Are you sure, sweetheart, that you want to be well? This question has always haunted my spirit. It’s from Toni Cade Bambara’s novel, The Salteaters. It is also apt for today. That and what does being well mean for the public’s health, from a social justice lens, radical wellness too and not from experts alone, or those who have credentials, but from you the general public and with your fiction or nonfiction?

Who are your go to references for being radically well and how do you even begin to define wellness for yourself? Of course it led me down a rabbit hole, one where I am now obsessed with how people, those in fiction and non fiction, those with expertise and none, define what they mean by wellness.

I have been struck by the myriad of ways people define wellness, especially those focused on people of color. It matters to me these days that for the public, we define what wellness means, not just from what the dominant literature may tell us, but from everyday people who continue to struggle with answering the question: ‘Are you sure, sweetheart, you want to be well.’ So, from what I gathered from the Bettina Love’s profound book ‘We want to do more than survive’ wellness is:

A choice

A type of freedom that comes when you let go of your fears and move your anger into a space of healing.

Wisdom and being well is hard work.

Part of social justice work.

An inner life that refuses to be treated less than human.

Being vulnerable.

Finding the roots of your own Black Joy, Black love, and humanity.

Choosing to see ourselves beyond illness or disease.

Having an inner self that can be quiet and enjoy life.

Recognizing the pain of our ancestors knowing the beauty and resilience of that pain lives on in us.

Knowing who you are regardless of what is thrown at you.

Integenerational.

Different for different people.

Healing that is unrecognizable to White people and different from them.

Being your best self while fighting injustice.

Fighting racism with life, grace, compassion.

Having mental space and freedom to dream, give hell, and retreat to one’s community of love for support, fulfillment, and nourishment.

Being whole.

Bringing your full self.

Joining others in the fight for humanity and antiracism in love and solidarity.

Confronting internalized White supremacy, sexism, homophobia, transphobia, Isamophobia, fat phobia, classism, ableism, and the rage that comes as a result of these hateful ideas.

Keep doing more than surviving with these radical wellness definitions in mind.

Keep Professor Love’s approach to wellness in mind.

There was a time, all I did was fail with every grant I wrote. Welcome to a new month. I woke up to an email sent to the entire university celebrating a recent success today. I am honored and grateful but I can’t help but remember the times of failure. Yes, failure. Sure the messages and all the well-wishes, have been heartfelt and words fail me. But it’s the failures that I want to dwell on today. I want you reading this to know that success comes at a major cost. For me, with every one grant you see that is successful, there were close to 7 (in my beginning days, but now 2-3) that were not successful. So when I see this beautiful write up of one success, my heart goes out to wrinkles along the way. All of them that paved the way to make this one success come through.

So with the story of STAR, what many may not know was that it was written after a major loss. I had written a grant called, I-ARISE. I love naming all my grants by the way and everyone writing a grant should always be intentional with their names.

I-ARISE was over $13 million or so. It was and still remains the most expensive NIH grant I have ever assembled. It also failed. I went into depression. I still remember seeing the news of it’s failure that faithful July month and just being in a rot for days. I didn’t eat. Just slept in my room and cried and cried and wondered why such a beautiful grant failed. When I got through the sadness, I got our team together and we immediately started taking pieces of it apart. What many may not know was that I-ARISE became LIGHT (see here:LIGHT), which was literally a sidenote on the grant. I turned one massive failure into the thing that gives me joy everyday.

See the side of the magazine. lol.

With the beginning of LIGHT, came thoughts on what else to do that would literally bring more light. Enter STAR. I-ARISE is also STAR and much better. We began writing that grant in August (please I do not recommend writing an NIH grant in a month. I just have a decade of experience with plenty failures).

We were also writing an NIH Fogarty D-43 at the same time. I tend to write 2 grants with similar deadlines. It seems to help me see things better. The D-43 was aptly called I-RISE, and yes it was my self-care attempt at getting over the failure of I-ARISE. The name alone got me through the failure. I worked on the D-43 literally feeling like I was rising from the ashes like a Phoenix.

While writing the D-43, I came across the NIAID R-25 announcement. They were both similar in nature, only that one was for my work in Nigeria, while the other would allow me to finally give back in the US. It was no brainer. I am a Penn State McNair Scholar, a Penn State MHIRT scholar, a Penn State Bunton-Waller scholar, all of which were geared towards helping minority students succeed at Penn State. McNair in particular was my first foray to research with Dr. Cassandra Veney, a woman studies professor, as my very first mentor ever. Dr. Airhihenbuwa was my second mentor. The two of them are the foundation upon which I stand.

