Latest / All About The Joy / Zero Maternal Deaths, 900 Lives Changed: The Power of Showing Up - And Interview with Dr. Means

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Zero Maternal Deaths, 900 Lives Changed: The Power of Showing Up - And Interview with Dr. Means · All About The Joy

• 0:05
  Carmen Lezeth: Hi everyone, welcome to All About the Joy, the private lounge and of course I have Cynthia, my counterpart, and we are so privileged to have Dr Rosanna Means in the house.
• 0:16
  Carmen Lezeth: Did I say your first name correctly?
• 0:18
  Dr. Roseanna Means: You did.
• 0:18
  Dr. Roseanna Means: It's like banana beans, but it's Rosanna Means.
• 0:20
  Dr. Roseanna Means: I love it.
• 0:24
  Carmen Lezeth: Did you see my face?
• 0:25
  Carmen Lezeth: I was like what?
• 0:26
  Carmen Lezeth: So I told Cynthia that I was going to embarrass you because, first of all, I am feeling so really privileged that you said yes to doing this interview, and I always like to tell people how I met you, but I've never met you.
• 0:44
  Carmen Lezeth: This is actually Cynthia's get.
• 0:45
  Carmen Lezeth: How did you guys meet before I embarrass you?
• 0:50
  Dr. Roseanna Means: You want me to say that how we met.
• 0:52
  Carmen Lezeth: I'm going to do this one, because I have a lot of questions for you, cynthia.
• 0:56
  Carmen Lezeth: How did you guys meet?
• 0:57
  Cynthia Ruiz Lopez: So we met when I started working at Brigham and Women's at the free center at 850 Boylston and I was so like intimidated by all the doctors and everything.
• 1:08
  Cynthia Ruiz Lopez: And one day I'm at lunch and Dr Meany just comes in and comes and sits with the rest of us like any normal person.
• 1:16
  Cynthia Ruiz Lopez: I said, oh, she's cool, I like her.
• 1:18
  Cynthia Ruiz Lopez: So then from there we just kind of clicked and, yeah, you've been friends ever since.
• 1:23
  Carmen Lezeth: Well, that's a great segue.
• 1:25
  Carmen Lezeth: I know I should let my guests speak, but I can't do that yet.
• 1:30
  Carmen Lezeth: I have to first embarrass you.
• 1:31
  Carmen Lezeth: The reason why I'm actually not going to embarrass you you already kind of know what I'm going to do, but I think it's important, especially as a woman, as somebody who cares about.
• 1:41
  Carmen Lezeth: Anyways, let me just, before I go on my diatribe, let me just say I am going to read part of your bio because I think it's important for people to know who we're talking to.
• 1:53
  Carmen Lezeth: I have cut out it because, if not, it would be the whole 45 minutes of the show, because your bio is so rich and brilliant and who you are and what you have done is just incredible.
• 2:04
  Carmen Lezeth: And who you are and what you have done is just incredible.
• 2:09
  Carmen Lezeth: And I live in Los Angeles, I work for a lot of celebrities.
• 2:10
  Carmen Lezeth: I never get flummoxed.
• 2:11
  Carmen Lezeth: Flummoxed Is that the word Flummoxed?
• 2:13
  Carmen Lezeth: I never get excited about a celebrity, but this, this Meeting someone like you, this is everything for me.
• 2:22
  Carmen Lezeth: So let me just go here.
• 2:23
  Carmen Lezeth: Okay, dr Rosanna means MSC, which is master of science, which I did not know.
• 2:31
  Carmen Lezeth: So on top of being a doctor, she has a master's in science right has been on the medical staff of Brigham and Women's Hospital since completing her internal medicine residency there in 1984.
• 2:44
  Carmen Lezeth: She is a senior staff attending in the Division of Women's Health and an Associate Professor of Medicine at Harvard Medical School.
• 2:52
  Carmen Lezeth: Y'all know how I'm feeling about this already.
• 2:57
  Carmen Lezeth: Dr Means is the founder and past CEO CMO of Healthcare Without Walls, formerly Women of Means, a nonprofit organization of volunteer physicians and staff nurses who provide free, bridging medical care and care coordination for unhoused and housing insecure women and families in Boston.
• 3:18
  Carmen Lezeth: In 2013, while at Healthcare Without Walls, she launched Bridges to Elders for Vulnerable Women Age 55 and Older.
• 3:28
  Carmen Lezeth: That made me cry when I first read it.
• 3:30
  Carmen Lezeth: In 2016, she launched Bridges to Moms at the Brigham and Women's Hospital to Close Gaps in Healthcare Access and Social Determinants I hope I said that word right of health for homeless and housing insecure pregnant women receiving maternity care at BWH, which is Brigham Women's Hospital.
• 3:51
  Carmen Lezeth: Bridges to Moms is part of the Division of Women's Health in the Department of Medicine at BWH and serves as a model of successful, innovative whole health approach towards vulnerable women, and we're going to get into the nitty gritty of that once I am finished this long ass bio and.
• 4:12
  Carmen Lezeth: I read how we're going to speak.
• 4:14
  Carmen Lezeth: Doc, I have another page and a half.
• 4:16
  Carmen Lezeth: Just bear with me.
• 4:17
  Carmen Lezeth: There's a reason why I'm doing this.
• 4:18
  Carmen Lezeth: There's a reason because I have to do this because I believe strong women need to always be uplifted even more when they are in our presence.
• 4:26
  Carmen Lezeth: That's just how I feel about it.
• 4:28
  Carmen Lezeth: Dr Means has been recognized for distinguished community service by the Massachusetts Medical Society, healthcare for All, mit Alumni Association, tufts University Alumni Association and Harvard Medical School.
• 4:40
  Carmen Lezeth: In 2008, dr Means was awarded an honorary doctor of humane letters by Babson College.
• 4:46
  Carmen Lezeth: In 2010, she was recognized as a community health leader by the Robert Wood Johnson Foundation, and in 2011, she was named a CNN hero, which I know our audience knows.
• 4:59
  Carmen Lezeth: Okay, did you hear that?
• 5:01
  Carmen Lezeth: Okay, in 2012, she was recognized as a woman of courage and conviction by the Boston chapter of the National Council of Negro Women, and in 2017, was named one of Boston's top doctors by Boston Magazine.
• 5:18
  Carmen Lezeth: I'm almost done.
• 5:19
  Carmen Lezeth: Okay, I've cut out a lot, right, dr Means?
• 5:23
  Carmen Lezeth: You know I've cut out a lot.
• 5:25
  Carmen Lezeth: Okay, this is what I thought was like the juicy parts, and that's okay.
• 5:29
  Carmen Lezeth: In 2021, dr Means was recognized by the Brigham and Women's Hospital Physician Organization with the prestigious.
• 5:37
  Carmen Lezeth: Do you say Pillar or Pilar?
• 5:39
  Carmen Lezeth: Pillar, like a pillar?
• 5:41
  Carmen Lezeth: Okay?
• 5:42
  Carmen Lezeth: Pillar Award in community service.
• 5:44
  Carmen Lezeth: Having spent over four decades serving underserved populations.
• 5:48
  Carmen Lezeth: In 2023, harvard Medical School recognized her with its Equity, social Justice and Advocacy Award.
• 5:55
  Carmen Lezeth: In 2024, she was recognized by the BWH Department of Medicine for exemplary service Okay.
• 6:06
  Carmen Lezeth: At all stages of her professional career, dr Means has mentored and inspired dozens of pre-med and medical students, nursing students and medical trainees.
• 6:15
  Carmen Lezeth: And here's my favorite part A graduate of MIT, bs and MSC, which we've already discussed and Tufts University School of Medicine, her MD.
• 6:26
  Carmen Lezeth: She completed her residency in internal medicine at the Brigham and Women's Hospital in 1984.
• 6:32
  Carmen Lezeth: Dr Means is a founding member of the Friends of MIT Crew and serves on the board of the MIT Crew Alumni Association.
• 6:41
  Carmen Lezeth: So, after all that, the MD of this sentence is about the rowing team, which we also do.
• 6:47
  Carmen Lezeth: So welcome to the show, right?
• 6:50
  Carmen Lezeth: Welcome to the show and thank you for all of that.
• 6:54
  Carmen Lezeth: I'm inspired.
• 6:55
  Dr. Roseanna Means: Oh well, thank you.
• 6:57
  Dr. Roseanna Means: I mean, I'm lifted up by the women that I've taken care of all my life, so I feel blessed.
• 7:06
  Carmen Lezeth: Well, but why did you decide to get into that field?
• 7:11
  Carmen Lezeth: Like, what made you?
• 7:12
  Carmen Lezeth: What was?
• 7:12
  Carmen Lezeth: It's not the field of medicine I'm talking about.
