As a continuation of the partnership between the St. Louis Regional Health Commission (RHC) and Humans of St. Louis, Dr. Jade James-Halbert, Provider Services Advisory Board member and patient advocate, shares her work in the community and journey as a clinician. Read Dr. Jade’s’ story below and click here for additional RHC and Humans of St. Louis stories.
“We all know health is not just disease; health is not just medical care. Health is so much broader. And other entities have an impact on your medical care, how you respond to it, and how you respond to being a better you. So, what are people seeing and what are people doing?”
Jade James-Halbert, MD, MPH, RHC Provider Services Advisory Board Member
Story 1
“I’m a native of St. Louis, and I have been practicing healthcare, obstetrics and gynecology, and women’s health for over 20 years. I went to undergrad at Fisk University and went to Meharry Medical College in Nashville, did OB-GYN residency training in New York, and then came back home. I was born in the ’70s. At that time, although true racial discrimination was illegal, there were a lot of systemic effects showing racism still occurred. So getting hospital care was really utilizing healthcare in a crisis management fashion because Black parents, families, and friends didn’t trust the healthcare system. Maybe it was because they had already had a bad experience, it wasn’t affordable, or it was the effects of racism. Well, growing up, many Black children went to one to three pediatricians in St. Louis. Mine was Dr. Helen Nash. I remember seeing her as a five-year-old child. But my true reverence for her I didn’t learn until I came back to St. Louis and started to see, hear, and experience the legacy she started to build while I was growing up. She was a real trailblazer for healthcare particularly because she was a pediatrician. As a little girl, I took that to mean there must not be enough Black doctors for Black patients. That’s why I started saying I wanted to be a doctor. I just thought there weren’t enough.”
Story 2
“One of my grandmothers, Cleora Johnson, among many professions was a special education teacher. She taught children at Michaels School for developmentally disabled children. Because of her, I had a soft spot for physically and developmentally disabled kids because she would take us with her to work a few times a year and it was enough to have an impact. My other grandmother, Josephine Massey, was the neighborhood grandmother.
Everybody knew Aunt Jo. She gave that inherent love. I joke with people that, ‘I didn’t know I was poor until I went away.’ Because the love was there, the community was there, the spirit was there. My mother also wore several hats and ultimately got into the world of education. So it was very clear to me that education was an elevator.
Well, I’m a graduate of Cardinal Ritenour High School and there is a community service component to graduating. Everything about me and around me and what I was involved with was about community service. You gave and you received. It wasn’t always about money. It could be about your time and talent in addition to your treasure.”
“Whatever I had to give, I gave it. And when I was meant to receive it, I received it. I’ve always had a passion for service and serving the underdog because too many times their voices and concerns are unheard and made to feel invalid. All of those things make me who I am.”
Jade James-Halbert, MD, MPH, RHC Provider Services Advisory Board Member
Story 3
“I will always love Cardinal Ritenour because it understands the period of adolescence. It allows youth the stumbling that occurs without having that zero-tolerance policy that makes you feel like you’re a number. It will give you chances to be the best adult and give you opportunities to learn. That was huge for me. Growing up, as great as some things were in some instances, there were some dark spaces and places in others. As a young person, you believe you can be anything you want but there are also insecurities about your physical appearance or ability. And at this school, we had people feeding us every day with, ‘If that’s what you want to do, then do that.’ Outside forces may have been looking at us like, ‘That’s too big of an idea. You should think about doing something else.’ So I’m forever grateful for the day someone from school said, ‘Let me help you get there.’
For so long, I said I wanted to be a doctor. And people were gracious enough to have the attitude of, ‘How do I help you get there?’ There’s so much to be said about the school from the culture, the environment, and the expectation for academics. It supported you in what you wanted to do and held you accountable for what you said you wanted to do, or it allowed you to shift if shifting is what you needed. Teachers cared about the students and it wasn’t just about career climbing or getting a check. We’ve had several teachers go to the other side if you will — We’ve had several teachers go to the other side if you will — Mr. Boettcher, Mr. Henderson, Mr. O’Brian. And these are just some of the people who loved on us every day. Staff would pick students up for school and take them home. The cross country coach would run with us because he said, ‘I don’t expect more from you than what I expect of myself.’ So if a student was struggling, he’d say, ‘We’re gonna get across this finish line together.’ He did that in sports and he did that in life.”