I wrote the D-43 and R-25 at the same time. Deadlines were very close. D-43 in August, R-25 in September. The D-43 failed. It wasn’t even discussed. In fact, reviewers said I had no business or experience writing one, my paraphrase of their summary statement. The R-25 is what we celebrate today. I share this story because behind every success, there are failures and honestly I made crucial mistakes with the D-43. I saw them while writing the R-25. I needed to write the D-43 in other to get the one that was meant for me. I am nothing without my failures and I hope they inspire you to keep yours too. They will one day inspire your success. You can read the successful story here: STAR R-25 Grant . I only want you to keep all your failures in mind.

I spent 2 hours today learning, absorbing, and exchanging wellness, healing from what it means to be black and woman in academia. Many of us have been battered. The weights of all we carry chokes and continues to choke. But the power of our narrative, the gifts we offer and the knowledge we provide, our very essence which Toni Morrison once’s described as the ‘rim of the world,’ all of the the pieces of us, are valued, visible, no longer on tiptoes but standing tall and erect because we choose to transform our silence to action. The meeting was for a future podcast with Health Promotion and Practice. I was open about my experience and time as a public health researcher. Something that happened because of this blog.

Early on in the pandemic, I re-read Audre Lorde’s transformation of silence into language and action. In fact, it was my first attempt at facing myself as a black woman in academia. There have been many casualties along the way when we think of the black woman’s experience within a system we were never meant to survive in. There have been few warriors too.

I wanted to be one of them. So that meant I needed to confront the words that I did not yet have.

I knew there were things I needed to say. I knew I had swallowed so many things that even choked me in silence. So I choose to face my fears. I started my blog, as well as writing letters as we published in the journal, to acknowledge that I too, I am a Black woman, a mother, a wife, a sister, a friend, myself, doing the necessary work of transforming my silence into action.

I hoped that through the blog and letter, other women like me would face their fears. These words from Ms. Lorde were the torch light for me: this idea, ‘that you’re never really a whole person if you remain silent.’ And to survive, each of us needs to learn first that we were never meant to survive. I channeled that knowledge into strength, and created a space where I have been chronicling all the ways I survive and continue to survive within a system I was never meant to survive.

So the fact that we are here, and we have this blog and now letter as a paper, even the podcast was our attempt to break that silence and bridge some of those differences between us, knowing too for so many women that look like us, there are so many silences that need to be broken. Keep breaking them. You can download the paper below or read here: Dear Health Promotion Scholar

Each day, nearly 28 women die from cervical cancer in Nigeria. Angela Akumuo, my sister-in law, was one of them in the summer of 2021. She was 53 years old. Her death, like those of many women who continue to die from cervical cancer in Nigeria and globally, could have been prevented. It was also discovered late. She lived in pain for years, and died within 3 months of finally opening up about her illness. There are so many effective evidence-based tools to prevent, diagnose or treat cervical cancer. Research too, with the field of dissemination and implementation science, my chosen field of study. Yet, why are women, like my sister in-law, in the prime of their lives, still dying from cervical cancer in Africa?

Look at the state of cervical cancer in Nigeria and many other African countries and you’ll understand. With an estimated population of 206 million individuals, Nigeria has over 56 million women aged 15 years and above who are at risk of developing cervical cancer. Most cases of cervical cancer are caused by human papillomavirus, with 67% attributed to HPV 16 and 18. As a result, the government recommends screening for cervical cancer from aged 30. Young girls and women are recommended to get vaccinated as well from age 9. Yet less that 10% of eligible women are screened and 14% of girls are vaccinated. Is it any wonder that cervical cancer remains the second most common cancer among women in Nigeria, also one of the most preventable? 

In 2020, nearly three years ago, the World Health Organization (WHO) and 194 countries, pledged for the first time to eliminate cervical cancer by pursing three key steps: vaccination, screening and treatment. A recent costing exercise by WHO for the Nigerian government’s strategic plan on prevention and control of cervical cancer estimated that $18.1 million will be needed to fully immunize Nigerian girls at $3.98 per girl aged 9-13 years, $919 million will be needed to provide 24.8 million screening services and 2.2 million pre-cancer treatments, while $59 million will be required for cancer diagnosis, treatment and palliative care. Right now, Nigeria dedicates 5.75 percent of its budget to health with about N81 billion naira (roughly $100 million dollars) to health care services, all of which are insufficient to help the country reach its global goals for cervical cancer elimination by 2030. The cost of vaccination, screening and treatment remains an obstacle for many Nigerian women and girls. So, it’s no surprise then that Nigerian researchers and key stakeholders are turning back to Nigerians themselves to find innovative ways to lead the national response to eliminate cervical cancer. 