• 7:15
  Carmen Lezeth: I am talking about um, the organization where bridges to moms.
• 7:21
  Carmen Lezeth: Like, how did that happen?
• 7:26
  Dr. Roseanna Means: It's an evolution of thinking.
• 7:28
  Dr. Roseanna Means: But you know, more importantly, what happened was during my residency.
• 7:34
  Dr. Roseanna Means: You know, I was at the Brigham and Women's Hospital, you know, a very prestigious Harvard teaching hospital.
• 7:42
  Dr. Roseanna Means: I was absolutely petrified.
• 7:43
  Dr. Roseanna Means: I mean, you hear about things like imposter syndrome.
• 7:46
  Dr. Roseanna Means: I had that in spades because I had come from Tufts Medical School, not Harvard Medical School.
• 7:51
  Dr. Roseanna Means: So I was just careful that I didn't make a big mistake and every time I opened my mouth and I felt so fortunate to be there.
• 8:02
  Dr. Roseanna Means: And then in the second year of my residency it's a three-year residency they ask you if you want to specialize and I kind of follow the crowd and said, well, I think I want to be a cardiologist, because that's what people do when they come to a Harvard teaching hospital is they do something prestigious like that?
• 8:18
  Dr. Roseanna Means: And so I lined up a cardiology fellowship back at Tufts, my alma mater for medical school, lined up a cardiology fellowship back at Tufts, my alma mater for medical school.
• 8:28
  Dr. Roseanna Means: And then, after that happened, it turns out that I was contacted by a colleague and, as many people know, the Vietnam War ended in 1975.
• 8:39
  Dr. Roseanna Means: And after the Vietnam War ended, the Vietnamese invaded Cambodia.
• 8:44
  Dr. Roseanna Means: The Vietnam War ended, the Vietnamese invaded Cambodia and a dictator came to power named Pol Pot and started slaughtering everyday Cambodians.
• 8:51
  Dr. Roseanna Means: And I was a person that grew up during the 1960s and I was one of those people that marched out of Washington and protested against the war and we wanted peace and all that kind of stuff.
• 9:02
  Dr. Roseanna Means: And so it really spoke to me because I thought, okay, I really wanted to help the people on the other side of the world, and so I asked my residency director at great peril because, again, I was terrified that I would give up this incredibly golden opportunity.
• 9:18
  Dr. Roseanna Means: But I said, look, I really feel called to go help in this refugee camp.
• 9:23
  Dr. Roseanna Means: So there was a Cambodian refugee camp and there were a lot of international aid organizations there.
• 9:29
  Dr. Roseanna Means: The one I worked for was called the International Rescue Committee and they still do work all over the world.
• 9:35
  Dr. Roseanna Means: They're an amazing organization.
• 9:38
  Dr. Roseanna Means: So I literally left my husband, my job, my family, and traveled across the world and lived in this little village in Thailand and went into this refugee camp and as I spent three months there and I was so impressed this is such a cliche I was so impressed with the power of the human spirit, what these individuals had overcome, crossing the mountains where there were landmines.
• 10:04
  Dr. Roseanna Means: I mean, the first thing I saw in the refugee camp was a 12-year-old boy getting his foot amputated without anesthesia Wow, the landmine that had blown off his lower leg.
• 10:16
  Dr. Roseanna Means: And these 100,000 refugees in this camp and there were multiple camps along the border, but they had all given up everything to try to escape for freedom.
• 10:26
  Dr. Roseanna Means: And what they had done during that time was, um, in addition, to just try to survive.
• 10:32
  Dr. Roseanna Means: And, you know, figure out what the next step was in their lives.
• 10:34
  Dr. Roseanna Means: They were teaching the kids that you know many of them were orphans teaching these kids their cultural values, their, their skills, the weaving, the music, the songs, the cultural norms.
• 10:46
  Dr. Roseanna Means: It was just incredibly impressive and I thought I would like to be able to spend my life taking care of people like this, who are willing to give up everything to find a better path forward.
• 11:02
  Dr. Roseanna Means: And so I came back to the Brigham after three months and, instead of doing my cardiology fellowship, I canceled my cardiology fellowship.
• 11:12
  Dr. Roseanna Means: I thought they were going to take me out into the middle of Brigham circle and break my stethoscope in a public ceremony.
• 11:17
  Dr. Roseanna Means: Wow, you don't want to be an academician?
• 11:20
  Dr. Roseanna Means: What is wrong with you?
• 11:21
  Dr. Roseanna Means: So, anyway, I followed primary care and I soon I looked for a population I could work with in Boston and I discovered that there was a whole program that was beginning in Boston helping homeless persons, and so I started working with them and I also continued with my career.
• 11:40
  Dr. Roseanna Means: I had two paths.
• 11:41
  Dr. Roseanna Means: As Cynthia knows, I was taking care of a very well-heeled practice in, you know, in a suburb of Boston.
• 11:47
  Dr. Roseanna Means: People who you know, who were like I am.
• 11:50
  Dr. Roseanna Means: They go home to a nice house and they have health insurance and you know all the things they need.
• 11:55
  Dr. Roseanna Means: And then I would also spend hours every week going onto the streets and into the shelters and taking care of people who had nothing and that really spoke to me.
• 12:05
  Dr. Roseanna Means: And after I did that for a few years, I realized that my background in women's health was really important for the women that were becoming homeless.
• 12:15
  Dr. Roseanna Means: It's a different pathway for women who become homeless than it is for men and they have different biologies and different needs and different things.
• 12:22
  Dr. Roseanna Means: So I left that program.
• 12:24
  Dr. Roseanna Means: Analogies and different needs and different things.
• 12:25
  Dr. Roseanna Means: So I left that program and really these are all crazy ideas, but if it inspires people, you know, I left the program and said I think I need to start my own nonprofit Now, did I know how to start a nonprofit?
• 12:40
  Dr. Roseanna Means: Did I know how to create a budget?
• 12:46
  Dr. Roseanna Means: No.
• 12:47
  Dr. Roseanna Means: Did I know how to write a grant?
• 12:47
  Dr. Roseanna Means: No.
• 12:47
  Dr. Roseanna Means: But what I did is I went to my church and I talked to the board of outreach and I said I've been volunteering in these shelters for a number of years and I really want to help the women.
• 12:53
  Dr. Roseanna Means: Would you give me some money?
• 12:55
  Dr. Roseanna Means: And they did so.
• 12:57
  Dr. Roseanna Means: They gave me a little money and I started my nonprofit and that grew and I spent 25 years doing that and then Bridges to Moms came about at the Brigham.
• 13:08
  Dr. Roseanna Means: Again back to the academic teaching hospital, because I've never left there.
• 13:11
  Dr. Roseanna Means: It's been my professional home.
• 13:12
  Dr. Roseanna Means: And in 2015, the hospital management came to me and said you know, we have kind of a crisis on our hands.
• 13:21
  Dr. Roseanna Means: You know, they are a tertiary care hospital, which means people refer to them.
• 13:26
  Dr. Roseanna Means: They do very high level I mean extraordinary medicine.
• 13:29
  Dr. Roseanna Means: It's absolutely amazing.
• 13:31
  Dr. Roseanna Means: And so people who are very wealthy come to that hospital.
• 13:34
  Dr. Roseanna Means: I make no bones about it.
• 13:36
  Dr. Roseanna Means: But the one population they couldn't understand was women who were poor, that were unhoused or at risk of being unhoused, who were coming to this hospital because it was a referral hospital for high-risk pregnancies.
• 13:50
  Dr. Roseanna Means: And so women, mostly women of color in Boston, had needed to have a place to go where they could have their blood pressure, their diabetes, their history of preeclampsia, other things addressed.
• 14:03
  Dr. Roseanna Means: And what they were discovering discovering the social workers when these women were being discharged was that women would look up at them before they got in that little wheelchair to go down to the front door and say, well, where do I go with my baby, my baby's, two days old, where do I go?
• 14:18
  Dr. Roseanna Means: And you know, what they were doing is putting them in a taxi, sending them down to the state housing office.
• 14:23
  Dr. Roseanna Means: But but you know, we all know that.
• 14:25
  Dr. Roseanna Means: Well, not everybody knows.
• 14:26
  Dr. Roseanna Means: What happens is that the late day discharges mean that you are at the state housing office in the afternoon.
• 14:33
  Dr. Roseanna Means: Everything is gone.
• 14:34
  Dr. Roseanna Means: There's no shelter beds, there's no place to go at night, and so the women would be going through their phones who can I call?
• 14:41
  Dr. Roseanna Means: Like the boyfriend had long since left them and they were there with this newborn and no place to go.
• 14:46
  Dr. Roseanna Means: They couldn't go back to the hospital.
• 14:47
  Dr. Roseanna Means: So this was happening.