Story 4
“Mr. Henderson is who introduced me to Fisk University, an HBCU in Nashville, Tennessee. It’s the home of John C. Lewis, Kym Whitley, Mathew Knowles. We have a lot of great things to come out of Fisk. And I tried to fight Mr. Henderson tooth and nail. Like, ‘What do I want from country Nashville, TN?’ He was like, ‘You want to be a doctor, right? Then you’re gonna go there.’
He was the guidance counselor at the time and I remember when he called me to his office. I was not the quiet nerd. I was the class clown nerd. I thought, ‘I didn’t even do anything today. I can’t be in trouble.’ He said, ‘You’re gonna stop ignoring me and you’re gonna sit here and fill out this application.’ I was like, ‘I’m not filling out that application.’ He made me sit there until it was done. And I got a full-tuition scholarship to Fisk. Another example of someone who saw things in me I didn’t even see in myself.
I got Pell grants and other government subsidies and I went to college for free as long as I kept up my GPA. It was about four and a half hours from St. Louis — far enough away but close enough to get back. I was doing well in school and there were discussions about this joint program where you could go to Fisk for three years and, in your fourth year, enter Meharry Medical College right across the street to continue to matriculate and get your degree. Lo and behold, four other students and myself were asked to come to a meeting to be part of the first class for this program. Talk about being placed by the spirit, the universe — whatever your belief is. So I was walking this journey, I was deepening my faith, and I knew there was a spirituality within me. Now I was seeing for myself what that meant in my own life. I entered the joint program and did eight years in seven.”
Story 5
“I’ve always been told and shown that ‘no’ just means there’s a different path. I’ve been told no way more than I care to admit. And I’ve learned that it’s less about being told no, but it’s how you respond to it. Each part of my journey had stumbles and outright falls. But, in those moments, you develop resilience and opportunity. And when people keep encouraging you — ‘Keep going, it’s not over,’ I’ve learned to look at no’s as opportunities to shift.”
Jade James-Halbert, MD, MPH, RHC Provider Services Advisory Board Member
“Not getting into residency was one of those hard pills to swallow, but there was no turning back. What was I gonna do? I actually didn’t match with OB-GYN my first year. The program has remained competitive and I knew I wanted to go into it. So I opted to do one year in a surgical specialty to make me a little more competitive for when I re-entered the match the following year. I went to Buffalo, New York to do surgical training and then switched to OB-GYN and did training in Jamaica, Queens.
I re-entered the match and got the spot I got in New York. And there were other places I really wanted to go that told me no. I didn’t pick New York, but I didn’t not. But, who would be open and who would take people like me? And when I say that, I’m not just referring to my skin color. I’m referring to the educational track I’d been down, the institutions I’d been in, the fact that I’d been told no once already. Because at that point in my career, that was a huge no. Some wouldn’t even look at you as a candidate because someone’s already vetted you to say you weren’t good enough. So that yes for me was New York. Sometimes you look back and there are people who thought you wouldn’t climb that wall. Sometimes it’s a few steps, but you’re gonna climb that wall and make it over.”
Story 6
“Three years into residency, 9-11 happened. I was in Jamaica, Queens and the hospital was designated as the location where they’d bring survivors. We were in this huge 72-hour standoff and providers were taking shifts. The surgeon was brought into the OR and we as OB-GYN were in the ER so people who needed to go straight to surgery could. It was very well-intended.
Unfortunately, around hour 72, it was such a deflating feeling because it wasn’t that people were brought to other hospitals, it’s that there just weren’t many survivors. Then there was the whole emotional thing of whether you knew people, whether you had people, people were calling to check on you, you’re trying to make calls to say you’re okay.