Enter For girls and women by girls and women. This new crowdsourcing program led by myself and researchers at the Nigerian Institute of Medical Research led by Dr. Oliver Ezechi and the University of North Carolina, Chapel Hill, led by Dr. Joseph Tucker, is the latest from our, for youth by youth group, that has spent the past five years working to promote HIV self-testing with Nigerian youths themselves using crowdsourcing open calls, 48-hours designathons, month-long innovation boot camps and subsequent implementation of finalist programs in community settings. Crowdsourcing allows large number of people to become involved and engaged in developing solutions to health issues. Our program, now in its fifth year, boldly displays how Nigerian youth themselves can be partners and leaders with HIV prevention interventions and not just beneficiaries of interventions designed by researchers alone. Interventions created by the group, has led to an increase in HIV self-testing from 29% at baseline to 90% at 3 months follow.

We are striving to repeat the same success but this time with HPV vaccination among girls and HPV screening among their mothers or female caregivers. We know that the thought of cervical cancer may strike fear in people’s heart, producing a deep sense of powerlessness. But it is possible to act against it by partnering with us to lead the design and implementation of HPV campaigns, particularly HPV vaccination of young girls and HPV screening of eligible women. Our crowdsourcing open calls will be launched in Nigeria this January and it is our hope that through our program goals, Nigerian girls and women can become prime leaders in designing, implementing and evaluating interventions that increase uptake of HPV vaccinations and HPV screening, while eliminating cervical cancer as we know it.

Angela Akunmo may have died from a disease so preventable. However, through the launch of the crowdsourcing open calls for HPV campaigns for girls and women by girls and women, her death will not be in vain.

Be open to the story changing. Anyone passing through life and never expecting things to change is simply passing. I am prepared to embrace life and all it brings including times and moments where things take a turn. That’s all. Keeping this here as a reminder to myself that it’s okay when things change. It’s okay when chapters close. Change is inevitable. Hard too. But it’s okay. I’m embracing this now for myself. Also open to how the story continues to unfold. Keep being open.

Image courtesy of SSM Health at STL. Beautiful art work along the corridor of the hospital.

Lucille Clifton once noted that ‘the surest failure is the unattempted walk.’ It was part of her poem entitled ‘Questions and answers.’ I am keeping this here because I have been walking through a path that feels so difficult that all I can keep doing is walking. So many times I wanted to quit. So many times I felt like why even bother. But I kept walking remembering this quote. What must it be like to keep walking when everything seems so against you? Pain, rough, but I keep walking knowing who leads me.

Illustration by Brian Pinkey

I am maintaining perspective, knowing patience is no virtue, at least for me, everything tried this week, to stop the path he destined for me, forgetting too, that great is his mercy towards me, and that even what they may see, is bigger than what he imagines for me.

So I will not rage, though they came close to making me curse. Life doesn’t frighten me. I will not regret and I will only continue, knowing he is forever faithful towards me, always providing for me too, things I least expect, like how to be limitless, through barren places, in need of evergreen trees, between hills and valleys, without regret, without judgements, just remembrance of all the ways he holds me. My heart and soul says yes. Do with me what you will.

Poem by Maya Angelou.

We are in the homestretch of a grant that I will honestly say is the most difficult grant I have ever written. I say this all the time but this one was gut wrenching to the point of being sick. And why write grants that only serve to make you sick. When you have a plan in mind, when you know how limitless his plans are also for you, then will you understand the true meaning of Psalm 23. I saw dark valleys this week. Walked through them too. But he was there every step of the way, holding my hands to the point where I woke up this morning and ran 4 miles. That’s what happens when he orders your steps. You will walk through deep valley but rest too in green pastures. The key is to keep all things in perspective. He is your shepherd after all. You have every single thing you need in life. I am learning that with everything I keep, with my family and of course with every grant I write. Keep all things in perspective.

We entered the month of November in silence. Death has a way of keeping people mute. Last night, there was a rumor that the son of a Nigerian musician was dead. We prayed it was a bad dream and all would be right with the morning sun. Only that it wasn’t a bad dream and a little boy who recently turned 3 years old in October was indeed dead. So we started this month in silence. Started this month knowing that silence can have multiple meanings, whether for survival or exercising our fundamental human right. But then I am reminded by the words of bell hooks that when we end our silence, when we speak in a liberated voice, our words connect us to one another. So let me share the following, protect your kids at all times. That’s is it.