• 14:49
  Dr. Roseanna Means: The social workers were distressed, the hospital leaders were distressed and they came to me because I was an expert on homelessness and women's health and said you know, find a way, you know a program.
• 15:01
  Dr. Roseanna Means: And so I did.
• 15:04
  Carmen Lezeth: So that's what I did, and so, just to be clear, what your program actually does is not only when women come to you in their pregnancy mode.
• 15:15
  Carmen Lezeth: They're in their late stages, right of pregnancy, or is it sometimes at the beginning?
• 15:20
  Dr. Roseanna Means: So I'm not an obstetrician, ok, so they come in, they're registered as obstetrics patients and that the obstetricians and the social workers refer to me.
• 15:29
  Dr. Roseanna Means: And it could be literally, you know, the first trimester, their first OB visit, and somebody says, well, you know I, you know, I, I don't know how to apply for WIC, which is the federal program that helps women.
• 15:42
  Dr. Roseanna Means: I, I don't know how to apply for food stamps, I'm not eating, I don't have any money, I don't have a job, my boyfriend left me.
• 15:48
  Dr. Roseanna Means: And then they hear those words and they go okay, we need some help here.
• 15:53
  Dr. Roseanna Means: And then we hear about those people and our whole team goes into action.
• 15:57
  Dr. Roseanna Means: So we are addressing everything housing, transportation, to all medical appointments throughout the pregnancy and postpartum period, wic and SNAP, which is food stamps safety big issue, lots of interpersonal violence, domestic violence, trauma and, in our immigrant community, tremendously perilous journeys coming up through the, you know, through the Darien gap and so forth and um, and making sure that they have a place to go home with their baby.
• 16:31
  Dr. Roseanna Means: And so we're this is our 10th year and we we have helped almost 800 women at this point and 95% are women of color.
• 16:43
  Dr. Roseanna Means: This is a group that has three to five times the maternal mortality rate.
• 16:47
  Dr. Roseanna Means: Not a single maternal death.
• 16:50
  Dr. Roseanna Means: Right, you have not lost anyone.
• 16:52
  Dr. Roseanna Means: Right, we have not lost anyone.
• 16:54
  Dr. Roseanna Means: We are.
• 16:55
  Dr. Roseanna Means: You know.
• 16:56
  Dr. Roseanna Means: We see these women through the pregnancy 100% placement.
• 17:00
  Dr. Roseanna Means: Not a single family is sleeping on the streets.
• 17:03
  Dr. Roseanna Means: Not a single family is sleeping at Logan Airport.
• 17:04
  Dr. Roseanna Means: Not a single family is sleeping at Logan Airport.
• 17:06
  Dr. Roseanna Means: Even throughout this last immigrant so-called crisis, we have been taking care of our families and we follow the family through the baby's first year.
• 17:16
  Dr. Roseanna Means: Make sure that if they start out in an emergency shelter and they need to transfer, we help them facilitate that transfer shelter and they need to transfer, we help them facilitate that transfer.
• 17:27
  Dr. Roseanna Means: My team is entirely bilingual.
• 17:28
  Dr. Roseanna Means: We make sure that if they're at risk of eviction, we go to housing court.
• 17:31
  Dr. Roseanna Means: We protect them on housing court.
• 17:34
  Carmen Lezeth: We make sure that they get connected to primary care because so you're and I don't mean to interrupt you, but I just want to make sure for our listeners as well.
• 17:41
  Carmen Lezeth: You're providing a safety net.
• 17:45
  Carmen Lezeth: You're providing a safety net for people who have fallen through the cracks for whatever reason.
• 17:50
  Carmen Lezeth: And one of the things I mean I have no reason to believe you know anything about me, but my trigger is when we talk about homeless people.
• 17:59
  Carmen Lezeth: I get really upset with people not you, but people who don't understand the situation at all.
• 18:05
  Carmen Lezeth: Can you talk a little bit about why some of these women find themselves in this situation, as opposed to people just thinking, you know, oh, they're just taking advantage of Dr Means.
• 18:17
  Carmen Lezeth: That's what they're doing because it's free.
• 18:19
  Carmen Lezeth: They're getting everything for free.
• 18:20
  Dr. Roseanna Means: They're getting free healthcare you know, well, you know, nothing is free as you know it.
• 18:25
  Dr. Roseanna Means: But you know, so many of these women are women from sort of 17, 18 on up to like early 50s that have been referred to us, and the typical kind of situation is that they're in a relationship.
• 18:41
  Dr. Roseanna Means: Very often in these relationships the man is not willing to use birth control.
• 18:47
  Dr. Roseanna Means: We know that.
• 18:47
  Dr. Roseanna Means: And they get pregnant.
• 18:49
  Dr. Roseanna Means: They think they're not going to get pregnant.
• 18:51
  Dr. Roseanna Means: They get pregnant and, um, and then, as soon as they announced to their partner that they're pregnant, they're there, the partner's gone, okay.
• 19:00
  Dr. Roseanna Means: So somebody who might've promised oh, I've got a job, I can take care of you, or I want to be the father of your baby, I want to raise your children, I want to do job, I can take care of you.
• 19:07
  Dr. Roseanna Means: Or I want to be the father of your baby, I want to raise your children, I want to do this, I'm going to do that.
• 19:13
  Carmen Lezeth: And let me make it clear, I'm not a man hater.
• 19:14
  Dr. Roseanna Means: I love men, I love men too, but this is harder to be with you, yeah.
• 19:34
  Carmen Lezeth: The relationship is fraught and it's not it'sB which is like no she did it, but they've been abandoned.
• 19:39
  Dr. Roseanna Means: And you know, I would say I'm not kidding About 70% of the women are working.
• 19:46
  Dr. Roseanna Means: They're working full-time, they're working part-time and the cost of living just is not cutting it.
• 19:52
  Dr. Roseanna Means: And so the cost of rent, the cost of groceries, the cost of supplies, the cost of utilities, transportation, everything is costing way too much.
• 20:01
  Dr. Roseanna Means: And people would be surprised.
• 20:03
  Dr. Roseanna Means: Some of the people that come through our program, we've had nurses, we've had secretaries, we've had hospital workers, I've had people who are employees at my hospital, who have been referred to my program.
• 20:18
  Dr. Roseanna Means: I mean, it is incredible, and I think the general public doesn't realize that there is a whole part of our society that is doing the best they can and they are working, they're following all the rules, they're doing everything they were told to do and it's not enough.
• 20:35
  Dr. Roseanna Means: You know everything costs too much and they can't make ends meet and the rents keep going up.
• 20:40
  Dr. Roseanna Means: And then they, you know, if they go into an apartment with a guy and the guy leaves, then suddenly they're stuck paying the rent for the landlord.
• 20:50
  Carmen Lezeth: And there's not.
• 20:51
  Carmen Lezeth: You know, not everyone has extended family and has.
• 20:55
  Carmen Lezeth: Yeah, I mean, it's not like you can call your mom and dad and be like can I just get a little more money from my trust fund?
• 21:02
  Carmen Lezeth: Like I have people who don't understand.
• 21:05
  Carmen Lezeth: I mean, we're laughing about it, but I work for pretty wealthy people and if you even talk to some of their kids who are you know, some of them are older than me they're just they don't understand that.
• 21:16
  Carmen Lezeth: They're like, well, worst case, I'll have to go get a loan on my own.
• 21:20
  Dr. Roseanna Means: Like no, like you know, there's no.
• 21:27
  Dr. Roseanna Means: You know, aunt Berthatha, uncle charlie, that's going to slip you a $20 bill.
• 21:29
  Dr. Roseanna Means: Yeah, it doesn't, it doesn't happen.
• 21:30
  Dr. Roseanna Means: Now I will tell you and I, if this ever plays at my hospital, I'm sorry, but this is who I am I have been known to slip a $20 bill to my patients because they parked at the brigham.
• 21:42
  Dr. Roseanna Means: They were able to, they were living out of their car, or you know, they were borrowing a car.
• 21:46
  Dr. Roseanna Means: They parked at the brigham and they were living out of their car, or you know, they were borrowing a car.
• 21:47
  Dr. Roseanna Means: They parked at the Brigham.
• 21:48
  Dr. Roseanna Means: And they come to my clinic and they I say, how did you get here?
• 21:50
  Dr. Roseanna Means: I always ask how they get there, because doctors don't ask how people got to their office.
• 21:54
  Dr. Roseanna Means: They think it's magic.
• 21:55
  Dr. Roseanna Means: And they, you know, and I said they parked in.
• 21:58
  Dr. Roseanna Means: You know they use valet parking and so forth, and I said, okay, just give me a second here.
• 22:02
  Dr. Roseanna Means: I leave the room and come back and I just give them an envelope and I say, look, you know you need to, you need to be able to.