It was a point when I had to decide what I was going to do next. And it was clear I was not staying in New York. It wasn’t because of 9-11. But when you come from the Midwest, New York is a wonderful place to visit and has a lot of wealth and breadth, but the amount of money it takes to live in New York… I was like, ‘I can go back and visit from time to time.’ I went as a resident and as a single person and I didn’t get the feeling that that was where I wanted to raise a family. I asked myself, ‘Where am I goin’ next? Cause this ain’t it. I’m goin’ home.’”
Story 7
“National Health Service Corps is a government-funded program that pays educational expenses in return for committed service once you’re trained. At the time, they paid for three years if you served for two. You had to go to what they considered Health Resource Shortage Areas (HRSA) shortage areas. A lot of people would think they’re in rural areas, but many are in inner cities. So when I looked at the areas in Missouri, four places in St. Louis popped up. I was like, ‘This is a win-win! I’m going home. I’m getting paid. I’m doing what I want to do.’ No brainer, right?
I started applying and ended up back in the neighborhood I grew up in but now as a physician. Part of me is just committed to this community and my neighborhood, and daily I’m reminded of what this place gave to me to be who I am today. You can never repay that debt, but I’m always so grateful and satisfied that I could allow the community to see the return on investment.”
“Being able to serve people who look like me and to serve them in ways they had been shunned before — that was a full-circle moment. I was now providing service to people who deserve it and shouldn’t be made to feel like they’re the burden. And it’s not to say I don’t enjoy caring for people who don’t look like me. There’s just something different and special when you can validate that people aren’t the problem or you can understand someone’s situation from their lens. So patients who don’t get their medicine before you call them noncompliant, let’s figure out why. Was it money or transportation or did the meds make you sick and you just stopped it? Let’s talk about that instead of judging someone as if they’re not invested in their own health.”
Jade James-Halbert, MD, MPH, RHC Provider Services Advisory Board Member
“When people tell you, ‘Nobody ever asked me that. Thank you,’ you can see their gratitude. When you see them frustrated from multiple systemic injures and you break through to them and you see them for a second or third visit, or they bring their daughter or sister to you, or they’re telling their story like, ‘Go see the lady at the clinic,’ it makes me understand this is why I do what I do. I stay in community health for the patients. The administration and red tape are often very defeating and deflating. But you go to meetings, you try to be that voice, you have people hear what you have to say, and then you go back and it only takes one patient to make you smile and forget all that craziness. It’s like, ‘I do this because of you.’”
Story 8
“The Nash family is critical and integral for African American physicians in St. Louis. Dr. Helen Nash was a pediatrician who laid the foundation. Dr. Homer Nash was her younger brother who also became a pediatrician. Homer had five daughters, one of which is Alison, a physician who also became a pediatrician. Growing up, Helen and Homer had a pediatric office together.
As Helen retired and pulled away from the practice, Alison and her dad were in practice together. Helen was 95 when she passed and I was fortunate to speak at her funeral. I was president of Mound City Medical Forum, the local organization of African American physicians, which is an affiliate of the national medical organization. So it was another full-circle moment to speak as a physician and former patient.
She was so instrumental and had done a lot with her time as a practicing physician. When I came back to St. Louis to practice, I had the opportunity to interact with her. I said, ‘Dr. Nash, I don’t know if you remember me. But you were my pediatrician and I told you I wanted to go to med school.’ She asked, ‘Well, where did you go?’ I said, ‘I went to undergrad at Fisk and I went to Meharry for med school.’ And she said, ‘Well, you got one of those right.’ She was a Meharry graduate and a Spellman undergrad. I’ll always remember her as having a sense of humor and it was never defeating.”
Story 9
“I got involved with the St. Louis Regional Health Commission because they started out around policy making and wanted healthcare better for the region. So from 2010 to 2012, despite the fact that I’d been a physician for 10 years, I went back to school to study public health at SLU because I wanted to make a transition into administrative roles.”
“As much as I love taking care of patients, you do it one patient at a time. I bumped my head enough to realize we need systems change. The system is what helps more people.”
Jade James-Halbert, MD, MPH, RHC Provider Services Advisory Board Member
“So my master’s degree opened different doors. I got hired by the Saint Louis County Department of Health (DPH) as their Director of Research and Environmental Services which works with community health clinics. So that position allowed me to see how the health department was involved across the region and to see healthcare at a higher level.
