How much education does it take to learn to wash people’s feet?

By Barbara Waldorf RN, MPH (candidate)
Boston University School of Public Health
Recently, in a health policy class at BUSPH, I listened to Dr. Jim O’Connell describe how, as a hot-shot young doctor fresh from being the chief resident at MGH, he was told that to start his new job at the Pine Street Inn, he would be washing the feet of the homeless clients at the nursing clinic. The struggle with his (and the medical profession’s) ego was palpable. To his credit and the benefit of thousands of homeless people over the next 20 years, he chose, in that moment, to not know, to trust the nurses and to learn a in new way.

Ruth Stark, in her training manual for working abroad, speaks of the critical importance of learning to listen when in a another country or culture. Her advice to everyone who ventures beyond their boundaries, who wishes to have an impact in a different cultural context, is to spend significant time asking questions rather than assuming prior knowledge, and to cultivate humility.

There is no doubt that facts and figures, economic theory and the scientific process are important. These can be taught. Graduate education in public health gives us the tools for financial analysis, the application of management principles and the rigor of epidemiology and biostatistics. These are the building blocks of the profession.

Yet, without the more intangible skills of listening, humility, curiosity about the unknown and a profound respect for the deep threads of humanity that bind us together, we will not be able to make the right decisions. Paradoxically, the depth of respect for, and willingness to learn from, other people’s wisdom and knowledge is based in the confidence and knowledge of one’s own culture, experience and education. Without grounding in self-respect, how can we access that which needs to be given? In order to become an advocate for real change and have the discernment to make important decisions, we need to know ourselves.

I washed the feet of homeless women at the Pine Street Inn the same year as Jim O’Connell. As a student nurse at UMass/Boston, it was my community health placement. I was young, suburban, and middle class with noe xperience of inner city, drug addicted, alcoholic or mentally ill homeless folks. I was scared and felt I had nothing to give. But as I sat with them, day after day, soaking their feet, listening, being with them as a human being, something happened.

Something was touched that opened my eyes, both inner and outer, to a very different way of being. It changed me in a fundamental way and shifted both the trajectory and context of my professional life. I owe the homeless women who allowed me to wash their feet for an education I have utilized all my life. It has taken me throughout the world, and allowed me to be with people I could not speak with; to work in situations I did not understand and to take risks and move into arenas I did not know.

That thread has led me to now pursue a Masters degree in public health, where new vistas are opening up. Understanding how economic theory explains the provision of care, finding a new perspective on health care systems and gaining the building blocks to decide when and where to intervene in complex emergencies. Something has come together here, which is the place where my education from the university meets my education from the women of Pine Street, from the Tibetan refugees I cared for in the mountains of Nepal and from my schizophrenic clients in Boston.

To answer the question, it takes a lot of education to wash people’s feet, to be present for them, to be a true advocate and to understand when to speak and when to listen.

Barbara Waldorf is an RN and working on her MPH at Boston University School of Public Health with a concentration in International Health. Having lived and worked in Asia, Europe and Australia, her current interest is in the emerging field of Global Health nursing and learning from other nurses who are active in this field.

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