The very best of me.

The igbos have a saying that “Uwa bu afia,” the world is a marketplace and when your transactions are complete, you will return back to where you came from. I have been thinking of this saying ever since a young man pulled a gun at a local school in Saint Louis. That he felt lonely, unloved, and without friends meant that when his time was up, he preferred leaving chaos and sadness behind, taking two innocent lives too, while the rest of us are left wondering how long do we engage in this chaotic marketplace. While we are at it, Jean Kuczka and Alexandria Bell deserve to be alive too. But the are gone because we failed to do the necessary at this marketplace, call out the public health impact, life and death impact too, of guns on everyday people.

I find myself wondering too, how long it will take before we truly account for the public health impact of gun violence for a generation of children that continue to see this as part of the norm and not an anomaly. We shouldn’t live in a constant state of fear of our lives, not in our streets or churches, not in our movies or hospitals, and certainly not where we are supposed to nurture and protect the next generation of scholars.

As a teacher, one that interacts with college students every day, I see the toll life brings on them. I had my own share of burdens, having dropped out of my first year of college because we could not afford the tuition at the time. I was out of state and the only thing that made sense was to stay away from school for one year so that I could pay in state tuition. My grace has never been without struggle so I know struggle. But this style of struggle that this generation is experiencing is heavier than the ones we experienced. I wasn’t barraged with violence in the way this generation of students are facing. I had friends and didn’t need social media likes to validate our friendships. Ours were deep, insightful, full of fistfights if you knew the spirit of girls from Philadelphia, but genuinely full of love. I miss my Philly crew as they helped shaped the person I became. I haven’t even spoke for years to many of them, but if and when we see each other, it would be like we were right back to the streets of state college, Pa. Penn state was love and will always remain that despite my many real struggles there.

I share all this to say that we need to do better for this generation for children and students. We need to help them even if they are struggling and feeling empty with the world. Violence is never an answer. Killing innocent lives is never a solution and I don’t know yet what I will do but I will keep writing until something gives. Keep knowing that guns are intimately connected to the public’s health and when shootings at schools or anywhere occurs, saying enough is enough will not do. Not when lives keep ending for things we could account for while we still have time at this marketplace called life.

I’ll rather do as Baldwin says and rejoice in the force that is life now. This tasteless and blasphemous rubber we continue to chew and subject ourselves too, is costing lives and if we do not act now, do not then be surprised when this comes knocking close to home. This week it did for me. This week, I choose to keep taking of the mask that we fear. I choose love and life for all. Everything we want, even in a marketplace called life, is in our hands.

I walked through the halls of our school of medicine today. Something about history moved me. There were things about the school’s history that I didn’t know. Like a Nobel Prize in Physiology and Medicine in 1943 to Dr. Edward Doisy for his discovery of vitamin K. When I started this blog, legacy was the impetus. I imagined that one day I will leave this earth, but I wanted my kids to have something that characterized my life story. I also wanted to share it my way, not as told or remembered by others, with the caveat too that I was a born dreamer and a storyteller and that in the end, I did it my way. This caveat would keep me happy no matter where I end in the next life.

Seeing all the work of Dr. Doisy make me glad I’m on this journey for myself. It also made me realized that what I keep with each single day, no matter how small, is for that legacy and myself. The past couple of days have tried to keep these words hidden from the world, tried to keep me down, as if to say I have no right to rise. But in the words of Maya Angelou, I rise. I rise. I do so knowing that What I Keep, is the life story of a life lived in prayer and thanksgiving and joy and love for all the ways I am guided to do more than I could ever imagine with this thing called life.

The journey of a lifetime begins the day we are all born and continues long after we are gone. Some may have a history that tell their story eloquently with a library that displays all they achieved. Some may never have their story told, not even a notable achievement or joy or struggles. Ije Uwa as my dear friends father would say, is a gift, one that I intend to keep for history. So I ask you today, what are you keeping for yourself, from yesterday, for today, and for tomorrow. For me, everything. My history, my story, my way. It’s a gift that keeps giving. One I am grateful for.

What was kept about Dr. Doisy’s achievement. To think that vitamin k, that thing in the cream you use today was discovered at my university and by him is wow. Keep your history.