I got introduced to the RHC and started to learn what they do, how they do it, and what my role was as an employee of the county health department. When I moved on from that job, I continued to watch the work of the RHC and asked to still be involved as a provider — whatever I could do to be a voice about services, challenges people face, what we see on the ground, how we address this or not… So I’ve been a representative at the agencies I’ve worked for. Currently, I am on the Provider Services Advisory Board to continue to make people aware but also to be made aware. Sometimes it’s easier to be in your own silo. But I stay involved because I’m interested in the community as a whole.”
Story 10
“We all know health is not just disease; health is not just medical care. Health is so much broader. And other entities have an impact on your medical care, how you respond to it, and how you respond to being a better you. So, what are people seeing and what are people doing?”
Jade James-Halbert, MD, MPH, RHC Provider Services Advisory Board Member
“This is where my job and what I do becomes a love-hate thing. Because I love the patients I serve. I love talking to them. I love trying to go beyond what actually brought you into the office. And, in my humble opinion, 80% of people don’t come to the doctor for the doctor’s visit. The doctor is just a person who can respond to a complaint that’s probably caused by something else. And healthcare is often in the position to be the responder who can’t refuse.
For example, on the hospital side, oftentimes individuals flood the ER because they don’t have anywhere to stay. They have a medical complaint that needs to be evaluated that sometimes takes hours to address. So a patient is inside, on a stretcher, getting evaluated, in the A.C., they get a meal even if just for a few hours. Some actually have a medical issue, but many just need respite. Even from the clinical side, if you have Internet access, a lot of people diagnose themselves. Like, ‘These are my symptoms, this is what Google told me, I’ll get some over-the-counter meds.’ And they only show up if that doesn’t work. If it works, they save time and money and life is grand. What if it doesn’t work? They call the doctor for answers.
So healthcare is the space where people really can’t refuse. You gotta do something because the patient made the appointment. And there are all these other regulations where you can be evicted from an apartment, your car can be repossessed, the grocery stores don’t have to sell you food. Public education is always available and even they have policies that can put you out. But with healthcare, once someone makes the appointment, you gotta at least see what’s wrong. So people come with a ‘healthcare’ issue and if you just give them 10 extra seconds, you can give them what they really want. Because oftentimes it’s probably not healthcare.”
“It’s interesting what we’ve experienced with the pandemic, in particular, is the uncovering of bandages that have been placed for centuries. So not only from a healthcare perspective but from a racial perspective, a systemic perspective, an educational perspective, all of these voices who have tried to say as loudly as they could, ‘These are the gaps in our systems,’ were simply ignored. And it wasn’t until this pandemic that it equalized everybody and it didn’t care whether you were young, old, rich, poor, Black, white, American, international — it shut the entire world down.
So everybody could focus on getting rid of this one thing, but they couldn’t continue that limited focus because that one thing revealed all the barriers that had always been in the way.
So when we talk about what people are experiencing, some became uncomfortable and inconvenienced for the first time. Those are your privileged people. Many of us are experiencing layer after layer of what we go through on a daily, weekly, or monthly basis. So, anybody who has felt uncomfortable or inconvenienced, frustrated or unheard, we’ve been saying that for centuries. It’s not new to us. But what that does to us is it uncovers all of those bandages piled up time and time and time again.”
Story 11
“I went to Cardinal Ritenour, a predominantly Black high school with 400 kids who look like me. How am I different? You go to an HBCU where there are several thousand young adults who look like me, we’re all doing well, so how am I different? I’m not the exception. I’m the rule. You want me to be the exception. But in my life, in my journey, there are so many more that come with me.
I’m an OB-GYN. I see pregnant women all the time. There was one lady who came in and I could see her edge. I could feel her edge. Her answers were so sharp and curt. And I stood at her side and said, ‘Do me a favor. Breathe with me. Breathe in; breathe out.’ We took about five deep breaths and I said, ‘You’re here because you said you want me to check your baby. And I’m gonna do that. But right now, I want to know what’s wrong with you.’ She looked at me and tears just started falling. I said, ‘Your concern is valid and I don’t want to minimize that, but I see so much more.’