• 22:09
  Dr. Roseanna Means: You know, do this.
• 22:11
  Dr. Roseanna Means: And, by the way, we provide transportation and we also provide, by the way, tickets to the hospital cafeteria.
• 22:16
  Dr. Roseanna Means: So when they come, when they come to our program, anytime they come to the hospital for their prenatal care, many of them have not had something to eat that day, that entire day.
• 22:27
  Dr. Roseanna Means: And so what we go in, we get on these tickets.
• 22:30
  Dr. Roseanna Means: We say you need to eat lots of protein, you know if they have other kids with them.
• 22:34
  Dr. Roseanna Means: They say go get some pizza or some ice cream, you know.
• 22:37
  Dr. Roseanna Means: Just, you know you need to take care of yourself.
• 22:40
  Dr. Roseanna Means: So that's just life, you know you got to do.
• 22:44
  Carmen Lezeth: You got to treat it as part of healthcare basically, I'm going to let Cynthia like get one question in.
• 22:54
  Dr. Roseanna Means: Okay, I'm ready, I'm ready.
• 22:57
  Cynthia Ruiz Lopez: What's the most difficult part of you doing this, like doing the whole thing, like what do you find is the most difficult part of your job or part of the program?
• 23:10
  Dr. Roseanna Means: Yeah For the Bridges to Moms program.
• 23:12
  Dr. Roseanna Means: There's a tremendous amount of absolutely wonderful moments in this program.
• 23:19
  Dr. Roseanna Means: The difficult part is that I wish I had, you know, a million dollars.
• 23:24
  Dr. Roseanna Means: I wish I had ways to help the women even more.
• 23:28
  Dr. Roseanna Means: For instance, we give them gift cards to buy things like strollers and car seats and baby supplies, because of course nobody's thinking about this stuff, you know.
• 23:36
  Dr. Roseanna Means: So to me it's part of healthcare, but but the most difficult thing is when the baby dies.
• 23:43
  Dr. Roseanna Means: That's the hardest part, because we had no maternal mortality and it's very, very rare.
• 23:52
  Dr. Roseanna Means: But some of these women, when they come to us, their first prenatal visit is like 32 weeks of pregnancy.
• 23:59
  Carmen Lezeth: Okay Okay.
• 24:00
  Carmen Lezeth: I've never been pregnant, so I don't know what that means.
• 24:02
  Dr. Roseanna Means: It's 40 weeks, so 32 weeks is just you know you're right there ready to from you know from from delivery.
• 24:10
  Carmen Lezeth: So when, when you're first pregnant and I know people who listen I'm going to be like oh, carmen is so dumb.
• 24:15
  Carmen Lezeth: When's your first regular appointment?
• 24:18
  Carmen Lezeth: When you find out you're pregnant, when are you supposed to?
• 24:20
  Dr. Roseanna Means: go.
• 24:21
  Dr. Roseanna Means: It varies.
• 24:22
  Dr. Roseanna Means: So it should be like you miss your period and you think, okay, you start doing the counting on your fingers Like, what about this?
• 24:27
  Dr. Roseanna Means: And when did I last have sex, and stuff like that, and then it might be you miss a second period and then generally people do a home pregnancy test and find out.
• 24:35
  Dr. Roseanna Means: But you know, for people who are poor it costs money to buy a home pregnancy test, Right.
• 24:39
  Dr. Roseanna Means: So sometimes they don't know until they're really far along and they might have cramps, they might go to an emergency room and then someone will do a pregnancy test.
• 24:52
  Dr. Roseanna Means: So it can be any way, from like 11 weeks of pregnancy early on until, like I say, people who have had no prenatal care for various reasons, and for some of the women who came through the immigrant journey, sometimes they will come through Mexico, central America, when they're pregnant and come here and they've had no prenatal care.
• 25:08
  Dr. Roseanna Means: But when the baby dies it's for, you know, the baby has had not enough nourishment during pregnancy, not enough prenatal care.
• 25:18
  Dr. Roseanna Means: There were fetal abnormalities for various reasons or genetic things.
• 25:22
  Dr. Roseanna Means: That happen.
• 25:22
  Dr. Roseanna Means: It happens in all pregnancies.
• 25:25
  Dr. Roseanna Means: I mean there's, you know, there's a certain number of these that don't end well.
• 25:29
  Dr. Roseanna Means: But in the case of these women, it's so hard because, when they're pregnant, these women are so determined to be a good mother.
• 25:38
  Dr. Roseanna Means: They've given up everything and they've just focusing on this baby, no matter where they come from, whether they're Boston, they've come in from California, they've come in from, you know, haiti or Venezuela.
• 25:49
  Dr. Roseanna Means: Wherever they're coming from, they're right in front of us.
• 25:53
  Dr. Roseanna Means: We're there.
• 25:54
  Dr. Roseanna Means: It's our obligation to take care of them, and we are more than happy to do so.
• 25:58
  Dr. Roseanna Means: And we do everything we can to make that journey as easy for them as we can, with all the things I mentioned.
• 26:03
  Dr. Roseanna Means: But if, inevitably, the baby dies, it's a very, very sad thing, and so we, of course, embrace that woman, we comfort her, we do whatever we can.
• 26:16
  Dr. Roseanna Means: We have been known to pay for funerals because sometimes that's the only resource that they have, and we do that as a gift to the women.
• 26:24
  Dr. Roseanna Means: They don't ask, they never ask.
• 26:29
  Carmen Lezeth: I do want to just give the.
• 26:33
  Carmen Lezeth: I'm sorry, I'm so thrown when you just said about the baby dying and then the funeral.
• 26:38
  Carmen Lezeth: I'm sorry, see, Cynthia, this is why I didn't want her on the show.
• 26:43
  Carmen Lezeth: Cynthia knows I get a lot of people who like requests to be on the show, and they usually through LinkedIn or whatever, and I have to vet them.
• 26:53
  Carmen Lezeth: And you know as much as I'd like to say we have a huge staff or whatever.
• 26:56
  Carmen Lezeth: We're a tiny little boutique.
• 26:58
  Carmen Lezeth: So Cynthia says hey, we were talking about homelessness the other day.
• 27:02
  Carmen Lezeth: I thought I'd have Dr Means on.
• 27:04
  Carmen Lezeth: You know she helps homeless pregnant women.
• 27:08
  Carmen Lezeth: I'm like what is wrong with you?
• 27:09
  Dr. Roseanna Means: I don't want to talk about this, but but you know I but, carmen, let me tell you a great story, cause we had a woman that happened to you know, a little over a year ago, year and a half ago, she, her baby, died and it was tragic, it was awful, and she had to.
• 27:26
  Dr. Roseanna Means: She had to go through the entire grieving process, which she did.
• 27:29
  Dr. Roseanna Means: But listen to this this woman, within about six months, she had signed up for classes, she, she had took English classes, she took training lessons, she, she, just this this month, moved into her own and she has completed her training as a home health aide.
• 27:49
  Dr. Roseanna Means: Wow, and this is somebody who dealt with the loss, grieved it appropriately, was able to put it all together.
• 28:00
  Dr. Roseanna Means: Of course, she got counseling and so forth, but she put her whole life together.
• 28:03
  Dr. Roseanna Means: She took a deep breath, she moved forward and look at her.
• 28:06
  Dr. Roseanna Means: You know what, 18 months later?
• 28:09
  Carmen Lezeth: I mean, that is incredible courage and resilience, no, and that's why your program is so important, and let me just give for the audio, if you want to give and everyone should give something.
• 28:19
  Carmen Lezeth: Who's listening?
• 28:21
  Carmen Lezeth: That's me being very kind.
• 28:23
  Carmen Lezeth: But bwhgivingorg forward, slash bridges.
• 28:30
  Carmen Lezeth: And if anyone is like me who always spells bridges wrong, I'm going to spell it out for you.
• 28:36
  Carmen Lezeth: It's B-R-I-D-G-E-S.
• 28:39
  Carmen Lezeth: So again, bwhgivingorg forward, slash bridges.
• 28:44
  Carmen Lezeth: That's where you can donate money and everyone could give a little something to help another woman who needs assistance, like if we all gave a little bit, even if it's like $5 a dollar, we can help and do something big to help another woman in distress who needs just a little nurturing.
• 29:08
  Carmen Lezeth: And that's kind of the thing is.
• 29:10
  Carmen Lezeth: You just talked about this lovely woman who went through all this trauma and then turned her life around, right?
• 29:15
  Carmen Lezeth: Or I'm not even going to say that.
• 29:16
  Carmen Lezeth: She just walked through the steps and did what she needed to do and became who she is supposed to be in that moment, and she did it with support.
• 29:25
  Carmen Lezeth: We all need support.
• 29:27
  Dr. Roseanna Means: Yeah, we all need nurturing.
