Workers on Work: Essential Workers

Essential Workers

Essential workers as defined by Georgetown Law Workers’ Rights Institute:

“Essential workers are those whose jobs are critical to maintaining the core functions of public health, society, and the economy, and who cannot work remotely amidst the COVID-19 pandemic.”

“There are an estimated 50 million essential workers, nearly a third of the American workforce.”

“Essential workers are more likely to be women, people of color, and immigrants than are other workers.”

With the pandemic “over”, aren’t they still essential workers?

Clinical social worker and therapist

Used and discarded needle. Utah Street near 17th, San Francisco, California. 9 August 2021

Joe Sciarrillo, 39 A licensed clinical social worker and therapist, he works outreach with the unhoused and addicts.

“The most frustrating thing is feeling like I’m just a band aide amidst many gaping wounds.”

I’ve been a social worker for about 9 years now. I’ve always wanted to be a social worker. I grew up in a family that was very influenced by Jesuits, and I got involved in the progressive side of the Catholic Worker, service orientated, the more liberal side of the Catholic Church. I had some teachers at my Jesuit school who were activists in the Tenderloin and that really influenced me to do something that addressed the inequality on the street.

Social work is great. It lets you have a therapist’s hat, but it also lets you get involved in the systems, connecting the dots among all the agencies that are supposed to be serving people.

I work with people who are mostly unhoused in the Tenderloin, Mission, Bayview, and SOMA neighborhoods. Mostly (I) do therapy on the street with people

who are unhoused, and a little bit of case management: connecting people to housing, to doctors, to therapy, to job programs. ◊ Our organization’s motto is, “Come as you are”, so therapy on the street involves letting people approach you with whatever issues they’re going through, being non-judgmental and willing to listen. That often involves being attentive to someone’s trauma, possibly their depression, and anxiety.

Being able to listen with compassion, affirm people’s identity, what they’re going through, and provide emotional support and encouragement, as well as to support people to make whatever next steps they need to make.

For me the most frustrating thing is knowing that

“I feel like I am able to do my selfcare when I get home - go skateboarding, watch movies, watch music - and I can decompress” in a city like San Francisco there are thousands of people who are in dire straits, and me talking to someone can be a positive interaction. But there is so much more support the city needs to provide. The city needs to do a better job of providing access to housing, access to medical care. The most frustrating thing is feeling like I’m just a band aide amidst many gaping wounds. There needs to be a lot more ser-

vices, medical and housing, addressing the economic system that doesn’t fit for everyone. ◊ The common issue is someone having past trauma.

Whether that being the jail system, being in foster care, a traumatic divorce, or an accident, and not having enough of a safety net, or support, to cope.

Or being very isolated and

struggling and that leading to depression. But all that is sparked by a trauma.

They’re struggling to figure out how to heal.

It’s very common, but not always the case, for people to be using drugs as a way of coping. ◊

ways need to talk to someone about what I’ve gone through throughout the day.

It was worse when I wasn’t doing this work, when I was just a student I would be consumed by reading the news and theoretical things about society and injustices.

I was emotionally a lot more wound up in being frustrated back then than I am now.

[Do you take all this home with you?] My wife would say yes. I would ◊ say I’ve always had these social injustices in the front I’ve only formally been a soof my mind, since I was a cial worker for 9 years. Bekid. fore that, for 20 years, I was either a paralegal or a caseI think that by being inworker. I would say all of volved in the work, being that was social work withface to face with the issues, out the name. So, I’ve been I’m able to compartmental- doing it for over 20 years ize it a lot more than when because it’s just ingrained I wasn’t a social worker. I in how I see the world. feel like I am able to do my self-care when I get home It gives meaning to my life - go skateboarding, watch by feeling like I am a factor movies, watch music - and in trying to create positive I can decompress. But I al- change in society, or some

individual’s life. And it’s reciprocal. I take meaning out of it, and I hopefully give meaning to someone, as well. That’s how I see the world.

It makes life so much more meaningful if we are there for each other. If we’re able to do that for our 9-5 job, that’s so much greater. So, I intend to do something like this for the rest of my life, if I can. ◊ I would just say that when people like me say the city should do more, I’m saying city agencies should do more, but also individuals, as well.

I think if more people saw people on the street as their neighbors, that would have a ripple effect how the average person interacts with someone on the street, even if it just means looking peo-

ple in the eye and saying hi.

That can have a ripple effect into what type of policies we vote for, how we put pressure on our supervisors, and city departments, to implement more humane programs.

As far as what needs to be addressed, the list could go on: affordable housing, more protections against evictions, more access to pro bono attorneys for tenants’ rights.

There needs to be more green spaces, more safe spaces for people to nap on the streets. More access to healthy food - not just soup kitchens - but more affordable healthy food. It’s been good to see more water fountains open.

There needs to be more public toilets, not just for the unhoused but for everyone who’s out and about during the day.

Dore Street. San Francisco, California. 20 July, 2020

There needs to be safe injections sites. There are 700 people dying of overdoses a year and we just keep sweeping that fact under the rug. It’s not going to go away unless there is more of a safe community to support people as they go through their addiction.

weeks, a few months, but didn’t work for them in the long-term sense. That opened my eyes because I always assumed that doing one or two rehab stints could be a long-term solution. But I’ve learned how complicated and nuanced addiction is.

