At 24, I was a new nurse practitioner is a small urban clinic, suddenly keenly aware of how much I didn’t know. One day I stood at my boss’s desk summarizing a patient I had just seen and seeking advice on how to proceed.

“Did you ask her about sex?” my veteran NP boss asked without looking up from her paperwork.

“Ugh, no…”

“Well, if you don’t ask, you don’t know,” She replied.

Off I went to bumble my way through another patient history with someone twice my age and way more life experience. Yet, over the years I have come to find that asking questions is my favorite part of my job.

As a health care provider asking questions is clearly necessary to do my job: “Where does it hurt? When did it start? What did you take?” Missing the right question can mean missing the correct diagnosis. But questions are also what connect me to the humanity of what I do. “How is your daughter coping? What was labor like? How did it feel going back home? How did he die? What worries you the most?” These questions create partnerships and trust. Because if you don’t ask, you don’t know and that means you might not know the most important thing.

More recently, I’ve come to better understand how asking questions matters in thinking about communities, health, and equity. I have discovered there is a lot I didn’t know because I wasn’t asking. “What housing is affordable at minimum wage? Why is the produce section so different from a major grocer in one neighborhood to the next? Can the decisions I make about where to send my kids to school further educational inequity? How am I upholding oppressive systems because they have been largely favorable to me?”

In writing How Neighborhoods Make Us Sick, my favorite part was interviewing the people featured throughout the book. We ended each interview with the question, “If people reading this want to improve housing/education/poverty/racism/unemployment, what should they do?” The answers were varied but honest and practical. They became their own chapter (Chapter 18: Rx for Change).

I’ve decided I need to ask more questions and I think maybe we all do. On a busy day in the clinic it is easier to skip the extra questions and focus on what I perceive to be the problem. But that approach can cause me to miss what my patient needs to be healthy. It’s also easiest to go through life focused on what I need to be happy and healthy and secure. But I risk never knowing what my neighbor needs to be the same. Even worse, I might cause harm. So I’m going to keep asking: What do my neighbors need to be healthy? Because if you don’t ask, you don’t know.        

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