• 29:29
  Dr. Roseanna Means: Yes, and I don't know how people don't get that.
• 29:31
  Dr. Roseanna Means: Yeah, she did it.
• 29:32
  Dr. Roseanna Means: She did it with support.
• 29:33
  Dr. Roseanna Means: We supported her, but she did it with an incredible grace and focus and I think you know.
• 29:40
  Dr. Roseanna Means: I think that when you're talking to me about what was the hardest thing about about what I do, when you were talking to me about what was the hardest thing about what I do, the hardest thing is is is being on that journey with somebody who has such a profound loss.
• 29:50
  Dr. Roseanna Means: It's also part of the joy is what you see when the women have gone through that journey and have come out the other side, and I will share with you and also with your audience, that I also lost a baby during pregnancy.
• 30:04
  Dr. Roseanna Means: I had a baby that died at 27 weeks of pregnancy and it was a little girl, and I have three sons.
• 30:10
  Dr. Roseanna Means: So when a woman loses her baby, I feel very fortunate that I can be the person that helps her get through that moment.
• 30:24
  Cynthia Ruiz Lopez: That's incredible for anyone like listening who can't donate monetarily.
• 30:31
  Cynthia Ruiz Lopez: Are there other things that they could do to help?
• 30:37
  Dr. Roseanna Means: um, um, it's hard.
• 30:39
  Dr. Roseanna Means: You know, we are like you're saying, we are kind of a small group and we do this.
• 30:43
  Dr. Roseanna Means: We have two events.
• 30:44
  Dr. Roseanna Means: If they're in Boston.
• 30:45
  Dr. Roseanna Means: We have two events every year that we provide for the women.
• 30:50
  Dr. Roseanna Means: One is a day of beauty in May around Mother's Day, and the other is career day in the fall.
• 30:56
  Dr. Roseanna Means: Volunteers for those events, because that's, you know, that takes up a lot, of, a lot of time and the biggest role for volunteers is watching the babies during these events.
• 31:09
  Dr. Roseanna Means: Oh right, competition for that volunteer role.
• 31:11
  Dr. Roseanna Means: But let me tell you about the Day of Beauty, because it's the coolest thing.
• 31:14
  Dr. Roseanna Means: So, day of Beauty, we decide, you know, the women come to us one by one, Okay.
• 31:18
  Dr. Roseanna Means: So we have a hundred or 150 women a year that get referred to us and they meet us and we have that one conversation and then they're assigned to one of our case managers community health workers, and we have a full-time social worker as well and they go off and you know we continue to do this, help for them.
• 31:36
  Dr. Roseanna Means: But you know they don't know each other.
• 31:38
  Dr. Roseanna Means: I mean, everybody feels like I'm I'm doing this by myself myself.
• 31:41
  Dr. Roseanna Means: I am having the worst time of my life, like nobody could possibly be as miserable as I am right now.
• 31:48
  Dr. Roseanna Means: I've got a baby coming, I have no money, nobody's talking to me, the boyfriend left me, you know.
• 31:53
  Dr. Roseanna Means: So we all do that.
• 31:54
  Dr. Roseanna Means: And then we decided but these women need, they need a tribe, they need a network.
• 32:00
  Dr. Roseanna Means: You know we all need to be around each other.
• 32:03
  Dr. Roseanna Means: So we designed these two events to bring them together into one room.
• 32:06
  Dr. Roseanna Means: So the Day of Beauty is the coolest thing because it comes around Mother's Day.
• 32:10
  Dr. Roseanna Means: It's for the moms who've just had their babies.
• 32:12
  Dr. Roseanna Means: They've been through this whole thing.
• 32:14
  Dr. Roseanna Means: They've had their babies and a few of them that are about to burst.
• 32:19
  Dr. Roseanna Means: We weren't sure, so we bring them in anyway.
• 32:20
  Dr. Roseanna Means: And we have this in a you know big building at the Brigham and we provide it's all free, you know, free transportation to and from the event, uh, free food all day, free child care, which I told you is a volunteer, and then, um, but they get free hairstyling, makeup, makeup and manicures.
• 32:43
  Dr. Roseanna Means: And the first year we invited people from the community that we all knew, who came in and donated their services.
• 32:49
  Dr. Roseanna Means: But we just had our third one.
• 32:51
  Dr. Roseanna Means: And this year almost every single person who provided services was a woman who had been through our program, who knew how to style hair, knew how to do makeup and wanted to give back.
• 33:07
  Dr. Roseanna Means: And you know it's just like the coolest thing.
• 33:08
  Dr. Roseanna Means: And so the women all get to like mix and mingle and talk trade stories, trade phone you know phone numbers and you know they meet each other as babies.
• 33:16
  Dr. Roseanna Means: The babies play together and, um, this year we had a photo booth so after they looked beautiful, they could have a picture taken.
• 33:23
  Dr. Roseanna Means: Oh, that's so cool.
• 33:24
  Dr. Roseanna Means: And then another woman who's a doula, which is a birth doula, who was in another program that we work with.
• 33:33
  Dr. Roseanna Means: She also makes this incredible jewelry, and so she came down and she gave every woman her own beautiful piece of jewelry oh, that's so cool.
• 33:43
  Dr. Roseanna Means: Yeah, every woman her own beautiful piece of hand-made clothing.
• 33:44
  Dr. Roseanna Means: Yeah, and they get goodie bags.
• 33:45
  Dr. Roseanna Means: And they get goodie bags for babies with age-appropriate clothing and diapers and so forth, and gift cards and so forth.
• 33:51
  Dr. Roseanna Means: So Day of Beauty is really cool, and then Career Day in the fall is introducing the women same thing food, transportation and so forth and meeting each other.
• 34:00
  Dr. Roseanna Means: But we also give them a chance to learn about training opportunities, educational opportunities and so forth, and even during the year we have a workforce development coordinator who connects with all these women and finds out what they want to learn and connects them to educational classes, training programs and anytime anybody in our program gets a certificate or anything.
• 34:25
  Dr. Roseanna Means: It could be a first aid course or care assistant, anything.
• 34:29
  Dr. Roseanna Means: They get another gift card.
• 34:31
  Carmen Lezeth: Oh, wow, really.
• 34:32
  Carmen Lezeth: Oh, that's so cool.
• 34:33
  Dr. Roseanna Means: As a reward for the accomplishment.
• 34:35
  Carmen Lezeth: Did you know you were going to be doing this when you were a little girl?
• 34:39
  Dr. Roseanna Means: No, I wanted to be an angel.
• 34:41
  Dr. Roseanna Means: People asked me when I was little what I wanted to be.
• 34:43
  Dr. Roseanna Means: I mean, look, I've got the hair.
• 34:46
  Cynthia Ruiz Lopez: I think that's kind of sort of what you're doing, though right the irony.
• 34:52
  Dr. Roseanna Means: I mean, you kind of said it as a joke, but it's kind of you know, I just feel like the universe leads you to where your place is supposed to be and to me it gives me great joy and I feel it's my calling and it certainly is my sense of purpose in the world and I think we all do better if we have a sense of purpose, and this is my purpose.
• 35:14
  Carmen Lezeth: What do you see as the problem when people like I get really incensed for a very different reason, when people you know we treat dogs, stray dogs Like.
• 35:25
  Carmen Lezeth: If I see one more commercial of no offense to dog owners but it drives me insane.
• 35:31
  Carmen Lezeth: You know the sad music and the poor dog or whatever.
• 35:35
  Carmen Lezeth: But those same people will be on the street and for no reason whatsoever, snicker at a homeless person and be mean and cruel or say something mean.
• 35:46
  Carmen Lezeth: So what do you think we can do as individuals to be better about that?
• 35:52
  Carmen Lezeth: Or why do you think we react that way?
• 35:54
  Carmen Lezeth: I'm just curious.
• 35:56
  Dr. Roseanna Means: Well, I think we react that way out of ignorance and fear.
• 35:58
  Dr. Roseanna Means: You know, I don't think it's.
• 35:59
  Dr. Roseanna Means: If people really knew the people that they were behaving towards, it would, it would be a different situation.
• 36:06
  Dr. Roseanna Means: But you know, we have a societal problem.
• 36:08
  Dr. Roseanna Means: We don't, we do not have the political will under either political party to change the situation.
• 36:14
  Dr. Roseanna Means: It's a terrible, terrible situation.
• 36:16
  Dr. Roseanna Means: And you're right.
• 36:17
  Dr. Roseanna Means: I mean, I know in Massachusetts there are more shelters for animals than there are for women, and people also hear the stories.
• 36:24
  Dr. Roseanna Means: They hear the story about the bag lady who had $100,000 under a mattress, or somebody who was masquerading as an addict and got away with something, and I think people just don't understand, when I was working in the women's shelters in Boston, that for the women who didn't have children, um, I would ask them, like, what is the one thing that drives you crazy the most about?
