Reflecting on reflections on reflected reflections. I'm living in a meta world of reflections. As my final year of training draws to a close, I also have to submit multiple reflections on my experiences. Normally, this isn't too hard. Narrative reflections are easy enough - I tell the story of what's happened and generally explore why this happened and how if impacted me. Critical reflection is so much harder.
For example, on reflecting on my Indigenous Health rotation, I firstly needed to recognize and reconcile the intense experience and emotional upheaval associated with it. I needed to recognize why I was upset: I felt anger and injustice for the people of the local Indigenous community. Then what I did about it: made practice alterations and accommodations for culturally safe care. Then why I felt the need to be upset: colonialism's legacy and ongoing, chronic racism of Canada towards the Indigenous communities. Then why I felt the community needed me in their healthcare: they don't have anyone else, but does that mean I'm the best person to provide it? White (although I'm not white but I may as well be for my upbringing) savior industrial complex perhaps? Then what are my motivations for wanting to go back to the community: to serve the community as a healthcare provider. Why do I want to go back: perhaps guilt of not seeing more patients, or perhaps more of the savior complex, as if the community itself cannot rise to the challenge of low physician to patient ratio?
At the end of the big round of reflections (which take several hours to days to reach, I might add), I've reached the pits of the colonialist, racist roots that being a settler has grown within me. It's scary. I like to think I know better. I thought I knew better. I have a background in Indigenous Health, I've supported smudging ceremonies, I've even analyzed literature written by Indigenous authors - way outside of the healthcare world. I'm also an ethnic minority who knows and has experienced the harms of racism. I would not have called myself racist before now, but turns out I am. Turns out we all are - depending on how far you dig and how far you're willing to dig.
Believe me, it doesn't feel good during it. It's constantly interrogating one's self. Why? Why? Why? Why did I do this? Why do I think this? Why did I feel this? Someone pass me a creaky chair and dangling single light bulb on the ceiling please. I'm playing good cop bad cop with myself as the interrogators and the interrogated. The process of reflecting critically is challenging my feelings, my motivations, the drivers behind my motivations and tracing just how far back those threads go. I fear that, unlike Theseus, at the end of my spool of thread I will not find the exit to the maze but rather the minotaur. And I'll also be the minotaur in disguise. Turns out I'm also one of the monsters who eats the sacrificial children? Well, maybe not that far, but it can feel that disheartening questioning my real motivations on what seems surface level god and kind acts.
Maybe there's a room for true altruism versus selfish and egotistic altruism here.
I do think it's a necessary process. It is necessary to constantly challenge ourselves and evaluate our feelings and reactions. To be a truly self-aware and culturally safe provider, these are painful processes I must go through. But it doesn't make it any easier to be sitting here at 1AM chugging coffee and realizing on reflection that I'm not nearly so good a person as I'd like to think.
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