We know even if they want to, they can’t quit right away. We need more crisis response teams, not just during the day but overnight.

There are so many variables to treating addiction that we have to have an open mind to harm reduction programs, [but] also to those more traditional programs that do work for some people. Addiction isn’t a one size fits all.

Yeah the list can go on. ◊ About addiction, I never realized, up until this last year, how addiction can be so inexplicably difficult to step out of. I’ve been able to meet people that have gone through rehab programs – AA or inpatient treatment – that maybe worked for them for a few

I have a lot more patience now with listening to different approaches to addressing addiction. I’m more humble about addressing it and talking about it, than I used to be. ◊

I think the biggest tool and skill is compassion, that’s the foundation when I’m encountering whatever traumas, or whatever social ills, injustices, sufferings people are going through.

my personal life than they need to. And me sharing too much.

Having my grounding in figuring out and believing that we are all connected.

That we all have a purpose to help each other, to support each other, and that all comes from values that I’ve grown up with.

◊

Listening! I think listening is a tool that is not talked about very much. Being able to be fully present with someone and listen more than you talk.

Compassion can be an issue when it connects to the issue of boundaries.

I’ve struggled with working overtime, and that bleeds into my family time, or people learning more about

You have to balance the compassion with some type of self-care.

Emergency Room Doctor

Waiting for stitches, Highland Hospital ED. Alameda County, California 2004

“Do I get bored? I don’t get bored in the Emergency Department. There’s not a second to get bored.”

Resident Lia Losonczy, M.D. Emergency Room Highland Hospital Oakland, California

It took me quite a while to decide exactly what I wanted to do. It became more and more apparent that I liked absolutely everything, and I had no idea what I wanted to do. I was applying in general surgery, and I did a rotation in neurology and absolutely loved it. And I was like, wait a minute, how can I take out gallbladders and deal with strokes at the same time? Then the more and more I got to know the people who are motivated for emergency medicine, the people who are passionate and care about the under served populations that we primarily served, the more I realized this is what’s for me.

My first day at Highland ED: My first day in Highland ED, I remember my very first patient had eye pain. And I remember thinking like, oh just a little eye pain. This is easy.

No problem. And it was a woman who had been wearing her contacts for 10 years without ever taking them out, because nobody had ever told her you’re supposed to take them out.

She had them completely infected, deteriorated, had gone blind in both eyes, and waited two years after being blind to actually come and see a doctor. I was dumbfounded at that position, and that’s the thing that’s consistent at Highland [and any public hospital], over and over and over again, it’s like these tiny little complaints that anywhere else you would think, OK, whatever, their arm is swollen.

But here their arm is like five times the size of their body, and there’s different objects and things hanging out of it, and the other arm is missing – they forgot to tell you.

I had another person whose

chief complaint was all over body pain. He was paralyzed from the neck down and had been that way for several weeks. It’s always ten times worse, tons of social complications, and really, really, interesting difficult lives people lead – phenomenally interesting and motivating and moving.

because the whole room fills with this putrid, nasty that’s clearly been rotting away inside somebody’s buttocks for weeks. Solid bacteria. That’s always a good one (smell). ◊

This is my third day in Labor and Delivery (L&D), I just helped on a cesarean ◊ section with two attending OBs. That was really The smells, oh God! There fun. Got to see a baby beare some good smells, occa- ing born, which is always sionally, although I’d prob- good and there was only a ably say the overwhelming 1000mL blood lose, which smells are less than posiprobably doesn’t mean very tive. much, but it always seems like there’s a lot more blood There’s the occasional GI than there is when it’s bleeder which will fill up pouring out really fast. But the entire station and make it was fine. She did well. at least half the other patients nauseous and our Labor and Delivery has a orders for Zofran go up lot of down time. There is exponentially. Sometimes some time to read, talk and there’s just a buttocks abeat. I had a nice conversascess that soon as you open, tion about parenting with you know that you got it the nurses yesterday, some

thing I couldn’t quite relate to but that sounded very interesting. ◊ Do you get bored? Do I get bored? I don’t get bored in the Emergency Department. There’s not a second to get bored. If you’re even thinking of getting bored, you get through about the letter T of that sentence and then there’s six more patients to see that are all super interesting and complicated. ◊ I think that what is really, special about Highland is all the physicians, the nurses, and the techs.

Everybody here is really motivated for the mission of the hospital. It’s amazing to work with people who really care above and beyond just the basic med-

ical needs of a patient, but [also care] where the patients are going home.

What they’re going to eat.

Whose been hitting them, and what the violent circumstances in their life are.

of communications difficulties. That certainly toke me more by surprise than I expected, more than anything else. The violence and poverty, and gruesomeness of a lot of the pathologies, I feel like I saw them a lot in It’s great to be around peo- Baltimore. I saw it in New ple that really care. It moti- York before I was in medvates you, and makes work- ical school. But certainly, ing in this environment the variety of cultures is where people really do have greater here than I possibly such horrific life circumimagined. And that was a stances, much more fulfill- surprise. ing. ◊ ◊ I’m from the Bronx and then I went to med-school in Baltimore so … I mean Oakland is a lot like Baltimore in many ways. I think that what is more complicated about everybody’s life here is it’s never one thing that’s wrong. It’s always 50 things that are wrong on top of an inability to speak the language, an inability to get here, and just layers

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