Turned out she had a different school-aged child who was likely on the spectrum, who attacked her and her family, and she couldn’t get any assistance from the school. She felt like she was turning her back on her kid because she was thinking of the decision of committing him to a behavioral health institution. And that’s to get some respite and resources. At the end of the day, she didn’t want her kid boxed in, but he was displaying all these behaviors, and very few if anybody was trying to get to the problem. They were just throwing out solutions. She was stressed beyond belief.
So he had hit his head on her stomach and it wasn’t the first time she had this sort of trauma from him. But she needed a break. She needed to think about herself and her unborn child for a little and then go back to her other kid. It would have been very easy for me to put an ultrasound on her, to listen to the heart tones. I probably could have had her in and out in 15 minutes. But that’s not what she really needed.”
“Ideally, you want it to all come together, because when I realized that patient needed school help and behavioral health help, we should be able to direct her to appropriate resources to get what she needed to lessen her frustrations so it decreases her stress and her chances of preterm labor and preterm birth. Treat the whole person and not just an individual condition. Sometimes we’re really good at that and sometimes we suck really bad. But we have to keep trying.
Because maybe a handful of people know about the system and don’t talk that much. But if those tell another handful of people, now more know the system.
So today is your day of compassion. You’re holding the horn, singing the tune of community health, like, ‘Hey, I can help! Do you know about this resource?’ Tomorrow is my day of compassion. Like, ‘Listen. I got this. Let me help.’ You don’t have to be on point all the time. Because if we work on the team, somebody is on point for where the team needs to be. When you develop a team, teams don’t work well as individuals or silos. They work better and go harder as an actual team.”
Story 12
“There are a number of challenges the RHC faces. The first one is that the work doesn’t happen as fast as you’d want it to or as fast as it should. Another challenge is that you are working amongst and between organizations and all organizations don’t get it. There are still people who just want to check boxes to get the funds or say they achieved a goal. Some are doing the work at a superficial level. But you cannot turn your back on them because people are using those organizations.
We all play a role in the ecosystem. Some of us do well in our roles and others don’t. So we have to continue to try to partner those doing well with those who can be doing better so the ecosystem can start to gel and even out. I’m no good if I’m the best of the best and everybody else is failing. And I’m no good if I’m failing and everyone around me is elevated. We’re really only good as a system when we’re rising together. There are still plenty of systems that need to be rearranged. So they either need to be broken and built or build on some of the good they’ve done.
Sometimes the people in the system are the issue. Sometimes the resources are the issue. Sometimes the patients are the issue. But people are learning to use the system at the time that benefits where they need help. It’s so much deeper than, ‘Well, we created a program and the recipients are not using it.’”
“Whether I’m a friend, a mother, a daughter, a wife, a provider, a physician, a colleague, I’ve always had this mantra: ‘If I can help you, I will.’ And without expecting anything in return. It just always feels like the right thing to do. As long as I have that perspective, service will always be a part of me. Just as people invested in me, I hope I’m investing in others to get the next return.”
Jade James-Halbert, MD, MPH, RHC Provider Services Advisory Board Member
“When my daughter was younger, I put her in different activities. As an able-bodied person, if I make the decision to go to the laundromat in the neighborhood where my daughter does her extra-curriculars, because I can do laundry while she does her activity, it’s a two-for-one for me. I’m a smart parent. I’m a go-getter.
When this community organization is going to allot ‘X’ amount of dollars for these single mother renters to have washers and dryers in their homes and they’re wondering why the machines are just sitting there and assuming the mothers are irresponsible or ungrateful… Well, why are you gonna put a washer and dryer in their homes if they’re not there to use them? If you put a laundromat in their path, they can use those machines to wash their clothes. But you have to first talk to them to ask, ‘How can I help you?’ instead of telling them, ‘This is what you need.’”
“That’s why we have to get people involved in our systems — to inform us about what the barriers are and not have us perpetuate what we think the perceived barriers seem to be.”
Jade James-Halbert, MD, MPH, RHC Provider Services Advisory Board Member