I spent this evening learning about wonder. It was from a philosopher at my institution. We were both attending an evening event and once we were free to mingle, she immediately approached me and we practically ended up spending the evening talking to each other. Initially I was hesitant to say anything to her. In fact what do you say to a philosopher. I had 2 philosophy friends in college. We were all doctoral students at the time, and I was struck by everything they did. One of them, Ronke Oke, has remained a dear friend and I will forever be grateful to her for the invitation to attend one of her classes where they talked about Franz Fanon and his books. I left that class buying the books and holding them for life. So anyone with a philosophy background scares me, hence why I was initially hesitant. But now, I am open to where they lead me.

Then I asked finally, what do you do. She said these words that stuck with me. ‘I study wonder.’ My ears and soul were open. Wonder, is that the same thing as curiosity, I asked? She said no. Wonder actually precedes and sets the foundation for curiosity. It’s like an engine for curiosity. She also mentioned how early philosophers spent time wondering before delving deeply into curiosity. We also display this better in childhood, with stories that seem so far fetching yet open and believable to a child’s mind. It is then no surprise that some child feel like they can fly and well actually proceed to fly never mind that they crash down to the ground.

I was struck and spent the rest of the evening listening to her. I saw myself in everything she said down to why I write grants. She concluded, you almost always begin in the realm of wonder, before curiosity leads you to ultimately write your grant. I was spell bound by this time. Wonder is truly the foundation of my work as a grant writer. I say it always that I have to visualize what I am writing first. I have to paint the full picture in my mind, before then writing it out. I am in the middle of a significance section of a new grant and I have spent close to an entire day on this section, just to have only 2 short paragraphs written. I have imagined what these sections should look like. I see them in my mind. But words are not coming together and so I keep imagining whatever will get that section written out in the way I have visualized it. So I close with the following prayer to this gift of insight called Wonder shared with grace from a philosopher at my institution (She has written it all as a book by the way and it is currently under review and I promise to be the first to purchase it once it becomes ready. I thank her too for offering to give me a copy).

My sons depictions of a butterfly inspires me always.

I pray that wonder cracks open your mind. I pray that it forces your eyes to bulge open and once open, may you be drawn into the underside of everything that comes your way. The torture, the pain, the joy, the wonder of it all, may all of them usher you through this maze called life.

I have met the source of my curiosity. It has always been there everytime I grumbled, stumbled, mumbled, and humbled myself through silences unearthing impossible desires within. Some of them were ordinary, but insisted that they become extraordinary in my hands. I cherish the scars left behind better now. All the ways things once indescribable have become describable these days. Everything I write seems possible now that I know my soul. I am content too with failing, knowing that the journey ahead towards what belongs to me has been cleared. I go through now with ease because you call me.

I know this moment is a witness to a struggle, a metamorphosis of sorts, a period of wading through life, until one becomes the butterfly that sees life beyond ourselves and all the ways we come out of shells to become more of ourselves.

I pray that wonder continues to carry you, me through this unavoidable journey. Without withholding, without scolding, but still molding all its range and depths. Still unfolding even as we change and accept, all the things we never thought possible, like death, like anger, like madness through this journey called cancer or things that arrest me now like wonder.

May you keep wonder, in the ways that butterflies sojourn through life.

By the way there was another philosopher there who has a book on human suffering. She said to send her an email and she will send it to me. I am on it. I see why I should continue to surround myself with them.

Some thoughts remain like shadows, creeping till sane things become insane, even as you retain, all that keeps you sane. These days some thoughts have been persistent, attacking like cancer, as if life has no hope, wanting instead to leave one helpless, as if on a downward slope to all things inferior. These days too, I choose thoughts that leave me breathless, those that keep me restless, as if life can be extraordinary, as if dreams can be revolutionary, like the momentary madness of falling leaves, or the luminary visions of orange trees, and all things superior, all things possible. I am in a place surrounded by falling leaves. Surrounded too by thoughts that keep me falling deep. Something about Fall and leaves, and visions and dreams, keeps thoughts that never leave, like ending cancer now.

The changing colors of leaves every Fall season is a sight worthy of inspiration. They agree with me.

I got some news that helped to crystallize why I do what I do. They say never write grants that keep you so passionate to do extraordinary work. But passion is all I have and these days I am in a space where I only want to do work that keeps me advocating for people. I also know the road ahead is daunting. Cancer is a very tough task to take on. But I’m all in for all things and the moonshot goals to end it as we know it. I am also ready to do the impossible, do things sustainable and equitable so that we prevent unnecessary illness and death. Every Fall season, I am amazed by the changing colors of leaves. They do the impossible in a necessary way and keep me motivated to do so to. I am in a phase where Fall and the changing colors of leaves agree with me. They keep me inspired.