that shame, right? Maybe you're numbing with alcohol. As humans, I think we're meant to be in reconciliation and in relationship and a good and healthy, dignified relationship to one another. So when we are not, we're either numbing or we're stressing the systems, family systems out around us, and that affects our health.

Show me the person who's living an unaccountable life who's healthy. You could argue maybe there's the rare case of the sociopath, right? The true, which is rare, sociopath who cannot feel. But as long as we are attached to our feelings, which the majority of us are, then accountability is fundamental to our physical health. 

And I would love for primary care doctors to ask these types of questions. Like where in your life do you need forgiveness? Who do you need to forgive? Where is accountability needed?

Jennifer

It sounds like you’re saying that without taking accountability for our mistakes and trying to be better and do better, we are not whole people.

Michelle Bernabe 

You may say if the body keeps the score, right? 

Jennifer

Let’s switch subjects slightly to cancel culture. I know this is something about which you care deeply.

Michelle Bernabe  

Okay, cool. Cancel culture. Yeah, I guess it's really tied into prisons for me. So again, you know, one of my great teachers in this life is an author named adrienne marie brown. She writes a little booklet called We Will Not Cancel Us.  One of the many brilliant things she says is one of the you know, if we follow cancel culture to its  biggest extent, it's prison, right? 

So we have this whole system where we are canceling people for their mistakes. Prison and cancel culture would be great if it actually led to rehabilitation, if it actually..if the other side of cancel culture was a more loving whole human. I remember being mocked as I volunteered in prison. These like really muscular men who are smoking very mockingly saying thank you for participating in our rehabilitation. And it was almost like with the tone of like, fuck you, you know? There's little rehabilitation that happens in prison. I do think the Buddhists were doing a good job. But yeah, so if the other side of cancel culture was love and a more whole person, then I would be all for it. But it seems like the other side of cancel culture is disconnection and isolation and shame. 

And I understand in a culture that thinks punishment is a way to rehabilitate. I understand how we got to cancel culture. But I think we can observe, even just Googling recidivism rates for prison, that punishment is not how we make more, make human beings to be more loving and more connected.

Jennifer 

It feels like you've experienced exile in your life from your church and that you've chosen to leave certain places. Does prison feel like a form of exile? Is cancel culture a form of exile?

Michelle Bernabe 

They're both, yeah, they are both exiles. 

You know, you can't be in your fullness of health when you're not in community with others. We need community for health, the opposite of health is isolation, mental health, physical health. And yeah, so we're going to want to not exile. And yeah, I don't think it leads to innovation. We don't have the skill set because we aren't taught accountability processes. We don't have the skill set to be in relationship with people when they've harmed us. That's the heart of restorative justice. How can we stay in relationship despite harm? And of course, it's allowing the person to keep harming us. There's an accountability process where the person is committed to not repeating the harm again. because we lack that cultural wisdom of how to do that, we just...exile. Like, you hurt me. You're bad. Let me shame you. And then we keep ourselves as a culture from all this generative conflict. There's so much to learn from conflict if we can be accountable and safe with it. But we are limiting ourselves. And we can see this like at scale with prisons.

We are limiting ourselves from a whole group of very talented people. And one of the roles in this particular prison I volunteered in was we had to make sure we had no keys showing because there was a prisoner who was so talented he just stared at a single key. Like, whatever, for hours, anytime this volunteer came and then he was able to recreate the key. And so they banned keys, but that type of intelligence with just by, you know, looking whatever, whatever period of time and then just being able with your own, you know, limited supply set to recreate the key. So we limit ourselves, I think from the fullness of our own human collective potential by exiling.

Jennifer  

Imagine what that brain could have been used for.  

Michelle Bernabe 

Exactly. There's also tons of studies that when you shame people and punish them that it actually deteriorates the brain. And you can see on fMRIs that the frontal cortex doesn't light up when you're in a state of shame. And so we are limiting collective human potential by having giant shame and punishment institutions.

Jennifer  

Thinking about dignity and the lack thereof in many of our institutions that are sort of part of the dominant culture, thinking about exile, thinking about accountability, what do you think we're called to do as individuals and as a society?

Michelle Bernabe

I think that's the other essence of moral health is there's no one answer and that it takes a contemplative spirit to figure out what you're called to do. That you need to pause and listen, you know, make sure you're not numbing and that...making sure you're in good relationships with others. if you're in relationship with people who don't know how to take accountability, that you need to go find a group of people who can, right? It's not about being in relationships who don't have conflict. It's about being in relationships where they can be accountable to harm and sticking with those people and then, you know, in that community.

For me, I think, again, it's trying to bring accountability to health care. And in a way that is loving and just having a process, contemplative process to figure that out for yourself is important and that it's continual, right? Because I may have overstayed my purpose in institutions and in relationships. And I think that...that continuous check in with self is important to keep pushing the story forward in a more grander accountability narrative.

Jennifer  

What's one wish you have for our listeners?

Michelle Bernabe 

That if you don't know an accountability process, you look up accountability process, restorative justice, you'll find some great works, that's one. Two, any relationships that aren't accountable, that aren't accountable to you and that there's you know, this essence of a commitment to not keep harming that you free yourselves of those relationships. And that's personal and that could also be with your job. I think my biggest wish is yeah, that you learn the accountability process yourself because it starts with self.

Jennifer 

Michelle, thank you so much for being on The Dignity Lab today.

Michelle Bernabe  

Thank you. What a lovely way to spend my afternoon talking about dignity. 

Jennifer

We hope you enjoyed this conversation with Michelle. Please rate, review, and share this episode with someone in your life, whether at home, at work, or in your community. How can we build restorative justice into our relationships, including into our systems? Are you in relationships in which there is accountability? Have you ever been canceled? This type of exile is painful and does not lead to healing or restoration. 

If you’re interested in learning more about restorative justice, check out our episode on restorative justice with Dan Green from Season 2. We’ll put a link in the show notes as well.

If conversations about dignity and, in particular, accountability are something you’d like more of, consider joining The Dignity Lab, a small group leadership roundtable. You can learn more on my website, jennifergriggs.com. If you’d like to set up a no obligation call with me, you can also do that on the website.

We’re going to be taking a break for a few weeks as we prepare for our next season, which will focus specifically on trauma at work and forgiveness and healing after harm. Make sure you don’t miss the launch by subscribing to my newsletter on our website, thedignitylab.com.

Thank you as always for listening, and we’ll see you next time.