• 36:47
  Dr. Roseanna Means: You know it's the average public and it's really being ignored.
• 36:50
  Dr. Roseanna Means: It's like if you see someone on the street who's panhandling, instead of walking by or turning your head and ignoring them, just say, hey, how you doing now good morning, or yeah, all the time for money.
• 37:01
  Dr. Roseanna Means: Mean, if I gave people money on the street, you know, over the past 40 years?
• 37:07
  Carmen Lezeth: I'd be broke.
• 37:07
  Carmen Lezeth: I said to someone the other day I'm like nobody carries cash anymore and he's like funny, because he was like I have a credit card machine.
• 37:19
  Carmen Lezeth: I was like you do.
• 37:20
  Carmen Lezeth: He was like no, I don't.
• 37:21
  Carmen Lezeth: But it was an interaction, having a conversation with somebody.
• 37:23
  Dr. Roseanna Means: Recognizing that they're another human being.
• 37:25
  Carmen Lezeth: Yes.
• 37:27
  Dr. Roseanna Means: So that's important.
• 37:28
  Dr. Roseanna Means: But I got to tell you a really funny story because there was one day this woman who unfortunately has passed on I love this woman I mean I love all the women, but I love this woman and she was pretty street smart, pretty tough, and she was to come down to the shelter that I worked in in downtown Boston, and and in one day I was walking down downtown Boston I saw her, saw her on the street with a little cup and she was shaking the cup, trying to get people to put money in her cup.
• 37:54
  Dr. Roseanna Means: This is many years ago when people did cash carry in their pockets and it was the day of a Red Sox game, so people were sort of pouring through downtown Boston to get to Fenway Park and lots of people, so she had, you know, lots of attention of people.
• 38:06
  Dr. Roseanna Means: And so I saw her and I said, hey, how you doing?
• 38:09
  Dr. Roseanna Means: And she said, hey, dr Rosanna, that's what they call me.
• 38:11
  Dr. Roseanna Means: Hey, dr Rosanna, how are you?
• 38:13
  Dr. Roseanna Means: And I said fine, and I sat down on the curb next to her and I said, talking to her, chit, chat, okay, so I'm doing everything I just told you people should do, right, right.
• 38:22
  Dr. Roseanna Means: So you know, after a few minutes she started, starts to like she's rattling her cup over here, she's doing this, she's doing this and you know, and I and I I'm trying to talk to her she says hold on, hold, have to let yourself go a little bit and be real with people.
• 39:01
  Dr. Roseanna Means: But it is true, it you know and be real with people.
• 39:05
  Dr. Roseanna Means: But it is true.
• 39:06
  Dr. Roseanna Means: There are people on the street who have severe mental illness untreated and who have other problems with substance use and all sorts of things, and some of them are dangerous.
• 39:13
  Dr. Roseanna Means: Some of the men are ex-convicts.
• 39:16
  Dr. Roseanna Means: It is true that that is a reality of the population, but we have not figured out as a society how to get help to people that is lasting.
• 39:27
  Dr. Roseanna Means: Yes, you could have street teams, you can have harm reduction programs, you can do all these things, you can do needle exchanges.
• 39:33
  Dr. Roseanna Means: All those things are good, but they're not permanent solutions.
• 39:38
  Carmen Lezeth: Well, the thing you don't know about me and of course, cynthia knows because she's my cousin, but she's also known me but I mean, I think that you know, I lost my mom when I was really young and I don't have a father and, long story short, I ended up on the street.
• 39:50
  Carmen Lezeth: So I was on the streets in Boston for a long time.
• 39:58
  Carmen Lezeth: Someone, whether it was a teacher or someone I danced with, or some of the parents, all of those people chipped in and tried to help so I wouldn't fall through the cracks.
• 40:09
  Carmen Lezeth: So there were just all these people on the way.
• 40:11
  Carmen Lezeth: And this is what people don't understand, the reason why I get so incensed about it.
• 40:14
  Carmen Lezeth: It's like it doesn't take much to be a good, decent person, and every time you say that you would be there for someone and then you treat a homeless person the way you do, that's how I know you're a liar.
• 40:31
  Dr. Roseanna Means: It's true, and that's why, when I say I give out a $20 bill from time to time, you know what?
• 40:35
  Dr. Roseanna Means: Okay, so I'm not going to have pizza this weekend.
• 40:37
  Dr. Roseanna Means: Big deal.
• 40:38
  Dr. Roseanna Means: I have a safety net.
• 40:41
  Dr. Roseanna Means: I'm more comfortable than the people that I'm talking about here, and so why can't I give up a meal out?
• 40:49
  Dr. Roseanna Means: I once did a calculation, actually, of what we spend as Americans on pizza every year.
• 40:54
  Dr. Roseanna Means: It was in the billions.
• 40:55
  Dr. Roseanna Means: I'm thinking okay, if everybody gave up a pizza one day a week, it would probably solve the homelessness problem in this country.
• 41:04
  Carmen Lezeth: Isn't that so weird?
• 41:05
  Carmen Lezeth: Or one coffee, although I know people need their coffee, but like I drink coffee at home, I make it, but even like a $7 coffee.
• 41:15
  Carmen Lezeth: I was out with my niece the other day and what are the matcha?
• 41:21
  Carmen Lezeth: I've never had a matcha thing, but it was $7.
• 41:25
  Carmen Lezeth: Cynthia, you know I'm not cheap.
• 41:28
  Carmen Lezeth: You know, like I don't know your $20 thing we're going to have to talk later because I know you make more money than I do, but I'm like $7 for a matcha.
• 41:37
  Carmen Lezeth: I was like no, it's crazy.
• 41:39
  Carmen Lezeth: It's crazy.
• 41:40
  Carmen Lezeth: Yeah, people talk a lot about wanting to help and I know people mean well, we had a conversation on one of our other shows.
• 41:50
  Carmen Lezeth: I was trying to explain to people that the thing about homeless people that you don't understand is that when they have a bad day, they've been having them one right after the other.
• 41:59
  Carmen Lezeth: So when they get a little bit of money and they want to get a drink, I'm not mad at them.
• 42:04
  Carmen Lezeth: I come home from my plush job, into my nice little home near the beach and the first thing I want to do is have a drink.
• 42:11
  Carmen Lezeth: Why would I think?
• 42:13
  Carmen Lezeth: when someone's having a miserable time, I'm not excusing it, I'm trying to make people relate to the idea that homelessness is not something that can't happen at any moment, to any one of us, at any time.
• 42:25
  Dr. Roseanna Means: Well, I think you're also talking about how people, when they give money to someone on the street like that, it's kind of like with a sense of there are strings attached, that I want to give this to you but you better not don't use it on that, thing, Right If that's going to bother you.
• 42:40
  Dr. Roseanna Means: if you're going to connect a face with your moral outrage, then give to an organization like mine or like other programs that help homeless persons, because the help is really desperately needed.
• 42:55
  Dr. Roseanna Means: And if you go into this with a sense of moral judgment about it, then you really don't have the right attitude.
• 43:02
  Cynthia Ruiz Lopez: And instead of buying the pizza for yourself, buy a pizza for the homeless.
• 43:05
  Dr. Roseanna Means: That's what I yeah, I mean I literally would bring food to people I'd see in the street.
• 43:09
  Dr. Roseanna Means: I'd bring coffee, or bring donuts or breakfast sandwich or something like that.
• 43:13
  Dr. Roseanna Means: If, if you know, if you don't have cash, you can go get something at a local store, give it to them.
• 43:18
  Carmen Lezeth: Or you can just be kind oh my God Also, just be kind and not be mean to homeless people.
• 43:27
  Carmen Lezeth: I, yeah, I it's.
• 43:29
  Carmen Lezeth: It's one of my biggest pet peeves, especially because here in Los Angeles and I live right near the beach and so there's a lot of homeless people and I'm not mad about it I'm like if I was homeless, I would have flown to LA too back then, cause it's warm, it's nice here, we have programs, like there's a reason why people are here, but it's all over the country.
• 43:49
  Carmen Lezeth: We have a problem.
• 43:50
  Carmen Lezeth: We have a problem.
• 43:52
  Dr. Roseanna Means: Yeah, we do have a problem, but it's, you know it's.
• 43:54
  Dr. Roseanna Means: It's not that there's not capacity, it's that they you know it's a this is a bigger conversation, but it's there.
• 44:01
  Dr. Roseanna Means: There aren't enough shelter beds.
• 44:03
  Dr. Roseanna Means: There aren't enough treatment programs.
• 44:05
  Dr. Roseanna Means: They're not used to be like you go into detox, then you go to rehab and then you go to a sick halfway house and people don't do that anymore.
