The University of Texas Rio Grande Valley

UTRGV School of Medicine

“Life can only be understood backwards; but it must be lived forwards.” - Søren Aabye Kierkegaard

Kierkegaard, one of the world’s greatest existentialists perhaps best remembered by his works critical of religion, greatly contributed on the experience of despair as a key to understanding and helping those who are suicidal.

“Nowadays not even a suicide kills himself in desperation. Before taking the step he deliberates so long and so carefully that he literally chokes with thought. It is even questionable whether he ought to be called a suicide, since it is really thought which takes his life. He does not die with deliberation but from deliberation.”

For those of us who are clinicians and deal with people who are suicidal, our mission is to feel their fear, their frustration, their despair and discouragement, and understand their journey. The journey is likely to be a white-knuckle trip, and our salient mission is to accompany them backwards, while we help them live forward. Sometimes, this journey is called “compassionate witnessing.”

That is the mission of our UTRGV team in Edinburg at the John Austin Peña Memorial Center. Most of you reading this do not know or recognize the name of the son of former Texas Rep. Aaron Peña – now chief litigator for the Texas Land Commission. The clinic building in Edinburg is named for his son, John Austin, who died all too young from a drug overdose.

As we planned the care for triply diagnosed individuals (those with medical, behavioral and addiction problems), we developed an integrated-care, team-based approach. We thought, too, about where our School of Medicine clinic should be, and we felt a strong moral imperative to be at the John Austin Peña complex. Our mission is restoring health and relieving suffering, and this is where we felt we “ought” to be.

It is said that the paths of life are intermingled lives. Last week, that was certainly the case. There we were, working at the John Austin Peña Memorial Center, and in walked a young woman and her grandmother.

The woman was John Austin Peña’s daughter, Chelsea. She had not been to the clinic, but had heard through her family that we were there and she wanted to learn about what we were doing.

A while back, I started my series of these newsletters with Yogi’s quote: “When you come to a fork in the road, take it.” Every day, we cross so many different paths, but this one shapes all of us in our mission. What better way to share our work with the triply diagnosed than to do so with Chelsea and her family. In many ways, we as a community are at a crossroads with our School of Medicine and the health initiatives we face.

We are at a fork in the road – and we are taking it.

Like the Native American Ojibwe prophecy of the seven fires, the seventh prophet comes like no other – “young, and with a light in their eyes” – to illuminate the choices before us.

That was certainly true of Chelsea, standing at that fork in the road, staring right at us, reminding us of the choices before us – a well-worn, tried-and-true path, and a new, green path that speaks to something different.

The question is, which one to take?

One of Kierkegaard’s points is that, like the Ojibwe prophecy, no matter the path, we should always strive for one with ontological goodness of fit. This means more than the popular “doing what is right for us,” but rather, doing what is best, and equitable, for all.

Equality of outcomes is the path the UTRGV School of Medicine has taken – both in education, by espousing our interprofessional, team-collaborative, integrated-care model, and in health outcomes, by espousing health equity and population health initiatives to address the disparities in our communities.

Chelsea’s impromptu visit was there to remind us, just like the indie rock band Typhoon does in the song “Honest Truth”:

Be kind to all of your neighbors
‘cuz they’re just like you …
and you’re nothing special
unless they are too.

Fernandez Newsletter photo - Pena Center group shot with Chelsea Pena

Front row: Allison Villa; Linda Nelson, RN, MSN; Jmeela Banu; Dr. Lydia Aguilera; Enedina Enriquez; Chelsea Peña, Miss Junior Texas Galaxy; Aracely Ramirez; Nelda Rodriguez.

Back row: Miguel Lopez; Eron Manusov, MD; Dr. Adrian Sandovala; Dr.Keri Parchman-Gonzalez; Dr.Zishan Hirani; Dr. John Ronnau.