PhotoStory

The Story Behind the Scenes

From "Good Idea" to Reality

Annette's journal of the process.
In The Beginning

Nurse B and I met in April. Her flight had been cancelled and of the 15 passengers promised a seat on the next plane, she was the only one who didn't get on. She made it onto the third flight to Denver. I was on that flight. Neither of us is chatty on planes. Who knows why we started talking? We just did.

She told me she was a nursing practitioner and I said I was a consultant. When I found out that she had been banned from a (shall remain unnamed) School System I knew she was special. One of her community nursing students took her advice and took "action" by writing a letter about there being no toilet paper in the children's bathroom in a City Name school. It seems that the kids would make a mess with the toilet paper so the administration's decision was simple: no toilet paper, no mess. All hell broke loose. We giggled about that much fuss over a letter in big looped cursive writing on the pretty flowered stationery of an 18-year-old nursing student. Two heretics had found one another.

I told her that I had been searching for a partner who was as willing to rock the boat as I was - to try out some non-traditional community action. At the same moment I mentioned using storytelling as in intervention - she rushed in with a description of something she saw at a conference called "photovoice." A group of health researchers handed out disposable cameras to allow the population that hoped to help (in this case women in China) to document and dialogue about issues. In an instant we combined the two ideas and promised to try and make it happen in the community that Nurse B served.


Emails through May, June, July and August firmed up our plans. Nurse B applied for a grant and I booked my ticked and designed a day of "training." During that time we had some pressure to produce "measurable results." We indulged in a bit of ranting and raving:

Annette's Email: Measurable Outcomes!!...don't get me started. Measurable outcomes have destroyed more good ideas, good education and good working practices than drugs, guns, and alcohol put together. I liken it to obsessive compulsive disorder. Management types hate the idea that they are not in control, can't be in control, and don't know what is going on (the unavoidable dilemma of being human)--so they react in the exact same manner as someone with OCD. Like Jack Nicholson in As "Good as it Gets," they count whatever they can count purely for the comfort of the counting. Locking the door exactly 8 times is just as rational as standardized tests for pupils to evaluate the competency of teachers. This is one of my major pet peeves.

In corporate they call it accountability - like performance reviews - a special form of mutual persecution that feeds the cycle of abuse throughout the system. It is so much a part of the system that it never occurs to anyone that monitoring might be unnecessary (at the very least less necessary) if they'd spend half as much time and money developing trust as they do number based information systems that treat adults like untrustworthy children. ... But you can't measure trust. And without empirically validated evidence why it must not exist...like I said, don't get me started.

Nurse B's response: We in "health care" spend considerable time and money doing "assessments" that I have come to believe are pretty much irrelevant --- we set up a list of questions or some set of criteria that we think we need to know (which usually has no significance to the people we are asking) and we are surprised when they give us irrelevant answers. For instance, there is a woman who says she can't see how this will work (photostory), told a "story" one day at a conference about how the foundation previously used a needs assessment questionnaire in communities to find out what services people wanted or needed. But dental needs was not listed because no one at the Foundation thought there might be a need. No question — no need! One university has been talking about doing a "needs assessment" for this community for 3 years but it hasn't done it yet. And what kind of needs assessment would you do? There are 33,000 people in X Community. Do they all have the same needs and does a check in a box really reflect or more importantly convey to others what this means in the lives of people who live there?

I worked with this community for over 2 years before I found out that you can't get pizza delivered to your home if you live in X Community. Pizza places won't deliver - too dangerous. But the people who live there can tell you exactly what goes on after dark, where those people hang out and usually have some pretty good ideas of how to fix or get rid of the offenders. If they had some support from the appropriate authorities or money to do it themselves, they probably could. They have city buses and even a nice big bus terminal station at the edge of the community that service the residents but what that doesn't tell you is that it takes two transfers (three buses) to get to the other side of X Community (a distance of 5 miles) to get to the health clinic where you will sit for approximately 6 hours if you have an appointment and then will wait another 2 hours to have prescriptions filled. "

We fed off each other's righteous indignation and forged ahead. The first day was to be on August 27, 2000. I flew in the night before. Nurse B and I had dinner at a Mexican restaurant and crashed. She has four teenagers and I had been traveling way too much. The next morning after coffee, we were out the door by 7:00 a.m. looking for a store that sold markers and masking tape. Nurse B had worked so hard getting the right people, making phone calls, fending off worried parties, and answering questions that markers and masking tape had had to wait.