• 44:13
  Dr. Roseanna Means: It takes time to go from homeless in the streets and dealing with alcohol or drugs and then getting your life back together.
• 44:20
  Dr. Roseanna Means: You can't just snap your fingers and have it happen.
• 44:23
  Carmen Lezeth: And everyone who's homeless is not someone who isn't like.
• 44:26
  Carmen Lezeth: I know people who were educated, who, like you, were talking about all the lists like.
• 44:31
  Carmen Lezeth: There are people.
• 44:32
  Carmen Lezeth: It's not about just being some scuzzy, poor person who does it who's lazy and an alcoholic.
• 44:39
  Carmen Lezeth: That is not true.
• 44:40
  Carmen Lezeth: If you took a moment and understood the person that was panhandling, you might learn that they were some famous musician or whatever.
• 44:47
  Carmen Lezeth: They could have been a doctor.
• 44:49
  Dr. Roseanna Means: They could have been a lawyer and just fell into hard times it really it does happen, but it is like I mentioned before.
• 44:55
  Dr. Roseanna Means: There's fear and ignorance, and sometimes people are so unable to handle those emotions in themselves that they kind of project you know qualities onto people that would make it okay for them to judge that person harshly, and that's just.
• 45:10
  Dr. Roseanna Means: I think that's a weakness on their part as individuals and we just have to work on that as a society.
• 45:15
  Carmen Lezeth: So I have a question because I so.
• 45:18
  Carmen Lezeth: For me it's really hard to work with homeless people and it's really hard for me to work with teenagers, and I know for myself well, it's just because that was my life.
• 45:29
  Carmen Lezeth: No, teenagers are like the hardest group to work with, to do volunteer work somewhere.
• 45:43
  Carmen Lezeth: So I was like I'm going to go you know where I know and I'm going to, and I couldn't do it.
• 45:45
  Carmen Lezeth: It was emotionally too draining and so I volunteer in other ways and other organizations because I think it was just too close to me, right?
• 45:51
  Carmen Lezeth: So my question for you is is how do you emotionally keep yourself?
• 45:56
  Carmen Lezeth: I mean, you have such a great spirit, you seem so happy.
• 45:59
  Carmen Lezeth: I would think this is emotionally draining for you as well.
• 46:12
  Dr. Roseanna Means: It is.
• 46:12
  Dr. Roseanna Means: I mean, it's hard.
• 46:13
  Dr. Roseanna Means: I live in the suburbs.
• 46:15
  Dr. Roseanna Means: I have a backyard with lots of bunny rabbits and chipmunks.
• 46:17
  Dr. Roseanna Means: This time of day I look up at the trees.
• 46:18
  Dr. Roseanna Means: Most nights in this season of the year I'll come home, pour a glass of wine, walk out to my deck, look at the bunny rabbits and the squirrels and the chipmunks and look up at the trees, watch the clouds go by, you know, and just kind of reconnect with nature and the world and think about the women and I, you know, I kind of process the day and kind of put it all into some perspective.
• 46:43
  Dr. Roseanna Means: You know I have said this before.
• 46:47
  Dr. Roseanna Means: I don't mean to sound like a Pollyanna, but I have been incredibly blessed in my life and I feel like I was so lucky to find this path because I have my own life experience that I brought into this.
• 47:01
  Dr. Roseanna Means: That you know.
• 47:02
  Dr. Roseanna Means: I say to people you know, don't put me on a pedestal.
• 47:05
  Dr. Roseanna Means: I'm, you know, not that person.
• 47:07
  Dr. Roseanna Means: You know I do this for a reason.
• 47:15
  Cynthia Ruiz Lopez: No sorry.
• 47:16
  Carmen Lezeth: Not on this show, sorry, you don't know me.
• 47:17
  Carmen Lezeth: You don't know me.
• 47:19
  Carmen Lezeth: That's not the work on this show.
• 47:21
  Dr. Roseanna Means: Well, anyway, but I feel anyway she's like, but anyway.
• 47:24
  Dr. Roseanna Means: But besides that, charmin, I just feel like I was.
• 47:32
  Dr. Roseanna Means: You know, the connection was great.
• 47:34
  Dr. Roseanna Means: And again, if I, you know, if you believe in God or the Holy Spirit or whoever, whatever being in the universe speaks to you, I feel like I, you know I made the right connection and I'm really happy about that.
• 47:45
  Dr. Roseanna Means: So I come back, I come in and I have my thing, I have my drink, I have my dinner, I watch crappy TV, I stay away from the news and I kind of recharge my batteries for the next day and I have.
• 47:56
  Dr. Roseanna Means: Also, I have an amazing team.
• 47:58
  Dr. Roseanna Means: I have amazing people that do this work and and they're all kind of completely committed and dedicated to helping these women.
• 48:07
  Dr. Roseanna Means: Many of them have the same, similar lived experience and so they want to be able to help out.
• 48:12
  Dr. Roseanna Means: You know it doesn't get better than that.
• 48:13
  Dr. Roseanna Means: I mean, medicine has changed.
• 48:16
  Dr. Roseanna Means: You know, medicine has become much more corporate.
• 48:18
  Dr. Roseanna Means: The things that I'm doing, that I'm calling healthcare, like making sure that you have a home, making sure you have enough food, making sure you have transportation to get to your appointments I consider those part of healthcare.
• 48:29
  Dr. Roseanna Means: Now, the healthcare system doesn't consider those part of healthcare.
• 48:31
  Dr. Roseanna Means: I mean they consider them sort of factors in healthcare, like you know.
• 48:35
  Dr. Roseanna Means: Oh, mrs Jones, you aren't eating enough protein.
• 48:38
  Dr. Roseanna Means: Well, you better go home and eat some more protein, instead of saying, mrs Jones, do you have enough money for protein?
• 48:43
  Dr. Roseanna Means: Right, and with your grocery bills, like, well, you know how can we help you make sure you have enough of the right kind of diet?
• 48:50
  Carmen Lezeth: But I wonder why that changed, because I remember I got braces for free.
• 48:55
  Carmen Lezeth: I told this story before because students would come into the neighborhood, into the into, like the local JP Health Center, remember that place and they would.
• 49:04
  Carmen Lezeth: They had students worked on my teeth and I have to tell you, life changing because I had teeth all in front of each other, whatever.
• 49:12
  Carmen Lezeth: And then I had this remarkable smile right which is but I don't mean it in an ego way, I'm saying it changes your confidence, it matters, yeah.
• 49:21
  Carmen Lezeth: So why don't they do these things anymore?
• 49:23
  Carmen Lezeth: Is this a money thing?
• 49:24
  Carmen Lezeth: Or it's just because it's a money thing.
• 49:26
  Dr. Roseanna Means: It's a money thing, it's always about money.
• 49:28
  Dr. Roseanna Means: It's all about money and you know we all you know we have like corporate marketing, we have AI, we have, you know, budget cuts.
• 49:37
  Dr. Roseanna Means: You know government grant cuts and things like that.
• 49:39
  Dr. Roseanna Means: You know people pivot to the most essential things and you know the healthcare system is basically controlled by the insurance industry.
• 49:50
  Dr. Roseanna Means: So you know what doctors and other providers have to do is do the billing that's going to adhere to, whatever the insurance companies are going to be able to pay them so they can keep the programs going.
• 49:57
  Dr. Roseanna Means: There's no room for that kind of you know.
• 50:01
  Carmen Lezeth: Let me give out this website again, just so that we can.
• 50:04
  Carmen Lezeth: Did I just cut you off?
• 50:05
  Carmen Lezeth: I think you just went blank.
• 50:07
  Carmen Lezeth: Oh, okay, I do it all the time.
• 50:10
  Carmen Lezeth: But you can already tell Okay Again, if everyone who can, I guess you can volunteer.
• 50:17
  Carmen Lezeth: But you can also give some money, because I know some people who listen to this show.
• 50:20
  Carmen Lezeth: I know who you is Okay.
• 50:22
  Carmen Lezeth: Because I know some people who listen to this show, I know who you is Okay.
• 50:24
  Carmen Lezeth: Bwhgivingorg forward.
• 50:25
  Carmen Lezeth: Slash bridges.
• 50:27
  Carmen Lezeth: And again I want to spell bridges B-R-I-D-G-E-S.
• 50:31
  Carmen Lezeth: I'm telling you, I know I'm the only one who doesn't spell it right, but I'm just going to pretend.
• 50:34
  Carmen Lezeth: A lot of people know.
• 50:35
  Carmen Lezeth: Cynthia, do you have any last questions?
• 50:41
  Cynthia Ruiz Lopez: So if you had a magic wand I don't, let me, just let me make sure I'm reading this correctly If you had a magic wand to change one policy that would help your clients and organization, what would it be?
• 50:59
  Dr. Roseanna Means: If I had a magic wand to change one policy, like a government policy or yes, yeah.
• 51:10
  Dr. Roseanna Means: Um, I think what it would be would be to make sure any woman who's pregnant, under whatever circumstances, citizen or not, would have a completely free ride from the moment her pregnancy is diagnosed until the baby goes to kindergarten.
• 51:27
  Dr. Roseanna Means: Mm-hmm, I love that.
• 51:30
  Dr. Roseanna Means: I love it.
• 51:30
  Dr. Roseanna Means: Those first five years are the developmental space, the first months, first days.
• 51:39
  Dr. Roseanna Means: One more thing I just need to say in our program, moms whose babies end up in a neonatal ICU okay, those babies are sick and those babies are tiny and they need lots and lots of care.
• 51:53
  Dr. Roseanna Means: Those babies are sick and those babies are tiny and they need lots and lots of care.
• 51:55
  Dr. Roseanna Means: And the mom, to be a good mom, needs to be at that baby's bedside every single day that baby's in the ICU.
• 52:01
  Dr. Roseanna Means: There's no program that I know of in Massachusetts or the country that does what we do.
• 52:07
  Dr. Roseanna Means: No matter where that woman is placed, because she's discharged from the hospital because she had the baby, the baby's in the ICU, she's done the baby.
• 52:17
  Dr. Roseanna Means: The mom goes to a shelter somewhere could be anywhere in Massachusetts and to order to see that baby.
• 52:20
  Dr. Roseanna Means: Our program Bridges to Moms gives her a ride from wherever she is in the state to back to the hospital every single day that baby's in the ICU make sure that mom bonds with her baby, learns how to feed her baby and take care of her baby, and that baby's brain is going to grow because that mother was there every single day and that's you know.
• 52:43
  Dr. Roseanna Means: So when I say, if I had a magic wand and bazillions of dollars, I would want that whole developmental period, from you know, pregnancy all the way up through starting kindergarten, to be covered.
• 52:56
  Carmen Lezeth: It has to be quite a big one yeah, but I love how she said magic wand and bazillion dollars like I like it.
• 53:04
  Carmen Lezeth: That's how I do it.
• 53:06
  Carmen Lezeth: That's how I would do it too.
• 53:07
  Carmen Lezeth: I'd be like you said magic wand, but I heard money and I gotta say how, how.
• 53:15
  Cynthia Ruiz Lopez: I don't know how any doctor, even you like, talk about this without crying, because I'm over here.
• 53:20
  Cynthia Ruiz Lopez: I don't even know if you've noticed that my eyes are like watering hearing these stories.
• 53:24
  Cynthia Ruiz Lopez: Yeah, like I don't know how you guys do it.
• 53:27
  Dr. Roseanna Means: Well, I cry.
• 53:28
  Dr. Roseanna Means: I actually do cry all the time.
• 53:29
  Dr. Roseanna Means: In fact, my team gave me for Christmas this past year.
• 53:32
  Dr. Roseanna Means: They gave me a hat that said marshmallow on it, because you know, I'm a marshmallow and it doesn't mean I don't have nerves of steel and I, you know, I'm not really, I'm not afraid of anything basically.
• 53:43
  Dr. Roseanna Means: But when it comes to these women, you know, you know, in Carmen, I'm sorry, you have never had a child of your own, but if you are a mother, the moment you hold that baby in your arms, you would stand in front of a moving train for that child.
• 53:58
  Carmen Lezeth: Oh, I think Cynthia knows I would stand in the middle of the train for any child.
• 54:04
  Dr. Roseanna Means: Like I know these mothers would do anything for their children and I kind of feel like I would do anything I could to help these mothers.
• 54:12
  Dr. Roseanna Means: You know, as being a mom and doing everything you can to have a healthy child is going to have a normal, you know, normal development, growth and good health.
• 54:21
  Dr. Roseanna Means: That's what it's all about.
• 54:22
  Dr. Roseanna Means: And you know we do a little tiny bit, you know in what we do in our program in Boston.
• 54:27
  Dr. Roseanna Means: But you know, if the health profession and the government, whatever you know, would realize how important that is, because it's really you pay the money upstream when the mom's pregnant in those first few years, the payoff is enormous.
• 54:41
  Carmen Lezeth: No, no, listen, I don't know why people don't get that.
• 54:44
  Carmen Lezeth: It's such a simple thing.
• 54:45
  Carmen Lezeth: I am a productive human and I know it's not the same thing, but it is.
• 54:49
  Carmen Lezeth: I was a little kid with nothing, with no one.
• 54:53
  Carmen Lezeth: I was nurtured, I was taken care of by so many different people, by whatever fluke and love of life or whatever, and I am now a successful human being who contributes to society and, I hope, great ways and it's like.
• 55:06
  Carmen Lezeth: But that is the trajectory that we're talking about.
• 55:10
  Dr. Roseanna Means: It takes a village, it takes a village.
• 55:12
  Dr. Roseanna Means: Yeah, somehow the villages have gone a little bit dark in recent years.
• 55:16
  Carmen Lezeth: No, no no, but you know what we're doing this and I hope you'll come back and maybe bring your team.
• 55:21
  Carmen Lezeth: Maybe we can make this something that we could do on a more regular basis.
• 55:26
  Carmen Lezeth: I'm not trying to exploit what you do, but I'm going to say this what you do, but I'm going to say this I think you already know.
• 55:34
  Carmen Lezeth: I think you're an incredible human being.
• 55:35
  Carmen Lezeth: I don't know you.
• 55:36
  Carmen Lezeth: I've learned so much about you and I want to be in your atmosphere in one way, shape or another, because I think I'm a better person for knowing someone like you and I think we can all learn from you, and I know that you are very humble.
• 55:49
  Carmen Lezeth: I can tell you're very kind and you like to shoo that off.
• 55:52
  Carmen Lezeth: I'm gonna keep reminding you and other people, but I would love to have you back on, have your team on.
• 55:58
  Carmen Lezeth: I know everyone's busy or whatever.
• 56:00
  Carmen Lezeth: We can work around people's schedule, but maybe there's a way in which we can do something, even if it just touches one other person, or help somebody else and maybe raise some money along the way you know.
• 56:11
  Dr. Roseanna Means: Well, I know our time is running short, and so I'm going to dangle a little piece of candy in front of you.
• 56:20
  Carmen Lezeth: Chocolate cake is better, but I'll take it.
• 56:24
  Dr. Roseanna Means: Chocolate cake of all time.
• 56:25
  Dr. Roseanna Means: So I'm working on another new project.
• 56:29
  Dr. Roseanna Means: Oh, that is not at the Brigham, it's not Bridges to Moms.
• 56:34
  Dr. Roseanna Means: Bridges to Moms is still going and it's still this thing.
• 56:37
  Dr. Roseanna Means: But there is another project that I'm working on that it's.
• 56:42
  Dr. Roseanna Means: Maybe sometime I can come back and talk to you about that.
• 56:44
  Dr. Roseanna Means: So it is a I can't say too much about it because it's a little bit of a secret right now, but it's going to be a true game changer in maternal health for vulnerable women.
• 56:58
  Carmen Lezeth: Okay, well, okay, we're definitely going to have you back.
• 57:01
  Carmen Lezeth: I love this.
• 57:01
  Carmen Lezeth: Thank you so much for taking the time, and I'm not going to say goodbye to you because we're going to have you back, cause now I need to know.
• 57:09
  Carmen Lezeth: I need to know what this is about.
• 57:11
  Carmen Lezeth: So thank you so much for being here.
• 57:13
  Carmen Lezeth: We appreciate it so much, cynthia thank you for introducing me to such a wonderful person, and everyone again.
• 57:23
  Carmen Lezeth: I am going to put this in the show notes as well.
• 57:26
  Carmen Lezeth: I just want to say it one more time Please remember bwhgivingorg forward, slash bridges, please donate, find out more information.
• 57:37
  Carmen Lezeth: And thank you so much, dr Means.
• 57:39
  Carmen Lezeth: It was a pleasure.
• 57:40
  Carmen Lezeth: Bye everyone.
• 57:42
  Carmen Lezeth: Thank you, remember.
• 57:43
  Carmen Lezeth: At the end of the day, it really is all about the joy.
• 57:45
  Carmen Lezeth: Don't hang up.
• 57:49
  Carmen Lezeth: Don't hang up yet.
• 57:50
  Carmen Lezeth: Bye everyone.
• 57:51
  Carmen Lezeth: Thanks for stopping by.
• 57:55
  Carmen Lezeth: All about the joy.
• 57:56
  Carmen Lezeth: Be better and stay beautiful folks.
• 57:58
  Carmen Lezeth: Have a sweet day.